Surgery Care and Follow-Up Appointments

● Continue with a liquid diet, soft diet you were directed to take, until you can swallow without any pain. Drink fluids (6-8 glasses a day).● Call Dr. Hansen for persistent nausea (feeling sick to your stomach), vomiting, bloating or difficulty swallowing.

It is very important not to strain during bowel movements. If constipation should occur, you may:● Take a mild laxative (such as Milk of Magnesia®).● Add fruit and bran to your diet.● Drink more fluids.● Call your caregiver if constipation is not relieved.

If you feel feverish or have shaking chills, take your temperature. If it is 101.5 or above, call Dr. Hansen. The fever may mean there is an infection.

● If a prescription was given for a pain reliever, please follow your caregiver’s directions.● Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed. Motrin 600 mg four times a day helps a lot. If the pain is not relieved by your medicine, becomes worse, or you have difficulty breathing, call Dr. Hansen.

● Your incisions should be watertight so you can get them wet in the shower. If there is any drainage keep it dry for two days after drainage stops. Once the drainage has stopped, leave your incision(s) open to air.● Check your incision(s) and surrounding area daily for any redness, swelling, increased drainage, or bleeding. If any of these are present or if the wound edges start to separate, call Dr. Hansen.● If you have small adhesive strips in place, they will peel and fall off. (If these strips are covered with a clear bandage, your doctor will tell you when to remove them.)

● Infection. A germ starts growing in the wound. This can usually be treated with antibiotics. In some cases, the wound will need to be opened and cleaned.● Bleeding.● Damage to other organs.● Sores (abscesses).● Chronic pain at the incision sites. This is defined as pain that lasts for more than 3 months.● Blood clots in the legs that may rarely travel to the lungs.● Infection in the lungs (pneumonia).

Appendectomy is usually performed immediately after an inflamed appendix (appendicitis) is diagnosed. No preparation is necessary ahead of this procedure.

You will be given medicine that makes you sleep (general anesthetic). After you are asleep, a flexible tube (catheter) may be inserted into your bladder to drain your urine during surgery. The tube is removed before you wake up after surgery. When you are asleep, carbon dioxide gas will be used to inflate your abdomen. This will allow Dr. Hansen to see inside your abdomen and perform your surgery. Three small incisions will be made in your abdomen. Dr. Hansen will insert a thin, lighted tube (laparoscope) through one of the incisions. Your surgeon will look through the laparoscope while performing the surgery. Other tools will be inserted through the other incisions. Laparoscopic procedures may not be appropriate when:● There is major scarring from a previous surgery.● The patient has bleeding disorders.● A pregnancy is near-term.● There are other conditions that make the laparoscopic procedure impossible, such as an advanced infection or a ruptured appendix.● If Dr. Hansen feels it is not safe to continue with the laparoscopic procedure, he will perform an open surgery instead. This gives the surgeon a larger view and more space to work. Open surgery requires a longer recovery time. After your appendix is removed, your incisions will be closed with stitches (sutures) or skin adhesive.

You will be taken to a recovery room. When the anesthesia has worn off, you will be returned to your hospital room. You will be given pain medicines to keep you comfortable. Ask your caregiver how long your hospital stay will be.

● Do not drive while taking narcotic pain medicines.● Use stool softener if you become constipated from your pain medicines.● Change your bandages (dressings) as directed.● Keep your wounds clean and dry. You may wash the wounds gently with soap and water. Gently pat the wounds dry with a clean towel.● You can shower immediately as there is glue on top of absorbable incisions● Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. Motrin 600 mg 4 times a day works well. Use it first.● You may continue your normal diet as directed.● Do not lift more than 10 pounds (4.5 kg) or play contact sports for 3 weeks, or as directed.● Slowly increase your activity after surgery.● Take deep breaths to avoid getting a lung infection (pneumonia).● Call Dr. Hansen’s office for a follow-up appointment in 2 weeks or sooner if you have any concerns at (801) 523-6177.

Call your doctor immediately if you have any of the following:● You cannot empty your bladder.● Chills.● Fever above 101.5°F or 38.5°C.● Redness, swelling, increasing pain, pus, or a foul smell at the incision site.● Increasing abdominal pain.
In the first 3 weeks after your surgery, please call Dr. Hansen on his cell phone if there is any concern for which you are contemplating going to the emergency department or urgent care: (801) 971-1469.

● Your provider will give you a list of your medicines when you leave the hospital.● Know your medicines. Know what they look like, how much you should take each time, how often you are to take them, and why you take each one.● Take your medicines exactly as your provider tells you to.● Carry a list of your medicines in your wallet or purse. Include any nonprescription medicines and supplements on the list.● Your provider may prescribe medicine to:- Treat pain- Treat or prevent an infection- Prevent side effects, such as nausea or constipation, from other treatments- Soften stool and reduce straining with a bowel movement● If you have had surgery without a colostomy, to care for your incision:- Keep your surgery site clean.- If you are told to change your dressing on your incision, wash your hands before and after changing the dressing and after disposing of the dressing.● If you have had a colostomy:- You will have a pouch covering your stoma (the part of the intestine outside the body) to collect stool as it drains. Pouches must be emptied regularly so that they do not become too heavy and leak. Some pouches may be opened or unclamped at one end to allow drainage without removing the pouch. Other pouches can be removed, emptied, and cleaned before they are reattached. Be sure to follow the manufacturer’s directions for your type of pouch.- You will need to learn to care for your stoma and change the pouch.

● Follow your provider’s instructions for follow-up appointments.● Keep appointments for any routine testing you may need.● If you are age 50 or older, you should have colorectal cancer screening with a test for blood in the stool and a sigmoidoscopy, colonoscopy, or barium enema. You may need to start colorectal cancer screening earlier if a member of your immediate family has had colon polyps or colon cancer, especially if their cancer occurred before they were 50 years old.● Talk with your provider about any questions or fears you have.

● Follow the treatment plan your healthcare provider prescribes.● Follow activity restrictions, such as not driving or operating machinery, as recommended by your healthcare provider or pharmacist, especially if you are taking pain medicines.● Get plenty of rest while you’re recovering. Try to get at least 7 to 9 hours of sleep each night● Ask your provider about any changes you may need in your diet.● Eat a diet high in fiber and low in fat and cholesterol. If you are not used to high-fiber diets, begin slowly.● Drink plenty of water to help your intestines work well.● Exercise as your provider recommends.● Don’t smoke. Smoking reduces blood flow to the intestines.

● Change in bowel habits, such as pain, mucus, diarrhea, constipation, or other intestinal problems.● Abdominal bloating.● Abdominal pain that goes away and then comes back worse than it was.● Nausea or vomiting.● Blood in your bowel movements.● Blood in your vomit.● Signs of infection around your surgical wound if you had surgery. These include:- The area around the wound is more red or painful.- The wound area is very warm to the touch.- You have blood, pus, or other fluid coming from the wound area.- You have a fever higher than 101.5° F (38.6° C).- You have chills or muscle aches.

● You can take a bath or shower immediately. If there is any drainage, keep a sterile dressing and keep it dry for two days until the drainage stops
● If you have strips of tape on your incision, leave them in place until they fall off (usually within 7 to 10 days). Your doctor may take them off, along with any stitches, at your follow-up visit. If the edges of the tape strips start to peel, trim them with scissors. Let your doctor know if the tape strips irritate your skin. In this case, you may need to remove them earlier.
● Tell your doctor if you have signs of infection at the incision site. These include increased redness or swelling, pus, or fever over 101°F.

● You may have the following types of pain or discomfort after surgery:- Incision pain for the first few days. It may take a few weeks to go away completely.- Shoulder or neck pain for the first 2 or 3 days. The pain may get better if you change positions. A heating pad is often helpful over the referred pain area.- Cramping or swelling in your abdomen for the first several days.- A sore throat from the breathing tube used to keep your airway open during the procedure. This should go away in 1 to 2 days.● You will be given pain medicine (pills). Take this medicine exactly as ordered by Dr . Hansen. Pain medicine may cause constipation. If necessary, you may use a mild laxative.

Your doctor will want to see you about 2 weeks after the procedure. Be sure to keep your follow-up appointment.

● Your doctor may recommend that you start with clear liquids for the first day and then slowly add solid food over the next day or two.
● You may have some indigestion or diarrhea, which should get better within a few days. However, it may take a few weeks for your digestive system to adjust fully after your procedure.
● Once you’re back to normal, eat a balanced diet.

● You are likely to feel tired on the day of surgery, so rest that day.● For the next 3 to 5 days, get up and walk 4 to 5 times each day. This will improve the blood flow in your legs and reduce the risk of blood clots or muscle soreness. Deep breathing for the first few days after surgery is also helpful.● Avoid heavy lifting or exercise for the first 7 days or so. You can get back to work and your other daily activities as you can tolerate after that time.

● You can’t urinate within 8 to 10 hours after surgery or have no bowel movements after 3 days.● You have severe or increasing pain, or pain you can’t control.● You have nausea, vomiting, or diarrhea that doesn’t go away within a few days.● Your stomach feels swollen or severely bloated.● You feel faint or light-headed, even when lying down.● You have chills or a fever over 101°F.● You have increased redness or swelling at your incision sites.● You have a large amount of bleeding.● You have jaundice (yellow eyes or skin).● You feel short of breath.● You have pain or swelling in your lower leg.