CION Cancer Clinics
Your first day after cancer surgery, hour by hour | CION Cancer Clinics
The first day after cancer surgery is usually spent sleepy, closely watched and attached to a few tubes. You wake in a recovery room, then move to a ward, HDU or ICU. The team controls your pain, checks your breathing and blood pressure, and helps you start moving. This page explains what is normal, what each tube is for, and what to tell a nurse straight away. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
On this page
- What happens in the first day after cancer surgery?
- How does the first day usually unfold?
- What are all the tubes and wires for?
- Is it normal to feel this bad on the first day?
- What do the words you hear on the ward mean?
- What do families often get wrong about the first day?
- Common questions about the first day after surgery
The short answer
What happens in the first day after cancer surgery?
For most people the first day is spent sleepy, closely watched and attached to a few tubes. You wake in a recovery room, move to a ward, a high dependency unit or the ICU, and the team spends the day controlling pain, checking your breathing and blood pressure, and getting you moving a little.
Where you wake up
Almost everyone wakes in a recovery room first. It sits close to the operation theatre and has a nurse watching each patient. You stay there until you are awake enough to answer a question, your breathing is steady and your pain is under control. Only then are you moved on.
Where you go next depends on the operation
After a smaller operation you go to a ward bed. After a long or major operation, or if you have heart or lung problems, the team may plan a night in a high dependency unit or the ICU. That plan is usually made before the day. Being taken there is not by itself a sign that something went wrong.
What your family can expect
The surgeon or a senior member of the team usually speaks to the family soon after the operation ends. They will explain what was done and where you are going. Detailed answers about the cancer itself come later, once the removed tissue has been examined.
Hour by hour
How does the first day usually unfold?
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Waking in recovery
You may feel cold, shivery, dry-mouthed or confused about where you are. An oxygen mask may be on your face. Nurses check your blood pressure, pulse and pain score often, and give pain relief as soon as you need it.
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The move to your bed
You are wheeled to the ward, HDU or ICU still lying down. Staff connect you to a monitor, check every tube and drain, and settle you with the head of the bed raised a little to help your breathing.
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The first few hours
This is mostly sleep, broken by checks. Nurses look at the wound dressing, the drain bags and the urine bag, and ask about pain and sickness. Answer honestly.
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First sips and first breaths
Many teams now let you take sips of water early, if the operation allows it. You will be asked to take slow deep breaths and cough gently, holding a pillow against the wound.
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Sitting up, and sometimes standing
Later in the day, or the next morning, a nurse or physiotherapist may help you sit on the edge of the bed or into a chair. It feels too soon. It protects your lungs and lowers the chance of a clot.
Not sure whether this applies to you?
Ask an oncologistWhat is attached
What are all the tubes and wires for?
Not everyone has all of these. The type of operation decides which ones you wake up with.
The drip
A thin tube in a vein, usually in the hand or arm, gives fluids and medicines while you are not eating and drinking normally. After larger operations there may also be a line in the neck.
Pain relief
This may be a thin tube in your back called an epidural, a pump you press yourself, or medicine through the drip. Each is designed to keep you comfortable enough to breathe deeply and move.
Drains
Soft tubes near the wound let fluid and a little blood run out into a bag or bottle. Some staining in the bag is expected. The nurses measure what collects.
Catheter and monitor
A tube in the bladder measures how much urine you pass, which tells the team how well your kidneys and circulation are doing.
Stickers and clips
- Chest stickers for the heart tracing
- A finger clip for oxygen level
- An arm cuff for blood pressure
Chest pain, sudden breathlessness, a dressing soaking through with fresh blood, a painful swollen calf, or pain that suddenly gets much worse all need a nurse now, not at the next round. Family should also speak up if the person becomes newly confused, very drowsy or hard to wake. Press the call bell and say plainly what has changed. Do not wait in case you are being a nuisance.
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What is normal
Is it normal to feel this bad on the first day?
Feeling sleepy, sore, sick and weak on the first day is expected after a major operation. It does not tell you how the rest of your recovery will go.
Common and usually short-lived
A sore throat from the breathing tube, shivering, a dry mouth and feeling sick are all common. So is sleeping on and off all day. Some older people become muddled or see things that are not there, especially at night. This usually settles as the anaesthetic wears off and sleep returns, but always tell the team.
Pain should be managed, not endured
Some pain is expected. Pain that stops you breathing deeply, coughing or shifting in bed is too much, and there is almost always something more the team can do. Ask early. It is harder to bring pain down once it has built up.
What this page cannot tell you
Every operation and every body is different. This page cannot tell you how long your own stay will be, or whether a particular feeling is expected after your particular operation. Your nurse and surgical team can, and asking them is always the right move.
On the ward
What do the words you hear on the ward mean?
- Recovery room
- The area beside the theatre where you wake up and are watched closely before moving to your bed.
- HDU
- High dependency unit. Closer watching than a ward, with fewer patients to each nurse, but less intensive than the ICU.
- Nil by mouth
- Nothing to eat or drink for now. The drip keeps you supplied until the team says sips are safe.
- Obs
- Short for observations: pulse, blood pressure, breathing rate, temperature and oxygen level, checked regularly.
Commonly believed
What do families often get wrong about the first day?
Lying still for days raises the chance of chest infection, clots and weak muscles. Gentle movement from early on is part of the treatment plan. The team will tell you how much is right, and help with every step.
Strong pain relief given in hospital for pain after an operation, and then reduced as the pain settles, is very different from long-term misuse. Uncontrolled pain slows recovery. Say when it hurts.
For many major cancer operations a night in the ICU or HDU is planned in advance, simply so that breathing and blood pressure can be watched more closely. Ask the surgeon whether it was planned. The answer is often yes.
Questions we are asked
Common questions about the first day after surgery
When will I be able to see my father after the operation?
Usually once he has left the recovery room and settled in his bed, which can take some hours after the operation ends. If he goes to the ICU, visiting follows that unit's rules. Stay near the waiting area and keep your phone switched on, so the team can find you when he is ready.
Why is he so sleepy and not making sense?
The anaesthetic and strong pain medicines both cause sleepiness, and some people are muddled for a while, especially older people. It usually improves as the medicines wear off. Tell the nurse if the confusion is new, getting worse or makes him try to pull at his tubes.
Can I drink water on the first day?
It depends on the operation. After many operations sips are allowed early. After surgery on the food pipe, stomach or bowel, the team may keep you nil by mouth for longer so the joins can heal. Always ask the nurse first, and do not let visitors give you anything without checking.
Is it normal for the drain bag to have blood in it?
Some blood-stained fluid in a drain is expected after most operations, and it usually becomes paler over the following days. The nurses measure it regularly. Tell them at once if the bag fills quickly with bright red blood, or if the dressing around the drain soaks through.
Why do they keep waking me up for checks?
Regular checks of your pulse, blood pressure, breathing and oxygen level are how the team spots a problem early, when it is easier to deal with. They are more frequent in the first hours and become less frequent as you settle. Ask if checks can be grouped together so you can sleep.
Should someone from the family stay overnight?
On a ward, many hospitals in India allow one attendant to stay. In the ICU or HDU relatives usually wait outside rather than at the bedside. Ask the unit what it allows. One calm, rested family member helps far more than several tired ones.
Why does my throat hurt when the surgery was on my stomach?
During a general anaesthetic a breathing tube usually sits in your throat. It often leaves the throat sore or the voice hoarse for a day or two afterwards. Sips of water, once allowed, help. Tell the team if swallowing becomes very painful or the soreness does not ease.
When will the doctor tell us if all the cancer was removed?
On the day, the surgeon can tell you what was removed and how the operation went. Whether the edges of the removed tissue are clear of cancer is only known once the pathology report comes back, which takes longer. Ask when that report is expected and who will go through it with you.
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- Cancer Research UK — Surgery for cancer
- Macmillan Cancer Support — Surgery
- NHS — General anaesthesia
- American Cancer Society — Cancer surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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