Knowing what to expect after surgery for primary bone cancer can be reassuring.
When you wake up after your operation
After a big operation, you may wake up in the intensive care unit or a high dependency recovery unit. You usually move back to the ward within a day or so.
In intensive care you have one to one nursing care. In the high dependency unit you have very close nursing care. Your surgeon and anaesthetist review you regularly and watch your progress closely.
These units are busy and often noisy places that some people find strange and disorientating. You'll feel drowsy because of the anaesthetic and painkillers.
Tubes and drains
When you wake up, you will have several different tubes in place. This may make you feel a little anxious. But it helps to know what they are all for. You might have:
- drips (intravenous infusions) – so you can have blood transfusions if you need them and fluids until you are eating and drinking again
- one or more drains from your wound – these help to drain blood and tissue fluid from around the operation area
- a catheter (tube into your bladder) – it makes it easier for you to pass urine until you are moving around again and the nurses can measure how much urine you pass
- spinal anaesthetic – this is a thin tube into the fluid around your spinal cord to give you painkillers
Your nurse takes out the drainage tubes when fluid from the wound has stopped draining out. This can be up to a week later.
They take the drip out as soon as you are able to eat and drink normally. This usually takes a couple of days. They take the catheter out when the doctors are happy that you are passing a normal amount of urine.
You may have a couple of electronic pumps attached to your drips. These give you painkillers, antibiotics and any other medicines you may need while you are recovering.
After lung surgery
You will have a drainage tube into your chest as well if you've had surgery to remove bone cancer that had spread to the lungs. The tube is connected to a suction bottle. The gentle suction helps your lung to inflate properly again after a chest operation.
You have a blood pressure cuff on your arm when you first wake up. Your nurse checks your blood pressure often for the first few hours after you come round from the anaesthetic.
You might have a little clip on your finger, called a pulse oximeter. This measures your pulse and blood oxygen level. You may also have an oxygen mask on for a while.
Your nurse also monitors your urine output because it helps to show whether you have too much fluid or are becoming dehydrated.
It’s normal to have pain for the first week or so after bone surgery. Your doctor and nurses will give you painkillers.
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. Painkillers work best when you take them regularly.
Immediately after surgery you can have painkillers through either a:
- drip into the bloodstream that you control (PCA or patient controlled analgesia)
- small thin tube put into your back and connected to a pump that gives you a constant dose of painkiller (epidural)
Some hospitals give you painkillers or local anaesthetic directly into the nerves of the arm or leg that was operated on.
You'll have painkillers to take home. Follow the instructions your nurse gives you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.
Phantom limb sensation
If you had surgery to remove a limb, you might experience phantom limb sensation. Immediately after surgery, it might feel as if the amputated limb is still there. Experiences differ from person to person. You might feel the whole limb or just part of it such as the toes. Sensations vary from feeling like your leg is in an odd position or has the same length and weight as your other leg.
Phantom limb sensation is common for many people. It happens because the brain is still sending signals to the limb that is no longer there. This will gradually fade. In the first few months after surgery, it can be easy to forget that your limb is no longer there. So you should take extra care before getting up, especially at night or after sitting for a long period.
Phantom limb pain
If you have had an amputation, you may feel pain in an arm or leg which is no longer there. This is called phantom pain. But it is very real, although not everyone has it. The pain can be tingling, burning, itching or cramping.
Doctors are starting to understand how and why phantom pain happens. Phantom sensations can be triggered by many different things. It can differ from person to person. Common triggers are swelling, muscle spasms, temperature changes, emotional changes or changes in the weather. For most people, it settles down in time. But if not, there are ways of helping to control it, including painkillers. Some people might be prescribed pain killers before they have their amputation.
Let your doctor or nurse know if you are having any phantom pain.
Eating and drinking
You should be able to eat and drink quite soon after your surgery. Your nurse will let you know when you are able to start eating and drinking.
The wound will be covered up when you come round from the operation. It will be left covered for a couple of days. Then the nurse may change the dressings and clean the wound.
The wound drains will be left in until they stop draining fluid. Your nurse can usually take out the wound drains 1 to 2 days after your operation. They leave in your stitches or clips for at least 10 days.
If you have a cast on your arm or leg, you may want to ask about a waterproof cover. There are covers available to keep your cast dry in the bath, shower or even if you go swimming.
Getting up and making progress
For the first few days after surgery, getting up and moving around may seem very difficult. 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.
Your nurses will encourage 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. After a couple of days the drips and drains will come out. This means you can move about better.
Your specialist surgeon will give the nurses and physiotherapists very detailed instructions about your recovery. If you have had limb sparing surgery, the bone will have to heal before you can use it very much. Your surgeon will tell you when you can get up and how you can use the limb that has been operated on.
After your amputation
After your surgery, you will have a stump or wound area that is sore and sensitive. Once this has healed and any swelling has settled down, you will see a prosthetist. Prosthetists are specialists who design and fit artificial limbs (prostheses) to replace those lost through amputation.
The prosthetist will make a cast or impression of your stump to make sure that the prosthesis fits as well as it can. They then use the cast to design a suitable limb.
They fit the limb so that it works as well as possible for you. They also continue to care for you and carry out adjustment or repairs to the prosthesis if needed.
You will have a lot of help from your prosthetist, physiotherapist and occupational therapist to help you learn to use your prosthesis.
Having an amputation is a lifechanging event. It will take time to adjust emotionally and physically. Talk to your healthcare team if you find it hard to cope. They can offer advice and support.
Everyone recovers from surgery differently. Your team will let you know when you are ready to go home.
You’ll need help when you first go home. You physiotherapists can help you make a daily plan for the first few weeks at home. Contact your doctor or specialist nurse if you have any problems or symptoms you’re unsure about.
Follow up appointments
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.