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Patient Information

Sleep Apnea Surgery

Before Surgery

The evaluation begins in the office with a medical history and physical exam, as well as looking at the results of the previous sleep study you had done prior to this appointment.

If Dr. Hoff considers you to be an appropriate candidate for surgery, you may undergo another examination called a sleep endoscopy. This is an exam that allows Dr. Hoff to look at your airway from the inside, while you are sleeping. This examination will help with planning for your surgical procedure. After this a date can be set for your surgery.

The type of surgery you will be scheduled for will use the DaVinci Robot©, operated by Dr. Hoff, to go through the mouth and to remove sites of obstruction that make it difficult to breath during sleep.

After Surgery

After surgery most patients stay in the hospital for 1-2 days. Typically the first night is spent in the surgical intensive care unit (SICU), so the nurses can closely watch your breathing. After one night in the SICU, patients either are allowed to go home or transfer to another hospital bed, before going home in the next day or so.

Recovery can be slow.

  • It may take 2-3 weeks to return to your usual level of energy.
  • If your job is strenuous, you may consider taking off 3 weeks.
  • It is important to rest and only do quiet activities for about 10 days, as too much activity can cause bleeding.
  • You may resume normal physical activity and non-contact sports after 14 days.
  • Contact sports and high-intensity activities can start again 3-5 weeks after surgery.
  • No traveling for 2 weeks after surgery.

After surgery a nurse will visit your home and assist with care and monitoring your progress. Home Care has been set up for you with St Joseph Mercy Home Care. If you have a home care agency you prefer, please let us know.

What should I eat and drink after surgery?

Swelling and pain in your throat after your surgery are common. However, if you have difficulty breathing or speaking, contact Dr. Hoff’s office immediately or call 911.

Recommended diet after surgery includes:

  • Mainly liquids for the first 2 weeks. Start with small, frequent sips. Initially, thicker liquids (nectars, thick shakes) may be tolerated better than thin liquids.
  • After two weeks you may try more solid food. However, there will be discomfort with eating and it can be better to avoid foods with rough edges (e.g. crackers, chips, bran cereals) for an additional two weeks.
  • Room-temperature or cold liquids (e.g. ice cream, applesauce) typically cause less pain.
  • Avoid the use of straws for the first two weeks.

Dehydration (not drinking enough fluids) is a common problem after surgery

  • Goal is to drink 8 cups or 64 ounces of liquids per day.
  • A way to tell if you are drinking enough is to watch how many times a day you urinate. The goal is once every 2-3 hours, and to pass pale yellow urine.
  • Signs of dehydration include:
    • Dark urine
    • Excessive thirst
    • Dizziness or room-spinning when you stand up quickly

Additional tips for the first week

  • The more you swallow and chew the faster you get better.
    • Chew gum as much as you can tolerate during the first week.

Expect that there will be pain, and that it will be get better with the pain medication, time, and the more you chew and use the muscles in your face and mouth.

Food ideas

  • You can expect to lose weight following surgery because you cannot eat as well.
  • It is important to focus on liquids that have calories and protein, these include:
    • Milk & Greek yogurt
    • Creamed soups
    • Nutritional supplements: Ensure®, Boost® or Carnation Instant Breakfast®
    • Smoothies and shakes
    • To increase calories you can:
      • Use whole milk
      • Add butter or margarine to foods
      • Add dry milk powder to milk and soups
      • Add ice cream / frozen yogurt to Ensure®, Boost®, Carnation Instant Breakfast®
  • You can also put regular food in the blender: (Always clean the blender well after each use.)
    • Fruits + fruit juice
    • Meats, fish, poultry + broths, water, or milk
    • Vegetables + water, broths, cream

Click here to view Patient Pathway for Sleep Apnea Surgery.

Smoothie and Shake Recipes

Peanut Butter Smoothie
1 frozen banana cut up
1 cup milk
¼ cup peanut butter
1 tsp cinnamon
Cherry Cheesecake Smoothie
½ cup frozen cherries
¼ cup cottage cheese
¼ cup milk
1 cup vanilla frozen yogurt
Chocolate Delight
1 cup milk
½ cup chocolate frozen yogurt
4 ounces soft tofu
2 TBL protein powder
Nutmeg Smoothie
1 cup milk
1 banana
2 TBL protein powder
1 tsp ground nutmeg
Chocolate Peanut Butter Shake
1 cup milk
1 cup vanilla frozen yogurt
1 TBL chocolate sauce
2 TBL protein powder
2 TBL peanut butter
Orange Sherbet Cup
½ cup milk
½ cup orange sherbet
¼ cup vanilla frozen yogurt
¼ tsp vanilla extract 1 TBL protein powder

Pain Expectations and Management
What to expect

Altered taste is common after surgery and typically recovers over several weeks to months. Some patients describe a bitter or metallic taste. Difficulty swallowing (due to pain) is normal during the first 2 weeks after surgery and gradually resolves in 3-4 weeks. Pain is managed with a variety of liquid pain medications. Some patients may experience a persistent foreign body sensation(like a popcorn kernel) that can persist for months; this is scar tissue and takes time to soften.

  • You may have a significant amount of throat pain after surgery
  • You may also have ear pain, which is common 5-6 days after your procedure. This does NOT mean you have an ear infection!
  • Pain will gradually improve, but it may hurt to yawn for a month or longer

Pain management is important and will allow you to eat and drink more comfortably.

  • What you may be given for pain:
    • Oxycodone liquid -take by mouth every four hours as needed for severe pain
    • Tylenol liquid - take by mouth every six hours while awake
    • Gabapentin tablet - take by mouth every eight hours
  • Other medications you may be prescribed:
    • Viscous lidocaine - swish and swallow every four hours as needed to numb the throat/esophagus
    • Try to use 10-15 minutes before eating/drinking/taking other medicine to make the process more tolerable
    • Nystatin suspension - take by mouth four times daily
    • Prednisolone - take by mouth every day for one week
  • Medications like Oxycodone have several common side effects; the most common of which are nausea and constipation.
    • Ondansetron - take one tablet under tongue every six hours as needed for nausea
    • Miralax - take 17 g powder by mouth every day

Click here for a Patient Intake Log.

Avoid

Non-steroidal anti-inflammatory agents which can thin blood and may increase your risk of bleeding.

  • Common examples include:
    • Aspirin, Ibuprofen (Motrin, Advil), Naproxen (Aleve)
    • Check with Dr. Hoff’s office before taking anything for pain other than what you were prescribed after surgery

Incision Expectations and Care

After surgery a gray or white thin film, called a membrane, will form on your tonsils and palate. This membrane will later turn red in color. This is normal and part of the healing process.

A scab will form at the site where surgery was performed. This scab will fall off one to two weeks after surgery. If there is bleeding when the scab falls off, gargle with a solution made of equal parts peroxide and water, or use ice water. This is easiest to do reclined in bed with your head elevated. If the bleeding lasts for longer than 15 minutes please go to the emergency room.

Altered taste

Up to 25% of patients will have a temporary change in taste. some describe a bitter or metallic taste. Some describe numbness of the tongue. These symptoms typically resolve quickly. Tongue numbness is the result of pressure on the tongue during surgery and resolves in a few days typically. Metallic or bitter taste is less predictable but is rarely a long term problem. However there are 2-5% of people who notice long term taste disturbance and is likely due to trauma to small branches of the glossopharyngeal nerve as is passes in to the back of the tongue.