Having your operation for soft tissue sarcoma
Having your operation for soft tissue sarcoma
Before your operation your doctor and anaesthetist will see you to explain what is going to happen. They can answer any questions you may have. Your nurse will teach you breathing and leg exercises to help prevent chest infections and blood clots.
When you wake up, you will have several different tubes in place. You may have a drip to give you blood transfusions and fluids and one or more drains coming out near your wound. There may be a tube into your bladder (catheter) so that your urine output can be measured. You will also have a blood pressure cuff on your arm and a clip on your finger to measure your pulse and oxygen level.
You will almost certainly have some pain for the first week or so after a major operation. It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. After an amputation, some people feel pain in the limb that has been amputated. This is called phantom pain and you may need specific types of painkiller for it.
This may seem very difficult at first. Moving about helps you to get better but you will need to start very gradually. If you have had a sarcoma removed from a limb, the limb will need to heal before you can use it very much. If you have an amputation, you will need an artificial limb. Artificial limbs are individually made to fit. A prosthetist (artificial limb fitter) will visit you before and after your operation to explain more about this.
You can view and print the quick guides for all the pages in the Treating soft tissue sarcoma section.
Your doctor and anaesthetist will come to see you to make sure you understand what is going to happen, and answer any questions you may have. You will need to sign a form agreeing to the surgery. This is the time to make sure you ask all the questions you need to. The more you know about what is going to happen, the less frightening it will seem. Don’t worry if you think of more questions later. Just speak to your nurses. They can answer your questions or contact the doctor to come and talk to you again.
You will have some tests to make sure you are fit enough to have the surgery and that you will be able to recover well. The tests include
- Blood tests to check your general health and how well your kidneys work
- A chest X-ray to check your lungs are healthy
- A CT scan
- An ECG to check your heart is healthy
Your nurse will teach you breathing and leg exercises. You can help yourself to get better by doing these exercises after your operation. You should do them as often as you are told you need to. Breathing exercises will help to stop you getting a chest infection. Leg exercises help to stop clots forming in your legs. Blood clots and chest infections can occur when you are not moving around as much as you would normally.
Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.
View a transcript of the video showing breathing and circulation exercises after surgery (opens in new window)
If you have body hair on the surgery area, your nurse may need to shave you before your operation. Or you may be shaved in the operating theatre after you have had your anaesthetic.
If you have had a big operation you may wake up in intensive care or a high dependency recovery unit. These are places where you can have one to one nursing care. And your surgeon and anaesthetist can keep a close eye on how you are. As soon as your doctors are sure you are recovering well, you will be moved back to the ward.
When you wake up, you will have several different tubes going in and out of your body. This can be a bit frightening. But it helps to know what the tubes are for. You may have some or all of the following.
- Drips (intravenous infusions) to give you blood transfusions and fluids until you are eating and drinking again
- One or more drains coming out near your wound – these help to drain blood and tissue fluid from around the operation area
- A tube into your bladder (catheter) so that your urine output can be measured
You will have a blood pressure cuff on your arm when you first wake up. There will be a clip on your finger to measure your pulse and the oxygen levels in your blood (called a pulse oximeter). You may also have an oxygen mask on for a while. The nurses will measure your blood pressure often for the first few hours after you come round from the anaesthetic. They will also keep a close eye on your urine output because it can help to show whether you have too much fluid or are getting dehydrated. The nurse will remove the wound drain when it has stopped collecting fluid from the operation area.
You may have a couple of electronic pumps attached to your drips. These are there to give you painkillers, antibiotics and any other medicines you may need while you are recovering.
If you have had plastic surgery, your nurses will keep a close eye on the wound area to make sure it has a good blood supply. They will check a flap repair to make sure the skin has a good colour and temperature and is not getting swollen.
If you have had an amputation, the remaining stump of your limb will be covered with tightly fitting bandages when you wake up. This maintains the shape of the stump, which helps to make sure your artificial limb (prosthesis) will fit well.
You will almost certainly have some pain for the first week or so after a major operation. There are many different pain killing drugs you can have. Painkillers work best when you take them regularly, and it is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. You may have a hand control with a button to press to give yourself extra painkillers as you need them. This is called PCA or patient controlled analgesia. Do use it whenever you need to. You can’t overdose because the machine is set to prevent that. Do tell your nurse if you need to press the button very often. You may need a higher dose in the pump.
Some hospitals use painkillers given into the spine (a spinal anaesthetic) for the first day or so after surgery. These work very well. You have a very fine tube taped to your back. It is connected to a pump that gives you a continuous dose of painkiller. Tell your nurses if you are in pain, as they can increase the dose.
Many hospitals use nerve blocks for pain relief after surgery to an arm or leg. This means that local anaesthetic is injected around the main nerves going to the affected limb. This works very well. But it means that the nerves do not work for a time. So you may find you can't move your arm or leg properly. Don't worry about this. You will be able to move normally again when the local anaesthetic wears off.
Getting up may seem very difficult at first. Your nurses will encourage you to get up and about as soon as possible after your operation. Moving about helps you to get better, but you will need to start very gradually. Your physiotherapist will visit you every day after your operation to help you with your breathing and leg exercises. Some sarcoma operations are major surgery and you may need to stay in bed for the first couple of days. You may need to wear elastic stockings or inflatable boots to help prevent blood clots forming. You may also need injections of anti clotting medicines to help thin your blood.
Your nurses will help you to get out of bed and sit in a chair one or two days after your surgery. They will help you with all the drips and drains. Over the next couple of days, the tubes, bottles and bags will start to be taken out. Then, it will be much easier to move and you will really feel that you are starting to make progress.
Your specialist surgeon will give the nurses and physiotherapists very detailed instructions about your recovery. If you have had a tumour removed from an arm or leg, the limb will need to heal before you can use it very much. Your surgeon will tell you when and how you can use the limb that has been operated on.
If you need to have an amputation, you will need an artificial limb afterwards. Once the stump has healed, you will have a prosthesis fitted – a false arm or leg. A prosthetist will visit you before and after your operation to explain the types of artificial limb you can have and to take measurements. They make a plaster cast of your stump. They use the cast and sometimes computer assisted design (CAD) to create a false limb (prosthesis) that fits over the stump. They work with you to adjust the prosthesis so that it works as well as possible.
Most people go home from hospital a couple of weeks after surgery. Normally you will be fitted with a temporary false limb (prosthesis) while your artificial limb is being made, so that you can become familiar with using one. You will have a lot of physiotherapy and occupational therapy to help you learn to use your prosthesis. This takes a lot of determination, but you should have a lot of support to help you.
After amputation, some people feel pain in the limb that has been amputated. This is called phantom pain. Most people find that this eases off after a while. Some people have more long term problems with phantom limb pain. If you do, your specialist may suggest particular drugs for nerve pain, as they can help.
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