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Marc E. Lieberman, MD, FACS Ear, Nose and Throat ENDOSCOPIC SINUS SURGERY AND/OR INTERNAL NASAL RECONSTRUCTION
2 WEEKS BEFORE SURGERY
 Do not take aspirin or aspirin containing products for 2 weeks prior to the surgery and for
2 weeks following the surgery. Aspirin will increase the risk of post-operative bleeding. 2 DAYS BEFORE SURGERY
 A Sterapred pak (low dose of steroids) is prescribed to aid in the healing and comfort. Begin taking this prescription 2 days prior to surgery and continue to take it for a total of 6 days. Follow the instructions on the package. NIGHT BEFORE SURGERY
 Do not have anything to eat or drink starting 8 hours before surgery.
THE DAY OF SURGERY
 With a sip of water, take the 1st pill from day 3 of the Sterapred pak as well as any blood pressure medicine. Resume all other medications after surgery as directed.
 Following the surgery you will stay in the recovery room until you are fully awake. After a few hours you will be discharged to go home.  You may be nauseated after general anesthesia. This usually clears after a few hours. If the nausea persists or if you vomit repeatedly, Dr. Lieberman should be contacted.  You may eat normally as tolerated. You may prefer a thick soup as opposed to food that requires heavy chewing. Also, because your nose will be “packed”, it will be uncomfortable to breathe if you fill your mouth with food. The choice is yours!  Please have someone stay with you for the 1st 24 hours after your surgery 1600 36th Street, Suite A Vero Beach, Florida 32960 Telephone (772) 569-7800 Fax (772) 569-9252 Diplomate, American Board of Otolaryngology Diplomate, American Board of Facial Plastic & Reconstructive Surgery Marc E. Lieberman, MD, FACS Ear, Nose and Throat
2 WEEKS AFTER SURGERY
 You can begin to irrigate your sinuses as demonstrated in the office. Mix 3 teaspoons of salt with 24 ounces of water at body temperature, and place in the Water Pik reservoir. Irrigate each nostril for 5 minutes every morning and every evening everyday! Adjust the intensity of the Water Pik so that you can feel a firm stream, but not to the point of it being uncomfortable. ADDITIONAL INSTRUCTIONS AND INFORMATION
 You will be given a prescription for pain medicine that should be filled before your surgery. Take it as prescribed. Do not wait until you are in a great deal of pain as the
medication will be less effective and take longer to “kick in”. If your pain is severe, Dr.
Lieberman should be contacted.
 You will have a drip pad on for the first 24 hours and there will be some oozing. If you have to change your drip pad more frequently than once an hour because it is saturated, Dr. Lieberman should be contacted.  It is okay to change your nasal drip pad as needed for the first 24 hours post-operatively.  The nasal packing is uncomfortable and will be removed by Dr. Lieberman the day after  Do not blow your nose for 2 weeks following your surgery. You can use a saline nasal
spray (Ayr or Ocean), 1 puff each nostril 4 times a day or more often as needed. If you still feel congested, please call our office to schedule a time for additional suctioning. If you need to sneeze, open your mouth.  Elevate your head on 3 pillows or sit/sleep in a recliner.  Ice packs may be placed over your cheeks every 3 to 4 hours for 15 to 20 minutes at a  If you experience any vision problems, Dr. Lieberman should be contacted.  A temperature of over 100.4 should be reported to Dr. Lieberman.  Use a cool vapor humidifier at your bedside until the packing is removed.  Numbness or discomfort may occur in the upper front teeth. This is temporary and not  Occasionally, some temporary swelling, bruising, or numbness of the lip or temporary bruising of the area around the eyes may occur.  Air under the skin around the eyes or cheeks may occur and is temporary.  It may take 5 to 6 weeks for full recovery and improvement in your symptoms. Please be 1600 36th Street, Suite A Vero Beach, Florida 32960 Telephone (772) 569-7800 Fax (772) 569-9252 Diplomate, American Board of Otolaryngology Diplomate, American Board of Facial Plastic & Reconstructive Surgery Marc E. Lieberman, MD, FACS Ear, Nose and Throat ACTIVITY
 No strenuous activity for 2 weeks. Gradually increase to low activity 3 – 4 days after your surgery. You can return to school or light duty work after 1 week. 1600 36th Street, Suite A Vero Beach, Florida 32960 Telephone (772) 569-7800 Fax (772) 569-9252 Diplomate, American Board of Otolaryngology Diplomate, American Board of Facial Plastic & Reconstructive Surgery

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Arava 20mg tablets

1. NAME OF THE MEDICINAL PRODUCT 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each tablet contains 20 mg of leflunomide. Each tablet contains 72 mg of lactose monohydrate. For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Yellowish to ochre and triangular film-coated tablet, imprinted with ZBO on one side. 4. CLINICAL PARTICULARS 4.1 Therapeuti

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