You have tests to check you are fit for surgery.
You have tests before your operation to check:
- your fitness for a general anaesthetic
- that you'll make a good recovery from surgery
Tests might include:
- blood tests to check your general health and how well your kidneys and liver are working
- an ECG to check that your heart is healthy
- breathing tests (called lung function tests)
- an echocardiogram (a painless test of your heart using sound waves)
- a chest x-ray to check that your lungs are healthy
Pre assessment clinic
Your pre assessment appointment prepares you for your operation.
You meet members of your treatment team at this appointment and you can sign the consent form to agree to the operation.
Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital so don’t worry if you forget to ask some.
At the hospital you might meet:
A member of the surgical team will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
The anaesthetist gives you the anaesthetic and they look after you during the operation. The anaesthetic is the medicine that keeps you asleep during your operation. They make sure you’re fit enough for the surgery.
The clinical nurse specialist
The nurse checks your:
- general health
- blood pressure
The nurse also checks what help and support you have. Then they can see what you will need when you go home. They are your point of contact and will care for you throughout your treatment.
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.
The physiotherapist also teaches you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.
The dietitian gives you help and advice about managing your diet. They might give you nutritional supplement drinks to have before surgery. And they:
- help you get as well as possible before your operation
- explain how the surgery affects your diet
- give useful tips on how to increase your nutrients and calories
Speech therapists don't just help people with speech problems. They also help people who have difficulty swallowing after surgery to the head and neck area. They assess you and can advise on the right texture of food or fluid to help you swallow safely.
Restorative dentistry consultant
A restorative dentist might assess your teeth before you have surgery. They may recommend that you have some teeth removed if they are decaying or loose. They also give you advice on how to look after your mouth and teeth after treatment. You may also see a dental hygienist to help keep your mouth and teeth clean. And reduce the risk of infection.
The restorative dentist will also help your recovery. They may suggest using false teeth or a replacement part (prosthesis). They can help to make your facial appearance as normal as possible after treatment.
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.
You start the injections before your operation. You might also wear compression stockings.
Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.
This 3-minute video shows you how to do the breathing and leg exercises.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a hu. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
Your doctor will encourage you to stop smoking before the operation. Giving up smoking can be very difficult, especially if you have smoked for a long time. But it will help you recover from treatment faster and help to prevent further cancers.
Stopping smoking also helps to lower the risk of a chest infection and wound infection after surgery.
The evening before
You might go into hospital the evening before or the morning of your surgery.
Your nurse might give you a carbohydrate-rich drink to have the evening before the operation. You might also have it the following morning. The drink gives you energy and can speed up your recovery.
When you're in hospital your nurse will check your blood pressure, pulse, temperature and breathing rate. You might have fluids through a drip (intravenous infusion) into your arm before your surgery if you have recently been finding it diffiucult to drink.