How you feel after your operation depends on the type of surgery.
When you wake up after your operation
After a big operation, you 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 might have:
- a drip (intravenous infusion) into your arm to give you fluids until you are eating and drinking again
- a breathing tube in your neck
- a fine tube into your stomach (gastrostomy tube) or into your stomach via your nose (nasogastric tube) for liquid feeds
- wound drains in your neck or near your wound
- a tube into your bladder (catheter) to collect and measure urine
Talking after your operation
If you had surgery to your voicebox, mouth, jaw, tongue or throat you will have problems talking after your operation. This can be frustratng and you may feel you have no control over things.
Staff will be aware of this. You will have a call bell close by so you can call for help if you need it. Your nurse can give you a pen and paper to write down what you want to say.
After your surgery, you might wake up with a breathing tube in a hole in your neck. The hole is called a stoma or tracheostomy.
This is usually temporary. You breathe through the tube for 3 or 4 days and then one of your team removes it. The hole then closes up on its own.
A few people will need a permanent tracheostomy.
There are different types of feeding tubes. One type is a tube straight into your stomach called a gastrostromy tube. You have liquid feeds into the tube until you are eating and drinking again.
A tube into your stomach via your nose is called a nasogastric tube. It helps to stop you feeling sick. Later it will be used as a feeding tube.
The nasogastric tube might go up your nose, down your throat and into your stomach. Or it may go into your breathing stoma, through a small hole at the back of your windpipe (trachea) and into your foodpipe (oesophagus). The tube helps to keep the hole in your neck open, if you need to have a speaking valve fitted later on.
It’s normal to have pain for the first week or so. You have painkillers to help.
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 might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA).
Or you might have painkillers through a small thin tube that is put into your back. This tube is connected to a pump that gives you a constant dose of painkiller. This is called an epidural.
You get 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.
After a few days
Your nurses will encourage you to get out of bed and sit in a chair one or two days after surgery. They will help you with all the drips and drains. Over the next couple of days your nurse will take out most of the drips, drains and tubes. Then it will be easier to get around. Your physiotherapist will visit you every day to help you with breathing and leg exercises.
Your wound might be covered with a dressing for a few days. Some surgeons use a clear protective spray instead of dressings. Your wound drain stays in until it stops draining fluid. This is usually 3 to 7 days after your operation.
Your stitches or clips might need to stay in for up to 10 days.
Eating and drinking
Whether or not you can eat or drink after your operation depends on your type of surgery. Any surgery to your mouth usually means you can't eat or drink for a few days. You have fluid through a drip and you can wet your mouth with ice or sips of water.
If you have a feeding tube, a dietitian will see you to decide how much liquid feed you need, until you are eating and drinking normally.
Once your wound has healed you can gradually increase the amount you drink. Soon you can start to eat a soft diet, such as soup or jelly. Your dietitian will monitor this, and gradually cut down your liquid feeds.
Possible problems after surgery
Having surgery to the mouth and oropharynx may:
- change how you chew and swallow
- change how you breathe
- change the way you talk
- change your sense of smell
- change your appearance
Some of these changes may happen because your face is swollen and sore after surgery. These temporary changes will improve once you start to heal and swelling goes down. But some changes may be permanent.
Your surgeon will always try to avoid changing your appearance. They will also try to keep functions such as breathing, speech, sight, chewing and swallowing as normal as possible. But sometimes this isn't possible. Your surgeon will tell you more about what to expect after your operation.
Follow up appointment
You 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.