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Microsoft word - post-op - max surgery.doc
northern virginia center
oral, facial & implant surgery
We would like to thank you for choosing us to perform your Oral, Facial and or Implant
Surgery. We are committed to providing quality post-operative care fol owing your surgical
procedures. Therefore, we have provided some basic post-operative care instructions; please
refer to them to assist you through this recovery period. In addition, feel free to contact the
office at any time, there is a surgeon on cal 24 hrs a day, 365 days a year (703) 449-8888.
Some degree of discomfort and pain arises as the numbness subsides. At the first sign
of pain or discomfort, take the Motrin 800 mg as prescribed or take (2-4) 200mg
Advil/Ibuprofen/Motrin, if you cannot take NSAIDS products, then take (2) 365mg
Tylenol/Acetaminophen. Repeat every 6-8 hours as necessary. If the pain is not
relieved, then you may take the prescribed pain medication, but only in smal doses and
only after eating some food. All pain medications have the ability to cause severe nausea
and vomiting, hence, it is very important that you have some food in your stomach
take Motrin/Ibuprofen 600 mg as prescribed or (2-4tabs) 200mg
Advil/Ibuprofen/Motrin as the numbness wears off. Do not take the prescribed narcotic
pain medicine unless absolutely necessary.
DO NOT DISTURB THE AREA OF SURGERY.
The first stages of healing are
aided by placing tissues at rest. Avoid vigorous chewing, excessive spitting, or rinsing
for the first 24hrs. as initial healing may be delayed, active bleeding restarted, or
Expect minor bleeding or OOZING
from the operative site. This bleeding may
continue throughout the first day.
For the first hour, keep firm pressure on the
area of surgery by biting on the gauze sponge placed in your mouth at the office. If
bleeding persists, continue constant pressure on a fresh gauze sponge for an additional
30 minutes. Biting on a moist tea bag wrapped in gauze may help control persistent
oozing from the surgical site. Tea has an ingredient cal ed tannin that promotes blood
If active bleeding should recur at any time, carefully rinse your mouth with cold water
and apply a fresh gauze sponge to the bleeding site. Firm pressure for 15-30 minutes
usually controls the problem. Should active bleeding persist, please call the office
(703)449-8888; or contact the Doctor’s pager after hours: Dr. Doriot’s pager
(703)218-7343; Dr. Shami’s pager (703)213-2247
LIMIT STRENOUS PHYSICAL ACTIVITY
during the first week after surgery.
Over exertion may lead to postoperative bleeding and discomfort. When you lie down,
keep your head elevated at least 45 degrees on a pil ow.
PAIN FOLLOWING ORAL & FACIAL SURGERY
To limit the amount of pain,
you should take Motrin/Ibuprofen 800 mg or (2-4 tabs) 200mg Advil/Motrin/Ibuprofen
or (2tabs) 365mg Tylenol/Acetaminophen before the numbness wears off. If you have
to take the prescribed narcotic pain medication, remember to have some food intake
prior to ingesting and to start slowly. Please do not drink alcoholic beverages while
taking prescription pain medication. Do not wait for the pain to become unbearable
before using some form of pain medication, as then it wil be more difficult to control.
Moderate to severe pain usual y does not last longer than 24-72 hours, sometimes
peaking on the 3rd postoperative day
. Relief should begin on the 4th post-operative
day. Persistent or increasing pain 3-5 days fol owing oral surgery may be caused by early
loss of the blood clot (dry socket) or infection. If you feel that this may be happening to
you, please contact us so the surgical site may be re-evaluated.
SWELLING RELATED TO THE SURGICAL PROCEDURE
usual y develops
during the first 12-24 hours fol owing surgery, often peaking on the 3rd post-operative
day. It should begin to subside by the 4th day after your surgery. Swelling can be
minimized a great deal by wearing an ice pack on the side of your face for 30-45 minutes
every hour while you are awake during the first 24 hours fol owing the surgery, unless
you receive special instructions. Anti-inflammatory medications, such as
Motrin/Advil/Ibuprofen and Steroids (if prescribed), also may help decrease swelling.
FLUID INTAKE/NUTRITION IS VERY IMPORTANT.
I suggest you start with
clear carbonated beverages, such as ginger ale, Seven-Up, or Sprite. Once your stomach
has settled, you can advance to other fluids such as water, teas, soda, broth, soups, or
juices as tolerated. Please avoid hot liquids until the numbness has worn off, and the
bleeding has stopped. You should try to maintain a normal fluid balance, to assist in the
healing process, please contact us if you have any questions regarding your post-
AVOID USING A STRAW
to ingest milk-shakes or thick beverages, as it may cause
the blood clot to dislodge and delay healing. A straw is OK for liquids such as water,
ginger ale etc…, but try to avoid generating excessive negative pressure.
is largely a matter of your choice. Soft, cool foods
require little or no chewing are most easily tolerated initial y. A nutritious diet
throughout your healing process is very important to your comfort and to assist your
immune system. Since you wil be taking medication, it is important to remember that
eating can prevent nausea
sometimes associated with certain medications.
If vomiting occurs please do not ingest water after you vomit, use an acidic
beverage to return your stomach to an acidic level, water will only encourage further
vomiting, ginger ale or sprite are recommended, please
Contact the office if excessive nausea and vomiting continues
Once your stomach is settled, soups, broiled fish, stewed chicken, mashed potatoes,
macaroni and cheese, and cooked vegetables can be added to your diet as your comfort
indicates. Ensure, Carnation Instant Breakfast and/or yogurt supply excellent added
nutrition. You are strongly encouraged to add a Multivitamin to your post-operative
Take any special medication such as antibiotics
we have prescribed on the specified
dosing schedule. Yogurt with active cultures or acidophilus
should be taken while
on antibiotics to prevent diarrhea. It is important to take the antibiotics to completion
(as directed). If you are given antibiotics and take birth control pil s, you should be
aware that the birth control pil may become ineffective,
therefore please consider
Take any regularly scheduled medication (for diabetes, high blood pressure, etc.) on
your regular schedule unless advised to do otherwise.
TRY TO AVOID SMOKING COMPLETELY,
as it tends to slow the healing
process and may also contribute to development of a dry socket, infection, or increased
DO NOT DRIVE AN AUTOMOBILE
for 24 hours fol owing surgery if you have
had general anesthesia, or if you are taking prescription narcotic pain medication.
THE DAY FOLLOWING SURGERY AND THEREAFTER
On the morning of the day fol owing surgery, rinse your mouth carefully with the
solution made by adding 1/2 teaspoon of salt to a large glass of warm water.
Repeat three times a day for 1 week postoperatively. Resume brushing any remaining
teeth and your regular oral hygiene as soon as possible. Do not avoid brushing the area
as this wil cause more inflammation in the area. Please do not use a syringe or Water
Pik® to aggressively rinse during the first week. This can dislodge the blood clot.
Do not worry about the stitches.
Stitches (also known as sutures) are usual y
placed to control bleeding, aid healing and help prevent food from col ecting in the
surgical site - - especial y for lower teeth. The sutures we use dissolve in 5-7 days and
typically do not require removal
Any swelling, soreness, or stiffness in the jaw muscles
can be relieved by applying
a warm moist towel to the affected side of the face several times a day. Moist heat
should be used after the first 24 hours. If swelling, tenderness, or pain should increase
after the first 3 days postoperatively, please contact the office.
Sometimes a soft diet may be necessary for the first few days fol owing surgery. Most
patients are able to resume regular food intake within a short time.
marks may appear on the skin of the face during the first few days after
surgery. Moist heat application wil help relieve this condition.
A slight elevation in temperature or fever
is normal in the 1st 24-48 hours
may develop in the adjacent areas to the surgical site, especial y if a tooth
or teeth were surgical y removed, adjacent teeth may become sensitive, this wil resolve
may develop, this is referred pain
and can be felt anywhere in the facial
region after surgery, it is normal and wil resolve shortly.
A sore throat
If the corners of the mouth were stretched during surgery, they may become dry and
crack, keep your lips moist during the post-operative period to prevent this
Faithful compliance with these instructions will add to your comfort and hasten
Be sure to fol ow these instructions carefully. Only in this way wil you avoid
the complications which lead to unnecessary discomfort and delayed recovery. Should any
undue reaction or complications arise, notify the office immediately.
If you need to contact us after office hours, please call the surgeon on call:
Dr. Doriot’s PAGER (703) 218-7343
Dr. Shami’s PAGER (703) 213-2247
We make every attempt to answer the emergency pager as promptly as possible. Occasional y,
your messages do not reach the pager. If you do not hear from the doctor on cal within one-
half hour, please cal back and page the doctor again. Do this until your page has been
Definition SHBG erniedrigt, v.a. bei adipösen u. insulinresistenten Frauen 17-OH-Progesteron hochnormal (vermehrte ovarielle Inhibin B erhöht, in der frühen Follikelphase fast Polizystische Ovarien (mind. 12 kleinzystische Strukturen <10mm DM und/oder vergrössertes ovarielles Volumen >10mL (HxBxL / 2). ) AMH erhöht, korreliert mit Ovargrösse u. Follikelzahl 2 von 3 Kriterie
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