You will be kept without anything to eat or drink immediately after the surgery until you have some return of bowel function. This can take on average anywhere from 2-5 days. It may, however, be earlier or later than this. Once you have evidence of bowel function, you will be started on a bland liquid diet such as Gatorade, tea, coffee, water, soup and crackers, or jell-o. If you tolerate this, you will slowly be increased to a regular diet.
As soon as you reach home, you may resume normal ad lib activity. You are encouraged to begin walking and resuming household activity as tolerated immediately. Going up and down stairs is also ok. You should refrain from engaging in any strenuous activity such as running, riding a bike, heavy exercising in a gym, etc. for at least 4-5 weeks. You should also avoid any heavy lifting greater than 20lbs. for 4-5 weeks. After that, you may resume any activity as tolerated.
You will have a gauze bandage on your incision immediately after surgery. Leave this bandage on for 48 hours after the surgery. Your surgeon or nurse will change your bandage for the first time. The incision will most likely be closed with small metal clips called skin staples. These will eventually be removed by your surgeon or a nurse, usually about 10-14 days after the surgery. This is done relatively painlessly using a specialized staple remover. You may shower starting 48 hours after the surgery. Running soap and clean water over the incision is ok, but avoid submersing the incision in any dirty water such as baths, lakes, swimming pools, jacuzzis, etc. for at least 3-4 weeks. You may apply ice to the wound for 15-30 minute intervals at a time for pain or swelling, for several days after the surgery. A small amount of bleeding, redness, and swelling may be normal. If there is any excessive pain, bleeding, swelling, redness around the wound, green/white drainage, or fever, please call your surgeon immediately.
Once you have been started on an oral diet, you may resume all your normal medications after surgery except for aspirin or other anticoagulants. You should wait at least 48 hours after surgery before beginning aspirin or other anticoagulants. You may need to wait longer, but please consult your surgeon first.
You will most likely be sent home with a prescription for narcotic pain medications. Use the narcotics as directed on the prescription. You may take less than what is indicated on the bottle, but not more. Be sure to take narcotic pain medication with food so as not to upset your stomach. You may begin to taper your narcotic medication as tolerated and discontinue them as soon as possible. As you are tapering off the narcotics, you may transition over to Ibuprofen. You should not drive or operate any mechanical equipment while on narcotic medications. Wait for at least 24 hours after discontinuing the narcotic medications before driving.
It is not unusual for patients who have been through surgery, a general anesthesia, and who are taking narcotics to become constipated. This can often be remedied by increasing your activity and making sure you stay hydrated. If this does not work, you should first try to increase you fiber intake either through diet or through supplements (Metamucil, Benefiber, etc.). You may also try to take an over-the-counter stool softner such as Colace or Sennekot. You should have a bowel movement every day, but may go 2-3 days after returning home without one. If you have had a bowel resection of any kind, consult your surgeon before taking any laxatives. If none of these measures work or if you begin to have significant abdominal pain, nausea/vomiting, or diarrhea, please contact your surgeon immediately.
You will be instructed as to when you should return to the office on your discharge instructions. The exact date will either be scheduled for you before you leave the surgery center, or you will be instructed to call the office to schedule this. You will usually be seen again approximately 2-3 weeks after the surgery. If you had a bowel specimen from your surgery, the pathology department usually takes 3-5 days to send results of your specimen analysis to our office. If there is important information from the report to tell you before your follow-up appointment, you will be notified immediately.