After Your Osseointegrated Device Implantation (Baha)

NORMAL POST OP COURSE: In general, BAHA surgery is a very safe surgery with limited post-operative pain and few complications. Pain at the surgical site is usually temporary. Stiffness of the jaw is also common.

1. It is safe to sleep on the side of your operative ear.
2. There is a slight chance that you may experience taste disturbance (commonly described as a metallic taste) following surgery. This should go away within a few days-a few weeks. In rare instances, may take a few months.
3. You may have temporary imbalance and dizziness that may persist for a week or more due to swelling at the surgical site, and prescribed anti-nausea, or pain medications.
4. Temporary numbness in and around the ear is normal following surgery. This may last 6 months or more.
5. Narcotic pain medication may have been prescribed for you to take as needed. If you decide not to take Narcotic pain medication, you may take Tylenol or Ibuprofen for any discomfort and pain control.
6. If antibiotics have been prescribed to you, take the full prescription until it is finished.
7. If you experience increased redness, drainage or odor from the incision site or if you develop a fever of 101.5, notify our office.

RISKS:

1. There is the risk that the surgical site may become infected, which in very rare may require an additional surgery and possible removal of the device. You may be given antibiotics around the time of surgery to decrease this risk.
2. Rarely, the implanted device may malfunction and require replacement.
3. Due to the close location of the facial nerve to the cochlea, there is a remote possibility that temporary or permanent facial weakness/paralysis may occur after surgery. This risk is minimized by the use of a monitor of the nerve throughout the operation.
4. Bruising may occur the first few days after surgery in front of the ear, around the eye, and down the neck. This is caused by the needle probe which monitors facial nerve function during surgery.

MEDICATIONS:

1. Do not take Non-Steroidal Anti-Inflammatories such as Ibuprofen or Naproxen
2. Medications used for your anesthetic will be acting in your body for at least 24 hours. During this time:
   1. Do not drive a car, operate machinery, or use power tools
   2. Do not drink alcohol or take tranquillizers
   3. Do not make legally binding decisions

WOUND CARE:

1. If you have a head dressing, it may be removed 24 hours after surgery.
2. Beginning 24 hours after surgery, gently wash the surgical site with soap and water daily.
3. You will likely have Derma bond (surgical glue) to close the incision behind your ear. No special care is necessary. Wash gently behind the ear. It will begin to peel off in 7-10 days.
4. You may shower and wash your hair the day after surgery. Use your finger tips to clean and massage the area with soap and water. Clean your white healing cap with soap and water as well.
5. It you wear eyeglasses and your incision is behind your ear, the earpiece on the side of your surgery may place pressure on the incision. If this occurs, have the earpiece removed for the initial postoperative period.
6. You will have a healing cap in place. You may need to remove this cap once cleared by your doctor during your 7-10 day post op check.
7. Once cleared, you may remove the healing cap during showers. Keep the cap in place at all times other than during showers. The cap will help prevent swelling.
8. Keep the areas surrounding the abutment and cap open to the air and uncovered.

To remove the cap, gently lift an edge until you feel the soft click. Do not twist the cap to remove or apply it.

ACTIVITY:

1. No strenuous, physical activity and no lifting 20 pound or greater for 2-3 weeks.
2. If you develop a cold, you may start an over the counter decongestant. If you have heart disease or high blood pressure, check with your primary care doctor prior to starting decongestant. Call the office if ear pain, drainage or reduced hearing occurs.
3. Air travel is allowed 1 day following surgery. If you have trouble clearing your ears, you may take an over the counter decongestant 2 hours prior to take off, and for trips over 6 hours, again before landing. We recommend chewing gum and drinking fluids liberally while in flight.

3 WEEKS AFTER SURGERY:

1. Daily Care: Use a non-alcoholic baby wipe to gently clean around and over the abutment. This will keep the site clean as well as prevent skin from growing over the abutment.
2. Weekly Care: Begin using the surgical scrub brush if provided to you at your 10 day incision check. The brush should be used while showering to keep the area clean and prevent any skin debris from building up around the abutment. The body is always producing new skin cells and sloughing the old. If skin cells are not removed, skin may begin to grow over the abutment.
3. Regular Inspection of the Abutment: Always check that the abutment or magnet is firmly in place. You can do this yourself or ask your physician to help you during routine appointments. Call your physician if you have persistent problems such as soreness, infection, or inflammation around the abutment.

6 WEEKS AFTER SURGERY:

You will have an activation/fitting appointment with audiology. Expectations include:

• A nurse will check the surgical site to ensure proper healing.
• The audiologist will ask you to listen to certain sounds through the sound processor much like a traditional hearing test. The sound processor will then be programmed specifically to your sound detection and personal needs.
• You will receive instruction on how to attach/detach the processor, how to adjust the volume, and general processor care/maintenance.

DIET: You may resume your normal diet. You may find liquids, crackers and toast more tolerable at first. Avoid heavy, greasy, or spicy foods for the first 12 hours. Drink at least 8-10 glasses of water per day.

OTHER:

1. You will receive an ID card for your implant after surgery. Please make copies of the card and keep a copy of your implant card with you at all times.
2. We recommend you get a medical bracelet identifying you as an osseointegrated device user.
3. You will be given your external device in a brown or black box. Please bring this with you to your activation appointment after surgery.
4. You may resume sexual activity once you feel able, but consider being the less active partner at first.

You should have a post op appointment for 1 week after surgery.

For questions, problems or refills, call the office at (425) 775-6651.

Pain medications require a written prescription, so call for a refill before you run out of medication.

Medication or refill requests must be made during office hours.

There is always a doctor on call for emergent problems after office hours: (425) 775-6651