Pancreatectomy Post-Operative Instructions

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Pancreatectomy Post-Operative Instructions What should I expect after my surgery? Some patients who have had part of their pancreas removed may require insulin. Your doctor will determine this during the
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Pancreatectomy Post-Operative Instructions What should I expect after my surgery? Some patients who have had part of their pancreas removed may require insulin. Your doctor will determine this during the course of your hospital stay. Patients who are already or who become diabetic after pancreas surgery will likely need to monitor their blood sugar levels. In addition, you will likely need to follow a diabetic diet and may need to take pancreatic enzymes which help digest food. If you have had your entire pancreas removed (completion pancreatectomy/total pancreatectomy), you will need lifelong insulin therapy. Your insulin requirements will be determined during your hospital stay, and you will receive education on how to manage your blood sugar (glucose) levels. How do I take care of my incision? The incision normally heals over several weeks. There may be swelling and a feeling of firmness around the area of the incision that can last for several months. Your incision site(s) may be sensitive, so wearing loose clothing may be more comfortable. Avoid wearing tight restrictive clothing. If staples were used to close your incision, leave them in place. They will be removed in the clinic during a follow-up visit. They are usually removed 7-14 days after surgery. Unless instructed otherwise, after 48 hours you may gently wash over your incision with soap and water using a clean cloth. Use a clean towel to gently pat the incision dry You may shower, but do not take a bath, get in a hot tub or swimming pool until your surgeon tells you it is okay to do so. Do not apply ointments or powders to your incision(s) unless specifically directed to do so by your doctor. Avoid smoking. It prevents proper wound healing. Scars are most noticeable 1-2 months after operation and gradually become less so over the first year. Until that time, you may notice the color is redder than the surrounding skin. This is normal and will usually improve. Your surgeon will give you specific recommendations about activity and weight lifting limits. Are there any diet restrictions? Depending on the type of pancreatic operation you had, you may have some dietary restrictions. Always eat a well-balanced diet unless directed otherwise by your doctor. You may find your appetite is decreased at first, but it will improve as you recover. You may find eating smaller, more frequent meals is easier and will maintain your nutrition status. Make sure to stay well hydrated. Nutritional supplements such as Boost or Ensure (or others) may also be used to increase caloric and protein intake. There are alternative supplements for diabetic patients. When can I resume normal activities? Walk as much as possible. Gradually increase the length of time and the distance that you walk. You may climb stairs. Do not drive until you are no longer taking narcotics and your activity level is back to normal. Do not lift, pull, or push anything greater than 10 pounds (about a gallon of milk) for at least 4 weeks or as directed by your doctor Avoid activities that would make you tense or strain your abdominal muscles for at least 4 weeks or as directed by your doctor. These activities may include lots of twisting or vacuuming. You may resume all other normal activities as soon as you feel up to it. How will I manage my pain at home? NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve) or acetaminophen (Tylenol) are most helpful for pain experienced after surgery. To prevent overdosing on acetaminophen, do not take it at the same time as a narcotic medication that also contains acetaminophen, such as Vicodin or Norco. You may take them 4-6 hours apart as long as the total maximum daily dose of acetaminophen is not exceeded. A prescription for stronger pain medications or narcotics (such as Vicodin, Norco, or Oxycodone) will be given to you. This medication will be tapered off over several weeks as you recover. Do not drive a car or drink alcohol while taking these medications. Narcotics can cause constipation. Stool softeners (Colace), fiber (fruits, bran, vegetables), and extra fluid intake may help. A stimulant laxative (Milk of Magnesia, Senokot) may be needed as well. When should I call my doctor? Most patients have no problems after surgery, but if you are concerned, please do not hesitate to call us for the following situations: If you develop a fever greater than degrees Fahrenheit. We do not recommend you regularly take your temperature. Take your temperature only if you feel like you have a fever. It is common to have a low grade fever in the late afternoon/early evening. This does not mean you have an infection If you have difficulty breathing or note yellow sputum production when you cough. If your incision becomes red or begins to drain fluid. If you have difficulty urinating and feel like you aren't fully emptying your bladder. If you begin feeling worse several days after surgery rather than better. If you are discharged with a drain and the site becomes red, swollen, or you have a large change in the amount of drainage (more or less). If you are unable to eat or drink, have ongoing nausea or vomiting, or your abdomen becomes significantly distended and you can't pass gas or have a bowel movement. If you experience extreme fatigue, weakness, weight loss, dizziness, muscle cramps, or faint. Who should I call if I have questions? Please try to call during the day between 7:30am and 4:30pm, but you may call at any time if there is a problem. Call Center: Contact the Call Center and ask for the Surgery Nurse Coordinator (Monday Friday, 8am - 4pm) Hospital Paging: On weekends, holidays, or evenings call hospital paging and ask for the Surgery resident-on-call. You may also call the main hospital number (734) When will I receive follow-up care? You will be scheduled for a return visit in the Surgery clinic about 2 weeks after surgery. The clinic nurse coordinator will call you several days after your discharge to see how you are feeling. If blood tests have been requested at the time of your return visit, please remember to go to the lab before you check in for your appointment. Take - 4 - your lab requisition form with you and allow minutes to have your blood drawn. Disclaimer: This document contains information and/or instructional materials developed by the University of Michigan Health System (UMHS) for the typical patient with your condition. It may include links to online content that was not created by UMHS and for which UMHS does not assume responsibility. It does not replace medical advice from your health care provider because your experience may differ from that of the typical patient. Talk to your health care provider if you have any questions about this document, your condition or your treatment plan. Author: Erin Larowe Reviewers: Barbra S. Miller, MD Patient Education by University of Michigan Health System is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License. Last Revised 4/
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