It’s easy for us to say that having surgery in the office is a piece of cake, but we understand the anxieties that can come along with this. Dr. Sikand and his team strive to make sure that every patient is comfortable when preparing for balloon sinus surgery. Not only during the surgery, but also with the decision to have a procedure while being awake.
♦ PREPARING FOR BALLOON SINUS SURGERY
1. ONE WEEK BEFORE SURGERY, stop all medications that can cause or worsen bleeding during and after the surgery . These include:
- NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen (Motrin), naproxyn (Aleve), aspirin, Meloxicam, Celebrex, Advil, and Excedrin.
- All vitamins and herbal supplements including fish oil (Omega), Vitamin E, and gingko biloba.
- If you take a prescription blood thinner such as Coumadin, Eliquis, or Plavix, discuss this with Dr. Sikand. He may contact the prescribing doctor on your behalf to discuss instructions on stopping and resuming these.
2. Get all medications and supplies that you will need before and after the surgery:
- Benadryl 25mg tablets ( taken on the day of surgery to help with nausea) -Take two tablets (50mg)
2 1/2 hours before arriving to the office.
- Extra Strength Tylenol (over-the-counter) in case you need to take something for post op discomfort.
If a prescription pain medication was prescribed, a handwritten prescription should have been given to you to drop off at the pharmacy. That prescription will expire two weeks from the date it is written, so please take it to the pharmacy as soon as possible. If it has expired, call the office for another written prescription or you can get it before you leave the office on the day of your surgery.
- Distilled water: 2-3 gallons for saline sinus rinses after surgery. These rinses are done for 3-4 weeks after surgery.
Afrin nasal decongestant spray (or generic equivalent). This is different from fluticasone, Nasacort, or azelastine. It is helpful with nasal congestion (used after surgery for 3 days only) and to help with bleeding.
Bag of frozen peas or soft ice pack (to apply to the face to help with any facial pain).
- Ice chips (or crushed ice cubes) – to help soothe the throat, keep the mouth moist, and stay hydrated. You could also purchase Biotene oral spray from your local pharmacy.
- Optional items to purchase at the pharmacy: saline nasal spray, sudafed (if you do not have high blood pressure, allergy (antihistamines) pills like Zyrtec, Claritin, or Allegra. These medications are recommended to help with nasal congestion after the surgery.
3. Arrange for someone to drive you to and from the office. Although you will be awake during the procedure, the Benadryl and lorazepam (Ativan) taken before you arrive to the office can make you drowsy.
♦ ON THE DAY OF SURGERY
Before arriving to the office:
- Eat a normal breakfast. If your procedure is scheduled in the afternoon, also have a light lunch.
- 2 1/2 hours before the arrival time given to you, take two Benadryl 25 mg tablets. This is taken for anti-nausea. If Zofran (ondestran) was prescribed, take this instead of the Benadryl.
- 2 hours before your arrival time, take the anti-anxiety medication if it was prescribed.
- You can take a shower, wear makeup, and use hair styling products.
- Wear comfortable clothing. It can get chilly in the treatment room, so long sleeves and pants are suggested in case you get cold.
- Expect to be at the office for 1-1.5 hours. Sometimes extra time is needed in case something unplanned occurs.
- For example, there can be more nasal polyps hiding in places not seen on a CT scan or the sinus disease has worsened since the time of scheduling.
Arrange for someone to drive you to the office.
♦ WHAT CAN I EXPECT DURING THE PROCEDURE?
- When you arrive, we will bring you to the treatment room, take your vitals, and get you comfortable.
- Your nose will be numbed with a series of topical medications to help open and numb the nasal passages. These include nasal sprays, a numbing gel, anesthetic via injections, and medications placed on pledgets (cotton balls rolled and cut into thin squares). This takes about 20-30 minutes.
- Once good anesthesia is achieved, a thin device with the balloon is guided through your nasal passages to your sinus. The balloon is gently inflated for five seconds and then deflated. You may feel facial pressure and hear a “crackling” sound. Dr. Sikand will treat all necessary sinuses in the same manner. If eustachian tube dilation is part of your planned surgery, this will also be done using the same balloon device. The balloon will then be removed and discarded. If other procedures were planned, those will be performed as well.
- Majority of our patients report not feeling any pain. 95% of patients asked said they felt minor pressure when the balloon is inflated or they didn’t feel anything at all.
♦ IMMEDIATELY AFTER THE SURGERY
- Nasal packing is not required after the surgery. If you have a septoplasty, soft splints may be placed in each nostril to help protect the nasal tissue. These are generally removed in the office the following day.
- A nasal drip pad will be placed underneath your nose to collect drainage. You can change this gauze as often as you feel necessary. The drainage (“oozing”) or bleeding will lessen over the first 24 hours after surgery and typically goes away by the next day.
- The topical and local anesthetics used at the beginning of the surgery can cause the throat to feel numb for the first 1-2 hours after surgery. You may find that it is difficult to swallow or feel like you have something stuck in your throat. This is normal, so relax and stay calm. Use ice chips to help soothe the throat for the first few hours after surgery. DO NOT eat or drink anything until you can comfortably swallow. Sometimes your voice may change or you may not be able to talk right away, but this will go back to normal once the numbing medicine wears off.
- Once the procedure is done, we will move you to another room to let you recover for 10 to 15 minutes. A member of Dr. Sikand’s staff will go over your post-op instructions in detail with you and the person driving you home before being discharged from the office.