What can I expect to have on my body?
After your surgery, you will have:
Incisions: Your surgery will be completed either by a thoracotomy or by video assisted surgery (VATS). Your surgeon will tell you where and how big your incision (cut) will be.
Thoracotomy: A thoracotomy means the incision is on your side. The incision will be anywhere from 8 to 25 centimetres (about 2½ to 10 inches) long.
VATS: If you are having video assisted surgery (VATS), you will have 3 to 5 small incisions on your side. Each incision is about 2 centimetres (about ¾ of an inch) long. You will have 1 to 2 small incisions on your side for the chest tube(s). Each will be about 2 centimetres (about ¾ of an inch) long. Bandages cover your incisions. We remove them the following day after your surgery.
Stitches or staples: Your surgeon usually uses dissolvable stitches to close your incisions. This means they go away on their own. If they are not dissolvable, your nurse usually removes the stitches or staples 14 days after your operation. If your stitches or staples need to remain in after you are discharged home, your family doctor can remove them. We will tell you if this is the case and give you a staple remover to take to your family doctor.
Chest Tubes: You will have 1 to 2 chest tubes coming out of the side of your chest. These tubes remove air and fluid from the inside of your chest area. The tubes are attached to a machine that helps suck the air and fluid out. We use stitches to keep the chest tubes in place. These are not dissolvable. We remove your chest tubes once it is safe. The stitches are to be removed by your family doctor 14 days after we take the tubes out.
Heart monitor: You will be on a heart monitor while you are in the Step Down Unit. This doesn't mean there is a problem with your heart. We do this for all patients who have your type of surgery.
Urinary catheter: You will have a tube draining your bladder overnight. We remove it the next morning. While you are in the hospital, the nurse measures how much you urinate.
Intravenous (IV): You have an IV so we can give you fluids and medicines. It stays in until you are drinking well or you no longer need pain medicine through a pump.
Arterial line: This tube looks like an IV, and we use it to take blood samples without having to poke you with a needle. It also closely monitors your blood pressure.
Oxygen: You may need oxygen after your surgery. At first, you will have an oxygen mask over your nose and mouth. When you no longer need the mask, you may get oxygen through your nostrils (nasal prongs). You may need oxygen overnight after surgery. We remove the oxygen once your oxygen levels are good enough.
Is there anything else I can expect?
- A physiotherapist may treat you once or twice a day. The physiotherapist helps you improve your movement. They help you do:
- Deep breathing and coughing exercises to clear your lungs of mucous. This helps to prevent pneumonia.
- Shoulder exercises on the side of your surgery. These exercises help to keep your shoulder joint moving fully.
- How often you see the physiotherapist depends on your condition during the day. Your nurse helps you with these exercises at night.
- You are usually able to drink the evening after your surgery. You may have a light meal if you want it. Your appetite may be poor. This is normal. Try to eat a little at each meal. Your body needs nutrients to heal and recover after surgery.
- During your surgery, we will give you a general anesthetic. This will make you feel sleepy for some time after the operation.
- You may have nausea and be sick to your stomach. The nurse will tell you to take deep breaths. This helps to decrease your nausea and fully expand your lungs.
- During your surgery, you will also have a breathing tube in your throat. This may cause your throat to be sore afterwards. It should feel better after a couple of days. Tell your nurse and doctor if your throat is sore.
We will work with you to manage your pain. We can give you pain medicine in different ways. These include:
Epidural: With an epidural, a doctor puts a small tube in your back. They usually do this right before your surgery. The tube is left in place to give you pain medicine after your surgery. It's attached to a pump, which gives you the medicines. They include a pain killer and medicine that numbs the area where you had surgery. They may make your legs feel numb or heavy.
Extrapleural catheter: This can be used to manage pain in patients who had a thoracotomy incision. The pain medicine runs through a small tube placed under your skin near your incision. It's usually placed near your chest tube. The tube is attached to a pump which gives you the medicine. The tube stays in place until your chest tube is removed.
Intravenous (IV) Patient Controlled Analgesic or PCA: A PCA pump is connected to your IV. The pump gives you pain medicine through your IV when you push the button. You should press the button:
- When you start to feel pain.
- Before you do something that brings on pain
- Before you do deep breathing and coughing exercises
- Before you start to move or turn.
You should feel the effects of the medicine within 2 to 3 minutes. If you don't feel any pain relief, let your nurse know. You are only allowed to have a certain amount of pain medicine every 4 hours. To control how much medicine you get, the PCA pump has a safety timer called a lockout. If you press the button during the lockout time, you won't get more medicine. Only you should press the button.
Intravenous (IV) medicine: You get your pain medicine through an IV. It's important to let your nurse know when you have pain so they can give you the pain medicine. If you don't feel any pain relief after getting the medicine, let your nurse know.
Medicine by mouth: You may get your pain medicine in tablets that you swallow. This will happen once you are drinking fluids. Let your nurse know when you have pain, so they can give you the pain medicine.
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