SNORE SURGEY PRE OP PACK (Tonsillectomy, UPPP, Tongue Channelling)
Please note that the following is a general guideline only. For a full assessment, exclusion of any other underlying cause for your symptoms and an individualised treatment approach, you will need to be seen by a qualified specialist.
Prior to any surgery it is important that necessary precautions are taken to the risk of operative bleeding as well as general anaesthesia. Following are some important pre operative instructions.
If you or any blood relatives have tendency to bleed or bruise easily please notify the surgeon.
Disclose all medical illness to the surgeon and the anaesthetist. By doing so the doctors are able to determine your anaesthetic risk, and do appropriate pre operative investigations and optimise your medical treatment. If there is a need your surgeon may get other appropriate specialists involved for the pre operative work up.
If you are a smoker, you must stop smoking for up to two weeks prior to surgery.
If you take blood-thinning medications such as Warfarin, Aspirin or Newer anti platelet medications, these need to be disclosed to the surgeon. The surgeon will ask you stop these for 10 days if it is safe to do so, after consultation with your physician. He may cancel surgery if the risk of stopping such medications is too high.
There is potential of certain dietary supplements, including garlic, Ginkgo biloba, ginger, ginseng, glucosamine fish oil, and vitamin E, to interfere with haemostatsis. These and any other supplements should also be stopped well in advance.
Practical matters: Organise sufficient assistance at home. Stay with close proximity to a hospital. Ensure you have some one to drive you to emergency, incase of a bleed. Have access to a phone. Do not plan travel for at least four week following surgery.
Do not eat for 6 hrs pre operatively
Please read the surgical information sheet given. If you have any concerns or wish to speak to your surgeon please contact the reception.
WHAT IS TONGUE CHANELLING?
Tongue channelling by using a plasma wand, is designed to cause a gentle shrinkage of the deep musculature and connective tissue of the tongue whilst leaving the surface intact and causing minimal discomfort. Each placement of the probe into the depth of the tongue will cause a channel of shrinkage of the tongue musculature, which over the next 4 to 6 weeks will gradually cause the tongue, itself, to shrink down in size and continue to improve snoring and sleep apnoea.
Visible and permanent reduction in tongue size has been measured to occur in this procedure with minimal post-operative discomfort and significant improvement in snoring and sleep disordered breathing.
WHAT IS COBLATION?
Coblation is an advanced technique that quickly and effectively removes and shrinks soft tissue inside the tongue using gentle radiofrequency energy and natural saline. Coblation is a non-heated driven process so that the surrounding healthy tissue, on the surface of the tongue, is preserved allowing a fast and easy recovery.
POST OP INSTRUCTIONS
Pain:
You will be quite sore post operatively. Take paracetamol every four to six hours for 10 days even if not sore. Take endone only as prescribed and ask for instructions from your nurse prior to going home. Ensure that you know how to take the correct amount. DO NOT use endone in the presence of drowsiness. Sleep Apnoea patients should not take endone at home, unless they had received the correct dose under observation in the hospital, and correct advice had been given.
Eating
One should eat normally. Do not heat hot or spicy foods.
Rare Emergencies-Bleeding, Breathing
Bleeding may occur 1-2 out of a hundred up to two weeks and very rarely up to four. If there is any fresh blood dripping, or clots noted you must be admitted to hospital to be kept under observation. There is a very rare risk of haemorrhage following small “warning” bleeds. Bleeding should not be taken lightly.
Ver rarely tongue swelling may cause some difficulty with breathing. It is highly unlikely that this would occur after the 24 hour observation period in hospital. If any such concern go straight to Frankston or Monash ED (not Private ED) all call for help.
Sleeping
Its best to sleep slightly propped up. Lying completely flat congests the throat, and can increase the chance of bleeding.
Traveling
Stay close proximity to a hospital even up to four weeks. Generally is safe to go to Work after two weeks but NOT Camping!!
General activity
I would just be sensible. Nothing too vigorous. avoid very hot showers.
Infection
Surgery site will be quite yellow, and that is normal. However it is common to be given about 10 days of antibiotics.
Home
You must have access to a phone and a friend to drive you to hospital in the case of haemorrhage. Have assistance at home.
If Concerns
Contact surgeon, the hospital and if an emergency go to closest ED-Frankston or Monash not the Private ED
Contact surgeon, the hospital and if an emergency go to closest ED-Frankston or Monash not the Private ED
CONSENT
Informed consent is a process of finding out information about the recommended treatment, alternative options and weighing up the benefits and risks involved. It is not about just signing a form. This involves
It is not possible, however, to provide complete information or predict outcomes or assess risks with certainty; and patients need to be aware of this uncertainty.
If you have any specific matters which you like to further discuss you are requested to contact the surgeon and make another appointment prior to surgery. You have the right to cancel surgery if you wish to do so.
Like any procedure, rare complications can occur. Injury to the nerves and blood vessels of the tongue is possible, although these instances are very uncommon. If they did occur some shrinkage and wasting of the tongue muscle could occur, which may, if severe, cause an alteration or movement of the tongue and possibly some affects on speech and tongue movement. In a larger series of tongue channelling reported, in over 2,000 cases, there were no reported incidences of this occurring.
Summary
1) Pain: Tonsillectomy-UPPP can be very painful. Tongue not so much usually
2) Infection, sutures coming out early ( if happens the wound will be allowed to heal by its self)
3) Bleeding / Rare risk of haemorrhage and need of a transfusion.
4) Extremely rare risk of a life threatening bleed
5) Injury to teeth and other surrounding structures
6) Altered voice
7) Tongue: Rare: Altered taste, tongue movement rare nerve vessel damage and resultant effects on eating and speech
8) Rare: swelling of tongue, airways compromise which may need surgical airway (tracheostomy) or intubation. You will be closely monitored for 24 hours. The chances of such emergency thereafter is much less likely.
9) Risks of anaesthesia: Anaesthetist will discuss this on day of surgery
10) Small risk of reflux of air, food to the nose
11) Abnormal sensation in the surgical site
12) Ongoing sleep disordered breathing which may require further treatment.
DURING ASSESSMENT YOU WILL RECEIVE THE FOLLOWING
Surgical Information Pack - Pre Op, Post Op and Consent
Printed surgical information sheet with details
Multimedia video clip
Hospital Admissions Form
Patient to complete and return to the selected hospital
Anaesthetic Services Fee and Booking Form
Patient to complete and return to Anaesthetic Service
Confirm Theatre Admission with the selected Hospital
Information about the process on the day
Patient to contact the surgeon if you have any further questions, after reading through all of the information.
Quote for Theatre Procedures. A deposit will be required 7 days prior to confirm your place in theatre. This is non refundable and non transferable. It is advised that you contact your health fund and confirm that your procedure is covered prior to payment of the deposit.
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