Patient Information / Allergy Patient Information
Mendy Maccabee, MD performs Uvulopalatopharyngoplasty (UPPP) to surgically trim off excess, loose or floppy tissue along the lower part of the soft palate with general anesthesia. If the tonsils have not previously been removed, a tonsillectomy also done as a standard part of the procedure. The uvula is partially or completely removed. The configuration or appearance of the palate after healing is usually quite different since there is no longer a uvula hanging down the center, but rather, there is a generally a smooth curved arc across the palate, and it appears significantly shorter. This surgery on average reduces the frequency of sleep apnea episodes in half, but you will likely still end up needing CPAP after surgery, although typically at a lower and more comfortable pressure. A sleep study is done around 3-6 months after surgery to check this.
No aspirin, Motrin, Ibuprofen, Advil, or any other anti-inflammatory medicine for one week before and one week after surgery. Also avoid Vitamin E, herbal supplements, herbal teas, and red wine for one week prior to surgery. Tylenol is permitted at any time. If you take Coumadin or other blood thinners please discuss this with your surgeon. Please do not eat or drink anything after midnight the night before surgery, but you may take any prescription medicines the morning of surgery with a sip of water and you may brush your teeth. The hospital or surgical center will call you the day before with time and instructions for surgery. Make arrangements for a ride home after surgery. You will not be able to drive yourself home from the hospital after surgery.
You will experience a moderate to severe pain level for the first few days after surgery. Pain is usually the worst on the third or fourth day after the surgery. Pain, especially with swallowing, may last from 10 days to 3 weeks after surgery. Ear pain is common after surgery because one of the nerves to the ear passes near the tonsil area. It does not mean you have an ear infection. Pain medication will be prescribed to you and should be taken as directed. We typically give liquid Lortab and/or Vicodin pills. The pills may be crushed to make it easier to swallow them.
You may also be given a prescription for steroid pills to help reduce the swelling in the throat and palate area. The liquid pain medication may burn in the back of your throat when you take it. This is normal and short lived.
A small amount of blood-stained mucous or saliva is common in the first week. However, if bleeding is prolonged or recurrent, come to the office during business hours, or go to the nearest E.R. Call us immediately at 509-637-2810 to let us know you are on your way. Gargling ice water may slow the bleeding.
Be sure to drink plenty of liquids. Cool, clear liquids (water, Gatorade, clear juices) are best, and you should keep a glass or bottle with you all the time while you are awake. Jello and popsicles are good to eat after the surgery. Avoiding dehydration is important to speed recovery, reduce the pain, and reduce the risk of bleeding. Generally, you should start with soft foods and advance your diet as tolerated. Because of the new shape of your throat, you may notice some food or liquid will back up into your nose.
When lying in bed, keep your head and shoulders elevated above your hips, as this will help to reduce swelling and discomfort.
You may notice a change in the sound of your voice. After a few days or weeks, when your muscles have learned to adapt, this should resolve.
After several days you can gradually return to limited activities in your home. You should plan on about two weeks out from school or work. No heavy lifting or strenuous activity for 2-3 weeks also.
Excessive bleeding. Dehydration—If the patient has taken little or no fluids by mouth for 12 hours or has not urinated for 8 or more hours, they need to go the hospital for I.V. fluids. Fever—Temperatures greater than 101.5. Any difficulty breathing.
Bleeding—please do not take aspirin or Motrin (Advil or Ibuprofen) for one week before or one week after surgery. Infection . Nausea/Upset stomach. Airway Blockage—difficulty breathing, you may be kept in the hospital overnight to watch for this. Pain. Dehydration o Nasopharyngeal stenosis—scarring that may lead to nasal obstruction. Velopharyngeal insufficiency—regurgitation of liquids/solids through your nose and a nasal sounding voice. Change in taste or sensation in the tongue, which usually resolves in several weeks. Inability to improve sleep apnea– Even when patients are carefully screened for this surgery, we expect that you will still have some degree of obstructive sleep apnea after surgery. You will very likely need CPAP or further procedures. This is not meant to be a cure for your sleep apnea but rather to make your use of CPAP more comfortable to use and better tolerated.
Some patients note a dry feeling in the back of the mouth, and the swallow may feel “forced” or more difficult. This usually improves, but may be permanent. Reaction to anesthesia or medications given during the surgery.
Additional Patient Instructions
DO NOT drive, make important decisions, use power tools, drink alcohol, tend children, or climb ladders for the first day or two after surgery. Your judgment or alertness is probably seriously impaired. • Fainting or lightheadedness may occur. Use caution and move slowly when getting up from a bed or chair. • Avoid strenuous activities or lifting any object heavier than 20 pounds for the next 2-3 weeks. Avoid bending at the waist as much as possible. These may contribute to bleeding. • Call our office with any questions or concerns. • In case of emergency go to the nearest Emergency Room or call 911.
FOLLOW UP APPOINTMENTS ARE IMPORTANT
Please schedule your follow up appointment for two weeks from your surgery. This is usually done at the time of your surgery scheduling or at your pre-operative appointment. If it was not please call to schedule or have them schedule when you are in the hospital recovering from your surgery.
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