Dr. Brian Wilson-Boyd: Pre and Post Operative Information

New patients are asked to complete a Patient Information form. You can do this online or when you arrive at the practice.

Arrival Time

My office will be in contact with you to advise the time you need to arrive at the hospital.

Fasting

Dr. Brian Wilson-Boyd’s office will be in contact with you to advise the time you need to fast from. Fasting means no food and no water unless directed otherwise.

You should continue to take regular prescribed medications at the usual time with a small amount of water. Please advise the anaesthetist of this. The anaesthetist will visit you on the day of your surgery.

Medications and natural medicines to avoid prior to surgery.

DO NOT TAKE the following medications below for two weeks prior or after surgery. They promote bleeding. This is not an exhaustive list. If you are in any doubt about whether it is safe to stop anyone of the medicines listed below, please contact your local doctor (or the specialist who prescribed the medication) as to whether it is safe to stop the medicine.

ACLIN	CODOX	MORPHALGIN	TILCOTIL
ACTIPROFEN	CODRAL	NAPROGESIC	TICLODIPINE
AGGREASTAT	CODRAL	NUROFEN	TILODENE
ALEVE	CODIPHEN	NUROFEN JUNIOR	TORADIL
ANAPROX	CELEBREX	ORTHOXICOL	VEGANIN
ARTHREXIN	DECRIN	ORUDIS	VINCENTS
ASA	DENAC	ORUVAIL	VIOXX
ASASANTIN	DENAC	PLAPRIN FORTE	VOLTAREN
ASPALGIN	DISPRIN	PERPAIN	WARFARIN
ASPIRIN	DOLOXENE	PERSANTIN	WINSPRIN
ASPRO	ECOTRIN	PIROX
ASTRIX	FELDENE	PLAVIX
BEX	HYCODIN	PONSTAN
BRUFEN	IBUPROFEN	RAFEN
BUFFERIN	INDOCID	SALDAC
CANDYL	INDOMED	SOLCODE
CARDIPRIN	ISCOVER	SOLPRIN
CARTIA	MAREVAN	SOLVIN
CHEMGESIC	MEFIC	S.R.A.
CLINORIL	MOBILIS	SURGAM

Natural Products to avoid

Avoid eating these in your food.

GINGKO	OMEGA-3 LIQUID	FEVERFEW
GARLIC	FISH OIL	GINGER
ECHINACEA	VITAMIN E	GINSENG

Safe medications prior to surgery

If you have pain or a headache prior to surgery, it is SAFE to take:

CAPADEX	DYMADON	PANADOL
CODALGIN	MERSYNDOL	PANAMAX
DIFFLAM	PAINSTOP	PARACETAMOL
DIGESIC	PANADEINE	PARADEX
	PANADEINE FORTE

Please bring the following with you on the day:

• Medicare, Health Insurance, Pension, Workcover, Veteran affairs details
• X-rays, Ultrasounds, CT scans, MRI scans
• Prescribed medications and pharmaceutical benefits card
• List of allergies
• Test results
• Night attire, toiletries etc if you are staying overnight
• Method for settling your hospital account
• Please do not bring valuables
• For a child – favourite toy, formula, bottle

Day case patients generally need to stay for a few hours after surgery. You must be accompanied home by a friend or relative.

You must not drive a car, operate machinery or make important financial decisions for at least 24 hours after your surgery. You should arrange for a responsible friend or relative to help care for you and your family after surgery.

For more information, please don’t hesitate to contact the office

Pain Relief

Pain is the main problems following Tonsillectomy. The wound at the Tonsillectomy site is usually left open and this wound fills with bacteria and slough, which causes pain and inflammation.

It takes several days for the bacteria to multiply and the inflammation to occur hence the pain following Tonsillectomy is usually the worse on the 4th and 5th day following the surgery. It is important to have good pain relief prior to this peak and this is achieved with a combination of Paracetamol or Codeine/Oxycodone or the two drugs in combination.

These medications should be prescribed on discharge and usually required every four hours except when sleeping. Children can use Painstop, available over the counter at your chemist, but this drug should not be used with Paracetamol or Codeine/Oxycodone as it contains both of these medications and there is a risk of over dosage.

I avoid Aspirin and anti-inflammatory medicines during the post-operative period, as this can be the cause of nuisance, anxiety-provoking bleeding.

Severe pain not controlled with Paracetamol and Codeine/Oxycodone may require further measures. Your general practitioner or myself should be contacted in this case for a combination of Penicillin, oral steroid, hydrogen peroxide gargles or a local anaesthetic gel (Xylocaine viscus). These measures should improve tolerance of normal diet.

Activity

Although the operative site is small, Tonsillectomy can make you feel lethargic and generally unwell. Any significant physical activity is usually poorly tolerated. I usually recommend ten days off work or school to allow enough time to recover. Excessive physical activity with an increase in blood pressure and pulse rate may lead to bleeding from the tonsillar fossae.

Diet

The open wound at the site of Tonsillectomy fills with bacteria and slough leading to pain and inflammation. It is important to eat a normal diet with rough type foods to debride or remove the slough from the healing wound site.

Although it is more painful to eat bread, toast and cereal consistency foods, this results in fewer bacteria in the wound and less pain between meals. Traditional ice cream and jelly feels better to eat but results in more bacteria lining the pharynx and subsequently more pain between meals.

Generally those presenting with post-operative bleeding have not been eating adequately. It is essential to have adequate fluid intake especially in younger children where dehydration can occur.

Complications

You should be well informed of the potential complications following Tonsillectomy by reading The Royal Australasian College of Surgeons pamphlet provided. The main concern is bleeding from the mouth and if this occurs you should contact myself or present to your nearest hospital via ambulance if required.

You may need to return to the operating theatre to have the bleeding stopped. Ear pain is not uncommon after Tonsillectomy and is the result of referred pain from the tonsillar fossae and usually does not indicate an abnormality in the ear. Bad breath is common and is due to the build up of bacteria and slough in the tonsillar fossae. This will be less with a normal diet, which debrides theslough.

Follow-up

You should have received an appointment card following your surgery for your post-operative appointment with Dr. Brian Wilson-Boyd.

If your only surgery is Tonsillectomy follow-up is usually at four weeks following the operation unless there are problems in the interim. It may be necessary to be seen earlier if another procedure has occurred in conjunction with your Tonsillectomy.

Dr Wilson-Boyd recommends these audiology clinics.

Some companies have several practices throughout Brisbane. Please phone, or visit their websites for more information on locations or to make a booking.

Downloadable Literature

• Indications for Tonsillectomy
• Post operative Instructions – Tonsillectomy
• Pre – operative Medication Guidelines