ONCE YOU ARE HOME

• If you have any questions or concerns once you return home, please call your doctor’s office at 305-243-9110, option 4.
• If you are experiencing any of these concerns after hours (after 5 p.m.), please contact our office number to speak to the on-call physician.
• If you are having any issues with your home health agency, please call 305-689-5512.

Remember: Your surgeon’s instructions supersede any material discussed in this document.

THINGS TO LOOK OUT FOR POST-OP

Issues Deferable to Clinic:

Wounds:

• Smaller Wounds: Wounds, such as ostomy reversal sites or Pfannenstiel incisions, that develop a seroma can be managed in the clinic. You may be sent home with oral antibiotics. We also provide wound vacuum (VAC) changes if home health care services are delayed.

Ostomy:

• Ostomy Complications: If you have difficulty with pouching or concerning stoma changes, visit the clinic. If home health care services are delayed due to insurance, seek assistance in the clinic.

Stoma Concerns:

• After-Hours Issues: If you have stoma concerns after hours or on weekends, visit the ED.

Other Situations:

• Clinic Visit Issues: If you experience low blood pressure, weakness, lightheadedness, nausea, vomiting, or abdominal pain during a clinic visit, you will be transferred to the ED for further evaluation.
• Chemotherapy and Recent Surgery: If you are undergoing chemotherapy after recent surgery and your imaging shows a DVT/clot or present with symptoms of a clot, the attending physician or nurse practitioner will send you to the ED.

Please call the clinic at 305-243-9110, option 4, for any of the above concerns or if you have any questions after your procedure.

WHEN TO RETURN TO THE EMERGENCY DEPARTMENT OR SEEK ADMISSION

Abdominal Complications:

• Fever: If your temperature exceeds 100.4°F (38°C), return to the ED immediately. This may indicate early signs of an anastomotic leak or abdominal fluid collection.
• Worsening Abdominal Pain or Distention: If you experience increasing abdominal pain, distention, nausea, diarrhea, and/or vomiting, return to the ED. This could signal a post-op ileus or leak.
• Diet Intolerance: If you cannot keep food down and have nausea and/or vomiting, return to the ED. This may indicate a post-op ileus or leak.
• Signs of Peritonitis: If you have abdominal pain, distention, and cannot tolerate the pain, seek immediate medical attention. This could be a possible leak.

Drains:

• Drain Issues: If you have a JP drain and notice feculent matter, pus, or a significant increase in output, return to the ED.

Wounds:

• Infection Signs: If your surgical wound shows signs of infection, the severity will determine if you need to visit the clinic or the ED. If you have a fever, you may require IV antibiotics and possible admission.

Post-Op Hemorrhoidectomy:

• Severe Pain: It is common to experience a significant level of pain after a hemorrhoidectomy, especially after your first bowel movement. While pain medications may provide some relief, they often cannot completely alleviate the discomfort. Unfortunately, only time will help reduce these symptoms. If your pain becomes unmanageable, return to ED.

Obstructive Symptoms:

• No Bowel Movements: If you have no bowel movements, nausea, vomiting, or no ostomy output for over 24-48 hours, seek further evaluation in the ED.

Ileostomy:

• High Output: If your ileostomy output exceeds 1.2 liters (1200 cc) in 24 hours, you are at high risk for dehydration and may need IV hydration and antidiarrheal medications. Return to the ED.

Peristomal Complications:

• Stoma Prolapse or Ischemia: If you experience stoma prolapse or ischemia, seek immediate medical attention.