After mesothelioma surgery

Waking up after an operation can feel quite strange. You might feel very confused or disorientated. You'll feel drowsy because of the anaesthetic and painkillers. This is normal. But knowing what to expect can help.

You might wake up in the recovery room close to the operating theatre. A nurse will look after you and monitor you closely. When you first wake up, you will have a little clip on your finger called a pulse oximeter. This measures your pulse and blood oxygen levels. You might also have an oxygen mask on for a while.

Your nurse will measure your pulse and blood pressure often during the first few hours.

If you've had a big operation, you might 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 your progress. As soon as your doctors are sure you are recovering well, you will go back to the ward.

Tubes and drains

You might have several different tubes in place when you wake up. This can be a bit frightening. It helps if you know what they are all for.

You might have:

• a drip (intravenous infusion) to give you liquids
• a tube down your nose and into your stomach to stop you feeling sick (a nasogastric tube)
• one or more wound drains coming out of your wound
• a tube into your bladder (catheter) to collect and measure your urine
• a thin tube going into your back to give painkillers (an epidural catheter)

Your nurse will take your drip out as soon as you can start eating and drinking again. After surgery for pleural mesothelioma, this is usually the day after the operation.

After surgery for abdominal mesothelioma, it may be longer before you can eat or drink. Your doctor will listen to your abdomen with a stethoscope. As soon as the doctor can hear your bowel working again, you will be able to start taking sips of water. Gradually you will work up to eating and drinking normally.

The wound drainage tubes usually stay in as long as they carry on draining fluid. This could be more than a week. If you have had just the pleura removed, you will have one or two tubes called chest drains coming out of your chest on the side where you have had your surgery. These are attached to glass bottles, which are connected to a suction machine. The gentle suction helps your lung on that side to expand again after collapsing during the operation. Sometimes, the drains are just connected to a drainage bag.

Your wound

You have dressings over your wounds. After a couple of days your nurse changes the dressings and cleans your wounds.

The type of wound you have will depend on the area of surgery and whether you had open surgery or keyhole surgery. You might have about 3 smaller wounds if you had keyhole surgery. Or you will have at least one longer wound with open surgery. 

You will have stitches or clips that stay in for at least 10 days. You can go home with the stitches in if your wound is still healing and you are otherwise well. The practice, district or hospital nurse then takes them out. This could be at home or you might need to go back to hospital.

Before you go home, your nurse gives you information about how to care for the wound.

Painkillers

You will almost certainly have some pain and discomfort for the first week or so. But it is possible to control your pain. There are many different painkilling drugs you can have.

It is very 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. Painkillers work best when you take them regularly.

You might have a local anaesthetic given slowly and continuously through a small tube into the fluid around your spine. This is called an epidural. It is a very effective way of controlling pain. The tube is put in while you are still asleep in the operating theatre. It will stay in for up to a week, even when you are up and about. 

After your epidural has been taken out, you might still need painkillers to keep you comfortable. Painkillers work best when you take them regularly. It is important for you to be comfortable so that you can breathe deeply, cough easily, and move around as freely as possible. This helps to stop a chest infection or blood clot developing.

Pain can sometimes be a long term problem following this type of operation but there are effective medicines you can have. Pain may start a few weeks or months after the operation. This is usually because nerve endings have been damaged during the operation. If you have any pain, tell your doctor. They can prescribe medicines to help or they can refer you to specialist doctors in a pain clinic.

Moving around

Your nurses will help you to get up and move around gently as soon as possible. Even when you are still in bed, they will help you to do deep breathing and leg exercises. This helps you to get better and makes complications such as chest infections or blood clots much less likely.

Making progress

During the first few days after your operation you’ll start to feel better. The drips and drains come out and you start eating and can move around better.

You’ll begin to feel that you’re making progress. Most people go home about 7 to 15 days after the operation.

Going home

You’ll need some help when you first go home. You’re likely to feel very tired for several weeks or a few months after your surgery. It helps to do a bit more every day.

You can try:

• sitting for less time each day
• walking around the house a bit more each day
• building up to walking outside

What you can do depends on how fit you were before your surgery and any problems you have afterwards. Talk to the physiotherapist or your doctor if you’re not sure what you should be doing.

Contact your doctor or specialist nurse if you have any problems or symptoms you’re unsure about.

Follow up

You have regular check ups after cancer treatment, to check your recovery and sort out any problems. This is called follow up. You can also use your appointments to raise any concerns you have.

Further treatment

Depending on the surgery you had, your surgeon might refer you to a cancer specialist to have chemotherapy or radiotherapy treatment once you have recovered.