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Uvulopalatopharyngoplasty

WHAT YOU SHOULD KNOW

Uvulopalatopharyngoplasty (YOU-view-low-PAL-at-oh-fair-ING-oh-plass-tee), or UPPP, is surgery to remove the uvula (the small piece of tissue that hangs at the back of the throat) and all or part of the soft palate (the soft part of the roof of the mouth in front of the uvula). When a laser is used, doctors call this surgery "LASUPPP" for short. The procedure is done to help stop snoring or sleep apnea. If you still have your tonsils, the doctor will remove them as well. After this operation, the throat tends to swell and close up. To maintain an airway, the surgeon may insert a tracheostomy tube in your throat through an incision in your neck. Alternatively, an endotracheal (ET) tube may be passed through your nose or mouth and down the throat. Once the swelling subsides, the tube is removed.

Risks

There are always risks with surgery. You might develop internal bleeding or get an infection. Blood clots could form and lodge in the lungs, making it difficult to breath. However, medical personnel are always alert for such complications, and know how to remedy them.

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

  • The Week Before Surgery:
  • You'll probably need to stop taking aspirin and ibuprofen; the doctor will tell you when. If you're taking aspirin for your heart, don't stop without asking the doctor first. Also ask whether you can take any over-the-counter medicines.
  • Your doctor will tell you whether you need to have blood drawn.
  • The Night Before Surgery:
  • Your physician may suggest you take a sleeping pill.
  • Just before surgery, you should not eat or drink anything (even water). Your doctor will tell you when to begin fasting.

When You Arrive

  • Check with your doctor before taking insulin, diabetes pills, blood pressure medicine, heart pills, or any other medication on the day of surgery.
  • Do not wear contact lenses to the hospital. You may wear glasses.

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.
  • Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
  • Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
  • Chest X-ray: The doctor will check this picture of your lungs and heart to make sure they can handle the stress of surgery.
  • Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Typically, three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat.
  • IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
  • Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
  • General Anesthesia: For this type operation, you'll need pain-killing medication that puts you completely to sleep. It is given either as a liquid in your IV or as a gas through a face mask or endotracheal tube placed in your mouth and throat.

After Surgery:

You'll need to stay in bed until the doctor says it's safe to get up. As you begin your recovery, you can expect the following:
  • Ventilator: This is a special machine that can do your breathing for you. It can be hooked up to the airway tube inserted during the operation.
  • Wrist Restraints: These strips of cloth or leather fasten your wrists to the sides of the bed. They prevent you from accidentally pulling out your airway tube. They will be taken off as soon as the tube is removed.
  • Day or Night Confusion: Patients recovering in the ICU often can't tell whether it's day or night, since the lights are on 24 hours a day. This problem will disappear once you are moved to a room on a regular floor.
  • Blood Gases: This test measures the amount of oxygen, acids, and carbon dioxide in the blood---measurements that are especially important if you're having any trouble breathing. The blood sample for the test is taken from an artery in the wrist, elbow, or groin.
  • Deep Breathing and Coughing: These exercises help prevent a lung infection after surgery. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum from your lungs and keep them clear. You should deep breathe and cough every hour while you are awake, including any time you spend awake during the night.
  • Hold a pillow tightly against your abdomen to help reduce pain from your incision. Take a deep breath and hold it as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
  • Incentive Spirometer (spy-ROM-uh-tur): This piece of equipment helps you take deeper breaths. Put the plastic nozzle into your mouth, take a very deep breath, and hold it as long as possible. Then blow as hard as you can into the mouthpiece. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
  • Pressure Stockings: These tight elastic stockings keep blood from collecting in the legs and causing clots.
  • Pneumatic Boots: For extra insurance against blood clots, these plastic boots or leggings are applied over pressure stockings or ace wraps and connected to an air pump machine. The pump rhythmically tightens and loosens different parts of the boots, helping to push the blood back up to the heart.
  • Activity: You will need to rest in bed for a while. But even if you are confined to bed, it's important to exercise your legs in order to stop blood clots from forming. Lift one leg off the bed and draw big circles with your toes, then repeat with the other leg. You can also try lying on your side and pretending to pedal a bike. When you're told it's OK to get out of bed, make sure someone is with you the first time you try. If you feel weak or dizzy, sit or lie down right away.
  • Eating: When your doctor can hear bowel sounds (stomach growling) through a stethoscope, you'll be able to eat. You will probably get ice chips first and then liquids (water, broth, apple juice, or soda). If you do not have problems with the liquids, you'll then be allowed to eat soft foods such as ice cream, applesauce, or custard. If these foods agree with you, you can return to a regular diet.
  • Medicines:
  • Antibiotics: These medicines help prevent bacterial infection. They may be given by IV, as a shot, or by mouth.
  • Pain Medicine: To ease pain after the operation, your doctor will probably prescribe medication to be given by IV, as a shot, or by mouth. Tell the doctor or your nurses if the pain won't go away or keeps coming back.
  • Anti-Nausea Medicine: This medicine calms your stomach and controls vomiting. Your doctor may suggest you take it at the same time as your pain medicine, which sometimes upsets the stomach.

After You Leave

  • Slowly start to do more each day, resting as needed. Once you feel stronger, start a regular exercise program. Exercise makes the heart stronger, lowers blood pressure, and keeps you healthy. Your doctor can help you plan the program.
  • Eat healthy meals from all 5 food groups: fruits, vegetables, breads, dairy products, and meat. This will increase your energy level and promote faster healing.
  • Unless instructed otherwise, drink 6 to 8 large glasses of liquid, such as water, juices, and milk, each day. Limit caffeinated beverages, such as coffee, tea, and soda.
  • Always take your medicine exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.

Call Your Doctor If...

  • You have a high temperature.
  • You develop itchy, swollen skin or a rash. You may be allergic to your medicine.

Seek Care Immediately If...

  • You have chest pain or sudden trouble breathing. You might have a blood clot in your lung, or could be having an allergic reaction to one of your medicines. Call 911. This is an emergency.

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