After surgery care
After the surgery, you may be transferred to the Intensive Care Unit (ICU) for monitoring, before going to the surgical ward. Your family will be able to visit you. You’ll be looked after by a team of doctors, nurses, physiotherapists and other members of the care team. If you have a stoma formed you’ll be followed up by a stoma nurse for stoma management/education.
You’ll receive blood-thinning injections to prevent blood clots. The injections may continue to be required after discharge from hospital.
Your lungs may not have full function due to:
- general anaesthetic;
- your lying down position for the operation and
- hesitance in taking deep breaths due to pain from the surgery.
To promote normal lung function immediately after your operation, you may be asked to take regular deep breaths as well as hold your breath for a few seconds before breathing out – this is to encourage smaller airways of the lungs to re-fill with air.
The ERAS regime requires that you move out of bed and sit upright in a chair, for periods of at least an hour and a maximum of two to four hours on the day of your surgery if you’re medically safe to do so. Early mobilisation (which includes standing and walking) is critical in the prevention of complications.
The day after your surgery, it’s beneficial to continue sitting in a chair for period throughout the day and to start walking short distances. All these forms of movement are intended to promote heart, lung and bowel functions, helping to prevent blood clots (DVTs and/or PEs), pneumonia and bowel obstructions respectively.
Nursing and physiotherapy staff will provide re-assurance and assistance where needed.
Medications are readily given to stop nausea and vomiting. The ERAS method of care allows you to drink fluids when you can tolerate them. You’ll also receive two protein drinks per day, commencing about six hours after your operation.
Movicol-Half will be given to help your bowels get started and to keep them going as you recover. A bowel movement chart will be kept and filled in, by the nursing staff.
You’ll commence a normal diet as soon as you can tolerate it. You’ll be encouraged to sit upright in a chair to eat your meals.
A fluid balance chart will be used to monitor your daily intake (oral or intravenous) and output of fluids.
On day two or three, the epidural catheter or the wound soaker (whichever is applicable) will be removed and the oxygen mask will be taken down. The drip in your arm will be removed if you’re tolerating fluids and a normal diet. The urinary catheter will be removed. You will be able to take a shower, with assistance if required. Your wound will be monitored daily and covered with a dressing.
A cancer coordinator assists with all aspects of cancer care if applicable.
The dietitian will oversee your dietary requirements when needed.
A physiotherapist may continue to review your progress during hospital, until you’re able to walk enough distances to maintain general health. You may also be referred for an outpatient physiotherapist appointment at six weeks, if you have a new stoma formed.
The discharge planner will assess your needs for when you are discharged from hospital. You may need help around the house for the first few weeks. You should expect to be discharged from hospital around day five. You’ll need to be picked up by a family member or a friend.
Before you leave hospital, you’ll be given the telephone numbers to contact in case of an emergency. An appointment will need to be made for you to visit your surgeon for follow up care. You may have skin staples that will need to be removed, pathology results to discuss and any other treatment plans such as chemotherapy or radiotherapy to be organised.
When you go home, avoid leafy vegetables (e.g. cabbage) for about seven days as they contain a large amount of fibre. Continue walking for exercise with frequent breaks. Avoid straining or heavy lifting for six to twelve weeks (nothing over five kg).