In order to ensure the best possible result after a Nuss procedure there are certain restrictions to your activity.
Care after Nuss procedure
Mobilization after Nuss procedure
As soon as you wake up from the anaesthetic and regain feeling in your legs you must wiggle your feet. This is to encourage your circulation and reduce the risk of blood clots.
After the operation it is important that you prevent complications, e.g. of the heart, lungs and gastrointestinal system. It is thus of great importance that you quickly get on your feet again. We expect you to sit up, stand and walk on the day of the operation.
You should not lie in bed, but should promptly resume your everyday life. This is all part of your exercise regime. You should get up and walk around, and sit in a chair when you are eating, watching TV etc.
It is important that you wear your own clothes when you are up and about. This will help increase your feeling of wellbeing. Initially, though, you will need bed rest several times a day.
Walking around promotes gastric function, thereby decreasing the risk of constipation, but it also means you can better inhale air right down into your lungs, thus reducing the risk of pneumonia. You will also be given a special flute that you must breathe
through several times a day; this will also improve your breathing.
Straight after the operation you will need the help and support of the staff. The nursing staff and the physiotherapist will help and instruct you regarding how best to move, bearing in mind your restrictions.
Your relatives will be encouraged to help you and keep you company, but they must remember that you will need a few hours' peace and quiet in the middle of the day, after lunch.
The physiotherapist will instruct you regarding the exercise regime, which you must continue following discharge. The physiotherapist will come once or twice a day to provide guidance in the exercises.
Baths and bandages
You can take a bath without any dressing on 24 hours after the operation or 24 hours after any drain has been removed. Whilst you still have a dressing on you must bear in mind that it must be changed if it is wettened by blood or water. It is alright for there to be a spot on the dressing.
During hospitalization the nurse will help you look after the dressing and if necessary change it. When the wounds are no longer producing exudate you will not need any dressing.
Pain relief after Nuss procedure
For the first few days you will receive analgesics through the catheter in your back. This takes place automatically using a small pump. You must also take analgesic tablets at regular intervals four times a day. This will be OTC medication supplemented with something stronger.
You will be talking to the staff about pain relief several times a day, so we can adapt it to your needs. You cannot expect to be without pain whilst you are hospitalized, but we will collaborate on making your pain level acceptable.
The catheter in your bladder will be removed at the same time as the epidural catheter on Day Two. You may have difficulty urinating on your own the first few times, and it may be necessary for us to help you use a disposable catheter the first couple of times, until you can urinate on your own again.
Whilst you are receiving analgesics and are not moving about as normal you will need a laxative to keep your bowel moving. It will also help to drink a lot of water – approx. 1½ litres a day.
You will be given antibiotics during hospitalisation to reduce the risk of inflammation.
Planning your discharge
At an early stage we will discuss discharge with you and, where appropriate, your relative, the aim being optimum planning of the discharge. The discharge will be planned as a collaboration between you, your relative, the physiotherapist, the nurse and the surgeon who operated on you.
Before you are discharged you must discuss with the physiotherapist where the subsequent exercises are to take place and what they will comprise. You will be referred for physiotherapy.
Your rib cage will be X-rayed before discharge by way of documentation that the materials are in the correct place. You and, where applicable, the relative(s) who will be helping you at home will talk to the nurse about analgesics, the wound, the dressing, bowel function and follow-up of developments before you go home.
You can go home as a passenger in a normal car. The physiotherapist or nursing staff will walk you to the car and show you how best to get into it. If the journey is to be long it may be a good idea to have a break or two so you can get out and stretch your legs.