THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 11, Number 3, 2005, pp. 549–559 © Mary Ann Liebert, Inc. PARADIGMS Generalized Entanglement: A New Theoretical Model for Understanding the Effects of Complementary ABSTRACT Background and problem: A main problem for the acceptance of many methods belonging to the broad spectrum of complementary and alternative medicine (
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Microsoft word - tonsillectomy.docTONSILLECTOMY WITH OR WITHOUT ADENOIDECTOMY
• Plan on arriving 90 minutes prior to your surgery time.
• Adults must have nothing to eat or drink after midnight the night prior to your surgery. Infant
and toddlers may take clear liquids up to 6 hours before the procedure. Avoid taking aspirin,
ibuprofen (Advil, Motrin) or products that contain these medications within 7 days of the procedure.
This decreases the chance of bleeding problems during and after surgery.
• If you are having surgery at Lutheran Medical Center, you must be pre-admitted. If you have not been contacted by the hospital before the night prior to surgery, please call (303) 467-8735 to pre-admit. • If you desire, please call the office with a pharmacy phone number so we may call in your postoperative prescriptions. Please notify the office if you have any sensitivities or side effects with a particular narcotic pain medicine. POSTOPERATIVE INSTRUCTIONS
What to expect
• Recovery from the pain of tonsillectomy may take anywhere form 7-14 days. Plan on 7 days off from school or work. Adenoidectomy alone usually requires only a 2-3 day recovery. • Ear pain is extremely common, usually several days after surgery. Pain is referred from the throat to • For adenoidectomy alone, the only complaint may be stiff neck, neck pain, or a feeling like a cold. • After surgery, there will be two large white patches where the tonsils were. These are the scabs and are a normal part of the healing process. This is not infection. • It is very normal for the uvula (between the tonsils) to swell to a large size after tonsillectomy for a few days (sometimes as big as your thumb). Cold fluids or foods can help. • A low-grade fever to 1010F is normal for a few days. • There will be a foul odor to the breath until the scabs dissolve. • It is not unusual to experience the worst pain 2-7 days after the surgery. The pain may improve and then get worse on these days. Do not be alarmed. Postoperative management
• You may eat or drink anything you like at any temperature that is comfortable. Trial and error and common sense should be your guides. Most important is staying well hydrated, especially for infants and kids. You must force yourself to drink. • Adult pain control: you will be given a prescription for narcotic pain medicine. Start with a small dose to test your body’s reaction, and then increase up to the prescribed doses if tolerated. Plain Tylenol
may also be used, but remember that the prescription medicine also contains Tylenol. To help drink
and get the medicine in, one could try a throat lozenge or Chloroseptic spray. This will burn initially,
then, when the throat is numb, swallowing will feel funny for about 15-30 minutes. Avoid ibuprofen,
since it may increase the risk of bleeding.
• Children pain control: Generally the same as adults. You could try liquid Tylenol alone first. The addition of liquid Benadryl to the Tylenol can also be effective and sedating. Avoid ibuprofen, since it may increase the risk of bleeding. • Activity may increase as tolerated. It is normal to have reduced endurance for 2-4 weeks after the • Your doctor may prescribe other medicines to help in the postoperative period. • Other helpful hints patients have shared are small, frequent sips of water and ice around the neck.
When you should contact us
• Bleeding that is more than blood-tinged saliva is unusual. If the patient is spitting blood or clots for more than 5 minutes, call the office or the doctor on call at (303) 487-0834 day or night. When bleeding occurs, it is usually either the day of the procedure or one week after. • Call for a sustained fever (6-8 hours) greater than 1010F or more. Again, fever less than this is common, and is usually helped by drinking more fluids. • Dehydration is more common in children than adults. If a child is refusing to drink for a day, becoming lethargic, not urinating 3-4 times a day, or nauseated, he/she may be dehydrated. This will usually require an ER visit for IV hydration, but contact the doctor for advice. • Before or after surgery, call us to arrange for a brief postoperative office visit 2-4 weeks after surgery. • Should any other question arise pertaining to your care or comfort, please call our office.
The levonorgestrel intra-uterine system: Therapeutic application in family planning Lucia Margaret Dolan , MB BCh, MRCGP, MRCOG, Specialist Registrar Obstetrics and Gynaecology ; Margaret Mulholland , MB BCh, BAO, MFFP, Family Planning Officer ; John Price , MD, FRCOG, Consultant Obstetrician/Gynaecologist, Belfast City Hospital, Belfast, Northern Ireland. Institution: Ulster Commun