Patient education after the surgery

We pray you have had a successful surgery and that you are on the road to recovery. The following instructions will guide you for an early recovery after your surgery.

Breathing Exercises:

Taking deep breaths helps to improve your blood oxygen level which will protect you from getting infections after surgery. You must start it from before surgery and continue after surgery for at least a week. This involves taking 10 deep breaths and holding each breath for a few seconds. This should be done multiple times a day. Your doctor may ask you to blow balloons to practice breathing or instead may order for you a device, called an ‘Incentive Spirometer’, to do these exercises. Using this device will help increase your blood oxygen levels that will help you recover quickly.

Here the steps to use the incentive spirometer:

  1. Try to use it while in sitting up position as it will be easier to take deeper breathes in that position. 
  2. Attach the tube to the device and adjust the mouthpiece. Clean the mouthpiece between uses.
  3. Hold the device vertically with the three balls at the base of the device.
  4. First exhale completely, then take slow deep breaths. 
  5. As you inhale the balls will rise up. Initially the left side ball will rise and as the breath gets stronger the other balls will also rise. 
  6. Take 10 deep breaths every hour and aim to rise up all three balls. It is normal to have difficulty raising the balls after surgery but as you practice the breaths will get stronger and the balls will rise.  
  7. Try to hold your breath for 3-5 seconds before exhaling. 

Physical Activity:

Early ambulation after surgery has been scientifically proven to enhance your recovery. Unless restricted by your surgeon, you should try to walk as soon as possible. If you have had orthopedic surgery then please ask your surgeon what you are allowed to do before getting out of bed. 

Before getting out of bed, make sure you do not feel dizziness or have a risk of falling. Here are some precautions that will save you from falling:

  1. Ask someone to be with you when getting out of bed the first time or any time you feel you may get dizzy. Please inform your nurse when you wish to get out of bed the first time after surgery.
  2. Sit on the bedside and hang your feet from the bedside for a few minutes to make sure you do not feel dizziness. 
  3. Then with someone’s help, try to stand up and wait for a few seconds before moving away from the bed.
  4. Make sure the tubes connected to you are not tangled with your feet that may trip you.
  5. Take a few steps in the room and make sure you are able to go to the toilet or to a chair in the room.  If you are connected to an IV medications device attached to a pole, then take the pole with you. 
  6. Once you feel confident then try walking up and down the halls on your floor. 
  7. You can always ask for a walker if you need walking assistance.
  8. Other precautions to take: 
    1. Keep the bed to the lowest level with side rails up.
    2. Make sure your clothing and all tubing and wires do not obstruct your ability to move freely. 
    3. Do not walk on wet floors always use non-slippery shoes. 

Wound Care and Bathing: 

Wounds differ based on their location and type of surgery. Most wounds are closed however some may be left open by your surgeon. 

The wounds maybe closed by suture or staple clips. Some sutures are under the skin and they dissolve on their own, while other sutures and clips may need removal during your follow-up. Wounds may be covered with paper strips called steri-strips. These are water proof and you can shower with steri-strips in place, but do not rub them with soap and water. The steri-strips can stay on your wound for 2-3 weeks after your surgery without being changed.

There may be an additional dressing over the steri-strips which may or may not be water proof.  It is recommended to change this dressing if it gets wet or after every 3-4 days to avoid any skin irritation. 

You should ask your surgeon or your nurse before taking a shower. For most cases taking a shower is allowed unless instructed differently by your surgeon. Do not take a tub bath or use a Jacuzzi, pool or hot tub until your wounds are fully healed.

Remember to always keep your dressing dry and in place till you see your surgeon as follow up after the surgery.

Preventing blood clots:

After any surgery there is a risk to develop blood clots. These blood clots may be present as painful swellings of your legs. These clots can travel to the lungs and affect the blood oxygen levels. The risk of developing blood clots differs between patients and type of surgeries. They can be prevented by promoting blood circulation in the legs and by using blood thinner medications. 

The best way to promote blood circulation is by frequent walking and using leg pressure stockings or even leg compression devices to promote the blood flow. Your surgeon may or may not prescribe blood thinning medications depending on the type of surgery you have had. The recommended thinner medications are usually given as an injection under the skin; your doctor may want you to take these injections for a period of time even after being discharged.

Fig: Compression stockings that help avoid clots develop in your legs

Preventing blood clots:

How to take the blood thinner injections to avoid blood clots: 

 

  1. These injections are commonly given under the skin on the upper arm, the abdomen, or the thighs. 
  2. It is better to rotate the site of the injections.
  3. These injections can cause skin bruising. 
  4. To administer the injection, pinch a thick fold of your skin. Please be sure to only pinch the skin and fat underneath. Do not pinch the muscle or inject the medication in the muscle under skin. 
  5. Clean the area with an alcohol pad and insert the needle into the fat under the skin. Then release the pinched area and slowly inject the medication.
  6. Do not rub or massage the area. 
  7. The injections are pre-filled dosages. If in doubt about the dosage then please confirm the dosage with your nurse or doctor.
  8. The syringes usually have a small air bubble. Do not push this air out of the needle before injecting, it is meant to remain in the syringe at the end.
  9. Dispose the used needles in a safety container for sharp items. 
  10. Be sure to consult your surgeon before traveling.
  11. The risk for developing clots can increase when taking oral contraceptives pills. Be sure to ask your doctor when to resume these pills after surgery.

Purification and prayers after surgery:

We recommend you to complete your obligatory prayers during your stay if capable. If you need to perform ablution (Wudhu), kindly contact your nurse to assist you. If your doctor has prohibited you from washing your body or you are unable to go to the sink, you may perform tayamum using talc powder on a soft cloth. 

If you have a urinary catheter inserted or intestinal stoma bag attached to your abdomen then you can still perform purification for prayers by making ablution (Wudhu) or tayammum before every prayer.

Your nurse can help you with the Qibla direction and may help you turn your bed in that direction. However if you have tubes or monitors attached and cannot move your bed, the scholars permit you to perform the prayers in any direction. For your convenience a prayer mat and Holy Quran can be provided in the room.

Activity recommendations: 

Unless instructed differently by your surgeon, the following activity schedule is recommended:

  • You may sleep on any side you are comfortable, unless instructed differently.
  • It is recommended that you pray on a chair for 10 days. You can pray normally when you feel comfortable. Please ask your doctor what is best for you.
  • Marital relationship can be resumed after 2 weeks unless you are restricted differently by your surgeon.
  • Aerobic exercises, jogging and swimming are usually allowed after 4-5 weeks if the wounds have completely healed up.
  • Weight training and strenuous abdominal exercises must be avoided for 8 weeks.

Final tips:

  • Your surgeon will advise you whether time off work is required and we will provide you with the necessary documentation. Inform your doctor if you need one. 
  • If your child is undergoing surgery, one parent must remain with them at all times in hospital. Please arrange for siblings to be cared for at home.
  • Surgeries with local anesthesia, you may return to normal activities except those specifically mentioned by your doctor.

Thank you for choosing ALSA PAKISTAN for your surgery, we take pride in providing you the best healthcare possible!