Recovery From Surgery Part Three

This is the third and final part of “Recovery from Surgery”. In part one we discussed things to do before your surgery to help you once you have surgery. In part two we talked a lot about wound care. In this final article, we will talk about what recovery from surgery looks like. 

What can you expect after surgery?

Here are some general things to expect after surgery. The more minor your surgery, the fewer symptoms you should notice. With more involved surgeries, you will notice more symptoms.

Surgery obviously involves an incision. You may have a simple incision that is sealed with a closure such as sutures, staples, or surgical glue and tape strips. Or your surgical wound may be more complex and require dressing changes.

Follow your surgeon’s instructions as to when you can remove or change the dressing and when you can bathe or shower.

Wound care

Your wound care may be as simple as removing a dressing in a day or so, to complex dressing changes that need to be done several times daily. Your surgeon or nurse will instruct you when to remove the dressing. If you need to do dressing changes, they will instruct you or your caregiver on how to do the dressing changes. If you should need a nurse to change the dressings, the hospital staff will help arrange this for you once you leave the hospital.

You may also need to have a drain in when you come out of surgery. Drains are necessary to give the excess fluid around an internal surgical area a way to leave the body. Your surgeon will tell you when it is time to have the drain removed. This typically happens when the fluid collecting in the drain is low enough to not allow fluid build-up inside you once the drain is removed.

Reduced activity level

Depending on your surgery, your surgeon may advise you to restrict your activity level. This reduction can be as simple as decreasing the amount you are permitted to lift, up to complete bed rest. Your surgical discharge instructions will inform you what your restrictions are and for how long. Be sure to follow these restrictions carefully to prevent injury to the surgical incision. You definitely don’t want to have additional surgery to fix something because you did not follow your restrictions and injured yourself.

Pain control

Follow the instructions you are given regarding taking pain medication. Monitor your pain to see how soon after taking the medication your pain begins to subside. Also, note how long the pain medication lasts until you feel that you need to take the next dose.

If you are taking narcotic pain medication, ask your surgeon for a non-narcotic pain med to begin once you no longer need to take the narcotics.

Something to know about pain meds is that they will not necessarily relieve your pain completely in the immediate recovery phase. The goal of pain medication is to reduce the pain to a tolerable level so that you can breathe and rest relatively comfortably. Activity will increase pain, so rest when you can, but move about according to your activity limits. Lying or sitting too much after surgery can lead to blood clots.

If you take your pain medication as instructed but the pain returns in less than half the time to your next scheduled medication dose, try these things to relieve/reduce your pain:

Apply an ice pack to your surgical site if this is not contraindicated. Ice helps reduce the swelling in the area and settles down the nerves that perceive pain.

If you had surgery on your arm or leg, elevate the limb to again help reduce swelling.

Avoid exertion and lifting heavy objects until you are permitted to do so by your surgeon.

Some pain is to be expected after surgery. But pain can also be a sign that something is wrong. Do not hesitate to contact your surgeon if your pain is not well controlled or if you notice an increase in pain or swelling in the surgical area.

Nausea

Narcotic medications for pain control can cause nausea. Usually, you are given an anti-nausea prescription as well if you are prescribed narcotic pain medication. Follow your surgeon’s instructions carefully as to how often to take these meds. Nausea should at least subside if not be relieved completely by the anti-nausea medication. If nausea persists, try sipping on a ginger drink like ginger ale if your diet restrictions permit this.

If nausea persists to vomiting, a few things you can try are:

Take note of what may be causing nausea/vomiting and try to avoid that if possible. Narcotics can cause these problems. If you can use non-narcotic pain medication, this may be advised. Non-narcotic pain meds do not control pain to the extent that narcotic pain meds can though.

If your pain is not controlled with non-narcotic pain medications and you are still vomiting, call your surgeon. You do not want to become dehydrated from loss of fluids from vomiting and not being able to drink fluids as well.

Another thing that can cause nausea after surgery is “advancing your diet” too soon. Typically, after anesthesia/sedation, you should start with clear liquids such as broth or water. If you can tolerate these without nausea, then you can try something a little heavier like pudding. When you can tolerate pudding, next you can eat bland, solid food like oatmeal. And finally, if your stomach can tolerate this step then you can eat small, regular meals and progress to your normal eating pattern.

If you try to eat heavy foods sooner than you can tolerate, then you may experience nausea and vomiting. If that occurs, follow the instructions above until you get to the level that does not cause your stomach to be upset. You may have to stay on one level for a day or more before you can progress up.

If you are on a clear liquid diet and still vomiting, call your surgeon. You need to be able to keep at least fluids down. If not, then you may need to go to the hospital to receive fluids intravenously.

Besides nausea, another common side effect of narcotic pain medication is constipation. Try to avoid this if possible. Some ways you may be able to avoid constipation are by drinking extra fluids, eating high-fiber foods, and moving around as much as you are able or permitted to.

But even by following these steps, you may still become constipated. With your surgeon’s approval, you can try a stool softener. A stool softener draws more fluid into your intestine which makes the bowel material softer, bulkier, and easier to pass.

If this is not effective, you may need to use a laxative. Start with a gentle laxative, drink the recommended amount of water as per the instructions for the laxative, then wait the recommended time as per the instructions for the laxative. If that still does not cause your bowels to move, you should contact your surgeon. A serious complication from constipation may be a bowel blockage which can be a medical emergency.

Follow-up appointments

Except for a very minor surgical procedure, you should expect to see your surgeon at least once during your recuperation period. At the appointment, your surgeon will examine you to make sure you are healing as expected. If you have any drains in, these may be removed at this visit if they have not been removed already.

As you recuperate from surgery, your incision should heal, your pain should subside, and your strength and stamina should return.

But what if you think something is not right? What should you do then?

Here are some abnormal signs that you should be aware of:

Notify your surgeon if you notice:

Infection:

Signs of infection include:

Fever

Chills

Redness

Swelling

Pus

Odor

Increased pain

Nausea

Possibly red streaks

Other complications to be aware of after your surgery

Sudden chest pain or difficulty breathing

Unexplained weakness/fatigue

Pain not relieved with pain meds

Unrelieved nausea/vomiting

Unable to drink/keep fluids down

Confusion

Unexplained pain or excess swelling

Painful, swollen calf

If you notice anything mentioned above, call your surgeon. If it is after office hours call your surgeon’s office anyway, but do not leave a message on the recorder if they are closed and your situation is urgent. The office staff may not get to the message right away. Typically, they will have an answering service taking their calls after hours, or the recorded message will tell you how to reach the on-call physician.

But what if it is not just a simple surgery?

So, what happens if your surgery is not a simple incision that will heal on its own in a few weeks? What if your surgery is such that you will have a long recovery?

Sometimes surgeries must be done in stages. This can happen when surgery will take so long that it is safer for you to have two or more shorter surgeries instead of one long surgery. Some things that your surgeon will take into consideration when deciding this include:

How much anesthesia surgery will require?

How well you can tolerate surgery?

If you have other health concerns, these also play a factor in determining how to approach your surgery.

I am ready to go home. Now what?

Where will you be going after surgery?

Lots of things can come into play when deciding where you will go when you leave the hospital. For instance:

Are you and or your family members able to care for you at home?

Do you have any limiting factors at home to take into consideration such as stairs?

Would it be better for you to go to a relative’s house until you can be on your own at home again?

Do you require even more care like a long-term care or rehab facility?

What kind of surgery did you have and how did it go?

Is it time to think about going to a hospice facility or having in-home hospice care? If this is what is best, the case worker at the hospital may be able to help you make these arrangements.

This has been an overview of things you may experience as you recover from surgery. Your specific course of recovery is something for you to discuss with your surgeon before you have surgery. And you should inform your surgeon of any concerns you have during your recovery.

Wishing you all the best,

Kelly

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Yes, I am a nurse. No, I am not your nurse. The medical topics discussed in this, or any article on this site, are intended to be issues for you to discuss with your medical team if you feel they apply to you. None of the information you are about to read in this article is treatment advice for you from me. I do not have that authority.