Find out how you may feel after your surgery, possible problems and when you can go home.
When you come round from the anaesthetic, you will be in a recovery area for a short time. Don't worry about this. It is so that a nurse can keep a close eye on you until you are awake. They will check your heart rate and blood pressure. You might have an oxygen mask on.
Once you have woken up and stable, you will be taken back to your ward. You will be sleepy for a few hours after the operation. How long this lasts depends on the type of surgery you had and the length of your anaesthetic. Some people feel fine after an anaesthetic. Others can feel groggy, tearful, cold and sick.
On the ward
When you first go back to the ward the nurses will keep a check on you. At first they will do checks every 15 minutes. Gradually they check you less often, so that within a few hours it will be every 4 hours. The checks include your blood pressure, pulse, temperature and a check on your wound.
Some surgery for salivary gland cancer is through the mouth. The wound will have stitches but no dressing. If your wound is on your neck and side of your face you may have a dressing over it. Or your surgeon may have just sprayed it with a protective clear spray.
Your doctors and nurses will check your wound regularly to make sure it is healing well. They will also check for signs of infection. You may have stitches or clips that stay in for up to 10 days. These may be removed while you are still in hospital. But if you are recovering well enough, you may be able to go home before they come out.
Removing stitches or clips
You will either go back to the hospital to have them taken out or a district nurse can visit you at home. Or you may have stitches that dissolve and don’t need to be removed.
You may need to take antibiotics to stop infections.
Tubes and drains
You may have one or more small tubes near your wound to drain fluid. Stopping fluid build up near the wound helps it to heal and reduces the chance of infection. Once there is no fluid draining your nurse will take the tubes out. This is usually within a couple of days.
You may have a drip in your arm. This keeps you hydrated. Once you are drinking and eating, your nurse will take it out.
You may also have antibiotics through your drip to help stop you getting an infection.
Your doctors and nurses will give you painkillers by drip or injection immediately after your operation. Once you are able to eat and drink you can take them as tablets or as liquid medicines.
The painkillers you might have through a drip into the bloodstream that you control is called patient controlled analgesia (PCA). This tube is connected to a pump that gives you a constant dose of painkiller. You just press a button to give yourself more painkillers.
It's normal to feel pain for the first week or so. It is important that your pain is well controlled. Do tell your nurses if you don’t think your painkillers are working well enough. They can adjust the dose to make you more comfortable. Then you can get up and about more quickly, breathe properly and sleep better. All of these will help your recovery.
Eating and drinking
When you can start eating and drinking again after surgery depends on the type of operation you had.
If you have a sublingual or minor salivary gland cancer, and have had surgery through your mouth, you may have to wait a few days. This allows the wound inside your mouth to heal. You will have fluid through a drip. You can also wet your mouth with small amounts of ice or water.
If you have had reconstructive surgery you may not be able to eat or drink for 7 to 10 days. During this time, you may be fed through a nasogastric tube. A speech and language therapist may help you if it is difficult for you to swallow.
Talking after surgery
After salivary gland cancer surgery, it can be difficult to talk. This is usually temporary and most people are able to speak normally once the swelling and bruising has gone.
People most likely to have a problem include those who have:
- had surgery through their mouth
- had surgery to their jaw
- swelling or bruising around the nerves that control the tongue and lips
Having trouble speaking can be very frustrating. The staff will be aware of this and will give you paper and a pen so that you can write down what you want to say.
If you continue to have problems with talking you will see a speech and language therapist who will help you.
The nerves controlling movement and feeling in your face and mouth can be affected by the tumour or by surgery to the salivary glands. This is usually temporary but occasionally may be permanent. The symptoms that you have depend on the salivary gland that is affected.
Surgery for a parotid gland cancer can cause numbness in the earlobe and the skin around the wound. Or you may have facial weakness so that your face looks like it has drooped. This only affects the side of the face where you had surgery. It is usually temporary.
Some people have sweating of the face at meal times. This is called Frey’s syndrome. It happens when nerves that control saliva production grow and join nerves that control sweating in the skin. It may happen many months after your operation.
Surgery for submandibular gland cancer can affect the nerve that controls movement in your lower lip. This can mean that you have a crooked smile. The nerve that controls feeling in the side of the tongue can be bruised during surgery, causing numbness. These effects are usually temporary but in rare cases can be permanent.
Surgery to the sublingual salivary gland can make the tongue numb. This is caused by bruising and swelling in the area. It is usually temporary.
When you have surgery to your face it can be particularly difficult to cope with. Many people worry about how they will look after the operation. The scar line after surgery will depend on the type of operation you have had.
Immediately after the surgery your face will be swollen but this will settle down after a few days. If you have your lymph nodes removed the swelling lasts for longer.
Most people are able to go home within a week. But it depends on the type of surgery. You may still be tired and it will take a few weeks to fully recover.
If you need to have stitches or clips taken out your nurse will arrange this. You will have an appointment to see your surgeon in the outpatient department. The appointment is usually about 6 weeks after your operation.
Find out about possible problems after surgery
You’ll have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.