Robert C. Wright, M.D., P.S.
MERIDIAN SURGERY CENTER
POST-OPERATIVE INSTRUCTIONS FOR LAPAROSCOPIC HILL PROCEDURE FOR HIATAL HERNIA REPAIR:
** Follow any instructions Dr. Wright may have given you in addition to the following:
1. DIET: Slowly start with clear liquids (tea, apple juice) then gradually add in foods from the PHASE I DIET (attached) for at least one week. Once you are comfortable with PHASE I, then progress to Phase 2 DIET. Break gas swallowing habits by drinking from a glass, fill mouth then swallow. DO NOT use a straw. Stop swallowing habits such as gum chewing, sucking on hard candy, chewing tobacco, sipping coffee all day, etc.
2. CAUTION: Do not rush into the next phase. Doing so prematurely can cause choking, pain and/or delay healing. If you have the sensation of food “getting stuck” this indicates food progression should be delayed until the sensation goes away. NO carbonated beverages in Phase 1 or 2.
3. Eat smaller, frequent meals. Take smaller bites and chew food thoroughly. It is not uncommon to feel bloated and discomfort from gas buildup because you may not be able to burp. This is why it’s important to break old swallowing habits to reduce air/gas build up. You may also find it necessary to avoid gas-producing foods for a while until your healing process is completed (4-6 weeks).
4. Nausea can be caused from eating too much, too fast, too much air in the stomach, or from the narcotic pain medication. If you are nauseated, you need to take the prescribed anti-nausea medication as directed. Throwing up will cause damage to your repair. Eat smaller amounts and chew food well.
5. FOR YOUR SAFETY A RESPONSIBLE ADULT MUST DRIVE YOU HOME AND STAY WITH YOU FOR 24 HOURS FOLLOWING YOUR SURGERY.
6. For at least 24 hours or while taking pain medicine do not drive a motor vehicle or any dangerous machinery, do not drink any alcohol or make any important decisions as your judgment will be impaired.
7. Call Dr. Wright at (253) 840-1999 if you have:
A. Fever (greater than 101 degrees orally)
B. Excessive dizziness should be reported immediately.
C. Shortness of breath, chest pain or extreme pain in calf/calves (Call 911)
D. Continued nausea and/or vomiting not relieved by the prescribed medication.
E. Excessive bleeding at surgical site. Very slight bleeding is ok.
F. Severe pain unresponsive to the prescribed pain medicine.
G. Rash/Hives/Itching – stop prescribed medication, take Benadryl immediately and call the office. If you can’t breathe or swallow call 911.
H. Changes in the wound appearance: Increased redness, swelling, warm to touch, or any unusual drainage (yellow, foul-smelling).
8. If you have a problem and cannot reach your doctor or the doctor on call, go to the emergency room, or call 911 for any life threatening emergencies.
9. Dr. Wright can continue your care at St. Clare Hospital Emergency Room, Lakewood, WA – (253) 985-8700
10. SPECIAL INSTRUCTIONS & WOUND CARE:
A. No Aspirin or Ibuprofen products for one week; Tylenol is okay if not taking prescription pain medication containing acetaminophen.
B. Minimal activity for 2-3 days. Walking around the house is strongly encouraged.
C. Remove the outer band-aids in 24 hours and shower using a mild soap, pat skin dry. Leave the steri-strips on until they fall off (usually a week). No soaking in a bathtub, hot tub, pool, lake/river for 2 weeks. Do not use any antibiotic ointment, creams or hydrogen peroxide on incision unless directed by Surgeon. Use a regular band-aid(s) and change once a day or as needed if it becomes soiled. If the steri-strips are causing blisters, remove them and use a regular band-aid to protect the wound.
D. Use prune juice, Miralax, “Smooth Move” tea and Milk of Magnesia until bowel movements are normal.
E. Do not lift more than 15 pounds until approved by your doctor. After laparoscopic surgery, most people can go back to work or their normal routine in about 1 to 2 weeks, depending on their work.
F. It’s not uncommon to feel sharp pain or pressure in your upper shoulder(s) or between your shoulder blades. This pain is related to sutures in the diaphragm placed during your laparoscopic surgery. We recommend you sit up . Lying flat makes it worse. Hiccups are another common sign of diaphragm irritation. This will resolve itself in time.
G. If upper abdominal gas pain can not be relieved because you can’t burp, lay on your LEFT side for 10 minutes to allow gas to leave the stomach.
H. If you have not had a BM in 2-3 days and are getting abdominal bloating, nausea and increasing pain, it’s best to take a Ducolax suppository or Fleets enema to stimulate a BM. These can be purchased over-the-counter.
11. Supplies taken home:
12. Your Post-op Appointment has been schedule for
13. You should expect a call within the next day or two from our nursing staff to check on your progress. If you have a problem, contact Dr. Wright before going to the emergency room.
ESCORT SIGNATURE Date ______
R.N. Time ______am / pm
1703 SOUTH MERIDIAN, SUITE 304 PUYALLUP, WA 98371 253-840-1999
REVISED 1/08 MLH