physiotherapy advice for patients undergoing thoracic surgery
physiotherapy advice for patients undergoing thoracic surgery
physiotherapy advice for patients undergoing thoracic surgery
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Plymouth Hospitals<br />
NHS Trust<br />
PHYSIOTHERAPY ADVICE<br />
FOR PATIENTS UNDERGOING<br />
THORACIC SURGERY
During your hospital stay<br />
A physiotherapist will usually see you the day after<br />
your <strong>surgery</strong>, they will normally:<br />
• Listen to your chest and go through your<br />
breathing exercises to make sure you can clear<br />
any phlegm you may have.<br />
• Check your arm and leg exercises.<br />
• Help you to stand and either march on the spot<br />
or to walk up and down the ward.<br />
• Start you on an exercise bike if your chest<br />
drains are on suction.<br />
The physiotherapist will continue to do the above<br />
daily until: -<br />
• You are managing to do the exercises<br />
effectively by yourself.<br />
• You are SAFE to walk by yourself or with<br />
another member of staff<br />
The physiotherapist will usually assess your ability<br />
to climb the stairs be<strong>for</strong>e you go home. DO NOT<br />
DO THIS WITHOUT A MEMBER OF STAFF<br />
UNLESS OTHERWISE TOLD.
Breathing Exercises<br />
1. Make sure your pain is well controlled (you<br />
should be able to breath deeply without feeling<br />
too uncom<strong>for</strong>table) ask your nurse <strong>for</strong> extra<br />
painkillers if you need them.<br />
2. Make sure you are sitting com<strong>for</strong>tably in an<br />
upright position.<br />
3. Take a slow deep breath in through your nose<br />
and hold it <strong>for</strong> a count of three.<br />
4. Try and sniff in an extra bit of air be<strong>for</strong>e you<br />
breathe out.<br />
5. Breathe out gently through your mouth.<br />
6. Repeat this three times.<br />
7. Breathe normally <strong>for</strong> two or three breaths.<br />
8. Repeat steps 2 – 7 twice more. Support your<br />
wound with your hand and ‘’HUFF’’ (this is like<br />
a short sharp breath out with your mouth open).<br />
9. After three huffs, do a strong cough – still<br />
supporting your drain sites.<br />
If you have a lot of phlegm on your chest<br />
repeat 2 – 9 again.
How to support your wound area.
Arm Exercises after <strong>surgery</strong><br />
All exercises should be done on your operation<br />
side, up to the point where you start to feel either a<br />
stretch or pain (or both). You should not push<br />
through pain or over stretch at this point.<br />
PhysioTools Ltd<br />
PhysioTools Ltd<br />
PhysioTools Ltd
Leg Exercises after <strong>surgery</strong><br />
PhysioTools Ltd<br />
PhysioTools Ltd<br />
PhysioTools Ltd
What should I do when I get home?<br />
• Continue with your painkillers if you are still<br />
experiencing pain. This will allow you to<br />
manage your daily tasks more com<strong>for</strong>tably and<br />
aid recovery.<br />
• You may feel very tired, so take things slowly.<br />
You may find it helpful to have a rest in the<br />
afternoon.<br />
• Try and get back into your normal routine, <strong>for</strong><br />
instance waking at normal times and dressing<br />
fully.<br />
• If you were a smoker when you came into<br />
hospital you will have been given help and<br />
<strong>advice</strong> on stopping. Your long-term recovery<br />
will be slower if you continue smoking. If you<br />
feel ready it is a good opportunity to stop <strong>for</strong><br />
good.<br />
• You should receive details on smoking<br />
cessation support groups from the ward staff<br />
when you come in to hospital.
Exercise<br />
After <strong>surgery</strong> you need to gradually increase your<br />
exercise / activity levels.<br />
• Walking is the easiest way to exercise. On<br />
discharge from hospital begin with two to three<br />
walks a day, the same distance you were<br />
managing in hospital. Then over time gradually<br />
increase this distance so that in 6-8 weeks you<br />
can walk <strong>for</strong> half an hour or more (this will<br />
depend on your fitness level be<strong>for</strong>e you had<br />
<strong>surgery</strong>, discuss distance with your<br />
physiotherapist if you had problems with<br />
mobility be<strong>for</strong>e <strong>surgery</strong>). This will improve your<br />
heart and lung fitness.<br />
• When walking remember that you should be<br />
able to hold a conversation, if you become too<br />
short of breath to do this, stop, rest and recover<br />
be<strong>for</strong>e you continue.
Exercise Progression<br />
Gradually over the next 2-3 months you can begin<br />
other activities to progress from walking. Aim to do<br />
these two – three times a week <strong>for</strong> twenty minutes<br />
to improve your general fitness. Your wound should<br />
be fully healed over be<strong>for</strong>e you begin these<br />
exercises.<br />
Activity<br />
• Bowls<br />
• Swimming<br />
• Gym work<br />
• Badminton<br />
• Tennis<br />
• Golf<br />
Time to begin<br />
2 months<br />
2-3 months<br />
2-3 months<br />
3 months<br />
3 months<br />
4-6 weeks (putting only)<br />
2 –3 months (full swing)<br />
• Gardening 4 – 6 weeks. Light pruning /<br />
Potting / Weeding etc<br />
2-3 months mowing / digging.
Lifting<br />
Once home you are safe to do light activities. To<br />
begin with do not lift more than the weight of your<br />
chest drain. After 6-8 weeks you can gradually<br />
increase your activities, as long as it remains<br />
com<strong>for</strong>table on your wound. Avoid heavy lifting <strong>for</strong><br />
at least three months.<br />
Driving<br />
Do not drive a car <strong>for</strong> 6-8 weeks (unless otherwise<br />
stated by your consultant). It is a good idea to<br />
in<strong>for</strong>m your insurance company following major<br />
<strong>surgery</strong>, so you do not invalidate your insurance<br />
policy.<br />
Back To Work<br />
Do not return to work until after your out patient<br />
clinic appointment. Your may be advised to stay off<br />
<strong>for</strong> a longer period of time if you have a manual job.<br />
Good luck with your exercises. If you have any<br />
questions or problems with the above in<strong>for</strong>mation<br />
you can contact your physiotherapist on<br />
0845 1558208 Ask <strong>for</strong> bleep 153 or 175<br />
Donna Pike July 2004