About Your Nasal Cavity and Paranasal Sinus Surgery

This guide will help you get ready for your nasal cavity and paranasal sinus surgery at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery.

Use this guide as a source of information in the days leading up to your surgery. Bring it with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.

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About Your Surgery

Your nasal cavity and paranasal sinuses

Your nasal cavity is a large, air-filled space above and behind your nose, in the middle of your face. It has 2 openings, called the nostrils, that warm and moisturize the air you breathe in.

Inside your nasal cavity, you have 4 types of paranasal sinuses, usually called sinuses (see Figure 1). Your sinuses are a group of hollow, air-filled spaces that surround your nasal cavity. These include:

  • Frontal sinuses, which are above your eyes.
  • Ethmoid sinuses, which are between your eyes.
  • Sphenoid sinuses, which are deep in your nasal cavity, behind your ethmoid sinuses.
  • Maxillary sinuses, which are on the sides of your nose.

Your nasal cavity and sinuses are covered with a layer of cells that make mucus and warm the air you breathe. They also affect how your voice sounds when you speak.

Paranasal sinuses

Figure 1. Your paranasal sinuses

Nasal cavity and sinus surgery

Nasal cavity and sinus tumors are usually treated with surgery. The goal of the surgery is to remove the whole tumor and a small amount of normal tissue around it.

Your nasal cavity and sinuses are small areas that have many muscles, nerves, blood vessels, and other important structures. If any of these other structures need to be removed during your surgery, it can affect how you look and how you perform basic functions. Therefore, another goal of surgery is to help you look the same and be able to breathe, chew, talk, and swallow without difficulty after your surgery.

You’ll have many different providers working together before, during, and after your surgery. Depending on your surgery, your treatment team may include:

  • Head and neck surgeon, plastic reconstructive surgeon, and neurosurgeon
  • Radiation oncologist
  • Medical oncologist
  • Dentist
  • Nurses
  • Speech and swallowing therapist
  • Clinical dietitian nutritionists
  • Case managers
  • Social workers

Your healthcare provider will talk with you about which surgery you’re having. The type of surgery depends on the where the tumors are, how big they are, and what other structures are involved. Here are descriptions of the different types of surgeries.

Types of nasal cavity surgery

  • Some nasal cavity tumors can be removed with a surgery called wide local excision. This surgery removes the tumor and a small amount of normal tissue around it.
  • Tumors that are on your nasal turbinates (long, thin bones on the inside walls of your nose) can be removed by a surgery called medial maxillectomy.
  • Tumors that involve the tissue on the outside of your nose may be removed by removing part of your nose or your entire nose.

Types of sinus surgery

  • Tumors that are small, noncancerous (not cancer), and involve only your ethmoid sinuses are removed with a surgery called external ethmoidectomy.
  • Tumors that have grown into your maxillary sinus can be removed by a surgery called maxillectomy. The extent of the surgery depends on where the tumor is and if it involves nearby tissue and structures. During a maxillectomy, the following things may be partly or completely removed:
    • Bone around your maxillary sinus
    • Bone of your hard palate (roof of your mouth)
    • Upper teeth on one side of your mouth
    • Part of or your entire orbit (eye socket)
    • Part of your cheekbone
    • Part of the bony part of your upper nose

If part of your hard palate is removed, there may be an open connection between your nasal cavity and your oral cavity (mouth). Your dental surgeon will take impressions (make a mold of your upper mouth) before and the day of your surgery. They’ll put a temporary surgical obturator (plate) to close the opening in your palate during your surgery. This will help you speak and eat after surgery.

You’ll be discharged from the hospital with the temporary surgical obturator in place. About 2 weeks after your surgery, you’ll have an appointment with your dental surgeon to remove the surgical obturator. During this appointment, your dental surgeon will fit a removable obturator to your mouth. They’ll also give you instructions for cleaning and taking care of the obturator. You’ll have regular follow-up appointments with your dental surgeon to check the obturator and adjust the fit if needed.

  • Tumors in your ethmoid, frontal, or sphenoid sinuses are removed by a surgery called craniofacial resection. This surgery involves removing the tumor through incisions (surgical cuts) on your face and skull. By accessing the tumor from two directions, your surgeons have a better chance of removing the entire tumor. This also helps decrease possible damage to your brain, nerves, and other major structures. You’ll have a head and neck surgeon, plastic surgeon, and neurosurgeon working together on your surgical team.

Endoscopic surgery

This surgery uses endoscopes (thin, flexible, lighted tubes) that are put into your nose to reach your nasal cavity and sinuses. This surgery is used for tumors that are small and less involved with surrounding structures. It may also be used to treat sinus diseases that aren’t cancer.

Lymph node removal

Nasal cavity and sinus tumors sometimes spread to lymph nodes in your neck. Lymph nodes are removed through a surgery called neck dissection. Your surgeon will see if you need a neck dissection based on a medical exam and a computed tomography (CT) or magnetic resonance imaging (MRI) scan.

If you have lymph nodes removed, you’ll have a drainage tube in place while you’re in the hospital. Your nurses will keep track of the amount of drainage. Once the drainage is less than 20 to 30 milliliters (about ½ ounce) in 24 hours, the drain will be removed. This is usually 3 to 5 days after your surgery.

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Before Your Surgery

The information in this section will help you get ready for your surgery. Read this section when your surgery is scheduled and refer to it as your surgery date gets closer. It has important information about what you need to do before your surgery.

As you read through this section, write down any questions you want to ask your healthcare provider.

Getting ready for your surgery

You and your care team will work together to get ready for your surgery.

Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you aren’t sure.

  • I take a blood thinner, such as:
    • Aspirin
    • Heparin
    • Warfarin (Jantoven® or Coumadin®)
    • Clopidogrel (Plavix®)
    • Enoxaparin (Lovenox®)
    • Dabigatran (Pradaxa®)
    • Apixaban (Eliquis®)
    • Rivaroxaban (Xarelto®)
    There are others, so be sure your healthcare provider knows all the medications you’re taking.
  • I take prescription medications (medications my healthcare provider prescribes), including patches and creams.
  • I take over-the-counter medications (medications I buy without a prescription), including patches and creams.
  • I take dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
  • I have sleep apnea.
  • I’ve had a problem with anesthesia (medication to make me sleep during surgery) in the past.
  • I’m allergic to certain medication(s) or materials, including latex.
  • I’m not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke or use an electronic smoking device (such as a vape pen, e-cigarette, or Juul®).
  • I use recreational drugs.

About drinking alcohol

The amount of alcohol you drink can affect you during and after your surgery. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

  • If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these complications, we can prescribe medications to help keep them from happening.
  • If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

Here are things you can do before your surgery to keep from having problems:

  • Be honest with your healthcare providers about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. If you develop a headache, nausea (feeling like you’re going to throw up), increased anxiety, or can’t sleep after you stop drinking, tell your healthcare provider right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you can’t stop drinking.
  • Ask your healthcare provider questions about drinking and surgery. As always, all of your medical information will be kept confidential.

About smoking

If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling 212-610-0507.

About sleep apnea

Sleep apnea is a common breathing disorder that causes you to stop breathing for short periods of time while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes completely blocked during sleep. OSA can cause serious problems during and after surgery.

Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing device (such as a CPAP device) for sleep apnea, bring it with you the day of your surgery.

Using MyMSK

MyMSK (my.mskcc.org) is your MSK patient portal account. You can use MyMSK to send and receive messages from your care team, view your test results, see your appointment dates and times, and more. You can also invite your caregiver to create their own account so they can see information about your care.

If you don’t have a MyMSK account, you can visit my.mskcc.org, call 646-227-2593, or call your doctor’s office for an enrollment ID to sign up. You can also watch our video How to Enroll in MyMSK: Memorial Sloan Kettering's Patient Portal. For help, contact the MyMSK Help Desk by emailing mymsk@mskcc.org or calling 800-248-0593.

Within 30 days of your surgery

Presurgical Testing (PST)

Before your surgery, you’ll have an appointment for presurgical testing (PST). The date, time, and location will be printed on the appointment reminder from your surgeon’s office. It’s helpful to bring the following things to your PST appointment:

  • A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
  • The name(s) and telephone number(s) of your healthcare provider(s).

You can eat and take your usual medications the day of your appointment.

During your PST appointment, you’ll meet with a nurse practitioner (NP). They work closely with anesthesiology staff (specialized healthcare providers who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You may have tests, such as an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

Identify your caregiver

Your caregiver plays an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when you’re discharged from the hospital. They’ll also help you care for yourself at home.

For caregivers

‌  Resources and support are available to help manage the responsibilities that come with caring for a person going through cancer treatment. For support resources and information, visit www.mskcc.org/caregivers or read A Guide for Caregivers.

Complete a Health Care Proxy form

If you haven’t already completed a Health Care Proxy form, we recommend you complete one now. If you’ve already completed one or have any other advance directives, bring them to your next appointment.

A health care proxy is a legal document that identifies the person who will speak for you if you can’t communicate for yourself. The person you identify is called your health care agent.

Talk with your healthcare provider if you’re interested in completing a health care proxy. You can also read the resources Advance Care Planning and How to Be a Health Care Agent for information about health care proxies, other advance directives, and being a health care agent.

Do breathing and coughing exercises

Practice taking deep breaths and coughing before your surgery. If you have any questions, ask your nurse or respiratory therapist.

Exercise

Try to do aerobic exercise every day. Aerobic exercise is any exercise that makes your heart beat faster, such as walking, swimming, or biking. If it’s cold outside, use stairs in your home or go to a mall or shopping center. Exercising will help your body get into its best condition for your surgery and make your recovery faster and easier.

Follow a healthy diet

Follow a well-balanced, healthy diet before your surgery. If you need help with your diet, talk with your healthcare provider about meeting with a clinical dietitian nutritionist.

7 days before your surgery

Follow your healthcare provider’s instructions for taking aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding.

Follow your healthcare provider’s instructions. Don’t stop taking aspirin unless they tell you to. For more information, read the resource Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your surgery. These things can cause bleeding. For more information, read the resource Herbal Remedies and Cancer Treatment.

2 days before your surgery

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

Stop taking NSAIDs, such as ibuprofen (Advil® and Motrin®) and naproxen (Aleve®), 2 days before your surgery. These medications can cause bleeding. For more information, read the resource Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

1 day before your surgery

Note the time of your surgery

A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, they’ll call you on the Friday before. If you don’t get a call by 7:00 pm, call 212-639-5014.

The staff member will tell you what time to arrive at the hospital for your surgery. They’ll also remind you where to go.

This will be one of the following locations:

  • Presurgical Center (PSC) on the 2nd floor
    1275 York Avenue (between East 67th and East 68th Streets)
    New York, NY 10065
    Take the M elevator to the 2nd floor
  • Presurgical Center (PSC) on the 6th floor
    1275 York Avenue (between East 67th and East 68th Streets)
    New York, NY 10065
    Take the B elevator to the 6th floor

Shower

Wash yourself with soap and water the night before your surgery.

Instructions for eating before your surgery

‌  
Do not eat anything after midnight the night before your surgery. This includes hard candy and gum.
 

The morning of your surgery

Instructions for drinking before your surgery

‌  You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.

Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Take your medications as instructed

If your healthcare provider told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.

Things to remember

  • Wear something comfortable and loose-fitting.
  • If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
  • Don’t wear any metal objects. Remove all jewelry, including body piercings. The tools used during your surgery can cause burns if they touch metal.
  • Don’t wear any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
  • Leave valuable items at home.
  • If you’re menstruating (have your monthly period), use a sanitary pad, not a tampon. You’ll get disposable underwear, as well as a pad if needed.

What to bring

  • A button- down or loose-fitting top.
  • Your breathing device for sleep apnea (such as your CPAP device), if you have one.
  • Your Health Care Proxy form and other advance directives, if you completed them.
  • Your cell phone and charger.
  • Only the money you may want for small purchases (such as a newspaper).
  • A case for your personal items (such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles), if you have one.
  • This guide. Your healthcare team will use it to teach you how to care for yourself after surgery.

Where to park

MSK's parking garage

MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.

To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There’s a tunnel that you can walk through that connects the garage to the hospital.

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Once you’re in the hospital

You’ll be asked to say and spell your name and birth date many times. This is for your safety. People with the same or a similar name may be having surgery on the same day.

When it’s time to change for surgery, you’ll get a hospital gown, robe, and nonskid socks to wear.

Get dressed for surgery

When it’s time to change for surgery, you’ll get a hospital gown, robe, and nonskid socks to wear.

Meet with a nurse

You’ll meet with a nurse before surgery. Tell them the dose of any medications you took after midnight (including prescription and over-the-counter medications, patches, and creams) and the time you took them.

Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse doesn’t place the IV, your anesthesiologist will do it in the operating room.

Meet with an anesthesiologist

You’ll also meet with an anesthesiologist before surgery. They will:

  • Review your medical history with you.
  • Ask you if you’ve had any problems with anesthesia in the past, including nausea or pain.
  • Talk with you about your comfort and safety during your surgery.
  • Talk with you about the kind of anesthesia you’ll get.
  • Answer your questions about your anesthesia.

Get ready for your surgery

When it’s time for your surgery, you’ll need to remove your hearing aids, dentures, prosthetic devices, wig, and religious articles, if you have them.

You’ll either walk into the operating room or a staff member will bring you there a stretcher. A member of the operating room team will help you onto the operating bed and place compression boots on your lower legs. These gently inflate and deflate to help blood flow in your legs.

Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV line and you’ll fall asleep. You’ll also get fluids through your IV line during and after your surgery.

During your surgery

After you’re fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. A urinary (Foley) catheter will also be placed to drain urine (pee) from your bladder.

Once your surgery is finished, your incision will be closed with staples or sutures (stitches). You may also have Steri-Strips (thin pieces of surgical tape) or Dermabond® (surgical glue) over your incisions. Your incisions may be covered with a bandage.

Your breathing tube is usually taken out while you’re still in the operating room.

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After Your Surgery

The information in this section will tell you what to expect after your surgery, both during your hospital stay and after you leave the hospital. You’ll learn how to safely recover from your surgery.

As you read through this section, write down any questions you want to ask your healthcare provider.

In the Post-Anesthesia Care Unit (PACU)

When you wake up after your surgery, you’ll be in the PACU. A nurse will be keeping track of your body temperature, pulse, blood pressure, and oxygen levels. You may be getting oxygen through a thin tube that rests below your nose or a mask that covers your nose and mouth. You’ll also have compression boots on your lower legs.

Pain medication

You’ll get IV pain medication while you’re in the PACU. You may be able to control your pain medication using a button called a patient-controlled analgesia (PCA) device. For more information, read Patient-Controlled Analgesia (PCA).

Tubes and drains

You’ll have 1 or more of the following:

  • Drainage tubes near your incisions. These help drain fluid from the area to help your wounds heal.
  • A Foley catheter through your urethra, into your bladder. This drains urine (pee) from your bladder.
  • A face mask and humidifier. This helps keep your airways moist.
  • A nasogastric (NG) feeding tube, if needed. This is a tube that goes through your nose, into your stomach. It’s used to give you nutrition. If you need a NG tube, it will be placed while you’re asleep during surgery and removed once you’re ready.
  • Splints in your nose (Doyle splints). These help prevent scarring in your nose. They’ll be removed during your first appointment after surgery.

Moving to your hospital room

Depending on the type of surgery you had, you may stay in the PACU for a few hours or overnight. After your stay in the PACU, a staff member will take you to your hospital room.

In your hospital room

The length of time you’re in the hospital after your surgery depends on your recovery. A member of your healthcare team will tell you what to expect.

When you’re taken to your hospital room, you’ll meet one of the nurses who will care for you while you’re in the hospital.

While you’re in the hospital, your nurses will teach you how to care for yourself while you’re recovering from your surgery.

Read the resource Call! Don't Fall! to learn about what you can do to stay safe and keep from falling while you’re in the hospital.

Managing your pain

You’ll have some pain after your surgery. At first, you’ll get your pain medication through your epidural catheter or IV line. You’ll be able to control your pain medication using a PCA device. Once you’re able to eat, you’ll get oral pain medication (medication you swallow).

Your healthcare providers will ask you about your pain often and give you medication as needed. If your pain isn’t relieved, tell one of your healthcare providers. It’s important to control your pain so you can use your incentive spirometer and move around. Controlling your pain will help you recover better.

You’ll get a prescription for pain medication before you leave the hospital. Talk with your healthcare provider about possible side effects and when to start switching to over-the-counter pain medications.

Moving around and walking

Moving around and walking will help lower your risk for blood clots and pneumonia (lung infection). It will also help you start passing gas and having bowel movements (pooping) again. Your nurse, physical therapist, or occupational therapist will help you move around, if needed.

Exercising your lungs

It’s important to exercise your lungs so they expand fully. This helps prevent pneumonia.

  • Use your incentive spirometer 10 times every hour you’re awake. For more information, read the resource How to Use Your Incentive Spirometer.
  • Do coughing and deep breathing exercises. A member of your care team will teach you how.

Eating and drinking

For your first meal after your surgery, you’ll have only clear liquids. After that, you’ll slowly start following a puréed diet, then a mechanical soft diet. For more information, read the resource Eating Guide for Puréed and Mechanical Soft Diets.

If you have questions about your diet, ask to see a clinical dietitian nutritionist.

Caring for your tubes and drains

A staff member will care for your tubes and drains while you’re in the hospital. If you’ll be leaving the hospital with tubes or drains, they’ll also teach you how to care for them so you can do it yourself at home. It may be helpful if your caregiver learns too.

Showering

  • If you have drainage tubes near your incision, you can shower, but don’t get the drainage tubes wet. A staff member will help you. You can take a normal shower 24 hours after your drainage tubes are removed.
  • If you don’t have drainage tubes near your incision, don’t take a shower for first 48 hours after your surgery. You can take a sponge bath. A staff member will help you.

Planning for your discharge

Your nurse will teach you the self-care you’ll need to continue caring for yourself at home. This may involve irrigating your mouth and nose, if needed. You’ll also learn exercises to prevent trismus. This is the inability to open your jaw that can develop from scarring or changes in the muscles around your jaw. For more information, read the resource Preventing Trismus.

If you stay in the hospital for less than 1 week, you’ll leave the hospital with staples or stitches in your incision. They’ll be removed during a follow-up appointment after surgery. If you stay in the hospital for longer than 1 week, some or all of your staples or stitches will be removed before you leave.

Leaving the hospital

By the time you’re ready to leave the hospital, your incision will have started to heal. Before you leave the hospital, look at your incision with one of your healthcare providers. Knowing what your incision looks like will help you notice any changes later.

On the day of your discharge, plan to leave the hospital around 11:00 am. Before you leave, your healthcare provider will write your discharge order and prescriptions. You’ll also get written discharge instructions. One of your healthcare providers will review these instructions with you before you leave.

If your ride isn’t at the hospital when you’re ready to be discharged, you may be able to wait in the Patient Transition Lounge. A member of your healthcare team will give you more information.

At home

Read the resource What You Can Do to Avoid Falling to learn what you can do to stay safe and keep from falling at home and during your appointments at MSK.

Filling out your Recovery Tracker

We want to know how you’re feeling after you leave the hospital. To help us continue caring for you, we’ll send questions to your MyMSK account every day for 10 days after you leave the hospital. These questions are known as your Recovery Tracker.

Fill out your Recovery Tracker every day before midnight (12:00 am). It only takes 2 to 3 minutes to complete. Your answers to these questions will help us understand how you’re feeling and what you need.

Based on your answers, we may reach out to you for more information or ask you to call your surgeon’s office. You can always contact your surgeon’s office if you have any questions. For more information, read the resource About Your Recovery Tracker .

Managing your pain

People have pain or discomfort for different lengths of time. You may still have some pain when you go home and will probably be taking pain medication. Some people have soreness, tightness, or muscle aches around their incision for 6 months or longer. This doesn’t mean something is wrong.

Follow the guidelines below to help manage your pain at home.

  • Take your medications as directed and as needed.
  • Call your healthcare provider if the medication prescribed for you doesn’t ease your pain.
  • Don’t drive or drink alcohol while you’re taking prescription pain medication. Some prescription pain medications can make you drowsy. Alcohol can make the drowsiness worse.
  • As your incision heals, you’ll have less pain and need less pain medication. An over-the-counter pain reliever such as acetaminophen (Tylenol®) or ibuprofen (Advil® or Motrin®) will ease aches and discomfort.
    • Follow your healthcare provider’s instructions for stopping your prescription pain medication.
    • Don’t take more of any medication than the amount directed on the label or as instructed by your healthcare provider.
    • Read the labels on all the medications you’re taking, especially if you’re taking acetaminophen. Acetaminophen is an ingredient in many over-the-counter and prescription medications. Taking too much can harm your liver. Don’t take more than one medication that contains acetaminophen without talking with a member of your care team.
  • Pain medication should help you resume your normal activities. Take enough medication to do your activities and exercises comfortably. It’s normal for your pain to increase a little as you start to be more active.
  • Keep track of when you take your pain medication. It works best 30 to 45 minutes after you take it. Taking it when you first have pain is better than waiting for the pain to get worse.

Preventing and managing constipation

Talk with your healthcare provider about how to prevent and manage constipation. You can also follow the guidelines below.

  • Go to the bathroom at the same time every day. Your body will get used to going at that time. If you feel like you need to go, though, don’t put it off.
  • Try to use the bathroom 5 to 15 minutes after meals. After breakfast is a good time to go. That’s when the reflexes in your colon are strongest.
  • Exercise, if you can. Walking is an excellent form of exercise.
  • Drink 8 to 10 (8-ounce) glasses (2 liters) of liquids daily, if you can. Choose liquids such as water, juices (such as prune juice), soups, and ice cream shakes. Avoid liquids with caffeine (such as coffee and soda). Caffeine can pull fluid out of your body.
  • Slowly increase the fiber in your diet to 25 to 35 grams per day. Unpeeled fruits and vegetables, whole grains, and cereals contain fiber. If you have an ostomy or have had recent bowel surgery, check with your healthcare provider before making any changes in your diet.
  • Both over-the-counter and prescription medications are available to treat constipation. Check with your healthcare provider before taking any medications for constipation, especially if you have an ostomy or have had bowel surgery. Follow the instructions on the label or from your healthcare provider. Examples of over-the-counter medications for constipation include:
    • Docusate sodium (Colace®). This is a stool softener (medication that makes your bowel movements softer) that causes few side effects. You can use it to help prevent constipation. Don’t take it with mineral oil.
    • Polyethylene glycol (MiraLAX®). This is a laxative (medication that causes bowel movements) that causes few side effects. Take it with 8 ounces (1 cup) of a liquid. Only take it if you’re already constipated.
    • Senna (Senokot®). This is a stimulant laxative, which can cause cramping. It’s best to take it at bedtime. Only take it if you’re already constipated.
    If any of these medications cause diarrhea (loose, watery bowel movements), stop taking them. You can start again if needed.

Caring for your incision

Your healthcare provider will give you written instructions on how to care for your incisions before you leave the hospital.

It’s normal for the skin below your incision to feel numb. This happens because some of your nerves were cut during your surgery. The numbness will go away over time.

Call your healthcare provider’s office if:

  • The skin around your incision is very red.
  • The skin around your incision is getting more red.
  • You see drainage that looks like pus (thick and milky).
  • Your incision smells bad.

If you go home with staples or stitches in your incision, your healthcare provider will take them out during your first appointment after surgery. It’s OK to get them wet.

If you had radiation therapy to your neck before your surgery, your healthcare provider will take out your staples or stitches 2 to 3 weeks after your surgery.

Eating and drinking

Your healthcare team will tell you if you need to follow a special diet at home. If you have questions about your diet, ask to see a clinical dietitian nutritionist.

Nasal changes after sinus surgery

If you had sinus surgery, you’ll have congestion (stuffiness) and drainage. This can come and go. Your healthcare provider will help you manage these during your appointments after surgery.

You may have less of a sense of smell for some time after your surgery. This can also affect your sense of taste. These things will come back as you heal.

Nasal precautions after sinus surgery

If you had a sinus surgery, follow the precautions below for the first 4 to 6 weeks after your surgery.

  • Don’t put anything in your nose.
  • Don’t drink through a straw.
  • Don’t lower your head below your shoulders.
  • Sneeze with your mouth open.
  • Cough with your mouth open.

Your healthcare provider will tell you if this applies to you.

Physical activity and exercise

When you leave the hospital, your incision will look like it’s healed on the outside, but it won’t be healed on the inside. For the first 4 to 6 weeks after your surgery:

  • Don’t lift anything heavier than 10 pounds (about 4.5 kilograms).
  • Don’t do any strenuous activities (such as jogging and tennis).
  • Don’t play any contact sports (such as football).

Doing aerobic exercise, such as walking and stair climbing, will help you gain strength and feel better. Walk at least 2 to 3 times a day for 20 to 30 minutes. You can walk outside or indoors at your local mall or shopping center.

It’s normal to have less energy than usual after your surgery. Recovery time is different for each person. Increase your activities each day as much as you can. Always balance activity periods with rest periods. Rest is an important part of your recovery.

Driving

Ask your healthcare provider when you can drive. Most people can start driving again 1 week after surgery. Don’t drive while you’re taking pain medication that may make you drowsy.

You can ride in a car as a passenger at any time after you leave the hospital.

Going back to work

Talk with your healthcare provider about your job and when it may be safe for you to start working again. If your job involves lots of movement or heavy lifting, you may need to stay out a little longer than if you sit at a desk.

Traveling

If you had sinus or skull base surgery, don’t fly in a plane for 6 weeks after your surgery. Your healthcare team will tell you if this applies to you.

Getting your test results

The tissue that was removed during your surgery will be examined by a pathologist after your surgery. The test results are usually ready in 1 week, but they can take longer depending on the tests that are done. Your healthcare provider will discuss the results with you during your first follow-up appointment after your surgery.

Follow-up appointments

Your healthcare provider will talk with you about your long-term follow-up care. Your first appointment after your surgery will be about 7 to 10 days after you’re discharged from the hospital. During this visit, your nurse will teach you how to care for your nose and sinuses at home, if needed.

If you have a sinus surgery, you’ll have regular appointments with your doctor during the first month after surgery. They’ll help keep your nose and sinuses clear which can help you heal and keep you comfortable.

You’ll have regular appointments with your dental team for several months after your surgery. If you have an obturator, they’ll adjust it as needed to help you be able to chew, swallow, and speak. If needed, a facial prosthesis will be made to help you look the same as you did before your surgery.

If needed, a speech pathologist from the Speech and Hearing Center will work with you. A speech pathologist treats:

  • Voice loss
  • Swallowing disorders
  • Impaired speech

Your speech pathologist will help you regain as much of your speech and swallowing as possible.

If you have any questions or concerns, you can contact your healthcare provider’s office at any time after you’ve been discharged from the hospital.

Managing your feelings

After surgery for a serious illness, you may have new and upsetting feelings. Many people say they felt weepy, sad, worried, nervous, irritable, and angry at one time or another. You may find that you can’t control some of these feelings. If this happens, it’s a good idea to seek emotional support. Your healthcare provider can refer you to MSK’s Counseling Center. You can also reach them by calling 646-888-0200.

The first step in coping is to talk about how you feel. Family and friends can help. Your healthcare providers can reassure, support, and guide you. It’s always a good idea to let us know how you, your family, and your friends are feeling emotionally. Many resources are available to you and your family. Whether you’re in the hospital or at home, we’re here to help you and your family and friends handle the emotional aspects of your illness.

Your treatment may change your appearance. This can be especially upsetting. There are many resources to help you and your family during your recovery. Some are here at MSK and others are in your community. Ask your doctor, nurse, or social worker about options. You may also want to speak with a head and neck cancer survivor. This can be arranged through our Patient and Caregiver Support Program. Most people find it very reassuring to see someone who has been through something like what they’re facing.

The Resources for Life After Cancer (RLAC) Program provides support and education for people who are finished with treatment. To learn more about the programs they offer, call 646-888-8106 or go to www.mskcc.org/experience/living-beyond-cancer/services-survivors

Depression can occur at any time when you have a cancer diagnosis. It’s important to recognize the symptoms. Help is available to treat and manage it. Signs of depression are:

  • Feelings of helplessness and sadness lasting longer than usual
  • Inability or difficulty to concentrate, carry out normal activities, or both
  • Change in mood
  • Change in sleep pattern
  • Change in appetite

If you have any of these symptoms and they last more than 2 weeks, tell your healthcare provider.

When to contact your healthcare provider

Contact your healthcare provider if:

  • You have a fever of 100.5 °F (38 °C) or higher.
  • You have chills.
  • You’re having trouble breathing.
  • The skin around your incision is warmer than usual.
  • The skin around your incision is getting redder.
  • The area around your incision is starting to swell.
  • The area around your incision is getting more swollen.
  • You have drainage or fluid coming from your incision site.
  • You have any questions or concerns.

Monday through Friday from 9:00 am to 5:00 pm, contact your healthcare provider’s office. After 5:00 pm, during the weekend, and on holidays, call 212-639-2000 and ask to speak to the person on call for your healthcare doctor.

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Support Services

This section has a list of support services that may help you get ready for your surgery and recover safely.

As you read through this section, write down any questions you want to ask your healthcare provider.

MSK support services

Admitting Office
212-639-7606
Call if you have questions about your hospital admission, including requesting a private room.

Anesthesia
212-639-6840
Call if you have questions about anesthesia.

Blood Donor Room
212-639-7643
Call for more information if you’re interested in donating blood or platelets.

Bobst International Center
888-675-7722
MSK welcomes patients from around the world. If you’re an international patient, call for help arranging your care.

Chaplaincy Service
212-639-5982
At MSK, our chaplains are available to listen, help support family members, pray, contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can request spiritual support, regardless of formal religious affiliation. The interfaith chapel is located near the main lobby of Memorial Hospital and is open 24 hours a day. If you have an emergency, please call the hospital operator and ask for the chaplain on call.

Counseling Center
646-888-0200
Many people find that counseling helps them. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed. To make an appointment, ask your healthcare provider for a referral or call the number above.

Food Pantry Program
646-888-8055
The food pantry program provides food to people in need during their cancer treatment. For more information, talk with your healthcare provider or call the number above.

Integrative Medicine Service
646-888-0800
Integrative Medicine Service offers many services to complement (go along with) traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.

MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or speak with the library reference staff to find more information about your specific cancer type. You can also visit LibGuides on MSK’s library website at libguides.mskcc.org.

Patient and Caregiver Education
www.mskcc.org/pe
Visit the Patient and Caregiver Education website to search our virtual library. There you can find written educational resources, videos, and online programs.

Patient and Caregiver Peer Support Program
212-639-5007
You may find it comforting to speak with someone who has been through a treatment similar to yours. You can talk with a former MSK patient or caregiver through our Patient and Caregiver Peer Support Program. These conversations are confidential. They may take place in person or over the phone.

Patient Billing
646-227-3378
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
212-639-7202
Call if you have questions about the Health Care Proxy form or if you have concerns about your care.

Perioperative Nurse Liaison
212-639-5935
Call if you have questions about MSK releasing any information while you’re having surgery.

Private Duty Nursing Office
212-639-6892
You may request private nurses or companions. Call for more information.

Resources for Life After Cancer (RLAC) Program
646-888-8106
At MSK, care doesn’t end after active treatment. The RLAC Program is for patients and their families who have finished treatment. This program has many services, including seminars, workshops, support groups, counseling on life after treatment, and help with insurance and employment issues.

Sexual Health Programs
Cancer and cancer treatments can have an impact on your sexual health. MSK’s Sexual Health Programs can help you take action and address sexual health issues before, during, or after your treatment.

  • Our Female Sexual Medicine and Women’s Health Program can help if you’re dealing with cancer-related sexual health challenges such as premature menopause or fertility issues. For more information or to make an appointment, call 646-888-5076.
  • Our Male Sexual and Reproductive Medicine Program can help if you’re dealing with cancer-related sexual health challenges such as erectile dysfunction (ED). For more information or to make an appointment, call 646-888-6024.

Social Work
212-639-7020
Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also help refer you to community agencies and programs, as well as financial resources if you’re eligible.

Tobacco Treatment Program
212-610-0507
If you want to quit smoking, MSK has specialists who can help. Call for more information.

Virtual Programs
www.mskcc.org/vp
MSK’s Virtual Programs offer online education and support for patients and caregivers, even when you can’t come to MSK in person. Through live, interactive sessions, you can learn about your diagnosis, what to expect during treatment, and how to prepare for the various stages of your cancer care. Sessions are confidential, free, and led by expert clinical staff. If you’re interested in joining a Virtual Program, visit our website at www.mskcc.org/vp for more information.

For more online information, visit the Cancer Types section of www.mskcc.org.

External support services

Access-A-Ride
web.mta.info/nyct/paratran/guide.htm
877-337-2017
In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who can’t take the public bus or subway.

Air Charity Network
www.aircharitynetwork.org
877-621-7177
Provides travel to treatment centers.

American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

Cancer and Careers
www.cancerandcareers.org
A resource for education, tools, and events for employees with cancer.

CancerCare
www.cancercare.org
800-813-4673
275 Seventh Avenue (Between West 25th & 26th Streets)
New York, NY 10001
Provides counseling, support groups, educational workshops, publications, and financial assistance.

Cancer Support Community
www.cancersupportcommunity.org
Provides support and education to people affected by cancer.

Caregiver Action Network
www.caregiveraction.org
800-896-3650
Provides education and support for people who care for loved ones with a chronic illness or disability.

Corporate Angel Network
www.corpangelnetwork.org
866-328-1313
Offers free travel to treatment across the country using empty seats on corporate jets.

Gilda’s Club
www.gildasclubnyc.org
212-647-9700
A place where men, women, and children living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

Good Days
www.mygooddays.org
877-968-7233
Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medication that’s part of the Good Days formulary.

Healthwell Foundation
www.healthwellfoundation.org
800-675-8416
Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medications and therapies.

Joe’s House
www.joeshouse.org
877-563-7468
Provides a list of places to stay near treatment centers for people with cancer and their families.

LGBT Cancer Project
http://lgbtcancer.com/
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.

LIVESTRONG Fertility
www.livestrong.org/we-can-help/fertility-services
855-744-7777
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.

Look Good Feel Better Program
www.lookgoodfeelbetter.org
800-395-LOOK (800-395-5665)
This program offers workshops to learn things you can do to help you feel better about your appearance. For more information or to sign up for a workshop, call the number above or visit the program’s website.

National Cancer Institute
www.cancer.gov
800-4-CANCER (800-422-6237)

National Cancer Legal Services Network
www.nclsn.org
Free cancer legal advocacy program.

National LGBT Cancer Network
www.cancer-network.org
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

Needy Meds
www.needymeds.org
Lists Patient Assistance Programs for brand and generic name medications.

NYRx
www.nyrxplan.com
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

Partnership for Prescription Assistance
www.pparx.org
888-477-2669
Helps qualifying patients without prescription drug coverage get free or low-cost medications.

Patient Access Network Foundation
www.panfoundation.org
866-316-7263
Provides assistance with copayments for patients with insurance.

Patient Advocate Foundation
www.patientadvocate.org
800-532-5274
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

RxHope
www.rxhope.com
877-267-0517
Provides assistance to help people get medications that they have trouble affording.

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Educational Resources

This section has the educational resources mentioned in this guide. These resources will help you get ready for your surgery and recover safely after surgery.

As you read through these resources, write down any questions you want to ask your healthcare provider.

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