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    Postoperative Problems

    Postoperative Problems

    Topic Overview

    Many people do not feel well after surgery. Pain, nausea, and a lack of energy may occur even after a minor surgery. Usually, getting some rest and following the instructions your surgeon gave you will help postoperative problems diminish over time.

    Different types of surgery require different home care instructions. Your surgeon will give you specific instructions to follow after your surgery. This includes learning about your medicines, diet restrictions, wound care, showering or bathing, and finding out when you can return to your regular activities. Your surgeon may think that you understand more than you really do about what you should or should not do when you return home. If you have any questions about your discharge instructions, be sure to ask your surgeon.

    Your surgeon will want to talk to you if you:

    • Have questions about your home care instructions, such as wound care, diet, or activity level, or when to schedule a follow-up appointment.
    • Develop a symptom or problem that you do not know how to handle.
    • Develop an unexpected symptom or problem.
    • Have problems with your prescription medicines. These problems may include a rash, hives, nausea, vomiting, or stomach problems.

    Check your symptoms to decide if and when you should see a doctor.

    Check Your Symptoms

    Have you had surgery in the past month?
    Yes
    Surgery in the past month
    No
    Surgery in the past month
    How old are you?
    Less than 12 years
    Less than 12 years
    12 years or older
    12 years or older
    Are you male or female?
    Male
    Male
    Female
    Female
    Do you have symptoms of shock?
    Yes
    Symptoms of shock
    No
    Symptoms of shock
    Could you be having symptoms of a heart attack?
    If you're having a heart attack, there are several areas where you may feel pain or other symptoms.
    Yes
    Symptoms of heart attack
    No
    Symptoms of heart attack
    Since having the surgery, have you had new or worse trouble breathing?
    Yes
    New or worse trouble breathing
    No
    New or worse trouble breathing
    Would you describe the breathing problem as severe, moderate, or mild?
    Severe
    Severe difficulty breathing
    Moderate
    Moderate difficulty breathing
    Mild
    Mild difficulty breathing
    Have you had any new neurological symptoms?
    Yes
    Neurological symptoms
    No
    Neurological symptoms
    Are you bleeding?
    Yes
    Bleeding
    No
    Bleeding
    Would you describe the bleeding as severe, moderate, or mild?
    Severe
    Severe bleeding
    Moderate
    Moderate bleeding
    Mild
    Mild bleeding
    Does it hurt when you breathe?
    This can be a warning sign of a blood clot in the lung, called a pulmonary embolism.
    Yes
    Pain when breathing
    No
    Pain when breathing
    Yes
    Symptoms of pulmonary embolism
    No
    Symptoms of pulmonary embolism
    Yes
    At risk for pulmonary embolism
    No
    At risk for pulmonary embolism
    Is there any pain?
    Yes
    Pain
    No
    Pain
    How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
    8 to 10: Severe pain
    Severe pain
    5 to 7: Moderate pain
    Moderate pain
    1 to 4: Mild pain
    Mild pain
    Is your belly painful, hard, or swollen?
    Yes
    Painful, rigid, or distended abdomen
    No
    Painful, rigid, or distended abdomen
    Does pain medicine relieve the pain?
    Yes
    Pain medicine helps
    No
    Pain medicine helps
    Do you have pain or swelling in one calf?
    Pain and swelling in the lower leg can be symptoms of a blood clot.
    Yes
    Pain or swelling in one calf
    No
    Pain or swelling in one calf
    Have you had surgery on your arm or leg?
    Yes
    Surgery on limb
    No
    Surgery on limb
    Is the limb blue, very pale, or cold and different from the other limb?
    If the limb is in a cast, splint, or brace, follow the instructions you got about how to loosen it.
    Yes
    Limb is blue, very pale, or cold and different from other limb.
    No
    Limb is blue, very pale, or cold and different from other limb.
    Is the incision opening up or are the stitches coming out?
    An incision is any cut that was made for the purpose of the surgery. It may have been closed with stitches, staples, or a bandage.
    Yes
    Incision opening or stitches coming out
    No
    Incision opening or stitches coming out
    Has more than one-third of the incision opened up?
    Yes
    More than one-third of incision has opened
    No
    More than one-third of incision has opened
    Do you think you may have a fever?
    Yes
    Possible fever
    No
    Possible fever
    Are there any symptoms of infection?
    Yes
    Symptoms of infection
    No
    Symptoms of infection
    Are you nauseated or vomiting?
    Nauseated means you feel sick to your stomach, like you are going to vomit.
    Yes
    Nausea or vomiting
    No
    Nausea or vomiting
    Is the vomiting severe?
    Yes
    Severe vomiting
    No
    Severe vomiting
    Have you felt nauseated or been vomiting for more than 4 hours?
    Yes
    Nausea or vomiting for more than 4 hours
    No
    Nausea or vomiting for more than 4 hours
    Do you have problems with urination?
    Yes
    Problems with urination
    No
    Problems with urination
    Are you able to urinate at all?
    Yes
    Able to urinate
    No
    Unable to urinate
    Yes
    Symptoms of urinary tract infection
    No
    Symptoms of urinary tract infection
    Are you having any problems with your bowel movements, such as constipation or diarrhea?
    Yes
    Bowel problems
    No
    Bowel problems
    Are you constipated?
    Constipation means your stools are hard and you have trouble passing them. If your stools are soft and pass easily, you are not constipated.
    Yes
    Constipation
    No
    Constipation
    Have you had a bowel movement in the past 3 days?
    Yes
    Bowel movement in past 3 days
    No
    Bowel movement in past 3 days
    Do you have diarrhea?
    Yes
    Diarrhea
    No
    Diarrhea
    Do you have severe diarrhea?
    Severe means more than 10 loose, watery stools in a single day (24 hours).
    Yes
    Severe diarrhea
    No
    Severe diarrhea
    Are you having any new or unexpected symptoms?
    Yes
    New or unexpected symptoms
    No
    New or unexpected symptoms
    Would you describe these symptoms as serious or minor?
    Serious
    Serious new or unexpected symptoms
    Minor
    Minor new or unexpected symptoms
    Do you think that a medicine may be causing your symptoms?
    Think about whether the symptoms started after you began using a new medicine or a higher dose of a medicine.
    Yes
    Medicine may be causing symptoms
    No
    Medicine may be causing symptoms

    Call 911 Now

    Based on your answers, you need emergency care.

    Call 911 or other emergency services now.

    Call 911 Now

    Based on your answers, you need emergency care.

    Call 911 or other emergency services now.

    After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

    Symptoms of infection may include:

    • Increased pain, swelling, warmth, or redness in or around the area.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.

    Severe trouble breathing means:

    • The child cannot eat or talk because he or she is breathing so hard.
    • The child's nostrils are flaring and the belly is moving in and out with every breath.
    • The child seems to be tiring out.
    • The child seems very sleepy or confused.

    Moderate trouble breathing means:

    • The child is breathing a lot faster than usual.
    • The child has to take breaks from eating or talking to breathe.
    • The nostrils flare or the belly moves in and out at times when the child breathes.

    Mild trouble breathing means:

    • The child is breathing a little faster than usual.
    • The child seems a little out of breath but can still eat or talk.

    Pain in children under 3 years

    It can be hard to tell how much pain a baby or toddler is in.

    • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
    • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
    • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

    Pain in adults and older children

    • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
    • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
    • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

    Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

    • Your age. Babies and older adults tend to get sicker quicker.
    • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
    • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
    • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
    • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

    Try Home Treatment

    You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

    • Try home treatment to relieve the symptoms.
    • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

    Symptoms of a heart attack may include:

    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.

    The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness, tingling, or a strange feeling in your chest or other areas.

    Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

    Symptoms of shock in a child may include:

    • Passing out.
    • Being very sleepy or hard to wake up.
    • Not responding when being touched or talked to.
    • Breathing much faster than usual.
    • Acting confused. The child may not know where he or she is.

    Symptoms of a pulmonary embolism may include:

    • Sudden shortness of breath.
    • Sudden, sharp chest pain that may get worse when you breathe deeply or cough.
    • Coughing up blood or pink, foamy mucus.
    • Fast heart rate.
    • Severe anxiety.
    • Fainting.

    If you have pain when you are breathing, you may be at immediate risk for a pulmonary embolism if you also have:

    • Pain deep in one leg for no clear reason. This can be a sign of a blood clot in the leg (deep vein thrombosis) that could travel to the lungs.
    • A history of problems with blood clots, such as deep vein thrombosis or a previous pulmonary embolism.

    Severe vomiting can mean that:

    • You vomit more than 10 times in 24 hours.
    • For at least 24 hours, you vomit every time you try to drink something.
    • The vomit shoots out in large amounts and with great force.

    Call 911 Now

    Based on your answers, you need emergency care.

    Call 911 or other emergency services now.

    Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

    Urinary tract infections may occur in the bladder or kidneys. Symptoms may include:

    • Pain or burning when you urinate.
    • A frequent need to urinate without being able to pass much urine.
    • Pain in the flank, which is either side of the back just below the rib cage and above the waist.
    • Blood in the urine.
    • Fever.

    Seek Care Now

    Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

    • Call your doctor now to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don't have one, seek care in the next hour.
    • You do not need to call an ambulance unless:
      • You cannot travel safely either by driving yourself or by having someone else drive you.
      • You are in an area where heavy traffic or other problems may slow you down.

    Seek Care Today

    Based on your answers, you may need care soon. The problem probably will not get better without medical care.

    • Call your doctor today to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don't have one, seek care today.
    • If it is evening, watch the symptoms and seek care in the morning.
    • If the symptoms get worse, seek care sooner.

    Severe trouble breathing means:

    • You cannot talk at all.
    • You have to work very hard to breathe.
    • You feel like you can't get enough air.
    • You do not feel alert or cannot think clearly.

    Moderate trouble breathing means:

    • It's hard to talk in full sentences.
    • It's hard to breathe with activity.

    Mild trouble breathing means:

    • You feel a little out of breath but can still talk.
    • It's becoming hard to breathe with activity.

    Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

    Symptoms of shock (most of which will be present) include:

    • Passing out.
    • Feeling very dizzy or lightheaded, like you may pass out.
    • Feeling very weak or having trouble standing.
    • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

    Neurological symptoms-which may be signs of a problem with the nervous system-can affect many body functions. Symptoms may include:

    • Numbness, weakness, or lack of movement in your face, arm, or leg, especially on only one side of your body.
    • Trouble seeing in one or both eyes.
    • Trouble speaking.
    • Confusion or trouble understanding simple statements.
    • Problems with balance or coordination (for example, falling down or dropping things).
    • Seizures.

    With severe bleeding, any of these may be true:

    • Blood is pumping from the wound.
    • The bleeding does not stop or slow down with pressure.
    • Blood is quickly soaking through bandage after bandage.

    With moderate bleeding, any of these may be true:

    • The bleeding slows or stops with pressure but starts again if you remove the pressure.
    • The blood may soak through a few bandages, but it is not fast or out of control.

    With mild bleeding, any of these may be true:

    • The bleeding stops on its own or with pressure.
    • The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

    Home Treatment

    If you have had surgery:

    • You will be given some general instructions about what to do after surgery. Your surgeon may also give you some special instructions on how to care for the surgery area. Be sure to follow those instructions carefully.
    • If the instructions from your surgeon are not clear or do not cover your particular problem, contact your surgeon.
    • If your symptom or problem starts after the office or health facility is closed, call your surgeon's office and leave a message with the answering service (or follow instructions given on the answering machine). If you leave a message, be sure to include your name and phone number so that your surgeon (or the on-call surgeon) can contact you.

    Do not smoke or use other tobacco products. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Smoking.

    Write down your symptom or problem. It may help you become more aware of your specific symptom or problem or give you ideas about its cause. It will also help prepare you to talk to your surgeon about what you are experiencing.

    Symptoms to watch for during home treatment

    Call your doctor if any of the following occur during home treatment:

    • A new symptom develops that is different than what your surgeon told you to expect.
    • Symptoms become more severe or frequent.

    Prevention

    You may be able to prevent problems after surgery by taking steps beforehand to improve your health.

    • Do not smoke or use other tobacco products. Complications involving the lungs are more likely to occur in people who smoke. Infections are more common in people who use tobacco products, because of reduced blood flow and from having more mucus stuck in the airways. For more information, see the topic Quitting Smoking.
    • Maintain a healthy body weight. Problems with increased abdominal pressure, complications involving the lungs, and infection occur more often in people who are overweight. For more information, see the topic Weight Management.
    • Practice deep breathing exercises before surgery.
    • If possible, be active before your surgery to increase your fitness level. For more information, see the topic Fitness.
    • Eat a balanced diet. Make an appointment with a dietitian if you need help with menu planning. For more information, see the topic Healthy Eating.

    Be sure to follow all of your surgeon's instructions after surgery to prevent problems. You may be instructed to:

    • Drink plenty of fluids. This can help prevent problems such as dehydration and constipation.
    • Sit up, cough, and breathe deeply to expand your lungs and help prevent breathing problems, such as pneumonia .
    • Walk as soon and as often as your surgeon recommends. Early activity helps prevent complications. Ask your surgeon how soon you can expect to get out of bed, sit in a chair, and walk. Walking increases circulation to your legs and helps prevent problems, such as blood clots. Walking also helps prevent constipation.

    Preparing For Your Appointment

    To prepare for your appointment, see the topic Making the Most of Your Appointment.

    You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

    • What kind of surgery did you have?
    • What type of anesthesia was used?
    • How long ago was your surgery?
    • When did the symptom or problem start?
    • Has anything made the symptom or problem better or worse?
    • What home treatment measures have you tried? Did they help?
    • What prescription and nonprescription medicines or dietary supplements do you take?
    • Do you have any health risks?

    Related Information

    Credits

    By Healthwise Staff
    William H. Blahd, Jr., MD, FACEP - Emergency Medicine
    H. Michael O'Connor, MD - Emergency Medicine
    Last Revised November 13, 2012

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