Thoracotomy

WHAT YOU SHOULD KNOW:

  • A thoracotomy is a surgery to repair any damage to the blood vessels and organs inside your chest. These organs may include your esophagus (food passageway), heart, lungs, and trachea (windpipe). A thoracotomy is also done to remove a lung tumor (lump) or an abscess (infection with pus). A thoracotomy may also be done to remove air or blood trapped inside your chest. During a thoracotomy, a large incision (cut) is made to open your chest.

  • You may also need a thoracotomy in an emergency to save your life. Emergencies may include penetrating (cutting) or blunt (not sharp) chest injuries from accidents, stab wounds, or gunshot wounds. Your caregiver will look for the damaged organs and repair them. Having a thoracotomy may resolve and prevent further organ damage inside your chest. A thoracotomy may resolve an infection, remove tumor tissues, and may save your life.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.

  • Pain medicines: These medicines may be given to help you with post-surgery pain. They may also be given if you have post-thoracotomy pain syndrome (PTPS). PTPS is when you feel pain at your surgery site, lasting for two or more months after your surgery. You may feel pain when your chest expands (gets big) while you breathe. This pain may cause you to have trouble breathing. You may be given any of the following:

    • Acetaminophen: This medicine is used to decrease pain and lower a high body temperature (fever). Taking too much acetaminophen can hurt your liver. Read labels so that you know the active ingredients in each medicine that you take. Talk to your caregiver before taking more than one medicine that contains acetaminophen. Ask your caregiver before taking over-the-counter medicine if you are also taking pain medicine prescribed (ordered) for you.

    • NSAIDs: Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.

    • Pain medicine: You may need medicine to take away or decrease pain.

      • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

      • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

    • Patient controlled analgesia:

      • You may get pain medicine from a special pump. You can receive the pain medicine through an IV or an epidural line. This is called patient controlled analgesia (PCA) or patient controlled epidural analgesia (PCEA). Your caregivers set up the PCA pump to give you small amounts of pain medicine. The PCA pump has a cord coming from it, with a push button on the end. When you feel pain, you may push the button to give yourself pain medicine. To keep you from getting too much medicine, there is a limit on how often you can get the medicine.

      • Do not let anyone else push the button for you. Your pump may give you a constant dose of pain medicine, as well as the medicine that you give yourself. If your pain continues even with the use of the PCA, let your caregiver know.

Follow-up visit information:

  • Ask your caregiver when to return to have your surgery site checked. You may also need to have your chest drain, stitches, or staples removed. If you were given PCA medicine, ask your caregiver when to return to have your IV or epidural line removed. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Preventing a lung infection:

  • Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum (spit) from your lungs for you to spit out. Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while you are awake. Remember to follow each deep breath with a cough.

  • You may need to use an incentive spirometer to help you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Then let out your breath. Ask your caregiver for information on how to use a spirometer.

CONTACT A CAREGIVER IF:

  • You have a fever and shaking chills.

  • You cough up yellow, green, or bloody phlegm.

  • Your skin is itchy, swollen, or you have a new rash.

  • You have questions or concerns about your condition, surgery, or medicines.

SEEK CARE IMMEDIATELY IF:

  • You are coughing up or throwing up blood.

  • You feel dizzy, or have trouble thinking or remembering things.

  • You feel your heart is beating fast or out of rhythm.

  • You suddenly have trouble breathing or chest pain.

  • Your bandage has blood soaking through it.

  • Your incision site is swollen, red, or has pus coming from it.

  • Your stitches or staples come loose or fall out.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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