About Your Abdominal Incisional Hernia Surgery

This guide will help you get ready for your abdominal incisional hernia surgery at MSK. It will also help you know what to expect during your recovery.

Use this guide as a source of information in the days leading up to your surgery. Bring it with you on the day of your surgery. You and your care team will use it as you learn more about your recovery.

About Your Surgery

About abdominal wall hernias

Your abdominal wall is made up of muscles. It protects the organs in your abdomen (belly).

A hernia is when an organ or fatty tissue squeezes through a weak spot in the abdominal wall or connective tissue (see Figure 1).

One type of hernia is an incisional hernia. It can develop around the incision (surgical cut) in scar tissue from an earlier surgery (see Figure 2). It can happen after surgery in your abdominal area, from the breastbone down to the groin.

With an incisional hernia, you may notice a swelling or a bulge under your skin where you had surgery. You may also have discomfort in your abdomen when lifting or bending.

About your hernia surgery

Surgery is the treatment for a hernia. There are different types of hernia surgeries, such as an open surgery and a laparoscopic surgery. Your surgeon will talk with you about the type of hernia surgery best for you.

Laparoscopic surgery

Your surgeon will make a few small incisions (cuts) in your abdomen. They will inflate your abdomen with air so they can see your organs. Your surgeon will put a thin, lighted scope (tube) called a laparoscope through the incision. They’ will put tools to fix the hernia through the other incisions.

Open surgery

Your surgeon will make an incision (cut) big enough to remove scar tissue and fat from your abdominal wall near the hernia. They also may put in a mesh patch to hold the weak part of your abdominal wall. The mesh patch will attach to your abdominal wall and cover the hole or weak area under it. Over time, this patch will be absorbed by your inner abdominal wall.

Your surgery will take about 3 hours.

Getting Ready for Your Surgery

This section will help you get ready for your surgery. Read it when your surgery is scheduled. Refer to it as your surgery gets closer. It has important information about what to do to get ready.

As you read through this section, write down questions to ask your healthcare provider.

Getting ready for surgery

You and your care team will work together to get ready for your surgery. Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you’re not sure.

• I take a blood thinner, such as:
  • Aspirin
  • Heparin
  • Warfarin (Jantoven® or Coumadin®)
  • Clopidogrel (Plavix®)
  • Enoxaparin (Lovenox®)
  • Dabigatran (Pradaxa®)
  • Apixaban (Eliquis®)
  • Rivaroxaban (Xarelto®)
  There are others, so be sure your healthcare provider knows all the medications you’re taking.
• I take prescription medications (medications my healthcare provider prescribes), including patches and creams.
• I take over-the-counter medications (medications I buy without a prescription), including patches and creams.
• I take dietary supplements, such as herbs, vitamins, minerals, or natural or home remedies.
• I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
• I have sleep apnea.
• I’ve had a problem with anesthesia (medication to make me sleep during surgery) in the past.
• I’m allergic to certain medication(s) or materials, including latex.
• I’m not willing to receive a blood transfusion.
• I drink alcohol.
• I smoke or use an electronic smoking device, such as a vape pen, e-cigarette, or Juul®.
• I use recreational drugs.

About drinking alcohol

The amount of alcohol you drink can affect you during and after your surgery. It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

• If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these problems, we can prescribe medications to help keep them from happening.
• If you drink alcohol regularly, you may be at risk for other problems during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

Here are things you can do before your surgery to keep from having problems:

• Be honest with your healthcare providers about how much alcohol you drink.
• Try to stop drinking alcohol once your surgery is planned. Tell your healthcare provider right away if you:
  • Get a headache.
  • Feel nauseous (like you’re going to throw up).
  • Feel more anxious (nervous or worried) than usual.
  • Cannot sleep.
  These are early signs of alcohol withdrawal and can be treated.
• Tell your healthcare provider if you cannot stop drinking.
• Ask your healthcare provider questions about drinking and surgery. As always, all your medical information will be kept private.

About smoking

If you smoke, you can have breathing problems when you have surgery. Stopping for even a few days before your surgery can help.

MSK has specialists who can help you quit smoking. For more information about our Tobacco Treatment Program, call 212-610-0507. You can also ask your nurse about the program.

About sleep apnea

Sleep apnea is a common breathing problem. It causes you to stop breathing for short lengths of time while you’re asleep. The most common type is obstructive sleep apnea (OSA). With OSA, your airway becomes fully blocked during sleep.

OSA can cause serious problems during and after a procedure. Please tell us if you have or think you might have sleep apnea. If you use a breathing device (such as a CPAP machine), bring it on the day of your procedure.

Within 30 days of your surgery

Presurgical Testing (PST)

You’ll have a PST appointment before your surgery. The date, time, and location will be printed on the appointment reminder from your surgeon’s office. You can eat and take your usual medications the day of your appointment.

It’s helpful to bring these things to your appointment:

• A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
• Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
• The names and telephone numbers of your healthcare providers.

During your PST appointment, you’ll meet with a nurse practitioner (NP). They work closely with anesthesiology staff (specialized healthcare providers who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You may have tests to plan your care. Examples are:

• An electrocardiogram (EKG) to check your heart rhythm.
• A chest X-ray.
• Blood tests.

Your NP may recommend you see other healthcare providers. They’ll also talk with you about which medications to take the morning of your surgery.

Identify your caregiver

Your caregiver plays an important role in your care. Before your surgery, you and your caregiver will learn about your surgery from your healthcare providers. After your surgery, your caregiver will take you home when you’re discharged from the hospital. They’ll also help you care for yourself at home.

For caregivers

‌  Caring for a person going through cancer treatment comes with many responsibilities. MSK offers resources and support to help you manage them. For information, visit www.msk.org/caregivers or read A Guide for Caregivers.

Fill out a Health Care Proxy form

If you have not already filled out a Health Care Proxy form, we recommend you do now. If you already filled one out or have any other advance directives, bring them to your next appointment.

A health care proxy is a legal document. It says who will speak for you if you cannot communicate for yourself. This person is called your health care agent.

• For information about health care proxies and other advance directives, read Advance Care Planning.
• For information about being a health care agent, read How to Be a Health Care Agent.
• If you have more questions about filling out a Health Care Proxy form, talk with your healthcare provider.

Do Breathing and Coughing Exercises

Practice taking deep breaths and coughing before your surgery. Your healthcare provider will give you an incentive spirometer to help expand your lungs. For more information, read How To Use Your Incentive Spirometer.

Follow a Healthy Diet

Follow a well-balanced, healthy diet before your surgery. If you need help with your diet, talk with your healthcare provider about meeting with a clinical dietitian nutritionist.

Buy a 4% Chlorhexidine Gluconate (CHG) Solution Antiseptic Skin Cleanser (Such As Hibiclens®)

4% CHG solution is a skin cleanser that kills germs for 24 hours after you use it. Showering with it before your surgery will help lower your risk of infection after surgery. You can buy a 4% CHG solution antiseptic skin cleanser at your local pharmacy without a prescription.

7 days before your surgery

Follow your healthcare provider’s instructions for taking aspirin

If you take aspirin or a medication that contains aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Aspirin can cause bleeding.

Follow your healthcare provider’s instructions. Do not stop taking aspirin unless they tell you to.

For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements

Stop taking vitamin E, multivitamins, herbal remedies, and other dietary supplements 7 days before your surgery. These things can cause bleeding.

If your healthcare provider gives you other instructions, follow those instead.

For more information, read Herbal Remedies and Cancer Treatment.

2 days before your surgery

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

Stop taking NSAIDs, such as ibuprofen (Advil^® and Motrin^®) and naproxen (Aleve^®), 2 days before your surgery. NSAIDs can cause bleeding.

If your healthcare provider gives you other instructions, follow those instead.

For more information, read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E.

1 day before your surgery

Follow a clear liquid diet

You’ll need to follow a clear liquid diet the day before your surgery. A clear liquid diet includes only liquids you can see through. You can find examples in the “Clear liquid diet” table.

While you’re following a clear liquid diet:

• Try to drink at least 1 (8-ounce) cup of clear liquid every hour you’re awake.
• Drink different types of clear liquids. Do not just drink water, coffee, and tea.
• Do not drink any liquids you can’t see through, such as milk or smoothies.
• Do not drink sugar-free liquids unless you have diabetes and a member of your care team tells you to.
• Do not eat any solid foods.

How to follow a clear liquid diet if you have diabetes

Ask the healthcare provider who manages your diabetes:

• What to do while you’re following a clear liquid diet.
• If you need to change the dose of insulin or other diabetes medication, if you take them.
• If you should drink sugar-free clear liquids.

Check your blood sugar level often while you’re following a clear liquid diet. If you have questions, talk with your healthcare provider.

Start bowel preparation, if needed

If your surgeon or nurse told you that you needed to do a bowel preparation, you’ll need to start it 1 day before your surgery. During your bowel preparation:

• Don’t eat any solid foods.
• Make sure to drink plenty of liquids other than water, black coffee, and tea. Try to drink at least 1 (8-ounce) glass every hour while you’re awake.

At 2:00 p.m. on the day before your surgery, drink the magnesium citrate.

Note the time of your surgery

A staff member from the Admitting Office will call you after 2 p.m. the day before your surgery. If your surgery is scheduled for a Monday, they’ll call you the Friday before. If you do not get a call by 7 p.m., call 212-639-5014.

The staff member will tell you what time to arrive at the hospital for your surgery. They’ll also remind you where to go.

This will be one of the following locations:

• Presurgical Center (PSC) on the 2nd floor
  1275 York Avenue (between East 67th and East 68th Streets)
  New York, NY 10065
  M elevator to 2nd floor
• Presurgical Center (PSC) on the 6th floor
  1275 York Avenue (between East 67th and East 68th Streets)
  New York, NY 10065
  B elevator to 6th floor

Shower with a 4% CHG solution antiseptic skin cleanser (such as Hibiclens)

The night before your surgery, shower with a 4% CHG solution antiseptic skin cleanser.

Do not use any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Sleep

Go to bed early and get a full night’s sleep.

Instructions for eating before your surgery

‌  
Do not eat anything after midnight the night before your surgery. This includes hard candy and gum.



 

The morning of your surgery

Instructions for drinking before your surgery

‌  You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.

Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Take your medications as instructed

A member of your care team will tell you which medications to take the morning of your surgery. Take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.

Shower with a 4% CHG solution antiseptic skin cleanser (such as Hibiclens)

Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before.

Do not put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Things to remember

• Wear something comfortable and loose-fitting.
• If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
• Do not wear any metal objects. Remove all jewelry, including body piercings. The tools used during your surgery can cause burns if they touch metal.
• Leave valuable items at home.
• If you’re menstruating (have your monthly period), use a sanitary pad, not a tampon. You’ll get disposable underwear, as well as a pad if needed.

What to bring

• Your breathing device for sleep apnea (such as your CPAP machine), if you have one.
• Your incentive spirometer, if you have one.
• Your Health Care Proxy form and other advance directives, if you filled them out.
• Your cell phone and charger.
• Only the money you may want for small purchases (such as a newspaper).
• A case for your personal items, if you have any. Examples of personal items include eyeglasses, hearing aids, dentures, prosthetic devices, wigs, and religious articles.
• This guide. You’ll use it when you learn how to care for yourself after surgery.

Where To Park

MSK’s parking garage is on East 66^th Street between York and 1^st avenues. If you have questions about prices, call 212-639-2338.

To reach the garage, turn onto East 66^th Street from York Avenue. The garage is about a quarter of a block in from York Avenue. It’s on the right (north) side of the street. There’s a tunnel you can walk through that connects the garage to the hospital.

There are other parking garages located on:

• East 69th Street between 1st and 2nd avenues.
• East 67th Street between York and 1st avenues.
• East 65th Street between 1st and 2nd avenues.

Once you’re in the hospital

When you get to the hospital, take the B elevator to the 2^nd or 6^th floor. Check in at the desk in the PSC waiting room.

Many staff members will ask you to say and spell your name and birth date. This is for your safety. People with the same or a similar name may be having surgery on the same day.

When it’s time to change for surgery, you’ll get a hospital gown, robe, and nonskid socks to wear.

Get dressed for surgery

When it’s time to change for surgery, you’ll get a hospital gown, robe, and nonskid socks to wear.

Meet with a nurse

You’ll meet with a nurse before surgery. Tell them the dose of any medications you took after midnight and the time you took them. Make sure to include prescription and over-the-counter medications, patches, and creams.

Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not place the IV, your anesthesiologist will do it in the operating room.

Meet with an anesthesiologist

You’ll also meet with an anesthesiologist before surgery. They will:

• Review your medical history with you.
• Ask you if you’ve had any problems with anesthesia in the past, including nausea or pain.
• Talk with you about your comfort and safety during your surgery.
• Talk with you about the kind of anesthesia you’ll get.
• Answer your questions about your anesthesia.

Get ready for surgery

When it’s time for your surgery, you’ll take off your eyeglasses, hearing aids, dentures, prosthetic devices, wig, and religious articles.

You’ll either walk into the operating room or a staff member will bring you there on a stretcher. A member of your care team will help you onto a bed. They will put compression boots on your lower legs. These gently inflate and deflate to help blood flow in your legs.

Once you’re comfortable, your anesthesiologist will give you anesthesia through your IV to make you fall asleep. You’ll also get fluids through your IV during and after your surgery.

During your surgery

After you’re fully asleep, your care team will place a breathing tube through your mouth into your airway. It will help you breathe. They’ll also place a urinary (Foley) catheter in your bladder. It will drain your urine (pee) during your surgery.

Once your surgery is finished, your incision will be closed with staples or sutures (stitches). You’ll also have Steri-Strips^™ (thin pieces of surgical tape) or Dermabond over your incisions. Your incisions may be covered with a bandage.

Your breathing tube is usually taken out while you’re still in the operating room

Recovering After Your Surgery

This section will help you know what to expect after your surgery. You’ll learn how to safely recover from your surgery both in the hospital and at home.

As you read through this section, write down questions to ask your healthcare provider.

In the Post-Anesthesia Care Unit (PACU) 

When you wake up after your surgery, you’ll be in the PACU. A nurse will be keeping track of your body temperature, pulse, blood pressure, and oxygen levels. You may be getting oxygen through a thin tube that rests below your nose or a mask that covers your nose and mouth. You’ll also have compression boots on your lower legs. They’ll be taken off when you’re able to walk.

Pain medication

You’ll be given medications to control your pain and keep you comfortable. There are different ways these medications can be given.

• If you’re getting epidural pain medication, it will be put into your epidural space through your epidural catheter. Your epidural space is the space in your spine just outside your spinal cord.
• If you’re getting a nerve block, your doctor will inject medication into some of your nerve to reduce pain after surgery.
• If you’re getting IV pain medication, it will be put into your bloodstream through your IV line.
• If you’re getting oral medications. Some people may get oral pain medications (medication that’s swallowed, such as pills).

You may have 1 or more of these after your surgery. They’re all good ways to control your pain. Your doctor will talk with you before choosing the best one(s) for you.

You’ll be able to control your pain medication using a button called a patient-controlled analgesia (PCA) device. For more information, read Patient-Controlled Analgesia (PCA).

Tubes and drains

You’ll have a Foley catheter in your bladder to keep track of how much urine you’re making. For most people, it’s removed 2 days after surgery.

You may also have a Jackson-Pratt^® drain (JP drain). The drain collects extra liquid from your incision (cut). This lowers your risk for infection and helps your body heal. Most of the time, the drains are removed after a few days. If you go home with a drain, your nurse will show you how to care for it.

Moving to your hospital room

You may stay in the PACU for a few hours or overnight. How long you stay depends on the type of surgery you had. After your stay in the PACU, a staff member will bring you to your hospital room.

In your hospital room

Most people are in the hospital for 2 days after a laparoscopic surgery and 5 days after an open surgery. This will depend on the exact surgery you had.

In your hospital room, you’ll meet one of the nurses who will care for you during your stay. Soon after you get there, a nurse will help you out of bed and into your chair.

Your healthcare providers will teach you how to care for yourself while you’re healing from your surgery. You can help yourself recover more quickly by:

• Starting to move around as soon as you can. The sooner you get out of bed and walk, the quicker you can get back to your normal activities. Walking every 2 hours is a good goal. This will help prevent blood clots in your legs.
• Using your incentive spirometer. This will help your lungs expand, which prevents pneumonia.

Managing your pain

You’ll have some pain after your surgery. At first, you’ll get your pain medication through your epidural catheter or IV line. You’ll be able to control your pain medication using a PCA device. Once you’re able to eat, you’ll get oral pain medication (medication you swallow).

Your healthcare providers will ask you about your pain often and give you medication as needed. If your pain is not better, tell one of your healthcare providers. It’s important to control your pain so you can use your incentive spirometer and move around. Controlling your pain will help you recover better.

If you had a robotic surgery, you may have pain in your shoulder. This is called referred pain and is common. It’s caused by the gas that was put into your abdomen during your surgery. If you have pain in your shoulder, tell one of your healthcare providers. They’ll bring you a hot pack to put on your shoulder to help with the pain.

You’ll get a prescription for pain medication before you leave the hospital. Talk with your healthcare provider about possible side effects. Ask them when to start switching to over-the-counter pain medications.

Moving around and walking

Moving around and walking will help lower your risk for blood clots and pneumonia (lung infection). It will also help you start passing gas and having bowel movements (pooping) again. Your nurse, physical therapist, or occupational therapist will help you move around, if needed.

Read Frequently Asked Questions About Walking After Your Surgery to learn more about how walking after surgery can help you recover.

Read Call! Don't Fall! to learn what you can do to stay safe and keep from falling while you’re in the hospital.

Exercising your lungs

It’s important to exercise your lungs so they expand fully. This helps prevent pneumonia.

• Use your incentive spirometer 10 times every hour you’re awake. For more information, read How To Use Your Incentive Spirometer. You can find it in the “Educational Resources” section of this guide.
• Do coughing and deep breathing exercises. A member of your care team will teach you how.

Eating and drinking

You may be able to have ice chips the day after your surgery. After that, you can start having sips of clear liquids. You’ll gradually move to a regular diet as you recover.

If you have questions about your diet, ask to see a clinical dietitian nutritionist.

Caring for your tubes and drains

It’s helpful if your caregiver also learns how to care for your JP drain. This will make it easier for them to help you care for yourself at home.

Planning for discharge

Your first appointment after surgery is usually 1 to 2 weeks after you leave the hospital. Your nurse will give you instructions on how to make this appointment, including the phone number to call.

Leaving the hospital

Before you leave, look at your incision with one of your healthcare providers. Knowing what it looks like will help you notice any changes later.

On the day of your discharge, plan to leave the hospital around 11 a.m. Before you leave, your healthcare provider will write your discharge order and prescriptions. You’ll also get written discharge instructions. One of your healthcare providers will review them with you before you leave.

If your ride is not at the hospital when you’re ready to leave, you may be able to wait in the Patient Transition Lounge. A member of your care team will give you more information.

At home

Read What You Can Do to Avoid Falling to learn what you can do to stay safe and keep from falling at home and during your appointments at MSK.

Managing your pain

People have pain or discomfort for different lengths of time. You may still have some pain when you go home and will probably be taking pain medication. Some people have soreness, tightness, or muscle aches around their incision for 6 months or longer. This does not mean something is wrong.

Follow the guidelines below to help manage your pain at home.

• Take your medications as directed and as needed.
• Call your healthcare provider if the medication prescribed for you does not help your pain.
• Do not drive or drink alcohol while you’re taking prescription pain medication. Some prescription pain medications can make you drowsy. Alcohol can make the drowsiness worse.
• As your incision heals, you’ll have less pain and need less pain medication. An over-the-counter pain reliever such as acetaminophen (Tylenol®) or ibuprofen (Advil® or Motrin®) will ease aches and discomfort.
  • Follow your healthcare provider’s instructions for stopping your prescription pain medication.
  • Do not take more of any medication than the amount on the label or as instructed by your healthcare provider.
  • Read the labels on all the medications you’re taking. This is very important if you’re taking acetaminophen. Acetaminophen is an ingredient in many over-the-counter and prescription medications. Taking too much can harm your liver. Do not take more than one medication that has acetaminophen without talking with a member of your care team.
• Pain medication should help you get back to your normal activities. Take enough medication to do your activities and exercises comfortably. It’s normal for your pain to increase a little as you start to be more active.
• Keep track of when you take your pain medication. It works best 30 to 45 minutes after you take it. Taking it when you first have pain is better than waiting for the pain to get worse.

Some prescription pain medications (such as opioids) may cause constipation (having fewer bowel movements than usual).

Preventing and managing constipation

Talk with your healthcare provider about how to prevent and manage constipation. You can also follow the guidelines below.

• Go to the bathroom at the same time every day. Your body will get used to going at that time. If you feel like you need to go, though, do not put it off.
• Try to use the bathroom 5 to 15 minutes after meals. After breakfast is a good time to go. That’s when the reflexes in your colon are strongest.
• Exercise, if you can. Walking is an excellent form of exercise.
• Drink 8 to 10 (8-ounce) glasses (2 liters) of liquids daily, if you can. Choose liquids such as water, juices (such as prune juice), soups, and ice cream shakes. Avoid liquids with caffeine (such as coffee and soda). Caffeine can pull fluid out of your body.
• Slowly increase the fiber in your diet to 25 to 35 grams per day. Unpeeled fruits and vegetables, whole grains, and cereals contain fiber. If you have an ostomy or have had recent bowel surgery, check with your healthcare provider before making any changes in your diet.
• Both over-the-counter and prescription medications are available to treat constipation. Check with your healthcare provider before taking any medications for constipation, especially if you have an ostomy or have had bowel surgery. Follow the instructions on the label or from your healthcare provider. Examples of over-the-counter medications for constipation include:
  • Docusate sodium (Colace®). This is a stool softener (medication that makes your bowel movements softer) that causes few side effects. You can use it to help prevent constipation. Do not take it with mineral oil.
  • Polyethylene glycol (MiraLAX®). This is a laxative (medication that causes bowel movements) that causes few side effects. Take it with 8 ounces (1 cup) of a liquid. Only take it if you’re already constipated.
  • Senna (Senokot®). This is a stimulant laxative, which can cause cramping. It’s best to take it at bedtime. Only take it if you’re already constipated.

If any of these medications cause diarrhea (loose, watery bowel movements), stop taking them. You can start again if needed.

Caring for your incision

Take a shower every day to clean your incision. Follow the instructions in the “Showering” section.

It’s common for the skin below your incision to feel numb. This happens because some of your nerves were cut during your surgery. The numbness will go away over time.

If there is anything draining from your incision, write down the amount and color.

Call your healthcare provider’s office if:

• The skin around your incision is very red or getting more red.
• The skin around your incision is warmer than usual.
• The area around your incision is starting to swell or getting more swollen.
•  You see drainage that looks like pus (thick and milky).
• Your incision smells bad.

Your nurse will talk with you about the signs of infection.

If you go home with bandages over your incision, change them at least once a day or anytime they’re wet. When there is no longer any drainage coming from your incision, it can be left uncovered.

If you have Steri-Strips or Dermabond on your incision, they’ll loosen and fall or peel off on their own. If they have not fallen off after 10 days, you can take them off.

Showering

You can shower when you get home. Taking a warm shower is relaxing and can help ease muscle aches.

If you have a bandage over your incision, you can remove it before you shower. Use soap when you shower and gently wash your incision. This will keep Steri-Strips or Dermabond in place. Pat the areas dry with a towel after showering. Leave your incision uncovered unless there is drainage. Call your doctor if you see any redness or drainage from your incision.

Do not take tub baths until you discuss it with your doctor at the first appointment after your surgery.

Eating and drinking

After your surgery, you may have a lack of appetite and feel full quickly after eating. These are expected and should improve over time. Try to eat small amounts of your favorite foods throughout the day. It is important to get enough calories and protein to prevent weight loss and promote healing.

If you have questions about your diet, ask to see a clinical dietitian nutritionist.

Physical activity and exercise

When you leave the hospital, your incision may look like it’s healed on the outside. It will not be healed on the inside. For the first 6 to 8 weeks after your surgery:

• Do not lift anything heavier than 10 pounds (4.5 kilograms) for at least 6 weeks. Ask your doctor how long you should avoid heavy lifting.
• Do not do any high-energy activities, such as jogging and tennis.
• Do not play any contact sports, such as football.

Doing aerobic exercise, such as walking and stair climbing, will help you gain strength and feel better. Walk at least 2 to 3 times a day for 20 to 30 minutes. You can walk outside or indoors at your local mall or shopping center.

It’s common to have less energy than usual after surgery. This may last for 6 to 8 weeks. Recovery time is different for each person. Increase your activities each day as much as you can. Get up, get dressed, and walk. Always balance activity periods with rest periods. Rest is an important part of your recovery. You may need a nap during the day, but try to stay out of bed as much as possible so you’ll sleep at night.

Driving

Ask your healthcare provider when you can drive. Most people can start driving again 10 to 14 days after surgery. Do not drive while you’re taking pain medication that may make you drowsy.

You can ride in a car as a passenger at any time after you leave the hospital.

Going back to work

Talk with your healthcare provider about your job and when it may be safe for you to start working again. If your job involves lots of movement or heavy lifting, you may need to stay out a little longer.

Traveling

You can travel after surgery. It’s important that you walk around every hour to prevent blood clots.

Managing your feelings

After surgery for a serious illness, you may have new and upsetting feelings. Many people say they felt weepy, sad, worried, nervous, irritable, and angry at one time or another. You may find you cannot control some of these feelings. If this happens, it’s a good idea to seek emotional support. Your healthcare provider can refer you to MSK’s Counseling Center. You can also reach them by calling 646-888-0200.

The first step in coping is to talk about how you feel. Family and friends can help. Your healthcare providers can reassure, support, and guide you. It’s always a good idea to let us know how you, your family, and your friends are feeling emotionally. Many resources are available to you and your family. We’re here to help you and your family and friends handle the emotional aspects of your illness. We can help, whether you’re in the hospital or at home.

When to Call Your Healthcare Provider

Call your healthcare provider if:

• You have a fever of 100.5 °F (38 °C) or higher.
• You have chills.
• You’re having trouble breathing.
• The skin around your incision is very red or getting more red.
• The skin around your incision is warmer than usual.
• The area around your incision is starting to swell or getting more swollen.
• You see drainage that looks like pus (thick and milky).
• Your incision smells bad.
• You have any questions or concerns.

Support services

This section has a list of support services. They may help you as you get ready for your surgery and recover after your surgery.

As you read through this section, write down questions to ask your healthcare provider.

MSK support services

Visit the cancer types section of MSK’s website at www.msk.org/types for more information.

Admitting Office
212-639-7606
Call if you have questions about your hospital admission, such as asking for a private room.

Anesthesia
212-639-6840
Call if you have questions about anesthesia.

Blood Donor Room
212-639-7643
Call for information if you’re interested in donating blood or platelets.

Bobst International Center
888-675-7722
We welcome patients from around the world and offer many services to help. If you’re an international patient, call for help arranging your care.

Caregivers Clinic
646-888-0200
www.msk.org/caregivers
At MSK, the Caregivers Clinic provides support specifically for caregivers who are having difficulty coping with the demands of being a caregiver. For more information, call Dr. Allison Applebaum’s office at 646-888-0200.

Counseling Center
646-888-0200
Many people find that counseling helps them. Our counseling center offers counseling for individuals, couples, families, and groups. We can also prescribe medications to help if you feel anxious or depressed. To make an appointment, ask your healthcare provider for a referral or call the number above.

Female Sexual Medicine & Women’s Health Program
646-888-5076
Cancer and cancer treatments can affect your sexual health, fertility, or both. Our Female Sexual Medicine & Women’s Health Program can help with sexual health problems, such as premature menopause or fertility issues. We can help before, during, or after your treatment. Call for more information or to make an appointment.

Food Pantry Program
646-888-8055
We give food to people in need during their cancer treatment. For more information, talk with your healthcare provider or call the number above.

Integrative Medicine Service
www.msk.org/integrativemedicine
Our Integrative Medicine Service offers many services to complement (go along with) traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy. To schedule an appointment for these services, call 646-449-1010.

You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They will work with you to come up with a plan for creating a healthy lifestyle and managing side effects. To make an appointment, call 646-608-8550.

Male Sexual and Reproductive Medicine Program
646-888-6024
Cancer and cancer treatments can affect your sexual health, fertility, or both. Our Male Sexual and Reproductive Medicine Program can help with sexual health problems, such as erectile dysfunction (ED). We can help before, during, or after your treatment. Call for more information or to make an appointment.

MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or call to talk with the library reference staff. They can help you find more information about a type of cancer. You can also visit LibGuides on MSK’s library website at libguides.mskcc.org

Nutrition Services
www.mskcc.org/nutrition
212-639-7312
Our Nutrition Service offers nutritional counseling with one of our clinical dietitian nutritionists. Your clinical dietitian nutritionist will talk with you about your eating habits. They can also give advice on what to eat during and after treatment. To make an appointment, ask a member of your care team for a referral or call the number above.

Patient and Caregiver Education
www.msk.org/pe
Visit our Patient and Caregiver Education website to search for educational resources, videos, and online programs.

Patient and Caregiver Peer Support Program
212-639-5007
It can be comforting to talk with someone who has been through a treatment like yours. You can talk with a former MSK patient or caregiver through our Patient and Caregiver Peer Support Program. Your conversations are private. They can be in person or over the phone.

Patient Billing
646-227-3378
Call if you have questions about preauthorization with your insurance company. This is also called preapproval.

Patient Representative Office
212-639-7202
Call if you have questions about the Health Care Proxy form or concerns about your care.

Perioperative Nurse Liaison
212-639-5935
Call if you have questions about MSK releasing any information while you’re having surgery.

Private Duty Nurses and Companions
917-862-6373
You can request private nurses or companions to care for you in the hospital and at home. Call for more information.

Resources for Life After Cancer (RLAC) Program
646-888-8106
At MSK, care does not end after your treatment. The RLAC Program is for patients and their families who have finished treatment.

This program has many services. We offer seminars, workshops, support groups, and counseling on life after treatment. We can also help with insurance and employment issues.

Social Work
www.msk.org/socialwork
212-639-7020
Social workers help patients, families, and friends deal with common issues for people who have cancer. They provide individual counseling and support groups throughout your treatment. They can help you communicate with children and other family members.

Our social workers can also help refer you to community agencies and programs. They also have information about financial resources, if you’re having trouble paying your bills.

Spiritual Care
212-639-5982
Our chaplains (spiritual counselors) are available to listen, help support family members, and pray. They can contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can ask for spiritual support. You do not have to have a religious affiliation (connection to a religion).

MSK’s interfaith chapel is located near Memorial Hospital’s main lobby. It’s open 24 hours a day. If you have an emergency, call 212-639-2000. Ask for the chaplain on call.

Tobacco Treatment Program
www.msk.org/tobacco
212-610-0507
MSK has specialists who can help you quit smoking. For more information about our Tobacco Treatment Program, call 212-610-0507. You can also ask your nurse about the program.

Virtual Programs
www.msk.org/vp
Our Virtual Programs offer online education and support for patients and caregivers. These are live sessions where you can talk or just listen. You can learn about your diagnosis, what to expect during treatment, and how to prepare for your cancer care.

Sessions are private, free, and led by experts. Visit our website for more information about Virtual Programs or to register.

External support services

Access-A-Ride
web.mta.info/nyct/paratran/guide.htm
877-337-2017
In New York City, the MTA offers a shared ride, door-to-door service for people with disabilities who can’t take the public bus or subway.

Air Charity Network
www.aircharitynetwork.org
877-621-7177
Provides travel to treatment centers.

American Cancer Society (ACS)
www.cancer.org
800-ACS-2345 (800-227-2345)
Offers a variety of information and services, including Hope Lodge, a free place for patients and caregivers to stay during cancer treatment.

Cancer and Careers
www.cancerandcareers.org
A resource for education, tools, and events for employees with cancer.

CancerCare
www.cancercare.org
800-813-4673
275 Seventh Avenue (Between West 25^th & 26^th Streets)
New York, NY 10001
Provides counseling, support groups, educational workshops, publications, and financial assistance.

Cancer Support Community
www.cancersupportcommunity.org
Provides support and education to people affected by cancer.

Caregiver Action Network
www.caregiveraction.org
800-896-3650
Provides education and support for people who care for loved ones with a chronic illness or disability.

Corporate Angel Network
www.corpangelnetwork.org
866-328-1313
Offers free travel to treatment across the country using empty seats on corporate jets.

Gilda’s Club
www.gildasclubnyc.org
212-647-9700
A place where men, women, and children living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

Good Days
www.mygooddays.org
877-968-7233
Offers financial assistance to pay for copayments during treatment. Patients must have medical insurance, meet the income criteria, and be prescribed medication that’s part of the Good Days formulary.

Healthwell Foundation
www.healthwellfoundation.org
800-675-8416
Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medications and therapies.

Joe’s House
www.joeshouse.org
877-563-7468
Provides a list of places to stay near treatment centers for people with cancer and their families.

LGBT Cancer Project
http://lgbtcancer.com/
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.

LIVESTRONG Fertility
www.livestrong.org/we-can-help/fertility-services
855-744-7777
Provides reproductive information and support to cancer patients and survivors whose medical treatments have risks associated with infertility.

Look Good Feel Better Program
www.lookgoodfeelbetter.org
800-395-LOOK (800-395-5665)
This program offers workshops to learn things you can do to help you feel better about your appearance. For more information or to sign up for a workshop, call the number above or visit the program’s website.

National Cancer Institute
www.cancer.gov
800-4-CANCER (800-422-6237)

National Cancer Legal Services Network
www.nclsn.org
Free cancer legal advocacy program.

National LGBT Cancer Network
www.cancer-network.org
Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

Needy Meds
www.needymeds.org
Lists Patient Assistance Programs for brand and generic name medications.

NYRx
www.nyrxplan.com
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

Partnership for Prescription Assistance
www.pparx.org
888-477-2669
Helps qualifying patients without prescription drug coverage get free or low-cost medications.

Patient Access Network Foundation
www.panfoundation.org
866-316-7263
Provides assistance with copayments for patients with insurance.

Patient Advocate Foundation
www.patientadvocate.org
800-532-5274
Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

RxHope
www.rxhope.com
877-267-0517
Provides assistance to help people get medications that they have trouble affording.

Educational resources

This section lists the educational resources mentioned in this guide. They will help you get ready for your surgery and recover after your surgery.

As you read through these resources, write down questions to ask your healthcare provider.

• Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), or Vitamin E
• Herbal Remedies and Cancer Treatment
• How To Use Your Incentive Spirometer
• Patient-Controlled Analgesia (PCA)