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Post Operative Instructions for Abdominal Surgery

Once the surgery is over, you play a large role in your own recovery. Complications from immobility after surgery can include pneumonia, blood clots, and prolonged ileus (intestinal immobility). You will be expected to take an active role in your care by doing the following:

1. Coughing and Deep Breathing Exercises

Pain from the incision along with lying in bed will prevent you from taking deep breaths and expanding your lungs completely. By coughing and deep breathing, you can help to prevent post operative pulmonary complications such as post operative pneumonia

You will be given a tool called an incentive spirometer which will help you do this. The spirometer has a mouth piece which you place in your mouth and then inhale as if you were sucking on a straw. This should be done in one long deep breath and it should be repeated 10 times every hour.

Coughing is important to rid you lungs of any fluid accumulation. The correct way to do it is to take a deep breath and cough on the exhale. Holding a pillow or you hands over your incision for support will help decrease the discomfort while coughing.

2. Resume activity

It is very important to get moving again after surgery. Abdominal surgery causes normal peristalsis (activity) in your intestine to slow down or stop. Getting up and moving around will help your intestinal function to return to normal. You will not be allowed to eat until this activity resumes. Pain medication also slows down the normal peristalsis as well. I t is important to realize that while we want you to be comfortable to walk, the more pain medication you take the slower your recovery will be. One thing to consider is that if the pain is right at the incision, then pain medication may help, however, if the pain is all over your abdomen, then there is a good chance that you are experiencing gas pain and pain medication will make it worse. The best thing for gas pain is walking as this will help you pass the gas rectally. Activity will also help to prevent blood clots.

3. Diet

You will not be allowed to eat anything until we are certain that peristalsis has returned. If you pass stool or gas, it is important that you let us know. We will also listen to your abdomen for bowel sounds to be able to assess this. When we have determined that it is ok for you to take anything orally, you will be started on clear liquids. This means small sips; no more than 2 ounces at a time. It is best to eat and drink while sitting up and to walk afterward. If you eat or drink too much before your body is ready you may wind up vomiting and this will set your recovery period back. You will gradually return to a low residue diet. Chicken, fish, pasta and rice are all low residue foods. Low residue is important because many patients experience looser, more frequent stools to start with. As your bowel movements return to normal and you start to feel better you will gradually incorporate cooked fruits and vegetables once you get home and then raw fruits much later in your recovery.

4. Restrictions

No heavy lifting; nothing heavier than a gallon of milk (8.8lbs). You can walk as much as you want, you can even walk on a treadmill. No weight lifting.
Driving should wait until after we evaluate you during the first post operative office visit.

You may shower, but you may not soak in a tub or go swimming.

5. Follow up

Call our office to schedule an appointment with the Nurse practitioner 7-10 days after you are discharged.

When you go home you need to check you temperature daily with a thermometer. Call our office if it is above 101.

It is important that you let us know if you are having any problems. If you suddenly need to start to take pain medication, when you had not been using any in the hospital, we need to know. If you have nausea, vomiting are constipated or have diarrhea, you need to let us know. If you are not sure if you are having a problem, please call the office to speak to someone.