Dr. Prabhakaran U

Proper preparation before surgery can significantly reduce risks and speed up your recovery.

• Stop smoking at least 4 weeks before surgery — smoking increases the risk of chest infections and slows wound healing significantly.
• Medications: Inform your doctor about all medications including blood thinners (aspirin, warfarin), diabetes medications, and herbal supplements. Some need to be stopped 7–10 days before surgery.
• Fasting: You will be asked to fast (no food or water) from midnight before your surgery. Follow your anaesthesia team's specific instructions.
• Bathing: Bathe with antiseptic soap the night before and morning of surgery.
• Dental check: Inform your surgeon if you have loose teeth or dental work — this is important for safe anaesthesia.
• Pre-operative tests: Blood tests, ECG, chest X-ray, and other tests will be done 1–2 days before surgery. Ensure all reports are with you.
• Mental preparation: It is normal to feel anxious. Speak to your surgeon about any concerns — no question is too small.

• Documents: All previous scan reports (CT, PET, MRI), biopsy reports, blood test results, referral letters, and hospital ID
• Medications: Bring all your current medications in their original packaging
• Clothing: Loose, comfortable clothing that opens at the front (button shirts are ideal post-surgery). Slip-on footwear.
• Personal items: Toothbrush, towel, phone charger, and any reading material for recovery
• Insurance documents: If using health insurance, carry your policy card and pre-authorisation letters
• Support person: Arrange for a family member or trusted person to stay with you — especially for the first night post-surgery
• Money: Keep some cash for pharmacy and incidental expenses

Pain after minimally invasive (laparoscopic or VATS) surgery is significantly less than after open surgery, but some discomfort is normal.

• First 24–48 hours: Pain is managed with IV medications in the ward. You will be monitored closely.
• VATS/thoracic surgery: You may feel a dull ache at the incision site and shoulder tip pain (from the diaphragm irritation by CO₂). This is normal and resolves in a few days.
• Abdominal surgery: Bloating and gas-like pain in the shoulder after laparoscopic surgery is from residual CO₂ gas — it resolves with walking and time.
• At home: You will be discharged with oral pain medications. Take them regularly as prescribed — don't wait until pain is severe.
• When to call: If pain is severe, worsening, or not controlled by prescribed medications, contact the clinic immediately.

Not all patients go to the ICU after surgery. For most minimally invasive procedures, patients recover in the regular surgical ward. However, for larger operations, a brief ICU stay helps ensure safe monitoring.

• Duration: ICU stays for cancer surgery typically range from overnight to 1–2 days depending on the complexity of surgery.
• Monitoring: You will have IV lines, a urinary catheter, and monitoring leads for blood pressure, heart rate, and oxygen levels. This is routine — not a sign of complication.
• Breathing support: Some patients may need a ventilator briefly after major thoracic surgery. This is usually weaned off quickly.
• Family visits: ICU visiting hours are usually restricted. Your family will be updated regularly by the nursing team.
• Eating: You will start on fluids and gradually progress to food after your bowels or respiratory function recovers.

After lung surgery (VATS or open), a chest tube is routinely placed to drain any air or fluid that may collect around the lung.

• What it looks like: A thin flexible tube coming from your side, attached to a sealed drainage bottle. You may see fluid or air bubbles in the bottle — this is expected.
• Is it painful? There may be some discomfort around the insertion site. Your pain team will manage this effectively with medications.
• Movement: You can and should walk with the chest tube in — the drainage bottle must remain below your chest level at all times.
• When is it removed? The chest tube is typically removed once drainage is minimal (usually Day 1–3 after VATS). Removal takes a few seconds and is mildly uncomfortable but brief.
• After removal: A small dressing covers the site. Most patients are discharged within 24 hours of tube removal.

Good nutrition after surgery is essential for healing, immune function, and recovery of strength.

• Day 1–2: Clear liquids — water, tender coconut water, clear soups, diluted juices. Avoid carbonated drinks.
• Day 3–5: Soft diet — idli, upma, khichdi, soft-cooked rice and dal, curd. Avoid spicy, oily, or heavy foods.
• After discharge: Gradually return to normal diet over 2–3 weeks. Eat small, frequent meals rather than large ones.
• Protein is key: Include eggs, dal, lean chicken, paneer, and milk — protein is essential for wound healing.
• After esophageal or stomach surgery: You will have specific dietary instructions from your team. A dietitian consult will be arranged.
• Avoid: Alcohol, smoking, and highly processed foods during recovery. These impair healing and increase infection risk.

Breathing exercises are one of the most important things you can do to recover well after lung or chest surgery. They prevent pneumonia and help the remaining lung expand fully.

• Deep breathing: Take a slow, deep breath in through your nose, hold for 2–3 seconds, then breathe out slowly through your mouth. Repeat 10 times every hour when awake.
• Incentive spirometer: A device given to you in hospital — breathe into it to keep your lungs open. Use it 10 times every 1–2 hours.
• Coughing exercise: Hold a pillow firmly against your chest/incision for support, then cough firmly to clear secretions. This is important — do not suppress coughs.
• Positioning: Sit upright rather than lying flat — this helps lung expansion. Sleep with your head slightly elevated.
• Start early: Begin breathing exercises within hours of surgery, as instructed by your physiotherapist.

Early movement is one of the most powerful things you can do after surgery. It reduces the risk of blood clots, chest infections, and muscle weakness.

• Day 1 after surgery: With support from your nurse and physiotherapist, try to sit up in bed and dangle your legs over the side.
• Day 2: Most patients can stand and take a few steps with help. Even 5–10 minutes of walking is beneficial.
• Walking goal: Increase walking distance each day. By discharge, aim to walk around the ward independently.
• Arm exercises: After breast or axillary surgery, specific shoulder and arm exercises are started early to prevent stiffness and lymphedema.
• At home: Short, gentle walks 2–3 times a day. Gradually increase over 2–4 weeks. Avoid heavy lifting (>2 kg) for 4–6 weeks.
• Driving: Do not drive until you are off strong pain medications and can perform an emergency stop comfortably — usually 2–4 weeks post-surgery.

Regular follow-up after cancer surgery is essential — both to check healing and to monitor for any signs of recurrence.

• 1–2 weeks post-surgery: First follow-up visit — wound check, stitch removal (if needed), and review of final pathology (histopathology) report.
• 1 month: Clinical assessment, review of any further treatment (chemotherapy or radiotherapy) if recommended.
• 3 months: CT scan or relevant imaging to assess recovery and baseline surveillance.
• Ongoing: Typically every 3–6 months for the first 2 years, then annually. Your oncologist will tailor this schedule based on your cancer type and stage.
• Pathology report: Discuss the pathology report in detail at your first follow-up — ask about tumour margins, lymph node status, and whether further treatment is needed.
• Never miss a follow-up. Early detection of recurrence dramatically improves outcomes.

Most patients recover smoothly at home. However, it is important to recognise warning signs early. Do not wait — contact your surgeon or go to the emergency room if you notice any of the following:

For non-urgent queries, call Dr. Prabhakaran's clinic at +91 90826 99710 or email drprabhakaranu@gmail.com.