Recovery in hospital

What happens after the operation?

When your operation has finished you will wake up in the recovery room. You can start to drink once you are more alert and the nurse tells you that you can. When you are comfortable and your nurse is happy with your recovery you will then be taken back to Ward 4, Ward 5 or the High Dependency Unit (HDU) on Ward 4. Sometimes you may need to be cared for in the HDU on ward 7 or in the Intensive Care Unit (ICU).

You will be monitored closely overnight, feel free to ignore us and keep sleeping unless we ask you questions. You may not want to drink very much at first but fluid can be given through a drip to keep you hydrated. You can eat and drink once you feel you want to. You can have visitors for a short while in the evening after your operation.

The next day
You will be seen by the doctors every day, usually between 8am and 9am (the ward round). They will check your progress and if there are any concerns. If you have any questions feel free to ask. They will assess any chest drains and check your pain is controlled. You will have a blood test and a chest X ray the day after your operation. A second ward round happens in the evening.
Chest drains
These are there to take air and fluid away from where the surgery was done. These are checked regularly and will be removed when the amount of fluid and air have reduced and your chest X ray is satisfactory (usually 1 – 4 days). If your drain becomes disconnected let your nurse know straight away.

Electronic chest drains

Many of our patients have electronic drains. They run on batteries which are recharged by putting it back on the docking station when you are by your bed. When it is fully charged the battery may last a couple of hours. The display shows the medical team whether there is any air leaking from the lung and how much. You can carry the drain and walk around.

If the drain makes a strange sound don’t panic – let your nurse know. Do not try to alter the drain settings or silence an alarm. Usually the drain needs something simple adjusting. Keep the drain upright, this keeps the filters clear.

Water seal chest drains

These drains look like a small, clear bucket with a lid and handle. Air will bubble in the drain if it is leaking out of the lung, the medical team check this by asking you to cough. Fluid in the drain bottle may look yellow, pink or light red. This is normal. You can carry the drain and walk around unless it needs to be attached to a suction tube from the wall. The drain must be kept upright and below chest level. Raising it too high could let fluid go back into the chest. Tipping the drain could lose the air seal and allow air into the chest. If the drain is accidentally knocked over put it back upright and let your nurse know what has happened.

Flutter bag chest drains

Sometimes air or fluid may come out of the drain for longer than average. A flutter bag has a one way valve which allows air and fluid out of the chest but not back in. A shoulder strap can be used and the drain can be hidden under clothes. You can go home with a flutter bag. If you go home with a flutter bag we will see you once per week. At these visits we will check that you are well and whether it is time for the drain to be removed.

Medications
As well as painkillers, we can give you anti-sickness and laxative tablets. We can give these to help with nausea and constipation. You will have oxygen at first, this is reduced and stopped when your oxygen levels are normal without it. Nebulisers help clear mucous from the lungs. These are a mist made of salty water or medication, given by a mask.

If you take medications at home these can normally be taken in hospital too. Medication for blood pressure will be stopped for the first few days after surgery. Your blood pressure is lower after surgery, medication can be restarted once your blood pressure comes up again. Aspirin or medications that thin the blood are restarted once the risk of bleeding is low.

Exercise and physiotherapy
We want you to be up and about as quickly as possible after surgery, depending on your operation. Walking helps your lungs recover. The day after your operation you will sit in a chair and go for a short walk. You may need help from the nurses or physiotherapists to do this at first.

You should sit in the chair rather than in bed and walk on a regular basis, with help as required. Your walking should improve daily.  It is important to be active after your surgery, it helps expand your lungs and prevent chest infections (pneumonia), constipation and blood clots.

It is normal to have some shortness of breath during walking in the first few weeks after surgery. This will improve with time as you exercise and walk more. Before you go home the physiotherapists will make sure you are fit to go home.

You need to breathe deeply after your surgery to clear mucus from your chest. If you need extra help with clearing mucus a physiotherapist will guide you. They may give you a device to help with deep breathing exercises. Using a rolled up towel to support your wound can help with coughing, we can show you how to do this.

Visiting times
Heartlands has a policy of open visiting, meaning you can have visitors from morning until 10pm at night. Support from family and friends is an important part of recovery.

For friends and family, please understand that patients also need rest. Visiting is not normally allowed during meal times, if you would like to help with meals please check with the nurse in charge.