Your Lung Volume Reduction Surgery and Hospital Stay
What can I expect the morning of surgery?
When you arrive at University of Wisconsin Hospital, you go to the First Day Surgery Unit (FDS) on D6/3 where a nurse helps you prepare for surgery. See map on last page. One family member or friend may stay with you in FDS. Your other family members and friends are guided to a waiting area. A nurse asks you questions about your health and helps you get ready for surgery. An anesthesiologist or nurse anesthetist meets with you and answers your questions. An intravenous catheter (IV) is placed in a vein of your hand or arm. The IV is used to give you fluids and medicines. You may be given medicine to help you relax.
When you are taken to the operating room (OR), your family and friends are guided to the Surgical Waiting Area on the 2nd floor (C5/2, just past the D elevator lobby). Here they are given updates from the OR. Their cell phone number will be taken or they may get a pager to get the updates. The pager range is within the hospital and parking area. If this waiting area is closed or full, they may also use the D4/5 waiting area.
Sometime during the day of surgery, your family or friends may take their parking passes to the main information desk to have them stamped. A parking pass is given to one person to be used during your stay.
What can I expect in the OR?
Once you are in the OR, you meet your nurse. He or she will answer any questions you have, make sure you are comfortable, and explain what is happening. The OR is often cold, so please let the nurses know if you would like an extra blanket. Electrocardiogram patches (also called ECG or EKG patches) are placed on your chest, a blood pressure cuff is put on your arm, and a plastic clip placed on your finger. The OR staff use these to watch your heart rate, blood pressure and oxygen level. Your anesthesiologist or nurse anesthetist asks you to breathe oxygen through a soft, plastic mask and medicines are given through your IV.
After you are asleep, a breathing tube (ET tube) is placed in your windpipe to breathe for you. Other lines and monitors are added after you are asleep.
Surgery often takes 3-4 hours, but it may take longer is some cases. You will be in the OR only for as long as you need to be and the OR staff will update your family while you’re there.
What can I expect when I wake up from surgery?
When your surgery is done, you are taken to the PACU (Post Anesthesia Care Unit). Your nurse in the PACU cares for you as you wake up. The breathing tube may be removed if it is safe to take out and the surgeon feels that you will be able to breathe well on your own. For your safety, there is a chance that the breathing tube may stay in for a day or two. Your throat may feel a little sore after the breathing tube is removed. Be sure to tell your nurse if you have pain, feel cold, or feel like you want to throw up. You may hear beeps, alarms, and voices. This is normal. Please ask your nurse if you have any questions or concerns.
What can I expect when I transfer to B4/5?
Once you are ready to leave the PACU, are taken to the Cardiothoracic Surgery unit on B4/5. This nursing unit is called a universal bed unit. This means that every room can be an intensive care (ICU), intermediate care (IMC), or general care (GC) room. So, you stay in one room for all stages of care. This includes ICU care to discharge. The care and equipment change in your room to meet your needs. Patients often need IMC for the rest of the day and night after they come from the PACU. For the rest of the time they are in the hospital, they often need GC.
When you first arrive on B4/5, you have IV lines, drains, and monitors. Your family and friends may visit once you are settled in your room and have had some time to recover. This may take 1-2 hours. A staff member will tell your family and friends when they are able to come into your room. Visitors are asked to sue the doorway near the D elevators to come into B4/5. The doorway near the B elevator is for staff use.
What can I expect during my recovery in the hospital?
As you become more stable, many of your IV lines and monitors are removed. As your condition improves, your nurses watch you closely but they aren’t at your bedside as often. They check on you every hour and when you need them. These are signs that you are doing well.
Most patients need IMC care for 24 hours or less. Those patients who have had LVRS surgery stay 5-10 days.
Rest is important for good healing. At the same time, getting up and walking helps to speed recovery. Most likely, your goal for the day of surgery will be to sit in a chair and go for 1 walk After that, your goal for each day will be to sit in a chair for most of the day and walk 4 times. You may be surprised how much better you feel each day.
Your nurses will ask you to breathe deeply, cough, and use a breathing tool called (incentive spirometer). Good breathing helps prevent pneumonia.
To cough and deep breathe
1. Place a pillow over your chest to reduce the pain and support your chest
while coughing.
2. Breathe in deeply and slowly through your nose. Hold it.
3. Exhale slowly through the mouth.
4. Repeat twice more.
5. Breathe in again; hold it, and then cough.
To use the incentive spirometer
1. Exhale and place your lips tightly around the mouthpiece.
2. Take a deep breath. Slowly raise the Flow Rate Guide between the arrows.
3. Hold the deep breath. Continue to inhale, keeping the guide as high as you
can for as long as you can, or as directed by your nurse or respiratory
therapist.
4. Exhale and relax.
5. Repeat 10 times each hour while you are awake.
How much pain will I have?
After your surgery, you will have pain in your incision area and feel sore all over your body. Some patients have more pain in their shoulders and back due to the chest tubes and their position during surgery. Your doctor and nurses will work with you to achieve good pain control. Good pain control helps you to:
1. Feel better.
2. Heal faster.
3. Take deep breaths.
4. Start walking and get stronger faster.
5. Leave the hospital sooner.
6. Have better results and avoid problems.
Drug and non-drug treatments can help prevent and control pain. Don’t worry about getting “hooked” or “addicted” to pain medicines. Studies show that this is very rare unless you already have this problem. Please ask if you have questions or concerns.
For best results:
1. Talk with your doctors and nurses about the choices you have. At first, you’ll receive pain medicine through an epidural. The Anesthesia staff will keep track of your pain and make changes to the epidural as needed. Once the epidural is gone (after a few days) you will be taking pain pills.
2. Ask for pain medicine when pain first begins. Do not wait until your pain is severe. This limits the effectiveness of the medicine. Pain pills take 20-30 minutes to work.
3. The nurses will ask if the medicine is helping your pain. You will be asked to rate your pain using this scale.
0-10 Number Pain Scale
______________________________________________________
0 1 2 3 4 5 6 7 8 9 10
No Mild Moderate Severe Worst
Pain Pain
Possible
4. The goal should be a level that allows you to deep breathe, eat, walk, and sleep. The doctors and nurses need you to rate your pain so they know how well your pain medicine is working.
5. Tell the doctors and nurses about pain that will not go away. Do not worry about being a “bother.” Pain can sometimes be a sign of problems.
Pain medicine may cause you to become drowsy, dizzy, or lightheaded. Narcotic pain medicine can cause constipation. Tell your doctors and nurses if you are having any of these problems.
While you are in the hospital and taking narcotic pain medicine, these are things you may do to prevent constipation:
- 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.
- Be as active as you can. Sit in a chair for all meals. Walk with help at least four times each day.
- Eat foods that have helped prevent constipation in the past.
- Try to set aside time for sitting on the toilet at the same time each day, if you can. The best time is after a meal.
- If your doctor prescribes a stool softener, take it as needed.
- Aim for a bowel movement every second or third day rather than every day.
- Do not stop taking your pain medicine because of constipation. Talk with your doctor or nurse if you are concerned.
How about activity after surgery?
It is best to be active soon after surgery. Being active will help prevent pneumonia and blood clots and help you get your strength back quicker.
The day after surgery you will sit in a chair for all meals and walk in the halls with the help of your nurse. You will need to walk at least four times each day. You should be able to walk a little farther each day.
Map to First Day Surgery Unit
Highland Avenue
To go to the First Day Surgery Unit, enter at the Hospital Entrance. Walk into the hospital.
When you get to the Information Desk, go left on Main Street.
Walk on Main Street past the Gift Shop and go left into the D Lobby.
Take the D elevator in the D Lobby to the 3rd floor. Look to your left when you walk out of the elevator and you will see First Day Surgery painted above an open doorway. You will also see a picture of a dog hanging on a wall near this doorway.
Walk past the picture and through the doorway into a hall where you will see a First Day Surgery sign hanging from the ceiling. The entrance to the First Day Surgery Unit is below the sign on your right.
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: 08/13/2012
Copyright © 08/13/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7398
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