After Your Thoracic Surgery
This excerpt from& About Your Thoracic Surgery describes what to expect after thoracic surgery at Memorial Sloan Kettering Cancer Center (MSK).
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. You will have 1 or 2 chest tubes attached to tubing that goes into a draining device. A nurse will be monitoring your body temperature, pulse, blood pressure, and oxygen levels.
You may have a urinary (Foley®) catheter 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 will have a pain pump called a patient-controlled analgesia (PCA) device. For more information, please read Patient-Controlled Analgesia (PCA). You may receive pain medication through an epidural catheter or your intravenous 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. There, your nurse will tell you how to recover from your surgery. Below are examples of ways you can help yourself recover safely.
- It is important to walk around after surgery. Walking every 2 hours is a good goal. This will help prevent blood clots in your legs and reduce your risk of developing pneumonia.
- Use your incentive spirometer. This will help your lungs expand, which prevents pneumonia. For more information, please read How to Use Your Incentive Spirometer, which is located in the “Resources” section of this guide.
- Continue to perform your breathing and coughing exercises every 1 to 2 hours while you are awake.
- Please see the lung pathway handout to see what to expect daily while you are in the hospital after your surgery.
The following section covers common questions patients ask after thoracic surgery. Speak with your doctor or nurse if you have any additional questions or if any of this information is unclear.
Will I have pain after my surgery?
You will have some pain after your surgery. Your doctor and nurse will ask you about your pain often. You will be given medication to manage your pain as needed. If your pain is not relieved, please tell your doctor or nurse. It is important to control your pain so you can cough, breathe deeply, use your incentive spirometer, and get out of bed and walk.
What is a chest tube?A chest tube is a flexible tube that is used to drain blood, fluid, and air from around your lung after surgery. The tube enters your body between your ribs and goes into the space between the inner lining and the outer lining of your lung (see figure). This is called the pleural space.
When will my chest tube be removed?
Once your lung heals, your chest tube will be removed. The area will be covered with a bandage. Keep the bandage on for at least 2 days, unless your nurse gives you other instructions. You will most likely go home 1 or 2 days after your chest tube is removed.
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. Walking 1 mile, which is 14 laps around the unit while you’re still in the hospital, is a good goal.
Will I be able to eat?
The day you are moved to your hospital room, you will be on a clear liquid diet. The first day after your surgery, you may be advanced to a light breakfast and light foods during the day (a sandwich, yogurt, soup, and liquids).
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 your calorie and protein intake, 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.
Will I have pain when I am home?
The length of time each patient has pain or discomfort varies. Some patients may have incisional soreness, tightness, or muscle aches for up to 6 months or longer. This does not mean that something is wrong. Follow the guidelines below.
- 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 incisions heal, 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.
- 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. It will not be as effective if you allow your pain to increase. Taking it when your pain first begins is more effective than waiting for the pain to get worse.
Can I shower?
You may shower 48 hours after your chest tube is removed. Taking a warm shower is relaxing and can help decrease muscle aches. Do not take tub baths until you discuss it with your doctor at the first appointment after your surgery.
Use soap when you shower and gently wash all of your incisions. Pat the areas dry with a towel after showering, and leave your incisions uncovered (unless there is drainage). Call your doctor if you see any redness or drainage from your incision.
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 boated, avoid foods that can cause gas, such as beans, broccoli, onions, cabbage, and cauliflower.
How can I help my lungs heal?
- Continue to exercise a minimum of 30 minutes per day. This will help you get stronger, feel better, and heal your lung. Make a daily walk part of your routine. Keep using your incentive spirometer and do your coughing and deep breathing exercises at home.
- Drink liquids to help keep your mucous thin and easy to cough up. Ask your doctor how much you should drink each day. For most patients, this will be at least 4 large glasses of water or other liquids (preferably juices) each day.
- Use a humidifier in your bedroom during the winter months. Follow the directions for cleaning the machine. Change the water often.
- Avoid sources of infection, such as contact with people with colds, sore throats, or the flu.
- Do not smoke. Smoking cigarettes is harmful to your health at any time. It is even more so at this time. Smoking causes the blood vessels in your lungs to become narrow. This decreases the amount of oxygen in the lungs. It can cause problems with breathing and regular activities. It is also important to avoid places that are smoky. Your nurse can also give you information to help you deal with other smokers or situations where smoke is present. Remember, if you need help quitting, MSK’s Tobacco Treatment Program can help.
- Do not drink alcohol, especially while you are taking pain medication.
How do I care for my incisions?
You will have more than 1 incision after your surgery. The location of your incisions will depend on the type of surgery you had. There will be incisions from the surgical site and the chest tube. You may have some numbness below and in front of your incisions. This is because your ribs were spread apart and some nerves were affected.
- By the time you are ready to leave the hospital, your surgical incision(s) will have begun to heal.
- You or 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.
Chest tube incision
- You will have a bandage covering your chest tube incision.
- Keep the bandage on your incision for 2 days after your chest tube is removed, unless it gets wet. If it gets wet, change it as soon as possible.
- You may have some thin, yellow or pink-colored drainage from this area, which is normal. Place a Band-Aid® or dry piece of gauze over the area and change the bandage as needed.
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 incisions, they can be left uncovered.
If you go home with Steri-Strips on your incisions, 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?
It is common to have less energy than usual after your surgery. Recovery time varies with each patient. Increase your activities each day as much as you can. Always balance activity periods with rest periods. Rest is a vital part of your recovery.
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. Walking and stair climbing are excellent forms of exercise. Gradually increase the distance you walk. Climb stairs slowly, resting or stopping as needed. You can do light household tasks. Try dusting, washing dishes, preparing light meals, and other activities as you are able. You may return to your usual sexual activity as soon as your incisions are well 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 can begin driving again after you have:
- Regained full movement of the arm and shoulder on the side of your surgery
- Stopped taking pain medication
Can I travel by plane?
Do not travel by plane until you have discussed this with your doctor at your first appointment after your surgery.
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?
Use the arm and shoulder on the side of your surgery in all of your activities. Use them when you bathe, brush your hair, and reach up to a cabinet shelf.
Slowly resume your normal activities to help restore full use of your arm and shoulder. The exercises shown below will help you to regain full arm and shoulder movement. You should begin these exercises as soon as your chest tube is removed.
- Sit in a straight-backed chair with your feet flat on the floor.
- Clasp your hands together.
- Lift your arms up and over your head.
- Slide your hands down to the back of your neck.
- Slowly twist the upper part of your body to the right side. Hold this position for 5 seconds while bringing your elbows as far back as possible.
- Return to the starting position.
- Slowly twist the upper part of your body to the left side. Hold this position for 5 seconds while bringing your elbows as far back as possible.
- Return to the starting position.
- Stand comfortably with your feet about 6 inches apart.
- Put your arms in front of your body and hold1 end of a hand towel in each hand.
- Bring your arms over your head, straighten your elbows, and stretch toward your upper back. Do not arch your back and do not force the movement if it is difficult. Try to hold the position for 5 seconds.
- Relax and return to the starting position.
- Stand as in Step 1.
- Grasp the towel behind your back and lift upward as far as possible. Be sure to stand straight. Try to hold the position for 5 seconds.
- Return to the starting position.
When can I lift heavy objects?
Check with your doctor before you do any heavy lifting. Normally, you should not lift anything heavier than 10 pounds for at least 3 weeks. Ask your doctor how long you should avoid heavy lifting. This depends on the type of surgery you had.
When can I resume heavy exercise?
Do not play sports until your doctor tells you it is safe. When you resume, remember that it will take time for you to return to your previous level of activity. Start out slowly and increase your activity as you feel better.
How can I cope with my feelings?
After surgery for a serious illness, you may have new and upsetting feelings. Many patients 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.
New or worsening shortness of breath
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 incisions that is foul smelling or pus-like
No bowel movement for 3 days or longer
Any new symptom or physical change
Any questions or concerns
After 5:00 pm, during the weekend, and on holidays, call 212-639-2000. Ask to speak to the thoracic doctor on call.Back to top