Esophagectomy: What to Expect at Home

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Your Recovery

An esophagectomy (say "ee-sof-uh-JEK-tuh-mee") is surgery to remove all or part of the esophagus. When you leave the hospital, the area around the cuts (incisions) may still be swollen or bruised. It may also feel numb. This is normal and may continue for a few weeks. You will probably need to take pain medicine for a few weeks.

You will have to be very careful about what you eat for 1 to 2 months after surgery and possibly for the rest of your life. You will probably have a feeding tube (J-tube) in your belly. This will come out when you are eating normally and getting enough nutrition. This could be about 4 to 6 weeks after surgery, but it could take longer. Your doctor will give you detailed information on what you can eat, how you should eat, and how to use the feeding tube.

You may also have digestive problems for a few months. These include weight loss, a lot of gas, and a problem called dumping syndrome. Dumping syndrome may cause you to feel light-headed or sick to your stomach, or to have cramps and diarrhea.

Most people go back to work or their normal routine after 6 to 12 weeks. You will need more time to get better if you need other treatment for cancer, such as chemotherapy. It will take 3 to 4 months to get back to your usual activities.

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. Sleep with your head up by using three or four pillows. You can also try to sleep with your head up in a reclining chair. You can put a rolled towel or foam padding under your pillow. You can also raise the head of your bed by putting bricks or wooden blocks under the head of the bed. Do not sleep on your stomach.
  • 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. You may climb stairs.
  • You may be able to take showers (unless you have a drain in your incision). If you have a drain, follow your doctor's instructions to empty and care for it. Keep your feeding tube taped to your skin so it will not fall off. Do not soak in a tub or use a hot tub.
  • Do not lean your head back quickly or for a long period of time. This puts pressure on the neck and may slow your healing.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. This includes mowing the lawn or shoveling snow.
  • Avoid lifting anything heavier than about 4.5 kilograms for about 6 weeks. 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.
  • Ask your doctor when you can drive again.

Diet

  • Your diet will go from a clear liquid diet, to a full liquid diet, and then to a soft diet before you can eat normally. This generally takes 1 to 2 months. Your doctor will give you specific information about what you can eat.
  • If you are on a soft diet, eat foods that are easy to swallow and digest. These include pancakes and waffles; most cereals; scrambled eggs and omelets; canned or cooked fruits; finely ground beef, chicken, turkey, and pork; mild cheeses; potatoes and pasta; and cooked vegetables.

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.
  • 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. Your doctor will tell you how to take care of this. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.

Other instructions

  • It is normal to have some yellowish mucus around your feeding tube. This is not a sign of infection.
  • Keep your feeding tube clamped unless you are using it.
  • Keep the tube taped to your skin at all times, and leave some slack in the tube. This helps prevent pain and keeps the tube from coming out.
  • If you are using your feeding tube:
    • Clean around the tube with water before and after you use it.
    • Flush the tube daily as your doctor tells you to.
    • Do not put any pills through the tube. They can clog it.

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 sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe trouble breathing.
  • You vomit blood or what looks like coffee grounds.
  • You have severe belly pain.

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

  • Your feeding tube begins to come out or begins to smell bad, or if the stitches holding your feeding tube in place begin to come out.
  • You have pain that does not get better after you take pain medicine.
  • You have a fever over 38°C.
  • Your stools are black and tar-like or have streaks of blood.
  • Your incision bleeds and you need to change your dressing more than 3 or 4 times in 24 hours.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have trouble taking care of your feeding tube.
  • You are sick to your stomach or cannot keep fluids down.
  • You have diarrhea or constipation that does not go away.
  • You are not getting better as expected.

Where can you learn more?

Go to http://www.healthwise.net/ed

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