Thoracotomy: What to Expect at Home

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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. The doctor is able to do surgery inside the chest through the incision. 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 makes 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.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • 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.
  • Try to avoid being around people who you know have a cold, the flu, or other illness.
  • 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 when it is safe to 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. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • 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.
  • 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 for a week or until it falls off.
  • 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 weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

Exercise

  • 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 practise taking deep breaths, which can help keep your lungs healthy.
  • Ask your doctor about exercises to keep your arm and shoulder muscles strong and flexible while you recover.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line 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.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You are sick to your stomach or cannot keep fluids down.
  • You have pain that does not get better after you take pain medicine.
  • You have a fever over 38°C.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • You cough up a lot more mucus than normal, or your mucus changes colour.

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

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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