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When your surgery is over, you will spend a short time in the Recovery Room prior to being transferred to the Thoracic Intermediate Care Unit (TICU) on 11B. NOTE: Some patients, in the opinion of the surgeon, require the additional monitoring provided in the Surgical Intensive Care Unit after surgery. You will know before surgery if you are going there. (In addition, circumstances beyond our control may result in a change in the bed assignment).
You will stay in the recovery room for 1-2 hours until you are ready to transfer to the Intermediate Care unit on 11B. In the recovery room you will have a chest x-ray and the nurse will take your vital signs every 15 minutes. You can expect the following lines and tubes:
The Thoracic Intermediate Care Unit is a 4 bed unit (male-female mixed) that provides monitored care with one nurse for two patients 24 hours a day. Your stay in the TICU, which will be about two to three days, is a busy and critical time in your recovery from surgery. Many factors contribute to your successful recovery. For instance your active participation with chest physical therapy and ambulation is necessary in promoting your recovery and in preventing complications.
You will begin deep breathing and coughing exercises the evening of your surgery. These are important to keep your lungs clear and to help prevent pneumonia.
You may be worried about pain control during coughing, but you will have a special catheter in your back to control your pain. This line is placed by the anesthesiologist while you are asleep. It is called an epidural catheter. It delivers pain medication directly to the area of the surgery. Most patients find their pain control to be excellent.
You will be getting out of bed and walking the morning after surgery. There are several exceptions to this which will be discussed with you if you fall into an "exception" category. We use a specially adapted walker to help you by providing extra support and oxygen. Walking will help your breathing and help to keep your strength up following surgery. The nurse or therapist will help you with your walks.
For the first few days after your surgery you will need extra oxygen. As your lung heals you will need less and less. Several days after surgery the chest tube will be removed.
You will begin the shoulder exercises as you can tolerate them. Remember, you don't want your shoulder to stiffen up and these exercises are important.
The therapist will also begin the tapping on your back to loosen secretions in your lung. There are always secretions following surgery. The percussion techniques will make it easier to cough up the secretions. Don't worry that you will break open the incision by coughing - you won't.
While you have the chest tubes, daily chest x-rays will be taken. These are used to help decide when to take the tube out. The removal of these tubes varies greatly from person to person so don't be discouraged if your roommate's comes out faster than yours.
Try to catch naps whenever possible. Rest is important to the healing process. Although you may not be hungry, try to eat something at each meal.
Because you need various aspects of nursing care a full 24 hours a day while in the TICU, you will notice that your normal sleep routine during the night may be changed. This means that although you may feel tired you will still require chest physical therapy and vital signs taken periodically throughout the night. As you continue to improve after surgery, your need for aggressive care at night will decrease and your opportunity to sleep for longer periods of time will increase.
When you are ready to leave the TICU you will be transferred to a general surgical bed on 11B, 11C, or 11D.
You will be discharged the day after your chest tubes are removed. The usual length of stay is 5-7 days, but length of stay varies depending on the extent of your surgery. Your follow up visit will be 10-14 days after discharge.
When you are ready to leave the hospital, you will be given a follow up appointment with the surgeon and will receive written discharge instructions and prescriptions for your nurse.
Comments to: KKee@partners.org
©2007, Division of Thoracic Surgery at Brigham and Women's Hospital. All rights reserved.
Division of Thoracic Surgery
Brigham and Women's Hospital
75 Francis Street
Boston, MA 02115
Phone: (617) 732-6824