Dr. Shah obtained his BA/MD from Boston University and completed his Otolaryngology residency at Tufts University followed by a fellowship in Pediatric Otolaryngology at Children's Hospital Boston at Harvard University. After fellowship, he joined the faculty of Children's National Medical Center in 2006. Dr. Shah is an active clinical researcher and has received numerous awards for his research.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
It is important that patients know precisely what time they are to check-in
with the surgical facility, and that they allow sufficient preparation time.
Bring all papers and forms, including any preoperative orders and history
sheets.
Patients should wear comfortable loose fitting clothes which do not have to
be pulled over their head. Leave all jewelry and valuables at home, including
ear rings, watches, rings, etc. Remove all make-up with a cleansing cream.
Patients should thoroughly wash their face with soap and water. Do not apply
make-up or cream to the face. If possible, avoid using hair clips or other
materials to hold up hair.
Do not take any medication unless instructed by the doctor or the
anesthesiologist. Usually, in the pre-operative holding room, a nurse will start
an intravenous infusion line (IV) and the patient may be given a medication to
help them relax.
What happens during sinus surgery?
In the operating room, the anesthesiologist will usually use a mixture of a
gas and an intravenous medication to put the patient to sleep and to maintain
anesthesia at a safe and comfortable level. During the procedure, the patient
will be continuously monitored. The surgical team is prepared for any emergency.
In addition to the surgeon and the anesthesiologist, there will be a nurse and a
surgical technician in the room. The whole procedure usually takes several
hours. The surgeon will come to the waiting room to talk with any family or
friends once the patient is safely in the recovery room.
What happens after sinus surgery?
After surgery, the patient will be taken to the recovery room where a nurse
will monitor the patients vital signs. Usually, patients will be able to go home
the same day as the surgery once they have fully recovered from the anesthetic.
This usually takes several hours. Patients will need a friend or family member
to pick them up from the surgical facility. Someone (a responsible adult)
should spend the first night after surgery with the patient in case any
post-surgical problems develop.
On arrival at home from the surgical facility, the patient should go to bed
and rest with their head elevated on two to three pillows. By keeping the head elevated
above the heart, edema and swelling from the sinus surgery can be minimized.
Patients may get out of bed with assistance to use the bathroom but should avoid
straining with bowel movements because this may cause some surgical site
bleeding. If the person is constipated, they should take a stool softener or a
gentle laxative.
Some patients may have noticeable swelling of the nose, upper lip, cheeks, or
around the eyes for several days after surgery. This swelling is normal and will
gradually go away. People can help reduce it by putting an ice-pack on the face,
bridge of the nose, and eyes as much as tolerated. This will also help with
postoperative edema and pain. Some patients have found frozen vegetables in
packages (for example bags of frozen peas) to be a convenient ice pack which
nicely conforms to the face. The frozen material should be separated from the
skin by a towel or similar barrier to avoid any skin damage. Many clinicians
suggest periods of 15 minutes of such ice-pack treatment followed by 15 minutes
of removal to not damage the skin.
Moderate bleeding from the nose is normal, and will gradually decrease. The
gauze dressing ("mustache dressing") will collect blood and should be changed as
needed. It is not unusual to change these dressings every hour during the first
24 hours after surgery. It is recommended to purchase gauze pads prior to
surgery so that the patient will have enough for dressing changes. After a few days
the patient will probably not need to use the
dressing any longer. Do not take aspirin, aspirin-containing medications, or
nonsteroidal anti-inflammatory medications (such as ibuprofen/Advil, Naprosyn,
and others) for as long as your surgeon has instructed following surgery,
because such medicine may increase bleeding and slow clotting at the surgical
site.
It is best to eat a light, soft, and cool diet as tolerated once the patient
has recovered fully from the anesthetic. Avoid hot liquids for several days.
Even though people may be hungry immediately after surgery, it is best to go
slowly to prevent postoperative nausea and vomiting. Occasionally, patients may
vomit one or two times immediately after surgery. If vomiting persists, please
contact the surgeon; the doctor may prescribe medication to reduce or eliminate
vomiting. It is important to remember that a good overall diet with ample rest
promotes healing.
Patients may be prescribed antibiotics after surgery, and should finish all
the pills that have been ordered. Some form of a narcotic may also be prescribed
and is to be taken as needed for pain. If the patient requires narcotics, they
should not drive and should consider having a responsible person stay with them.
In some situations the doctor may give steroids to be taken either
preoperatively and/or postoperatively. It is very important that the take this
medication as prescribed, and not discontinue it prematurely. The steroids are
instrumental in facilitating proper healing. If patients have any questions or
they feel that they are developing a reaction to any of these medications he or
she should consult their doctor immediately. Patients should not take any
other medication, either prescribed or over-the-counter, unless they have
discussed it with the doctor.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Allergic rhinitis symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) is usually caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year–round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependant upon the type of rhinitis condition.
The common cold (viral upper respiratory tract infection) is a contagious illness that may be caused by various viruses. Symptoms include a stuffy nose, headache, cough, sore throat, and maybe a fever. Antibiotics have no effect upon the common cold, and there is no evidence that zinc and vitamin C are effective treatments.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Sinus headache is caused by a sinus infection or inflammation of the sinus cavities. The primary symptom of a sinus infection is pain and increasing pressure overlying the area and associated tenderness to the touch. Treatment of a sinus headache depends on the cause.
A deviate septum is a condition in which the bone and cartilage that divide the nasal cavity of the nose in half (nasal septum) is significantly off center or crooked. The causes of a deviated septum can be congenital, or develop after a trauma or injury to the nose. Symptoms of a deviated septum include nasal congestion, recurrent sinus infections, nosebleeds, headache, facial pain, postnasal drip, snoring, and loud breathing. A deviated septum can be relieved with medications, and if necessary surgery, called a septoplasty.
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