Video-Assisted Thoracoscopic Surgery (VATS) or Open Thoracotomy

Recovering After Lung Surgery
This booklet is to help you understand what to expect, and how to manage when you are discharged from hospital following lung surgery.

We know that going home and leaving the support of the hospital can be a daunting experience. In order to support you in your first few weeks at home, we are available for you to contact with any issues, problems or questions you may have regarding your discharge or follow up.

You can call our office 281-888-0809, (Monday – Friday, 8am – 5pm).

There is an answering service, so if you cannot speak to them directly you can leave a message, and we will contact you within 24 hours (or on Monday morning if you leave a message during the weekend).

What will I be given before I go home?
Before you go home, the hospital staff will provide you with the following:

  • Medication – the hospital will ensure you have two weeks’ supply of the medicines you take regularly, plus about one week’s supply of medicines to take ‘as required’, such as painkillers. Your ward nurse or pharmacist will discuss with you how and when to take your medicines. You will need to contact your GP before the end of the first week to arrange further supplies of your medicines.
  • Information about preventing hospital-acquired blood clots.
  • Chest drain information and equipment (if required)
  • Information on pain management following surgery.
  • The hospital can provide you a copy of your discharge summary of your hospital stay as well as any follow up recommendations and a list of the medicines prescribed for you to take once you leave hospital.

What should I expect when I go home?
If you live alone, it is essential that you arrange for a friend or relative to stay with you, or for someone to help you on a regular basis, for at least the first week after your discharge from hospital.

You will find that you need help with even basic household tasks such as cooking, cleaning and shopping.

The amount of pain experienced following chest surgery varies between individuals, but you can expect to feel some discomfort for up to three months after your operation.  You should continue to take pain medications on a regular basis, especially during the first week after discharge.

We will prescribe pain medication upon discharge for 2 weeks. After 2 weeks you should start to take extra strength Tylenol or Ibuprofen, if these medications are not contraindicated. After 2 weeks, you will need to see your Primary Care Provider if you feel you need refills of narcotics.

Your Wound
Your surgical wound and your chest drain wound sites will be starting to heal well by the time you leave hospital. You will still have pain and some bruising, swelling and numbness, but this is quite normal, and may take some weeks to improve.

Try not to touch your wound(s), as this will increase the chance of infection.

Use a mirror or get a family member to check your wound(s) daily. If wounds are clean and dry, they should be left without a dressing. Do not worry about the scabs – these will fall off in time.

You will usually have at least one drain site stitch which should be removed five to seven days after drain removal. We will remove this at your follow up appointment. Some swelling around the wound is normal and will settle over the next few weeks.

If your wound becomes red, hot to touch, or if it oozes any type of fluid, you should contact our office at 281-888-0809

Bathing
You may take a bath or shower as normal. At first, do not bathe if you are alone in the house, as you may require help getting in or out of the bath or shower. Avoid rubbing soap directly over the wound or soaking the wound for long periods until it is completely healed.

Constipation
It is common to become constipated following surgery because painkillers used after an operation, such as Tylenol #3 and oxycodone can cause constipation.

Any constipation should improve once you go home and become more mobile. Eating fruit, vegetables and high fiber foods, drinking plenty of water, and walking will help your bowels return to normal. You can take over the counter laxatives (medicines used to treat or prevent constipation) or stool softeners.

If your symptoms persist for longer than four days, you should seek advice from your Primary Care Physician

Will I be short of breath after my lung surgery?
Whether or not you are short of breath will depend on the type of surgery you have had, your age, pre-existing medical conditions that may cause shortness of breath, and your general level of fitness before surgery.

Some shortness of breath is to be expected and is normal. When you are up and moving around your home and exercising you may feel breathless. This is normal and shows that you are working hard enough.

Returning to your normal level of fitness can take weeks or even months.

 

Will I be able to look after myself?
You will be able to care for yourself in terms of washing and dressing. We suggest you wear loose fitting clothes, as this will make you more comfortable.

Although you will be able to do some cooking, you should not lift heavy kettles, pots or pans. Ready meals are often a good idea for the first few days after going home.

You may notice your appetite is reduced during your first week of being at home and you may even lose weight.

Try to eat small meals regularly and preferably those that are high in calories. Avoid housework, including vacuuming or moving heavy objects for at least two weeks after your discharge from hospital.

Will I be able to go out and visit friends and family?
Take it easy for the first few days of being back at home. Try to establish a balance between activity and rest. We suggest that you continue to take a 1½ hour rest after lunch, as you will feel very tired for the first couple of weeks after discharge from hospital. However, you should not spend hours in bed as this will increase your risk of chest infection, lung collapse, and other postoperative problems like blood clots in the legs.

Aim to walk once or twice a day, gradually increasing the distance you achieve. Once you feel ready, you can walk or travel for longer distances to see friends and relatives in their homes or in public. You know your body best, and can assess when you feel ready to go out and how long you are comfortable being out of the house for.

When can I start smoking again?  Never!
If you smoked before your operation, it is likely that this contributed to the development of your illness. You will not have smoked while in hospital, so try to use this opportunity to become a non-smoker.

If you still require help or advice with giving up smoking, you can inquire about local smoking cessation services with your Primary Care Physician.

Can I go on vacation?
If you have planned a vacation, you should only go once you feel ready to travel. Holidays involving flying should not be taken until around six weeks after your operation.

You should get further advice about your fitness to fly from your surgeon at your first appointment after surgery.

When can my partner and I resume sexual relations?
Sexual activity can be resumed when your wounds are healed, when you feel comfortable, and when you and your partner are ready. This may take up to several weeks. Try to take on a more passive role until you feel confident again.

It is not uncommon following major surgery to experience a decrease in libido. You should resume sexual activity only when you both feel ready.

When can I return to work and drive?
Return to work is typically 4-6 weeks however we will determine this at your follow up appointment two to three weeks of your discharge from the hospital. At this appointment, we can discuss when you will be fit to drive and/or return to work. It may be a month or more before you feel well enough to return to work.


Activity and coping after your operation
After a major operation involving the lungs, it is common to feel low in mood or a bit ‘down’. This can be due to lack of energy, frustration at the impact an operation can have temporarily on jobs, hobbies and relationships, or the results of a diagnosis.

It is important to remember that it can take a few months until you feel you have regained your strength and energy. It may be helpful to set small goals to achieve for the first few weeks after your operation. This is far healthier than expecting to resume normal daily activities, which you may not be able to do immediately, leading to more disappointment and frustration.

During the first week
It is important you continue walking around at home. You should also continue with your posture and deep breathing exercises.

Initially you will feel more tired at home than you were in hospital. Take a 1½ hour rest in the middle of the day. You will gradually regain your energy levels, but it is normal to experience varying energy levels for a number of weeks.

Weeks 2 – 3
Start to increase activity at home by taking on some light tasks such as cooking or washing up, but avoid pushing, pulling or lifting. Start by taking short walks each day, increasing your distance as time goes on. It is very likely that you will experience breathlessness – this will happen less often as you make progress. Raise your arms above your head and do stretches to strengthen movement in your shoulder muscles.

Weeks 4 – 8
You should feel like taking on more activities such as easy gardening and light shopping. You should also be able to walk longer distances. Increase your activity within your own limits and try to take on more tasks around your home and garden.

Weeks 8 – 12
Life should be returning to normal by this point. Your wounds should be starting to look as though they are completely healed. If you previously played sport you can start to do this again, although this should be a gradual process. It is advisable that you speak with your surgeon before undertaking contact or competitive sports.