Once a procedure has been agreed upon with you and Dr. Hansen, our office will initiate the scheduling with the facility. You can then follow the instructions below for the information they request from you. Most of these have their own additional instructions, some of which are listed below.
What to Wear for the Day of Surgery
● Wear loose clothes that are easy to remove and get into.● Don’t wear make-up, perfume, or jewelry of any kind.● Don’t wear contacts, but if you must, bring a container to keep them in.
After Surgery Diet
Don’t eat or drink or smoke anything after midnight before your surgery unless otherwise instructed. This includes mints, candy, gum, vitamins etc. Any material in the stomach is a risk for aspiration. If you vomit during your procedure and are unable to clear your airway then it can get into your lungs and become a life-threatening condition.
After your surgery in most cases your usual diet can be resumed. It is generally a good idea to start with light foods until you can tolerate usual meals. Special diet instructions will be given if there are some unique to your surgical procedure.
Please read the instructions outlined below and refer to this sheet for the next few weeks. These discharge instructions provide you with general information on caring for yourself after you leave the hospital. While your treatment has been planned according to the most current medical practices available, unavoidable complications sometimes happen. If you have any problems or questions after discharge, please call Dr. Hansen at (801) 523-6177.
● Take frequent rest periods throughout the day.● Take frequent walks throughout the day. This will help to prevent blood clots.● Continue to do your coughing and deep breathing exercises once you get home. This will help to prevent pneumonia.● No strenuous activities such as heavy lifting, pushing or pulling until after your follow-up visit with your doctor. Do not lift anything heavier than 20 pounds.● Talk with your caregiver about when you may return to work and your exercise routine.● You may shower immediately after surgery. Pat incisions dry. Do not rub incisions with washcloth or towel.● Do not drive while taking prescription pain medication.
● 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.)
Appendectomy is surgery to remove the appendix. Laparoscopic surgery uses several small cuts (incisions) instead of one large incision. Laparoscopic surgery offers a shorter recovery time and less discomfort.
Let Dr. Hansen Know About
● Allergies to food or medicine.● Medicines taken, including vitamins, dietary supplements, herbs, eyedrops, over-the-counter medicines, and creams.● Use of steroids (by mouth or creams).● Previous problems with anesthetics or numbing medicines.● History of bleeding problems or blood clots.● Previous surgery.● Other health problems, including diabetes, heart problems, lung problems, and kidney problems.● Possibility of pregnancy, if this applies.
Risks and Complications
● 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).
Before the Procedure
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.
After the Procedure
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.
Home Care Instructions
● 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.
Discharge Instructions for Laparoscopic Nissen FundoplicationYou have had a procedure known as a laparoscopic Nissen hernia repair. A laparoscopic Nissen is a procedure to treat reflux (GERD) by wrapping the upper stomach around the end of the esophagus. As a result may people have difficulty swallowing for hte first few weeks after surgery.
● Ask someone to drive you to your appointments for the next 3 days. Don’t drive until you are no longer taking narcotic pain medication and are able to step on the brake pedal without hesitation.● Wash the skin around your incision daily with mild soap and water. It’s OK to shower 24 hours after your surgery. If you have bandaids in place please replace them with clean ones after each shower.● A few patients will have pain between the shoulder blades if they had a large hiatal hernia repaired. This will be worse when taking a deep breath.● You may only eat soft foods such as liquids and oatmeal, cream of wheat, ice cream, and scrambled eggs for the first week. You may only advance beyond this after you’ve seen Dr. Hansen 2 weeks after surgery. DON'T EAT BREAD OF ANY KIND.● Mild gas bloating occurs in a significant number of patients. It will resolve in time.● Remember, it takes at least 1-2 weeks for you to get most of your strength and energy back.● Make an office visit to talk to your doctor if the following symptoms don’t go away within a week after your surgery: Fatigue, pain around the incision, diarrhea or constipation, or loss of appetite.● Please schedule a postop visit with Dr. Hansen for about 2 weeks after surgery by calling (801) 523-6177 or 801-SURGERY.
When to Call Your Doctor
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.
Intestinal obstruction is a blockage of the small or large intestine (also called the small or large bowel). The blockage makes it hard for the contents of the bowel to pass through and out of the body. If the obstruction is only partially blocking the intestine, you may feel some relief from crampy abdominal pain and fullness as you pass liquid stool or gas. Sometimes the blockage cuts off blood flow to part of the bowel. When this happens, the bowel is said to be strangulated. The lack of blood flow can cause the death of some of the tissue and can be life-threatening.The most common cause of intestinal obstruction is scar tissue (adhesions) from previous surgeries. Other causes of a blockage may include:● Cancer.● Inflammation of the bowel from conditions such as Crohn’s disease or diverticulitis.● Twisting of the bowel.● A hard lump of stool (fecal impaction).● Intussusception, which is the intestine folding into itself, cutting off the flow of partly digested food and eventually cutting off blood flow to the tissues.● Narrowing of the bowel that has been present since birth.
How can I take care of myself when I go home
How long it takes to get better depends on the cause of your intestinal obstruction and the treatment you need. You may need to make dietary or other lifestyle changes to prevent future bowel obstructions.
● 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.
Diet, Exercise, and Other Lifestyle Changes
● 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.
Call your healthcare provider if you have new or worsening:
● 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.
Laparoscopic gallbladder surgery is a procedure to take out your gallbladder. During this procedure, the surgeon makes 4 small incisions (cuts) in your abdomen (belly). A harmless gas is pumped into your abdomen so that the doctor can better see your organs. A long tube with a tiny camera at the end (a laparoscope) is put through one of the incisions. The camera sends a video of the inside of the abdomen to a computer screen. This allows your doctor to see and take out the gallbladder using other small surgical tools. The entire procedure usually lasts less than 2 hours.
Note: There is a chance that your doctor may have to switch to open surgery if a more difficult problem is discovered. In this case, the doctor will need to make a larger incision, which will likely mean a longer hospital stay and recovery period.
What should I expect after the procedure?
● Closing your incisions: After the gallbladder is taken out, the incisions are closed with absorbable stitches and super glue so you can get in the shower immediately.
● Monitoring your recovery: After the procedure, you will be taken to a recovery room, where you will be monitored for about an hour or more.
● Going home: You can usually go home the same day. You will need a responsible adult to drive you home. Before you leave, your nurse will give you some home care instructions. Make sure someone is there to take notes because, after surgery, you may not remember everything.
● 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.
Rest and activity
● 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.
When should I call Dr Hansen at 801-523-6177?
● 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.
Follow-up care out to 90 days is covered with the primary procedure by most insurance plans. Visits after this time or due to other conditions will be billed to your insurance with the required copay and/or deductibles.
There may be additional payments required that the insurance doesn’t cover or for emergency situations. Limited monthly payments to the office can be set up.
Failure of payment or arrangement of payments will be subject to collection agency assistance with their associated fees and penalties. We will make reasonable efforts to assist you.