Dear Sir/Madam:

Greetings！

Thank you for choosing the Jiahui Health Surgery Center for your incision and abscess drainage with or without debridement. We sincerely wish to provide you with a top quality healthcare experience. To fully prepare for your surgical procedure, please read through the following instructions:

Before surgery 

1. Please let your doctor know if you are taking aspirin, clopidogrel (Plavix), warfarin, or any other blood-thinning medications. If necessary, your doctor might request that you stop taking these medications for about a week before the surgical procedure. 

Please follow your surgeon's advice as directed unless instructed by your cardiologist or any other specialist doctors to continue taking these medications. 

DO REMEMBER TO LET YOUR SURGEON KNOW IF YOU ARE CONTINUING WITH THESE MEDICATIONS.

Dear Sir/Madam:

Greeting!

Thank you for choosing the Jiahui Ambulatory Surgery Center for your anorectal surgical procedure. We sincerely wish to provide you with a top quality healthcare experience. To fully prepare for your surgical procedure, please read through the following instructions:

Before surgery

1. Medications 

Please let your doctor know if you are taking aspirin, warfarin, clopidogrel (Plavix), any other blood-thinning medications, or any over-the-counter medications or supplements. If necessary, your doctor might request that you stop taking these medications for about a week before the surgical procedure. 

Please follow your surgeon's advice as directed unless instructed by your cardiologist or any other specialist doctors to continue taking these medications. 

DO REMEMBER TO LET YOUR SURGEON KNOW IF YOU ARE CONTINUING WITH THESE MEDICATIONS.

2. An anesthesiologist will visit you before your surgical procedure if you require general anesthesia. Please provide necessary information for his/her professional evaluation. 

3. Diet recommendations 

4. Fasting requirements

Please stop eating and drinking:

5. Bowel preparation

i.  Dilute 2 packets of prescribed powder in 2 liters of warm water and mix well

ii. Finish the above prepared mixture within 2 hours:

a) Within the 1^st hour, finish 1 Liter of the prepared mixture

b) Within the 2^nd hour, drink 250 ml of prepared mixture every 15 minutes

After surgery

1. Recovering in the surgery center

a) If you have undergone the surgical procedure with spinal or epidural regional anesthesia, your anesthesiologist will instruct you to rest in a certain position for a specific number of hours. After that, you can gradually resume normal activities

b) Usually, pain relief medications are not needed, however please let you doctor or nurse know if you are experiencing pain or swelling so we can ensure you feel more comfortable before leaving the surgery center

c) You can resume your low-residue diet once you do not feel nauseous or dizzy

d) You will not have any real stool formation within 24 hours of the procedure. Therefore, avoid the urge to defecate during this time

2. Home care instructions

a) Bowel movements

• Please check that the Vaseline gauze is passed during your first bowel movement (usually 48 to 72 hours) after the surgical procedure. It is normal if you see some dark red coloration or red blood clots on the gauze

• It is also normal to find slight bleeding and pain during bowel movements 3 to 5 days after the surgical procedure

• Only take stool softeners or medications to relieve constipation prescribed by your doctor

b) Wound care

• Gently cleanse the anal area with water to keep the anal area clean after each bowel movement. You can use a washlet or bath/shower for this. You may also use non-alcohol baby wipes to keep the area clean

c) Diet

• Please start with a soft low-residue diet after your surgical procedure. After 24 hours, you can gradually resume your healthy diet

• Add more fluids, fruits, and fiber into your diet to keep your stools soft. Hard stools may cause your wound to bleed

d) Exercise and activity

• Avoid heavy lifting or strenuous exercise after the surgical procedure until you feel well

• Your doctor will teach you a set of exercises to strengthen your anal muscles to help with wound healing. Please follow your doctor's instructions

e) Follow-up care

• Stitches do not usually require removal after the surgical procedure. Your doctor will arrange a follow-up with you if needed

f) When to call your doctor

Please contact your doctor immediately if you have any of the following:

• Continuous bleeding

• Bloody stools increasing in amount and frequency

• Worsening or severe pain

• Fever higher than 38.0°C, with increased pain in the anal regio

• Increased pain or redness, swelling, or foul-smelling drainage from wound

• Unable to urinate more than 8 hours

What do I need to know about an ileostomy diet? 

You will need to make changes to the foods you eat for about 6 weeks after surgery. These changes will help your intestines heal and prevent problems that can occur when you have an ostomy. These problems include odor, gas, diarrhea, or obstruction (blockage in your intestines). After you heal, you can eat the foods you regularly ate before surgery. 

What foods can I eat after surgery?

You will be given clear liquids right after surgery. Examples include clear juices, coffee or tea (with no cream or milk), gelatin, and broth. Next, you will be allowed to eat low-fiber foods. At first, you will need to limit fiber to less than 8 grams each day. As you heal and your symptoms decrease, you will limit fiber to less than 13 grams each day. 

 •    Grains: Choose grains that have less than 2 grams of fiber in each serving. Examples include the following: 

   ○   Cream of wheat and finely ground grits

   ○   Dry cereal made from rice 

   ○   White bread, white pasta, and white rice

   ○   Crackers, bagels, and rolls made from white or refined flour

 •    Fruits and vegetables: 

   ○   Canned and well-cooked fruit without skins or seeds, and juice without pulp

   ○   Ripe bananas and soft melon

   ○   Canned and well-cooked vegetables without skins or seeds, and strained vegetable juice

   ○   Potatoes without skin 

   ○   Shredded lettuce on a sandwich

 •    Dairy:

   ○   Cow's milk, lactose-free milk, soy milk, and rice milk

   ○   Cottage cheese and yogurt without nuts, fruit, or granola

 •    Protein:

   ○   Eggs, fish, and tender, well-cooked poultry (such as chicken and turkey) and beef 

   ○   Tofu and smooth peanut butter

What foods should I avoid after surgery? 

Do not eat high-fiber foods right after surgery because they are harder to digest. Avoid foods that cause gas, odors, and diarrhea. Do not eat foods that may cause a blockage. 

•    Foods that are high in fiber: 

   ○   Whole-grain foods such as whole-wheat breads, brown rice, or oats

   ○   Raw fruits and vegetables

   ○   Dried fruit

   ○   Dried beans

 •    Foods that may cause blockage: 

   ○   Vegetable and fruit skins

   ○   Apples, dried fruit, grapes, coconut, and pineapple

   ○   Celery, corn, cucumber, green peppers, peas, and bean sprouts

   ○   Salad greens, cabbage, coleslaw, and spinach

   ○   Casing on sausage and tough, fibrous meats such as steaks

   ○   Nuts (such as almonds and pecans) and peanuts

 •    Foods that may cause gas or odor: 

   ○   Apples, bananas, grapes, prunes, and melons

   ○   Asparagus, broccoli, brussels sprouts, cabbage, cauliflower, and corn

   ○   Onions, garlic, or leeks

   ○   Cucumber, green pepper, onions, radishes, and turnips

   ○   Alcohol

   ○   Cheese, peanuts, dried beans and peas, eggs, and fish

   ○   Carbonated drinks such as sodas

 •    Foods that may cause diarrhea: 

   ○   Alcohol

   ○   Apricots, plums, peaches, prunes, and fresh or dried fruit

   ○   Fruit juice

   ○   Beans, fried meats, fish, poultry (chicken or turkey), nuts, or seeds

   ○   Broccoli, brussels sprouts, cabbage, corn peas, tomatoes, turnip greens, and green leafy vegetables

   ○   Bran, wheat, and other whole grains

   ○   Licorice and sugar-free substitutes 

   ○   Spicy foods

   ○   Drinks with caffeine

   ○   Foods high in fat and sugar

What are some nutrition guidelines I should follow after surgery? 

•    Drink plenty of liquids as directed. Your dietitian or doctor may recommend that you have at least 8 to 10 eight-ounce cups of liquid each day. You may need more liquid if you sweat more than normal, such as after exercise. You may also need to drink more if there is a large amount of liquid coming out of your stoma (opening). Ask which liquids are best for you. You may need to drink an oral rehydration solution (ORS). An ORS has the right amounts of sugar, salt, and minerals in water to replace body fluids. Drink liquids 30 minutes after you eat instead of with meals. This will help your body to absorb more nutrients from food

•    Take small bites of food and chew them well. This will allow your body to better digest and absorb nutrients. This will also help to prevent a blockage and decrease gas

•    Eat small amounts of food every 2 to 4 hours. Your appetite may be lower than normal right after surgery. Eat regularly throughout the day to get enough nutrients. Regular meals and snacks will also help decrease gas. Do not lie down within 1 hour after you eat

•    Eat your full meals in the middle of the day. This will decrease the amount of bowel movement that comes from your stoma at night

•    Avoid acidic, spicy, high-sugar, and high-fat foods. These foods can cause diarrhea. Acidic foods include citrus fruits such as oranges

•    Avoid chewing gum, drinking with straws, smoking, and chewing tobacco. This will help to decrease gas

•    Take vitamin or mineral supplements as directed. Chewable or liquid forms are the best types. You will need vitamin B12 supplements in the form of a nasal spray or injection. Your body will absorb vitamin B12 better if it is given as a nasal spray or injection

When should I contact my doctor? 

•    You are urinating less than usual or your urine is dark

•    You feel dizzy when you stand

•    You feel extremely tired

•    You have nausea, and you are vomiting

•    You have not had any bowel movement come out of your stoma for 4 to 6 hours

•    You have abdominal cramps that last more than 2 or 3 hours

•    You see pills or whole foods in your ostomy bag

•    You have questions or concerns about your condition or care

CARE AGREEMENT:

You have the right to help plan your care. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics. 

What causes a head injury?

A head injury is most often caused by a blow to the head. This may occur from a fall, bicycle injury, sports injury, being struck in the head, or a motor vehicle accident. 

What are the symptoms of a head injury? 

You may have an open wound, swelling, or bruising on your head. Right after the injury, you may be confused. Symptoms may last anywhere from a few hours to a few weeks. You may have any of the following: 

•    Mild to moderate headache

•    Dizziness or loss of balance

•    Nausea or vomiting

•    Change in mood, such as feeling restless or irritable

•    Trouble thinking, remembering, or concentrating

•    Ringing in the ears or neck pain

•    Drowsiness or decreased amount of energy

•    Trouble sleeping

How is a head injury diagnosed? 

•    Tell your doctor about your injury and symptoms. The doctor will do an exam to check your brain function. He or she will check how your pupils react to light. He will check your memory, hand grasp, and balance

What do I need to know about a colectomy diet?

 You will need to make changes to the foods you eat for about 6 weeks after surgery. These changes will help your colon heal and prevent certain problems that can occur when you have an ostomy. These problems include odor, gas, diarrhea, or obstruction (blockage in your intestines). After you heal, you can eat the foods you regularly ate before surgery. 

What foods can I eat after surgery? 

You will be given clear liquids right after surgery. Examples include clear juices, coffee or tea (with no cream or milk), gelatin, and broth. Next, you will be allowed to eat low-fiber foods. Your doctor may recommend that you limit fiber to 8 to 13 grams each day. 

•    Grains: Choose grains that have less than 2 grams of fiber in each serving. Examples include the following: 

○   Cream of wheat and finely ground grits

○   Dry cereal made from rice 

○   White bread, white pasta, and white rice

○   Crackers, bagels, and rolls made from white or refined flour

 •    Fruits and vegetables: 

○   Canned and well-cooked fruit without skins or seeds, and juice without pulp

○   Ripe bananas and soft melon

○   Canned and well-cooked vegetables without skins or seeds, and strained vegetable juice

○   Potatoes without skin 

○   Shredded lettuce on a sandwich

 •    Dairy:

○   Cow's milk, lactose-free milk, soy milk, and rice milk

○   Yogurt without nuts, fruit, or granola

 •    Protein:

○   Eggs, fish, and tender, well-cooked poultry (such as chicken and turkey) and beef 

○   Tofu and smooth peanut butter

What foods should I avoid after surgery?

Do not eat high-fiber foods right after surgery because they are harder to digest. Avoid foods that cause gas, odors, and diarrhea. Do not eat foods that may cause a blockage. 

•    Foods that are high in fiber: 

○   Whole-grain foods such as whole-wheat breads, brown rice, or oats

○   Raw fruits and vegetables

○   Dried fruit

○   Dried beans

 •    Foods that may cause blockage: 

○   Vegetable and fruit skins

○   Apples, dried fruit, grapes, and pineapple

○   Celery, corn, cucumber, green peppers, peas, and bean sprouts

○   Salad greens, cabbage, coleslaw, and spinach

○   Casing on sausage and tough, fibrous meats such as steaksNuts (such as almonds and pecans) and peanuts

•     Foods that may cause gas or odor: 

○   Apples, bananas, grapes, prunes, and melons

○   Asparagus, broccoli, brussels sprouts, cabbage, cauliflower, and corn

○   Onions, garlic, or leeks

○   Cucumber, green pepper, onions, radishes, and turnips

○   Alcohol

○   Cheese, peanuts, dried beans and peas, eggs, and fish

○   Carbonated drinks such as sodas

 •    Foods that may cause diarrhea: 

○   Alcohol

○   Apricots, plums, peaches, prunes, and fresh or dried fruit

○   Fruit juice

○   Beans, fried meats, fish, poultry (chicken or turkey), nuts, or seeds

○   Broccoli, brussels sprouts, cabbage, corn peas, tomatoes, turnip greens, and green leafy vegetables

○   Bran, wheat, and other whole grains

○   Licorice and sugar-free substitutes 

○   Spicy foods

○   Drinks with caffeine

○   Foods high in fat and sugar

What are some nutrition guidelines I should follow after surgery? 

•    Drink plenty of liquids as directed. Your dietitian or doctor may recommend that you have at least 8 to 10 eight-ounce cups of liquid each day

•    Take small bites of food and chew them well. This will allow your body to better digest and absorb nutrients. This will also help to prevent a blockage and decrease gas

•    Eat small amounts of food every 2 to 4 hours. Your appetite may be lower than normal right after surgery. Eat regularly throughout the day to get enough nutrients. Regular meals and snacks will also help decrease gas

•    Eat your full meals in the middle of the day. This will decrease the amount of bowel movement that comes from your stoma at night

•    Avoid acidic, spicy, high-sugar, and high-fat foods. These foods can cause diarrhea. Acidic foods include citrus fruits such as oranges

•    Avoid chewing gum, drinking with straws, smoking, and chewing tobacco. This will help to decrease gas

•    Take vitamin or mineral supplements as directed. Chewable or liquid forms are the best types

When should I contact my doctor? 

•    You are urinating less than usual or your urine is dark

•    You feel dizzy when you stand

•    You feel extremely tired

•    You have abdominal cramps

•    You have questions or concerns about your condition or care

CARE AGREEMENT:

You have the right to help plan your care. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

What is an abrasion?

An abrasion is a scrape on your skin. It happens when your skin rubs against a rough surface. Some examples of an abrasion include rug burn, a skinned elbow, or road rash. Abrasions can be many shapes and sizes. The wound may hurt, bleed, bruise, or swell. 

How can I care for my abrasion?

•  Wash your hands and dry them with a clean towel

•  Press a clean cloth against your wound to stop any bleeding

•  Rinse your wound with a lot of clean water. Do not use harsh soap, alcohol, or iodine solutions

•  Use a clean, wet cloth to remove any objects, such as small pieces of rocks or dirt

•  Rub antibiotic ointment on your wound. This may help prevent infection and help your wound heal

•  Cover the wound with a non-stick bandage. Change the bandage daily, and if gets wet or dirty

When should I seek immediate care? 

•  The bleeding does not stop after 10 minutes of firm pressure

•  You cannot rinse one or more foreign objects out of your wound

•  You have red streaks on your skin coming from your wound

When should I contact my doctor? 

•  You have a fever or chills

•  Your abrasion is red, warm, swollen, or draining pus

•  You have questions or concerns about your condition or care