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.2. Your doctor may request that you undergo an ultrasound or X-ray examination before surgery to check for the presence of foreign substances.3. Your doctor may give you medications for your pain (either pills or injections) before an extensive debridement to reduce pain and discomfort.After surgery1. Wound care• Depending on your situation and type of surgical procedure, your doctor may decide whether your wound dressing should be changed by a nurse or you can change the dressing at home by yourself. If you are caring for the wound at home by yourself, please closely follow instructions given by our medical staff, especially the following:  ○ Frequency of changing the wound dressing  ○ Type of wound cleansing solution required  ○ Type of wound dressing required  ○ Method of cleansing, packing, dressing, and bandaging your wound • You might need a wound drain (rubber tube) inserted by your doctor to remove infected pus. Please follow your doctor's instructions closely to care for your wound drain at home• Keep your wound dressing bandage clean and dry. You may want to cover your dressing to prevent it from getting wet when bathing2. Diet• Start with a soft diet and gradually resume with a healthy diet • Add protein to your diet to help with wound healing• Refrain from alcohol, smoking, and spicy food3. Activity• Avoid stretching and strenuous exercise to prevent bleeding, tearing, and swelling around your wound4. Medications• After surgery, your doctor will prescribe you some antibiotic pills to eliminate the infection. It is possible your doctor may switch your antibiotic pills depending on your culture results. The culture results usually require 2 to 4 days. Please finish all your medications as instructed by your doctor5. Follow-up appointments• Please attend follow-up appointments as instructed. Follow-up appointments are important for your doctor to review the recovery progress for your wound, and treat you accordingly6. When to contact your doctorPlease contact your doctor immediately if you have any of the following:• Worsening or severe pain• Continuous bleeding • Increased redness or swelling in the area• Fever higher than 38.0°C• The wound drain accidentally dislodges before the planned removal date

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 surgery1. 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 requirementsPlease stop eating and drinking: 5. Bowel preparationi.  Dilute 2 packets of prescribed powder in 2 liters of warm water and mix wellii. Finish the above prepared mixture within 2 hours:a) Within the 1st hour, finish 1 Liter of the prepared mixtureb) Within the 2nd hour, drink 250 ml of prepared mixture every 15 minutes After surgery1. Recovering in the surgery centera) 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 activitiesb) 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 centerc) You can resume your low-residue diet once you do not feel nauseous or dizzyd) You will not have any real stool formation within 24 hours of the procedure. Therefore, avoid the urge to defecate during this time2. Home care instructionsa) 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 doctorb) 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 cleanc) 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 bleedd) 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 instructionse) Follow-up care• Stitches do not usually require removal after the surgical procedure. Your doctor will arrange a follow-up with you if neededf) When to call your doctorPlease 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

Sprains are injuries to the ligaments in a joint. Ligaments are strong bands of tissue that connect the ends of the bones together, providing stable support to the joint. If you have sprained your ankle, it means the ligaments around your ankle joint are injured. During this time, your ankle joint will be painful and unstable. It is important that you take good care of your ankle to prevent long-term problems and maintain a good range of motion. What medicines will my doctor give me?Your doctor may give you medications to relieve pain and discomfort. Some of these medications may also help to reduce swelling around your injured ankle joint. What things can I do at home to feel better?For the first 24 to 48 hours, use the R.I.C.E (rest, ice, compression and elevation) method to care for your sprained ankle at home.Resting takes the pressure off your injured ankle joint and helps with healing. Avoid standing or putting weight on your injured ankle. If walking is too painful, your doctor may suggest that you use a crutch. Stay off your feet until you can walk without pain.Ice helps to reduce swelling and pain.To start with,a)    Wrap an ice pack in a thin towel and put it on the injured part of the ankle for 15 minutes b)    Take the ice off for 10 minutesc)    Put the ice back on for 15 minutesd)    Apply the ice pack for 15 minutes each time, 3 times a day, for 2 daysCompression helps to keep swelling down and support your injured ankle.Your doctor or nurse will show you how to wrap your ankle. For the next 48 hours, keep the elastic bandage around your ankle on. Be careful not to wrap it too tightly, as it will reduce blood flow to your foot. Loosen the bandage if you feel:•      Numbness•      Tingling sensation•      Increased painElevation helps to reduce swelling and pain. Keep your ankle raised above the level of your heart. Prop up your injured ankle with pillows while lying down or rest your injured ankle on a chair or table to reach the desired height.When can I return to normal activities and resume exercise?You can return to your usual activities and exercise when you can walk fully without any pain. If you return too soon, your injury may worsen. Your doctor and nurse will show you how to monitor your recovery progress. Your doctor may also recommend that you see a physical therapist to guide you with some ankle-strengthening exercises during this period. When do I need to seek further help or see my doctor again?Please contact your doctor or nurse if you have any of the following:•       Worsened pain or swelling•       No improvement in pain or swelling within 3 days •       Unable to bear any weight within 3 days•       Pain remains after 1 week With reference to www.uptodate.com

Eczema is a very common skin condition in children and adults. Your doctor may refer to your eczema as atopic dermatitis. It causes dry, itchy, scaly and red skin. For some, this problem is ongoing with frequent flare-ups that can be extremely uncomfortable and affect your daily life.What causes eczema?The outermost layer of the skin in people with eczema is usually drier and more sensitive. They react easily to certain allergens and irritants in the environment. This dryness and sensitivity usually runs in the family.How will my doctor treat my eczema? Your doctor may give you the following treatment to relieve the symptoms of your eczema:a)       Moisturizing creams or ointmentsThese keep your skin moist and prevent your skin from becoming dry. Dry skin causes itchiness that encourages scratching. Intense scratching will make it worse at times results in a skin break, increasing your chance of skin infection. b)      Steroid creams and ointmentsThese are applied to your skin to control skin sensitivity, relieve itching and redness. In severe cases, your doctor might prescribe steroid pills for you to take for a short period of time.c)      Antihistamine pillsAntihistamines are medications that people often take for allergies. They help relieve itching, especially at night, and can also help sleep.There are other treatments that include wet dressings, injectable medications, and medications that change the way the immune system works. Your doctor may recommend these treatments if you do not get better. Your doctor may also refer you to a skin specialist if your skin problem is severe. What things can I do at home to feel better?DOs•      Use moisturizer generously•      Apply at least twice daily, especially immediately after bathing while the skin is moist•      Keep the air in your home moist by using a cool-mist humidifier or vaporizer•      Take medications to reduce skin itching and irritation•      Maintain a cool temperature at home. Sudden temperature changes and sweating will worsen the symptoms of eczema•      Use hypoallergenic fabric for clothing and bed sheets•      Relax and maintain a calm mood. Some eczema can be worsened by stress and worryDON'Ts•      Avoid to use over-heated water during bathing. Hot water irritates and dries the skin•      Avoid to use harsh soaps and cleansing products•      Avoid to use perfumes•      Don’t scratchDo I need to seek further help from my doctor?Please contact your doctor if:a)     Your skin condition does not improve after using at-home careb)     The skin dryness gets worsec)     You suspect your skin becomes infected. A skin infection may have the following symptoms:   •      Pain   •      Redness   •      Swelling   •      Oozing/crustingd)     The itchiness is disturbing your sleepWith reference to www.uptodate.com

What does "fasting" mean?"Fasting" means not eating or drinking anything for a period of time. People sometimes need to fast before getting a medical test or having a procedure done. Will I need to fast before my surgery?You might. It depends on what kind of surgery you are having, and what kind of anesthesia you need. "Anesthesia" is a medical term for different types of medicine they give people before surgery or other procedures. These medicines ensure you do not feel pain during your surgery or procedure.If you have a scheduled surgery or procedure, your doctor or nurse will tell you if you need to fast before it. If you are only having a “local anesthetic”, you probably won't need to fast. A “local anesthetic” is where medicine is used to numb part of your body. It can be given as a shot, or as a cream, gel, or spray that goes on the skin.You will need to fast if you are having any of the following:(1)    General anesthesia – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during surgery. Some of the medicines are given through a thin tube that goes into a vein, called an "IV." Others are gases that you breathe in.(2)    Regional anesthesia – This type of anesthesia blocks pain in one area of your body, such as an arm, leg, or the lower half of your body. The doctor will inject medicine around the nerves that go to the area where you are getting surgery.(3)    Sedation – This is the term for getting medicines to make you relax and feel sleepy.Why do I need to fast? If you have food or liquid in your stomach, some of it could get into your lungs while you are under anesthesia. Normally, your body is able to prevent what's in your stomach from entering your lungs. But anesthesia medicines make it harder for your body to prevent this.When food or liquids from the stomach get into the lungs, doctors call it "aspiration." This is rare, but can be dangerous if it does happen. That's because it can lead to infection, lung damage, or breathing problems.How long before my surgery do I have to stop eating and drinking? For some people and some procedures, the duration to stop eating and drinking can be different from this general recommendation, such as people with diabetes. It is important you follow your doctor or nurses’ instructions carefully.The general recommendationShould I keep taking my medicines before surgery? It depends. Your doctor or nurse will tell you which medicines you should take and when. Some medicines need to be stopped before surgery. But for others, it's important that you keep taking them as usual. You might also get new medicines to take before surgery.Take the medicines your doctor or nurse tells you to. If you need to take medicine right before your surgery, you can take it with a sip of water. If you normally take your medicine with something else, like applesauce, talk to your doctor or nurse about what to do.What will happen if I don't fast? If you don't follow instructions about when to stop eating and drinking, you could be putting your health at risk. Be honest with your doctor or nurse if you did not follow the rules, even if it was an accident. If this happens, your surgery might need to be delayed until a later time.

How do vaccines work?When pathogens like virus or bacteria enter our bodies and our bodies do not produce enough antibodies to fight them away, we fall sick. Vaccines are made from a killed, weakened, or portion of virus or bacteria. Once injected into our bodies, the bodies will create the antibodies against the particular disease. When the virus or bacteria enter our bodies again, our body will recognize this disease and “fight” it.How do vaccines protect my loved ones and me?Vaccination builds up your immunity against the disease you are vaccinated. They are the safest way to protect you, your loved ones and your community from serious and sometimes deadly diseases. If only a few are immunized, contagious diseases spread easily from one to another. When enough people are immunized, you and your loved ones will be protected from the diseases. What are the diseases that can be vaccinated for protection?Hepatitis B is a viral infection that affects the liver. It can be spread through sex, mother to infant, contact with infected body fluids and contaminated needles. Can cause liver failure, liver cirrhosis (hardening) and liver cancer.Hepatitis A is spread through contaminated water, food or surfaces. Most serious complication is death, which is rare.Human Papillomavirus (HPV)is a sexually transmitted viral infection. Can also be infected by direct contact with infected mouths or genitals. HPV can cause cervix, mouth and throat cancers.Mumps is viral illness that is spread through coughs and sneezes. It is a painful disease and can also affect your brain, ovaries and testicles. At times, result in hearing loss.Pneumococcal is a bacteria causing severe pneumonia (lung infection) in older people and those with chronic diseases.Influenza is a viral infection spread through droplets and can infect a large group of people very fast causing outbreaks. Influenza can cause serious lung problems, infection of the blood and even death.Measles is a very infectious viral illness spread through coughs and sneezes. It can cause chest infection, fits, serious brain damage and even deaths.Varicella (chickenpox) is a highly contagious airborne viral infection. It causes fever and itchy rashes that become crusts. Can also cause brain problems and hospitalization.Rubella is a viral illness, also known as German measles. Rubella during pregnancy very serious. It can cause blindness, deafness, heart problems and even brain damage. Pregnant women should consider vaccination.Meningococcal is a serious bacterial infection affecting the lining and tissues around the brain. It can also cause infection of the blood, resulting in death.How often do I need to receive vaccinations?Where can I have these vaccinations?Different hospitals and clinics have different vaccinations depending on the government regulations. Please do check with us on the current availability of the vaccine you are interested in having.Talk with your Family doctor to have a personalized vaccination plan to protect you and your family against the mentioned diseases. If you are planning on traveling, it is important you discuss with your Family doctor ahead of time, as addition immunization may be required.For more information on vaccination available in Shanghai, you can contact:Shanghai Municipal Center for Disease Control and Prevention Telephone: 021-62758710Website: www.scdc.sh.cnShanghai Health and Family Planning Hotline: 12320 This written content is to better inform you. It does not substitute medical advice. Please seek the advice of your doctor and healthcare professionals if you have any questions about this material.

What causes nausea and vomiting after surgery?There is a part of our brain called the “vomiting center”. When this portion of our brain is stimulated, it will cause people to feel nauseous and vomit. Nausea and vomiting after surgery is a common problem. Certain people, types of anesthesia, and types of surgery trigger this “vomiting center” easier than others. Who has a higher chance of experiencing nausea and vomiting after surgery?The chance of experiencing nausea and vomiting is increased for the following people:• Children older than 3 years old• Women, especially young women• People who are overweight, pregnant, or have anxiety• People who have a history of motion sickness What are other factors that increase this risk?The following factors also increase the chances of experiencing nausea and vomiting after surgery:a) The type of anesthesia used. In general, most medications used for general anesthesia trigger the “vomiting center” easily. Thus, those who receive general anesthesia instead of local anesthesia are at increased riskb) The duration of general anesthesia and surgery. The longer the duration, the higher the riskc) The type of surgery performed. Ear, nose and throat surgery, laparoscopic surgery, gynecological surgery, dental surgery, and cosmetic surgery increase the riskd) How well the patient recovers after surgery. Those who have pain, low blood pressure, low blood oxygen, or gastrointestinal irritation after surgery are at increased riskIn short, regardless of whether it is because of the medications or surgical procedures, once they stimulate the nerves, they will trigger the brain’s “vomiting center”, resulting in nausea and vomiting.What are the consequences of nausea and vomiting after surgery?Persistent nausea and vomiting after surgery increases pain. It might also cause surgical wound bleeding and prolong wound healing time.Nausea and vomiting can also cause electrolyte and water imbalance, affecting the overall recovery and healing time. What are some measures to prevent or control nausea and vomiting after surgery?To a large extent, nausea and vomiting after surgery can be prevented and controlled.Many studies have found that taking anti-nausea medications before surgery can prevent nausea and vomiting after surgery to a certain extent. It has also been found that the effects of using two or more types of anti-nausea medications are better than just using a single type of medication.

This information will help you to:•      Learn about asthma•      Understand the types of medicines used to treat asthma•      Know when to seek medical care What is asthma?Asthma is a disease of the bronchioles, the tubes that carry air to the lungs.When someone has an acute asthma attack, the airways get narrow and may fill with mucus. This makes it hard to breathe. For someone having an asthma attack, it’s like breathing through a narrow straw.What are the symptoms of asthma?Symptoms can be different between adults and children. They also vary among individuals. Depending on how fast and how serious the symptoms are, each asthma attack can be very different.Early symptoms may include:•      Coughing•      Wheezing•      Difficulty speaking•      Chest tightness•      Trouble breathing•      Trouble exercising or playing How will my doctor treat my asthma?Inhalers and medicine delivery devicesMost asthma medicines are kept in a small, handheld device called an inhaler. To help the medicine reach the lungs more easily, your child may also use a spacer or a valved holding chamber as an add-on device. Most children can be taught to use inhalers directly or with the right spacer device.A child who cannot use an inhaler may need to use a nebulizer. This device turns the liquid medication into a mist that can be inhaled through a mouthpiece or mask.Quick-relief or “rescue” medicinesThese medicines are also called bronchodilators. They help to open the bronchioles, making it easier to breathe. Used to treat an acute asthma attack, rescue medicine should be used when asthma symptoms first occur.  The most common rescue medicine used is albuterol (Ventolin).Long-term controller maintenance medicinesController medicines are used daily to keep asthma under control, reducing the severity and frequency of attacks.Types of controller medicines include:1. Inhaled corticosteroids These medicines help to decrease swelling and inflammation, making asthma attacks less frequent. They are usually taken every day, even if your child is not experiencing any symptoms.Examples include Flixotide and Pulmicort. 2. Long-acting bronchodilators  These help keep the airways from narrowing. They are usually used along with inhaled corticosteroids.An example includes Seretide.Oral steroidsYour doctor may recommend steroids taken by mouth (in pill or liquid form) if the asthma is not well controlled. They reduce inflammation and can help the airways become more responsive to inhalers. Steroids usually start to work within about six hours so are not used in acute attacks. Your child should continue to take quick-relief and long-term controller medications while taking oral steroids. What else do I need to know about asthma?Follow all instructions you have been given about treating and controlling asthma, including:•      Recognizing and avoiding asthma triggers•      Having an asthma action plan with your health care provider•      Knowing how to use inhalers and related medicine delivery devices •      Knowing how to care for, store, and clean the inhaler mouthpiece, face mask, spacer, and valved holding chamber•      Knowing how to refill prescriptions When should I seek emergency care?If your child has any of these warning signs, call 120 or seek emergency medical care immediately.When your child has been diagnosed with asthma, it is important that he or she is monitored by a healthcare provider. Be sure to take your child to all follow-up healthcare appointments.

What is an X-ray Imaging?X-ray beams are a form of wavelength radiation with strong, penetrating rays. They pass through all body fluids, soft tissue, and structures easily, except highly dense tissue such as bones. The shades of grey shown on the film or imaging plate indicate the amount of X-ray beams that are passed through the body. Thus, bones that allow little X-ray beams to pass through show up white while lungs which allow more X-ray beams to pass through show up black. The medical imaging doctor interprets differing degrees of gray shades to make a diagnosis. These are the basic principles of X-rays.A routine X-ray imaging is an essential part of the assessment and diagnosis for many diseases. It is a fast, convenient and inexpensive test. However routine X-ray imaging cannot accurately detect problems in soft tissue. Therefore, at times a more complex type of imaging may be required such as a CT scan or MRI.When is X-ray imaging usually done?A routine X-ray imaging is usually done to assess or diagnose:•       Problems related to lungs, bones, and teeth, such as pneumonia, bone fractures, and decayed teeth•       Joint and spinal abnormalities, such as osteoarthritis and vertebral compression fractures•       Certain cardiac disorders, showing the shape and size of the heart, such as rheumatic heart disease•       Tumors, such as lung tumors and breast tumors•       Fluid accumulation, such as fluid in the lungs or gastrointestinal tract Are X-ray beams harmful to our bodies?The amount of radiation from X-ray beams determines whether an X-ray imaging is harmful to our bodies.The amount of radiation from X-ray beams used in X-ray imaging is usually very low and is very unlikely to be harmful to the body. However repeat X-ray imaging may result in some risk because the radiation accumulated may damage some cells in the body, possibly leading to cell mutations which may induce cancer.Can pregnant women have X-ray imaging done?Established medical organizations such as the American College of Radiology (ACR) and the American Congress of Obstetricians and Gynecologists (ACOG), state that the radiation amount from a single X-ray imaging used for diagnosis generally do not harm an embryo or fetus, and X-ray imaging of the head, limbs, and chest are also generally harmless.We still recommend, however, that pregnant women avoid medical imaging using X-ray beams where possible, particularly during the first three months of pregnancy. This includes routine X-ray imaging and CT scans, especially of the abdomen and pelvic cavity. Pregnant women can choose alternative types of medical imaging, such as ultrasound or MRI, which do not harm the fetus. If, a routine X-ray imaging is still required due to clinical situation, pregnant women can wear lead-protective clothing to protect and reduce radiation exposure to their abdomen and pelvic cavity.

What is an ultrasound?An ultrasound is a form of medical imaging using sound wave frequencies transmission and echoes to create images of the soft tissue and organs within our bodies. These images can be films/pictures or video recordings. Ultrasound physicians interpret the characteristics of these images to make diagnoses.Ultrasound is a safe and painless test that does not involve exposure to radiation. This test is often down lying down on a bed. Your ultrasound doctor will apply a gel that helps with sound waves transmission over the area that is required to be scanned. After which, he/she will move a probe over the skin surface to obtain images from different angles.Ultrasound scans usually take less than 30 minutes, depending on the body area that is being examined. Complex ultrasound scans may require more time.  When is an ultrasound used?An ultrasound is used when your doctor needs to determine the size, shape and consistency of your internal organs and soft tissue. These organs include the heart and blood vessels, liver, gallbladder, pancreas, kidneys, bladder, thyroid, breast, uterus, and ovaries. Ultrasound can also be used to determine whether lumps are solid tumors or fluid-filled cysts.Ultrasound is also often used for ultrasound-guided tissue biopsies, because of its excellent ability to locate tissue.    What should I prepare before and after the ultrasound?No special preparation is needed. Unless specifically advised, you can eat and drink normally before and after your ultrasound test and continue taking medications. Wear comfortable, loose-fitting clothing during the test to expose the body area being examined easier. Sometimes you may be asked to wear a gown. You may also need to remove any jewelry you’re wearing.For ultrasound scans on certain body area, you may need to:What limitations does an ultrasound have?Gas can easily interfere when obtaining images using ultrasound. Therefore, ultrasound is not an ideal method for examining hollow organs containing gas, such as the lungs or digestive tract. Ultrasound is also not useful for examining the internal structure of bones (except for infants).