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Neck Dissection: What to Expect at Home

Your Recovery

A neck dissection is surgery to remove all or some of the lymph nodes and surrounding tissue from the neck. Lymph nodes are small, round or bean-shaped glands that act like filters. They remove germs from your body, help fight infection, and trap cancer cells. This surgery is most often done to treat cancer of the head and neck.

You may leave the hospital with stitches in your cut (incision). Your doctor will tell you if you need to return to have these removed. You may still have a tube called a drain in your neck. Your doctor will probably take this out a few days after your surgery.

The area may also be swollen, and you may have a stiff neck. For most people, the swelling starts to go away 4 to 5 days after surgery. You may have numbness in your neck and ear. Your lower lip or shoulder may feel weak. For most people, these problems go away in 6 to 12 months. But sometimes these problems can be permanent. You may always feel a little numb, stiff, or weak in some areas.

If a neck muscle was removed, your neck may look flatter or thinner.

If you have cancer, you may still need other treatment after surgery, such as radiation or chemotherapy.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

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. When you lie down, put 2 or 3 pillows under your upper back and shoulders so that your neck and head are supported.
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.
Avoid strenuous physical activity, lifting heavy objects, and airplane travel for 3 weeks after surgery or until your doctor says it is okay.
Ask your doctor when you can drive again.
You may be able to take showers (unless you have a drain near your incision). If you do have a drain near your incision, follow your doctor's instructions to empty and care for it.

Diet

If it is painful to swallow, start out with cold drinks, flavoured ice pops, and ice cream. Next, try soft foods like pudding, yogurt, canned or cooked fruit, scrambled eggs, and mashed potatoes. Avoid eating hard or scratchy foods like chips or raw vegetables. Avoid orange or tomato juice and other acidic foods that can sting the throat.
If you cough right after drinking, try drinking thicker liquids, such as "smoothies."
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. You will also get 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.
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.
Your doctor may have 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 your doctor told you how to care for your incision, follow your doctor's instructions. If you did not get instructions, follow this general advice:
- After the first 24 to 48 hours, wash around the incision with clean water 2 times a day. Don't use hydrogen peroxide or alcohol, which can slow healing.
You may have a drain near your incision. Your doctor will tell you how to take care of it.

Exercise

If you have trouble with shoulder and arm strength and movement, you may need physiotherapy. Your doctor or physiotherapist will help you with this.

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 advice line (811 in most provinces and territories) 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 trouble breathing.

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

You have loose stitches, or your incision comes open.
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.
Bleeding from your incision soaks through your bandages.

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

You do not get better as expected.

Where can you learn more?

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

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.