About Your Liver Surgery

This guide will help you prepare 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 the Liver

Your liver is a large organ located on the right side of your body, just under your ribs. It’s shaded in Figure 1, below. Your liver has many functions, including:

  • Storing and filtering blood.
  • Making bile, which helps with the breakdown of food (digestion), 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 is left after surgery will grow larger to replace the part that was removed. It should return to its original size within a few weeks. However, it will take longer for your liver to be fully functional.

Figure 1. Your liver

Liver Surgery

There are several kinds of liver surgeries to treat cancer. One is a liver resection, in which the part of the liver with the tumors is removed. Another is a liver ablation, which kills cancer cells by exposing them to very high temperatures or electric currents.

Your doctor will explain which type of surgery you will have. Some people may have a combination of both a liver resection and a liver ablation.

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, your surgeon will look at your liver using an ultrasound to confirm the location and number of tumors in it.

If your surgeon is removing 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).

Your surgeon may decide that the best way to treat your tumor(s) is to ablate it. There are different methods used for liver ablation. Radio frequency ablation (RFA) and microwave ablation kill cancer cells by heating them. Irreversible electroporation is a new method of ablation which uses an electric current to kill cancer cells.

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.

The length of your surgery will depend on how many tumors need to be treated. Most surgeries take between 2 and 4 hours but others may be longer. Your surgeon may close your incision with staples, sutures (stitches), or glue.

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Before Your Surgery

The information in this section will help you prepare for your surgery. Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It contains important information about what you need to do before your surgery. Write down any questions you have and be sure to ask your doctor or nurse.

Preparing for Your Surgery

You and your healthcare team will work together to prepare for your surgery.

About Drinking Alcohol

The amount of alcohol you drink can affect you during and after your surgery. It’s important that you talk with us about your alcohol intake so that we can plan your care.

  • Stopping alcohol suddenly can cause seizures, delirium, and death. If we know you are at risk for these complications, we can prescribe medication to help prevent them.
  • If you use alcohol regularly, you may be at risk for other complications during and after surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

Here are things you can do to prevent problems before your surgery:

  • Be honest with your healthcare provider about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. If you develop a headache, nausea, increased anxiety, or cannot sleep after you stop drinking, tell your doctor right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you cannot stop drinking.
  • Ask us any questions you have about drinking and surgery. As always, all of your medical information will be kept confidential.
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 heparin, warfarin (Coumadin®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and tinzaparin (Innohep®). There are others, so be sure your doctor knows all the medications you’re taking.
  • I take prescription medications, including patches and creams.
  • I take any over-the-counter medications, 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 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 Smoking

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

About Sleep Apnea

Sleep apnea is a common breathing disorder that causes a person 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. It 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) 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 who works closely with anesthesiology staff (doctors and specialized nurses who will be giving you medication to put you to sleep during your surgery). Your nurse practitioner 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 necessary to plan your care. Your nurse practitioner may also recommend you see other healthcare providers.

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

It is very helpful if you bring the following with you to your PST appointment:

  • A list of all the medications you are taking, including 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).

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 are unable to communicate for yourself. The person you identify is called your health care agent.

If you are 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 directive, bring it with you 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, please read 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, such as walking at least 1 mile, swimming, or biking. If it is cold outside, use stairs in your home or go to a mall or shopping market. Exercising will help your body get into its best condition for your surgery and make your recovery faster and easier.

Eat a Healthy Diet

You should eat 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 dietitian.

10 Days Before Your Surgery

Stop Taking Certain Medications

If you take vitamin E, stop taking it 10 days before your surgery. If you take aspirin, ask your surgeon whether you should continue. Aspirin, medications that contain aspirin, and vitamin E can cause bleeding. If your cardiologist feels you need to remain on aspirin, liver surgery can be performed safely while you continue to take this medication. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

Purchase Hibiclens® Skin Cleanser and Clear Liquids

Figure 2. Hibiclens skin cleanser

Hibiclens is a skin cleanser that kills germs for 6 hours after using it (see Figure 2). Showering with Hibiclens before surgery will help lower your risk of infection after surgery. You can buy Hibiclens at your local pharmacy without a prescription.

Purchase clear liquids to drink the day before your surgery. For a list of clear liquids that you can drink, see the table in this section.

Purchase Supplies for Bowel Preparation, If Needed

If you need to do a bowel preparation before your surgery, your nurse will tell you how. Use the area below to check off and write in any supplies you’ll need.

Magnesium citrate bowel preparation
  • 1 (10-ounce) bottle of magnesium citrate
MiraLAX® bowel preparation
  • 1 (5 mg) tablet of bisacodyl (Dulcolax®). These are usually sold as a box of 10 tablets.
  • 1 (238 gram) bottle of polyethylene glycol (MiraLAX)
  • 1 (64-ounce) bottle of a clear liquid

7 Days Before Your Surgery

Stop Taking Certain Medications

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (e.g., Advil®, Motrin®) or naproxen (e.g., Aleve®). These medications can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

Stop Taking Herbal Remedies and Supplements

Stop taking herbal remedies or supplements 7 days before your surgery. If you take a multivitamin, talk with your doctor or nurse about whether you should continue. Stop taking herbal remedies or supplements. For more information, read 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 Sloan Kettering’s main hospital on the day of your surgery.

1 Day Before Your Surgery

Note the Time of Your Surgery

A clerk from the Admitting Office will call you after 2:00 pm the day before your surgery. The clerk will tell you what time you should arrive at the hospital for your surgery. If you are scheduled for surgery on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call 212-639-5014.

Presurgical Center (PSC)
1275 York Avenue (between East 67th and East 68th Streets) New York, NY
B elevator to 6th floor

Drink Only Clear Liquids

You will need to follow a clear liquid diet the day before your surgery. A clear liquid diet includes only liquids you can see through. Examples are listed in the table below.

While you are on this diet:

  • Do not eat any solid foods.
  • Make sure to drink plenty of liquids other than water, coffee, and tea. Try to drink at least 1 (8-ounce) glass of clear liquid every hour while you’re awake.
Clear Liquid Diet

 

Drink

Do Not Drink

Soups
  • Clear broth, bouillon, or consommé
  • Any products with particles of dried food or seasoning
Sweets and Desserts
  • Gelatin, such as Jell-O®
  • Flavored ices
  • Hard candies, such as Lifesavers®
  • All others
Drinks
  • Clear fruit juices, such as apple, cranberry, lemonade, or grape
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer
  • Gatorade®
  • Black coffee
  • Tea
  • Water
  • Juices with pulp
  • Nectars
  • Milk (or cream)
  • Alcoholic beverages

Start Bowel Preparation, If Needed

If your doctor or nurse told you that you needed to do a bowel preparation, you will need to start it 1 day before your surgery.

During both the magnesium citrate and MiraLAX bowel preparations:

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

Magnesium citrate bowel preparation

  • At 2:00 pm on the day before your surgery, drink the magnesium citrate.

MiraLAX bowel preparation

  • On the morning before your surgery, mix all 238 grams of MiraLAX with the 64 ounces of clear liquid until the MiraLAX powder dissolves. Once the MiraLAX is dissolved, you can put the mixture in the refrigerator, if you prefer.

The MiraLAX bowel preparation will cause frequent bowel movements, so be sure to be near a bathroom the evening before your surgery.

At 3:00 pm on the day before your surgery, take 1 bisacodyl tablet by mouth with a glass of water.

At 5:00 pm on the day before your surgery, start drinking the MiraLAX bowel preparation. Drink 1 (8-ounce) glass of the mixture every 15 minutes until the container is empty. When you’re finished drinking the MiraLAX, drink 4 to 6 glasses of clear liquids. You can continue to drink clear liquids until midnight, but it is not required.

Apply zinc oxide ointment or Desitin® to the skin around your anus after every bowel movement. This helps prevent irritation.

Shower with Hibiclens

The night before your surgery, shower using Hibiclens. To use Hibiclens, open the bottle and pour some solution into your hand or a washcloth. Rub it gently over your body from your neck to your waist and rinse. Don’t let the solution get into your eyes, ears, mouth, or genital area. Don’t use any other soap. Dry yourself off with a clean towel after your shower.

Sleep

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

Morning of Your Surgery

Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of clear liquids (see Figure 3). 

Figure 3. 12 ounces of clear liquid

Examples of clear liquids include:

  • Water
  • Clear broth, bouillon, or consommé (no particles of dried food or seasonings) 
  • Gelatin, such as Jell-O® 
  • Clear fruit juices (no pulp), such as white cranberry, white grape, or apple 
  • Soda, such as 7-Up®, Sprite®, ginger ale, seltzer, or Gatorade® 
  • Coffee or tea, without milk or cream 

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 use any other soap. Don’t put on any lotion, cream, powder, deodorant, makeup, or perfume after your shower.

Take Your Medications

If your doctor or nurse practitioner instructed 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.

Things to Remember

  • Don’t put on any lotions, creams, deodorants, makeup, powders, or perfumes.
  • 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.
  • Leave valuables, such as credit cards, jewelry, or your checkbook at home.
  • Before you are taken into the operating room, you will need to remove your hearing aids, dentures, prosthetic device(s), wig, and religious articles (such as a rosary).
  • Wear something comfortable and loose-fitting.
  • If you wear contact lenses, wear your glasses instead.

  • Your breathing machine for sleep apnea (such as your CPAP), if you have one.
  • Your portable music player, if you choose. However, someone will need to hold this items for you when you go into surgery.
  • Your incentive spirometer, if you have one.
  • Your Health Care Proxy Form, if you have completed one.
  • Your cell phone and charger.
  • A case for your personal items, such as eyeglasses, hearing aid(s), dentures, prosthetic device(s), wig, and religious articles, if you have it.
  • This guide. Your healthcare team will use this guide to teach you how to care for yourself after your surgery.

Parking When You Arrive

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 is a pedestrian 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

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

Get Dressed for Surgery

When it is 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 your nurse the dose of any medications (including patches and creams) you took after midnight and the time you took them.

Meet With Your Anesthesiologist

Your anesthesiologist will:

  • Review your medical history with you.
  • Talk with you about your comfort and safety during your surgery.
  • Talk with you about the kind of anesthesia (medication to make you sleep) you will receive.
  • Answer any questions you may have about your anesthesia.
Prepare For Your Surgery

Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your surgery to begin. When it is time for your surgery, your visitor(s) will be shown to the waiting area. Your visitors should read 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 circulation in your legs.

Your anesthesiologist will place an intravenous (IV) line into a vein, usually in your arm or hand. The IV line will be used to give you fluids and anesthesia (medication to make you sleep) during your surgery.

Your anesthesiologist may also put an epidural catheter (thin, flexible tube) in your spine (back). This will be used to give you pain medication. The medication is delivered into your epidural space, which is the area just outside your spinal cord. It will give you pain relief with fewer side effects, such as nausea, vomiting, and sleepiness. This is similar to what is given to women when they have babies.

Once you are 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 catheter placed to drain urine from your bladder.

Once your surgery is finished, your incision will be closed with staples or with sutures. Steri-StripsTM (thin pieces of tape) will be placed directly on your incision and covered with a bandage. Your breathing tube is usually taken out while you are 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 any questions you have and be sure to ask your doctor or nurse.

What to Expect

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

You will receive oxygen through a thin tube that rests below your nose called a nasal cannula. A nurse will be monitoring your body temperature, pulse, blood pressure, and oxygen levels.

You may have a urinary catheter (Foley®) in your bladder to monitor the amount of urine you are making. You will also have compression boots on your lower legs to help your circulation.

You may have a pain pump called a patient-controlled analgesia (PCA) device. For more information, read Patient-Controlled Analgesia (PCA). If you do not have an epidural catheter, your pain medication will be given through an IV line.

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.

Depending on the type of surgery you had, you may stay in the PACU overnight. After your stay in the PACU, you will be taken to your hospital room. Soon after you arrive in your room, you will be helped out of bed and into a chair.

Your nurse will tell you how to recover from your surgery. Below are examples of ways you can help yourself recover safely.

  • You will be encouraged to walk with the help of your nurse or physical therapist. We will give you medication to relieve pain. Walking helps reduce the risk for blood clots and pneumonia. It also helps to stimulate your bowels so they begin working again.
  • Use your incentive spirometer. This will help your lungs expand, which prevents pneumonia. For more information, read How to Use Your Incentive SpirometerYour nurse will teach you to splint your incision. This will reduce the movement of your stomach muscles and decrease pain while you do the coughing exercises.

Commonly Asked Questions: During Your Hospital Stay

Will I have pain after my surgery?

Yes, you will have pain after your surgery, especially in the first few days. Your doctor and nurse will ask you about your pain often and give you medication as needed. If your pain is not relieved, tell your doctor or nurse. You will be given a prescription for pain medication before you leave the hospital.

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

Why is it important to walk?

Walking will help prevent blood clots in your legs. It also decreases your risk of having other complications such as pneumonia.

Will I be able to eat?

You will not be allowed to eat for the first day or 2 following the surgery. Then you will be on a clear liquid diet. After that, your diet will progress to a regular diet as tolerated.

Eating a balanced diet high in protein will help you heal after surgery. Your diet should include a healthy protein source at each meal, as well as fruits, vegetables, and whole grains. For more tips on increasing the amount of calories and protein in your diet, ask your nurse for the resource Eating Well During and After Your Cancer Treatment. If you have questions about your diet, ask to see a dietitian.

How long will I be in the hospital?

Most people are in the hospital for 5 to 7 days after having a liver resection or ablation but this will depend on the exact surgery that is done.

Commonly Asked Questions: After You Leave the Hospital

Will I have pain when I am home?

The length of time each person has pain or discomfort varies. You may still have some pain when you go home and will probably be taking pain medication. Follow the guidelines below.

  • Take your medications as directed and as needed.
  • Call your doctor if the medication prescribed for you doesn’t relieve your pain.
  • Do not drive or drink alcohol while you are taking prescription pain medication.
  • As your incision heals, you will have less pain and need less pain medication. A mild pain reliever such as acetaminophen (Tylenol) or ibuprofen (Advil) will relieve aches and discomfort. However, large quantities of acetaminophen may be harmful to your liver. Do not take more acetaminophen than the amount directed on the bottle or as instructed by your doctor or nurse.
  • Pain medication should help you as you resume your normal activities. Take enough medication to do your exercises comfortably. Pain medication is most effective 30 to 45 minutes after taking it.
  • Keep track of when you take your pain medication. Taking it when your pain first begins is more effective than waiting for the pain to get worse.

How can I prevent constipation?

  • Go to the bathroom at the same time every day. Your body will get used to going at that time.
  • If you feel the urge to go, do not put it off. Try to use the bathroom 5 to 15 minutes after meals.
  • After breakfast is a good time to move your bowels. The reflexes in your colon are strongest at this time.
  • Exercise, if you can. Walking is an excellent form of exercise.
  • Drink 8 (8-ounce) glasses (2 liters) of liquids daily, if you can. Drink water, juices, soups, ice cream shakes, and other drinks that don’t have caffeine. Drinks with caffeine, such as coffee and soda, pull fluid out of the body.
  • Slowly increase the fiber in your diet to 25 to 35 grams per day. Fruits, vegetables, whole grains, and cereals contain fiber. If you have an ostomy or have had recent bowel surgery, check with your doctor or nurse before making any changes in your diet.
  • Both over-the-counter and prescription medications are available to treat constipation. Start with 1 of the following over-the-counter medications first:
    • Docusate sodium (Colace®) 100 mg. This is a stool softener that causes few side effects. Do not take it with mineral oil.
    • Polyethylene glycol (MiraLAX®) 17 grams daily.
    • Senna (Senokot®) 2 tablets at bedtime. This is a stimulant laxative, which can cause cramping.
  • If you haven’t had a bowel movement in 2 days, call your doctor or nurse.

Can I shower?

Yes. Taking a warm shower is relaxing and can help decrease muscle aches. Use soap when you shower and gently wash your incision. Pat the areas dry with a towel after showering, and 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.

Is it normal not to feel hungry after surgery?

It is common to have a decreased appetite after surgery. Try eating several smaller meals that have each of the food groups (i.e., fruits/vegetables, meat/chicken/fish, breads/grains, dairy products). This will help you heal faster.

In addition to not being hungry, you may also not be able to taste things the way you did before your surgery. This will improve with time.

How can I prevent constipation?

Your usual bowel pattern will change after surgery. You may have trouble passing stool (feces). This is a common side effect of pain medication. Please review the material your nurse gave you about fiber and constipation.

To avoid constipation, take a stool softener such as docusate sodium (Colace®) 3 times a day and 2 tablets of senna (a laxative) at bedtime. Continue taking the stool softener and laxative until you are no longer taking pain medication. Drink plenty of liquids. If you feel bloated avoid foods that can cause gas, such as beans, broccoli, onions, cabbage, and cauliflower.

Can I drink alcohol after surgery?

Alcohol is cleared out of the body through the liver. Do not drink alcohol until you check with your doctor or nurse.

How do I care for my incision?

The location of your incision will depend on the type of surgery you had. It is normal to have numbness of the skin below the incision because some of the nerves were cut; this sensation will lessen over time.

  • By the time you are ready to leave the hospital, your surgical incision will have begun to heal.
  • You and your caregiver should look at your incision with your nurse before you leave the hospital so you know what it looks like.
  • If any liquid is draining from your incision, you should write down the amount and color. Call your doctor’s office and speak with the nurse about any drainage from your incision.

Change your bandages at least once a day and more often if they become wet with drainage. When there is no longer any drainage coming from your incision, they can be left uncovered.

If you go home with Steri-StripsTM on your incision, they will loosen and fall off by themselves. If they haven’t fallen off within 10 days, you may remove them.

Is it normal to feel tired after surgery?

Feeling tired (fatigue) is the most common complaint after liver resection or ablation. It is an expected side effect. You may need a nap during the day, but try to stay out of bed as much as possible. That will help you sleep at night. It usually takes 6 to 8 weeks until your energy level returns to normal.

When can I resume my activities?

It is important for you to resume your 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.

You may experience swelling in both of your lower legs following surgery. This will get better with time. If you feel that the swelling is getting worse while you are home and is interfering with your activities please call your doctor and let him or her know.

You may return to your usual sexual activity as soon as your incision is healed and you can do so without pain or fatigue.

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.

When is it safe for me to drive?

You may resume driving 3 weeks after surgery as long as you are not taking pain medication that may make you drowsy.

When can I return to work?

The time it takes to return to work depends on the type of work you do, the type of surgery you had, and how fast your body heals.

What exercises can I do?

Exercise will help you gain strength and feel better. Walking and stair climbing are excellent forms of exercise. Gradually increase the distance you walk. Climb stairs slowly, resting or stopping as needed. Ask your doctor or nurse before starting more strenuous exercises.

When can I lift heavy objects?

Check with your doctor before you do any heavy lifting. Normally, you shouldn’t lift anything heavier than 5 pounds (2.27 kilograms) for at least 6 weeks after your surgery. Ask your doctor how long you should avoid heavy lifting.

How can I cope with my 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 cannot 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 is always a good idea to let these professionals know how you, your family, and your friends are feeling emotionally. Many resources are available to patients and their families. Whether you are 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.

When is my first appointment after my surgery?

Your first appointment after surgery will be in 1 to 3 weeks after you leave the hospital. Your nurse will give you instructions on how to make this appointment, including the phone number to call.

During this appointment, your doctor will discuss the pathology results with you in detail.

What if I have other questions?

If you have any questions or concerns, please talk with your doctor or nurse. You can reach them Monday through Friday from 9:00 am to 5:00 pm.

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

  • A temperature of 101° F (38.3° C) or higher
  • Pain that does not get better with your medications
  • Redness, swelling, or drainage from your incision that is foul smelling or pus-like
  • No bowel movement for 3 days or longer
  • Nausea or vomiting
  • Jaundice (yellow skin or eyes)
  • Diarrhea
  • Constipation that does not get better in 2 to 3 days
  • Any new symptom or physical change
  • Any questions or concerns
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Resources

This section contains a list of MSK support services, as well as the resources that were referred to throughout this guide. These resources will help you prepare for your surgery and recover safely. Write down any questions you have and be sure to ask your doctor or nurse.

MSK Resources

Anesthesia
212-639-6840

Call with questions about anesthesia.

Blood Donor Room
212-639-7643

Call for more information if you are interested in donating blood or platelets.

Bobst International Center
888-675-7722

MSK welcomes patients from around the world. If you are an international patient, call for help coordinating 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 Services
646-888-0100

Many people find counseling helpful. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed.

Integrative Medicine Service
646-888-0800

Offers patients many services to complement traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.

Look Good Feel Better
800-227-2345

Learn techniques to help you feel better about your appearance by taking a workshop or visiting the program online at www.lookgoodfeelbetter.org.

Patient-to-Patient 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-to-Patient Support Program, we are able to offer you a chance to speak with former patients and caregivers.

Patient Billing
646-227-3378

Call Patient Billing with any questions regarding preauthorization with your insurance company. This is also called preapproval.

Patient Representatives
212-639-7202

Call the Patient Representatives office if you have any questions about the Health Care Proxy Form or if you have any concerns about your care.

Perioperative Clinical Nurse Specialist
212-639-5935

Call if you have any questions about MSK releasing any information while you are having surgery.

Private Nursing Options
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.

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 referring 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 additional online information, visit LIBGUIDES on MSK’s library website at http://library.mskcc.org or the Liver Cancer section of mskcc.org. You can also contact the library reference staff at 212-639-7439 for help.

External Resources

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 are unable to take the public bus or subway.

Air Charity Network
877-621-7177

Provides travel to treatment centers.

American Cancer Society (ACS)
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

A comprehensive resource for education, tools, and events for employees with cancer.

CancerCare
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

Provides support and education to people affected by cancer.

Caregiver Action Network
800-896-3650

Provides education and support for those who care for loved ones with a chronic illness or disability.

Corporate Angel Network
866-328-1313

Offers free travel to treatment across the country using empty seats on corporate jets.

Gilda’s Club
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
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 is part of the Good Days formulary.

Healthwell Foundation
800-675-8416

Provides financial assistance to cover copayments, health care premiums, and deductibles for certain medications and therapies.

Joe’s House
877-563-7468

Provides a list of places to stay near treatment centers for people with cancer and their families.

LGBT Cancer Project

Provides support and advocacy for the LGBT community, including an online support groups and a database of LGBT friendly clinical trials.

LIVESTRONG Fertility
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

National Cancer Legal Services Network

Free cancer legal advocacy program.

National LGBT Cancer Network

Provides education, training, and advocacy for LGBT cancer survivors and those at risk.

Needy Meds

Lists Patient Assistance Programs for brand and generic name medications.

NYRx

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

Partnership for Prescription Assistance
888-477-2669

Help qualifying patients without prescription drug coverage get free or low-cost medications.

Patient Access Network Foundation
866-316-7263

Provides assistance with copayments for patients with insurance.

Patient Advocate Foundation
800-532-5274

Provides access to care, financial assistance, insurance assistance, job retention assistance, and access to the national underinsured resource directory.

RxHope
877-267-0517

Provides assistance to help people obtain medications that they have trouble affording.

Additional Resources

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