Patient Information

Lung Surgery

This booklet has been prepared to help you and your family understand more about the operation that is planned for you.  It will give you general information about what to expect from the time of your admission to your discharge home.  It will also give you some practical advice about what to do when you get home.  However it is not intended that the booklet will replace talking with medical or nursing staff.

At the end of this booklet you will find a list of organisations that may be able to provide further information.

You can use this space below to write down questions you may want to ask during your admission or at your outpatient appointment:

Your lungs and how they work

When you breathe in through you nose or mouth, the air passes down your windpipe (trachea) which then divides into two tubes (bronchus) one going into each lung.  Each lung has a number of sub-divisions called lobes.  The right lung has three lobes and the left lung has two.

(picture)

Reason for operation.

Your surgeon will have discussed with you, that the appropriate treatment for you condition is to remove the diseased part of your lung.  The amount of lung to be removed will depend on the size, position, type and extent of the disease.  There are various conditions which can be helped by removing the affected part of lung tissue.

If you have any questions about your particular condition and your treatment options you will be able to discuss them with your consultant, specialist nurse or GP.

What are the benefits of having lung surgery?

Your consultant will discuss with you the perceived individual benefits of having lung surgery. In the majority of cases, an operation is recommended with a view to alleviating symptoms and in some cases improving the quality and length of your life. 

What are the risks involved?

As with all surgical procedures, lung surgery carries some risks.  These risks vary according to the type of operation, your overall health and your individual condition.  You will have an opportunity to discuss the risks and the benefits of the proposed surgery so that you have sufficient information to be able to sign the consent form. 

Some of the risks involved with lung surgery include:-

Wound infections, bleeding and inflammation of the lungs (pneumonia). 

There is also a risk of developing a collapsed lung (pneumothorax). If this happened you may require treatment to help reinflate the lung. Developing blood clots in the leg (deep vein thrombosis) or in the lung (pulmonary embolism) is another possible risk.

What operation may I need?

This depends on the extent of the disease and the amount of lung to be removed.  The following types of lung surgery are performed under a general anaesthetic and usually involve staying in hospital between 7-14 days.

Wedge resection - is the removal of part of the lung, in a wedged shaped portion.

Lobectomy - is the removal of one lobe of the lung. There are three lobes in the right lung and two in the left.

Pneumonectomy- is the removal of the whole of one lung.

Thoracotomy - is the surgical incision (wound) made in the chest wall to enable the surgeon to get to the lung.

On some occasions it may be appropriate to only take a sample (biopsy) of the diseased area for further testing.  Your consultant will discuss with you what your operation will involve and how it will affect you afterwards.  If you require further information please ask questions.

Following your surgery, your consultant may discuss with you referral to another specialist, for consideration of additional treatment to get the best result from surgery for example chemotherapy or radiotherapy.

What are the alternatives to lung surgery?

This depends on your condition.  Alternatives to lung surgery for cancer include radiotherapy, chemotherapy. Your consultant will be happy to discuss other treatments if they are applicable to you, and make the appropriate referral to an oncologist to discuss these treatments

Before coming into hospital

If you smoke, giving up before the operation reduces the risk of breathing problems.  The longer you can give up beforehand the better.

If you would like some information and support to stop smoking, please ring our smoking cessation advisor on 0151 293 2455, who will arrange to see you, or alternatively speak to your GP.

If you are taking medication you should bring a supply of them with you on admission.  Please keep them in their original box/bottle.

Pre admission clinic

You may be invited to attend a pre admission clinic prior to coming into hospital.  You will have various tests in preparation for your surgery and meet with a nurse practitioner who will talk to you about the procedure and about recovering afterwards. The nurse practitioner will be able to discuss any questions that you may have.   

You may find it useful to prepare a list of questions prior to your appointment as it is important that you fully understand the procedure and aftercare arrangements.  Please use the space below to write any questions

After admission for your operation

Dependant upon what investigations you have already had done, your consultant may bring you into hospital a few days prior to your operation.

Some of the following tests which may be carried out:

Chest X-ray - this will look at the size and shape of the heart and the general condition of your lungs.

Electrocardiogram (ECG) – this shows the electrical activity of the heart and is routine for anyone undergoing an anaesthetic.

Blood tests – a blood sample is taken from your arm and various tests are carried out including your blood group.

Pulmonary function tests – these are breathing tests which measure how well your lungs are working.

CT Scan (CAT scan) – this is a type of X –ray that produces detailed cross sectional images from inside the body.

Bronchoscopy – this is a procedure carried out under a general anaesthetic.  It is a test that allows the doctor to look directly down your windpipe and into some areas of your lungs.  The doctor is able to view both lungs by passing a long thin tube with a camera and a light on the end of it (bronchoscope) down your throat.  During the test different procedures may be performed in order to obtain samples for further examination in the laboratory.

Before the operation

Eating and drinking

You will not be allowed to eat and drink anything for several hours prior to surgery.  The nursing staff will inform you when to stop eating and drinking.  It is important not to eat or drink anything after this time as it may delay your operation or cause complications with your anaesthetic.

Bathing

It will be necessary for you to have a bath or shower before your operation.  The nursing staff will advise you when the best time is for you to do this.  They will also provide you with an antiseptic skin wash to use.  This will help to prevent any infection occurring in your wound.  If you need assistance, please inform the nursing staff.

Shaving

Before the operation, it may be necessary to remove hair from around the operation site. Your ward nurse will discuss this with you.

Stockings and gown

You will be given a theatre gown and a pair of elastic stocking to wear prior to going to theatre.  The stockings are to help your circulation and blood flow, whilst your mobility is restricted.

Pre- medication

If prescribed by your anaesthetist, you will be given medication before your operation.  This is given to help reduce or relieve anxiety.  Following the pre-medication you must stay in bed and call for a nurse should you need anything.  You may also be given some oxygen.

A ward nurse will accompany you to the theatre and will stay with you until you are introduced to the anaesthetic nurse.

Family

Your family may wish to visit you on the day of your operation and during your stay.  They should discuss visiting arrangements with the ward nurse or ward manager.

After your operation

Your operation will take approximately 2 – 4 hours, following which you will regain consciousness in the recovery area of the theatre.  There will be a nurse or practitioner in attendance who will monitor your blood pressure, pulse rate and oxygen levels.

It may be necessary for you to spend a period of time in the high dependency unit or intensive care unit before returning to your ward.

Breathing

While you are still recovering from your anaesthetic you can expect to have an oxygen mask over your mouth and nose.  It is important that you take deep breaths and cough, this will help to expand your lungs and prevent infection.

Infusions and catheters

Whilst you are asleep, a drip will be placed in a vein in your arm or neck which will allow you to have any drugs or fluids required.  You may also have a catheter (fine tube) in your bladder, which allows urine to drain freely.  These will all be removed as soon as possible after your operation.

Pain

Effective pain relief is important following surgery for your comfort and recovery.  You may be given pain control through a fine tube in your back; this is known as an epidural or alternatively via a patient controlled analgesia device in your arm, which will help to keep you comfortable.  It is very important that you let the staff attending to you know if you are experiencing pain, as they will then review your pain relief.

Chest drains

Following surgery, you may have one or two chest drains.  These are tubes leading from your chest to a bottle, which drain air and fluid.  The chest drains may be attached to ‘suction’ which is a mild vacuum, this will help your lung re-expand more quickly.  This does however, restrict your mobility in moving around the bed area, as the drains cannot be disconnected from suction, unless the doctor feels that you condition allows this.

It is important to keep the chest drain bottles in an upright position.  If the bottle gets knocked over or disconnected, please ring for the nurse immediately.  The ward nurse will discuss with you how to look after your drains.

Removal of the chest drains

The chest drains will be removed when they are no longer required, usually this occurs after 2-3 days although sometimes it takes longer, this will be explained to you by the doctor.  Prior to removal of your chest drains you will be given pain control.

Once removed, you will have a stitch at each drain site, which will be removed after 7-10 days.  If you have been discharged before this we will arrange for a district nurse to do this.

Personal hygiene

Initially the ward nurse will help you with your personal hygiene at the bedside, however after a few days you will be able to go to the bathroom to have a bath or a shower.

Your heart beat

After the operation, you may feel that your heart sometimes misses a beat or is racing.  This is not uncommon after lung surgery and should not hinder your recovery.  If you are aware of this, please inform your ward nurse or doctor.  If this is detected during your hospital stay, you may be prescribed tablets that control your heartbeat.  If however this becomes a noticeable problem whilst at home, consult your General Practitioner.

Eating and drinking

Initially your appetite may be poor, so try to drink and eat a little when you can as this helps with wound healing.  The dietician will offer nutritional support if required.

Constipation

Indigestion and constipation are also common, as your normal functions may slow down during surgery.  Some patients suffer from nausea as a result of the anaesthetic and the drugs.  Do ensure that you inform the nursing staff should this happen to you, as it can be treated.

Mobilisation

We will want you to be up and about quite quickly, depending on what type of operation you have had.  You should be able to walk around your bed, within 2-3 days.  The physiotherapists and nurses will help you carry out your exercises regularly.  Exercise is encouraged to prevent stiffness, bedsores and constipation, it will also help your lung function.

In addition to your support stockings, you will also be given a small injection of an anti- coagulant, which is medication to help the blood flow freely and prevent clots from forming.

You will be shown how to move yourself without putting strain on your wound.  However, if you are unable to move yourself, the nurses will assist you and may use a lifting aid such as a hoist.

Wound

Most patients having chest surgery have a wound that will extend from just under your shoulder blade around the side of your chest to under your armpit.  The nurses will check your wound regularly until you leave hospital.  It is important to report if there is any redness, pain or leakage from the wound, so that this can be treated appropriately.  You may have stitches in your wound that will need removal 7-10 days after your operation. If you are discharged beforehand the ward nurse will arrange for a district nurse to remove them at home.

Breathlessness

If you find that you are experiencing breathlessness, you should inform the ward staff.  The physiotherapist may show you the positions that are described below, as they may ease it.  In addition if you concentrate on breathing out slowly, this can help to control your breathing.

Try leaning forward whilst sitting in a chair with your forearms resting on your thighs.  Try to keep upper chest and shoulders relaxed, therefore keeping the lower part of your chest free to expand.

Discharge home

Length of stay; you should expect to remain in hospital for 7-14 days after your operation.  This may very according to the individual, and your progress will be assessed closely by the doctors and nurses. 

Transport home; we would advise that a relative or friend accompanies you home on discharge, wither by driving you home or by taxi.   Wherever possible you should try to arrange your own transport home.  If however you are unable to do so you should let your ward nurse know on admission and ambulance transport will be arranged to take you home.

What happens when I go home?

Before admission please give some thought to how you will manage after discharge.  The following information may answer any questions you have.  However please feel able to discuss any concerns you have with your ward nurse during your stay.  During the first few days at home you may feel quite vulnerable, so it is an advantage to have someone at home with you during that time.  If you live alone please discuss this with your nurse on admission.  It may be necessary for convalescence or support at home to be arranged for you by the hospital social worker.

Medication

Prior to your discharge from hospital, you will receive a supply of the tablets which you will need to continue to take at home.  The nurse will explain the reason for medication and when you should take it.  If you have any questions relating to your medication, then a pharmacist is available for advice.  If you are unsure about when to take your medication please ask for written instructions.

Repeat prescriptions

Prior to your discharge you will be given a letter to give to your General Practitioner.  This letter contains a list of the medication that your General Practitioner should continue to prescribe for you, and will also contain information about your hospital stay.  This letter needs to be taken to your GP’s surgery within a couple of days following your discharge home.  Your GP will then have up to date information about your medication and your condition.  A detailed letter will be also sent to your GP by your surgeon.

We would advise you to contact your GP’s surgery within the first couple of days of being home as it may be necessary for you to make an appointment to see your GP to discuss your progress and arrange a further prescription.

Medication

Frequently asked questions and the pharmacist’s response.

Q.     The label says ‘Take half an hour to one hour before food’ does this mean that I have to eat a meal an hour after taking my tablets?

A.   No.  In most cases it means that the medicine works better if your stomach is empty.  Take the medicine half an hour before a meal or three to four hours afterwards.  Small snacks such as biscuits do not count as meals.

Q. The label says ‘with or after food’.  Should I skip my tablets if it’s not a meal time?

A. No.  Food protects the stomach from tablets which can sometimes upset it.  A glass of milk or a small amount of food such as a biscuit will protect your stomach if it is not a mealtime.

Q. The label says ‘one tablet twice a day’ can I take both tablets together?

A. No. Some tablets don’t work for long enough to take only once a day. Unless you have been told differently take one in the morning and one in the evening.  If the tablet will work all day then we will write ‘two tablets daily’ on the label and you can take these tablets together.

Q. I find it hard to open childproof lids on tablet bottles.  Can I have plain lids?

A. Yes.  Ask your pharmacist when you hand in your prescription.  Remember to keep medicines in a safe place away from children.

Q.  I always feel sick after taking my tablets.  Is there anything I can do to help this?

A. Yes. Try taking the tablets after food.  Do not do this if the label tells you to take them before food.

Q. I find it hard to remember to take my tablets every day. Is there a good way to help me remember?

A. Yes. Some people find that using a calendar or diary helps.  Keep it with your medicines and tick off when you have taken them.  You can also purchase a compliance aid such as a ‘dosette box’ from your pharmacy.  This box has separate compartments for you to place your medication in.  These compartments are labelled with the times of day to take your medicines.  Ask your pharmacist for details.

Q.  Is it alright to drink alcohol when I am taking medicine?

A.  It is usually alright to drink alcohol whilst taking medicine if:

1. The label on the bottle does not say avoid alcohol.

2.  Your doctor has agreed that alcohol will not affect your illness.

3.  You only have one or two drinks and do not drink to excess.

If you have any other questions about your medicines, speak to your doctor or pharmacist.

Resuming activity at home

Most people find that it takes approximately 3 months after the operation for them to make a full recovery.  Obviously there is considerable variation depending on how fit you were before your operation and the type of operation performed. 

Generally people who have had part, or all of their lung removed take longer to recover than people having other types of lung surgery.  Age is also relevant, older people may require a longer period of convalescence than younger people.

Exercise is an important factor in your recovery following surgery.

·        For the first few days, take it easy and restrict yourself to the house or garden.  After a few days, you should take a short walk on the flat gradually increasing the distance and gradient over a period of weeks.  Initially, it is advisable to avoid going out on cold, wet or windy days.

·        Your aim over the next 3 months should be to increase your activities day by day.  Introduce new activities but not all at once.  You should, however get into the habit of taking regular exercise.  A lot will depend on the nature of your surgery and your age.  Exercise within your limits.

·        Activities that involve carrying or lifting heavy items (shopping bags/hovering etc) should be avoided for 6 weeks following your surgery.

You may experience some breathlessness whilst you are carrying out activities, which is acceptable as long as it is not distressing for you.  A good way to know if you are overdoing things is to be able to talk at the same time as exercising.

Always rest between periods of exercise.  Try and get a good nights sleep.  If you notice yourself becoming easily tired, you are probable overdoing things, in which case reduce the distance you are walking or the activities you are doing.  The amount and type of exercise which patients are able to do in the early weeks is extremely variable.  The best guidelines are to do what you can without becoming too tired or short of breath.

A guide for the first few weeks at home

The following advice is for guidance only, pages 18 to 23 contain some information regarding some specific activities

First week – walk around at home as you did in hospital.  You should continue with the breathing exercise that the physiotherapist taught you.  Do make sure you get plenty of rest and do not have too many visitors.

Second week onwards - You should gradually introduce light tasks into your daily routine, for example dusting, washing up and cooking light meals.   Do not do anything more strenuous at this stage; particularly avoid heavy lifting, pulling or pushing as this will place a strain twisting movements of your chest, for example walking an energetic dog.  Do not lift children or grandchildren.

Four to six weeks – You can gradually introduce more demanding tasks such as ironing, light shopping, light gardening or cleaning the car.

After eight weeks – Your wound should be healing well and therefore other tasks such as hovering, raking leaves, driving the car and small jobs within the home may be undertaken.

After twelve weeks – You may wish to resume or take up other activities including cycling, fishing, walking and swimming.  At first, it is better to use a heated swimming pool and the stroke that feels most comfortable to you.  If you play golf, you may start practising you swing and hitting a few balls at this time.  If you wish to play competitive games or contact sport you should consult you General Practitioner or Consultant surgeon.

You may feel able to do everything that you were doing before the operation.  However, a patient’s recovery is individual and in some circumstances your ‘normal’ activities may need to be adapted.

You may continue to experience some chest discomfort or skin sensitivity for a period of time.  This may be aggravated by strenuous activity especially if it has been resumed too soon after your operation.  If you are experiencing any ongoing problems please discuss them with your GP, your Consultant Surgeon or Lung Nurse Specialist.

Specific information once you are at home.

Arm exercises

It is important to maintain the range of movement in your shoulder following surgery as it may be stiff.  During the first few weeks after your operation you should continue to stretch your arm above your head as you were shown in the hospital by the Physiotherapist.  You may experience a restriction to the end of the movement.  This is normal and will reduce with practice.

These exercises should be continued for the first 4 weeks after the operation.

Constipation

Constipation can occur following any type of surgery.  This is due to the effects of the anaesthetic and also the pain control you will need to take.  If necessary you will be given laxative to take home with you.  To help prevent constipation try to eat a well balanced diet e.g. added fruit and fibre and drink plenty of fluid.   Mobility also aids the function of the gut.  If you normally move your bowels on a daily basis and are now constipated, seek advice from your GP.

Wounds

Prior to your discharge home, the ward nurse will explain to you whether you have any stitches that require removal at home.  If you do, the nurse will arrange for a district nurse to visit you at home.

If your wound or drain sites require any dressing, the ward nurse will arrange for this be reviewed by the district nurse once you are at home.  In general the wound will be healing without problems when you go home, although occasionally you can expect a slight ooze from the wound which requires a simple dressing.

If, however, your wound becomes quite red or suddenly becomes more painful or starts leaking a discoloured fluid you should consult your GP or district nurse immediately.  They can contact the hospital for advice as required.

Employment/work

It is wise to allow yourself time to make a complete physical and emotional recovery before returning to work.  At your outpatient appointment with your Consultant Surgeon you can discuss the timing of your return to work, which will depend on the type of work that you do.  If your job is not too physically or mentally demanding, you may be able to return to work 2 months after the operation.

If your job involves heavy manual work or is stressful, a longer period of recovery is advised.  You should allow at least 3 months following surgery before returning to this type of employment.  If it is possible you should resume your employment on a part-time basis at first, either working shorter days or shorter weeks.  You should discuss this option with your employer.

Moods and emotions

Immediately after the operation, you may have had days when your spirits were low and you felt depressed.  These feelings are known as the ‘post-op’ blues and many patients recovering from the operation get them.  Patients can feel unusually emotional and irritable during the first 6 weeks after the operation.  This can often happen without prior warning and you may feel tearful, anxious, very depressed or resentful.  These feelings are common after the operation and should not be a cause for concern to you or your family.  They generally resolve spontaneously.  Remember that you and your family will be affected by these feelings and it is important that you discuss what you are experiencing.

Family members will have a tendency to become over- protective when you first go home.  Do not resent this.  Be patient with them.  Remember it also took you time to realise that you could do things for yourself.  Listening to your family and informing them of how you are feeling will ease these feelings.

If you are feeling unduly depressed or have continuing problems with loss of memory or concentration consult your General Practitioner.

Rest, sleep and relaxation

During the first few weeks at home, you will find you tire easily, so adequate rest is as important as exercising for your recovery.  Have a rest in the afternoon for an hour and make sure that your friends and relatives are aware of when your rest periods are, to reduce disturbances.

If you tire during a particular activity such as climbing stairs, sit down and rest.

Try and have a good 8-10hours sleep each night.  This may be difficult at first because your normal sleeping pattern will have been disturbed.  It may take you a week or two to settle back into your normal sleeping routine.  In addition, you may find that your normal sleeping position is not comfortable in the early days after your operation, due to wound soreness.  It is important to continue taking your pain control regularly at night to aid sleeping.

Gardening

Light gardening such as weeding may be done 4-6 weeks after discharge.  Mowing the lawn should not be considered until you are fully recovered.

Bathing

Do not be afraid to get your wounds wet.  Showering or bathing will keep your wound clean and encourage healing.  However, we would advise for 6 weeks following your surgery, you not to soak for long periods in the bath.

If you have the choice of a shower or a bath, take a shower instead of a bath for the first 2 weeks following your surgery.

For your safety we would advise that you do not attempt to have a bath when you are alone in the house for the first 2-3 weeks following your surgery.

If you do take a bath, please note the following;

·        Empty the water out of the bath before you get out.

·        Place a non-slip mat or a towel in the bath before attempting to stand up.

·        If possible get assistance to get out of the bath.

Alcohol

Alcohol may be taken in moderation after discharge from hospital, but you should ask your nurse or pharmacist for information about alcohol consumption with your particular medication.

If you need or want to reduce your alcohol intake please discuss this with your GP.

Smoking

To help make sure that smoking remains a past activity you may find the following points helpful:

·        Keep a list of reasons for stopping smoking and refer to it regularly.

·        Contact the smoking cessation advisor who is based at The Cardiothoracic Centre.  You can contact them on 0151 293 2455 for practical help to help you stop smoking or for you to continue not to smoke.  They do offer a home visiting service.

·        Find other ways to relax, e.g. talking with friends, listening to music, or take up a new hobby.

Driving

Do not drive following discharge from hospital until you have been reviewed at your outpatient appointment and advised by your surgeon that it is safe.  As a result of the wound and the healing process, muscular strength and general agility is reduced and sudden movements can bring on pain.  It is therefore, essential that you do not drive a motor vehicle until the healing process is sufficiently advanced.

When driving a car or as a passenger, you are not exempt from wearing a seat belt.

Sexual activity

Many patients who have undergone thoracic surgery experience anxiety about resuming sexual relationships.  It is quite safe to have sex and/or sexual stimulation after the operation whenever you feel ready for it.  However, we generally advise you to wait between 2 -4 weeks to allow your body and wounds time to recover.

Choose an ideal time when you feel relaxed, comfortable and in familiar surroundings.  Avoid times when you feel tired, tense or after a large meal.  Do not expect too much of each other initially.  It is unlikely that you will do any damage to the surgery, but sensible measures should be taken to avoid extensive strain on the chest wound.  Choose a position, which is comfortable and does not restrict breathing and stress to your chest.  Do not take your weight or your partner’s weight on your arms. Do not attempt to be too energetic at first.

Holiday and flying

Now the operation is over, you may wish to plan a holiday. A restful holiday in this country may be undertaken at any time, providing you are able to cope with the travelling. Holidays abroad should be deferred for at least 8 weeks after the operation.  At your outpatient appointment discuss your plans with the surgeon.

Avoid strenuous holidays and extensive travelling at first.  Cover the scars with complete sunblock when sunbathing in the first 6 months.  It is also important to clarify your holiday insurance.

Dietary advice

During convalescence the food you eat plays an important part in the healing process.

It is not unusual for your appetite to be poor in the early weeks following surgery.  Regaining your appetite fully may be a gradual process. 

You may have experience some weight loss prior to surgery.  This may have happened due to your medical condition and anxiety experienced at this time.

Any condition where breathing is difficult causes the body to use up more energy in the effort to breathe.

Therefore it is very important that your nutrition after surgery is aimed at ensuring you have enough to eat and also to build yourself up if you have lost weight.

If your appetite is small, aim to have five or six small meals/snacks during the day.  It is easier to eat more this way.  Ensure you use full cream milk and generally low fat/diet type foods.  Enjoy a wide variety of different foods and eat more of the things you know you like.

You may have been prescribed a high protein supplement drink as advised by the dietician or GP, continue with these as long as your appetite remains poor or until you have regained your lost weight. 

If you have some weight to lose, do not cut down on your food intake at this stage.

After a period of three months you should be resuming your normal eating patter; it is at this time that you should consider ‘Healthy Eating’.

However if weight loss continues to be an issue for you, please consult your GP and disregard the following information.

Advice regarding ‘Healthy Eating’

There are three most important aspects of a healthy diet, which have been shown to help maintain good health.

·        Eating more oily fish

Oily fish contains oils known as omega-3 fatty acids.  There is strong evidence to show that these help to protect your heart.  Try to eat two to three large portions each week.

Oily fish include – sardines, mackerel, herring, kippers, tuna, trout, pilchards and salmon.  This includes canned fish as well as fresh or frozen fish.

·        Eat more fruit and vegetables

Fruit and vegetables provide vitamins and minerals, which help protect us against heart disease.  Try to have at least five portions of fruit and vegetables each day.

An example of portions –

·        1 apple, orange, pear or banana

·        1 large slice of melon or pineapple or half a mango

·        2 tablespoons of vegetables- this includes raw, cooked, frozen or canned.

·        1 small bowl of  salad

·        one glass of unsweetened fruit juice

·        Eat less fat

Fat is an important part of our diet because it gives us energy and vitamins.  However eating too much   fat can increase the risk of heart disease and lead to weight gain.

How can we eat less fat?

·        Grill, bake or steam food instead of frying it.

·        Use skimmed or semi skimmed milk

·        Spread unsaturated margarine or low fat spread thinly.

·        Cut off before cooking.

·        Use a small amount of oil in cooking

·        Changing to a healthy diet needn’t be difficult or more expensive.

Above all it is important to enjoy your food.

Outpatient Appointment

Your surgeon will see you approximately 6-8 weeks after your operation as an outpatient.  This may be at The Cardiothoracic Centre or at your local hospital.  This appointment may be given to you prior to your discharge or sent through the post.  Please ask your ward nurse if you are unsure about the details.

Further treatment

Occasionally patients who have undergone surgery for lung cancer, may need to be referred to another specialist (an Oncologist) for consideration of further treatment i.e. radiotherapy/chemotherapy.  If this is necessary your surgeon will discuss this with you.

Useful contact numbers and website addresses

There are a variety of different organisations working within the National Health Service who provide valuable information and support for patients.  Listed are a few contact details which may be of some use to you.

Lung Nurse Specialist

If you have been diagnosed with lung cancer, the Lung Nurse specialist is available to you and your family for support and information.  You may have already met your local nurse.  However if you have not, you should be able to contact your Lung Nurse Specialist via the switchboard at your local hospital.

If you are not able to get these details, please call the Lung Nurse Specialists, at the Cardiothoracic Centre on 0151 293 2312 and they will advise you of the details of your local nurse.

Roy Castle Lung Foundation

A nationwide lung cancer patient support and information network is available through the Roy Castle Lung Cancer Foundation.  Services include:-

·        A free national help line that provides information on support groups in each area.  There are several across the country, telephone 0800 358 7200 to find out about your local group.

The Liverpool lung cancer patient support group is held monthly.  For further information telephone the Lung Specialist Nurses at The Cardiothoracic Centre on 0151 293 2312.

·        Written information books are also available.

Cancer BACUP

Freephone 0808 800 1234

Provides advice and support for patients and their families following diagnosis of cancer.  A range of free publications is available.

Macmillan Cancer Relief

0845 601 6161

Supports and develops services for people with cancer and provides Macmillan nurses, doctors and cancer care.

British Lung Foundation

020 7688 5555

Works throughout the UK to improve the prevention, diagnosis and treatment of all lung diseases.  It can provide information and advice to patients and families affected by any lung disease.

·        The Northwest Group can be contacted on 0151 224  7778

There are many ways of finding information.  One of the most common ways is though the internet and below are some suggested websites that contain a variety of information.  If you do not have access to the Interned at home, there are many local libraries and interned cafes that you may use.

www.roycastle.org

www.cancerguide.org

www.nhsdirect.nhs.uk

www.bacup.org.uk

www.cancerline.uk

Remember there is no way of monitoring the quality of information you may receive on a website.  If you are unsure of any information please ask your hospital Consultant, Ward Manager, General Practitioner or Specialist Nurse.

Specific information

It may be useful for you to have the details below filled in, before you are discharged home.  Your ward nurse will help you if you are unsure of any of the details.  You can then use this information should you require further information advice at home.

The Cardiothoracic Centre – NHS Trust, 0151 228 1616

We hope this booklet has been helpful in answering some of your questions.  Do not forget, it is only a guide and every individual differs.

Please bring this booklet with you when you are admitted to the hospital.

If you require a copy of this leaflet in any other format or language please contact the PALS office on 0151 600 1257 quoting the leaflet code and the language or format you require.

Thoracic/001

Date of publication May 04

Reviewed September 06

Review September 08