Thoracotomy

WHAT YOU SHOULD KNOW:

Thoracotomy (Discharge Care) Care Guide

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

AFTER YOU LEAVE:

Medicines:

  • 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 that lasts for 2 or more months after your surgery. You may feel pain when your chest expands during breathing. This pain may cause you to have trouble breathing. You may be given any of the following:

    • Acetaminophen: This medicine decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

    • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's doctor.

    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.

    • Patient-controlled analgesia:

      • You may get pain medicine from a 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 primary healthcare provider know.

  • 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.

Follow up with your primary healthcare provider as directed:

Ask 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 when to return to have your IV or epidural line removed. Write down your questions so you remember to ask them during your visits.

Prevent a lung infection:

  • Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum (mucus) from your lungs for you to spit out. Take a deep breath and hold the breath as long as you can. 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 and then let out your breath. Ask your primary healthcare provider for information on how to use a spirometer.

Contact your primary healthcare provider if:

  • You have a fever and shaking chills.

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

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

  • You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

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

  • Your heart is beating fast or out of rhythm.

  • Blood soaks through your bandage.

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

  • Your stitches or staples come loose or fall out.

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up or vomit blood.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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