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Thoracic Surgery Tips and Tricks


LouT

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Okay, your surgery is scheduled.  This post is meant to provide you with information and tips to prepare for thoracic surgery, what to do in the hospital, and when you return home.  I’m hoping that the information here will alleviate some of your anxiety and fears.

You can do this; you will get through it!  Be open to the support of family and friends as well as the folks here at Lungevity.  We are here for you.

Pre-Surgery

o  Eat healthily, get sleep, and also do some physical activity.  It might just be walking, but the better your body works before surgery, the more quickly it can recover post-surgery.  

o  Make sure you have someone to count on for your first few days at home.  You'll be tired and likely in some discomfort, so having someone there to assist you when you need it can be a real help. If you live alone and have Medicare, you can ask your doctor for a home nurse to visit, check on your progress, and change dressings.  In-home care also lets you ask questions about your recovery. 

o  Get a wedge pillow.  It will allow you to sleep in a more comfortable position, take the pressure off your back, and improve your ability to breathe comfortably.  You may also want to keep a small pillow available to press against your body's surgery side when you cough.

o  Arrange the nightstand with things you may need, so you have them within easy reach.  Remember stretching is something to avoid after surgery.

o  Make sure to fill your pain prescriptions and take them as recommended.  Once you’re home, you'll need to be active, and it is harder to do to if you’re in pain.  The meds are not a "forever thing," but are necessary to keep you comfortable enough to recover faster.

o  Have the numbers of your doctors readily available to call if you have questions or experience symptoms that concern you.

o  Pack your “hospital bag” bringing only the things you’ll need.  Remember, a thoracic procedure requires a post-surgical stay of a few days before being discharged.

In the Hospital

o  Show up on time.

o  On the day of surgery, after the surgery takes place, they will likely have you sit up, stand, or even have you walk to a chair to sit for a bit.  It is important to get you moving and exercise your lungs. Remember the surgeon likely gave you a pain block, so it’s unlikely you’ll feel pain.

o You should be given a Spirometer (if not, ask for one).  Use it often; it will help to keep your lungs clear and rebuild lung capacity.

o  TAKE YOUR PAIN MEDS AS INSTRUCTED.  The pain block will wear off within 12-20 hours after surgery, and without the additional pain meds, you will get uncomfortable quickly, so please take the pain meds as prescribed.

o  The day after surgery, you, your IV’s and chest tube/pump will go for a walk around the ward.  Do not be an overachiever; do what is required and practice slow deep breathing when exercising.

o  If you miss bathing, the nurse can provide towelettes as a substitute.

o  Once you are stable, if your lung is not leaking air, and your body is properly absorbing post-surgery fluids, you’ll be set up for discharge.  They’ll remove the chest tube, IV’s, and other paraphernalia they’ve attached, and you’ll be ready to go home.

Home Post-Surgery

o  Have a plan to exercise. It should be walking; at first around your house and later outside (sunshine and fresh air are excellent tonics).  But take it easy--this is not a sprint but a long race that you will win with each increasing step over time. 

o  Continue to use your spirometer; it is your best friend for increasing lung strength and function. 

o  You will be sent you home with pain meds.  Take them as prescribed until pain is diminished.  Pain restricts exercise and prolongs healing. 

o  REST WHEN YOU FEEL TIRED.  Sorry for the caps, but this is important. You've had major surgery and need time to heal, adjust to changes, and adapt to old activities.  Be kind to yourself and give yourself grace until you’re strong enough to manage your new normal.

o  If you have any symptoms that concern you contact your doctor asap.  For example, some people may hear/feel gurgling when breathing while it may be nothing it might be a condition (subcutaneous emphysema) that your doctor should be aware of. It can often resolve on its own, but keeping the doctor updated is a wise choice. 

o  When you're feeling up to it, update us on our forum. Let us know how you're doing and ask any questions.  We're here for you!

Recovery differs for everyone; in my case it was about 6 weeks before I was almost back to routine activities after my Lobectomy. Please stop into the forum if you have questions.  A good group of people will be there for you.

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Great summary, Lou, I can't think of a thing to add.

Except maybe one. It's a rare situation that doesn't affect most people, but it did me and a few other people I know. I developed something called "crepitus" or "sub-cutaneous emphysema" right after surgery. Has nothing to do with what most people think of as emphysema. This is a small leak of air that gets into the tissues under your skin (sub-cutaneous). It made me feel at first like my glands in my neck were swollen and then it spread to my whole chest and up my face. I looked like a chipmunk with the mumps! 

Sometimes this resolves on its own but if it progresses, it becomes VERY uncomfortable--if you look it up online you can see some people have even their eyes swollen shut! So you do NOT want to let it get to that point. 

I had to go back in the hospital for a few days with a chest tube to slowly deflate, and then I was fine. 

As I said, it's pretty rare but it does happen, and if it does, it's something to report to your doctor. Not generally life-threatening, but a complication you want to address ASAP.

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Great summary that landed just in time!  My Uncle was diagnosed with lung cancer this week (pathology pending).  Lou was kind enough to send me a sneak preview.  It was invaluable for my Aunt who is an awesome caretaker.  Love you guys!  

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  • 2 weeks later...

another great article.  what  did you bring to the hospital?  can I put on pajama pants before walking around the hospital?

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Thank you Barbara.  In my case it was two gowns (front and back) but you could bring pj pants and see if they let you wear them.  I don’t see a reason why they wouldn’t.  
 

Lou

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  • 1 year later...

Thank you so much for putting this together! I find it interesting -- I am a counselor for children and adults with cancer, and many of the things that you have advised are the same things I regularly write to patients and their families. Now, though, the shoe is (once again, SIGH) on the other foot, and this time, with major cancer #3, I need to truly learn to practice what I preach. I am an infamous "over-doer"  and suffer from the common long-term patient's inclination to over-do when feeling slightly better. That, I believe will be my hardest and most important job post-surgery. Thank you for guiding me here; I needed to see this information aimed at ME, not the other way around this time. Much, much appreciated! I am happy to have found and joined you here. Thank you. I send warm greetings from the coastal forests of northern California.  ❤️ ~ joana

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Joana,
You’re welcome and I can only say being an overachiever got me into a lot of trouble during my recovery and I hope you don’t fall prey to the same temptation.

Lou 

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  • 10 months later...

Lou,

this SO very helpful. Thank you so much for all this wonderful information. It really helps tremendously to know what to prepare for! I’m going to order a wedge pillow right now! ; )

I too, am an active, over achiever. I will be sure pace myself now after reading of your experience!

Best to you and best of luck on Monday!

Lori

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Lori,

Thanks, I'm glad it helps you.  There will be plenty of time to overachieve once you finish your recovery.  So, take it easy and get healthy first!
And thanks for the good wishes...I'm keeping all digits crossed and leaving the rest up to God.

Lou

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Yep, Lou's right. Get the wedge pillow. And follow the rest of his suggestions, too. He's put  this classic together from his own experience and that of others on here and it's helped a lot of people.  Thanks again, Lou!

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