1. Ear plugs are recommended only for swimming in freshwater ponds or in oceans. The risk of bathwater or chlorinated pool water causing an ear infection is minimal, and ear plugs are optional.

2. Discharge from the ear is to be expected. It may be bloody at first. Prolonged bleeding or discharge should be reported to the head and neck surgery clinic or emergency room.

3. There may be mild to moderate pain on the day of surgery. It may be controlled with the child's usual dose of Tylenol for the first day. There is no need for pain control passed the first day.

4. It is possible to have ear infections even though the tubes are in place. Pain, foul discharge, elevated temperature over 100.5° or any other symptoms suspicious of ear infection should be reported to your pediatrician, the head and neck surgery clinic or the emergency room.

5. Hearing may be dramatically improved. Loud noises or voices can surprise smaller children. Be alert to loud noises and offer reassurance. Lower volume on the television.

6. The tubes can fall out at any time. When they do, the ear drum will heal over the tube site. There is nothing you can do to make it to stay in longer. The child cannot reach them with a finger in the ear.

7. You or your child may return to work, school, or play the day after placement of the tubes if no other surgery was performed. Regular diet may be taken the day after surgery.

8. The tube itself should cause no symptoms other than early ear drainage and better hearing. It acts to allow air to ventilate the middle ear as should occur normally.

9. You or your child will be given a telephone post operative check appointment. This is a short appointment to check on the status of your child. If you need to change the appointment, please call the head and neck surgery clinic at 510-675-4241.

10. Doc's Proplugs are fitted in the head and neck surgery clinic and are available for purchase in the Kaiser pharmacy.