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IntroductionThis information should increase your understanding of the programme and how you can play an active part in your recovery. If there is anything you are not sure about, please ask. It is important that you understand so that you, and possibly your family or friends, can take an active role in your recovery. Eating and drinkingAt the pre-assessment clinic the week before your operation, you will be able to taste some nourishing drinks. They are called Fortisip, Fortijuice, Fortimel and Build-up. You will be given four drinks of your choice to take home. Two days before your operation, you need to have three of the drinks. On admission day, you should have one before you come to hospital. Another drink will be available for you when you are in hospital, as well as two glasses of a clear carbohydrate drink (called Pre-Load) about 8-12 hours before your operation. About three hours before your operation, you should take another two glasses of the clear carbohydrate drink. A few hours after your operation, you will start drinks and, if you wish, food. You should have two nourishing drinks on this day and three per day thereafter. These drinks are important after your operation as your body needs more nourishment to help heal your wounds, reduce the risk of infection and help your recovery generally. You also need to have ordinary drinks. It is important that you eat and drink early after your operation and we will encourage you to have normal food as well as nourishing drinks. For stoma patients onlyYou will be offered an appointment in the Stoma Care Department to find out more about your stoma operation and how to care for the stoma. It is important to know what to expect. This appointment may take up to 1 hour. The day after your operation you will be well enough to participate in learning how to care for the stoma and you will carry out a bag change every day until you feel confident to do so alone. This is expected to be approximately the 5th-6th post operative day when you will be ready for discharge home. Preparing for theatreOne the day before your operation, you may be asked to have some medicine to help clear the contents of your bowel. This gives you loose stools and it is important that you drink plenty of fluid to replace what is lost. Otherwise, you may feel dizzy, sick or have a headache. Some patients have an enema two hours before their operation to clear the lower end of the bowel. You will be given a small injection of clexane at 10pm. This helps reduce the risk of blood clot (thrombosis) occurring in the legs by thinning the blood. This will be given to you each day while you are in hospital. Staying out of bed and walkingAfter you wake up from your operation, it is important that you start deep breathing exercises. Support your abdomen with a towel and your arms, bring your knees up slightly and lower your shoulders. Breathe in through your nose and out through your mouth slowly. Do this three times and then "huff" with your mouth as if trying to clean spectacles. Repeat the exercise twice. The whole process should be repeated each hour. This should reduce the risk of chest infection. Your should also point your feet up and down and circle your ankles to reduce the risk of clots in your legs. The staff will help you out of bed about six hours after your operation. You will spend two hours out of bed on the day of surgery and then at least eight hours out of bed on each subsequent day. You will be encouraged to walk about 60 metres 4-6 times a day after surgery. By being out of bed in a more upright position and by walking regularly, lung function is improved and there is less chance of chest infection as more oxygen is carried around the body to the tissues. Try and wear your day clothes after your operation as this can help you feel positive about your recovery Pain ControlIt is important that your pain is controlled so that you can walk about, breathe deeply, eat and drink, feel relaxed and sleep well. You may have an injection in your back (epidural) which allows a continuous supply of pain relieving medicine to be given. This is generally removed 2 days after your operation. The doctors will also prescribe other types of pain relieving medicines which work in different ways and you will have these regularly (three or four times a day). SicknessSometimes after an operation, a person may feel sick or be sick. This is usually caused by the anaesthetic agents or drugs we use. You will be given medication during surgery to reduce this, but if you feel sick following surgery, tell the staff who can provide other medications. It is important to relieve sickness in order to allow you to feel better so that you can eat and drink normally which will aid your recovery. Tubes and DripsDuring your operation, a tube will be put in your bladder so that we can check that your kidneys are working well and producing urine. This will be removed as soon as possible, usually on the morning after your operation. You will have a fluid drip put in your arm during your operation to make sure you get enough fluid. This should be removed the day after your operation. You may be given extra oxygen to breathe after the operation until you are up and about. MonitoringMany different things will be monitored during your treatment including:
Please remember to tell us about everything that you eat and drink and what you pass. You will be encouraged to write some of this information on the charts yourself. Important Discharge InformationWhen you leave hospital Complications do not happen very often, but it is important that you know what to look for. During the first two weeks after surgery, if you are worried about any of the following, please phone the telephone numbers listed below. If you cannot contact the people listed, then ring your GP.
Abdominal Pain You will most likely suffer gripping pains during the first week following removal of a portion of the bowel. The pain usually lasts for up to a few minutes and will go away completely between spasms. Severe pain that lasts for several hours may indicate leakage of fluid from the area where the bowel has been joined together. This can be a serious complication, which rarely happens. Should this occur, it may be accompanied by fever. On occasion through, leakage may occur which makes you feel generally unwell, cases fever but is without pain. If you have severe pain lasting more that 1-2 hours or have a fever and feel generally unwell, you should contact us on the telephone numbers listed above. Your wound It is not unusual for your wound to be slightly red and uncomfortable during the first 1-2 weeks. Please let us knot if your wound is:
Your bowels Your bowel habits may change after part of your bowel is removed. Your motions may become constipated. Make sure you eat regular meals 3 or more times a day and take regular walks during the first two weeks after your operation. If you are passing loose stools more than three times a day, for more than four days, we advise taking medication such as loperamide, lomotil, or codeine phosphate. If you are constipated for more than 3-4 days taking a laxative is advised. For stoma patients only Your Stoma Care Nurse will give you plenty of supplies to take home. Your bowel function via the stome will be the same as described above. A follow up appointment to see you in your home or the Stoma Care Department will also be arranged. Passing urine Sometimes after bowel surgery, you may experience a feeling that your bladder is not emptying fully. This usually resolves with time. If it does not or if you have excessive stinging when passing urine, please ring us as you may have an infection. Exercise Activity is encouraged from day one following your surgery. You should take regular exercise daily. Gradually increase your exercise during the 4 weeks following your operation until you are back to your normal level of activity. Do not undertake heavy lifting until 6 weeks following your surgery. If you are planning to jog or swim, wait until 2 weeks after your surgery and then start gradually. Common sense will guide your exercise and rehabilitation. If your wound is uncomfortable, go easy with your exercise. Once your wound is pain free, you can undertake most activities. Work Many people are able to return to work within 2-4 weeks following their surgery. If your work involves heavy, manual labour, do not return to work until 6 weeks following your surgery. Driving Do not drive until you are confident that you can drive safely. It is best to check with your insurance company before you start driving again. Hobbies/Activities In general, you can take up hobbies and activities as soon as possible after your surgery. This will benefit your convalescence. However, do not do anything that causes significant pain or involves heavy lifting for the 6 weeks following your surgery. This information is also available to download and print in the form of a leaflet.
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