Discharge Instructions after Thoracic Surgery

We wish you a speedy recovery. Here is some information about caring for yourself when you go home.

When can I shower?
You can shower at home, 24 hours after all of your tubes have been removed -- as long as your incision is dry (not oozing) and appears to be healing. Limit your showers to no longer than 10 minutes until your skin has healed.

• Gently wash the incision area with mild soap and a soft wash cloth, using an up and down motion. Do not scrub the incision area until scabs are gone and the skin is healed.
• You may use hydrogen peroxide to further cleanse the incision area and chest tube sites.
• After bathing, keep all wounds open to the air unless it is draining. If a wound is draining, apply a dry sterile dressing to the wound. If the drainage appears to be new, please call your surgeon’s office immediately.
• Do not apply lotion, ointments, antibacterial creams, oils, salves or any other substance to the wounds, unless you received other instructions from your doctor.
• Do not expose the incision area to the sun. During healing, the incision area is sensitive to the sun and can easily burn. Limited sunbathing is allowed if you protect your incision.
• Any sutures that are present will be removed during your follow-up appointment.

How long will it take for my incision to heal?
It will take about six to eight weeks for your incision to heal and for you to recover from surgery.

When can I go back to work?
Your doctor will tell you when you can go back to work, usually within 6-8 weeks after you go home. If you have the flexibility at your job, ease back to your regular work schedule. Start back part-time, if possible, and gradually increase to your normal schedule.

• Do not lift objects that weigh more than 5 pounds.
• Do not hold your arms above shoulder level for a long time.
• Avoid activities that require pushing or pulling heavy objects, such as shoveling the snow or mowing the lawn.
• Do not drive while taking narcotics for pain.
• You can walk up and down the stairs unless this has been restricted by your doctor. You may need to rest part of the way if you become tired.
• Try to arrange your activities so you do not have to climb up and down stairs several times during the day, especially when you first arrive home.
• The amount of energy required during sexual intercourse is similar to climbing one or two flights of stairs. If you cannot climb stairs without becoming tired or short of breath, allow additional recovery time before resuming sexual activity. For the first 6-8 weeks, use positions that limit pressure or weight on the incision and tension on the arms and chest.
• Try to walk as much as possible.
• You can do light household chores, such as laundry, shopping cooking, light cleaning and washing dishes when you feel up to it.
• Try not to stand in one place for more than 15 minutes.
• Do not sit for more than one hour at a time; take a break to move your legs before sitting back down.

My pain medication makes me constipated. What can I take for constipation?
For patients who can take medications by mouth, we recommend taking Senokot S-2 pills twice a day, and if needed, 30 cc of Milk of Magnesia at night, until you discontinue the pain medication. Take the Senekot S regularly with your pain pills; do not wait until you are constipated to take it.

All of the medications mentioned above are available without a prescription and can be purchased at your local drugstore. If you have an allergic reaction to any of these medications, contact your health care provider for other options.

How long should I use the incentive spirometer?
Continue to use your incentive spirometer for four weeks after you are at home. Also continue to practice your coughing exercises. These activities will help expand your lungs and remove excess drainage.

When should I call my doctor’s office?
Call your doctor’s office and ask to speak with one of the nurses if you:

• Have diarrhea or constipation
• Have a temperature higher than 101 degrees Fahrenheit or 38.4 degrees Celsius –twice in 24 hours
• Have leg swelling, new onset of cough, abdominal pain, or increased shortness of breath

Signs of infection
Call your health care provider right away if you have any of these signs of infection:

• Increased drainage, bleeding, or oozing from the incision
• Increased opening of the incision line
• Redness around the incision
• Warmth along the incision line
• Increased body temperature (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius)

When to seek emergency treatment
Call 9-1-1 or go to your local emergency department if you experience:

• Chest pain
• Extreme shortness of breath
• Irregular heartbeat
• Coughing up bright red blood
• Severe abdominal pain

What if I have problems with the drainage tube?
Call your doctor’s office and ask to speak with one of the nurses if:

• The tube falls out
• There is increased drainage or bleeding from the tube, or if the drainage has a bad odor
• You have redness, pain, drainage or swelling at the catheter insertion site

What if I have problems with the Pleurx catheter?
Call your doctor’s office and ask to speak with one of the nurses if you have:

• An increased amount of drainage or a change in the color of drainage
• Redness, pain, drainage or swelling at the catheter insertion site