The quantity and quality of pain experienced after surgery is often a result of the nature of the surgery and the threshold of the patient.
We often tell the patient to expect 3-5 days of soreness. In approximately one week, the patient will undergo suture removal. Some procedures take 2-3 weeks for the patients to feel like themselves again. Extraction sites can take weeks, even months, to close- which is why a monojet ("squirt gun") syringe is given.
In most cases, start taking the prescribed medications after the procedure with food (i.e. applesauce). It is important to take your medications on a full stomach, regardless of what the label says.
If you have I.V. Sedation/General Anesthesia you may be given an antibiotic, pain killers, and anti-swell medication during your procedure. (You can ask the assistant in the recovery room after your surgery.) Therefore, you will start these medications six hours later. Advil or Tylenol may be given to you before you leave. When you get home after you have something to eat, you can take the prescribed pain reliever, if needed. It is best to take it sooner rather than later.
If you have not been given any medications during the surgery, start your antibiotic, pain reliever, and anti-swell medication when you get home and after you have eaten. You may space these out 15-30 minutes apart to avoid nausea.
Antibiotics: Penicillin (Pen VK, Veetids), Amoxicillin, Augmentin, Keflex, Cipro or Cleocin (Clindamycin). This medication is to prevent infection. If you are allergic to Penicillin, you will be given Cleocin, which is not in the Penicillin family. These are to be taken after every procedure, four times a day, until finished. All antibiotics have one refill. You will be instructed to take the refill at the post-op appointment as needed. Implant cases, some bone graft cases, and sinus lift cases will usually continue antibiotics for up to two weeks. Severe infections may require double or triple antibiotic therapy: (Keflex/Flagyl/Cleocin; Cleocin/Flagyl; Augmentin/Keflex/Flagyl). If Flagyl (Metronidazole) is given, do not drink alcoholic beverages.
Anti-swell mediation: Medrol (methylprednisone). This is taken on a full stomach to prevent swelling. If you are diabetic, you may not be given this prescription because it may slightly elevate blood sugar. If your blood sugars are under control, you may be able to take the Medrol (please consult your physician for guidance), or you may adjust your insulin level. You would take all six pills on the ENTIRE top row, all together at once on the first day. Starting the second day, follow instructions in the packet (one before breakfast, etc.) until the prescription is finished. Flushing of the skin is a common side effect. Children are instructed to take ½ the dosage- i.e. 3 tabs instead of 6 as a loading dose, etc. These may be crushed and placed in applesauce, as they don’t come in liquid form.
Pain Reliever: Non-Steroidal type (NSAIDS=non-steroidal anti-inflammatory drugs). Usually you will be prescribed Dolobid (Diflunisal) to be taken on a full stomach. This Motrin-type pain reliever works on the sight of pain. This acts like aspirin. If you have an adverse response to aspirin, due to stomach ulcers or an allergy, you may not be given this prescription. Take two tablets as a loading dose, then one tablet every 8 hours. Sometimes it is best to take this for the first one to three days to block pain mediators, whether you think you need it or not. Remember: D=Daytime=Dolobid=Diflunisal.
Pain Reliever: Narcotic type. Usually you will be prescribed Norco, Vicodin (Hydrocodone/Oxycodone), or Maxidone. These pain relievers work on your brain sensors to block the pain. We suggest that you take this at bedtime, since it can make you nauseous and drowsy. If you have an adverse response to codeine, you may not be given this prescription. However, some medications have synthetic codeine and you may still be able to take this prescription. You cannot drink, operate machinery, or drive while taking this medication. Narcotics are optional and needn’t be taken unless pain is severe, to help you sleep. It may be taken in conjunction with the NSAIDS, i.e. Dolobid, Motrin, Advil, etc.
SUMMARY: D=DOLOBID=DIFLUNISAL=DAYTIME PAIN CONTROL AND N=NORCO=NARCOTIC=NIGHTTIME PAIN CONTROL!
All prescriptions are to be filled and started after the surgery unless otherwise suggested by Dr. Bryan Gulley. The antibiotics and anti-swell medications are to be taken until finished. As already mentioned, it is suggested that you take the non-steroidal (Diflunisal) pain relievers whether or not you have pain the first few days. This will help block the pain from starting.
Once there has been a lapse, it will take time for the NSAIDS to build up an effective level in your system again.
All medications should be taken on a FULL stomach. You may coat your stomach with Mylanta, Pepto Bismol or take Zantac, Pepsid, Axid, Prilosec, Prevacid, etc. as needed.
You may supplement your diet with lactobacillus, acidophilus, yogurt, or Bacld (prescription) to help restore your normal fiora (good bacteria) in your body.
IMPORTANT: IN THE EVENT THAT YOU EXPERIENCE VOMITING AND DIARRHEA, PLEASE FOLLOW THESE INSTRUCTIONS: Start with Bananas, bread without crust/not toasted, Gingerale and broth. If you are feeling better: Add Potatoes, Jello and Gatorade.
After 3 days: add apple juice. Coke syrup helps nausea or any upset stomach. IF YOU EXPERIENCE SEVERE COLITIS (DIARRHEA- i.e. more than 5 times per day) CALL OFFICE IMMEDIATELY and/or M.D. and we will give you a prescription to counteract the effects.
The M.D. may wish to see you to obtain a stool specimen to culture for C. dificil that could cause pseudomenbranone colitis.