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Preparing for Surgery as a Treatment for Mesothelioma

Before Surgery

Standard procedure is to schedule a pre-operative appointment before your surgery which will include a complete physical exam, an electrocardiogram (EKG), and lab work.  An EKG is a painless test that involves attaching small patches (electrodes) to your body to measure how fast your heart is beating, the regularity of the rhythm of your heartbeat, and the hearts electrical activity. 

The hospital will also ask for all related medical history so come prepared with all prior tests results and documentation that you have.

The Day of Surgery

You will be given specific instructions on where to go and how to prepare.  Before entering the operating room, a nurse or surgeon will go over any questions and the details of the surgery and finalize any paperwork needed.    You will then be taken to the operating room and family and friends will be asked to wait in the waiting room. 

Once lying down and in a hospital gown, you will be given medication that will help you to relax in preparation for anesthesia.  When the medication begins to take hold, the medical team will begin to place different intravenous and catheter lines that will help provide fluids and oxygen, monitor your blood pressure, and administer medicine for post-operative pain. During the operation, you will be completely sedated (asleep).

After Surgery

Coming out of anesthesia can be difficult, and this is the time it might be helpful to have earphones to listen to soothing music or something pre-recorded that helps orient and relax you.  The anesthesiologist will administer pain medicine into the epidural catheter to help as well.  When you have sufficiently awakened, the breathing tube will be removed and you will be moved to a recovery room where loved ones can visit and be with you.  As soon as the surgeon is able, he/she will meet with you to discuss the results of the operation.

Post-operative monitoring is necessary to ensure that your heart rate, blood pressure, and breathing are all good.   Such monitoring is usually done with the use of chest tubes (especially with malignant pleural mesothelioma where there can be fluid build up around the lungs), intravenous lines to supply pain medication and fluids, and epidural and urinary catheters placed prior to surgery.  These will usually stay in place for 2-3 days after surgery and removed as soon as the body has recovered and is functioning well. 

Mesothelioma patients will be asked to cough and breathe deeply while respiratory and lung functioning is being monitored.  When your treating doctor feels you are ready, you will stay in the same hospital but be transferred out of the post-operative unit and be placed in a regular room. 

Returning Home After Surgery

As with most surgeries, two to three weeks of at home recovery time is often needed.  During this time, it is important to follow all post-operative directions carefully.  If you are experiencing pain, it is much better to manage it before it becomes too great.  Sometimes patients will not want to take the pain medication, but if they wait too long, then it can lead to complications as they pass a pain threshold that the medicine can not then alleviate. 

It is important to stay ahead of the pain level and not ever let it get too far along in the first couple of weeks.  If you have any questions or concerns about this, ask to speak to a palliative care nurse before being released from the hospital.

Considerations in the First Weeks After Surgery

  • Keep the site of your incision clean by showering with soap and water only (no lotions, powders, antibiotic creams) and keeping the area open to air. 
  • At first, you may be unable to be very active but as your body adjusts, you will recover more quickly if you can add short, simple activity, such as walking, stretching, and moving slowly.  Do not push it but realize it will help you feel better faster.
  • Do NOT lift anything heavier than 5 pounds or drive until you are told it is safe.  Likewise, you should not return to work until your follow up visit and/or the doctor gives you permission.
  • Eat a healthy diet, avoiding foods that can lead to stomach upset or constipation.  Including high fiber foods and lots of liquid can help offset some of the side effects of pain medication.

Length of time for Recovery

Depending on the stage and location of the mesothelioma tumors and how the surgery or debulking went, recovery can take some time, up to six weeks.  Following the suggestions above can help you to heal and feel better faster.   If you are diagnosed with malignant pleural mesothelioma, the doctor will ask you to cough and breathe deeply on a regular basis to keep your lungs clear.

Sometimes chemotherapy or alternative treatments are administered at the time of surgery, and this could lengthen recovery if there are added side effects and/or if fluid from the lungs is needed to be drained.

Several weeks after surgery, you will meet with the surgeon again to assess your recovery and plan any further steps of treatment that might relieve the symptoms of mesothelioma, extend survival times, and lead to a better quality of life.