Homeward Bound LVRS
What can I expect when I am discharged from the hospital?
You can expect to stay in the hospital about 5-10 days after lung surgery. Before you leave, you will learn how to care for yourself at home. A friend or family member should hear your instructions with you on the day of discharge. You will receive prescriptions for medicines. Your medicines may change after surgery. You may take some different ones. The doses of some may change. Please note the names, doses and times of your medicines. Do not take the medicines you were taking before surgery without checking with your surgery team. Bring your insurance card if you want to fill your prescriptions at the UW Hospital Pharmacy.
You need a responsible person to drive you home and stay with you for 24 hours a day for the first few days after surgery. It may help to have someone stay with you for the first week or two after you go home. Some patients may want or need to stay at a place for more rehab or skilled nursing care after they leave the hospital. Your surgery team will work with you to assess your needs. Your case manager or social worker will help arrange for special needs like Home Health or a nursing home stay.
Take note that you may need to be discharged with some equipment:
Oxygen – you may need to go home on oxygen after this surgery. The hospital’s Case Manager or Social Worker will help set up oxygen if needed.
Chest Tube – You may need to go home with your chest tube still in place. If you go home with a chest tube, the Clinical Nurse Specialist will give you and your caregiver hands-on teaching as well as written handouts about the chest tube and caring for it at home.
Most patients have follow-up clinic visit about 5-7 days after surgery.
How do I take care of my lungs at home?
While you are in the hospital, you breathe deeply, cough and use a breathing tool (incentive spirometer). Doing these things helps open the small air sacs in your lungs and keep your airways clear. This helps prevent pneumonia.
You should use your incentive spirometer at home for 3 weeks. Good deep breathing is the best way to help your lungs heal. To review how to use this tool, please see the Health Facts for You in your binder called “Lung Volume Reduction Surgery.”
How do I take care of my pain at home?
You will likely have some pain after you leave the hospital and become more active at home. You may take narcotic pain pills at home for the pain. Be sure to use the pain pills when you need them, but be careful. Pain medicine may cause you to become drowsy, dizzy, or lightheaded. Do not drive, use machines, or drink alcohol after you have taken narcotic pain medicine.
As your pain decreases, you may use Extra Strength Tylenol® in place of narcotic pain pills. If your pain is new, sharp, constant or getting worse, call your doctor.
How do I prevent or relieve constipation?
If you have very few bowel movements, hard bowel movements, or trouble passing bowel movements, you may be constipated. There are a lot of reasons for constipation after surgery. The most common ones are:
Change in your diet such as not eating what you often eat, not eating much, or not drinking much fluid.
Change in how active you are. You may not be doing the things you often do. You may be sitting a lot more.
Change in your daily routine. You may not be doing things at the same time of day that you often do them or you may not be doing them at all.
Change in the medicine that you take. Narcotic pain medicine can cause constipation.
To prevent or relieve constipation:
Eat foods that have helped you prevent or relieve constipation in the past.
Eat food high in fiber or roughage. This includes food such as uncooked fruits, raw vegetables, and whole grain breads and cereals. Try prune juice. Buy some unprocessed bran and add 1 or 2 tablespoons to your food. Keep a shaker of bran handy at mealtimes and sprinkle it on foods. If you are not hungry, do not make yourself eat fiber.
Drink plenty of liquids. Eight to ten 8-ounce glasses of fluid each day will help keep your stools soft. Warm liquids often help your bowels to move. Have a warm drink about half an hour before your planned time for a bowel movement.
Exercise as much as you are able each day or at least every other day. Increase the amount you walk. Check with your doctor or nurse about the exercises that are best for you.
Plan your bowel movements for the same time each day, if you can. Set aside time for sitting on the toilet or commode. The best time is after a meal. Aim for a bowel movement every second or third day rather than every day.
Do not stop taking your narcotic pain medicine if you need it to control your pain. Talk with your doctor about stool softeners and laxatives. Many people who take narcotic pain medicine need the help of a stool softener. This alone may not work. You may need to add a gentle laxative. Be sure to check with your doctor or nurse before taking any of these on your own.
What about laxatives, suppositories, and enemas?
Your doctor or nurse may suggest taking a laxative on a regular schedule rather than waiting for constipation to happen. There are many types and brands of laxatives. Talk with your doctor about which may work best for you.
Bulk laxatives and fiber like Metamucil® absorb water and expand to increase bulk and softness of stool. They are not the best to use for constipation due to narcotic pain medicine. They should only be used if you are able to drink plenty of fluids throughout the day.
Both suppositories and enemas can be helpful if used correctly. It is not a good idea to use enemas as a regular part of a plan to prevent constipation. Talk with your doctor or nurse before using either of these.
What are examples of high fiber foods?
| Cereals and flours | Bran Cereals, whole-wheat bread, rye bread and crackers, wheat germ, corn, cornmeal, wild rice, brown rice, barley, popcorn |
| Fruits | Fresh, canned, or dried fruits, expecially those with skin or seeds (apples, plums, pears, peaches, tomatoes, berries, raisin, and dates |
| Vegetables | Any raw or cooked vegetable (not overcooked) such as carrots, cabbage, peas, dry beans, and lentils |
Fruit Pudding – (1-2 tablespoons one to three times a day)
Pudding recipe (in blender combine)
3 oranges peeled
4 apples with skins
2 cups raisins and dates
2 cups prunes
add prune juice to consistency of sauce or pudding
Can keep in refrigerator 7-10 days, can be frozen
Bran Muffins – (1-2 muffins daily)
Bran muffin recipe
2 ½ teaspoons. baking soda
½ quart buttermilk
2 ½ cups flour (1 ½ whole wheat; 1 white)*
1 cup sugar
½ package (15 oz.) Raisin Bran cereal
1 teaspoon. salt
2 eggs slightly beaten or 1 cup egg substitute
½ cup oil
* ½ cup wheat germ may be substituted for ½ cup whole-wheat flour
Combine all ingredients. Bake in greased muffin pans at 400 degrees for 18-20 minutes. Makes two dozen muffins.
How do I care for my incision?
Your incision may look a little red for several days. Keep your wounds clean and dry. Shower or wash them daily with mild soap and water. You may have small tape strips (steri-strips) on your wounds. It’s ok if they fall off. Any steri-strips or stitches you still have will be removed during your first clinic visit.
Do not put ointments, powders or lotions on your incisions. Leave old chest tube sites uncovered. Only cover them if they are draining. Small amounts of a thin, pink fluid drain from the chest tube sites. This is normal. If they are draining, cover them with dry gauze. Change the gauze daily until it stops.
Call your doctor if you notice any signs of infection
Swelling
Drainage
Tenderness
Fever over 100.5 F taken two times, 4 hours apart
Increased redness around the incisions.
How active should I be?
As you heal, you will slowly feel stronger and more independent. You should become more active each day. Walking is a good safe way to exercise after surgery. Try to find a balance between being more active and getting enough sleep. Be as active you can be, but also take time for rest and quiet things. Please call your surgery team with any questions or concerns.
You can begin doing your normal routine with these limits:
No driving for 2-4 weeks. No driving when you have taken narcotic pain pills. Ask your doctor when you can start driving again.
No lifting over 10 pounds (a gallon of milk) for 4 weeks.
Do not do one-arm exercises that are hard. It is ok to use the arm on your surgery side for easy things.
At your first clinic visit, ask your doctor when you can go back to work. Also ask about doing other things that you enjoy.
Good deep breathing is the best way to help your lungs heal. You should use your incentive spirometer at home for 3 weeks to help your lungs heal.
What about sexual activity?
As you feel better, you may want to resume having sex. This is common. At first you may not feel like being close because you may feel that you don't have the energy. You may worry about your incision or becoming short of breath. These are normal feelings and concerns. When you feel ready, move slowly from hugging and holding to other sexual activities. Getting this part of your life back is important to your recovery.
What about my mood?
It is common to have some changes in your feelings or mood for a number of weeks after your surgery. You may feel uncertain, scared and maybe even depressed. Your energy level and appetite may change at times.
Do things that you enjoy and are within your limits. Do things that make you feel good about you. Share activities with your family and friends. Talk about your feelings with them. Keep in mind that people do much better when they feel they have support. When you feel able, call people and have them stop by for short visits. Make the most of the support you have around you. If you are having problems coping or need support, please talk with your doctor or nurse.
When may I return to work?
Each person recovers from surgery at their own pace. How you are feeling and the kind of job you have will help your surgeon decide when you can return to work. Many patients may feel ready to return to work about 4-6 weeks after surgery. When you first go back to work, you may want to work less than normal until you are fully recovered.
If your job requires lifting greater than 20 pounds, you have two choices. You do other work at your job that does not require much lifting or you wait to go back to work until you can lift this much. If you need forms filed for your job, please bring them with you for your surgeon to complete.
What if I smoke?
If you smoke, you need to stop to prevent further lung damage. We know this is hard. We will support you. For more details or help with quitting, call:
• The Smoking Cessation Clinic (608) 263-0573
• The Wisconsin Tobacco Quit Line 1-800-784-8669 (1-800-QUIT-NOW).
• Your primary care doctor
What are the contact phone numbers?
If you have any questions or problems please call.
The phone numbers for the surgeons’ offices and surgery clinic during business hours (Monday through Friday, 8:00 am to 4:30 pm):
• Dr. Weigel’s office: (608) 265-0499
• Dr. Maloney’s office: (608) 263-5215
• Surgery Clinic: Mon-Fri 8:00 – 4:30 pm, (608) 263-7502
After hours, nights, weekends and holidays, call the Surgery Clinic (608) 263-7502. This will get you a paging operator. Ask for the thoracic surgery resident on call. Leave your name, and phone with area code. The doctor will call you back.
If you live out of the area, please call 1-800-323-8942.
What about resources?
Cancer Information Service (CIS)
1-800-4-CANCER
The Cancer Information Service, a program of the National Cancer Institute. It has a phone service for cancer patients and their families and friends, the public and health care workers. The CIS staff answer questions and sometimes mail booklets about cancer. They also may know about local resources and services. Their toll-free number, 1-800-4- CANCER will put you in touch with their office that serves your area.
American Cancer Society (ACS)
1599 Clifton Road, N.E.
Atlanta, GA 30329
1-800-ACS-2345
The American Cancer Society is a group of volunteers with a national office and units all over the country. It supports research, provides education, and offers many services to patients and their families. To get information about services and activities in your area, call their toll-free number, 1-800-ACS-2345 or their number in the white pages of the phone book.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/02/2012
Copyright © 08/01/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7391
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