Discharge Instructions

After surgery, your support person will get information on what you need to do at home. This may include instructions about medicines, when and how to change bandages, and what to do if you have pain or an infection. It may cover how active you can be, and it may also tell you what you can eat and drink and what you should try to avoid.

How can you care for yourself after surgery?

Here are some tips for caring for yourself after surgery. But be sure to follow any instructions your doctor gives you.

General Instructions

• Take medicine as directed.
  • If you take aspirin or some other blood thinner, talk to your doctor before you start taking them again.
  • If your doctor prescribed medicine, take it exactly as directed.
  • Ask your doctor about over-the-counter pain medicine.
• Care for your cut (incision).
  • Change the bandage daily or more often if needed.
  • Gently wash the area daily with warm water and pat it dry.
  • You may shower 24 to 48 hours after surgery.
  • Do not take a bath or swim until your doctor says it is okay.
• Move Carefully.
  • Do not move quickly or lift anything heavy until your doctor says it is okay.
  • Ask your doctor when you can exercise and do other activities.
  • Rest when you feel tired.
  • Ask your doctor when it is okay to have sex.
• Eat and drink as directed.
  • When you feel like eating, start with small amounts of food.
  • You can eat your normal diet unless your doctor gives you other instructions.

Managing Pain - Medications

Different types of pain medication can treat different pain conditions. Each drug treats specific types of long lasting or short-term pain.

Some pain medications are available over the counter (OTC) at a pharmacy. Stronger pain relievers will require a doctor’s prescription. The right pain medication depends on the cause and intensity of pain.

Over-the-counter types
People may find three types of pain medications OTC:

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain from inflammation.
Some NSAIDs that people can try without a prescription include:

• Ibuprofen (Advil)
• Acetylsalicylic acid (Aspirin)
• Low dose naproxen (Aleve)

Side effects of NSAIDs include:

• Nausea
• Upset stomach
• Other gastrointestinal disturbances
• High blood pressure

Acetaminophen is a non-opioid pain reliever. People use acetaminophen (Tylenol) for mild to moderate pain. They are sometimes used in combination with other pain relievers. For severe pain, acetaminophen is less useful. Typically, acetaminophen is a safe trusted source when used correctly.

Side effects of acetaminophen include:

• Rash
• Allergic reaction
• Certain metabolic disorders, such as low sodium levels in the blood and low red blood cell count

Prescription NSAIDs
Certain NSAIDs are only available through a doctor’s prescription. They work in the same way as NSAIDs. People who need prescription NSAIDs may be experiencing inflammation and mild-to-moderate pain.

While the side effects of prescription NSAIDs are similar to over-the-counter NSAIDs, they can be more severe. A doctor must first authorize its use by assessing a person individually. They may also monitor people closely while taking prescription NSAIDs.

Antiacid medications may need to be taken with some prescription NSAIDs, and this is to counteract some of the gastrointestinal side effects. If people are experiencing any gastrointestinal symptoms, they should talk with their doctor before starting antacids.

Tramadol and opioids
Opioids include medications that resemble the natural plant alkaloids found in opium. Tramadol (Ultram) is a drug called an opioid agonist, but it acts differently than opioids. Both opioids and tramadol block certain receptors, which help treat pain. Tramadol acts on neurotransmitters, specifically norepinephrine and serotonin.
Examples of opioid drugs include:

• Morphine (MS Contin)
• Oxycodone (Oxycontin)
• Fentanyl patch

These are the most effective medications to relieve severe pain. Doctors prescribe the lowest effective dose for the shortest duration because of the risks of taking opioids. Taking opioids longer than 3 days increases your risk for these side effects:

Some side effects of opioids include:

• Extreme changes in mood
• Heavy sleepiness
• Constipation
• Nausea and vomiting
• Trouble breathing

Prolong use or misuse of Opioids can cause:
Liver problems
Kidney problems
Taking too much of the 
People can also develop a tolerance and addiction to opioids.

Sign and Symptoms to watch for After Surgery

Sometimes, complications can occur following surgery. The following are the most common complications. However, individuals may experience discomfort and complications differently. Specific treatment for any post-surgical complication(s) will be based on:

• Your age, overall health, and medical history
• Extent of the disease
• Type of surgery performed
• Your tolerance for specific medications, procedures, or therapies

What to expect after your procedure?

It is common for people to experience after surgery:

• Pain or discomfort at the IV site
• Have nausea or vomiting
• Have a sore throat or hoarseness
• Have trouble concentrating
• Feel cold or chills
• Feel weak, sleepy, or tired (fatigue)
• Have soreness and body aches. These can affect parts of the body that were not involved in surgery.

Complications that may arise after surgery include:

Shock is the dangerous reduction of blood flow throughout the body. Shock is most often caused by reduced blood pressure. Treatment may include any/all of the following:

• Stopping any blood loss
• Maintaining an open airway
• Keeping the patient flat
• Reducing heat loss with blankets
• Intravenous infusion of fluid or blood
• Oxygen therapy
• Medication

Hemorrhage means bleeding. Rapid blood loss from the site of surgery, for example, can lead to shock. Treatment of rapid blood loss may include:

• Infusions of saline solution and plasma preparation to help replace fluids
• Blood transfusion

Wound infection is when bacteria enter the site of surgery, an infection can result. Infections can delay healing. Wound infections can spread to adjacent organs or tissue, or to distant areas through the blood stream.
Treatment of wound infections may include:

• Antibiotics
• Draining of any abscess
• Signs of Infection After Surgery (verywellhealth.com)

Deep vein thrombosis is blood clotting occurring within deep-lying veins. Large blood clots can break free and clog an artery to the heart, leading to heart failure. Treatment depends on the location and the extent of the blood clot, and may include:

• Anticoagulant medications (to prevent clotting)
• Thrombolytic medications (to dissolve clots)
• Surgery

Pulmonary complications can sometimes arise due to lack of deep breathing within 48 hours of surgery. This may also result from inhaling food, water, or blood, or pneumonia. Symptoms may include wheezing, chest pain, fever, and cough (among others).

Urinary retention or the inability to empty the bladder, may occur after surgery. Caused by the anesthetic, urinary retention is usually treated by the insertion of a catheter to drain the bladder until the patient regains bladder control.

Reaction to anesthesia can be rare, however, allergies to anesthetics do occur. Symptoms can range from lightheadedness to liver toxicity.
Each person will respond differently to anesthesia and their surgery recovery. The amount of discomfort following surgery depends on the type of surgery performed. Some typical discomforts include:

• Nausea and vomiting from general anesthesia
• Soreness in the throat if the patient needs artificial ventilation (the soreness is caused by the tube placed in the windpipe for breathing during surgery)
• Soreness and swelling around the incision site
• Restlessness and sleeplessness
• Thirst
• Constipation and flatulence

When should you call for help?

Call your doctor if:

• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the incision.
  • Puss draining from the incision.
  • A fever.
• You have loose stitches, or your incision comes open.
• Bright red blood soaks through the bandage over your incision.
• You have pain that does not get better after you take pain medicine.
• You have nausea or vomiting that gets worse or will not stop.
• You are too sick to your stomach to drink any fluids.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments and call your doctor if you are having problems. It is also a good idea to know your test results and keep a list of the medicines you take.