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Interviewer: You're having sinus surgery and you're wondering how you prepare. We're going to talk about those issues next on The Scope.

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Interviewer: The purpose of this podcast is to help you, the patient who's decided that you want to get sinus surgery, to understand what you can do to best prepare for the procedure. There are a lot of things to consider, like how much time do you get off work, do you need to fast before, will you need to arrange for somebody to drive you.
We're going to talk about those and other things right now with Dr. Richard Orlandi. He's one of the experts here in this type of surgery at University of Utah ÐÇ¿Õ´«Ã½care. So what's the first consideration that somebody should think about or do before surgery?

Dr. Orlandi: I think the most important thing is they want to be sure about their decision, and I certainly want, in our practice we want to make sure that our patients' questions and concerns are fully addressed before they make this decision. We don't want them to have any second thoughts. And so, again, we try to address every concern that patients have and then certainly encourage them to seek a second opinion.
This is not a surgery, typically, that we have to rush into. Patients have typically had their symptoms for a long time. I think it's something that people can get a second opinion, take their time with this decision, talk to family and others who have had the surgery.

Interviewer: So if they're feeling a little uncomfortable with it or whatever that's a good indication maybe you should ask more questions beforehand.

Dr. Orlandi: Absolutely.

Interviewer: And the sooner the better, of course, because you don't lose your surgery day.

Dr. Orlandi: Well, asking those questions an hour before the surgery may be waiting a little bit too long.

Interviewer: Gotcha. What should I do leading up to surgery day and when does that all start?

Dr. Orlandi: We want the patients to have as much of the inflammation under control as possible, so we ask our patients to continue with the medications that they've been on before. We may stop them for a few days ahead of time for various reasons, but really, we think that continuing that medication ahead of time is really important to control the inflammation.
One of the other things that's really important for us and for our patients is to know what to expect after surgery, so we go through a lot of their post-operative care, actually, before the surgery to make sure they know how to rinse their nose out with salt water, take their medications, and make sure that, actually, even their medication prescriptions that they're going to need after surgery, we try to get those filled ahead of surgery so it's one less thing for them to worry about on the day of the surgery.

Interviewer: We've got a podcast, actually, that covers what to do and what you need to be aware about after surgery, so if you have any of those types of questions, not only check the information that you receive, but you could check out that podcast as well.
So are there any other considerations? It sounds like business as usual, take those medications. How far are you starting out in prep, a week before?

Dr. Orlandi: No, I think that again we're starting about a couple of weeks where we're continuing the medical therapy and then we may fine tune it within a few days prior to the surgery. But it is very similar to other surgeries where you're going to want to follow the instructions that you've been given as far as stopping eating or drinking, usually it's around midnight, sometimes a little later if your surgery is in the afternoon. Making sure someone can drive you. This is a surgery that's done typically under general anesthesia, meaning you're completely asleep. It can be done under local anesthesia if patients prefer. The vast majority prefer to be asleep, understandably.

Interviewer: Absolutely. That's a good consideration. You're going to have to have somebody to drive you home. How many days off of work should you take?

Dr. Orlandi: For sinus surgery, people typically take about a week, sometimes less, sometimes more, but on average about a week. Now if someone is having their septum corrected, the septum is the wall that runs down between the left and the right side of the nose, that septum, it's called a septoplasty to fix that. That septoplasty can actually be a little bit more painful. You're basically talking about kind of breaking the inside of the nose. Now, patients won't be black and blue after that on the outside, but it does cause a little bit more pain and sometimes patients will kind of lean more towards a 10-day time off work after that.

Interviewer: When I'm going in for my day of surgery I'm going to have somebody drive me. Hopefully I've already gotten my prescriptions. Do I need an overnight bag?

Dr. Orlandi: Nope, this is a surgery that's called an outpatient surgery. You come in and go home the same day. Sometimes patients will need to spend the night if they have another condition like sleep apnea or something like that, and that's discussed with the anesthesiologist, but most often this is something that's done in and out the same day, and when the patients do have to spend the night we make those plans ahead of time and so they know that.

Interviewer: For that person that's going to pick me up, can they just wait? Is it that quick of a procedure or should they go do something else?

Dr. Orlandi: It actually depends. There are four sinuses on either side and your surgeon may chose to operate on only one or all eight, so it really depends on the extent of the procedure. This is not a life-threatening surgery so people don't have to wait in vigil in the family waiting room. If they want to go and do something else, we'll call them ahead of time to come pick you up. That's certainly fine, too.

Interviewer: So it sounds like a question to ask and just something to be aware of.

Dr. Orlandi: Absolutely.

Interviewer: What other things do you tell your patients when it comes to preparing for the surgery?

Dr. Orlandi: You know, I think we've covered it. I think again that the most important point is to make sure you're comfortable with your decision. Don't feel rushed into this. This is something that you can take your time deciding on.

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