Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
After surgery,
the patient will be taken to the recovery
room
where a nurse will monitor them. Relatives are generally invited
into the recovery room as the patient becomes aware of their
surroundings, and if the patient is a child, they will be looking for his or her
parent(s) or caregiver. The patient, 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. The patient will need
a friend
or family member to pick them up from the surgical facility to
take them
home. A relative, caregiver, or friend should spend the first night after surgery with
the patient.
When the patient arrives home from the surgical facility, they
should go to bed and rest with the head elevated on 2-3
pillows. Keeping the head elevated above the heart minimizes
edema and
swelling. Applying an ice pack to the neck may help decrease
swelling.
The patient may get out of bed with assistance to use
the
bathroom. Visitors should be kept to a minimum since they may
unknowingly
expose the patient to infection, or cause over excitement. If the patient
is
constipated, avoid straining and take a stool softener or a gentle laxative.
Once the patient has recovered from the anesthetic, if tolerable, a light, soft, and
cool diet
is recommended.
Avoid hot liquids for several days. Even though the patient may be
hungry
immediately after surgery, it is best to feed slowly to prevent
postoperative nausea and vomiting. Occasionally,
the patient may vomit
one or two
times immediately after surgery. However, if it persists, the
doctor may
prescribe medications to settle the stomach. It is important to
remember
that a good overall diet with ample rest promotes healing.
Weight loss is
very common following a tonsillectomy. The patient need not worry about
nutritional requirements during the recovery so long as they are drinking adequate amounts of fluid.
The patient may be prescribed antibiotics after
surgery. The patient should take all of the antibiotics prescribed by the
doctor. Some form
of a
narcotic will also be prescribed (usually acetaminophen/Tylenol
with codeine), and is to be taken as needed. If
the patient requires
narcotics he or she is
cautioned not to drive. If the patient has nausea or vomiting
postoperatively,
the patient may be prescribed anti-emesis medications
such as promethazine
(Phenergan) or ondansetron
(Zofran). If the patient or caregivers have any questions or feel the
patient is
developing a reaction to any of these medications, a doctor should
be consulted. Patients should not take or give any other medications,
either
prescribed or over-the-counter, unless they have been discussed them
the
doctor.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Strep throat is a sore throat caused by a bacterium called streptococcus (strep) that can be treated through antibiotics. Common symptoms of strep throat include pinkeye, runny nose, skin rash, cough, hoarseness, diarrhea and more. Complications of untreated strep throat include middle ear infections, meningitis, pneumonia, rheumatic fever, and more.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Sleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
It is thought that the tonsils and adenoids assist the body in fighting incoming bacteria and viruses by helping the body form antibodies. This is thought to be important only during the first year of life. Acute tonsillitis, strep throat, mononucleosis (mono), chronic tonsillitis, peritonsillar abscess, and hypertrophic tonsils and adenoids are all common problems involving the tonsils and adenoids. Treatment of tonsillitis and adenoids include antibiotics and other medications depending on the cause. In some cases, a tonsillectomy or adenoidectomy (the removal of the tonsils or adenoids) may be necessary.
Nausea and vomiting are symptoms that may be caused by many conditions. Antiemetics are drugs that treat nausea and vomiting. Though some antiemetics for motion sickness and mild nausea are available over the counter (OTC), most require a medical evaluation and prescription.
Bad breath can result from poor oral hygien habits and may be a sign of other health problems. Bad breath, also called halitosis, can be made worse by the types of food you eat and other unhealthy lifestyle habits.
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