I’ve gotten several emails in which patients awaiting cytoreduction surgery and HIPEC have asked me how to best prepare.  We are often told, as I was, to expect a 12 hours surgery, to be in ICU for a few days post-op and to be in the hospital for about 2 weeks.  We’ve all heard horror stories of those who have had many complications and who have been hospitalized for up to a month, and who have had very long recovery periods.  Much of the length of hospital stay and probability of complications is related to the extent of surgery needed, general health before surgery etc.  I had few abdominal tumors, so probably required less surgery than many others.  My surgery, expected to be 12 hours, but was instead 5-6.  I did not need to go to ICU post-op, and was discharged in 6 days, not two weeks.  My recovery was not extended, I was back to doing what I normally did (albeit with some pain) in 2-3 weeks.  I also have a very high pain threshold, which also served me well.

There are things we can do though, to speed our recovery and prevent complications.  As a nurse, I know that those who don’t move post-op have more complications.  So I was insistent on getting out of the bed as soon as possible.  Within 36 hours of my surgery, I was walking the hospital halls almost all day, every day.  Walking helps bowel recover normal function, prevents blood clots, promotes wound healing and prevents pneumonia.  When I wasn’t walking, I was sitting in a chair in my room, I only went to bed to sleep.  I had to walk bent over for awhile at first as standing up straight made my abdominal incision more painful.

I personally didn’t like the morphine PCA they gave me at first…one of those things where you press a button to deliver morphine when you are in pain. Morphine made me feel drugged….and nauseated.  And nausea and vomiting is a painful thing to do when your abdomen has been cut open.  As I was a nurse, I knew of a drug that was not narcotic, Toradol.  It is, in essense, a powerful form of IV medication for pain.  I asked my morphine be stopped and replaced by periodic Toradol injections  Toradol was so much more effective for my pain, and I didn’t feel “drugged” or nauseated.   I was very lucky I had a physician who catered to my needs and suggestions.  Toradol can only be used for a few days, so after Toradol, I took ibuprofen for pain.Narcotics can depress breathing and slow bowel function also,so I felt I was better off without them.

I also brought books and a CD player to the hospital.  I needed things to distract me from my status as a patient, to distract me from pain.  Some hospitals now have internet access….you can bring your laptop and keep in touch with people if cell phones aren’t allowed.   Many also use the Caring Bridge site and have a person designated to keep the site up dated, so family and friends can get updates and you or your loved ones aren’t inundated with telephone calls while you are in surgery and recovery.

I also brought soft elastic-waisted pants and shirts as I didn’t want to wear a hospital gown, so I was in street cloths most of the time.  I also bought something called an abdominal binder…it is like a very wide elastic belt you can wear to splint your abdominal incision that was very helpful to me after I was discharged (about $20 at Walgreens).  They used to be commonly used for patients with abdominal surgery, not sure why they aren’t commonly used now.  It may have been sold at Walgreens as an elastic back brace, but it worked well as a binder.

It is also important to take several deep breaths and to cough every couple of hours; if coughing is painful, you can hold a pillow against your abdomen when you do it.  If you are in bed, you can do ankle exercises to help blood circulate in your legs to prevent clots from forming.

When I got home, I had no bowel or stomach issues, just didn’t have much of an appetite for awhile, so I ate frequent small amounts of high calorie food (egg nog, milk shakes, ice cream sundaes).  My appetite did return and I gained back all of the weight I lost with my surgery (about 20 lbs.).

If anyone else has other suggestions as to what helped them through this surgery, feel free to post in the comments here!