You may fatigue easily in the beginning but you will be able to build up your strength and energy by being persistent. Walking is an essential part of your recovery. Begin slowly and increase your activity over time. Walk every day, either outdoors, in a mall, in your home, or on a treadmill. No lifting greater than 10 pounds for a couple of weeks. Resume your daily activities when you are able. Do not try to do too much too soon. Allow yourself to take a rest or nap during the day.
Climbing stairs is permitted. Be sure to take your time and rest if you are uncomfortable or short of breath. If you anticipate any problems with climbing stairs during your hospital stay, a physical therapy evaluation may be requested to determine any problems and provide suggestions.
Range of motion exercises must be performed 10 times each, 3 times a day for 2 to 3 weeks on the sides where the chest tubes were located.
Range of motion exercises may also be performed in the shower. The warm water loosens the muscles and will make it easier to perform the exercises.
It is important to move both arms to prevent stiffness and limited range of motion. It is generally advised not to perform any heavy lifting for the first week or two after surgery if a VATS was performed. If a thoracotomy was performed, any heavy lifting should be restricted for at least 6 to 8 weeks. Please check with your doctor.
- Raise your arm over your head with the elbow straight. Bring your arm towards your ear.
- Place your hand behind your neck with the elbow bent and toward your back. Reach toward your shoulder blade.
- Hold your arm straight out in front of you, then cross it over to the other side of your body. Reach for you opposite shoulder.
- Shrug your shoulders up, down and in circles.
- Squeeze your shoulder blades together.
- Walk your hand up a wall until your arm is straight and your chest is against the wall.
You will need to continue using your triflow (incentive spirometer) at home while you are awake until you are back to your normal activity level. The deep breathing improves lung function and helps prevent postoperative complications such as pneumonia. Continue to perform deep breathing and coughing exercises as well. This will help keep the lungs re-expanded and assist in removing any secretions. Make sure to splint the incisions with a pillow or blanket to alleviate some of the pain during coughing. If necessary, nebulizers will be ordered at home. A home health agency will deliver the supplies to your home. The doctor will determine how long to continue the nebulizers at home.
You will be given a prescription for pain medication at the time of your discharge from the hospital. You may need to take this medication every four hours. In time, you will be able to decrease the amount of medication you require as postoperative pain does decrease over time. It can be expected that by six to eight weeks after surgery, most patients experience minimal discomfort. Sensation (feeling) along the surgical incisions is often decreased or may feel numb and usually returns in time.
If you find that you are almost out of pain medication and think you may need a refill, call the office 310-829-8618. Be sure to call before you are completely out of medication. Some medications require a written prescription to be refilled and cannot be called into your local pharmacy.
It is essential to take measures to prevent constipation while taking narcotics (pain medication). Listed below are a few suggestions. Most stool softeners and laxatives may be bought over the counter at any pharmacy.
- Drink lots of water
- Eat lots of fruits and vegetables
- Prune juice
- Milk of Magnesia
- Colace 100 mg by mouth twice a day
- Dulcolax pills or suppository
Pain medications have various side effects. Please do not let this keep you from taking your pain medication if you need it. If you have significant side effects from the pain medication, please let your doctor know so it may be changed to another one.
Common side effects from narcotics (pain medications) include: constipation, fatigue, upset stomach, nausea, vomiting, and drowsiness.
Pain medications after surgery are typically taken for a short period of time. It has been found that if pain medication is taken properly it is not addictive. Please do not let this keep you from taking your pain medication.
Acetaminophen may also be taken for discomfort. Be sure not to take acetaminophen and the prescribed pain medication together. Often the prescribed pain medication has acetaminophen in it. If you are uncertain please ask.
Anti-inflammatories may also be taken as long as you do not have an allergy to this medication or have significant stomach or kidney problems. These medications are held prior to surgery but are used after surgery for pain management. These medications help reduce swelling associated with surgery. These medications may be purchased over the counter without a prescription (Ibuprofen, Advil, Aleve, Motrin, etc). Please take as directed by your surgeon.
Warm showers allow the muscles to loosen and help minimize pain after surgery. Showering twice a day is suggested.
Heating pads may be placed near your incisions. Be sure to place a towel between you and the heating pad. Be sure not to fall asleep while the heating pad is on. This is to prevent burning the skin. A hot water bottle may be used instead if this is a concern.
Pillows may also be used to help minimize discomfort. Place a pillow over the incision and pull it close to the body (splinting). This helps alleviate postoperative pain while coughing and deep breathing.
You may resume a regular diet. There are no dietary restrictions. Nutrition is an essential part of healing after surgery. It aids in improving strength, promotes wound healing and prevents infection. It is essential to make every effort to eat. A nutritional supplement in addition to a least 3 meals a day is suggested if there is a loss of appetite. Eat high protein and take measures to increase your calories.
Once all of your tubes have been removed you may be permitted to shower. It is fine for the incisions to get wet in the shower. It is actually encouraged to shower twice a day. This will help loosen the muscles and reduce discomfort. Wash the incisions with a gentle soap and water. Do NOT scrub the area. Leave the incisions open to air. A dressing is usually not necessary unless there is drainage. Do NOT apply ointments or creams directly to the incisions until you have seen your doctor. You will NOT be permitted to take a bath, use a hot tub, jacuzzi or go swimming for several weeks after surgery. Make sure to check with your doctor.
When you are first at home you may find it difficult to sleep throughout the night. In time, this will improve.
You may drive when you are no longer taking narcotic pain medication.
After a surgery you may resume your activities when you feel you are able to do so. Most patients are able to resume their activities within a couple weeks after surgery. The recovery time after a thoracotomy usually takes longer since the incision is larger and causes more discomfort.
Typically a patient may return to work 4 to 6 weeks after surgery. Returning to work may depend on the type of surgery performed and the type of job you have. This may be discussed with your doctor. If you feel that you would like to return to work earlier than this period of time you may do so if permitted by your doctor.