Bechara Y. Ghorayeb, MD.  1140 Business Center Drive, Suite 560.  Houston, TX 77043
  Tel: (713) 464 2614
www.ghorayeb.com

Vagus Nerve Stimulation (VNS)
Post-Op Instructions 
Diet
Patients who have received general anesthesia may experience nausea and occasionally, vomiting.  It is therefore preferable to eat a bland light meal or a liquid diet on the first day after the surgery.  Regular diet may be resumed the next day. Also, pain pills may cause nausea if taken on an empty stomach. It is preferable to take those pills with a piece of toast or some food.

Activity and Wound Care
Elevate the head as much as possible. Sit in a recliner or use two or three pillows when sleeping. Head elevation reduces bruising and swelling. Occasionally, you may notice that the bruises or swelling have migrated to other places (usually lower regions). You may have a dressing or your wound may be exposed.

Wounds sealed with Dermabond acrylic coating:
Recently, we have been sealing all wounds with a coat of clear acrylic compound called Dermabond.  This protects your wound and allows you to take a shower without covering it.  Do not apply antibiotic ointment over the acrylic.  This acrylic coat will peal off in 10 - 15 days.

For exposed wounds:
If your wound is not sealed with acrylic (Dermabond), keep the exposed wound dry.  Avoid showers. You may take a bath with lukewarm (not hot) water.  If accidentally, water reaches the wound, dry it immediately with a clean towel.  Make sure you have someone with you in the house in case you feel drowsy or fainty from taking pain killers. Clean the wound once a day.  This is best done with a cotton swab dipped in 3% hydrogen peroxide.  If you have not received a prescription for antibiotic ointment, use over-the-counter triple antibiotic.  Apply a scanty amount on the suture line.  If you do not see the sutures, it is because they have been placed inside the wound.

Wounds with dressings or drains:
In very rare instances, you may have a dressing or a drain. Unless specifically instructed, do not remove them. Avoid showers and keep the dressing dry.  Drainage is expected for two to three days after surgery. Just kink the drain tubing, before detaching the bulb and emptying it.  By kinking the tubing, you prevent air and old drainage from being sucked back into the wound.

Medications
An antibiotic is prescribed for seven to ten days following the surgery. You should also receive a prescription for painkillers, usually, hydrocodone. Pain killers cause somnolence, drowsiness and constipation. Occasionally, Phenergan suppositories may be necessary for nausea or vomiting.

Follow-up
● If you have not already been given a follow-up appointment, please call (713) 464 2614 to schedule one in 10 to 15 days. 
● We are unable to refill your medications on weekends or after hours.
We do not refill painkillers over the phone. For prescription refills, please call during office hours:  Monday-Thursday: 9:00 am - 4:30 pm and Friday: 9:00 am - 3:30 pm 



For more information and pictures, please visit Dr. Ghorayeb's website: http://www.ghorayeb.com