PATIENTDIARYAND DISCHARGEINFORMATION … · St. James’s Hospital Department of Cardiothoracic Surgery PATIENTDIARYAND DISCHARGEINFORMATION FORPATIENTSFOLLOWING LUNGRESECTION SEPTEMBER

St. James’s HospitalDepartment ofCardiothoracic Surgery

PATIENT DIARY ANDDISCHARGE INFORMATIONFOR PATIENTS FOLLOWING

LUNG RESECTION

SEPTEMBER 2016

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Patient Diary ............................................................................................ 1�

Operation Day ................................................................................................................... 2�Day 1 ................................................................................................................................ 2�Day 2. ............................................................................................................................... 4�Day 3 ................................................................................................................................ 6�Day 4 ................................................................................................................................ 8�Day 5 .............................................................................................................................. 10�Day of discharge ............................................................... Error! Bookmark not defined.�

Now that you’re on your way home .................................................... 14�

Getting There .................................................................................................................. 14�What happens after I go home ? ...................................................................................... 14�Rest ................................................................................................................................. 14�Bathing ........................................................................................................................... 14�Wounds ........................................................................................................................... 14�Stockings ........................................................................................................................ 15�Emotions ......................................................................................................................... 15�Physiotherapy/Exercise at home ...................................................................................... 15�

Medications ............................................................................................ 17�

Things that you should know about your medications ...................................................... 17�Side effects...................................................................................................................... 17�Painkillers ....................................................................................................................... 17�Laxatives ......................................................................................................................... 21�

Frequently asked questions ................................................................. 22�

Will I need further treatment after my surgery ? .............................................................. 22�When will I see my Surgeon again ? ................................................................................ 22�When can I return to work ? ............................................................................................ 22�When can I fly ? .............................................................................................................. 22�When can I drive ? .......................................................................................................... 22�When can I resume sexual activity ? ................................................................................ 22�

Discharge home checklist: ................................................................... 23�

Useful Contact Numbers ...................................................................... 23�

Patient Diary

It is useful to keep a diary to record your goals and progress on the road to recovery

after your operation. You are responsible for your recovery and this diary sets out

goals for you to achieve in the days following your operation. The clinical team will

guide you through this process.

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Operation Day

A nurse will escort you to the High Dependency Unit/Ward after your operation. In

the first hour after your return, the nurses are setting up the monitoring equipment,

drips and checking your painkillers. They will do a full assessment of you and will

answer any questions you may have. You will be asked how your pain control is and

will also be advised to begin deep breathing exercises.

DAY 1

Plan/Goal: Sit out of bed. Go for a walk mid-morning and afternoon with the

physiotherapist. Eat and drink normally. Achieve satisfactory pain control.

Your goal for the day:__________________________________________________

Hygiene You will be assisted to have a wash and get dressed into your pyjamas. Moving around

Today you should sit in the chair for a minimum of four hours, with rests on the bed in between as you need. You will have a PCA pump (button for the pain that you control) and/or epidural (fine tube in your back). Twice daily physiotherapy sessions after your operation will guide you in deep breathing exercises to help you recover from the anaesthetic and keep your chest clear from secretions. Eating and drinking You should try to eat and drink today unless you have been advised otherwise. Aim for at least eight cups of fluid (unless advised to restrict fluid intake) and try to eat something at each mealtime this is very important. Pain control You can continue to use your PCA and/ or epidural. You may also request additional tablets for pain relief. Your checklist to complete Deep breathing exercises and a supported cough every hour. Take a walk at least twice during the day. Sitting out of bed at least 6 hours of the day Take 2 nutritional drinks today Time 8am 9am 10am 11am 12md 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm

Breathing exercises

Walked

Sitting out of bed

TIME

BreathingExercises

Walked

Sitting outof bed

Nutritionaldrink

8am 9am 10am 11am 12md 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm


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What have I had to eat today? Breakfast ................................................................................................. Lunch ....................................................................................................... Tea Time .................................................................................................. Snacks ......................................................................................................

Pain scored as follows:

If your pain score is 4 or above let your nurse know. What is my pain score? When resting ________ When moving _________When coughing ______ Do I feel nauseated? Yes No Have I passed urine? Yes No Have I passed wind? Yes No Have I opened my bowels? Yes No Have I achieved my goals today? Yes No Why did I not achieve my goals ? ___________________________________________________________________


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DAY 2.

Plan/Goal: Sit out of bed for breakfast. Take 3 walks with physiotherapist. Eat and drink normally and take two additional nutritional drinks. Achieve satisfactory pain control. Ensure discharge plan is in place. Your goal for the day: _________________________________________________ Hygiene You will be encouraged to be more independent with your hygiene needs, but please ask a health care attendant for assistance if required. Moving around Today you should sit in the chair for a minimum of six hours with short periods of rest on the bed if needed. Remember to sit out of bed for all your meals especially breakfast. Eating and drinking

You should continue to eat and drink normally today unless advised otherwise. It is really important that you are eating all your meals and taking two supplementary nutritional drinks. Pain control When you are comfortable and considered to be ready by the team, the PCA and/or epidural will be removed and you will continue on regular tablets for pain relief. Tell the nurse at any point if you are in pain. It is important to take regular pain medication so you can walk around the ward, clear secretions, help care for yourself and eat your meals comfortably. Your checklist to complete Deep breathing exercises and a supported cough every hour. Take a walk at least three times during the day. Sitting out of bed at least 6 hours of the day Take 2 nutritional drinks today Time 8am 9am 10am 11am 12md 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm

Breathing exercises

Walked

Sitting out of bed

TIME

BreathingExercises

Walked

Sitting outof bed

Nutritionaldrink


Plan/Goal: Sit out of bed for breakfast. Take 3 walks. Eat and drink normally and taketwo additional nutritional drinks. Achieve satisfactory pain control. Ensure dischargeplan is in place.


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Pain is scored as follows: �What is my pain score?

When resting ________ When moving ________ When coughing __________ Do I feel nauseated? Yes No Have I passed urine? Yes No Have I passed wind? Yes No Have I opened my bowels? Yes No Discussed my discharge plans with my clinical team? Yes No The nurses will start to plan your discharge home today in preparation for the next few days. Planned date/day of discharge? _____________ Checked my transport arrangements for getting home on discharge? Yes No Have I achieved my goals today? Yes No Why did I not achieve my goal ? _____________________________________


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DAY 3

Plan/Goal Sit out of bed and walk for short distances on the ward independently as advised by the physiotherapist. Eat and drink normally & take two additional nutritional drinks. Achieve satisfactory pain control. Ensure discharge plan is in place Your goal for the day:__________________________________________________ Hygiene You will be encouraged to be more independent with your hygiene needs, but please ask a health care attendant for assistance if required. They can assist you to have a shower. Moving around Today you should be sitting out of bed for most of the day. You should try to either walk or sit in the chair. Resting in bed should be kept to a minimal. Remember to sit out of bed for all you meals. Eating and drinking

You should continue to eat and drink today unless advised otherwise. Take two nutritional drinks in addition to your regular diet. Pain control If you are comfortable and considered to be ready by the team the PCA and/or epidural may be removed today and you will continue on regular oral pain relief medications. Remember to tell the nurse at any point if you are in pain. It is important to take regular pain medication so you can walk around the ward, clear secretions, help care for yourself and eat your meals comfortably. Discharge The nurses will continue to plan your discharge home today in preparation for the next few days.

Your checklist to complete Deep breathing exercises and a supported cough every hour. Take a walk at least four times during the day. Sitting out of bed at least 8 hours of the day Take 2 nutritional drinks today

Time 8am 9am 10am 11am 12md 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm

Breathing exercises

Walked

Sitting out of bed

TIME

BreathingExercises

Walked

Sitting outof bed

Nutritionaldrink


Plan/Goal Sit out of bed and walk for short distances on the ward independently asadvised by the physiotherapist and nursing staff. Aim to walk more than 3 times.Eat and drink normally & take two additional nutritional drinks. Achieve satisfactorypain control. Ensure discharge plan is in place


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What have I had to eat today? Breakfast ................................................................................................. Lunch ....................................................................................................... Tea Time .................................................................................................. Snacks ...................................................................................................... Pain is scored as follows:

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What is your pain score? When resting ________ When moving ________ When coughing __________ Do I feel nauseated? Yes No Have I passed urine? Yes No Have I passed wind? Yes No Have I opened my bowels? Yes No If your bowels have not acted since your surgery please tell the nurse caring for you Discussed my discharge plans with my team? Yes No Checked my transport arrangements for getting home on discharge? Yes No Planned day/date of discharge? _______________ Have / achieved my goals today? Yes No Why did I not achieve my goals ? _____________________________________ Note: We are here to support you through your recovery .Your clinical team will be able to explain things to you and answer any questions that you or your family have. Don’t be surprised today or tomorrow if you feel a little down, most patient experience this and is normal. You mood will improve as you work through you goals and you start to improve and get ready for discharge.


DAY 4

Plan/Goal: Sitting out of bed and walking independently at least 4 times today. Eat and drink normally. Take two additional nutritional drinks. Achieve good pain control. Ensure discharge plan is in place. Your goal for the day: _________________________________________________ Hygiene You will be encouraged to be more independent with your hygiene needs, but please ask a health care attendant for assistance if required. You can shower today if you feel up to it. Moving around Today you should be sitting out of bed for most of the day. Try to rest in the chair between exercises. Remember to sit out of bed for all you meals. Eating and drinking

You should continue to eat and drink today unless advised otherwise. Take two nutritional drinks in addition to your regular meals. Discharge

The team will continue to plan your discharge home today in preparation for the next few days. Pain control If not already removed, the PCA will be considered for removal by the team today. Remember the aim is to be pain free so that you can walk around the ward, clear secretions, help care for yourself and eat your meals comfortably. Your checklist to complete Deep breathing exercises and a supported cough every hour. Take a walk at least four times during the day. Sitting out of bed at least 8 hours of the day Take 2 nutritional drinks today


Breathing exercises

Walked

Sitting out of bed

TIME

BreathingExercises

Walked

Sitting outof bed

Nutritionaldrink


Plan/Goal: Sitting out of bed and walking independently at least 6 times today. Eatand drink normally. Take two additional nutritional drinks. Achieve good pain control.Ensure discharge plan is in place.

Deep breathing exercises and a supported cough every hour.Take a walk at least six times during the day.Sitting out of bed at least 8 hours of the dayTake 2 nutritional drinks today




Pain is scored as follows: �

What is your pain score? When resting ________ When moving ________ When coughing __________ Do I feel nauseated? Yes No Have I passed urine? Yes No Have I passed wind? Yes No Have I opened my bowels? Yes No If your bowels have not acted since your operation please tell your nurse Discussed my discharge plans with my nurse? Yes No Checked my transport arrangements for getting home on discharge? Yes No Planned day /date of discharge? __________________ Have / achieved my goals today? Yes No Why have I not achieved my goals ? ___________________________________________________________________


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DAY 5

Plan/Goal: Sitting out of bed and walking independently at least 4 times today. Complete stairs assessment with the physiotherapist. Eat and drink normally. Good pain control. Discharge plan is in place. Your goal for the day:__________________________________________________ Hygiene You will be encouraged to be independent with your hygiene needs, but please ask a health care attendant for assistance showering if required. Moving around Today you should be sitting out of bed for most of the day. Remember to sit out of bed for all you meals. You will do the stairs assessment with the physiotherapist. Eating and drinking You should continue to eat and drink today unless advised otherwise. Take two nutritional drinks in addition to your regular meals. Discharge The clinical team will continue to plan your discharge home today in preparation for the next few days. I have completed a stairs assessment with the physiotherapy team. If so sign the discharge checklist.

Your checklist to complete Deep breathing exercises and a supported cough every hour. Take a walk at least four times during the day. Sitting out of bed at least 8 hours of the day Take 2 nutritional drinks today


Breathing exercises

Walked

Sitting out of bed

If you have completed the stairs assesment with the physiotherapist, sign the discharge checklist.

bed

If you have completed the stairs assesment with the physiotherapist, sign the discharge checklist.

TIME

BreathingExercises

Walked

Sitting outof bed

Nutritionaldrink



Plan/Goal: Sitting out of bed and walking independently at least 6 times today.Complete stairs assessment with the physiotherapist. Eat and drink normally. Goodpain control. Discharge plan is in place.


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Pain is scored as follows:

What is your pain score? When resting ________ When moving ________ When coughing __________ Do I feel nauseated? Yes No Have I passed urine? Yes No Have I passed wind? Yes No Have I opened my bowels? Yes No Discussed my discharge plans with my nurse? Yes No Checked my transport arrangements for getting home on discharge? Yes No Planned day / date of discharge? __________________ I have completed a stairs assessment with the physiotherapy team Yes No Have / achieved my goals today? Yes No Why did I not achieve my goals ?

___________________________________________________________________


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DAY OF DISCHARGE

Hygiene At this stage you should be independent with your hygiene needs, but please ask a health care attendant for assistance if required. Moving around Today you should be sitting out of bed for most of the day. Eating and drinking You should continue to eat and drink normally today. Take two nutritional drinks in addition to your regular meals. Your checklist to complete Deep breathing exercises and a supported cough every hour. Take a walk at least four times during the day. Sitting out of bed at least 8 hours of the day Take 2 nutritional drinks today


Breathing exercises

Walked

Sitting out of bed

What have you had to eat today? Breakfast ................................................................................................. Lunch ...................................................................................................... Tea Time ................................................................................................. Snacks ......................................................................................................

TIME

BreathingExercises

Walked

Sitting outof bed

Nutritionaldrink




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Pain is scored as follows:

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What is my pain score? When resting _____ When moving ______ On coughing &deep breathing ________ Do I feel nauseated? Yes No Have I discussed my discharge plans with my team? Yes No Checked my transport arrangements for getting home on discharge? Yes No Have I read the ‘Now your on your way home’ section of the booklet? Yes No Have I completed the discharge home checklist ? Yes No

What is my pain score?

When resting _____ When moving ______ On coughing &deep breathing ________

Do I feel nauseated? Yes No

Have I discussed my discharge plans with my team? Yes No

Checked my transport arrangements for getting home on discharge? Yes No

Have I read the ‘Now your on you’re way home’ section of the booklet? Yes No

Have I completed the discharge home checklist ? Yes No


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Now that you’re on your way home

Getting There

It is not necessary to go home in an ambulance, however, you are not permitted to

drive yourself home from hospital. Organise a lift home a few days before your

discharge. If you are travelling a long distance you may need to stop during the trip

to stretch your legs.

What happens after I go home ?

Make arrangements that your first day home is restful. It is usually quite exciting to

be going home but it can be quite tiring so plan plenty of rest.

Most people find that it takes approximately 6 weeks after the operation for them to

make a full recovery. Obviously there is considerable variation depending on how fit

you were before your operation and the type of operation performed. The best

guideline is to do what you can without becoming too tired or short of breath.

Rest

It is recommended that you get at least 8-10 hours sleep per night. Sleep

disturbance is not uncommon following hospitalisation and surgery, but it should

resolve a few days after returning home. In the first few weeks you may feel that an

hours rest is needed in the afternoon. Get as much rest as you need in whatever

way suits you best. You may prefer to lie on the couch rather than rest in bed.

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Bathing

You may shower or bath daily. The first time you bath it may be advisable to have

someone nearby in case you have any difficulty getting in or out of the bath. Do not

use very hot water. You should wash your wound gently, do not scrub it. Run the

water over your wound, do not rub soap in to the wound. Dry by patting with a towel.

If you feel light headed or dizzy sit down.

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Wounds

It is normal for your wound to be sore, itchy and numb for the first few weeks after

surgery. You will get a prescription for pain killers and instructions on when to take

them. This should help control the wound pain.

It is not necessary to go home in an ambulance, however, you are not permitted todrive yourself home from hospital. Organise a lift home a few days before yourdischarge. If you are travelling a long distance you may need to stop during the trip tostretch your legs. You will be ready for discharge from 11am and may be moved to thedischarge lounge that morning.

Now that you’re on your way home


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When you return home following your surgery you may receive a visit from a public

health nurse who will check your wounds. In general the wounds will be healing

without problems by the time you go home. Occasionally there may be a slight

discharge from the wound which requires a simple dressing, if this is the case the

public health nurse will attend to the wound as needed. If you have stitches where

your chest drains were, a public health nurse or your GP will remove them on the

appropriate day.

Following discharge from hospital if there is any redness, pain or leakage from the

wound, it is important to report it to your GP so that this can be treated quickly and

appropriately.

Stockings

You will have been given special stockings to help improve circulation and prevent

blood clots while in hospital. You will not require them at home.

Emotions

It is normal to feel a change of mood following your surgery. Some of the most

common feelings are anxiety and depression. These feelings can present

themselves in many ways: altered sleeping patterns, lack of concentration, irritability,

inability to relax. You can discuss these feelings with any member of the team, the

lung cancer coordinators or your GP�

Physiotherapy/Exercise at home

You will have been given an incentive spirometer following your operation. You

should continue to use this when you return home. It encourages you to take deep

breaths.

Exercise is encouraged to prevent chest infection, stiffness, bedsores and

constipation. You may experience some breathlessness whilst you are carrying out

activities. This is acceptable as long as it is not distressing for you.

Going up and down the stairs does require more energy than walking, so it is

important to take the stairs slowly. If your bathroom or bedroom is located upstairs

there is no need to make alternative arrangements, just take it slowly. If you become

dizzy, light headed or breathless sit down and rest.

When exercising, you should still be able to talk comfortably. If you cannot, you may

be overdoing it. You are advised to walk most days�and increase your exercise

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Exercise is encouraged to prevent chest infection, stiffness, bedsores and

constipation. You may experience some breathlessness whilst you are carrying out

activities. This is acceptable as long as it is not distressing for you.

Going up and down the stairs does require more energy than walking, so it is

important to take the stairs slowly. If your bathroom or bedroom is located upstairs

there is no need to make alternative arrangements, just take it slowly. If you become

dizzy, light headed or breathless sit down and rest.

When exercising, you should still be able to talk comfortably. If you cannot, you may

be overdoing it. You are advised to walk most days�and increase your exercise

Physiotherapy/Exercise at home


gradually. You should aim to make walking part of your daily routine. A guide to

walking is shown below. TIMES WRITTEN ARE GUIDELINES ONLY

Week 1: 5-10 minutes of brisk walking daily






Do not exercise if you

Feel overtired, unwell or very breathless. Have chest pain or palpitations

Feel light-headed, dizzy or faint. Have a viral infection or fever

Most people find that it takes approximately 3 months to make a full

recovery. Obviously there is considerable variation depending on how fit you were

before your operation and the type of operation performed.

Shoulder Exercises

It is important to try to maintain good posture at all times. This means you should

gently pull your shoulders back and sit/stand up straight. You may feel your shoulder

is tight and it is important to exercise your shoulders regularly. Remember your

shoulder joint should work normally after the surgery. Here are two simple exercises

you should practice daily.

1 - Sit or stand. Lift your arm out to the side. Repeat 10 times

2 - Sit or stand. Lift your arm up over your head. Repeat 10 times

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Do not exercise if you

Shoulder exercises

gradually. You should aim to make walking part of your daily routine. A Guide to walkingis shown below. You should try to exercise or walk on more than 5 days of the week formore than 30 minutes. You should be somewhat out of breath.TIMES WRITTEN ARE GUIDELINES ONLY.







Do not exercise if you� Feel overtired, unwell or very breathless. � Have chest pain or palpitations

� Feel light-headed, dizzy or faint. � Have a viral infection or fever

� Most people find that it takes approximately 3 months to make a full recovery. Obviouslythere is considerable variation depending on how fit you were before your operation andthe type of operation performed.


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Medications

Things that you should know about your medications

Whatever medications you take it is important to know the following:

The name of the medicine, why you are taking it, When and how to take it, What side

effects might be expected.

You will find more details of specific medications in the following pages. Please read

the information carefully and ask if you do not understand anything or if something

requires clarification. Please note that many different manufacturers make

medicines, and will give their medicines a brand name. Brand names may be

recognised in this booklet by the symbol ®.

Side effects

All medicines can cause side effects. Usually these only affect a small number of

people. Talk to your doctor or pharmacist if you develop any unusual symptoms or

find any side effects troublesome. Do not stop, decrease or increase the amount of

medication without your doctor’s advice.

Painkillers

It takes about 4-6 weeks for your wound to completely heal. In this time aches and

pains can be expected. If pain is not controlled by the medication prescribed on

discharge, please contact your GP. Many of the painkillers you will be prescribed on

discharge can cause constipation, therefore, it is important to take laxatives as

prescribed with your painkillers�

Paracetamol

Common Preparations: Paralief®, Panadol®.

When and how do I take it?

The usual dose is TWO tablets up to FOUR times daily as needed. Do not take more

frequently than every four hours and do not take more than eight tablets in twenty

four hours.

Is there anything else I should know?

Do not take any other preparations containing paracetamol at the same time eg.

Lemsip®, Solpadeine®. If you are unsure whether a preparation contains

paracetamol, ask your pharmacist.

The name of the medicine, why you are taking it, when and how to take it, what sideeffects might be expected.

Common Preparations:

The usual dose is TWO tablets up to FOUR times daily as needed. Do not take morefrequently than every four hours and do not take more than eight tablets in twentyfour hours.


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Dihydrocodeine

Common Preparations: DF118® tablets 30mg

How do I take it?

The usual dose is one tablet every four to six hours as required for strong pain (or as

directed by your doctor). It can be taken in addition to paracetamol.

Are there any side effects that I should know about?

You may experience some side effects such as nausea, vomiting, constipation,

headache, dry mouth, confusion, dizziness or drowsiness. If affected do not drive or

operate machinery.


Do not take alcohol when taking these tablets – this may cause increased

drowsiness.

Oxycodone

OxyContin® tablets and OxyNorm® capsules both contain the drug oxycodone. This

drug belongs to a group of medicines called opioids, which are prescribed for the

relief of severe pain.

OxyContin® prolonged release tablets

The prolonged (slow) release tablets are designed to provide pain relief over a

twelve hour period. This means that they are only taken twice daily.

How, when & how often do I take it?

The tablets should be swallowed whole with a glass of water. Do not chew, crush or

dissolve them – this could cause serious side effects. The label on your medicine will

tell you how many tablets to take. Doses should be taken every twelve hours eg. if

you take a dose at ten o’clock in the morning, the next dose should be taken at 10

o’clock at night.


Constipation – a laxative will usually be prescribed to overcome this. Other common

side effects include nausea, drowsiness, dizziness, headache, itchy skin, dry mouth

and confusion.

Oxycodone

OxyContin® tablets and OxyNorm® capsules both contain the drug oxycodone. This

drug belongs to a group of medicines called opioids, which are prescribed for the

relief of severe pain.

OxyContin® prolonged release tablets

The prolonged (slow) release tablets are designed to provide pain relief over a

twelve hour period. This means that they are only taken twice daily.


The tablets should be swallowed whole with a glass of water. Do not chew, crush or

dissolve them – this could cause serious side effects. The label on your medicine will

tell you how many tablets to take. Doses should be taken every twelve hours eg. if

you take a dose at ten o’clock in the morning, the next dose should be taken at 10

o’clock at night.


Constipation – a laxative will usually be prescribed to overcome this. Other common

side effects include nausea, drowsiness, dizziness, headache, itchy skin, dry mouth

and confusion.


It is recommended not to drink alcohol whilst taking OxyContin® tablets. Your dosage

may be gradually reduced after you leave hospital – follow the instructions of your

doctor and pharmacist.


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It is recommended not to drink alcohol whilst taking OxyContin® tablets. Your dosage

may be gradually reduced after you leave hospital – follow the instructions of your

doctor and pharmacist.

OxyNorm® capsules

These capsules are designed to provide fast or immediate relief of severe pain.


The capsules should be swallowed whole with a glass of water. The label on your

medicine will tell you how many capsules to take and how often. Doses are usually

taken every four to six hours, but only when needed for strong pain.


Common side effects include constipation, nausea, drowsiness, dizziness,

headache, itchy skin, dry mouth and confusion.


It is recommended not to drink alcohol whilst taking OxyNorm®.

Lidocaine 5% w/w plaster

Common Preparations: Versatis® 5% medicated plaster

This is a plaster which contains lidocaine, a local anaesthetic, which works by

numbing the nerves in the area to which it is applied.

When and how do I use the plasters?

The plasters should be worn for twelve hours only out of twenty four, so that you

have a twelve hour period with no plaster. For example, if you have more pain during

the day, then wear from 8am until 8pm. Apply to the painful area(s), following the

directions in the pack. The plaster may be cut into smaller pieces to fit if required.


Skin irritation around the application site is the most common side effect. If irritation

or a burning sensation occurs, remove the plaster.


After first opening the sachet of five plasters, they should be used within 14 days.

Ensure the outer sachet is kept sealed to avoid the plasters drying out. Used plasters

should be folded in half with the sticky sides together and disposed of out of the

reach of children.

OxyNorm® capsules

These capsules are designed to provide fast or immediate relief of severe pain.


The capsules should be swallowed whole with a glass of water. The label on your

medicine will tell you how many capsules to take and how often. Doses are usually

taken every four to six hours, but only when needed for strong pain.


Common side effects include constipation, nausea, drowsiness, dizziness,

headache, itchy skin, dry mouth and confusion.


It is recommended not to drink alcohol whilst taking OxyNorm®.

Lidocaine 5% w/w plaster

Common Preparations: Versatis® 5% medicated plaster

This is a plaster which contains lidocaine, a local anaesthetic, which works by

numbing the nerves in the area to which it is applied.

When and how do I use the plasters?

The plasters should be worn for twelve hours only out of twenty four, so that you

have a twelve hour period with no plaster. For example, if you have more pain during

the day, then wear from 8am until 8pm. Apply to the painful area(s), following the

directions in the pack. The plaster may be cut into smaller pieces to fit if required.


Skin irritation around the application site is the most common side effect. If irritation

or a burning sensation occurs, remove the plaster.


After first opening the sachet of five plasters, they should be used within 14 days.

Ensure the outer sachet is kept sealed to avoid the plasters drying out. Used plasters

should be folded in half with the sticky sides together and disposed of out of the

reach of children.


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Diclofenac

Common Preparations: Difene®, Voltarol®

This is used to reduce pain or inflammation after your surgery.

When and how do I take it?

Swallow capsules whole, with or after food, with a glass of water or milk. Follow the

dosage directions on the medicine label.


If you suffer any stomach pain, heartburn or indigestion, please report this to your

doctor.

Pregabalin

Common Preparations: Lyrica®

This can be used to treat pain caused by damage to nerves.

How and when do I take it?

The capsules should be swallowed whole with water. The dose will have been

decided by your doctor and your pharmacist will have labelled your medicine with the

directions of how many to take and how often.


Pregabalin is associated with dizziness and sleepiness. This may be increased if you

are also taking OxyContin® or OxyNorm®. If you experience any changes in your

vision, please report this to your doctor straight away.


It is advised not to drink alcohol while taking pregabalin. As it may cause dizziness,

sleepiness and decreased concentration, you should not drive or operate machinery

if affected.

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Pregabalin

Common Preparations: Lyrica®


How and when do I take it?

The capsules should be swallowed whole with water. The dose will have been

decided by your doctor and your pharmacist will have labelled your medicine with the

directions of how many to take and how often.


Pregabalin is associated with dizziness and sleepiness. This may be increased if you

are also taking OxyContin® or OxyNorm®. If you experience any changes in your

vision, please report this to your doctor straight away.


It is advised not to drink alcohol while taking pregabalin. As it may cause dizziness,

sleepiness and decreased concentration, you should not drive or operate machinery

if affected.

�GabapentinCommon preparations: Neurontin®


How and when do I take it?The capsules should be swallowed with plenty of water. The dose will have been decidedby your doctor and your pharmacist will have labelled your medicine with the directionsof how many to take and how often.

Are there any side effects that I should know about?Gabapentin is associated with dizziness and sleepiness. This may be increased if you arealso taking OxyContin® or OxyNorm®.

Is there anything else I should know?As gabapentin may cause dizziness and sleepiness, you should not drive, operatemachinery or take part in other hazardous activities if affected.


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Laxatives

Senokot® Senna

When & how often do I take it?

The usual dose is two tablets, taken together at night. The tablets normally act within

eight to twelve hours.


If symptoms of constipation continue, please consult your doctor.

Lactulose

Common Preparations: Laxose®, Duphalac®

How do I take it?

The syrup can be taken directly from a spoon or measuring cup, or it can be mixed

with water or fruit juice. It is usually taken twice or three times daily. Taking a glass of

water at the same time will help this medicine to work. If symptoms of constipation

continue, please consult your doctor.

Disclaimer

The information about medications in this booklet is not exhaustive. Ask you doctor

or pharmacist for advice or see the patient information leaflets in the medicine boxes.

SennaCommon preparation: Senokot®

How do I take it?The syrup can be taken directly from a spoon or measuring cup, or it can be mixedwith water or fruit juice. It is usually taken twice. Taking a glass of water at the same timewill help this medicine to work. If symptoms of constipation continue, please consult yourdoctor.


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Frequently asked questions

Will I need further treatment after my surgery ?

Following surgery you may need to be referred to a medical cancer specialist (an oncologist)

for consideration for further treatment such as chemotherapy or radiotherapy. The need for

further treatment will depend on the type of cancer you have and the extent of the disease.

The decision regarding the need for further treatment is based on investigations carried out

on the piece of lung that was removed. Once available the results of these tests will be

discussed by your surgeon, an oncologist and a respiratory physician. A decision regarding

the need for further treatment is then made. This process can take up to two weeks to

complete, therefore, it is likely that you will be discharged before the decision is made. If this

is the case, you will be contacted at home by either the lung cancer coordinator or a Doctor

regarding a follow up plan.

When will I see my Surgeon again ?

Your surgeon will see you in the Out Patients Department approximately 6-8 weeks after

your operation. This appointment may be given to you prior to your discharge or sent by

post.

When can I return to work ?

Returning to work will be assessed on an individual basis, it will depend on the type of work

you do, the type of surgery you have had done and also on the possible need for further

treatment following your operation. You will definitely not return to work before the six week

follow up out patients appointment with your surgeon. If you have any doubts or questions

about returning to work discuss them with the team.

When can I fly ?

In general patients are advised that they cannot fly for at least six weeks following lung

resection surgery. However, ask your Doctor as there are sometimes exceptions to this and

advice will be given on a case by case basis.

When can I drive ?

You cannot drive for six weeks following your operation.

When can I resume sexual activity ?

Most people, both partners, tend to worry about having sex after an operation. Everyone

worries that having sex may damage the wound. Provided you feel relaxed, rested and

ready for sex, sexual activity can be resumed whenever you feel confident about it.


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Discharge home checklist:

I have a copy of my discharge letter for my GP

I have my discharge prescription and am happy with the instructions for taking my medications

My wound has been checked by a nurse today, and if required I have been referred to the public health nurse.I have been advised about caring for my wound at home. Chest drain site stitch to be removed by GP/Public health Nurse on…………..All drips have been removed from my arms

I am able to mobilise around the ward independently and have completed walking up stairs.

I am able to pass urine and my bowels have opened.

I am comfortable and my pain is controlled.

I am able to eat and drink normally.

I have arranged transport home.

All my valuables have been returned by security

I have the contact phone number for the lung cancer coordinator.

Useful Contact Numbers

St James’s Hospital Phone 01- 4103000

Lung Cancer Coordinators Bleep 101 via hospital switch

Cardiothoracic Advanced Nurse Practitioners Phone 01- 4103338

Physiotherapist Phone 01 - 4162503

Robert Adams Ward Phone 01- 4162088

Keith Shaw Ward Phone 01- 4103389

Private 2 Phone 01- 4103211

Mr Vincent Young’s Secretary Phone 01- 4103534

Mr Ronan Ryan’s Secretary Phone 01- 4162323


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Charitable Donations St. James’s Hospital Thoracic Service provides a state-funded public service but, now more

than ever, relies on funding over and above that provided by government to ensure patients

of the hospital receive the best possible care.

Donations received by the thoracic service are used to purchase equipment and improve

patient comfort. To date, money collected from fundraising and donations has been used to

purchase portable chest drain suction units, incentive spirometers and also a active &

passive exercise machine for post operative physiotherapy.

Individual or corporate donations are both welcomed and appreciated. Donations to and

fundraising for the service is managed through the St. James’s Hospital Foundation, a

limited company governed by a voluntary Board of Directors.

Donations can also be made by cheque, draft or postal order made payable to St James’s

Hospital Foundation/thoracic fund and posted to the Advanced Nurse Practitioners in Keith

Shaw Ward, St James’s Hospital.

If you would like to make a donation by electronic transfer, please contact the foundation

office at [email protected] or 01-428 4086.


Documents

PATIENTDIARYAND DISCHARGEINFORMATION … · St. James’s Hospital Department of Cardiothoracic Surgery PATIENTDIARYAND DISCHARGEINFORMATION FORPATIENTSFOLLOWING LUNGRESECTION SEPTEMBER