Schedule: Monday - Friday - 8:00 AM - 4:30 PM
(508) 757-0330

Patient Instructions

Patient Instructions

Nosebleeds are often caused by injuring a blood vessel in the nose with Q-tips®, fingertips, vigorous nose blowing or injury to the nose. Carefully follow the instructions below and your nose should heal quickly.

  • Do not pick your nose or insert anything into it (handkerchief corners, Kleenex®, etc.)
  • Do not blow your nose unless specifically told to do so by your provider.
  • When you sneeze, sneeze with your mouth open.
  • No bending, stooping, straining, heavy lifting, housework or yard work for one week. Doing these can increase the pressure on the bleeding area and start your nose bleeding.
  • Elevate your head on two or three pillows when lying down.
  • If constipated, take a laxative – avoid straining, it can cause a nosebleed.
  • Do not take aspirin, Advil®, Aleve®, Nurpin®, Motrin®, Naprosyn® or ibuprofen, as these may cause your nose to bleed.
  • If you are taking “blood thinning” medications (Coumadin® or aspirin) tell your provider. Do not stop taking them unless told to do so.
  • No smoking.
  • No hot foods or beverages for several days. The heat and steam causes blood vessels in your nose to “open up” and you may have another nosebleed. Avoid very hot showers.
  • No alcoholic beverages for one week after a nosebleed. They slow down healing and can cause the bleeding area to “open up” and begin bleeding again.
  • Use a cool mist humidifier at night to keep the lining of your nose from drying out.
  • Following a nosebleed, you should do the following:
  • Five to six times a day, use two sprays of saline nasal spray in each nostril. Bending forward slightly from the waist may make this easier.
  • Using a fingertip, apply Bacitracin® ointment to both nostrils at bedtime. Do not pick the nose with your finger.If your nosebleed starts again
  • Note: If there is any kind of packing in your nose, continue the saline spray right on the packing and in the healthy nostril.
  • Sit up with your head slightly forward and squeeze the lower half of your nose between your thumb and index finger squeezing the nostrils closed. Keep up this pressure for 10 minutes.
  • Sometimes a piece of moist cotton placed high inside your upper lip and in front of your upper teeth will help stop the bleeding.
  • If these remedies fail, spray Afrin (oxymetazoline) nasal spray directly on a cotton ball and stick in in the nostril on the side that is bleeding.
  • If the bleeding continues, please call our office.

Saline nasal irrigation has been prescribed to help clean and heal your nose and sinuses. When done regularly, it helps clean and moisturize the lining of your nose and sinuses. The procedure is very easy to do.

Recipe:

  • Choose a one-quart jar that is thoroughly cleansed.
  • Fill with water. You do not need to boil the water. You may use distilled or bottled water if you choose.
  • Add two to four teaspoons of pickling/canning or kosher salt (do not use table salt as it contains a large number of additives).
  • Add one teaspoon Arm and Hammer® baking soda (pure bicarbonate).
  • Mix ingredients together and store at room temperature. Discard after one week. If you find this solution too strong, you may decrease the amount of salt added to one or one and a half teaspoons. With children, it is often best to start with a milder solution and advance slowly.

Procedure:

  • Using an irrigating bottle, syringe or netti pot, draw up some solution.
  • Place the tip of the syringe/bottle into the nostril, then squeeze to irrigate. The netti pot is a passive irrigation method (see directions).
  • Irrigate one or both nostrils as directed by your health care provider.
  • Standing at the bathroom sink and bending forward slightly from the waist helps make it a bit easier to do the irrigation. If you have chosen the netti pot method, see directions.

Please call our office if you have any questions or concerns regarding the irrigation information.

  1. Your provider has recommended that you return for a strobe examination of your voice box (larynx) that is essential for proper diagnosis.
  2. The strobe exam or video strobe laryngoscopy is similar to an exam with a small scope that you may have already had here, but it provides a more comprehensive and magnified look at the voice box and other parts of the nose and throat anatomy.  The scope uses strobe lighting to better visualize and characterize the movement of the vocal cords.
  3. A nasal spray will be used before the strobe exam to help the scope pass through the nose and minimize discomfort.  The spray contains Afrin (oxymetazoline) and Tetracaine to numb the back of the throat to minimize gagging.  Most people tolerate the strobe exam well and with little pain.  The exam itself usually only lasts 1-3 minutes.
  4. You should avoid eating and drinking for 90 minutes before your strobe exam appointment.
  5. After the exam the numbing effect of the nasal spray may remain, it’s best to wait 1 hour before eating or drinking anything.
  6. If you cannot make the appointment, please give the office at least 48 hours notice (2 business days) otherwise, you will be billed a $50.00 charge.

                            Predinisone® – 10mg/Tablet – 21 Tablets

                                   Day 1: 6 tablets     Day 4: 3 tablets
                                   Day 2: 5 tablets     Day 5: 2 tablets
                                   Day 3: 4 tablets     Day 6: 1 tablet
•Take ALL tablets as a single dose in the morning.
•Take tablets with food, Maalox® or milk.
•Call our office if you experience stomach upset, black bowel movements, headaches lasting more than 48 hours, elevated blood pressure readings.
•Women taking ORAL CONTRACEPTIVES need to use a BACK-UP method of contraception for that cycle.
•If you have any questions regarding these instructions, please don’t hesitate to call the office.

Predinisone® – 10mg/Tablet – 39 Tablets

                                   Day 1: 6 tablets   Day 6: 4 tablets
                                   Day 2: 6 tablets   Day 7: 3 tablets
                                   Day 3: 5 tablets   Day 8: 3 tablets
                                   Day 4: 5 tablets   Day 9: 2 tablets
                                   Day 5: 4 tablets   Day 10: 1 tablet

  • Take ALL tablets as a single dose in the morning.
  • Take tablets with food, Maalox® or milk.
  • Call our office if you experience stomach upset, black bowel movements, headaches lasting more than 48 hours, elevated blood pressure readings.
  • Women taking ORAL CONTRACEPTIVES need to use a BACK-UP method of contraception for that cycle.
  • If you have any questions regarding these instructions, please don’t hesitate to call the office.

Predinisone® – 10mg/Tablet – 54 Tablets

                                   Day 1:  6 tablets    Day 8:   4 tablets
                                   Day 2:  6 tablets    Day 9:   4 tablets
                                   Day 3:  6 tablets    Day 10:  3 tablets
                                   Day 4:  6 tablets    Day 11:  2 tablets
                                   Day 5:  5 tablets    Day 12:  1 tablet
                                   Day 6:  5 tablets    Day 13:  no tablet
                                   Day 7:  5 tablets    Day 14:  1 tablet

  • Take ALL tablets as a single dose in the morning.
  • Take tablets with food, Maalox® or milk.
  • Call our office if you experience stomach upset, black bowel movements, headaches lasting more than 48 hours, elevated blood pressure readings.
  • Women taking ORAL CONTRACEPTIVES need to use a BACK-UP method of contraception for that cycle.
  • If you have any questions regarding these instructions, please don’t hesitate to call the office.

Foods and Products that Contain Naturally Occurring Salicylates that Should be Avoided

Foods Containing Natural Salicylates

Almonds, apples, apricots, blackberries, cherries, currants, gooseberries, grapes or raisins, nectarines, oranges, peaches, plums or prunes, raspberries, strawberries, cucumbers and pickles, tomatoes

Foods and Products Containing Artificial Flavors and Colors which Frequently Contain Salicylates

Ice cream, oleo margarine, cake mixes, bakery goods (except bread), jello, candies, gum, cloves, oil of wintergreen, mint flavors, lozenges, mouthwash, jam or jelly, luncheon meats, frankfurters

Beverages

Cider and cider vinegars, wine and wine vinegars, Kool-aid and similar, all soft drinks (soda), gin and distilled drinks (except vodka), all tea, beer, diet drinks and supplements

Drugs and Miscellaneous

  • All medicines containing aspirin, such as Bufferin®, Anacin®, Excedrin®, Alka-Seltzer®, Empirin®, Darvon®, etc. Please read the label.
  • Perfumes
  • Toothpaste (a mixture of baking soda and salt water can be used as a substitute)

Please check all labels of prepared foods or drugs for artificial coloring or flavoring.

A Peritonsillar Abscess (PTA) is a pus-filled cavity in the back of the throat near the tonsils. If you don’t get treatment, the abscess may spread into your head, neck and chest, and can include the lungs. An abscess that grows very large can even interfere with breathing. With care, however, the problem will begin to clear up within a few days.

CAUSE: The abscess is usually caused by a bacteria or virus that produces an infection in your tonsils, throat or mouth, which then spreads deep into the neck.

SIGNS/SYMPTONS: The abscess is accompanied by severe pain, swelling and redness in the throat, ear pain, trouble swallowing and talking, drooling, headache, fever, chills and tender glands of the jaw and throat.

CARE: The abscess must be broken to drain out the pus. The provider may prick it with a special needle or make a cut in it. If the condition is very severe, you may need to have your tonsils removed.

WHAT SHOULD YOU DO: After the abscess has been drained, it is VERY important that you do the following:

  • RINSE your throat with warm salt water ONCE AN HOUR. Mix one teaspoon of salt in one cup of warm water. After you finish rinsing, SPIT out the salt water; DO NOT SWALLOW IT. You will do this for 3 or 4 days then rinse your mouth 4-5 times a day after that for the next 3 to 4 days.
  • To help ease the pain, fill a plastic bag with ice and wrap it in a towel. Hold the ice on your neck for 20 minutes, 3 or 4 times a day.
  • DRINK plenty of warm fluids such as tea, soup and broth. With the warm gargles this helps to clean the infection out and heal the tissues.
  • Over-the-counter medications, such as acetaminophen (Tylenol®, Motrin®) and ibuprofen (Advil®), will ease the pain and help lower your fever. Take these EXACTLY as directed.
  • Your physician will prescribe an antibiotic. FINISH ALL THE MEDICATION EVEN IF YOU BEGIN TO FEEL BETTER. If you stop taking the antibiotic too soon, some bacteria in the abscess may survive and cause a second infection.
  • REST in bed or on the couch for 1 or 2 days, then slowly resume your regular activities. Your body needs time to heal.
  • EAT soft or liquid food for several days until your throat feels better. Sport drinks, milk shakes, “smoothies”, ice cream, Jell-O, soups, broth, instant breakfast and commercially available nutritional drinks, such as Ensure® or Carnation Instant Breakfast®. Slowly return to your normal diet.
  • DRINK 8 to 10 (soda-can size) glasses of water each day. For the first 1 or 2 days, it may feel better to sip the fluids.
  • While your throat is sore, TRY NOT to cough, clear your throat, sing, talk loudly or shout. Your throat needs to heal.
  • No alcoholic beverages or smoking for 10 to 14 days, until your throat heals a bit and feels better.

CALL YOUR HEALTH CARE PROVIDER IF:

  • You have more pain, swelling, redness or pus draining in your throat.
  • You develop a HIGH FEVER (over 102 degrees)
  • You get dizzy, have a really bad headache, or there is a change in your voice.

SEEK CARE IMMEDIATELY IF:

  • You cough or throw up BLOOD
  • Your throat pain GETS WORSE and you begin to drool
  • You have TROUBLE BREATHING or there is a change in your voice.

FOLLOW-UP:

  • Keep ALL scheduled office visits after your PTA has been drained.

If you have any questions or concerns, please contact our office.

You have just had your ears pierced with 24 karat gold over surgical stainless steel earrings.

  • Please leave earring(s) in for eight weeks. Do not take them out prior to this time.
  • Please leave them alone for the first 24 hours; begin cleaning with alcohol after the first 24 hours.
  • Clean them twice a day, once in the morning and once in the evening.
  • Clean them with 70% alcohol (available at any pharmacy) with cotton balls.
  • Swab the front and back of each earring with alcohol and twist earring(s) daily so that nothing builds up behind the earring(s).
  • If you should develop any redness, discharge or swelling, please contact the office
  • If you have any questions, please call 508-757-0330. Ask to speak to one of the medical assistants.