After surgery

When you wake up

You may spend a short time in an intensive care or high-dependency unit (HDU) after your operation. You will be closely watched before returning to the ward. When you wake up, you may have some tubes attached to your body. The type of tubes will depend on the type of surgery you had. Don’t be alarmed as they are normal after surgery.

Drips, drains and tubes

You may have some drips, drains or tubes attached to you after your operation.

• Intravenous (IV) drip: A drip will be put into a vein in your arm. This will give you fluids until you are able to take fluids by mouth again. You may also be given antibiotics to prevent infection.
• Drains: One or more thin tubes called drains may be attached to you near your wound. These help to drain blood and fluid from the operation site to let your wound heal.
• Epidural: You may have a thin tube called an epidural in your back. This is to help relieve any pain you might have.
• Nasogastric tube: A thin plastic tube may be placed in your nose leading to your stomach or small bowel. Your nurses can then draw up fluid to keep your stomach empty. This will stop you feeling sick and allow your operation site to heal more quickly. It’s usually removed after 48 hours, or once you are able to get out of bed.
• Urine tube (catheter): A thin flexible tube called a catheter may be put into your bladder to drain urine into a bag. This will save you having to get out of bed to go to the toilet and rests your bladder. Also, your nurses can check how much fluid you are passing.
• Chest drains: These drainage tubes are inserted into your chest during the surgery if you need them. They drain any fluid around your lungs into a bottle beside your bed. 
• Feeding tube: You may have a small feeding tube placed directly into your small bowel. This is called a jejunostomy or JEJ tube. The tube is put in through your tummy during surgery if you need it. It can be used to give you all the calories, protein and nutrients you need until you are ready to eat and drink again.

Pain relief

You may have some pain after the operation, especially when you cough or move. Your nurse can give you medicine to control the pain and stop you feeling or getting sick, if you need it. You may have an epidural tube in your back to relieve pain after the surgery. If you have a patient controlled analgesia pump (PCA), your nurse will show you how to use it. Always ask for help before the pain or sickness gets too bad.

Infection

After surgery, there is a risk you may get an infection. Your nurse will check your wound and the tubes twice a day. Let them know if any leakage happens at the wound or tube sites or if you feel hot or unwell.

Your bladder and bowel after surgery

Sluggish bowels
Surgery can slow down your bowels; some people experience constipation after surgery. 

Catheters
After surgery, you may have a thin, flexible tube called a catheter in your bladder for a day or two. It drains your urine into a bag and you can walk around with this. 

The tube will be removed once you are drinking normally and your urine looks fairly clear. Removing the tube is not painful but may be a little uncomfortable. This usually happens a couple of days after the surgery. 

Getting up and about

A physiotherapist may visit you regularly for the first few days. These visits are to help you with breathing and leg exercises. Doing the exercises can help to prevent a blood clot.

Even when you are in bed you will be encouraged to move your legs and do deep breathing exercises at least once an hour. On the day after surgery your nurses will help you get out of bed and take you for a short walk. These walks will become more frequent and longer as you feel stronger.

If you are in pain you may not feel able to do your breathing or leg exercises, so let your nurse or doctor know if you need medication to help with pain. The physiotherapist can also show you any other exercises that will help you to recover after surgery.

If your surgery means you find it hard to sit down, try not to worry. This should get better as your wound begins to heal. 

For some types of surgery you will have to be careful to avoid strenuous activity like gardening, vacuum cleaning or lifting anything heavy for at least 3 months. For example, surgery to the pelvic area for women. You may also be advised not to drive for a few weeks. Ask your doctor about any precautions you should take. 

Pathology report

During your surgery samples of tissue - including in lymph nodes - will be taken. The samples will be tested by a doctor called a pathologist to see how effective the treatment has been and help your doctors to decide if you need further treatment. 

Your doctor will discuss the results of these tests with you, and any plans for more treatment or monitoring your condition. Usually this happens at your first follow-up appointment, when you have had a chance to recover. 

If you can’t eat normally

• Nasogastric tube
  A nasogastric tube is a thin tube passed down your nose all the way to your stomach. This tube can be used to feed you and so help your wounds to heal and recover. It can be easily removed once you are ready to eat again.
• PEG tube
  PEG stands for percutaneous endoscopic gastrostomy. This is a tube passed through the wall of your abdomen into your stomach. It can be used to deliver liquid food directly into your stomach if you cannot eat normally after your surgery. PEG tubes can be left in permanently if needed. 

  Your dietitians will help to make sure you get enough nutrition if you have eating problems after surgery. They will discuss your nutritional needs with you and your doctors and prescribe supplements if needed. 

• Parenteral feeding
  Sometimes nutrition can be given directly into a vein after surgery. This is called parenteral feeding.

Weight loss

If you can’t eat normally, it’s likely you will lose some weight in the first few weeks after your operation. Try not to worry about it as weight loss is normal and should slow down once you begin eating well again. Let your medical team know if the weight loss continues.

The dietitian will give you advice before you go home. For example, advice on the best foods to eat and how to prepare them.

Going home

You may be in hospital for up to 14 days, depending on the type of surgery, but often it isn’t this long. How long you have to stay in hospital and the type of side-effects you might get depend on:

• Where the surgery was
• What type of surgery you had (for example, keyhole surgery vs open surgery) 
• If you have any side-effects from surgery that need to be managed in hospital. For example eating difficulties or problems going to the toilet
• Your general health 

The nurse will give you advice about how to manage at home. For example, if you have a catheter, stoma or a feeding tube, your nurse will give you advice about how to care for them. 

Before you go home, you will be given a date to come back for a check-up about 4–6 weeks later. You may also have to attend the hospital regularly so that your wound can be checked. 

Help at home

If you live alone or have problems getting around the house, talk to your nurse or the medical social worker on your ward as soon as you are admitted to the hospital. That way, they can organise any community services you may need after you leave hospital. This may include visits from your local public health nurse or home help. The medical social worker can also advise you about social welfare benefits or entitlements you can apply for.

Driving

Your doctor will tell you when you can start driving again but it is usually about 4 to 6 weeks after surgery. You won’t be able to drive if you’re still on strong painkillers that might make you drowsy. Check with your insurance company that you are covered to drive after your surgery.

Who to contact if you have any problems

You will be given contact numbers so that you can reach your doctor, nurse or hospital at any time. Contact a member of the team as soon as possible if you:

• Have any problems with feeding tubes, catheters or stomas, or any other medical issues, such as worries about your wound
• Have diarrhoea for more than 24 hours
• Have a temperature of 38°C (100.4°F) or higher. Or 35°C (95°F) or lower
• Feel unwell

If you have any worry or symptom that is causing you concern before your check-up date, contact your nurse specialist or hospital ward for advice.

Remember it will take about 3 months to recover from your operation and about a year to get back to your normal routine.