Frequently Asked Questions
Breathing Questions
Q. Will my cough get better or worse?
A. It depends. If the cough is from the tumor, then there may be less cough once it is removed. Sometimes the cough is from other lung diseases like asthma and emphysema and may require different treatments to make it better.
Q. Will my shortness of breath get better or be worse?
A. Your doctor tries to make sure that when the operation or treatments like radiation are over, the amount of working lung tissue that you have left will be enough to handle most of your needs. Sometimes removing the tumor will improve breathing by opening up passages to remaining lung tissue, reducing cough, or having other effects on the body. Some people may notice it is more difficult to breathe at times of increased exercise. These folks may benefit from rehabilitation services to improve their breathing status.
Q. Will I go home on oxygen?
A. If you were using oxygen before the operation, the answer is yes. If you were not, then every effort will be made to wean you off of oxygen while you are in the hospital. If you can not be weaned off of oxygen and are otherwise ready to go home, then you may be sent home with it temporarily. There is a good chance of the oxygen will be stopped when you come back for your first clinic visit, 1-2 weeks after your discharge.
Q. If I go home on oxygen, will I have to be on it the rest of my life?
A. Most of the time the answer is no - the oxygen use should just be temporary. Before surgery or other treatment, your doctor will make calculations to try to ensure that you will have enough working lung tissue after the operation or treatment. If your doctor's calculations predict your remaining lung function will be so low that you may need oxygen permanently, your doctor will discuss this with you before treatment, while you are deciding on your options. If you have major complications like pneumonia after your surgery and your remaining working lung is damaged, then your need for oxygen may be permanent.
Q. My pulmonologist started me on some inhalers - will I still need them after my surgery or even permanently?
A. We will try to continue as many of the medications as possible while you are in the hospital, particularly those that keep your breathing, blood pressure, and heart function normal. If your inhaler was for asthma or other chronic lung condition not related to the tumor, then you have a good chance of needing this drug a long time. If your pulmonologist started you on an inhaler because of a problem like a tumor, which can be removed, or smoking, which you can give up, then you may only need the inhaler for a short time.
Q. How long will I be intubated? (A tube in your throat to help breathing.)
A. Most patients will be able to leave the operating room without a breathing tube. If your lungs are really sick or your operation is particularly long or complicated, then it may be necessary to have you recover more slowly, and remove the breathing tube the next day. If this happens, you will be given sedation medication that will keep you relaxed. You will probably not even remember having the tube.
Pain/Wound Questions
Q. How bad is the pain and what medicines are available for me?
A. Pain varies by patient and operation. If you have a minimally invasive operation, much of the pain comes from the chest tube. The tube remains in place until your doctor is sure that your lung will stay inflated and will not bleed. Your pain can usually be controlled well with a combination of oral and intravenous medications. If your pain remains uncontrolled or if you have a large incision, then an epidural (near the spinal cord) pain medication may be used.
Q. WIll I have to go home with a chest tube?
A. Most likely you will not have to go home with a chest tube. There a few patients whose lung is slow to heal and who chose to go home with a portable chest tube drainage system rather than stay cooped up in the hospital.
Q. What kind of wounds will I have and how do I take care of them?
A. If you have a minimally invasive operation, there will usually be about 2 half-inch incisions and 1 two-inch incision. One of the smaller incisions will have a chest tube through it. Infrequently, a larger incision, 10 inches on average, will be needed if required by your disease. Generally, just keeping the wounds uncovered, clean, and dry is all that is needed. Two days after your chest tube is removed, you may take a shower. If your surgeon prefers not to stitch your chest tube site, then it might drain a small amount of clear or blood-tinged fluid for several days. You may need to change the dressing with tape and gauze to keep your clothes from being stained. Some people prefer to wear a clean cotton t-shirt rather than put tape on their skin. Some people may experience a large gush of fluid in the first few days after they arrive home. This is normal and unless the fluid is thick like pus, there is no reason to be alarmed. There are no activity restrictions if you have the small incisions, but your care team will give you specific instructions about lifting and other restrictions.
Recovery/Activity Questions
Q. How long is the surgery? How long in hospital? How long before I feel "normal" again?
A. For less invasive operations, a general rule of thumb is 3-4 hours in surgery, 3-4 days in the hospital, and 3-4 weeks until most of the effects of surgery have gone away. These numbers are just an average; results can range from patients who go home the very next day after surgery to those who require a long hospital stay. Sometimes, a minimally invasive operation needs more time but that does not seem to cause problems and patients still go home faster. Most of the time in the hospital is spent waiting for the lung to seal. For operations where a big incision is necessary, it can often require several months to feel close to normal again.
Q. When will I be able to go back to work?
A. Depending on your job, you may be able to go back in several weeks, particularly with the less invasive operations. The decision will depend upon whether you need strong pain medications, how much your strength has recovered, and whether you have any lifting restrictions.
Q. Will I need help at home when I’m discharged?
A. If you were very active at home before your surgery and your operation and hospitalization were uncomplicated, then it is likely that you will not need much discharge support. The more medical problems and physical restrictions you had before surgery, the more likely it is that you will need home support or even inpatient rehabilitation. If you have a minimally invasive operation, your chances of being independent at discharge are several times higher, particularly if you are older.
Q. When can I drive?
A. Provided that you did not have any limitations before surgery, you should be able to resume driving once you have stopped using strong pain medications. Your doctor may approve your driving at your first post-operative office visit, 2-3 weeks after discharge from the hospital.
Medication Questions
Q. Will the medicines that I had before surgery be the same as after surgery?
A. You likely will have some new pain medication or an increased dose of pain medication when you are sent home. If the pain medication is a strong narcotic, we will likely give you stool softeners as well, because pain medication is very constipating. If you are over 70 years of age, you may also be on some new medication to prevent your heart from going into an irregular rhythm. You will take this medication for about 1 month after surgery if the irregular heart rhythm does not occur. If the irregular heart rhythm does occur but it resolves, you may need the medicine for about 3 months. If you had a whole lung removed you will be started on an anticlotting medication (blood thinner) while you are in the hospital and will continue for 1 month because people who have this type of surgery (whole lung removed) have at high risk for blood clots.
