People often experience some anxiety when faced with leaving hospital after a major operation, about how they will manage at home, or when they are going to be able to get back to a normal routine. This is especially true for bowel cancer patients coping with a new bowel habit or stoma.
Hospital in-patient stays are getting shorter and laparoscopic surgery can mean that you are only in hospital for 3 or 4 days, compared with the 6–10 days usually associated with an 'open' operation.
- Get out of bed and get dressed every day. This will help you build up your strength and encourage the return of normal sleep patterns.
- Gradually start to increase your activity by doing some light jobs around the house as you feel able.
- Avoid standing still for long periods of time, and when sitting down, make sure your back is well supported.
- Talk to your friends and family and explain what you are/are not allowed to do during the recovery period. This will help them to understand when you need extra support and avoid you having to take on too much before you able.
- Start doing some form of gentle exercise as soon as you can, several times a day, to improve mobility and strength. Avoid any strenuous physical exercise for at least eight to ten weeks following the operation to avoid straining the healing tissues and muscles.
- Drink plenty of fluids and eat light, nutritious meals, slowly increasing the quantity as your appetite improves. Large meals once or twice a day can put extra strain on your digestive system and bowel, affecting your appetite in the recovery period. Smaller, nutritious meals eaten frequently throughout the day are good if your appetite is poor.
- Take your painkillers regularly, as prescribed, until you no longer have pain or discomfort. You may need to do this for some weeks after surgery to maintain mobility and independence, so that you get better more quickly. A painkiller before bed may help you settle to sleep more easily.
- Constipation is a common problem associated with a change in your diet, certain pain medications and a general decrease in activity. If you are affected, do consider using gentle laxatives prescribed by your doctor to ease discomfort, and make small changes to your diet and activity levels.
- Try and get back to normal social activities as soon as you are feeling well enough. It is usually safe to resume sexual activity as/when you feel able, unless advised otherwise by your doctor.
- Give yourself time and do not expect too much too soon. Unpredictable bowel habits and scars will gradually settle down. If you do experience any problems resuming sexual activity, you can talk to your specialist nurse, or other voluntary support groups specialising in this particular area.
- Don’t be surprised if your bowel habit has changed - your bowel habits could be loose, frequent and unpredictable after surgery. This is because you have had a section of your bowel removed. It is unlikely that your bowel habit will return to exactly how it was before the surgery, but it should settle down into a routine after a few weeks, or sometimes months.
- Don’t be surprised if you have trouble tolerating certain foods. This is all normal and part of the recovery process. Some foods may cause constipation; others may cause diarrhoea. Keeping a food diary may help you find which foods seem to upset your bowels and start identifying patterns.
- Avoid lifting any heavy items and doing heavy household tasks for at least ten weeks. This will allow all the internal structures and muscles to heal properly and reduce the risk of developing a hernia.
- Don’t drive until you feel fully confident you can perform a quick movement (i.e. an emergency stop) and you are no longer taking strong painkillers that may affect your concentration. Do check with your insurance company, as some insurers will not provide cover for a period of time following a general anaesthetic. You may also find it helpful to have someone with you when you first go driving again. Remember, having bowel surgery does not exempt you from wearing a seat belt.
- Don’t return to work until you have spoken to your GP and/or surgeon to confirm they are happy for you to do so - this is particularly important if your job involves physical activity.
- develop a high temperature.
- are unable to eat or drink for any reason.
- have persistent diarrhoea, nausea or vomiting.
- have constipation for three days or more.
- have increased abdominal pain not relieved with pain medication, or if your wound becomes red, warm to touch or develops an unusual, smelly or pus-like yellow/green discharge.