Home Care Instructions After Esophagectomy

Each day following your surgery you will feel better. Here is a guide to some general instructions for you and your caregivers to aid in your recovery.

Diet

• The feeding tube is used temporarily to help maintain your nutrition until after you have healed and are able to tolerate a diet that maintains your weight. You should have been instructed on the care of your feeding tube before you left the hospital. If you did not receive these instructions, please contact our office.
• A visiting nurse will come to your home and instruct you and/or your caregiver on the use of your feeding pump.
• You should have received diet instructions that will help avoid the foods that can cause “dumping syndrome.” It is best if you keep a daily food diary along with symptoms you may experience with different foods (belching, bloating, abdominal pain, diarrhea, etc.). This will help you distinguish which foods you are able to tolerate and those foods you need to avoid. Check your weight daily and record this in your food diary as well.
• Dumping syndrome occurs when food enters the small intestine too quickly. Symptoms include nausea, stomach pain, cramping, bloating, diarrhea, dizziness, feeling faint, fatigue, sweating, heart palpitations, and rapid heart rate. If you are repeatedly having such symptoms, contact our office.

Pain

• You may have pain and swelling along the incisions, which is normal. You may feel other sensations, such as numbness or discomfort below the breast, on the same side as your chest incision. This is normal as well.
• You will be given 1 to 2 prescriptions for pain medicine. Be sure to fill all of your prescriptions. If you are unsure about crushing a medication to put through your feeding tube, please contact our office.

Constipation

• Pain medicine can be constipating and you may need to take a stool softener while on the pain medicine. You should also drink plenty of water, unless otherwise instructed.
• We recommend purchasing docusate sodium (Colace®) or Senokot-S® if you are able to take medicine by mouth. This should be taken as directed on the package for as long as you are taking narcotic pain medication.
• If you still experience constipation you can try Milk of Magnesia or an enema.

Diarrhea

• Tube feeding formulas can cause loose stools or diarrhea. If you are having this problem, stop any stool softeners you are taking. If it persists or worsens and causes greater than three liquid stools per day, contact our office.

Incisions

• You may remove any bandages two days after being discharged.
• Keep your incisions clean and dry. Leave them uncovered as much as possible, to promote healing. Restrictive clothing, such as a bra, may irritate the incision.
• You may shower unless instructed otherwise. Do not scrub the incisions. Pat them dry. The use of your arms overhead to wash your hair may cause fatigue, shortness of breath, and pain. You may need someone to help you.
• No baths, hot tubs, or swimming until your doctor gives you medical clearance.
• Your chest tube site may drain red, brown, or straw-colored fluid. This is normal and you can cover the site with gauze to protect your clothing.
• Staples and/or sutures will be removed at your follow-up visit.

Driving

• You may not drive until your doctor gives you medical clearance. You should have someone with you the first few times you do drive. Pain may prevent you from being able to turn your head or upper body to drive safely.

Activity

• You may not perform heavy exercise until your doctor gives you medical clearance.  Daily walks, as tolerated, are encouraged.
• No heavy lifting (over 15 lbs.) until your doctor gives you medical clearance.
• Continue to use the incentive spirometer at home. This will help improve your breathing and lung function.
• No air travel until you have checked with your doctor.
• Sexual activity is allowed.  Lying on your back may place the least strain on your incisions. Avoid any activity or position that may cause strain on your incisions.

Call your physician if you experience:

• Increased shortness of breath
• Chest pain
• Fever of 100.5°F or higher
• Heart palpitations or rapid heart rate
• Swelling of an extremity with or without pain
• Increased redness around an incision
• Diarrhea greater than three liquid stools per day
• Vomiting
• Feeding tube falls out
• Increased swelling around an incision (some swelling is to be expected)
• Pus-like or foul smelling drainage from an incision
• A bubbling or sucking sound from an incision
• Persistent symptoms of Dumping syndrome

Emergency Contact Numbers

• Monday through Friday 8 am to 4:30 pm: Call 716 845-1141 (Thoracic Clinic)
• Evenings, Weekends or Holiday Call 716 845-2300 and ask for the doctor covering thoracic surgery