Get Well Soon

Helping you make a speedy recovery after surgery to remove a cancer of the gullet or upper stomach

What to expect after the operation

Scar

You will have a wound around the side of your chest. Depending on the approach used, you may also have a wound on your abdomen and sometimes in the neck. These may be raised and swollen at first but should gradually settle. You may bathe and shower as normal, but avoid rubbing soap or shower gel directly onto your wound. Pat it dry with a soft towel. Do not pick any scabs that form as they are protecting the new tissue growing underneath.

Stitches

If your surgeon has used stitches or clips, then the ward staff will arrange for a district nurse from your general practitioner (GP) practice to remove these for you. This is normally done at your home 7–10 days after the operation. If you have had a chest drain, the stitches from this will also be removed by the district nurse, but may be taken out at a different time.

Dressings

Some wounds require a dressing as they can leak a little fluid. If this is the case the ward nurses will arrange for the district nurses to come and change this dressing.

Discomfort

You will experience some pain following your surgery, around the site of your scar and on the back and side of the chest, but also at the front of your chest. You may feel a tingling or burning sensation in the front of your chest or a feeling of numbness; this is perfectly normal in people recovering from any operation that involves opening the chest (each rib has a nerve running underneath from front to back and these nerves are affected to some extent every time the chest is opened). This sensation can also occur in patients having keyhole surgery in the chest. The discomfort can be managed easily with painkillers. You are unlikely to experience these symptoms until after you have been discharged, because while in hospital you will probably have pain relief delivered by an epidural. You will normally be given a week’s supply of pain relief to take home with you (this will be decided according to your specific needs in consultation with your surgeon) and you will be able to get further supplies from your GP.

It can take a few weeks for the pain to settle and you may have some pain for up to 3 months after your operation. If you are experiencing pain, it’s important that you take your prescribed analgesics to relieve the discomfort. This will make you more mobile and will reduce the risk of complications such as chest infection. When the pain settles you should wean yourself off the pain-relief medication. A small minority of patients, about 5%, can develop long-term pain in their wound, but there are methods available to treat this if it occurs.

Exercise

It is important to do your breathing and coughing exercises after the operation; walking around the ward with help, as soon as the staff allow, is also very important. These simple things will speed your recovery and prevent complications after the operation.

Other symptoms

In the first few weeks after surgery you may experience a number of gastrointestinal symptoms, but most of these will settle down as your body adapts to its new way of working. Dumping syndrome is a common problem. There are two types – early and late.

Early dumping occurs soon after eating. It happens because after the operation the contents of the stomach can be emptied rapidly into the small intestine. Over-filling of the stomach can cause this, although there are other reasons. Symptoms may include dizziness, cramping, nausea, vomiting, sweating, or feeling ‘flushed’ after eating. Diarrhoea may also follow. The symptoms can be alleviated by eating little and often, avoiding drinking with meals, or in some cases, varying the diet.

Late dumping occurs an hour or so after a meal. It is caused by excess secretion of insulin in response to the stomach contents in the small intestine. This can lower blood sugar, and as a result the patient feels weak, finds it difficult to concentrate, experiences sweating, shakiness, and a feeling of hunger. Patients who experience late dumping symptoms have found that taking a glucose tablet or another form of sugar as soon as the symptoms start is very helpful in offsetting the effects.

Diarrhoea and flatulence can also be problems, as can gastric reflux and feeling sick, but these can generally be resolved with medication or diet and will improve over time as you learn to manage them. The Oesophageal Patients Association website also offers lots of good, practical advice in this area.

Tiredness

Your body is using a lot of energy to heal itself, so you’ll feel more tired than normal – sometimes it can come upon you suddenly, but don’t feel that it’s going to be that way forever. As your physical activity levels improve, you will start to feel less tired. In the first few weeks, however, try to go to bed each afternoon for a couple of hours’ sleep; this will really help.

Feeling emotional

If you feel upset or emotional in the days and weeks after your operation, don’t worry – this is a perfectly normal reaction that many people experience.