1. Go home and rest quietly for the remainder of the day. Do not drive, operate appliances, or make any legal decisions today.

2. Have a responsible adult drive you home and stay with you the remainder of the day.

3. You may resume your normal diet after the procedure. Avoid alcoholic beverages and depressant drugs for 24 hours.

4. Do not take aspirin-containing products, ibuprofen, vitamin E, or blood-thinning products (*Coumadin) for the next 24 hours. You may take Tylenol (1 to 2 tablets every four to six hours) for mild discomfort at the site. If you develop severe pain, swelling, or redness of the incision, call Dr. Osterman's office at (305) 932-7800.

5. If you develop a rapid pulse (greater than 100 beats per minute), feel faint, sweat profusely, experience a sudden onset of weakness or experience increased pain, swelling, or saturation of the dressing at the procedure site, call Dr. Osterman's office immediately.

6. If you develop a sudden onset of rapid breathing (greater than 20 breaths per minute), upper back or chest pain, shortness of breath, sweating, skin color change, or a sudden onset of anxiety, call Dr. Osterman's office immediately.

7. Report a temperature greater than 101º Fahrenheit (38.3º Celsius) to Dr. Osterman's office.

8. Check the dressing throughout the day for an increase in drainage. Keep the dressing dry for 24 hours.

a. Dressing change instructions:
i. Avoid contact with shower water or bath water.
ii. Cover dressing and surrounding skin with a piece of plastic food wrap (cling wrap, siran wrap) then you may bathe or shower.
iii. Remove plastic wrap and dressing
iv. Clean site with peroxide and sterile cotton ball, then allow to air dry.
v. Apply new sterile gauze dressing.

9. If you are unable to care for your tube at home, arrangements may be made through your primary care physician for a Home Healthcare Nurse to visit and perform hourly dressing changes. Notify our office if you need assistance in arranging for a Home Healthcare Nurse.

10. Do not smoke for 24 hours after the procedure.

11. Call Dr. Osterman's office for a follow-up appointment at (305) 932-7800.

12. If any questions or complications develop after you go home, please call Dr. Osterman's service at (305) 932-7800.

*Coumadin In most cases Coumadin therapy may be re-started 3 days after the procedure. You may discuss this with Dr. Osterman after the procedure or call the office for instructions.