Colorectal (bowel) cancer – Part 4

Getting ready to leave hospital, life after laparoscopic bowel surgery – Enhanced Recovery Programme

It is very important you continue to follow the Enhanced Recovery Programme.
You must contact your specialist nurse or ward if you have any worries or concerns about your operation or recovery. (The contact numbers are in Part 5 of this booklet.)

How can I help myself to recover?

Eating and drinking

You should eat a healthy, varied diet. Make sure you eat regular meals, 3 times a day or more. You may find some foods cause you to have loose bowel motions (like diarrhoea). If this is the case, you should avoid these foods for the first few weeks after your operation.

If you find it difficult to eat, it is very important that you try and eat foods with high levels of protein and calories, such as fish, cheese and meat.

If you have loose motions, it is important to replace your fluid loss by having extra drinks.

Bowel movements

You may notice some changes after having part of your bowel removed. When your bowel starts working again, your motions can be irregular and loose, normal or hard. This is usual after a bowel operation.

It can take some time for your bowels to settle down. Eating and walking regularly after your operation will help. If you are worried contact your specialist nurse for advice.

Stoma care

Your specialist nurse will have made sure you know how to care for your stoma before you leave hospital. Do not hesitate to contact him or her at any time if you have any problems with your stoma.

Passing urine

Sometimes after bowel surgery, you may feel that your bladder is not emptying fully. This usually settles with time. If it does not, or if it starts to sting when you pass urine, please contact your GP or ward, as you may have an infection and need treatment.

Monitoring your wound

It is not unusual for your wound to be slightly red and uncomfortable during the first 1 – 2 weeks after your operation.

You must contact your GP or ward if:

• your wound becomes inflamed (looks red), painful or swollen
• your wound discharges (leaks fluid)
• you feel feverish, unwell or develop a high temperature.

If you have any problems or worries, contact your specialist nurse or ward. (The contact numbers are in Part 5 of this booklet.)

Bathing

You can bathe or shower as you wish. A warm bath can help to ease any discomfort you may have. After any dressings have been removed, you can pat your wound area dry with a clean towel or use a hair dryer on a cool heat setting.

Pain

You should not have any severe pain from your wound after you go home from hospital. If you do have severe pain, you must contact the ward immediately.

You may, however, have some slight pain or discomfort. Taking paracetamol according to the manufacturers’ instructions can help. If you have constant pain that lasts more than 2 hours, or any severe pain, you must contact the ward immediately.

If you have:

• numbness near your wounds: this is normal and can take a few months to settle.

• ‘wind’ pains: this is normal and can be relieved by sucking peppermints or taking gentle exercise and by eating small regular meals.

Talk to your specialist nurse if you have any worries or concerns.

Exercise

When you go home, it is important that you continue to do the exercises shown to you by your physiotherapist. Gentle walking is good for you. If you feel pain, are sore or tired during any activities, stop and rest. Have rest periods during the day and reduce them as your strength builds up. Do not spend too long in bed.

Gradually increase your exercise during the first 2 weeks following your operation until you are back to your normal level of activity.

You must not:

• lift heavy objects for 6 – 8 weeks following your operation
  
• do strenuous exercise for 6 – 8 weeks following your operation

• do sports for 6 – 8 weeks, you can start again gradually following this time.

If you feel pain, discomfort or tired during any activities, you should stop and rest.

Hobbies and activities

You can start gentle hobbies and activities as soon as you want after your operation. This will benefit your recovery. However, you should not do anything that causes increased pain or involves heavy lifting for at least 6 weeks after your operation.

When can I start driving again?

You should not drive for at least 2 weeks. You should discuss this with your consultant or GP before you start to drive again.

When can I return to work?

This may vary depending on the type of work you do but is usually between 6 – 8 weeks after your operation. Ask your doctor or GP when the time is right for you.

When can I resume (have) sexual intercourse?

You can resume sex when you feel comfortable. This varies from person to person. If you have any worries or concerns talk to your specialist nurse.

Life after bowel surgery

Being told you have cancer is a shock, and one which may take

some time to come to terms with. Help is available.

You do not have to deal with this alone, unless you prefer to do so. Your specialist nurse, stoma nurse and the Macmillan Nursing Team are experts in supporting you at this time. The support of a caring partner or close friend can help.

Following your operation, it is common to feel a lack of confidence, especially if you have had a stoma.

Details of support groups both local and national, which may be able to help you, are given in Part 5 of this booklet.

When will I find out the results from my operation?

If you have not been given the results of your operation before you leave hospital, you will be given an appointment to see your consultant. This will usually be about 2 weeks after you are discharged from hospital.

If you have been given the results of your operation, you will be sent an appointment to see your surgeon about 6 weeks after you are discharged from hospital.

Will I need further treatment after my surgery?

If your results show you need further treatment, for example chemotherapy, you will be sent an appointment to attend the oncology clinic to discuss this. Your follow-up appointments will continue with the Oncology Department until your treatment is complete.

When your chemotherapy treatment has finished, your follow-up appointments will usually be carried out by a specialist nurse in a nurse-led clinic.

Will I have any follow-up appointments when my treatment is complete?

You will be followed up in a nurse-led clinic for 5 years. You will

usually be seen every 3 months during the 1st year; every 6 months

during the 2nd year and once a year during the 3rd, 4th and 5th

years.

During your follow-up appointments, you may be seen by either a

consultant or specialist nurse.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]