Without a doubt, sinus infections can recur. As mentioned earlier, surgery does not change the way you respond to the environment. At best, your sinuses will be near normal. Patients with significant sinus disease can expect that they will continue to get milder sinus infections, usually
less frequently. At worst, nasal polyps can continue to grow to where you may still need considerable medical care, chronic care debridement,
and possibly revision surgery. When your sinus symptoms flare, you need to address it immediately by seeing your surgeon, so that infection can be removed, along with any recurrent polyps. Your surgeon can decide if you require more medicines than you are taking for maintenance care. No matter where you fall on the spectrum, it is imperative for you to take good care of your sinuses so that they continue to stay healthy.
I often hear my patients complain: “I thought that after my sinus surgery I was never going to need any medicines.” As I’ve already highlighted, this is simply not true. Your surgery does not change the fact that you suffer from chronic sinusitis, and the reason that they call it chronic is because it is ongoing and you are stuck with it. In good hands, surgery can make a world of difference, but if you still smoke, are around noxious chemicals, or live or work in a mold-infested environment, then you are going to suffer significantly. Remember, surgery is an adjunct to medicines. To best take care of your sinuses after surgery, you should do the following:
1. Sniff sterile saline water via spray (i. e., Ayr, Goldberger’s) and spit out clots as often as possible. The more you wash the nasal cavity with saline, the cleaner it will be. Try to use one entire large bottle for the first 4 days (one 25 ml bottle each day), then Vz bottle each day for the next 4 weeks (approximately 12.5 ml). After the 4th week, I usually have my patients start irrigating their sinuses daily with a neti pot or a nasal irrigation apparatus using sterile normal saline or other preparation.
2. Do not take a bath for at least 1 week. A hot bath may cause your blood vessels to dilate, which can cause you to bleed internally into your nose and sinuses.
3. Take care of your environment. Follow the instructions in the allergy and mold categorys for keeping your house clean and irritant free.
4. Stay away from spicy foods for at least 1 week.
5. Do not do any heavy lifting and refrain from any strenuous activity that may raise your blood pressure for approximately 1 month. This will cause the raw surfaces of your nose to bleed
internally and will generally increase the time it takes to heal. This includes exercising, jogging, lifting, speed walking and long walks, and working out in the gym.
6. No nose blowing for a month. The walls between your eyes, your brain, and your sinuses have been weakened temporarily, and if you create pressure by blowing your nose, you can cause air to be forced into your brain and/or your eye and this can be potentially dangerous. If you feel extremely congested, run hot water in the shower and breathe in the steam and shower water.
7. Sneeze and cough only with an open mouth for 1 month.
8. Gargle with 8 ounces of water mixed with teaspoon of salt 2-3 times per day for 2 days.
9. Stay away from smoke-filled rooms, fireplaces, and cigarettes.
10. No ocean swimming for 1 month; no pool swimming for 2 months. No diving below the water (either scuba or off a diving board) for about 3 months.
11. You must take all your medicines. One of the biggest reasons for failure of surgery is improper use of medication. I typically have my patients take their antibiotics for 1-3 months after surgery. No matter how long your surgeon keeps you on antibiotics after surgery, you should not skip any doses or stop until you are told to do so by your surgeon. If you run out, you should refill your prescription.
12. You can take Tylenol with codeine or regular Tylenol for pain, if necessary. Stay away from aspirin or aspirin-containing compounds. Approximately 1 week after surgery, restart your nasal steroid spray. If you are taking allergy shots, you should continue with your shots after surgery and not take a break as this may interfere with their success. Any asthma, high blood pressure, or other medicines should be taken as prescribed by your other physicians immediately after surgery.
13. If you were placed on oral steroid tablets around the time of surgery, it is important for you to take them because they will reduce swelling, reduce postoperative pain/discomfort and generally allow you to heal more quickly. These small tablets are
best taken all at once in the morning as they will also usually give you a little extra energy and may make you a little restless at night if you take them in the evening.
14. Sleep on two pillows to elevate your head for at least the next month.
15. If surgery occurs during the winter months, use a humidifier until spring.
16. Continue eating a well-balanced diet and avoid those foods and beverages that upset your sinuses.