Recovery after surgery

Tuesday 1 April, 2014

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On this page: Hospital recovery room | Hospital ward | Leaving hospital (discharge) | Page's story | Taking care of yourself at home | Coping with your emotions | Rehabilitation | Key points


No matter what kind of operation you have, don’t be surprised if it makes you feel tired and drained. Even if your pain is under control, surgery can be physically and emotionally stressful.

Your medical team will talk to you about your recovery – it may take a few days or a week to recover from a less complex operation, but it can take a few months to recover from a major procedure. Follow your surgeon’s advice, and try to be patient and allow yourself time to recover.

Hospital recovery room

Immediately after surgery, you will be moved out of the operating theatre to a large area near the operating theatre with medical monitoring equipment (recovery room).

Sometimes hospitals have different names for this room – it may be called a post-anaesthesia care unit or recovery ward. It can be a shared space or a private room.

Some people who need a high level of care will go into the high dependency unit (HDU) or intensive care unit (ICU). Your condition is closely monitored in these units so potential problems can be identified early and treated as needed. You will be moved out of the HDU or ICU as your condition improves.

You may have had a tube down your throat for the operation to help you breathe (intubation). This will be removed, but your mouth and throat may feel temporarily dry or sore. 

The recovery nurse will monitor your vital signs while the anaesthesia wears off and give you medication or fluids to make you feel better and reduce side effects caused by anaesthesia. You’ll probably receive pain medication through tubes or an intravenous drip. There might be some drains to remove waste and fluid from your body. The surgeon may also examine you again. 

Family and friends may be able to visit you in the recovery room, but each area has different policies – for instance, only one visitor may be permitted at a time, or immediate family only. See below.

Hospital ward

If you are staying in hospital to recover (i.e. you didn’t have day surgery as an outpatient), you will be moved from the recovery room to a ward. You will be looked after by nurses and other health professionals, such as a physiotherapist or dietitian.

Tubes and drains

You may have some temporary drains or tubes inserted into your body. Drains will remove fluid or waste away from the site, and cannulas or other tubes may make it easier to take blood samples and give pain relief.

Pain control

You may be given a PCA (patient-controlled analgesia) device, which allows you to receive a dose of medication when you press a button. The device is programmed to prevent overdose. Tell the doctor or nursing staff if you’re in pain.

Breathing

Breathing exercises can help you develop lung strength and prevent infection and fluid build-up. A physiotherapist can show you how to do these exercises. A handheld device, called an incentive spirometer, can help improve your deep breathing.

Movement and circulation

When you return from theatre, you may be wearing stockings or calf stimulators to keep blood circulating through your legs, or have an injection of medication to prevent dangerous blood clots (deep vein thrombosis or DVT). It’s a good idea to get up and move around as much as possible. Nurses or a physiotherapist will give you advice about this.

Eating and drinking

Depending on the type of surgery you had, your diet may be affected. After surgery, some people resume eating by drinking broth and soup, then progress to plain foods and small meals. Some people receive nutrition through a tube, rather than eating foods.

If the cancer and surgery affected your digestive system (e.g. mouth, throat, oesophagus, stomach, bowels), you will need to take special care and follow the dietitian’s advice about eating and drinking. See nutrition for more information. 

Bathing

The timing of your first shower depends on how you are feeling – some people shower the same day or the next day if they are feeling up to it. The nurses will probably encourage you to shower as soon as possible, because this is a good reason to get up and get moving. Nurses can help you if you need to remove dressings or cover them to keep them from getting wet. If you can’t get out of bed, the nurses will give you a bed bath. 

"The hardest part was knowing how much progress I had to make after the operation. The nurses wrote some goals for me: pain control, breathing exercises, tubes out, getting out of bed, walking. It felt impossible, but I was battered, not broken. Over time, I was able to achieve all those things and go home." – Earl

Leaving hospital (discharge)

If you had day surgery, you will be discharged from hospital after you leave the recovery room. It’s important to pre-arrange for someone to take you home after day surgery. The nurses will contact this person and let them know when you’re ready to go.

If you had inpatient surgery, you will be officially discharged when the medical team thinks you are healthy enough to leave. Some people stay in hospital for a day or two, but others stay for several weeks or months. The total length of your hospital stay depends on the speed of your recovery and the type of operation you had.

Along with discharge papers, the medical team may give you:

  • scan and test results
  • instructions about how to take care of yourself at home (see below)
  • guidelines about when to contact your doctor (see below)
  • a medical certificate for your employer
  • insurance forms, bills or receipts
  • a list of any medications/prescriptions, or a small supply of medications (such as pain relief).

If you want specific paperwork (e.g. a letter for your employer) and it isn’t offered, you can request it from the doctor, nurses, receptionist or social worker. You may want to make a copy for your records or show it to your general practitioner (GP).

It’s natural to feel anxious about going home. Your medical team will give you information about your care so you can continue to recover safely.

Most people go home after discharge, but some go to an inpatient rehabilitation centre (see below). It’s also possible to have rehabilitation as a day patient.

Page's story

"I was diagnosed with breast cancer at age 41. The doctor arranged a mammogram, ultrasound and needle biopsy to confirm the diagnosis. It was quite a large 40mm tumour near the centre of my chest.

"Surgery was scheduled to remove the tumour about three weeks after diagnosis. I was nervous at the time because I didn’t know exactly how far the cancer had spread – they were going to determine how much tissue to remove during the operation and do further surgery if necessary.

"I had general anaesthesia and the surgeon removed about two-thirds of the breast. Unfortunately, the next day the pathology results came back and I had to have another operation to remove the remaining breast tissue. This was discouraging, but I was actually fine with having the whole breast removed.

"I coped well with the general anaesthesia, but it was difficult because I had two surgeries in a row so I had to fast. I felt hungry and thirsty. I felt pretty groggy at first. When my family came to hospital to visit, they said I looked very pale.

"When I was discharged from hospital, I had to wait a couple of weeks to drive because I had quite a large chest wound. The wound would fill with fluid, so I visited the doctor regularly to follow up and have the fluid drained.

"After surgery, I think you feel like a child for a while. At first, you can’t do what you’re used to doing at home – you have to depend on others. But you do get back to normal.

"I opted to have a reconstruction later. The surgeon lifted my right breast and used tissue from my tummy to create a left breast. I’m happy with the results."

Click here to tell your cancer story.

Taking care of yourself at home

Looking after yourself at home is one of the most important parts of your overall recovery. Even though you aren’t in hospital, you are still recuperating. Your rate of improvement and progress will depend on the type of surgery you had, what support you have at home, and your overall fitness and health.

If you live alone, it’s a good idea to organise another adult to stay with you at home the first night after discharge. This person can keep an eye on your recovery and wellbeing. You can also talk to the hospital social worker about accessing home help services, if required.

A community nurse may come to your house to check on you and change any dressings. If you are able to travel, you might go to your local GP, who can provide similar care. Try to find a GP you are comfortable with, and provide the hospital with your GP’s details so they can keep in touch about follow-up care.

Medication

The most common side effect of surgery is pain. Take pain relief medication as prescribed by your team. If your pain isn’t under control, gets worse, or if the medication causes side effects, talk to your GP.

Your doctor will give you instructions about re-starting any medication that you stopped taking before the operation. If you are prescribed antibiotics, take the full course as instructed. You may feel better after a few days, but the entire course of drugs are needed to completely kill bacteria and prevent infection. 

Rest

Although it’s a good idea to do gentle exercise, it’s also important to take it easy. Get plenty of sleep and take breaks if you feel tired.

Wound care

If you have a wound, your nurse will give you instructions about how to care for it. Don’t put lotions or perfumes on the incision – clean it with soap and water and pat it dry. You may be given instructions about how to change the dressings. If you have adhesive strips, they should fall off within a few weeks when the wound has closed, or a nurse can take them off. Don’t try to pull them off – you may open your wound. Your doctor or nurse will remove stitches or staples during a follow-up appointment (see below).

You might have some bruising around the operation area, but this will slowly fade over a few weeks. Don’t pick at any scabs around the wound, as this can cause infection. 

The Phamaceutical Benefits Scheme (PBS) subsidises some wound healing products and dressings to make them more affordable. For more information about this service, call 1800 020 613 or visit www.pbs.gov.au.

Bathing

Unless you’ve been told otherwise, you will be able to shower. Wash your body – especially the wound – as gently as possible, with warm water only. Pat it dry. If you have dressings, you might need to keep them dry – your nurse will give you instructions. 

Some people have trouble holding urine or bowel movements (incontinence) after surgery, especially abdominal procedures. This is usually temporary. Ask your surgeon or GP if you can speak to a continence nurse, who can help treat or manage this problem, or call the National Continence Helpline on 1800 33 00 66. 

Going to the toilet

Try not to strain when you go to the toilet, as this can tear your anus and cause swollen veins (haemorrhoids or piles). If you haven’t had a bowel movement within a few days of the operation, your chemist or doctor can give you advice or prescribe medication. If you are taking opioids, it’s a good idea to see your GP about your bowel habits, as they may want you to have a bowel movement every day.

Tubes and drains

Some people go home with a temporary drain or tube in their body, near the operation site. This collects extra fluid leaving the body. The nurse will teach you how to care for it, until it is removed (usually in the doctor’s surgery).

Eating and drinking

Some people feel queasy after surgery. Start with clear broth and water, then basic foods such as rice and toast, then resume your usual diet (or the special diet you were instructed to eat). To avoid constipation, eat fibre and drink plenty of water. Avoid alcohol, especially if you are taking medication.

Activity

You may need some equipment to help you move safely. An occupational therapist may show you how to use any equipment you need (e.g. walker, cane, shower chair, ramp). 

It’s a good idea to do some gentle exercise to build up your strength. A physiotherapist can give you advice about moving and exercising. Talk to your doctor about what level of activity is safe and what should be avoided (e.g. lifting heavy objects, driving, playing sports, swimming or having sex). It may take up to 4–6 weeks until you get back to your usual activities.

When to call the doctor or 000

See your doctor immediately or go to the hospital Emergency department if you have any of the following symptoms – don’t wait until your next scheduled follow-up appointment:

  • increased bleeding, swelling, redness, pus or drainage from your wound or around any tubes, stomas or drains
  • a fever over 38ºC
  • sudden, severe pain
  • pain or burning when urinating
  • nausea or vomiting for 12 or more hours
  • swelling in your limbs
  • trouble breathing, walking or doing things you could do previously.
"The doctors told us what signs to look out for. A week after hospital discharge Joe was running a fever of 39.6°C and shaking violently. He had an infection brewing in his pelvis. He was admitted to hospital again and he had a blood transfusion and antibiotics." – Amanda
Follow-up appointments

Your first follow-up appointment is usually 7–14 days after surgery. You may see the surgeon or your GP, depending on where you live and what the medical team recommends.

At this appointment, your doctor will remove any stitches, staples, adhesives or drains and check your wound. Your post-surgery pathology results may also be available and discussed, so you know if you need any further treatment.

Your doctor can also give you advice about getting back to normal activities, and refer you to other health services, if needed. If you have any concerns, you should mention these during the appointment. You may need to ask about specific things, such as driving or playing sport.

Coping with your emotions

For some people, having cancer is like an emotional roller-coaster. You may have many mixed feelings before, during and after surgery. It’s natural to feel anxious, scared or angry.

When you return home, you might feel vulnerable or helpless. You may need help doing things that you used to be able to do yourself, such as laundry or vacuuming. If your body has changed, it may affect your self-esteem.

If you have ongoing feelings of sadness and feel down most of the time, you may be depressed. This is called post-operative depression. 

Signs and symptoms of depression include:

  • feeling overwhelmed, sad, irritable and frustrated
  • not being able to concentrate
  • withdrawing from other people
  • relying on alcohol or drugs
  • thinking that life’s not worth living
  • having trouble sleeping (insomnia).

Some of the physical symptoms of depression include tiredness, appetite loss and sleep problems, but these can also be caused by surgery.

There is a range of effective treatments for depression, including counselling and medication. Talk to your GP, call the Cancer Council on 13 11 20 or go to www.beyondblue.org.au for information. There may be Medicare rebates available for some of these services.

Changing body image

Having surgery can change the way you think and feel about yourself (your confidence and self-esteem). You may feel less confident about who you are and what you can do. This is common whether your body has changed physically or not.

Give yourself time to adapt to any changes. Try to see yourself as a whole person (body, mind and personality) instead of focusing only on the parts of you that have changed.

For practical suggestions about hair loss, weight changes and other physical changes, call Cancer Council 13 11 20.

"I remember how liberating it felt during recovery, when I could finally lift my arm to brush or wash my hair and reach up for things on supermarket shelves. I really valued (and celebrated!) these little steps. For me, the best advice was to focus on what I could do, not what I couldn’t do, and be kind to myself." – Di 

Rehabilitation

Rehabilitation (rehab) may help you regain physical strength and get back to daily activities. This may include physical therapy (sometimes in a pool or gym) or specialist care if you need help with speaking, eating and other tasks.

Your surgeon may talk to you about the possibility of rehab before the operation, especially if you have inpatient care.

Inpatient rehabilitation

Some people recover in a rehab centre or nursing home before returning home. You need a doctor’s referral to receive inpatient care. The length of your stay depends on the speed of your recovery.

Outpatient rehabilitation

You can visit a rehab facility as a day patient to receive similar care. Hospital staff or your GP can organise this.

Key points

  • Immediately after surgery, you will be moved out of the operating theatre to a large area nearby with medical monitoring equipment (recovery room). Some people who need a high level of care will go into the high dependency unit (HDU).
  • The medical team will monitor your vital signs while the anaesthesia wears off and give you medication or fluids to make you feel better.
  • You’ll probably receive pain medication through tubes or an intravenous drip. There might be some drains to remove waste and fluid from your body.
  • Your medical team will give you advice about other post-operative issues, such as diet and bathing.
  • Generally, it’s highly recommended that you get up and move around as soon as possible. This helps to prevent blood clots and speed up your recovery.
  • If you had inpatient surgery, you will be officially discharged when the medical team thinks you are healthy enough to leave. The length of your hospital stay depends on your recovery progress and the type of operation you had.
  • Your first follow-up appointment is usually 7–14 days after surgery. You may see the surgeon or your GP. At this appointment, your doctor will remove any stitches, staples, adhesives or drains and check your wound.
  • Some people need rehabilitation to help regain physical strength and get back to daily activities. This may be in an inpatient rehab centre or nursing home, or you can visit a facility as a day patient. 

Reviewed by: Dr Bronwyn Avard, Deputy Director, Intensive Care Unit, The Canberra Hospital and Senior Lecturer, ANU Medical School, ACT; Kylie Foley, Registered Nurse, Urological, Gynaecological and Vascular Surgery, Royal North Shore Hospital, and Practice Nurse, Hills Family General Practice, NSW; Di Holt, Consumer; Shelly Hunter, Physiotherapist, Brisbane Private Hospital Rehabilitation Unit, QLD; Lorraine Kealley, Registered Nurse, Medical Oncology Ward, Royal Perth Hospital, WA; Shomik Sengupta, Urologist, Sengupta Urology, VIC; Dr BP Wheatley, Retired Generalist Obstetrician and Gynaecologist, SA; Carmen Heathcote, Yvonne Howlett and Amy Parker, Helpline Operators, Cancer Council Queensland.
Updated: 01 Apr, 2014