About Your Liver Surgery

This guide will help you get ready for your liver surgery at Memorial Sloan Kettering (MSK). It will also help you understand what to expect during your recovery.

Read through this guide at least once before your surgery and use it as a reference in the days leading up to your surgery.

Bring this guide with you every time you come to MSK, including the day of your surgery. You and your healthcare team will refer to it throughout your care.

About Your Surgery

About Your Liver

Your liver is a large organ located on the right side of your body, just under your ribs (see Figure 1). Your liver has many functions, including:

Figure 1. Your liver
  • Storing and filtering blood.
  • Making bile, which helps with digestion (the breakdown of food), especially of protein and fat.
  • Changing sugar into a form your body can use for energy.
  • Helping your body get rid of waste products.
  • Making the substances that your blood needs to clot.

The healthy part of your liver that’s left after surgery will grow larger to replace the part that was removed. Your liver should return to its original size within a few weeks, but it will take longer for it to be fully functional.

About Liver Surgery

There are several kinds of liver surgeries to treat cancer. The main kinds of liver surgery are:

  • A liver resection. This is a surgery to remove the part(s) of your liver with the tumors. When your surgeon removes a tumor, they will also need to take out a small amount of healthy tissue around it. The amount of tissue that will be removed depends on the size and location of the tumor(s).
  • Radio frequency ablation (RFA). This is a procedure to kill cancer cells by heating them to very high temperatures.
  • Microwave ablation. This is a procedure to kill cancer cells by heating them to very high temperatures.
  • Irreversible electroporation. This is a procedure to kill cancer cells using an electric current.

Your doctor will explain which type of surgery you will have. You may have a combination of both a liver resection and a liver ablation. Liver ablation methods can be used individually, in combination with a liver resection, or in combination with one another. The exact treatment differs from person to person.

Your surgeon will make an incision (surgical cut) to see your liver clearly. They will decide the size of the incision and if a minimally invasive technique (which makes very small incisions and uses cameras for guidance) is appropriate for you. Then, they will look at your liver using an ultrasound to confirm the location and number of tumors in it.

The length of your surgery will depend on how many tumors need to be treated. Most surgeries take between 2 and 4 hours, but some may take longer. Your doctor or nurse will tell you what to expect.

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Before Your Surgery

The information in this section will help you get ready for your surgery. Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It has important information about what you need to do before your surgery.

Write down your questions and be sure to ask your doctor or nurse.

Getting Ready for Your Surgery

You and your healthcare 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 aren’t sure.

  • I take a blood thinner. Some examples are aspirin, heparin, warfarin (Coumadin®), clopidogrel (Plavix®), enoxaparin (Lovenox®), dabigatran (Pradaxa®), apixaban (Eliquis®), and rivaroxaban (Xarelto®). There are others, so be sure your healthcare provider knows all the medications you’re taking.
  • I take prescription medications (medications prescribed by a healthcare provider), 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 have had a problem with anesthesia (medication to make you sleep during surgery) in the past.
  • I am allergic to certain medication(s) or materials, including latex.
  • I am not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke.
  • 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 complications, we can prescribe medications to help keep them from happening.
  • If you drink alcohol regularly, you may be at risk for other complications 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. If you develop a headache, nausea (feeling like you’re going to throw up), increased anxiety, or can’t sleep after you stop drinking, tell your healthcare provider right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you can’t stop drinking.
  • Ask your healthcare provider questions about drinking and surgery. As always, all of your medical information will be kept confidential.

About Smoking

If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. If you smoke, your nurse will refer you to our Tobacco Treatment Program. You can also reach the program by calling 212-610-0507.

About Sleep Apnea

Sleep apnea is a common breathing disorder that causes you to stop breathing for short periods of time while sleeping. The most common type is obstructive sleep apnea (OSA). With OSA, the airway becomes completely blocked during sleep. OSA can cause serious problems during and after surgery.

Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing machine (such as a CPAP machine) for sleep apnea, bring it with you the day of your surgery.

Within 30 Days of Your Surgery

Presurgical Testing (PST)

Before your surgery, you will have an appointment for presurgical testing (PST). The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office.

You can eat and take your usual medications the day of your PST appointment.

During your appointment, you will meet with a nurse practitioner (NP) who works closely with anesthesiology staff (doctors and specialized nurses who will give you anesthesia during your surgery). Your NP will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

It’s very helpful to bring the following things to your PST 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 name(s) and telephone number(s) of your doctor(s).

Identify Your Caregiver

Your caregiver plays an important role in your care. You and your caregiver will learn about your surgery from your healthcare provider. After your surgery, your caregiver should be with you when you’re given your discharge instructions so they’re able to help you care for yourself at home. Your caregiver will also need to take you home after your surgery.

Complete a Health Care Proxy Form

If you haven’t already completed a Health Care Proxy form, we recommend you complete one now. A health care proxy is a legal document that identifies the person who will speak for you if you can’t communicate for yourself. The person you identify is called your health care agent. For more information about health care proxies and other advance directives, read the resource Advance Care Planning.

If you’re interested in completing a Health Care Proxy form, talk with your nurse. If you have completed one already, or if you have any other advance directives, bring them to your next appointment.

Do Breathing and Coughing Exercises

Practice taking deep breaths and coughing before your surgery. You will be given an incentive spirometer to help expand your lungs. For more information, read the resource How to Use Your Incentive Spirometer. If you have any questions, ask your nurse or respiratory therapist.

Exercise

Try to do aerobic exercise every day. Examples of aerobic exercise include walking, swimming, or biking. If it’s cold outside, use stairs in your home or go to a mall or shopping center. Exercising will help your body get into its best condition for your surgery and make your recovery faster and easier.

Follow a Healthy Diet

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

10 Days Before Your Surgery

Stop Taking Vitamin E

If you take vitamin E, stop taking it 10 days before your surgery. Vitamin E can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

7 Days Before Your Surgery

Stop Taking Certain Medications

If you take aspirin, ask your doctor if you should keep taking it. Aspirin and medications that contain aspirin can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

Stop Taking Herbal Remedies and Other Dietary Supplements

Stop taking herbal remedies and other dietary supplements 7 days before your surgery. If you take a multivitamin, ask your doctor or nurse if you should keep taking it. For more information, read the resource Herbal Remedies and Cancer Treatment.

Watch a Virtual Tour

This video will give you an idea of what to expect when you come to Memorial Hospital (MSK’s main hospital) on the day of your surgery.

2 Days Before Your Surgery

Stop Taking Certain Medications

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®), 2 days before your surgery. These medications can cause bleeding. For more information, read the resource Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

1 Day Before Your Surgery

Note the Time of Your Surgery

A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, they will call you on the Friday before. If you don’t get a call by 7:00 pm, please call 212-639-5014.

The staff member will tell you what time to arrive at the hospital for your surgery. They will also tell you where to go. This will be the following location:

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 Hibiclens

Hibiclens is a skin cleanser that kills germs for 24 hours after you use it (see figure). Showering with Hibiclens before your surgery will help lower your risk of infection after surgery. Your nurse will give you a bottle of Hibiclens to use before your surgery.

The night before your surgery, shower using Hibiclens.

  1. Use your normal shampoo to wash your hair. Rinse your head well.
  2. Use your normal soap to wash your face and genital area. Rinse your body well with warm water.
  3. Open the Hibiclens bottle. Pour some solution into your hand or a washcloth.
  4. Move away from the shower stream to avoid rinsing off the Hibiclens too soon.
  5. Rub the Hibiclens gently over your body from your neck to your hips. Don’t put the Hibiclens on your face or genital area.
  6. Move back into the shower stream to rinse off the Hibiclens. Use warm water.
  7. Dry yourself off with a clean towel after your shower.
  8. Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Sleep

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

 

Do not eat or drink after midnight.

The Morning of Your Surgery

  Two hours before your scheduled arrival time, drink the ClearFast PreOp® drink your nurse gave you.

After you finish the ClearFast, do not eat or drink anything else. This includes water, hard candy, and gum.

Take Your Medications

If your doctor or NP told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take and the surgery you’re having, this may be all, some, or none of your usual morning medications.

Shower With Hibiclens

Shower using Hibiclens just before you leave for the hospital. Use the Hibiclens the same way you did the night before.

Don’t 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.
  • Don’t wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
  • Don’t put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
  • Leave valuable items (such as credit cards, jewelry, and your checkbook) at home.
  • Before you’re taken into the operating room, you will need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles.

What to Bring

  • Sneakers that lace up. You may have some swelling in your feet. Lace-up sneakers can accommodate this swelling.
  • Your breathing machine for sleep apnea (such as your CPAP machine), if you have one.
  • Your portable music player, if you choose. However, someone will need to hold it for you when you go into surgery.
  • Your Health Care Proxy form and other advance directives, if you have completed them.
  • Your cell phone and charger.
  • Only the money you may want for small purchases (such as a newspaper).
  • A case for your personal items (such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles), if you have one.
  • This guide. Your healthcare team will use this guide to teach you how to care for yourself after your surgery.

Where to Park

MSK's parking garage

MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.

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

There are also other garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Once You’re in the Hospital

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

You will be asked to say and spell your name and birth date many times. This is for your safety. People with the same or a similar name may be having surgery on the same day.

Get Dressed for Surgery

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

Meet With Your Nurse

You will meet with your nurse before surgery. Tell them the dose of any medications (including patches and creams) you took after midnight and the time you took them.

Your nurse may place an intravenous (IV) line into one of your veins, usually in your arm or hand. If your nurse doesn’t place the IV, your anesthesiologist will do it later once you’re in the operating room.

Meet With Your Anesthesiologist

Your anesthesiologist 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 will have.
  • Answer your questions about your anesthesia.

Your doctor or anesthesiologist may also talk with you about placing an epidural catheter (thin, flexible tube) in your spine (back). An epidural catheter is another way to give you pain medication after your surgery.

Get Ready for Your Surgery

Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your surgery to start. When it’s time for your surgery, your visitor(s) will be taken to the waiting area. Your visitors should read the resource Information for Family and Friends for the Day of Surgery.

You will either walk into the operating room or be taken in on a stretcher. A member of the operating room team will help you onto the operating bed. Compression boots will be placed 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 line and you will fall asleep. You will also get fluids through your IV line during and after your surgery.

During Your Surgery

After you’re fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. You will also have a urinary (Foley®) catheter placed to drain urine (pee) from your bladder.

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

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

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After Your Surgery

The information in this section will tell you what to expect after your surgery, both during your hospital stay and after you leave the hospital. You will learn how to safely recover from your surgery.

Write down your questions and be sure to ask your doctor or nurse.

In the Post-Anesthesia Care Unit (PACU)

When you wake up after your surgery, you will be in the Post-Anesthesia Care Unit (PACU).

A nurse will be monitoring 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 will also have compression boots on your lower legs.

Pain Medication

You will get epidural or IV pain medication while you’re in the PACU.

  • If you’re getting epidural pain medication, it will be put into your epidural space (the space in your spine just outside your spinal cord) through your epidural catheter.
  • If you’re getting IV pain medication, it will be put into your bloodstream through your IV line.

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

Tubes and Drains

  • You will have a Foley catheter in your urethra going to your bladder. This tube drains urine from your bladder so your care team can keep track of how much urine you’re making. Your Foley catheter is usually removed the day after your surgery.
  • You may have a drainage tube in your abdomen to drain fluid from the area. If you have this drainage tube, it’s usually removed a few days after surgery, but you may still have it when you’re discharged from the hospital. Read the “Caring for Your Tubes and Drains” section for more information.

Visitors

Your visitors can see you briefly in the PACU, usually within 90 minutes after you arrive there. A member of the nursing staff will explain the guidelines to them.

Moving to Your Hospital Room

Some people stay in the PACU for a few hours, while other people stay overnight for observation. Your healthcare team will tell you what to expect. After your stay in the PACU, you will be taken to your hospital room.

In Your Hospital Room

The length of time you’re in the hospital after your surgery depends on the type of liver surgery you had and your recovery. Most people stay in the hospital for 5 to 7 days after having a liver resection.

When you’re taken to your hospital room, you will meet one of the nurses who will care for you while you’re in the hospital. Soon after you arrive in your room, your nurse will help you out of bed and into your chair.

While you’re in the hospital, your nurses will teach you how to care for yourself while you’re recovering from your surgery. You can help yourself recover more quickly by doing the following things:

  • Read your recovery pathway. Your nurse will give you a pathway with goals for your recovery, if you don’t already have one. It will help you know what to do and expect on each day during your recovery.
  • Start moving around as soon as you can. The sooner you’re able to get out of bed and walk, the quicker you will be able to get back to your normal activities.

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

Managing Your Pain

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

Your doctor and nurse will ask you about your pain often and give you medication as needed. If your pain isn’t relieved, tell your doctor or nurse. 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 minimally invasive surgery, you may have pain in your shoulder. This is called referred pain. It’s caused by the gas that was put into your abdomen during your surgery, and it’s normal. If you have pain in your shoulder, tell your nurse.

You will be given a prescription for pain medication before you leave the hospital. Talk with your doctor or nurse about possible side effects and when you should 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. It will also help stimulate your bowels so you start passing gas and having bowel movements (pooping) again. Your nurse, physical therapist, or occupational therapist will help you move around.

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 the resource How to Use Your Incentive Spirometer.
  • Do coughing and deep breathing exercises. A member of your care team will teach you how to do these exercises.

Eating and Drinking

Right after your surgery, you won’t be able to eat solid foods. You will follow a clear liquid diet. After that, you will slowly go back to eating your regular diet. Read your pathway and talk with your care team for more information.

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

Caring for Your Tubes and Drains

Your nurse will help you care for your tubes and drains while you’re in the hospital.

If you have a drainage tube in your abdomen, your healthcare team will keep track of how much fluid is draining from the tube. Once the amount is low enough, they will remove the tube. This usually happens a few days after surgery, but you may still have the drainage tube when you’re discharged from the hospital. Your healthcare team will tell you what to expect.

If you will still have the drainage tube when you’re discharged, your nurse will teach you how to care for it at home. They will also give you the supplies you will need. Your case manager may also arrange for a home care nurse to visit you at home to help you.

Showering

You will be able to shower on the first day after your surgery. A member of your care team will help you.

Leaving the Hospital

By the time you’re ready to leave the hospital, your incision will have started to heal. Before you leave the hospital, look at your incision with your nurse and caregiver. Knowing what your incision looks like will help you notice any changes later.

On the day of your discharge, you should plan to leave the hospital around 11:00 am. Before you leave, your doctor will write your discharge order and prescriptions. A nurse or pharmacist will review your medications with you. You will also get written discharge instructions. Your nurse will review these instructions with you before you leave.

If your ride isn’t at the hospital when you’re ready to be discharged, you may be able to wait in the Patient Transition Lounge. A member of your healthcare team will give you more information.

At Home

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

Your first appointment after surgery will be in 10 to 14 days after you leave the hospital. Your nurse will give you instructions on how to make this appointment, including the phone number to call.

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 as they recover. This doesn’t mean that something is wrong. But, if it doesn’t get better, contact your doctor’s office.

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

  • Take your medications as directed and as needed.
  • Call your doctor if the medication prescribed for you doesn’t ease your pain.
  • Don’t drive or drink alcohol while you’re taking prescription pain medication.
  • As your incision heals, you will have less pain and need less pain medication. An over-the-counter pain reliever such as acetaminophen (Tylenol®) or ibuprofen (Advil®) will ease aches and discomfort.
    • Follow your doctor or nurse’s instructions for stopping your prescription pain medication.
    • Don’t take more acetaminophen than the amount directed on the bottle or as instructed by your doctor or nurse. Taking too much acetaminophen can harm your liver.
  • Pain medication should help you resume your normal activities. Take enough medication to do your exercises comfortably. However, 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 your pain first begins is better than waiting for the pain to get worse.

Pain medication may cause constipation (having fewer bowel movements than what’s normal for you).

Managing Constipation

Talk with your nurse about how to 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. But, if you feel like you need to go, don’t put it off.
  • Exercise. Walking is an excellent form of exercise.
  • Drink 8 (8-ounce) glasses (2 liters) of liquids daily, if you can. Drink water, juices (such as prune juice), soups, ice cream shakes, and other drinks that don’t have caffeine. Drinks with caffeine, such as coffee and soda, pull fluid out of your body.

If you haven’t had a bowel movement in 2 days, call your doctor or nurse.

Caring for Your Incision

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

The staples in your incision will be removed during your first appointment after surgery. This is usually about 2 weeks after you’re discharged. While the staples are in your incision, you may feel some tightness or a tugging feeling along your incision. This is normal. Doing gentle stretching can help.

If you go home with Steri-Strips or Dermabond on your incision, they will loosen and fall off by themselves. If they haven’t fallen off within 10 days, you can take them off.

If the area around your incision is red, puffy, or if you have any drainage from your incision, contact your doctor’s office.

Showering

Shower every day. Taking a warm shower is relaxing and can help ease muscle aches. You will also clean your incision when you shower.

When you shower, use soap to gently wash your incision. After you shower, pat the area dry with a clean towel. Don’t rub over your incision. Leave your incision uncovered, unless there’s drainage.

Don’t take tub baths until you discuss it with your doctor at your first appointment after your surgery.

Eating and Drinking

When you first start eating solid foods, you won’t be able to eat the same portions of food you did before your surgery. Try to eat 4 to 6 small meals a day.

It’s also important to drink plenty of liquids. Try to drink 8 (8-ounce) glasses of liquids every day. Don’t drink alcohol until you check with your doctor or nurse. Alcohol is cleared out of your body through your liver.

If you need to reach a clinical dietitian nutritionist after you go home, call 212-639-7312.

Physical Activity and Exercise

When you leave the hospital, your incision will look like it’s healed on the outside, but it won’t be healed on the inside.

  • Don’t lift anything heavier than 5 pounds (2.3 kilograms) for at least 8 weeks after your surgery.
  • Ask your doctor or nurse before starting strenuous exercises (such as jogging and tennis).

Doing aerobic exercise, such as walking and stair climbing, will help you gain strength and feel better. You can walk outside or indoors at your local mall or shopping center. Gradually increase the distance you walk. Climb stairs slowly, resting or stopping as needed. You can also keep doing your coughing and deep breathing exercises and using your incentive spirometer.

You may have swelling in your lower legs after your surgery. This will get better with time. If you feel that the swelling is getting worse while you’re home and is making it hard to do your daily activities, contact your doctor’s office.

Managing Fatigue

Fatigue is having less energy or feeling more tired than usual. It’s normal to feel fatigued after your surgery. This may last for 6 to 8 weeks after surgery, but it will get better slowly over time. Try to increase your activity level every day to help manage your fatigue. Get up, get dressed, and walk. You may need a nap during the day, but try to stay out of bed as much as possible so you will sleep at night.

It’s important for you to go back to your usual activities after surgery. Spread them out over the course of the day. You can do light household tasks. Try washing dishes, preparing light meals, and other activities as you are able.

Your body is an excellent guide for telling you when you have done too much. When you increase your activity, monitor your body’s reaction. You may find that you have more energy in the morning or the afternoon. Plan your activities for times of the day when you have more energy.

Driving

While your incision is healing, you may not be able to twist your body as well as normal. This can make it hard for you to drive. You also shouldn’t drive if you’re taking pain medication that may make you drowsy. During your first appointment after surgery, your doctor will tell you if it’s safe for you to start driving again.

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

Going Back to Work

Talk with your doctor or nurse 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 than if you sit at a desk.

Traveling

If you’re traveling a long distance, try to get up once an hour to walk around. This will help prevent blood clots. Remember to drink around 8 (8-ounce) glasses of liquids every day, even when you’re traveling.

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 that you can’t control some of these feelings. If this happens, it’s a good idea to seek emotional support.

The first step in coping is to talk about how you feel. Family and friends can help. Your nurse, doctor, and social worker can reassure, support, and guide you. It’s always a good idea to let these professionals know how you, your family, and your friends are feeling emotionally. Many resources are available to you and your family. Whether you’re in the hospital or at home, the nurses, doctors, and social workers are here to help you and your family and friends handle the emotional aspects of your illness.

Using MyMSK

MyMSK (my.mskcc.org) is your MSK patient portal account. You can use MyMSK to send and receive messages from your healthcare team, view your test results, see your appointment dates and times, and more.

If you don’t already have a MyMSK account, you can sign up by going to my.mskcc.org. For more information about signing up for a MyMSK account, watch our video How to Enroll in the Patient Portal: MyMSK. You can also contact the MyMSK Help Desk by emailing mymsk@mskcc.org or calling 800-248-0593.

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Contact Your Doctor or Nurse If:

  • You have a temperature of 100.5 °F (38 °C) or higher.
  • You have chills.
  • You’re having shortness of breath.
  • The skin around your incision is warmer than normal.
  • The skin around your incision is getting more red.
  • The area around your incision is starting to swell.
  • Swelling around your incision is getting worse.
  • You have pus-like (thick, yellowish, or foul-smelling) drainage from your incision.
  • You have any sudden increase in pain or new pain.
  • You have nausea and vomiting.
  • You have diarrhea.
  • You have constipation that isn’t relieved within 2 days.
  • You have fatigue that’s getting in the way of your day-to-day activities or your ability to get out of the house and exercise.
  • You have jaundice (yellow skin or eyes).
  • You have any new or unexplained symptoms.
  • You have any questions or concerns.

Monday through Friday from 9:00 am to 5:00 pm, contact your doctor’s office.

After 5:00 pm, during the weekend, and on holidays, call 212-639-2000 and ask to speak to the doctor on call for your doctor.

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Support Services

This section contains a list of support services that may help you get ready for your surgery and recover safely.

Write down your questions and be sure to ask your doctor or nurse.

    MSK Support Services

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

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

    Bobst International Center
    888-675-7722
    MSK welcomes patients from around the world. If you’re an international patient, call for help arranging your care.

    Chaplaincy Service
    212-639-5982
    At MSK, our chaplains are available to listen, help support family members, pray, contact community clergy or faith groups, or simply be a comforting companion and a spiritual presence. Anyone can request spiritual support, regardless of formal religious affiliation. The interfaith chapel is located near the main lobby of Memorial Hospital and is open 24 hours a day. If you have an emergency, please call the hospital operator and ask for the chaplain on call.

    Counseling Center
    646-888-0200
    Many people find that counseling helps them. We provide counseling for individuals, couples, families, and groups, as well as 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.

    Food Pantry Program
    646-888-8055
    The food pantry program provides 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
    646-888-0800
    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.

    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.

    MSK Library
    library.mskcc.org
    212-639-7439
    You can visit our library website or speak with the library reference staff to find more information about your specific cancer type. You can also visit LibGuides on MSK’s library website at libguides.mskcc.org.

    Patient and Caregiver Support Program
    212-639-5007
    You may find it comforting to speak with a cancer survivor or caregiver who has been through a similar treatment. Through our Patient and Caregiver Support Program, you’re able to speak with former patients and caregivers. These conversations may take place in person, over the phone, or through email.

    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 if you have 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 Nursing Office
    212-639-6892
    You may request private nurses or companions. Call for more information.

    Resources for Life After Cancer (RLAC) Program
    646-888-8106
    At MSK, care doesn’t end after active treatment. The RLAC Program is for patients and their families who have finished treatment. This program has many services, including seminars, workshops, support groups, counseling on life after treatment, and help with insurance and employment issues.

    Sexual Health Programs
    Cancer and cancer treatments can have an impact on your sexual health. MSK’s Sexual Health Programs can help you take action and address sexual health issues before, during, or after your treatment.

    • Our Female Sexual Medicine and Women’s Health Program helps women who are dealing with cancer-related sexual health challenges, including premature menopause and fertility issues. For more information, or to make an appointment, call 646-888-5076.
    • Our Male Sexual and Reproductive Medicine Program helps men who are dealing with cancer-related sexual health challenges, including erectile dysfunction. For more information, or to make an appointment, call 646-888-6024.

    Social Work
    212-639-7020
    Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also help refer you to community agencies and programs, as well as financial resources if you’re eligible.

    Tobacco Treatment Program
    212-610-0507
    If you want to quit smoking, MSK has specialists who can help. Call for more information.

    For more online information, visit the Cancer Types section of www.mskcc.org.

    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 25th & 26th 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.

    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.

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    Educational Resources

    This section contains the educational resources that were referred to throughout this guide. These resources will help you get ready for your surgery and recover safely after surgery.

    Write down your questions and be sure to ask your doctor or nurse.

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