About Your Total Pancreatectomy

Share
Time to Read: About 30 minutes

This guide will help you get ready for your total pancreatectomy (PAN-kree-uh-TEK-toh-mee) at MSK. It will also help you know what to expect as you recover.

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

About your total pancreatectomy

A total pancreatectomy is a surgery to take out your entire pancreas.

About your pancreas

Your pancreas is in the back of your abdomen (belly) behind your stomach and just above your small intestine (see Figure 1).

Figure 1. Your pancreas

Figure 1. Your pancreas

Pancreas function

Your pancreas makes enzymes that help digest fat. After your surgery, you will need to take an enzyme replacement medicine with your meals.

Your pancreas also makes 2 hormones: insulin and glucagon. They help regulate your blood sugar levels. After your pancreas is removed, you will have diabetes. You will need to test your blood sugar level and take insulin to keep it at a safe level. You will meet with an endocrinologist (EN-doh-krih-NAH-loh-jist) in the hospital. An endocrinologist is a doctor with special training in diabetes and other hormone problems. They will help you manage your diabetes. You will also need a doctor to help manage your diabetes once you leave the hospital.

Total pancreatectomy

During your surgery, your surgeon will take out your pancreas. Because of where your pancreas is in your body, they will also need to take out other organs (see Figure 2). These are:

  • Part of your stomach
  • Your duodenum (the first part of your small intestine)
  • The end of your common bile duct
  • Your gallbladder
  • Your spleen
Figure 2. The organs that will be removed during your surgery

Figure 2. The organs that will be removed during your surgery

Your surgeon will reconnect your stomach and remaining portion of your common bile duct to your jejunum (the second part of your small intestine, see Figure 3). This lets food and bile flow into your small intestines.

This surgery takes 3 to 4 hours.

Figure 3. Your abdomen after your surgery

Figure 3. Your abdomen after your surgery

Before your total pancreatectomy

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

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

Getting ready for your surgery

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

  • I take an anticoagulant (blood thinner), such as:
    These are examples of medicines. There are others.

    Be sure your healthcare provider knows all the medicines you’re taking.
    • Aspirin
    • Heparin
    • Warfarin (Jantoven®, Coumadin®)
    • Clopidogrel (Plavix®)
    • Enoxaparin (Lovenox®)
    • Dabigatran (Pradaxa®)
    • Apixaban (Eliquis®)
    • Rivaroxaban (Xarelto®)
  • I take an SGLT2 inhibitor, such as:
    • Canagliflozin (Invokana®)
    • Dapagliflozin (Farxiga®)
    • Empagliflozin (Jardiance®)
    • Ertugliflozin (Steglatro®)
  • I take prescription medicine(s), including patches and creams. A prescription medicine is one you can only get with a prescription from your healthcare provider.
  • I take over-the-counter medicine(s), including patches and creams. An over-the-counter medicine is one you can buy without a prescription.
  • 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 (A-nes-THEE-zhuh) in the past. Anesthesia is medicine to make you sleep during a surgery or procedure.
  • I’m allergic to certain medicines or materials, including latex.
  • I’m not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke or use an electronic smoking device, such as a vape pen or e-cigarette.
  • I use recreational drugs, such as marijuana.

About drinking alcohol

It’s important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.

If you drink alcohol regularly, you may be at risk for problems during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

If you drink alcohol regularly and stop suddenly, it can cause seizures, delirium, and death. If we know you’re at risk for these problems, we can prescribe medicine to help prevent them.

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

  • Be honest with your healthcare providers about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. Tell your healthcare provider right away if you:
    • Get a headache.
    • Feel nauseous (like you’re going to throw up).
    • Feel more anxious (nervous or worried) than usual.
    • Cannot sleep.

These are early signs of alcohol withdrawal and can be treated.

  • Tell your healthcare provider if you cannot stop drinking.
  • Ask your healthcare provider questions about drinking and surgery. All your medical information will be kept private, as always.

About smoking

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

Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling 212-610-0507.

About sleep apnea

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

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

Using MyMSK

MyMSK (my.mskcc.org) is your MSK patient portal. You can use it to send and read messages from your care team, view your test results, see your appointment dates and times, and more. You can also invite your caregiver to make their own account so they can see information about your care.

If you do not have a MyMSK account, you can sign up at my.mskcc.org. You can get an enrollment ID by calling 646-227-2593 or your doctor’s office.

Watch How to Enroll in MyMSK: Memorial Sloan Kettering's Patient Portal to learn more. You can also contact the MyMSK Help Desk by emailing [email protected] or calling 800-248-0593.

Within 30 days of your surgery

Presurgical testing (PST)

You’ll have a PST appointment before your surgery. You’ll get a reminder from your surgeon’s office with the appointment date, time, and location.

You can eat and take your usual medicine(s) the day of your PST appointment.

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

  • A list of all the medicines you’re taking, including prescription and over-the-counter medicines, patches, and creams.
  • Results of any medical tests done outside of MSK in the past year, if you have them. Examples include results from a cardiac stress test, echocardiogram, or carotid doppler study.
  • The names and telephone numbers of your healthcare providers.

You’ll meet with an advance practice provider (APP) during your PST appointment. They work closely with MSK’s anesthesiology (A-nes-THEE-zee-AH-loh-jee) staff. These are doctors with special training in using anesthesia during a surgery or procedure.

Your APP will review your medical and surgical history with you. You may have tests to plan your care, such as:

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

Your APP may recommend you see other healthcare providers. They’ll also talk with you about which medicine(s) to take the morning of your surgery.

Identify your caregiver

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

For caregivers

‌  Caring for a person going through cancer treatment comes with many responsibilities. We offer resources and support to help you manage them. Visit www.msk.org/caregivers or read A Guide for Caregivers to learn more.

Fill out a Health Care Proxy form

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

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

Talk with a member of your care team if you have questions about filling out a Health Care Proxy form.

Do breathing and coughing exercises

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

Do physical activity

Doing physical activity will help your body get into its best condition for your surgery. It will also make your recovery faster and easier.

Try to do physical activity every day. Any activity that makes your heart beat faster, such as walking, swimming, or biking, is a good choice. If it’s cold outside, use stairs in your home or go to a mall or shopping center.

Follow a healthy diet

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

Buy a 4% chlorhexidine gluconate (CHG) solution antiseptic skin cleanser, such as Hibiclens®

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

Buy clear liquids

You’ll need to follow a clear liquid diet before your surgery. It’s helpful to buy clear liquids ahead of time. Read the section “Follow a clear liquid diet” for a list of clear liquids you can drink.

Buy bowel prep supplies, if needed

Your healthcare provider may tell you to do bowel prep (clean out your bowels) before your surgery. If they do, they’ll also tell you what to do.

You’ll need to buy the following supplies:

  • 1 (238-gram) bottle of polyethylene glycol (MiraLAX®)
  • 1 (64-ounce) bottle of a clear liquid

You can buy these at your local pharmacy without a prescription.

7 days before your surgery

Follow your healthcare provider’s instructions for taking aspirin

Aspirin can cause bleeding. If you take aspirin or a medicine that has aspirin, you may need to change your dose or stop taking it 7 days before your surgery. Follow your healthcare provider’s instructions. Do not stop taking aspirin unless they tell you to.

To learn more, read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil

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

Vitamin E, multivitamins, herbal remedies, and other dietary supplements can cause bleeding. Stop taking them 7 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read Herbal Remedies and Cancer Treatment.

2 days before your surgery

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs, such as ibuprofen (Advil® and Motrin®) and naproxen (Aleve®), can cause bleeding. Stop taking them 2 days before your surgery. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil.

1 day before your surgery

Follow a clear liquid diet

You’ll need to follow a clear liquid diet the day before your surgery. Your healthcare provider will tell you if you need to start following a clear liquid diet sooner if you should do any additional bowel preparation.

While you’re following this diet:

  • Don’t eat any solid foods.
  • Try to drink at least 1 (8-ounce) glass of clear liquid every hour while you’re awake.
  • Drink different types of clear liquids. Don’t just drink water, coffee, and tea.
  • Don’t drink sugar-free liquids unless you have diabetes and a member of your healthcare team tells you to.
For people with diabetes

If you have diabetes, ask the healthcare provider who manages your diabetes what you should do while you’re following a clear liquid diet.

  • If you take insulin or another medication for diabetes, ask if you need to change the dose.
  • Ask if you should drink sugar-free clear liquids.

While you’re following a clear liquid diet, make sure to check your blood sugar level often. If you have any questions, talk with your healthcare provider.

Clear liquid diet
  OK to drink Do not drink
Soups
  • Clear broth, bouillon, and consommé.
  • Anything with pieces of food or seasoning.
Sweets
  • Gelatin, such as Jell-O®.
  • Flavored ices.
  • Hard candies, such as Life Savers®, lemon drops, and peppermints.
  • All others.
Drinks
  • Clear fruit juices, such as lemonade, apple, cranberry, and grape juices.
  • Soda, such as ginger ale, 7UP®, Sprite®, and seltzer.
  • Sports drinks, such as Gatorade® and Powerade®.
  • Black coffee.
  • Tea.
  • Water, including carbonated (fizzy) and flavored water.
  • Clear nutritional drinks, such as Boost® Breeze, Ensure Clear™, Pedialyte®, and Diabetishield®.
  • Juices with pulp.
  • Nectars.
  • Smoothies or shakes.
  • Milk, cream, and other dairy products.
  • Nut milks, plant milks, non-dairy creamers, and other dairy alternatives.
  • Drinks with alcohol.

Start your bowel preparation, if needed

If your healthcare provider told you to do bowel prep, start it 1 day before your surgery.

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

The MiraLAX bowel prep will cause frequent bowel movements. Make sure you’re near a bathroom the evening before your surgery.

At the day before your surgery, start drinking the MiraLAX bowel prep. Drink 1 (8-ounce) cup of the mixture every 15 minutes until it’s gone.

When you’re finished drinking the MiraLAX, drink 4 to 6 glasses of clear liquids. You can keep drinking clear liquids until 8 hours before your arrival time, but you don’t have to.

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

Note the time of your surgery

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

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

This will be the following location:

Presurgical Center (PSC) on the 6th floor
1275 York Ave. between East 67th and East 68th streets
New York, NY 10065
Take the B elevator to the 6th floor.

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

Shower with a 4% CHG solution antiseptic skin cleanser before you go to bed the night before your surgery.

  1. Wash your hair with your usual shampoo and conditioner. Rinse your head well.
  2. Wash your face and genital (groin) area with your usual soap. Rinse your body well with warm water.
  3. Open the 4% CHG solution bottle. Pour some into your hand or a clean washcloth.
  4. Move away from the shower stream. Rub the 4% CHG solution gently over your body from your neck to your feet. Do not put it on your face or genital area.
  5. Move back into the shower stream to rinse off the 4% CHG solution. Use warm water.
  6. Dry yourself off with a clean towel.

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

Instructions for drinking: 8 hours before your arrival time

8 hours before your arrival time, do not eat or drink anything except these clear liquids:

  • Water.
  • Soda.
  • Clear juices, such as lemonade, apple, and cranberry juices. Do not drink orange juice or juices with pulp.
  • Black coffee or tea (without any type of milk or creamer).
  • Sports drinks, such as Gatorade®.
  • ClearFast or Ensure® Pre-Surgery drink.
  • Gelatin, such as Jell-O®.

You can keep having these until 2 hours before your arrival time.

The day of your surgery

Remember, starting 8 hours before your scheduled arrival time, do not eat or drink anything except the things listed above.

Instructions for drinking: 2 hours before your arrival time

 Stop drinking 2 hours before your arrival time. This includes water.

Take your medicines as instructed

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

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

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

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

Things to remember

  • Wear something comfortable and loose-fitting.
  • If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
  • Do not wear any metal objects. Take off all jewelry, including body piercings. The tools used during your surgery can cause burns if they touch metal.
  • Do not wear any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
  • Leave valuable items at home.
  • If you’re menstruating (have your monthly period), use a sanitary pad, not a tampon. We’ll give you disposable underwear and a pad if you need them.

What to bring

  • Sneakers that lace up. You may have some swelling in your feet after surgery. Lace-up sneakers can fit over this swelling.
  • Your breathing device for sleep apnea (such as your CPAP machine), if you have one.
  • Your incentive spirometer, if you have one.
  • Your Health Care Proxy form and other advance directives, if you filled them out.
  • Your cell phone and charger.
  • Only the money you may want for small purchases, such as a newspaper.
  • A case for your personal items, if you have any. Eyeglasses, hearing aids, dentures, prosthetic devices, wigs, and religious articles are examples of personal items.
  • This guide. You’ll use it to learn how to care for yourself after surgery.

Where to park

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

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

There are other parking garages on:

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

Once you’re in the hospital

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

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

For caregivers, family, and friends

‌  Read Information for Family and Friends for the Day of Surgery to help you know what to expect on the day of your loved one’s surgery.

Meet with a nurse

You’ll meet with a nurse before surgery. Tell them the dose of any medicines you took after midnight (12 a.m.) and the time you took them. Make sure to include prescription and over-the-counter medicines, patches, and creams.

Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not place the IV, your anesthesiologist (A-nes-THEE-zee-AH-loh-jist) will do it in the operating room.

Meet with an anesthesiologist

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

  • Review your medical history with you.
  • Ask if you’ve had any problems with anesthesia in the past. This includes nausea (feeling like you’re going to throw up) or pain.
  • Talk with you about your comfort and safety during your surgery.
  • Talk with you about the kind of anesthesia you’ll get.
  • Answer questions you have about anesthesia.

Get ready for surgery

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

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

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

During your surgery

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

Your surgeon will close your incisions with staples or stitches once they finish your surgery. They’ll cover your incisions with a bandage.

Your care team will usually take out your breathing tube while you’re still in the operating room.

After your total pancreatectomy

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

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

What to expect

When you wake up after your surgery, you will be in the Post Anesthesia Recovery Unit (PACU). You will stay there overnight.

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

You will have a patient-controlled analgesia (PCA) device. PCA uses a computerized pump to deliver pain medication into your IV or epidural space (in your spine). To learn more, read Patient-Controlled Analgesia (PCA).

You will have a Foley catheter in your bladder to monitor the amount of urine you’re making. It should be removed 2 or 3 days after your surgery. You will also have compression boots on your lower legs to help your circulation. They will be taken off when you’re able to walk.

You may have a drain in your abdomen to drain extra fluid from the area. Most of the time, the drains are removed after a few days. If you go home with a drain, your nurse will show you how to care for it.

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.

After your stay in the PACU, you will be taken to your hospital room on the inpatient unit. You will be helped out of your 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. To learn more, read How To Use Your Incentive Spirometer.

Common questions: During your hospital stay

Will I have pain after my surgery?

You will have some pain from your incision(s) after your surgery. Your doctor and nurse will ask you about your pain often. You will get medication to manage your pain as needed. If your pain isn’t relieved, please tell your doctor or nurse. It’s important to control your pain so you can cough, breathe deeply, use your incentive spirometer, and get out of bed and walk.

How will I manage my diabetes?

During your hospital stay, you will see an endocrinologist and a diabetes nurse educator. This nurse will work closely with you and your caregiver to prepare you for managing your diabetes. You will learn:

  • How diabetes affects your body.
  • Which foods to eat and which ones to avoid.
  • How to check your blood sugar.
  • How to give yourself an injection of insulin.

You will need to start seeing an endocrinologist close to home who will help you manage your diabetes after you leave the hospital. We can help you find a doctor if you don’t already have one.

Will I be able to eat after my surgery?

You will be on a liquid diet for the first day or 2 following your surgery. After that, you can progress to a diabetic diet.

Your dietitian will work closely with you to plan your diet before you’re discharged.

At first, you’ll need to eat smaller portions of food than you did before your surgery. Try to eat 4 to 6 small meals a day. If you find that your appetite is not good at first, you may try a supplement such as Glucerna®.

You will be taking pancreatic enzyme replacement pills before every meal and with snacks. They help you digest fats. If you have diarrhea, tell your doctor or nurse. The dose of your enzyme pills may need to be adjusted. Finding the right dose may take weeks or even months.

How long will I be in the hospital?

Most people are in the hospital for 5 to 7 days after having a total pancreatectomy, but this depends on the exact surgery that’s done.

Common questions: At home

What is the Recovery Tracker?

We want to know how you’re feeling after you leave the hospital. To help us care for you, we’ll send questions to your MyMSK account. We’ll send them every day for 10 days after you’re discharged. These questions are known as your Recovery Tracker.

Fill out your Recovery Tracker every day before midnight (12 a.m.). It only takes 2 to 3 minutes to complete. Your answers to these questions will help us understand how you’re feeling and what you need.

Based on your answers, we may reach out to you for more information. Sometimes, we may ask you to call your surgeon’s office. You can always contact your surgeon’s office if you have any questions.

To learn more, read About Your Recovery Tracker.

Will I have pain when I’m 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 these guidelines to help manage your pain at home.

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

Some prescription pain medicines, such as opioids, may cause constipation. Constipation is when you poop less often than usual, have a harder time pooping, or both.

Is it normal to feel tired?

Yes, feeling tired (fatigue) is common after surgery. The fatigue may last for 6 to 8 weeks, but it will improve 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 can sleep at night.

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’s drainage. Call your doctor if you see any redness or drainage from your incision.

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

How do I care for my incision(s)?

The location of your incision will depend on the type of surgery you had. It’s normal for the skin below the incision to feel numb, because some of the nerves were cut. The numbness will go away over time.

  • By the time you’re 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 fluid 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 have Steri-Strips or Dermabond on your incision, they’ll loosen and fall or peel off on their own. If they haven’t fallen off after 10 days, you can take them off.

How will my diet change after my surgery?

You will need to follow a diabetic diet. A balanced diet will help keep your blood sugar levels within your target range. Your healthcare team will discuss your diet with you. If you have any questions, you can reach your dietitian at 212-639-7312.

You may not have an appetite after your surgery. Try to eat small amounts of your favorite foods often throughout the day. It’s important that you don’t skip entire meals, because this could cause hypoglycemia (low blood sugar). Hypoglycemia can be very serious if it isn’t treated. Symptoms of hypoglycemia include feeling faint, problems seeing, headache, shakiness, sweating, and a fast, forceful heartbeat.

Always carry a source of sugar with you. It can be hard candy or glucose tablets. Take it immediately if you have any symptoms of hypoglycemia.

Will I lose weight?

You may lose weight during the first couple of weeks after your surgery. You may regain the weight slowly as your appetite and amount of food you can eat increases but not everyone does. Your goal is to maintain your new weight.

When is it safe for me to drive?

You may resume driving 2 to 3 weeks after your surgery as long as you aren’t taking pain medication that may make you drowsy.

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 10 pounds (4.5 kilograms) for at least 6 weeks. Ask your doctor how long you should avoid heavy lifting.

When is my first appointment after my surgery?

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

How can I cope with my feelings?

You may have new and upsetting feelings after a surgery for a serious illness. Many people say they felt weepy, sad, worried, nervous, irritable, or 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. Your healthcare provider can refer you to MSK’s Counseling Center. You can also reach them by calling 646-888-0200.

The first step in coping is to talk about how you feel. Family and friends can help. We can also reassure, support, and guide you. It’s always a good idea to let us know how you, your family, and your friends are feeling emotionally. Many resources are available to you and your family. We’re here to help you and your family and friends handle the emotional aspects of your illness. We can help no matter if you’re in the hospital or at home.

When to call your healthcare provider

Call your healthcare provider if:

  • You have a fever of 101 °F (38.3 °C) or higher.
  • You have chills.
  • The area around your incision is getting more red.
  • There is more drainage coming from your incision than usual.
  • You have new pain or your pain is getting worse.
  • You have diarrhea (loose or watery poop).
  • You have constipation that doesn’t get better in 2 to 3 days.
  • You feel nausea (like you’re going to throw up).
  • You vomit (throw up).
  • You have a hard time keeping your blood sugar levels in your target range.
  • You have any new or unexplained symptom.

Support services

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

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

MSK support services

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

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

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

Bobst International Center
332-699-7968
We welcome patients from around the world and offer many services to help. If you’re an international patient, call for help arranging your care.

Counseling Center
www.msk.org/counseling
646-888-0200
Many people find that counseling helps them. Our Counseling Center offers counseling for individuals, couples, families, and groups. We can also prescribe medicine to help if you feel anxious or depressed. Ask a member of your care team for a referral or call the number above to make an appointment.

Food Pantry Program
646-888-8055
We give food to people in need during their cancer treatment. Talk with a member of your care team or call the number above to learn more.

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

You can also schedule a consultation with a healthcare provider in the Integrative Medicine Service. They’ll work with you to make a plan for creating a healthy lifestyle and managing side effects. Call 646-608-8550 to make an appointment for a consultation.

MSK Library
library.mskcc.org
212-639-7439
You can visit our library website or call to talk with the library reference staff. They can help you find more information about a type of cancer. You can also visit the library’s Patient and Health Care Consumer Education Guide.

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

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

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

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

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

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

Rehabilitation Services 
www.msk.org/rehabilitation 
Cancers and cancer treatments can make your body feel weak, stiff, or tight. Some can cause lymphedema (swelling). Our physiatrists (rehabilitation medicine doctors), occupational therapists (OTs), and physical therapists (PTs) can help you get back to your usual activities.

  • Rehabilitation medicine doctors diagnose and treat problems that affect how you move and do activities. They can design and help coordinate your rehabilitation therapy program, either at MSK or somewhere closer to home. Call Rehabilitation Medicine (Physiatry) at 646-888-1929 to learn more.
  • An OT can help if you’re having trouble doing usual daily activities. For example, they can recommend tools to help make daily tasks easier. A PT can teach you exercises to help build strength and flexibility. Call Rehabilitation Therapy at 646-888-1900 to learn more.

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

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

Sexual Health Programs
Cancer and cancer treatments can affect your sexual health, fertility, or both. MSK’s sexual health programs can help you before, during, or after your treatment.

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

Our social workers can also help refer you to community agencies and programs. If you’re having trouble paying your bills, they also have information about financial resources. Call the number above to learn more.

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

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

Tobacco Treatment Program
www.msk.org/tobacco
212-610-0507
If you want to quit smoking, MSK has specialists who can help. Call to learn more.

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

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

External support services

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

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

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

Cancer and Careers
www.cancerandcareers.org
646-929-8032
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.

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 medicine 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 medicines 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
www.lgbtcancer.com
Provides support and advocacy for the LGBT community, including online support groups and a database of LGBT-friendly clinical trials.

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

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

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

National 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 medicines.

NYRx
www.health.ny.gov/health_care/medicaid/program/pharmacy.htm
Provides prescription benefits to eligible employees and retirees of public sector employers in New York State.

Patient Access Network (PAN) Foundation
www.panfoundation.org
866-316-7263
Gives help 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.

Professional Prescription Advice
www.pparx.org
888-477-2669
Helps qualifying patients without prescription drug coverage get free or low-cost medicines.

Red Door Community (formerly known as Gilda’s Club)
www.reddoorcommunity.org
212-647-9700
A place where people living with cancer find social and emotional support through networking, workshops, lectures, and social activities.

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

Triage Cancer
www.triagecancer.org
Provides legal, medical, and financial information and resources for cancer patients and their caregivers.

Educational resources

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

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

Last Updated

Friday, February 2, 2024

Tell us what you think

Tell us what you think

Your feedback will help us improve the educational information we provide. Your care team cannot see anything you write on this feedback form. Please do not use it to ask about your care. If you have questions about your care, contact your healthcare provider.

While we read all feedback, we cannot answer any questions. Please do not write your name or any personal information on this feedback form.

Questions Yes Somewhat No
Please do not write your name or any personal information.