Post Adrenal Cancer Surgery Care Expectations

University Hospitals Seidman Cancer Center Helps Patients Recover From Adrenal Cancer Surgery

Once a surgical procedure has been selected for adrenal disease treatment, the medical team at UH Seidman Cancer Center's Urologic Oncology Center strives to educate the patient regarding how the procedure could affect his or her postsurgery lifestyle.

While individual reactions from patients may vary depending on the stage and type of adrenal disease and the surgical procedure used, there are a few general side effects that patients should be aware of during the recovery period. Patients with additional questions about severe or bothersome symptoms should contact their UH Seidman Cancer Center surgeon.

First Day Following Surgery

The day following a patient's adrenal cancer surgery, our surgical team will stop by his or her hospital room early in the morning. The team will examine the patient and check the incisions made during the procedure. He or she will also have blood drawn early in the morning the day following the surgical procedure. Patients are free to ask any questions that they may have during this time.

The first day following surgery, UH Seidman Cancer Center staff members typically urge patients to get out of their hospital bed, sit in a chair or even walk around the hospital hallways. Although patients may not feel like getting out of bed or moving around, this activity will make them feel better. Walking helps the lungs expand, which supports a quicker recovery. On the first day postsurgery, the patient's family is welcome to visit throughout the day.

Incentive Spirometer

Patients should continue using their incentive spirometer at least 10 times an hour while awake the day following surgery. Once a patient is able to get out the hospital bed, walk in the hospital hallways and cough well by themselves, they may stop using the incentive spirometer unless otherwise directed by their healthcare provider or nurse.

Urinary Foley Catheter

A recovering patient can expect to have a urinary foley catheter, which is placed inside the patient while he or she is in the operating room, draining his or her bladder for approximately one to two days after surgery. It is common for patients to have blood-tinged urine for a few days following the surgical procedure.

Antibiotics

A team member from UH Seidman Cancer Center will administer antibiotics and any pain medication through the patient's IV. Patients will be able to restart some of their normal medications following consultation with their physician. Patients should refer any questions to their UH Seidman Cancer Center nurse or a member of the Urologic Oncology Center team.

Dietary Instructions

Patients who are beginning to feel more like themselves following the procedure can take sips of liquids. If a patient feels full or nauseated, he or she may not want to drink any liquids or eat any food. Once a patient is tolerating liquids, UH Seidman Cancer Center team will advance his or her diet to include more solid food. It is quite common for patients not to have a normal appetite or to have a strange taste in their mouth the day after surgery.

Going Home

Patients may leave the hospital and return home once their pain is controlled exclusively by oral medication, their laboratory tests and vital signs are stable and they are eating a solid food diet. Most individuals are ready to head home two or three days after surgery. However, each patient is different and should go home only when he or she is ready.

Patients often want to know what activities they can engage in once they return home. In general, no heavy lifting or strenuous activity is allowed during the first few weeks following surgery. Patients will be given a follow-up appointment with a surgeon from UH Seidman Cancer Center's Urologic Oncology Center approximately one month after their surgery.

Following discharge from the hospital, the patient can resume his or her normal diet and regular medication schedule.

Patients are also advised to:

• Receive instructions regarding when to resume taking blood thinning medication.
• Take pain medication prescribed at discharge. An over-the-counter stool softener should be taken by mouth twice daily. Most pain medications cause constipation and a stool softener will help to prevent this side effect.
• Drink several glasses of water or liquid each day.

Activity Level

UH Seidman Cancer Center physicians encourage patients to walk following surgery because it can be extremely beneficial to the healing process. Other activities patients need to consider include:

• Walking and stair climbing as is tolerable
• Showering 48 hours after surgery
• Avoiding driving or lifting objects over five pounds until the postoperative appointment

Skin Care

Patients may have port sites, or small incisions where the surgery was performed, that are covered by Steri-Strips™ or a larger incision with staples that will be removed at the postoperative visit. Steri-Strips™ are small pieces of surgical tape that may be removed as early as 48 hours after surgery or they may stay in place until the patient’s follow-up appointment.

The patient’s incisions will be watertight in about 24 to 36 hours following the procedure, allowing the individual to carefully shower. The incisions typically heal within a few weeks.

Patients may experience swelling around the incision and a feeling of firmness under the skin where the incision was made. If an individual has surgical staples closing his or her wound, these will be removed about two weeks following the procedure.

Patients will have scarring that typically grows more noticeable in the one to two months following surgery. Until that time, patients may notice that the scar coloring is more red or irritated than the surrounding skin. This is normal and will improve over time.

Depending on the method of the patient's adrenalectomy (surgical or minimally invasive), the incision will also involve a variable amount of muscle. Since this may take a few weeks to heal, the patient should be cautious not to strain this area. The surgeon will give the patient specific recommendations about activity and weight lifting limits.

Problems Patients May Encounter at Home

• Bruising around the incision site(s): This common side effect should not alarm the patient and will subside over time.
• Blood in the urine: Patients frequently produce blood-tinged urine one to two days following the procedure.

Symptom that require immediate attention by the Urologic Oncology Center include:

• Fever (body temperature over 102° F)
• Chills
• Nausea or vomiting
• Bleeding
• Pain so excruciating that medication is not relieving it

Follow-up Visit

• Patients should schedule their follow-up appointment at UH Seidman Cancer Center for seven to 10 days following discharge.
• Patients can eat, drink and take medications prior to the appointment.
• Individuals should remember that recovery after surgery can be slow and time dependent.

For additional assistance: Patients that need emergency assistance for severe symptoms should call 911.