University College Hospital at Westmoreland Street. Physiotherapy advice following lung surgery. The next stage of your recovery
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1 University College Hospital at Westmoreland Street Physiotherapy advice following lung surgery The next stage of your recovery
2 2
3 3 Contents 1. Introduction 3 2. Chest complications post-surgery 3 3. Chest drains 6 4. Contact details 7 5. How to find us 8 If you would like this document in another language or format, or require the services of an interpreter, contact us on We will do our best to meet your needs.
4 4 1. Introduction The following information focuses on post-operative advice including: Helping prevent chest complications Improving your general mobility If you have any questions, please contact your Lung Clinical Nurse Specialist (CNS) on the numbers given on page six. 2. Chest complications post-surgery The causes of chest complications post-surgery include: Wound pain Poor posture Decreased activity The effects of anaesthetic As a result of using anaesthetic: Mucus becomes sticky and difficult to cough up You breathe more shallowly The effectiveness of coughing is reduced
5 5 Preventing chest complications: Breathing exercises: Relax the muscles of your upper chest by breathing at the base Put your hands on your lower chest and feel the movement in and out as you breathe Take a deep breath in and hold for three seconds. Repeat this three times Take a medium-sized breath in followed by a short, sharp breath out, through an open mouth (similar to steaming up mirror) Supported cough: roll up a towel and use this to apply firm pressure over the site of pain during coughing Complete these breathing exercises three times per hour Posture Sit in an upright position to enable you to take deeper breaths Avoid sitting in a slumped position Walking It is important to be walking as soon as possible after surgery You are encouraged to increase your walking distance daily, with the support of family, if necessary Goals: Day 1: Marching on the spot. Sitting in a chair morning and evening Day 2: Marching on the spot and walking short distances every hour Day 3: Walk independently around the ward every hour
6 6 Shoulder exercises There is a risk of shoulder stiffness after surgery on the side you were operated on. If you have any questions about these exercises please ask your ward Physiotherapist. Aim to complete ten repetitions of each exercise three times per day on the side you were operated on.
7 7 3. Chest drains Your chest drains help drain air or fluid from the lung and may be attached to suction. Suction is a vacuum for the lung to help it expand more easily. Your drips and drains may make walking difficult, but nursing staff and the Physiotherapist (if required) will assist you initially to manage these. Please ensure the drain is below your waist to effectively drain air or fluid from the lung. The drains will usually be removed after two to three days.
8 8 4. Contact details University College Hospital at Westmoreland Street The old Heart Hospital Westmoreland Street London W1G 8PH If you have any questions, please contact your Lung Clinical Nurse Specialist (CNS) at your hospital. If you do not have your CNS s individual number, then please phone the Thoracic CNS at University College Hospital at Westmoreland Street on the number below who will make arrangements for your Lung CNS to contact you. CNS direct line: CNS CNSThoracicSurgery@uclh.nhs.uk Secretaries: Medical PA to Mr Lawrence and Mr Panagiotopoulos: Medical PA to Mr Hayward & Mr Kolvekar: Switchboard: Extension: Fax: Website: Physiotherapy (via switchboard): ask for physiotherapy by bleep 3001 or 6951.
9 5. How to find us 9 Public transport to University College Hospital at Westmoreland Street By bus: Portland Place - no's 88, C2 Marylebone Road - no's 18, 27, 30 Oxford Street (Bond Street Station) - no's 7, 8, 10, 25, 55, 73, 98, 176 By Tube: Bond Street (Central / Jubilee Lines) Regents Park (Bakerloo Line) Baker Street (Bakerloo / Circle / Hammersmith & City / Jubilee / Metropolitan Lines) University College Hospital at Westmoreland Street Westmoreland Street London W1G 8PH Telephone: Clinical images for this leaflet supplied by kind permission of PhysioTools Ltd.
10 Space for notes and questions
11
12 Publication date: November 2014 Last review date: June 2015 Next review date: June 2016 Leaflet code: UCLH/SH/HH/LUNGSURG-PHYSIO/1 University College London Hospitals NHS Foundation Trust
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