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Gynecologic Oncology

Post-Operative Instructions for Major Surgery

These general guidelines and instructions have been found by Dr. Doherty in over three decades of surgical experience to be the most effective ways to avoid surgical complications and to enhance your surgical recovery. Please review them thoroughly, so that your recovery may be as trouble-free as possible.

Pain

Please consider the instructions on the label of your pain medication prescription as a starting point…adjust your intake upward or downward in a stepwise fashion as needed. Although these medications are usually narcotics, addiction has never been shown to occur if these pills are taken for pain. If taken for reasons other than pain, addiction is common.

Common side effects are constipation, disorientation, drowsiness, bad dreams, and startling awake from deep sleep. Do not take them and drive, operate machinery, or make important decisions. Safeguard these medications from theft, misuse, and from children. Transition to ibuprofen or aspirin when you feel able to do so. Do not hesitate to obtain a prescription refill from the office if needed and not authorized upon your original prescription.


Incision Care

Please wash your incision daily with bar soap (not liquid soap) and water until Steri-Strips are applied. There is no restriction on tub bathing or swimming. A small amount of redness is normal; however if it is increasing, or if pus is seen, come to the office for your incision to be examined. An incision may commonly exude clear, yellow, pink, or even bloody fluid. This does not need any attention other than absorbing the fluids and washing the incision regularly. You might not wish to wear your best clothes until skin edges have completely sealed together and incisional discharge has stopped.

If you have surgical staples, do not worry if one or two fall out. Generally, they should be removed in the office 7-14 days after discharge from the hospital. An abdominal binder is not necessary, though it might increase comfort in the case of larger incisions. Incisions may appear crooked, lumpy, or uneven and will usually even out as surgical swelling resolves over one or two months. In general, do not apply ointments, peroxide, or antibiotics. If you are concerned about reducing the scar, speak with the doctor about the use of Mederma, Scarinex, or Kelo-Cote, which may begin after Steri-Strips are no longer applied.


Nausea

Nausea is common after major surgery. It nearly always resolves as the intestines begin to function normally again and as pain medication use lessens. If you are vomiting, call or come in to the office. If your nausea is mild or moderate, reduce your oral intake temporarily to liquids and very soft foods, increase the number of meals and make them smaller, and call the office if you would like a medication prescribed for nausea. The over-the-counter medication Emetrol (or its generic equivalents) are often effective for mild postoperative nausea.


Diet

Please resume your normal diet upon leaving the hospital. You might avoid carbonated beverages until your bowels are back to normal, to avoid “gas pains.” Constipation is common and severe constipation should be avoided. You should not go more than 48 hours without a bowel movement. Unfortunately, many pain medications contribute to constipation, but do not avoid them. Instead, temporarily increase your fluid intake if you are not nauseated, and rely upon over-the-counter treatments to treat constipation if it occurs.

Milk of magnesia and stool softeners are the best tolerated laxatives in the postoperative period and should be relied upon liberally. Many patients tell us that bulk laxatives (Metamucil, psyllium, etc.) make them feel too full and even nauseated in the early postoperative period. Avoid cathartics such as Dulcolax in the early postoperative period as they will most likely INCREASE your discomfort.


Medications

Please resume all of your pre-surgical prescription and nonprescription medications at the exact same dose and frequency unless specifically advised otherwise. Over-the-counter medications are generally safe in this period.


Activity

One of the most important ways to prevent postoperative pneumonias and abnormal blood clotting is to resume your normal activities at the earliest opportunity. Please take enough pain medication to accomplish this. Also be aware that many well- meaning family members and acquaintances will advise you to rest. Resting actually predisposes you to pneumonia and abnormal blood clots! Though it is common to feel tired after surgery, it remains important to be active. Strenuous activity does not have to be avoided unless you are specifically told so by the doctor. Do not drive again until you have had at least three days with no experience of pain whatsoever. Do not resume vaginal intercourse until you are specifically released to do so. Doing so too early may cause a very serious surgical emergency called evisceration.

There is no restriction on travel as a passenger. You may freely vacation, visit family, and travel long distances.


Next Appointment

It is most important that you are seen in the office soon after major surgery. If you do not have a confirmed appointment by the time you are discharged from the hospital, please call the office that day and request a postoperative appointment. Our answering service answers 24/7/365 for your convenience with urgencies. Do not hesitate to call in the postoperative period with fever (temperature greater than 101 degrees F), worsening pain, increasing abdominal girth, vomiting that does not subside, new difficulty breathing, new pain upon urination, uneven swelling in your legs, pus from your incision, progressive incisional bruising, severe diarrhea, severe constipation, moderate or severe disorientation, or bleeding from the vaginal area greater than previous menstrual periods. If you feel deathly ill, however, do not delay in calling 911 instead of the office.

For prescription refill requests, please contact us during business hours.

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