Jeffrey segal md - post-operative instructions
POST- OPERATIVE INSTRUCTIONS
WHAT ACTIVITY CAN I DO?
Avoid strenuous physical activity and do not lift anything greater than 10 pounds (about
the size of a small cat or gallon milk) until your 6-week post-operative visit. This
includes no pushing and pulling as well as lifting (i.e. vacuum). You should not drive for
two (2) weeks. You may drive after two weeks, but avoid driving while taking pain
medications. You should speak to your doctor about limitations depending on what
surgery you had done.
• Climb stairs – but try to limit your trips up and down to 2 or 3 times each day,
A FEW THINGS TO REMEMBER:
• You should discuss with your doctor when to return to work.
• With your doctor’s permission, you may restart your vaginal estrogen cream
• Avoid sexual intercourse until your six-week post-operative check-up.
• Do not insert anything into the vagina or rectum for 6 weeks including tampons or
• It is normal to have vaginal discharge with blood for up to 6 weeks after surgery.
The amount of discharge should gradually decrease with time.
WHAT SHOULD I EAT?
To decrease post-operative nausea, try to eat small frequent meals. Eat foods high in
protein such as meat, fish, eggs, and dairy products. Eat foods with Vitamin C such as
citrus fruits. Consider taking a single multivitamin, which you can buy at any pharmacy.
Drink lots of fluids. CONSTIPATION
You will want to have a regular, soft daily bowel movement. You may be given a stool
softener with instructions to take it on a daily basis. If you do not receive one, you may
buy them from any pharmacy. Look for “docusate sodium” on the label, or ask the
If you are feeling constipated or if it has been more than a day since your last bowel movement, it is acceptable to try the following:
• Metamucil or Citrucel: one heaping tablespoon in 8 oz. of water twice per day
• Milk of magnesia, to be taken at bedtime following the directions on the label
• Be sure to drink at least 6-8 glasses of fluids per day. Water is best.
AVOID the use of rectal suppositories or enemas. WHAT MEDICATIONS CAN I USE?
If you regularly use aspirin or anti-inflammatory pain medications (such as Motrin or
Advil) you may be asked by your doctor to stop them prior to surgery. If you use these
medications or blood thinners regularly, please notify your physician.
After surgery you may resume all your normal medications. WHAT ABOUT PAIN MEDICATION?
You will be sent home with strong pain medications containing small amounts of
Some things you may want to remember:
• You may also use naproxyn (Naprosyn), ibuprofen (Motrin or Advil),
Acetominophen (Tylenol), or other non-steroidal anti-inflammatory medications for your pain. There are several ways to manage your pain:
√ Take your strong narcotic pain medications at night when
you need to sleep. Use other milder medications, listed above, during the day. √ Take the strong narcotic pain medications during the day and
use the milder medications to “take the edge off” in between.
• Take your pain medications when you first begin feeling discomfort. Don’t wait
until your pain is intense to take your medications. When used as directed, you will not become “addicted” to the pain medications.
• The narcotic pain medications which we send you home with may cause nausea
or constipation. As your surgery heals, you may find that you feel better when you don’t take those medications. If Tylenol or Motrin relieves the pain, use those medications instead.
• Remember; don’t drive while taking narcotic pain medications.
HOW DO I TAKE CARE OF MY INCISION?
You may get the abdominal (stomach) incision wet. Showers (NOT tub baths) are
preferred for the first 2 weeks after surgery. If the incision appears dirty or caked, you
may clean it with hydrogen peroxide on a cotton swab. You may have small plastic
bandages called Steri-strips across the incision. There is no need to worry if these fall
off. If they begin to curl at the edges, simply trim with scissors.
If you have had vaginal surgery, showers (NOT tub baths) are preferred for the first 2
weeks after surgery. You may do sitz baths once or twice a day with warm water. A
tablespoon of Epson salts mixed in the water may help healing and decrease pain. DO
WHAT ABOUT THE BLADDER CATHETER?
It is very normal to go home from the hospital with a catheter in your bladder.
The surgery your doctor performed tends to cause swelling around the opening to the
bladder, making it difficult for you to pass urine. If this is the case, you will be given
instructions in the hospital on the care of the catheter, and will be told when to come
back to the office for catheter removal. It is not unusual for it to take a few weeks for
your bladder to return to normal, so DON’T WORRY. Your bladder is a muscle that
needs to wake up from the surgery. The catheter needs to be plugged during the day.
You will get the urge to voids while the catheter is plugged. To drain your bladder,
simply unplug the catheter into the toilet. As the swelling decreases it is possible to
urinate around the catheter, and this is normal. During the night; you should connect
the catheter to a bedside bag to prevent getting up during the night. The nurse in the
hospital will make sure you are comfortable with this prior to you going home. You will
be given an antibiotic to take while the catheter is in place. This will help decrease the
chance of infection.
After the catheter is removed, try to urinate on a regular basis. A good way to do this is
to try to urinate every 3-4 hours during the day. That is, you might try urinating at 9AM,
12Noon, 3PM, and so on. By urinating on a scheduled basis you may prevent bladder
spasms. You do not have to wake up during the night to do this drill. WHAT SHOULD I WATCH OUT FOR?
There are several warning signs you should watch out for:
• Problems with your incision such as redness or discharge
• Vaginal bleeding heavier than what was a heavy menstrual cycle
• Increase in vaginal discharge, especially a strong odor
Should you have problems or questions during the day, call 973 322-9998 If you have an urgent matter that you need to discuss immediately, day or night,
please page Dr. Segal at: (973) 501-0611. Please include your area code.
FOLLOW- UP APPOINTMENTS
Upon leaving the hospital, you should call Dr. Segal’s office at 973-322-9998
normal business hours to schedule follow-up appointments. You will need to be seen
for the following:
□ Catheter removal in one week
□ Two-week follow-up
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C. Prestación Farmacéutica 14/1/05 16:24 Página 44ANEXO B. FÓRMULAS MAXISTRAIS E PREPARADOS OFICINAISLISTA DE PRINCIPIOS ACTIVOS PARA FORMULACIÓN MAXISTRAL Comentario ¤ /gramo ou enfermidades asociadas segundo a clasificación ICM-9 ou enfermidades asociadas segundo a clasificación ICM-9 activos en procesos patóloxicos que requiran fotoprotecciónC. Prestación Farmacéutica 14/1