After bone cancer surgery
Your recovery depends on the type of surgery you have. Surgery to remove all or part of a limb is major surgery. You will need to spend time in the hospital and then give yourself time to recover once you are home. After your operation, the nurses keep a very close eye on you.
When you wake up after your operation
After the operation, you wake up in the recovery room. You will have one to one nursing care. The nurse looks after you until you are awake and well enough to go back to the ward.
Everybody is different when they are waking up after an operation. It takes some people longer than others to wake up. Some people remain very sleepy for a while afterwards. You may be in the recovery room for hours before you are ready to go back to the ward.
Back on the ward your doctor will see you regularly. Specialist nurses may visit you. They look after people who have had major surgery but do not need to be in the intensive care or high dependency unit.
Sometimes you may wake up in the
(ICU) or (HDU) after your operation. This is so your doctors can keep a closer eye on you. This may happen if:
- your general health is poor
- the operation took longer than planned
- the operation was more complicated than the doctors thought it would be
In the ICU you have one to one nursing care. In the HDU you have very close nursing care.
The staff in the ICU or HDU will speak to a member of your family or friends about visitors. But, you usually move back to the ward within a day or so.
Tubes and drains
When you wake up, you will have several different tubes in place. This may make you feel a little anxious. But it helps to know what they are all for. You might have:
- drips (intravenous infusion) – you may have
blood transfusions , fluids until you are eating and drinking again and continuous pain relief - wound drains – to help drain blood and tissue fluid from around the operation area
- a tube into your bladder (catheter) – to collect and measure your wee, this is only temporary
- a thin tube into the fluid around your
spinal cord (spinal anaesthetic) to give you painkillers - a tube down your nose into your stomach (nasogastric tube) to drain bile and stop you feeling sick
Electronic pumps may control any medicines you have through your drip.
After lung surgery
You will have a drainage tube into your chest as well if you've had surgery to remove bone cancer that had spread to the lungs. The tube is connected to a suction bottle. The gentle suction helps your lung to inflate properly again after a chest operation.
Being monitored
You have a blood pressure cuff on your arm when you first wake up. Your nurse checks your blood pressure often for the first few hours after you come round from the anaesthetic.
You might have a little clip on your finger, called a pulse oximeter. This measures your pulse and blood oxygen level. You may also have an oxygen mask on for a while.
Your nurse also monitors how much you wee because it helps to show whether you have too much fluid or are becoming dehydrated. The catheter comes out when the doctors are happy that you are passing a normal amount of wee.
Painkillers
It’s normal to have pain for the first week or so after bone surgery. Your doctor and nurses will give you painkillers.
Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.
Immediately after surgery you have painkillers through either a:
-
drip into the bloodstream that you control (PCA or patient controlled analgesia)
-
small thin tube put into your back and connected to a pump that gives you a constant dose of painkiller (epidural)
Some hospitals give you painkillers or local anaesthetic directly into the nerves of the arm or leg that was operated on. These are called nerve blocks.
You'll have painkillers to take home. Follow the instructions your nurse and pharmacist gives you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.
Phantom limb sensation
If you had surgery to remove a limb, you might experience phantom limb sensation. Immediately after surgery, it might feel as if the amputated limb is still there. Experiences differ from person to person. You might feel the whole limb or just part of it such as the toes. Sensations vary from feeling like your leg is in an odd position or has the same length and weight as your other leg.
Phantom limb sensation is common for many people. It happens because the brain is still sending signals to the limb that is no longer there. This will gradually fade. In the first few months after surgery, it can be easy to forget that your limb is no longer there. So you should take extra care before getting up, especially at night or after sitting for a long period.
Phantom limb pain
If you have had an amputation, you may feel pain in an arm or leg which is no longer there. This is called phantom pain. But it is very real, although not everyone has it. The pain can be tingling, burning, itching or cramping.
Doctors are starting to understand how and why phantom pain happens. Phantom sensations can be triggered by many different things. It can differ from person to person. Common triggers are swelling, muscle spasms, temperature changes, emotional changes or changes in the weather. For most people, it settles down in time. But if not, there are ways of helping to control it, including painkillers. Some people might be prescribed pain killers before they have their amputation.
Let your doctor or nurse know if you are having any phantom pain.
Eating and drinking
You start eating and drinking within a couple of days after your surgery. Your nurse removes the drip as soon as you are able to eat and drink normally.
Your nurse will let you know when you are able to start eating and drinking.
Your wound
The wound will be covered up when you come round from the operation. It will be left covered for a couple of days. Then the nurse may change the dressings and clean the wound.
The wound drains will be left in until they stop draining fluid. Your nurse can usually take out the wound drains 1 to 2 days after your operation. They leave in your stitches or clips for at least 10 days.
If you have a cast on your arm or leg, you may want to ask about a waterproof cover. There are covers available to keep your cast dry in the bath, shower or even if you go swimming.
Getting up and making progress
Getting up may seem very difficult at first. Your nurses will encourage you to get up and about as soon as possible after your operation. Moving about helps you to get better, but you will need to start very gradually. Your physiotherapist will visit you every day after your operation to help you with your breathing and leg exercises.
Some sarcoma operations are major surgery and you may need to stay in bed for the first couple of days. You may need to wear elastic stockings or inflatable boots to help prevent blood clots forming. You may also need injections of anti clotting medicines to help thin your blood.
Your nurses will encourage you to get out of bed and sit in a chair one or two days after your surgery. They will help you with all the drips and drains. Over the next couple of days, the tubes, bottles and bags will start to be taken out. Then, it will be much easier to move and you will really feel that you are starting to make progress.
Your specialist surgeon will give the nurses and physiotherapists very detailed instructions about your recovery. If you have had limb sparing surgery, the bone will have to heal before you can use it very much. Your surgeon will tell you when you can get up and how you can use the limb that has been operated on.
After your amputation
After your surgery, you will have a stump or wound area that is sore and sensitive. Once this has healed and any swelling has settled down, you will see a prosthetist. Prosthetists are specialists who design and fit artificial limbs (prostheses) to replace those lost through amputation.
The prosthetist will make a cast or impression of your stump to make sure that the prosthesis fits as well as it can. They then use the cast to design a suitable limb.
They fit the limb so that it works as well as possible for you. They also continue to care for you and carry out adjustment or repairs to the prosthesis if needed.
You will have a lot of help from your prosthetist, physiotherapist and occupational therapist to help you learn to use your prosthesis.
Having an amputation is a lifechanging event. It will take time to adjust emotionally and physically. Talk to your healthcare team if you find it hard to cope. They can offer advice and support.
Going home
Everyone recovers from surgery differently. Your team will let you know when you are ready to go home.
You’ll need help when you first go home. You’re likely to feel very tired for several weeks and sometimes months after your surgery. You will need to take plenty of time to rest at first.
It helps to do a bit more every day. Try:
- sitting for less time each day
- walking or moving around the house a bit more each day
- building up to walking outside
What you can do depends on how fit you were before your surgery and any problems you have afterwards. Your physiotherapists can help you make a daily plan for the first few weeks at home. Talk to the physiotherapist or your doctor if you’re unsure about what you should be doing.
Contact your doctor or specialist nurse if you have any problems or symptoms you are unsure about. You’ll have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.
Follow up appointments
You’ll have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.
