Transplant and Pulmonary Hypertension
What to Expect After Surgery
The good news is that about 90 percent of lung or heart-lung transplant patients recover from the surgery. When you wake up, you will probably find a variety of tubes and monitoring equipment on your body.
The medical equipment used to monitor you may include the following:
- A breathing tube goes down your airway (trachea) so that you do not have to expend too much energy breathing on your own. The tube may remain in place for as little as three to four hours, or it may be required for several weeks.
- A nasal/gastric tube passes through your nose and down to your stomach to allow for the removal of digestive fluids until you can take in food/fluids by mouth.
- Chest tubes are flexible tubes that pass through your skin around the area where the surgery was performed. They drain the blood and fluids in the chest cavity. These are removed when drainage stops, usually in several days.
- A Foley catheter will be placed in your bladder for two to four days to track how much urine you produce.
- Large intravenous catheters will be placed in your neck and arm. These allow the nurses to draw most of the blood samples used for tests, so you will not have a needle stick every time blood samples are needed. The catheters also allow for the administration of intravenous medicines, especially while you still have the breathing tube in and cannot take medicines by mouth.
- Wrist restraints will be gently tied as a precaution so you don’t pull or dislodge your breathing tube or other equipment as you wake up.
You may experience any of a number of symptoms after surgery and in the weeks following:
- Pain or discomfort
- Nausea or poor appetite
- Increased heart rate
- Lack of sleep
- Strange dreams or hallucinations
- Weakness or dizziness
- Difficulty concentrating
- Mood swings or altered personality
Most patients are able to walk by the third or fourth day after they enter the ICU. When your tubes and catheters are removed and you can take all your medicines by mouth, you will be transferred to a room in the transplant unit. You will be continuously monitored for temperature, oxygen saturation, pulse and blood pressure, and you will have frequent chest x-rays and blood tests.
Some patients are discharged in a week; some require a month or more to recover. According to the Duke Transplant Center, the average patient can walk a mile a day in two to four weeks after transplant. Lung transplantees usually find that the size and function of the right ventricle of their heart becomes much more normal, often within those four weeks.
The recovery process involves a combination of chest physiotherapy (CPT), exercise and proper nutrition. CPT incorporates a number of activities that are designed to keep your lungs clear of secretions and prevent lung collapse and pneumonia. Activities include deep breathing exercises, use of an incentive spirometer, chest percussion and coughing. You will also be given inhalation medicines; these will be set up initially by your nurses, who will later teach you how to use the medicines by yourself.