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Patient Instructions


Patient Smiling
General Guidelines for all procedures:

Do not chew on hard, sticky or chewy foods for a least 24 hours. Never chew on ice. Avoid aggressive chewing and sticky foods such as “hard tack” candies that can loosen or damage a restoration. Carefully follow all guidelines provided by the doctor and their staff and most importantly practice good oral hygiene. Additional instructions following various types of treatment are listed below. Please click on the below topics for detailed instructions. In the event of an emergency, please call our office. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.


Please wear loose clothing to facilitate rolling up of the sleeve.
DO NOT eat anything for at least 8 hours before surgery.
Parents or guardians should observe children prior to surgery to make certain there is no consumption of foods or fluids.
You may drink clear liquids (water, fruit juices WITHOUT PULP, carbonated beverages, clear tea and black coffee) up to 4 hours before the appointment.
If you normally take pills for high blood pressure, thyroid or asthma, please take them with a LITTLE sip of water an hour before the appointment.
Please come 30 minutes ahead of your scheduled appointment if this is your first visit to our office.
Patients must be accompanied by an adult who will remain int he waiting area during surgery and until recover period is over. Any patient under the age of 18 must have a parent or legal guardian present at time of the procedure. (You will NOT be allowed to take a cab home.)
We encourage payments prior to your surgery to expedite your discharge after you awaken following surgery.
If you have been given an antibiotic prescription at the time of your consultation, PLEASE TAKE THE ANTIBIOTIC AN HOUR BEFORE YOUR APPOINTMENT WITH A SIP OF WATER.
Please remove nail polish and lipstick.
Notify our office if you develop a cold, sore throat, cough, fever or any other illness prior to the surgery.
REST ASSURED THAT YOU WILL RECEIVE COMPASSIONATE AND PROFESSIONAL SERVICE.

HELP EVER * HURT NEVER

Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply. Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. Our number is: 301–294–8700.

DAY OF SURGERY

FIRST HOUR: Bite down firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place. The packs maybe gently removed after you reach home. Look at the gauze before you throw it away, if it is soaked in blood, you do need to replace with fresh gauze. Prior to replacing the gauze, drink a milkshake/ice cream or yogurt with a spoon and then take your pain medications – one prescription strength Motrin and an extra strength Tylenol. Now take two pieces of gauze from the goody bag, roll it like a cigar and fold it and place it snugly in the area of extraction and bite down for 20 minutes. Redness in the center of the gauze is normal; the gauze needs to be replaced only if it is soaked in blood. Intermittent bleeding or oozing overnight is normal.

FIRST 24 HOURS: Do not disturb the surgical area. Do NOT spit, rinse, brush your teeth at night, consume hot food or use a straw on the day of the surgery. Please do not smoke since this is very detrimental to healing and may cause a dry socket. Use ice on the outside of the face, 20 minutes on and 5 minutes off until bed time. Do not smoke for the first 24 hours.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office to reach Dr. Sreeni. Do not physically exert yourself for 5 days following surgery as this will cause unexpected bleeding.

PAIN: Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the pills before the anesthetic has worn off you should be able to manage any discomfort better. Do repeat the pain medications (Motrin + Tylenol) every four hours on the first two days of surgery while awake. If you feel that the pain is not adequately controlled with the mild pain medication combination, please take the prescribed strong pain medication. We encourage our patients to be couch potatoes on the day of surgery as activities will increase ooziness and nausea. BSX of pain medications very widely among individuals. If you find you were taking large amounts of pain medication at frequent intervals, please call our office.

NAUSEA: Nausea is not uncommon after surgery. Sometimes the intravenous anesthesia or pain medications are the cause. Nausea can be reduced by proceeding each pain pill with a small amount of soft food. Try to keep taking clear liquids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola/soda may help with nausea.

DIET: Eat any nourishing food that can be taken with comfort. Avoid hot food on day of surgery. Do not use a straw for the first day after surgery. It is advisable to confined the first days intake to liquids or puréed foods (soups at room temperature, puddings, yogurt, milk shakes, etc.). It is best to avoid foods like nuts, sunflower seeds, popcorn, etc. for three weeks as they may get lodged in the socket areas. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits or follow instructions given by your doctor.

SHARP EDGES: If you feel something hard or sharp edges in the surgical areas, it is likely you were feeling bony walls which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Rinse only after the first 24 hours. Use 1/4 teaspoon of salt dissolved in 8 ounces of warm water and gently rinse with portions of solution, taking five minutes to use the entire glassful. Repeat as often as you like, but certainly after every meal.

BRUSHING: Begin your normal oral hygiene routine 24 hours after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

HEALING

Normal healing after tooth extraction should be as follows:

The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.

Following these instructions will assist you, but if you have questions about your progress, please call our office. You can contact the doctor Dr. Sreeni after hours. Calling during office hours will afford a faster response to your question or concern.

HELP EVER * HURT NEVER

WHAT TO DO AFTER SURGERY: The incision wounds after surgery usually heal quickly and without complications, if simple precautions are taken. Cooperating with your oral surgeon is important.

Here are some guidelines and instructions for you to follow to aid in your healing and recovery:

Rest at home, minimize talking, and generally take it easy for 24-48 hours following surgery. It may not be necessary to be in bed rest; but it is important that you rest. Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply, Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. Our number is: 301-294-8700.

DAY OF SURGERY

FIRST HOUR: Bite down firmly on the gauze packs making sure they remain in place. The packs may be gently removed after you reach home. Look at the gauze before you throw it away, if it is soaked in blood, you need to replace with fresh gauze. Prior to replacing the gauze, drink a milkshake, ice cream or yogurt with a spoon (DO NOT USE STRAW FOR AT LEAST SIX DAYS) and then take your pain medication one prescription strength Motrin and one extra strength Tylenol. Now take two pieces of gauze from the goody bag, roll it like a cigar and fold it and place it snugly in the area of the implant and bite dawn for 20 minutes (MOISTURIZE THE GAUZE WITH LITLLE BITE OF WATER BEFORE PUTTING IT IN). Redness in the center of the gauze is normal; the gauze needs to be replaced only if it soaked in blood. Intermittent bleeding or oozing overnight is normal.

FIRST 24 HOURS: Do not disturb the surgical area. Do not spit, rinse, brush your teeth at night, consume hot food or use a straw on the day of the surgery. PLEASE DO NOT SMOKE since this is very detrimental to healing.

SWELLING: The surgical area will swell and may become quite large. After the procedure apply an ice pack to the side of the face, 20 minutes on and 5 minutes off until bed time. Moist heat, like a warm, wet wash cloth, will aid in reducing swelling after the first 24 hours. Swelling usually reaches its maximum with in the first 40 hours post-surgery and then slowly decreases.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between the teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for a 30 minutes. If bleeding remains uncontrolled, please call out office to reach the doctor on call. Do no physically exert yourself for the 5 days following surgery as this will cause unexpected bleeding.

PAIN: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the pills before the anesthetic has worn off, you should be able to manage any discomfort better. Do repeat the pain medication (Motrin + Tylenol) every four hours on the first two days of surgery while awake. If you feel that the pain is not adequately controlled with the mild pain medication combination, please take the prescribed strong pain medication. We encourage out patients to be couch potatoes on the day of surgery as activities will increase ooziness and nausea. The effects of pain medication vary widely among individuals, if you find you are taking large amounts of pain medicine at frequent intervals. Please call out office.

DIET: Eat any nourishing food that can be taken with comfort. Avoid hot foods on day of surgery. Do not use a straw for the first day after surgery. It is advisable to confine the first day’s intake to liquids or pureed goods, (soups at room temperature, puddings, yogurt, milk shakes, etc.). It is best to avoid foods like nuts, sunflower seeds, popcorn etc. for three weeks, as they may get lodged in the socket areas. It is important not to skip meals! If you take nourishment regularly you will feel better, again strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits or follow instruction given by your doctor. Since you will be taking medication, it is very important that you eat before each medication course to prevent nausea.

FIRST 24 HOURS:  Cold, liquid diet only.

SECOND DAY AFTER SURGERY:  May start warm, soft food and continue it for 3 weeks.

Here are some foods we recommend:

  • Milk
  • Yogurt
  • Oatmeal or cream of wheat
  • Ice cream
  • Soft boiled or scrambled eggs
  • Milkshakes
  • Soups
  • Applesauce
  • Boiled fish
  • Pudding
  • Potatoes- baked or mashed
  • Jell-O

BRUSHING: Begin your normal oral hygiene routine 24 hours after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Rinse only after the first 24 hours. Use ¼ teaspoon of salt dissolved in an 8 ounces’ glass of warm water and gently rinse with portions of solution, taking five minutes to use the entire glassful. Repeat as often as you like, but certainly after every meal.

BRUISING: Bruising sometimes occurs after tooth exposure. It is natural result of the drilling involved in placing the implant- you should not be alarmed if it occurs. The bruising is often visible a few days’ post-surgery and may be located either above or below the area that the implants were places.

HEALING –  Normal healing after tooth exposure should be as follows:

The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.

NAUSEA: Nausea is not uncommon after surgery sometimes the intravenous anesthesia or pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food. Try to keep taking clear liquids a minimize dosing of pain medication, but call us if you do not feel better. Classic Coca Cola/ Soda May help with nausea.

HELP EVER * HURT NEVER

WHAT TO DO AFTER SURGERY: The incision wounds after surgery usually heal quickly and without complications, if simple precautions are taken. Cooperating with your oral surgeon is important.

Here are some guidelines and instruction for you to follow to aid in your healing and recovery:

Rest at home, minimize our talking, and generally take it easy for 24-48 hours following surgery. It may not be necessary to be in bed rest; but it is important that you rest. Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply, Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. Our number is: 301-294-8700.

DAY OF SURGERY

FIRST HOUR: Bite down firmly on the gauze packs making sure they remain in place. The packs may be gently removed after you reach home. Look at the gauze before you throw it away, if it is soaked in blood, you do need to replace with fresh gauze. Prior to replacing the gauze, drink a milkshake, ice cream or yogurt with a spoon (DO NOT USE STRAW FOR AT LEAST SIX DAYS) and then take your pain medication one prescription strength Motrin and on extra strength Tylenol. Now take two pieces of gauze from the goody bag, roll it like a cigar and fold it and place it snugly in the area of the implant and bite down for 20 minutes (MOISTURIZE THE GAUZE WITH LITLLE BIT OF WATER BEFORE PUTTING IT IN). Redness in the center of the gauze is normal; the gauze needs to be replaced only if it soaked in blood. Intermittent bleeding or oozing overnight is normal.

FIRST 24 HOURS: Do not disturb the surgical area. Do not spit, rinse, brush your teeth at night, consume hot food or use a straw on the day of the surgery. PLEASE DO NOT SMOKE since this is very detrimental to healing.

SWELLING: The surgical area will swell and may become quite large. After the procedure apply an ice pack to the side of the face, 20 minutes on and 5 minutes off until bed time. Moist heat, like a warm, wet wash cloth, will aid in reducing swelling after the first 24 hours. Swelling usually reaches its maximum with in the first 40 hours post- surgery and then slowly decreases.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between the teeth only and are not exerting pressure on the surgical areas. Try reposition the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for a 30 minutes. If bleeding remains uncontrolled, please call out office to reach the doctor on call. Do no physically exert yourself for the 5 days following surgery as this will cause unexpected bleeding.

PAIN: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the pills before the anesthetic has worn off, you should be able to manage any discomfort better. Do repeat the pain medication (Motrin + Tylenol) every four hours on the first two days of surgery while awake. If you feel that the pain is not adequately controlled with the mild pain medication combination, please take the prescribed strong pain medication. We encourage out patients to be couch potatoes on the day of surgery as activities will increase ooziness and nausea. The effects of pain medication vary widely among individuals, if you find you are taking large amounts of pain medicine at frequent intervals. Please call out office.

DIET: Eat any nourishing food that can be taken with comfort. Avoid hot foods on day of surgery. Do not use a straw for the first day after surgery. It is advisable to confine the first day’s intake to liquids or pureed goods, (soups at room temperature, puddings, yogurt, milk shakes, etc.).  It is best to avoid foods like nuts, sunflower seeds, popcorn etc. for three weeks, as they may get lodged in the socket areas. It is important not to skip meals! If you take nourishment regularly you will feel better, again strength, have less discomfort and heal faster.  If you are diabetic, maintain your normal eating habits or follow instruction given by your doctor. Since you will be taking medication, it is very important that you eat before each medication course to prevent nausea.

FIRST 24 HOURS:  Cold, liquid diet only.

SECOND DAY AFTER SURGERY:  May start warm, soft food and continue it for 3 weeks.

Here are some foods we recommend:

  • Milk
  • Yogurt
  • Oatmeal or cream of wheat
  • Ice cream
  • Soft boiled or scrambled eggs
  • Milkshakes
  • Soups
  • Applesauce
  • Boiled fish
  • Pudding
  • Potatoes- baked or mashed
  • Jell-O

IF YOU HAVE A TEMPORARY TOOTH PLACED OVER YOUR IMPLANT PLEASE CONTINUE YOUR SOFT SMOOSHI DIET FOR THE FOUR MONTHS.

BRUSHING: Begin your normal oral hygiene routine 24 hours after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Rinse only after the first 24 hours. Use ¼ teaspoon of salt dissolved in an 8 ounces’ glass of warm water and gently rinse with portions of solution, taking five minutes to use the entire glassful. Repeat as often as you like, but certainly after every meal. You have been prescribed a special mouth wash please start three days after surgery (NOT BEFORE).

HEALING

Normal healing after placement of an implant should be as follows:

The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.

BRUISING: Bruising sometimes occurs after implant surgery. It is natural result of the drilling involved in placing the implant- you should not be alarmed if it occurs. The bruising is often visible a few days’ post-surgery and may be located either above or below the area that the implants were places.

NAUSEA: nausea is not uncommon after surgery sometimes the intravenous anesthesia or pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food. Try to keep taking clear liquids a minimize dosing of pain medication, but call us if you do not feel better. Classic Coca Cola/ Soda May help with nausea.

DENTURES: If you currently wear a full or partial denture or a single-tooth prosthesis (called a “Flipper”), you may wear your appliance immediately after the implant surgery, unless your oral surgeon instructs you otherwise. Your appliance should be left in for the first 24 hours to help contour the gum underneath and minimize swelling. On the day following surgery, your appliance should be removed for cleaning purposes (rinsing and bruising); but you should not be left out for long periods of time until 72 hours’ post-surgery. If your gums hurt due to excessive soreness or unusual pressure from your appliance, you should not wear it until you have seen your dentist or surgeon and have had it modified or re-lined.

Following these instructions will assist you but, if you have questions about your progress, please call out office. You can contact the doctor on call after hours. Calling during office hours will afford a faster response to your questions or concern.

HELP EVER * HURT NEVER

WHAT TO DO AFTER SURGERY: The incision wounds after surgery usually heal quickly and without complications, if simple precautions are taken. Cooperating with your oral surgeon is important.

Here are some guidelines and instruction for you to follow to aid in your healing and recovery:

Rest at home, minimize our talking, and generally take it easy for 24-48 hours following surgery. It may not be necessary to be in bed rest; but it is important that you rest. Sometimes the after-effects of oral surgery are quite minimal, so not all of the instructions may apply, Common sense will often dictate what you should do. However, when in doubt follow these guidelines or call our office for clarification. Our number is: 301-294-8700.

DAY OF SURGERY

FIRST HOUR: Bite down firmly on the gauze packs making sure they remain in place. The packs may be gently removed after you reach home. Look at the gauze before you throw it away, if it is soaked in blood, you de need to replace with fresh gauze. Prior to replacing the gauze, drink a milkshake, ice cream or yogurt with a spoon (DO NOT USE STRAW FOR AT LEAST SIX DAYS) and then take your pain medication one prescription strength Motrin and on extra strength Tylenol. Now take two pieces of gauze from the goody bag, roll it like a cigar and fold it and place it snugly in the area of the implant and bite dawn for 20 minutes (MOISTURIZE THE GAUZE WITH LITLLE BIT OF WATER BEFORE PUTTING IT IN). Redness in the center of the gauze is normal; the gauze needs to be replaced only if it soaked in blood. Intermittent bleeding or oozing overnight is normal.

FIRST 24 HOURS: Do not disturb the surgical area. Do not spit, rinse, brush your teeth at night, consume hot food or use a straw on the day of the surgery. PLEASE DO NOT SMOKE since this is very detrimental to healing.

SWELLING: The surgical area will swell and may become quite large. After the procedure apply an ice pack to the side of the face, 20 minutes on and 5 minutes off until bed time. Moist heat, like a warm, wet wash cloth, will aid in reducing swelling after the first 24 hours. Swelling usually reaches its maximum with in the first 40 hours’ post- surgery and then slowly decreases.

PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between the teeth only and are not exerting pressure on the surgical areas. Try reposition the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for a 30 minutes. If bleeding remains uncontrolled, please call out office to reach the doctor on call. Do no physically exert yourself for the 5 days following surgery as this will cause unexpected bleeding.

PAIN: Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication. If you take the pills before the anesthetic has worn off, you should be able to manage any discomfort better. Do repeat the pain medication (Motrin + Tylenol) every four hours on the first two days of surgery while awake. If you feel that the pain is not adequately controlled with the mild pain medication combination, please take the prescribed strong pain medication. We encourage out patients to be couch potatoes on the day of surgery as activities will increase ooziness and nausea. The effects of pain medication vary widely among individuals, if you find you are taking large amounts of pain medicine at frequent intervals. Please call out office.

DIET: Eat any nourishing food that can be taken with comfort. Avoid hot foods on day of surgery. Do not use a straw for the first day after surgery. It is advisable to confine the first day’s intake to liquids or pureed goods, (soups at room temperature, puddings, yogurt, milk shakes, etc.). It is best to avoid foods like nuts, sunflower seeds, popcorn etc. for three weeks, as they may get lodged in the socket areas. It is important not to skip meals! If you take nourishment regularly you will feel better, again strength, have less discomfort and heal faster, if you are diabetic, maintain your normal eating habits or follow instruction given by your doctor. Since you will be taking medication, it is very important that you eat before each medication course to prevent nausea.

FIRST 24 HOURS: Cold, liquid diet only.

SECOND DAY AFTER SURGERY: May start warm, soft food and continue it for 3 weeks.

Here are some foods we recommend:

  • Milk
  • Yogurt
  • Oatmeal or cream of wheat
  • Ice cream
  • Soft boiled or scrambled eggs
  • Milkshakes
  • Soups
  • Applesauce
  • Boiled fish
  • Pudding
  • Potatoes- baked or mashed
  • Jell-O

BRUSHING: Begin your normal oral hygiene routine 24 hours after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

MOUTH RINSES: Keeping your mouth clean after surgery is essential. Rinse only after the first 24 hours. Use ¼ teaspoon of salt dissolved in an 8 ounces’ glass of warm water and gently rinse with portions of solution, taking five minutes to use the entire glassful. Repeat as often as you like, but certainly after every meal.

HEALING: Normal healing after sinus lift should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement.

BRUISING: Bruising sometimes occurs after sinus lift surgery. It is natural result of the drilling involved in placing the implant- you should not be alarmed if it occurs. The bruising is often visible a few days’ post-surgery and may be located either above or below the area that the implants were places.

NAUSEA: nausea is not uncommon after surgery sometimes the intravenous anesthesia or pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food. Try to keep taking clear liquids a minimize dosing of pain medication, but call us if you do not feel better. Classic Coca Cola/ Soda May help with nausea.

CERTAIN PRECAUTIONS WILL ASSIST HEALING AND WE ASK THAT YOU FAITHFULLY FOLLOW THESE INSTRUCTIONS:

TAKE PRESCRIPTIONS AS DIRECTED

  • Purchase AFRIN Nasal Spray (Available over the counter). Spray 2 puffs each nostril AM and PM for 3 days.
  • Do not forcefully spit for 1 week
  • Do not smoke for 10 days.
  • Do not use a straw for 1 week.
  • Do not forcefully blow your nose for at least two weeks, even though your sinus may fell “stuffy” or there may be some nasal drainage.
  • Use Q tips to clean nose.
  • Purchase OCEAN Nasal Spray (Available over the counter). Use several times a day to keep nose moist.
  • Try not to squeeze; it will cause undesired sinus pressure. If you must sneeze, keep your mouth open.
  • Eat only soft foods for several days, always trying to chew on the opposite side of your mouth.
  • Do not rinse vigorously for several days. Gentle salt water swishes. May be used.

Keep our office advised of any changes in your condition, especially if drainage or pain increases. It is important that you keep all future appointments until this is healed.

HELP EVER * HURT NEVER