Thoracotomy: What to Expect at Home

Your Recovery

A thoracotomy (say "thor-uh-KAW-tuh-mee") is a cut (incision) that the doctor makes in the chest wall through your front, side, or back. A thoracotomy may be used to do surgery on the lungs, esophagus, trachea, heart, aorta, or diaphragm. The exact place in the chest where the doctor made the incision depends on the reason for the surgery.

It is common to feel tired for 6 to 8 weeks after surgery. Your chest may hurt and be swollen for up to 6 weeks. It may ache or feel stiff for up to 3 months. You may also feel tightness, itching, numbness, or tingling around the incision for up to 3 months. Your doctor will give you medicine to help with pain.

You will have stitches or staples in the incision. You may have one or more tubes coming out of your chest to drain fluid and air that can build up after surgery. The tubes are often removed before you leave the hospital. Your doctor will remove the stitches or staples at your follow-up visit.

You may feel short of breath at first after the surgery. Your doctor, nurse, or respiratory therapist will teach you deep-breathing and coughing exercises to help your body get as much oxygen as possible. You also may need to get extra oxygen through a mask or a plastic tube in your nostrils (nasal cannula). This is called oxygen therapy.

The amount of time you will need to recover depends on the surgery you had. You probably will need to take at least 1 to 2 months off work.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Be as active as you can every day. For many people, walking is a good choice.
• Do not smoke or allow others to smoke around you. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. Also avoid swimming, tennis, golf, or other activities that could strain your arm and shoulder muscles, until your doctor says it is okay.
• Until your doctor says it is okay, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• If your incision is in the front or the side of your chest, hold a pillow over the incision when you cough or take deep breaths. This will support your chest and decrease your pain.
• Ask your doctor about exercises to keep your arm and shoulder muscles strong and flexible while you recover.
• Ask your doctor when it is safe for you to drive or fly. You probably will not be able to drive for at least 4 weeks. This is because your arm and shoulder muscles may be stiff after surgery and could make it difficult to steer.
• You may be able to take showers (unless you have a drain near your incision). If you have a drain near your incision, follow your doctor's instructions to empty and care for it. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
• Ask your doctor when it is okay for you to have sex.
• You will probably need to take at least 1 to 2 months off from work. It depends on the surgery you had and the type of work you do.

Diet

• You can eat your normal diet.
• Drink plenty of fluids (unless your doctor tells you not to).
• If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the incision, leave the tape on until it falls off.
• Gently wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which may delay healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing.
• Change the bandage every day or if it gets wet or dirty.
• Keep the area clean and dry.

Other instructions

• To help keep your lungs clear, cough and do deep breathing exercises as you are told by your doctor, nurse, or respiratory therapist.
• Your doctor may send you home with an incentive spirometer. This device helps you practice taking deep breaths, which can help keep your lungs healthy.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have severe trouble breathing.
• You have sudden chest pain and shortness of breath, or you cough up blood.

Contact your doctor now or seek immediate medical care if:

• You have nausea or vomiting or cannot keep fluids down.
• You have pain that does not get better after you take pain medicine.
• You have loose stitches, or your incision comes open.
• Bright red blood has soaked through the bandage over your incision.
• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the incision.
  • Pus draining from the incision.
  • A fever.
• You cough up a lot more mucus than normal, or your mucus changes color.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.