Discharge Information following
LUNG SURGERY
If you require a copy of this information sheet in
Large Print please ask a member of staff.
This information is not to replace the discharge chat with
your nurse but to compliment it and to use as a reference
when you go home.
Discharge
When you have been told by the Doctor you are medically fit for discharge home the
following arrangements may need to be put in place before you can leave. This is
to ensure that you return home safely. These arrangements do not apply to all
patients and are adapted to individual needs.
You may require:
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To be provided with any necessary equipment, medicines and dressings and
given instructions of use
A District Nurse Referral
Transport home if you are going home by ambulance
Any other support services if necessary (e.g. social services or dietician input)
Advice regarding the Discharge Advice
Appointment to be reviewed in clinic after discharge.
Sick note
Please note if you are told you are medically fit for discharge these arrangements
may take a number of hours. The nursing staff will ensure these are put in place as
soon as possible.
If you have any concerns about your discharge please inform the nursing staff
before leaving the ward.
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Discharge home
Length of stay; you should expect to remain in hospital for 7-14 days after your
operation. This may very according to the individual, and your progress will be
assessed closely by the doctors and nurses.
Transport home; we would advise that a relative or friend accompanies you home on
discharge, wither by driving you home or by taxi. Wherever possible you should try
to arrange your own transport home. If however you are unable to do so you should
let your ward nurse know on admission and ambulance transport will be arranged to
take you home.
What happens when I go home?
Before admission please give some thought to how you will manage after discharge.
The following information may answer any questions you have. However please feel
able to discuss any concerns you have with your ward nurse during your stay.
During the first few days at home you may feel quite vulnerable, so it is an
advantage to have someone at home with you during that time. If you live alone
please discuss this with your nurse on admission. It may be necessary for
convalescence or support at home to be arranged for you by the hospital social
worker.
Wound Care
Most patients having chest surgery have a wound that will extend from just under
your shoulder blade around the side of your chest to under your armpit. The nurses
will check your wound regularly until you leave hospital. It is important to report if
there is any redness, pain or leakage from the wound, so that this can be treated
appropriately. You may have stitches in your wound or chest drain site that will need
removal 7-10 days after your operation. If you are discharged beforehand the ward
nurse will arrange for a district nurse to remove them at home. Or alternatively it
maybe more convenient to visit a walk in centre
Breathlessness
If you find that you are experiencing breathlessness, you should inform the ward
staff. The physiotherapist may show you the positions that are described below, as
they may ease it. In addition if you concentrate on breathing out slowly, this can help
to control your breathing.
Try leaning forward whilst sitting in a chair with your forearms resting on your thighs.
Try to keep upper chest and shoulders relaxed, therefore keeping the lower part of
your chest free to expand.
Medication
Prior to your discharge from hospital, you will receive a supply of the tablets which
you will need to continue to take at home. The nurse will explain the reason for
medication and when you should take it. If you have any questions relating to your
medication, then a pharmacist is available for advice. If you are unsure about when
to take your medication please ask for written instructions.
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Repeat prescriptions
Prior to your discharge you will be given a letter to give to your General Practitioner.
This letter contains a list of the medication that your General Practitioner should
continue to prescribe for you, and will also contain information about your hospital
stay. This letter needs to be taken to your GP’s surgery within a couple of days
following your discharge home. Your GP will then have up to date information about
your medication and your condition. A detailed letter will be also sent to your GP by
your surgeon.
We would advise you to contact your GP’s surgery within the first couple of days of
being home as it may be necessary for you to make an appointment to see your GP
to discuss your progress and arrange a further prescription.
Follow up Appointments
A follow up appointment will be made for you to attend clinic approximately 2-6
weeks following discharge. If you have any queries regarding your appointment
please contact your Consultant’s secretary by ringing the main switchboard on 0151
228 1616.
Medication
Frequently asked questions and the pharmacist’s response.
Q. The label says ‘Take half an hour to one hour before food’ does this mean
that I have to eat a meal an hour after taking my tablets?
A. No. In most cases it means that the medicine works better if your stomach is
empty. Take the medicine half an hour before a meal or three to four hours
afterwards. Small snacks such as biscuits do not count as meals.
Q. The label says ‘with or after food’. Should I skip my tablets if it’s not a meal
time?
A. No. Food protects the stomach from tablets which can sometimes upset it. A
glass of milk or a small amount of food such as a biscuit will protect your stomach
if it is not a mealtime.
Q. The label says ‘one tablet twice a day’ can I take both tablets together?
A. No. Some tablets don’t work for long enough to take only once a day. Unless
you have been told differently take one in the morning and one in the evening. If
the tablet will work all day then we will write ‘two tablets daily’ on the label and
you can take these tablets together.
Q. I find it hard to open childproof lids on tablet bottles. Can I have plain lids?
A. Yes. Ask your pharmacist when you hand in your prescription. Remember to
keep medicines in a safe place away from children.
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Q. I always feel sick after taking my tablets. Is there anything I can do to help
this?
A. Yes. Try taking the tablets after food. Do not do this if the label tells you to
take them before food.
Q. I find it hard to remember to take my tablets every day. Is there a good way to
help me remember?
A. Yes. Some people find that using a calendar or diary helps. Keep it with your
medicines and tick off when you have taken them. You can also purchase a
compliance aid such as a ‘dosette box’ from your pharmacy. This box has
separate compartments for you to place your medication in. These
compartments are labelled with the times of day to take your medicines. Ask
your pharmacist for details.
Q. Is it alright to drink alcohol when I am taking medicine?
A. It is usually alright to drink alcohol whilst taking medicine if:
1. The label on the bottle does not say avoid alcohol.
2. Your doctor has agreed that alcohol will not affect your illness.
3. You only have one or two drinks and do not drink to excess.
If you have any other questions about your medicines, speak to your doctor or
pharmacist.
Resuming activity at home
Most people find that it takes approximately 3 months 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.
Generally people who have had part, or all of their lung removed take longer to
recover than people having other types of lung surgery. Age is also relevant, older
people may require a longer period of convalescence than younger people.
Exercise is an important factor in your recovery following surgery.
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For the first few days, take it easy and restrict yourself to the house or garden.
After a few days, you should take a short walk on the flat gradually increasing
the distance and gradient over a period of weeks. Initially, it is advisable to
avoid going out on cold, wet or windy days.
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Your aim over the next 3 months should be to increase your activities day by
day. Introduce new activities but not all at once. You should, however get
into the habit of taking regular exercise. A lot will depend on the nature of
your surgery and your age. Exercise within your limits.
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Activities that involve carrying or lifting heavy items (shopping bags/hovering
etc) should be avoided for 6 weeks following your surgery.
You may experience some breathlessness whilst you are carrying out activities,
which is acceptable as long as it is not distressing for you. A good way to know if
you are overdoing things is to be able to talk at the same time as exercising.
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Always rest between periods of exercise. Try and get a good nights sleep. If you
notice yourself becoming easily tired, you are probable overdoing things, in which
case reduce the distance you are walking or the activities you are doing. The
amount and type of exercise which patients are able to do in the early weeks is
extremely variable. The best guidelines are to do what you can without becoming
too tired or short of breath.
A guide for the first few weeks at home
The following advice is for guidance only
First week – walk around at home as you did in hospital. You should continue with
the breathing exercise that the physiotherapist taught you. Do make sure you get
plenty of rest and do not have too many visitors.
Second week onwards - You should gradually introduce light tasks into your daily
routine, for example dusting, washing up and cooking light meals. Do not do
anything more strenuous at this stage; particularly avoid heavy lifting, pulling or
pushing as this will place a strain twisting movements of your chest, for example
walking an energetic dog. Do not lift children or grandchildren.
Four to six weeks – You can gradually introduce more demanding tasks such as
ironing, light shopping, light gardening or cleaning the car.
After eight weeks – Your wound should be healing well and therefore other tasks
such as hovering, raking leaves, driving the car and small jobs within the home may
be undertaken.
After twelve weeks – You may wish to resume or take up other activities including
cycling, fishing, walking and swimming. At first, it is better to use a heated swimming
pool and the stroke that feels most comfortable to you. If you play golf, you may
start practising you swing and hitting a few balls at this time. If you wish to play
competitive games or contact sport you should consult you General Practitioner or
Consultant surgeon.
You may feel able to do everything that you were doing before the operation.
However, a patient’s recovery is individual and in some circumstances your ‘normal’
activities may need to be adapted.
You may continue to experience some chest discomfort or skin sensitivity for a
period of time. This may be aggravated by strenuous activity especially if it has been
resumed too soon after your operation. If you are experiencing any ongoing
problems please discuss them with your GP, your Consultant Surgeon or Lung
Nurse Specialist.
Specific information once you are at home.
Arm exercises
It is important to maintain the range of movement in your shoulder following surgery
as it may be stiff. During the first few weeks after your operation you should
continue to stretch your arm above your head as you were shown in the hospital by
the Physiotherapist. You may experience a restriction to the end of the movement.
This is normal and will reduce with practice.
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These exercises should be continued for the first 4 weeks after the operation.
Constipation
Constipation can occur following any type of surgery. This is due to the effects of the
anaesthetic and also the pain control you will need to take. If necessary you will be
given laxative to take home with you. To help prevent constipation try to eat a well
balanced diet e.g. added fruit and fibre and drink plenty of fluid. Mobility also aids
the function of the gut. If you normally move your bowels on a daily basis and are
now constipated, seek advice from your GP.
Wounds
Prior to your discharge home, the ward nurse will explain to you whether you have
any stitches that require removal at home. If you do, the nurse will arrange for a
district nurse to visit you at home.
If your wound or drain sites require any dressing, the ward nurse will arrange for this
be reviewed by the district nurse once you are at home. In general the wound will be
healing without problems when you go home, although occasionally you can expect
a slight ooze from the wound which requires a simple dressing.
If, however, your wound becomes quite red or suddenly becomes more painful or
starts leaking a discoloured fluid you should consult your GP or district nurse
immediately. They can contact the hospital for advice as required.
Employment/work
It is wise to allow yourself time to make a complete physical and emotional recovery
before returning to work. At your outpatient appointment with your Consultant
Surgeon you can discuss the timing of your return to work, which will depend on the
type of work that you do. If your job is not too physically or mentally demanding, you
may be able to return to work 2 months after the operation.
If your job involves heavy manual work or is stressful, a longer period of recovery is
advised. You should allow at least 3 months following surgery before returning to
this type of employment. If it is possible you should resume your employment on a
part-time basis at first, either working shorter days or shorter weeks. You should
discuss this option with your employer.
Moods and emotions
Immediately after the operation, you may have had days when your spirits were low
and you felt depressed. These feelings are known as the ‘post-op’ blues and many
patients recovering from the operation get them. Patients can feel unusually
emotional and irritable during the first 6 weeks after the operation. This can often
happen without prior warning and you may feel tearful, anxious, very depressed or
resentful. These feelings are common after the operation and should not be a cause
for concern to you or your family. They generally resolve spontaneously.
Remember that you and your family will be affected by these feelings and it is
important that you discuss what you are experiencing.
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Family members will have a tendency to become over- protective when you first go
home. Do not resent this. Be patient with them. Remember it also took you time to
realise that you could do things for yourself. Listening to your family and informing
them of how you are feeling will ease these feelings.
If you are feeling unduly depressed or have continuing problems with loss of memory
or concentration consult your General Practitioner.
Rest, sleep and relaxation
During the first few weeks at home, you will find you tire easily, so adequate rest is
as important as exercising for your recovery. Have a rest in the afternoon for an
hour and make sure that your friends and relatives are aware of when your rest
periods are, to reduce disturbances.
If you tire during a particular activity such as climbing stairs, sit down and rest.
Try and have a good 8-10hours sleep each night. This may be difficult at first
because your normal sleeping pattern will have been disturbed. It may take you a
week or two to settle back into your normal sleeping routine. In addition, you may
find that your normal sleeping position is not comfortable in the early days after your
operation, due to wound soreness. It is important to continue taking your pain
control regularly at night to aid sleeping.
Gardening
Light gardening such as weeding may be done 4-6 weeks after discharge. Mowing
the lawn should not be considered until you are fully recovered.
Bathing
Do not be afraid to get your wounds wet. Showering or bathing will keep your wound
clean and encourage healing. However, we would advise for 6 weeks following your
surgery, you not to soak for long periods in the bath.
If you have the choice of a shower or a bath, take a shower instead of a bath for the
first 2 weeks following your surgery.
For your safety we would advise that you do not attempt to have a bath when you
are alone in the house for the first 2-3 weeks following your surgery.
If you do take a bath, please note the following;
 Empty the water out of the bath before you get out.
 Place a non-slip mat or a towel in the bath before attempting to stand up.
 If possible get assistance to get out of the bath.
Alcohol
Alcohol may be taken in moderation after discharge from hospital, but you should
ask your nurse or pharmacist for information about alcohol consumption with your
particular medication.
If you need or want to reduce your alcohol intake please discuss this with your GP.
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Smoking
To help make sure that smoking remains a past activity you may find the following
points helpful:
 Keep a list of reasons for stopping smoking and refer to it regularly.
 Contact the smoking cessation advisor who is based at The Liverpool Heart
and Chest Hospital. You can contact them on 0151 600 1455 through
hospital switch board practical help to help you stop smoking or for you to
continue not to smoke. They do offer a home visiting service.
 Find other ways to relax, e.g. talking with friends, listening to music, or take up
a new hobby.
Driving
Do not drive following discharge from hospital until you have been reviewed at your
outpatient appointment and advised by your surgeon that it is safe. As a result of the
wound and the healing process, muscular strength and general agility is reduced and
sudden movements can bring on pain. It is therefore, essential that you do not drive
a motor vehicle until the healing process is sufficiently advanced.
When driving a car or as a passenger, you are not exempt from wearing a seat belt.
Sexual activity
Many patients who have undergone thoracic surgery experience anxiety about
resuming sexual relationships. It is quite safe to have sex and/or sexual stimulation
after the operation whenever you feel ready for it. However, we generally advise you
to wait between 2 -4 weeks to allow your body and wounds time to recover.
Choose an ideal time when you feel relaxed, comfortable and in familiar
surroundings. Avoid times when you feel tired, tense or after a large meal. Do not
expect too much of each other initially. It is unlikely that you will do any damage to
the surgery, but sensible measures should be taken to avoid extensive strain on the
chest wound. Choose a position, which is comfortable and does not restrict
breathing and stress to your chest. Do not take your weight or your partner’s weight
on your arms. Do not attempt to be too energetic at first.
Holiday and flying
Now the operation is over, you may wish to plan a holiday. A restful holiday in this
country may be undertaken at any time, providing you are able to cope with the
travelling. Holidays abroad should be deferred for at least 8 weeks after the
operation. At your outpatient appointment discuss your plans with the surgeon.
Avoid strenuous holidays and extensive travelling at first. Cover the scars with
complete sunblock when sunbathing in the first 6 months. It is also important to
clarify your holiday insurance.
Dietary advice
During convalescence the food you eat plays an important part in the healing
process.
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It is not unusual for your appetite to be poor in the early weeks following surgery.
Regaining your appetite fully may be a gradual process.
You may have experience some weight loss prior to surgery. This may have
happened due to your medical condition and anxiety experienced at this time.
Any condition where breathing is difficult causes the body to use up more energy in
the effort to breathe.
Therefore it is very important that your nutrition after surgery is aimed at ensuring
you have enough to eat and also to build yourself up if you have lost weight.
If your appetite is small, aim to have five or six small meals/snacks during the day. It
is easier to eat more this way. Ensure you use full cream milk and generally low
fat/diet type foods. Enjoy a wide variety of different foods and eat more of the things
you know you like.
You may have been prescribed a high protein supplement drink as advised by the
dietician or GP, continue with these as long as your appetite remains poor or until
you have regained your lost weight.
If you have some weight to lose, do not cut down on your food intake at this stage.
After a period of three months you should be resuming your normal eating patter; it is
at this time that you should consider ‘Healthy Eating’.
However if weight loss continues to be an issue for you, please consult your GP and
disregard the following information.
Advice regarding ‘Healthy Eating’
There are three most important aspects of a healthy diet, which have been shown to
help maintain good health.
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Eating more oily fish
Oily fish contains oils known as omega-3 fatty acids. There is strong evidence to
show that these help to protect your heart. Try to eat two to three large portions
each week.
Oily fish include – sardines, mackerel, herring, kippers, tuna, trout, pilchards and
salmon. This includes canned fish as well as fresh or frozen fish.
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Eat more fruit and vegetables
Fruit and vegetables provide vitamins and minerals, which help protect us against
heart disease. Try to have at least five portions of fruit and vegetables each day.
An example of portions –
 1 apple, orange, pear or banana
 1 large slice of melon or pineapple or half a mango
 2 tablespoons of vegetables- this includes raw, cooked, frozen or canned.
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1 small bowl of salad
one glass of unsweetened fruit juice
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Eat less fat
Fat is an important part of our diet because it gives us energy and vitamins.
However eating too much fat can increase the risk of heart disease and lead to
weight gain.
How can we eat less fat?
 Grill, bake or steam food instead of frying it.
 Use skimmed or semi skimmed milk
 Spread unsaturated margarine or low fat spread thinly.
 Cut off before cooking.
 Use a small amount of oil in cooking
 Changing to a healthy diet needn’t be difficult or more expensive.
Above all it is important to enjoy your food.
Outpatient Appointment
Your surgeon will see you approximately 2-6 weeks after your operation as an
outpatient. This may be at The Liverpool Heart and Chest Hospital or at your local
hospital. This appointment may be given to you prior to your discharge or sent
through the post. Please ask your ward nurse if you are unsure about the details.
Further treatment
Occasionally patients who have undergone surgery for lung cancer, may need to be
referred to another specialist for example, an Oncologist (cancer treatment
specialist) for consideration of further treatment i.e. radiotherapy/chemotherapy. If
this is necessary your surgeon will discuss this with you.
Useful contact numbers and website addresses
There are a variety of different organisations working within the National Health
Service who provide valuable information and support for patients. Listed are a few
contact details which may be of some use to you.
Lung Nurse Specialist
If you have been diagnosed with lung cancer, the Lung Nurse specialist is available
to you and your family for support and information. You may have already met your
local nurse. However if you have not, you should be able to contact your Lung
Nurse Specialist via the switchboard at your local hospital.
If you are not able to get these details, please call the Lung Nurse Specialists, on
0151 600 1182 who will advise you of the details of your local nurse.
Discharge Advice Line – Telephone - 0151 600 1056
There is a Discharge Advice Line available at the hospital
Monday – Friday 8 am – 4pm (excluding bank holidays)
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The hospital has a Discharge Advice Line for patients, relatives and carers for
information and advice following discharge.
A member of the nursing team will either take your call, or call you back if you leave
a message with your name and telephone number. This service is available Monday
to Friday. We aim to return all calls the same or next day. Please note that calls will
not be returned after 4pm or at week-ends. For help out of these hours please
contact your GP or NHS Direct.
This advice line is available for patients, relatives and carers for information and
advice following discharge.
The Discharge Advice Line can give advice on:
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Recovery after a procedure or operation
Mobility and activity
Wound care
Medication
Driving
Stopping smoking
Healthy Eating
Alcohol Intake
Relaxation & Stress Management
If you are in need of immediate help – for example are having chest pain,
breathlessness, palpitations, dizziness, please do not hesitate to contact your
GP for assessment or go to an A&E department or ring 999.
Roy Castle Lung Foundation
A nationwide lung cancer patient support and information network is available
through the Roy Castle Lung Cancer Foundation. Services include: A free national help line that provides information on support groups in each
area. There are several across the country, telephone 0800 358 7200 to find
out about your local group.
The Liverpool lung cancer patient support group is held monthly. For further
information telephone the Lung Specialist Nurses at The Cardiothoracic
Centre on 0151 293 2312.
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Written information books are also available.
Cancer BACUP
Freephone 0808 800 1234
Provides advice and support for patients and their families following diagnosis of
cancer. A range of free publications is available.
Macmillan Cancer Support
0808 808 0000 Monday – Friday 9.00 am – 8.00 pm
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Supports and develops services for people with cancer and provides Macmillan
nurses, doctors and cancer care.
British Lung Foundation – helpline
0845 8505020 Monday – Friday 9.00 am – 8.00 pm
BLF works throughout the UK to improve the prevention, diagnosis and treatment of
all lung diseases. It can provide information and advice to patients and families
affected by any lung disease.
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The Northwest Group can be contacted on 0151 224 7778
There are many ways of finding information. One of the most common ways is
though the internet and below are some suggested websites that contain a variety of
information. If you do not have access to the Interned at home, there are many local
libraries and interned cafes that you may use.
www.roycastle.org
www.cancerguide.org
www.nhsdirect.nhs.uk
www.macmillan.org.uk
We would like to take this opportunity to wish you well in your recovery.
For further information visit;
www.lhch.nhs.uk
www.nhsdirect.nhs.uk
www.bhf.org.uk
www.dipex.org
Or contact:
The British Heart Foundation information line on 0845 070 80 70
If you require a copy of this leaflet in any other format or language please contact the
Customer Care Team on 0151 600 1517 quoting the leaflet code and the language
or format you require.
‫إذا لديك الرغبة فى الحصول على نسخة من هذه المعلومات بأي ِّ لغة أخرى أو بشكل آخر ( على سبيل المثال‬
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.‫فيها‬
如果您想索取一份以其他語文或形式（如大字體）編印成的資料傳單，請致電
0151 600 1257向我們查詢，並說明您所需要的形式和語文。
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format lub język.
Haddii aad u baahan tahay koobiga wargelintan oo luqad ama qaab kale (sida far
waaweyn) fadlan nagala soo xiriir 0151 600 1257 adiga oo noo sheegaya luqadda ama
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