Not Done Yet....

I found this online and it made me feel better that Laurelle is hitting all of the correct benchmarks. Although she didn't have pancreatic cancer, this operation did the trick. So, ignore all of the references to diabetes.

An excerpt:

Immediately after your operation

If you have had very major surgery to try to cure your cancer, you will probably wake up in intensive care or a high dependency recovery unit. This is nothing to worry about. These are places where you can have one to one nursing care. And your surgeon and anaesthetist can keep a close eye on your progress. As soon as your doctors are sure you are recovering well, you will move back to the ward.

When you wake up, you will have several different tubes in place. This can be a bit frightening. But it helps to know what they are all for. You will have

• Drips (intravenous infusions) to give you blood transfusions, and fluids until you are eating and drinking again
• Tubes into your neck and arms to measure your blood pressure
• One or more tubes coming out of your abdomen near your wound. These wound drains stop blood, bile and tissue fluid collecting around the operation site.
• A tube down your nose into your stomach (nasogastric tube) to drain it and stop you feeling sick
• A tube into your bladder (catheter) so that your urine output can be measured
• A fine tube into your back that goes into your spinal fluid (epidural) to help relieve pain

You may also have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse. Keeping your blood pressure stable is very important after surgery to the pancreas. So, your nurses will measure your blood pressure very often for the first week or so. At first, they can monitor it through the tubes that go into your neck and arms. These go directly into your main blood vessels and give a more accurate measurement than a blood pressure cuff on your arm would. Your nurses will also check your urine output because it can help to show whether you have too much fluid or are becoming dehydrated.

You may have a couple of electronic pumps attached to your drips. One of these might have painkillers in it. You may have a hand control with a button to press to give yourself extra painkillers, as you need them.

If you have had major surgery to your pancreas, you may have another pump containing insulin. It is important that your insulin levels are kept within the normal range. Your nurse will test your blood insulin every hour or two at first. The pump will be set to give you just the amount of insulin you need.

Painkillers

You will almost certainly have pain for the first week or so. But there are many different pain-killing drugs you can have. There are also different ways of having painkillers. You can have them by mouth or by injection. Doctors can also give anaesthetic dugs into your spinal cord - this is called an epidural.

It is important to tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly so don't suffer in silence. If you have a button you can press to give yourself extra painkillers, do you use it whenever you need to. You can't overdose – the machine is set to prevent that. Do tell your nurse if you need to press the button very often. You may need a higher dose in the pump.

Eating and drinking

After surgery to any part of the digestive system, the bowel often stops working for a while. Until it starts up again, you will not be able to eat or drink.

If you have been ill for some time before your surgery, you may be very run down and malnourished. This is because the pancreas produces enzymes that help us digest our food. You may need extra help with nutrition to start with and may be given a white liquid called TPN through your drip. This stands for 'total parenteral nutrition'. It contains proteins, fats and carbohydrates that can be easily absorbed by the body.

Once your bowel starts working again, you will be able to try sips of fluids. Gradually the amount you are allowed to drink will increase. And soon you will be able to try other fluids as well as water. Once you are able to drink without being sick, your drip and nasogastric tube can come out.

Your wound

The wound from the operation will be covered up when you come round. It will be left covered for a couple of days. Then the dressings will be changed and the wound cleaned. The wound drains will be left in until they stop draining fluid. The bottles attached to them will be changed every day. Wound drains can usually be taken out about a week after your operation. This may be longer if there is any fluid leakage in the operation area. Your stitches will be left in for about 2 weeks.

Some surgeons leave a small tube (stent) inside you to help drain fluid from the pancreas after your surgery. This is usually removed about 3 weeks after the operation, so you have to come back to hospital to have it taken out in out patients.

Getting up

This may seem impossible at first. Moving about helps you to get better, but you will need to start very gradually. Your physiotherapist will visit you every day after your operation to help you with your breathing and leg exercises.

Your nurses will encourage you to get out of bed and sit in a chair one or two days after your surgery. They will help you with all the drips and drains. Over the next couple of days, the tubes, bottles and bags will start to be taken out. Then, it will be much easier to get around and you will really feel that you are beginning to make progress.

Making progress

After a few days you will be able to be up and about more. Gradually you will start to feel better. You will be able to eat more, but will have to stick to the diet that your dietitian has planned for you. Your diet will be low in fat and quite bland. Frequent small meals are easier to manage than 3 large meals a day. There is more about diet after pancreatic surgery in the, Living With Pancreatic Cancer section of CancerHelp UK.

Your blood sugar will continue to be monitored until it is stable. Unless you have had a total pancreatectomy, you shouldn't need to be on insulin for long. If your blood sugar is not stable by the time you go home, you and your family will be taught how to keep an eye on it.