Pituitary Innovation and Teaching

After your surgery

What happens? || Caring for your nose || Be careful of... || Activity || Eating || Symptoms

What happens in hospital after surgery?

  • Blood tests to check hormone levels or routine blood counts once or twice a day.

  • Keeping track of how much is being drunk and how much pee (urine) is being produced is very important to make sure that the pituitary gland is making the right amount of the water hormone ADH. You will be asked to write down how much you are drinking. You will need to collect all your pee and give it to the nurse. The nurse will accurately measure how much urine you produce every day. If you get very thirsty and make too much urine, you may need to take a medicine called DDAVP (which acts like ADH). DDAVP will help your kidneys hold water in your body to prevent you from becoming dehydrated.  Dehydration may cause low blood pressure.

  • The same day or a day after surgery, the Vaseline gauze packing in the nostrils will be removed. It is common for some nose bleeding when it is removed but it usually stops within the first or second day. The nurses will show you how to gently wash your nose with salt water (saline) rinse once mild bleeding stops.

Checking for fever, blood pressure and pulse several times a day is routine.

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How should I care for my nose after surgery?

It is important to take good care of your nose after surgery. You will need to rinse your nose six to eight times every day after you leave the hospital, for several weeks after the operation.

Do not blow your nose until the Ear Nose and Throat (ENT) surgeon has told you that your nose has fully healed. The pressure from blowing your nose can prevent the incision from healing and push germs up into the brain.  If the incision opens out, brain fluid can leak out and germs can enter the brain to cause an infection called meningitis.

A stuffy nose or blocked feeling can last a few weeks.  Gentle nasal washes with a sterile saline solution to clear out any blockages. For the first few weeks after surgery, use a gentle saline mist spray four to eight times per day. You can buy the spray at a local drugstore without a prescription.

Once the small plastic sheets in the nose are removed by the ENT Surgeon (usually two to three weeks after surgery), you can use a larger saline wash for your nose and sinus cavity. You can buy sterile saline packets and nasal rinse bottles at a local drugstore.

Instructions for nose saline washes

  1. Fill the nasal rinse bottle with 250mL (1 cup) of solution.

  2. While in the shower or over a sink, bend your head over and aim the head of the bottle nozzle away from the centre of your nose. Open your mouth and pour the saline solution in your nose.  The fluid will circulate in and out of your sinus cavities, coming back out of your nose.  It is okay if some of the solution comes out through your mouth. Try not to swallow large quantities.

  3. Repeat at least two to eight times a day (as a minimum, once in the morning and once in the evening), until the stuffiness is gone.

  4. After each use, rinse out the bottle and wash the tip with soap and water. Allow the bottle to air-dry completely. Once a week, sterilize the bottle by pouring 2/3 cup water and 1/3 cup of hydrogen peroxide into the irrigation bottle. Shake the solution and squirt it through the nozzle. Make sure the solution flows over the nozzle tip.

You can also make your own sterile saline solution by mixing 1 litre (1 quart) boiled or distilled water with 1 teaspoon canning/pickling/kosher salt (non-iodized) and 1 teaspoon baking soda.

If you make your own sterile saline solution, it is important to keep the solution in the refrigerator.  Before using the solution, make sure it is at room temperature. You can warm up the solution by using a microwave. After using the microwave, make sure the solution is cooled to room temperature before using.

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What should I be careful about after my surgery?

Sneezing: If you need to sneeze, keep your mouth open to avoid pressure.

Avoid straining yourself:

  • while lifting
  • during a bowel movement
  • during sex
  • do not blow your nose for three to four weeks after surgery and given the OK by the nose specialist or neurosurgeon

Straining increases pressure in your head and may damage the delicate surgical area. If the surgical area is damaged, this may cause a leak of cerebrospinal fluid.

Driving: Do not drive until you are off painkillers and your doctor says it is safe. Be sure to talk to your doctor before you drive. If your vision was affected before surgery, you will have to have a special visual field test and permission by the ophthalmologist before you are legally allowed to drive again. In many cases, the law requires that doctors report patients who might have impairments like loss of vision to the Ministry of Transportation and the Ministry may elect to suspend the patient’s driver’s license.

Travelling: Do not travel by airplane or go out of the country unless your doctor has checked your health and said it is safe. Do not plan to travel for at least 4 weeks after surgery and only once the surgeons and eye doctors say it safe to travel. Make sure to take along all of your medicine, as well as some of your medical notes describing your condition.  Family doctors usually receive this information if you include your family doctor’s address and fax number when you register at the hospital.

Working: Most people are off work for about six to eight weeks, but some are off for more or less time.

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Being active after your surgery

It is important to be active after surgery and to continue this at home. Gentle exercising will prevent complications after the surgery (such as pneumonia or a blood clot in your legs).

Walking often is the best exercise. Walk frequently and gradually for as long as you can every day. Try to walk for longer periods of time until you can walk for one hour without stopping. If you can’t walk for that long, try to do a little more each day.

Feeling tired is common and so short rests or even naps are OK.

Avoid heavy activities that may strain you.

Eating after your surgery

To prevent the result of straining (the need to strain during bowel movements):

  • eat foods rich in fiber (such as whole grains, fruits such as prunes, leafy greens, and other vegetables),
  • use stool softeners as needed (such as Colace).

Follow a normal balanced diet such as in Canada’s Food Guide.

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What changes can I expect in my symptoms?

You will know that your surgery has been a success if you have the following changes in your symptoms.

If your vision was affected before surgery:

  • some vision often returns within days or weeks of the surgery

If you have acromegaly or Cushing’s, your treatment is a success if:

  • your hormone levels return to normal
  • some of the changes that the tumour has caused go away

If you have a prolactinomas, your treatment is a success if:

  • your menstrual periods return
  • your fertility improves
  • milk production stops
  • you have improved sexual function or desire

If you have a large tumour and get headaches because of the tumour, your headaches will have a good chance of improving.

More information:

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Page last updated: November 22, 2016