Recovering from Lung Transplant Surgery
What happens after surgery?
- After surgery, you will be taken to the Intensive Care Unit (ICU) where you are closely monitored. You will be very drowsy during this time and will be sleeping most of the time.
- Special monitoring equipment will check your pulse and blood pressure every 15 minutes. Occasionally, this monitoring equipment will beep or sound an alarm. This does not necessarily mean anything is wrong. Regularly, an electrocardiogram will be done to measure your heart rhythm and rate.
- Your weight, and your intake and output of fluids will be checked frequently so your doctor can determine how well your heart and lung are functioning.
- The IV in your arm and the catheter in your neck or groin will still be in place to deliver fluids and medicines. The catheter also helps your doctor determine the pressure in your heart chambers to evaluate its function.
- You will have a tube in your throat leading to your windpipe (called an endotracheal tube). This tube is connected to a ventilator to help you breathe and receive the right amount of oxygen. At first, you might feel like you aren’t getting enough air. It takes time to get used to the machine. Try to relax and breathe with the ventilator to make it easier to breathe.
- When you are connected to the ventilator, you will not be able to talk. To communicate with your nurse, you can nod or shake your head to indicate "yes" or "no." Although this tube might be uncomfortable, it is necessary to help you breathe. As your lungs expand and when you are breathing on your own and getting the oxygen you need, you will be taken off the ventilator (usually in 1 to 2 days).
- You will have a dressing over your incision site. The nurse will check the incision frequently to detect bleeding.
- The nasogastric tube and urinary catheter will remain in place for a few days up to a week, until your bowel and urinary functions have returned to normal. If the catheter feels uncomfortable, tell your nurse so it can be adjusted.
- A chest drainage tube will remain in place for a few days to drain the fluid and blood that collect after surgery around the lungs.
Once your transplant team has determined your condition is stable, you will be transferred from the ICU to your room in the Transplant Unit. At times during your recovery, you might need to return to the ICU for specialized monitoring to ensure your best recovery.
What are the visiting hours?
The visiting hours in the ICU are different for each patient. Your Transplant Team will decide when you are well enough to see visitors and will tell your family when they are able to visit. Generally, after you’ve recovered from anesthesia, your family may see you in the ICU periodically, after checking with your nurse.
After you are transferred to your room in the Transplant Unit, the visiting hours are not strictly enforced. However, the staff recommends no more than two visitors at one time, since rest is an important part of your recovery. The Transplant Unit also requests that reasonable hours (from 9:00 a.m. to 8:00 p.m.) be observed. Children under age 6 should not visit while the patient is hospitalized. If you have any questions or concerns about visiting hours, please ask the Transplant Unit staff.
Here are some tips for making your hospital stay more comfortable:
- Bring a tape player, favorite music, books, or other things from home to make your stay more comfortable.
- Personalize your hospital room with photos of family and friends, cards, and get well wishes—whatever makes you feel comfortable.
- If nights are especially stressful, ask for special arrangements to allow your support person to stay with you. (Patients in the Children’s Hospital may always have a support person remain overnight. No special arrangements are necessary.)
- Keep a calendar of events or record your thoughts and feelings in a diary or on a tape recorder. Try to take one day at a time rather than worrying about what will happen next week.
Will I be in pain after the transplant?
As you recover and "wake up" from the anesthesia, you might experience pain and/or nausea. You also will feel some pain at your incision site.
In most cases, your pain will be managed by a patient-controlled pain pump to make you as comfortable as possible. The pain pump has a hand-held button that will allow you to deliver pain medicine (as prescribed by your doctor) directly into your IV on demand (when you decide you need it). After a few days, your discomfort should gradually decrease.
Breathing exercises and activity
A health care provider will show you how to do deep breathing exercises with an incentive spirometer. An incentive spirometer is a breathing aid to help keep your lungs clear and active while you are recovering from surgery.
You also will be asked to cough frequently. Because coughing will put pressure on your incision and might be painful, we recommend holding a pillow against your chest while you cough. Coughing helps remove secretions from your lungs to prevent infection.
It is important to change positions and move your legs and feet often during your recovery to maintain your circulation and improve your strength. The nurse will help you with these activities.
As soon as possible after surgery, your nurse will help you get out of bed and walk in the hallway. Your family and friends can walk with you when they visit. Stop and rest whenever you feel tired, but try to increase the distance you walk a little every day.
Will I have any diet restrictions after the transplant?
Initially, you will be given intravenous fluids and food through the tube in your arm.
After the tube in your throat is removed, you might only be able to eat ice chips and/or drink clear liquids. Your diet will gradually be increased to solid food over the next few days after your surgery.
A low-fat, low-sodium diet is required after transplant. If you have diabetes, you will follow the same diet you had before your surgery.
What is the daily hospital routine?
Initially, a member of the surgical team will visit you to tell you about the surgery. Every day while you are in the hospital, you can expect early morning visits, as well as periodic visits at night, from your doctors. Your transplant coordinator also will check on your progress frequently throughout the day.
The dressing over your incision will be changed, and blood samples will be taken every morning. The blood samples are tested in a laboratory, and the results indicate how well your new lung is working.
Your weight will be checked every day. Your weight reflects your fluid level and how well your kidneys are functioning.
Your urine output also will be measured daily. Once the catheter is removed, make sure you collect your urine so the nurse can record the amount.
How much you eat and drink will be recorded daily.
Every day, you will gradually increase your activity. You also will continue to learn more about your medicines and daily health care in preparation for your recovery at home.
Although you might find it difficult to be so dependent on your health care providers for your daily needs, you must remember that they are specially trained and know what type of care you need. You should be reassured that your health care providers are doing everything possible to help you regain your health.
Is it common to have trouble sleeping after surgery?
Yes. Many people complain of having trouble sleeping for some time after surgery. You might experience insomnia (an inability to sleep) because of:
- The effects of anesthesia
- Discomfort related to healing
- Unfamiliar surroundings or noisy environment
- Stress from personal concerns
- Side effects from medicine
If you cannot sleep, try these tips:
- Arrange the pillows so you can maintain a comfortable position.
- Avoid napping too much during the day. At the same time, remember to balance activity with rest during recovery.
- If you feel nervous or anxious, talk to your spouse, partner, or a trusted friend. Get your troubles off your mind.
- Listen to relaxing music.
- Practice relaxation techniques. Tense and relax your muscles. Begin with your feet and work your way up to your shoulders.
Length of stay
You can expect to stay in the hospital two to three weeks, depending on how quickly you recover from surgery and whether you develop any complications.
Remember, each patient has a different rate of recovery. You will be discharged only after your Transplant Team has determined that you have regained your strength and your health is stable.
You can expect to remain in the Cleveland area for an additional two to three weeks after discharge for close medical observation.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/15/2006...#4548