How to recover after surgery? Strict observance of a certain set of rules is a guarantee of a quick recovery after surgery and anesthesia.

A hysterectomy is a surgical procedure in which the female reproductive organ is removed. This operation is very common in gynecology. The uterus is removed when all other treatments have failed. Sometimes the uterus is removed along with the fallopian tubes and ovaries. The postoperative period is an important stage in the treatment of a woman, which may be accompanied by the development of complications, so it requires a professional approach.

Surgery to remove the uterus is quite common, which is carried out with very serious ailments that threaten the health of a woman. According to statistics, about a third of all women who have reached the age of 40 are forced to resort to such a procedure.

With any surgical intervention, injuries of varying severity occur, which are associated with damage to tissues and blood vessels. After a hysterectomy, damage also remains, and it takes time for the tissues to fully recover. The duration of postoperative rehabilitation depends on the severity of the disease, the type of operation and postoperative complications.

Most often removal of the uterus is indicated in the following cases X:

Depending on the severity of the disease carry out the following types of operations:

removal of only the uterus;
removal of the uterus and cervix (total extirpation);
removal of the uterus with appendages and lymph nodes located nearby (radical panhysterectomy).

How strong the traumatization will be depends not only on the type of operation, but also on the method of its implementation. The most radical is the abdominal technology, in which the walls of the peritoneum are cut, and another method is the vaginal method with an incision in the vagina. The least traumatic way is the removal of the uterus by laparoscopic method. In this case, a special laparoscope is used, which makes a very small incision. After laparoscopic surgery, complications are not so dangerous.

How long do people stay in the hospital after a hysterectomy? It depends on the type of operation. After laparoscopy, the patient can be discharged The next day. If an abdominal operation was performed, the patient can go home after 2 to 3 days.

Principles of rehabilitation

Recovery after surgery is divided into early and late stages. The early stage is carried out in a hospital under the supervision of a doctor. Its duration depends on the consequences that occurred after surgery. The early stage of recovery after abdominal surgery is usually 9-12 days, after which the doctor removes the stitches and the patient is discharged. After laparoscopy, early rehabilitation is reduced to 3.5 - 4 days.

Main tasks early stages of rehabilitation are:

getting rid of pain syndrome;
elimination of bleeding;
prevention of violations of the functions of internal organs;
exclusion of infection of the affected area.

The late stage of rehabilitation is carried out at home. If no complications develop after the operation, then recovery takes 28-32 days, and in case of complications, it is extended to 42-46 days. This stage is characterized by complete restoration of tissues, strengthening of immunity, improvement of the general condition, normalization of the psychological state, and full restoration of working capacity.

What measures are carried out immediately after the operation?

On the first day after surgery doctors take measures to eliminate painful symptoms, prevent complications and inflammatory processes from developing, exclude blood loss from internal bleeding and prevent infection. This period is very important at an early stage of rehabilitation.

The main activities include certain actions.

Anesthesia. After the operation, the woman has natural pains inside and in the lower abdomen. To anesthetize, prescribe potent drugs.

Activation of organ functions. In this case, measures are taken to normalize blood circulation and stimulate the intestines. If such a need arises, then to activate the functions of the intestine, Proserpine is administered by injection.

Diet. After surgery to remove the uterus with appendages, it is very important that normal intestinal motility is restored. The menu should consist of broths, drinks, mashed foods. If at the end of the first day there was an independent defecation, then the event was carried out correctly.

Immediately after the operation, the following drug therapy:

antibiotics to rule out infection;
anticoagulants to prevent the formation of blood clots in blood vessels;
infusion effect, carried out using intravenous droppers to restore blood volume and normalize blood circulation.

Complications in early rehabilitation

The first stage of rehabilitation may be accompanied by the following complications after hysterectomy:

How to recover after surgery? It is very important in the first 1 - 3 days to prevent infection. If this happens, then the temperature rises to 38.5 degrees. To eliminate the risk of infection, the doctor prescribes antibiotics and performs antiseptic treatment of the suture area.

Activities for late rehabilitation

After the woman is discharged from the hospital, her recovery after the removal of the uterus continues. The late stage of rehabilitation allows the body to fully recover. Must the following actions are carried out:

It is very important to organize proper nutrition after removal of the uterus. A woman should not “push” and strain her abdominal muscles, so it is recommended to reduce the load on the intestines, trying not to eat aggressive and indigestible foods. Nutrition should be such that a laxative effect occurs.

Diet after hysterectomy includes the following permitted products:

crumbly cereals;
green tea;
vegetable oil;
fresh vegetables and fruits (except grapes and pomegranate);
mashed boiled vegetables;
low-fat dairy products;
boiled meat.

Diet after hysterectomy prohibits the following dishes and products:

The diet after surgery should be prescribed only by a doctor.

Consequences

After extirpation of the uterus, along with the ovaries, the location of many pelvic organs begins to change. This rearrangement negatively affects the health of the intestines and bladder.

Consequences after removal of the uterus for the intestines and bladder:

constipation;
the appearance of hemorrhoids;
pain in the lower abdomen;
difficulty going to the toilet;
frequent urge to urinate, not leading to sufficient urine output;
urinary incontinence;
urination problems that occur due to squeezing of the bladder.

After operation the patient may experience the development of atherosclerosis of the vessels, as well as a woman can gain excess weight. Against the background of the operation, lymphostasis of the extremities often develops. To prevent this from happening, during the removal of the uterus with the ovaries and appendages, the lymph nodes are removed. Amputation of the uterus and ovaries ends with premature menopause. The body begins to rebuild, because the lack of estrogen leads to irreversible changes. Hot flashes are very common.

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Based on the functional characteristics of various systems and organs, as well as taking into account the specific physiological consequences of their surgical treatment, an appropriate surgical diet after abdominal surgery has been developed. Its goal is to reduce the load on the entire body and on the operated organ, but at the same time provide the body with energy.

What diet after surgery is prescribed immediately after it? Regarding the acceptable set of products and methods of their culinary processing, the most strict is the zero diet after surgery. In clinical practice, this diet is observed during the first three days after surgery. This diet consists of sweetened tea (with or without lemon), rosehip broth, various jelly and diluted fresh juices, fruit and berry jelly, fat-free meat broth, and slimy rice water. Portions are small, but meals are taken up to seven times a day.

Such nutrition helps to avoid unwanted stress on the gastrointestinal tract and the entire digestive system of the operated patient. Moreover, a diet after surgery on the esophagus, a diet after surgery for gastric cancer, a diet after surgery for peritonitis, and a diet after heart surgery can be prescribed by doctors only after a few days, since at first such patients in the intensive care unit can be fed through a tube or by parenteral the introduction of special drugs.

The zero diet after surgery has three options - A, B and C. The zero (surgical) diet 0A is described above, its daily calorie content is minimal - no more than 780 kcal. The 0B diet differs from it in the addition of rice, buckwheat and oatmeal (liquid and pureed), mucous cereal soups, vegetable decoction seasoned with semolina or low-fat chicken broth. In addition, depending on the condition of the patient, steamed omelet (only from egg whites) and steamed meat soufflé are allowed. This diet also provides low-fat cream, berry mousses and jellies (non-acidic). A single food volume is limited to 360-380 g, the number of meals is 6 times a day, and the daily calorie content should not exceed 1600 kcal.

The diet after abdominal surgery 0B (2200 kcal), in addition to mashed soups, includes dishes from mashed boiled meat, chicken and lean fish; vegetable puree; liquid milk porridge, grated cottage cheese with cream, kefir; baked apples and white crackers (no more than 90-100 g per day). In general, such a postoperative diet - as the condition of patients improves - is like a transition to a more complete diet, which in most cases is also limited to the indications of various therapeutic diets.

Diet 1 after surgery

It must be borne in mind that diet 1 after surgery (No. 1A surgical and No. 2 surgical) largely repeats the prescriptions of the 0B diet, but with a higher daily calorie content (2800-3000 kcal). Diet - 5-6 times a day. There are two options here - wiped and not wiped.

What can not be eaten after surgery if this diet is prescribed? You can not use meat and fish broths, fatty meat, poultry and fish, mushroom and strong vegetable broths, any fresh bread and pastries and, of course, all pickles, smoked meats, canned food, spicy sauces and seasonings. You also need to exclude millet, barley, barley and corn porridge, legume dishes, sour dairy products, spicy cheese and eggs - fried and hard boiled. White cabbage, radish and radish, cucumbers and onions, as well as spinach and sorrel are excluded from vegetables. Diet 1 rich in fiber, as well as sour fruits, also excludes after surgery. And also - chocolate, ice cream, black coffee and carbonated drinks.

What can you eat after surgery with this diet? Warm boiled (or steamed) food - in a highly chopped form. You can cook soups from mashed vegetables and boiled cereals and mashed soups from pre-cooked meat.

Following diet 1 after surgery allows the use of sweet fruits and berries in the form of puree, mousse and jelly, and from drinks - tea, jelly and compote.

It is this diet that is the diet after lung surgery, the diet after gastric ulcer surgery and the diet after stomach cancer surgery. Moreover, in the latter case, three weeks after the operation, doctors recommend that patients include meat and fish broth in the diet - so that the digestive system begins to work more actively.

Diet after gallbladder surgery

Diet after gallbladder surgery (its partial or complete resection) - after the abolition of diet 1 - imposes a complete ban on fatty and fried foods; for smoked meats, pickles and marinades; excludes the use of canned food, mushrooms, onions and garlic, as well as confectionery with cream, ice cream and carbonated drinks. Sweets are strictly limited, especially chocolate.

What can you eat after gallbladder surgery? Gastroenterologists recommend eating only low-fat varieties of meat and fish, first courses based on weak meat and vegetable broths, dried bread, and various low-fat dairy products. Between butter and vegetable oil, you should make a choice in favor of the latter.

It is harmful to eat very hot or cold: the optimal temperature of food corresponds to normal body temperature. Portions should be small, and there should be at least five meals throughout the day.

Diet 5 after surgery

Diet 5 after surgery is the main therapeutic diet after liver surgery, after gallbladder surgery (including its removal), as well as the most commonly prescribed diet after pancreatic surgery.

As expected, meals should be fractional, that is, five or six times a day. The patient needs about 80 g of proteins and fats per day, and carbohydrates in the range of 350-400 g. The daily calorie content does not exceed 2500 kcal. During the day, you need to drink at least 1.5 liters of water. This sparing diet after surgery allows you to consume 45 g of butter and 65 g of vegetable oil per day, no more than 35 g of sugar and up to 180-200 g of dried bread.

Diet 5 after surgery does not allow in the diet in foods such as fatty meats and fish, lard, offal; any broths; sausage and canned food; fatty dairy products; fried and hard boiled eggs. It is also unacceptable to eat garlic, green onions, radishes, spinach and sorrel, mushrooms and legumes, fresh bread and muffins, confectionery, ice cream, chocolate, black coffee and cocoa. And of the cooking methods, boiling and steaming are used, although baking and stewing are also allowed.

Diet after colon surgery

Given the localization of surgical intervention, the diet after intestinal surgery completely excludes the use of coarse vegetable fiber, as well as any foods that are difficult to digest, cause increased contractions of the walls of the digestive tract, that is, intestinal motility, and also provoke flatulence.

Easily digestible liquid homogenized food in small quantities 5-6 times a day are the main rules on which the diet after the operation of intestinal adhesions, the diet after the operation of the sigmoid colon, as well as the diet after the operation of intestinal obstruction and the diet after the operation of the rectum are based. As the condition improves with these pathologies, the doctor gives permission to include lean meat, poultry, sea fish, eggs and low-fat fermented milk products in the menu.

Since the most suitable for the intestines is a sparing diet after surgery, the food must be thoroughly crushed. Over time, diet 4 is prescribed, in which vegetables and fruits (in any form) are completely absent from the menu; milk soups and dairy products (except cottage cheese); bread and flour products (except wheat bread crumbs); meat soups (with any dressing, except for steamed meatballs or boiled minced meat); fatty meat, sausage and sausages; fatty or salted fish; fats (you can put only a little butter in ready-made dishes).

The diet after intestinal surgery does not allow the use of legumes and any pasta, all sweets (including honey), as well as cocoa, coffee and carbonated drinks.

What can you eat after bowel surgery? Pureed cereals (buckwheat, rice, oatmeal); vegetable broths (without the vegetables themselves); soft-boiled eggs and in the form of a steam omelette; kissels and jelly (from apples, pears, quince); black and green tea, cocoa, weak black coffee. It is recommended to drink diluted fresh fruit and berry juices (except grape, plum and apricot).

Diet after appendicitis surgery

The diet after the operation of appendicitis pursues the most rapid assimilation of food and consists in the use of exclusively liquid food in the first days after the operation. What can not be eaten after surgery to remove an inflamed appendix? It is strictly forbidden to use any raw vegetables and fruits, legumes, milk, fatty and fried, spicy and salty, as well as strong tea and coffee. Fractional nutrition also contributes to the rapid absorption of food: 7-8 times a day in small portions.

Within 8-10 days, the diet after appendicitis surgery consists of: low-fat broth, vegetable and rice broth, grated vegetable soups and liquid puree (zucchini, pumpkin, non-acidic apples). The diet menu after the appendectomy operation also includes porridges cooked on water (rice, buckwheat, oatmeal), boiled or steamed chicken, veal and low-fat sea fish, fruit and berry jelly, compotes, rosehip broth. Further, boiled and stewed vegetables, vermicelli, eggs (soft-boiled or protein steam omelette), yesterday's white bread, cottage cheese, sour-milk drinks are introduced into the diet.

After removing the stitches and discharge from the hospital, a sparing diet after surgery is recommended - therapeutic diet 2, in which the following are excluded from the diet: fatty meat, lard, salted and smoked, canned food, fresh bread, buns, legumes and millet, mushrooms, hard-boiled eggs . It is contraindicated to eat onions and garlic, radishes and radishes, sweet peppers and cucumbers, fresh fruits and berries with rough skins or grains. A total ban is imposed on cakes, ice cream, cocoa, black coffee and grape juice.

Diet after stomach surgery

At the first stage, the diet after stomach surgery and the diet after gastric ulcer surgery are diet 0A, 0B and 0B (read more above). The peculiarity of this clinical case is that salt can be completely excluded from the diet, and the number of meals increased up to 8-10 times a day - with the same minimum single amounts. But daily fluid intake should be at least two liters.

The diet after gastric ulcer surgery (on average, three days after surgery) is the 1A surgical (wiped) diet. The number of acceptable products includes the same as for an exacerbation of peptic ulcer, that is, low-fat chicken broth, milk and fruit jelly and jelly, low-fat cream, slimy soups (with the addition of butter), eggs (only soft-boiled), sweetened decoction or infusion rose hips, carrot juice and diluted non-acidic fruit juices. Patients adhere to this diet for about half a month. Then the range of products and the diet menu after the operation is gradually expanded, but the key principle of nutrition is preserved in order to protect the gastric mucosa from any irritants for as long as possible and thereby promote recovery.

Diet after hernia surgery

The diet prescribed by doctors after hernia surgery - the diet after inguinal hernia surgery or the diet after umbilical hernia surgery - in the first days is absolutely similar to the nutrition that patients receive after operations on the intestines and stomach.

Approximately on the fifth or sixth day after the operation, the diet expands due to various first courses, primarily vegetarian soups, as well as second courses - cereals and meat. However, the principles of a sparing diet after the operation remain for some time (it is determined only by the attending physician).

In order to prevent constipation, which leads to overstrain of the smooth muscles of the peritoneum and small pelvis, patients who have undergone hernia closure are advised by doctors to continue to refuse fatty foods, eat more plant foods, not overeat and control their weight.

Diet after hemorrhoid surgery

The diet after hemorrhoid surgery and the diet after anal fissure surgery, as well as the diet after prostate adenoma surgery, are based on the same principles. And the key point that unites clinical nutrition in the surgical treatment of these pathologies is the prevention of constipation, the prevention of flatulence and the relief of defecation.

Therefore, on the first day, such patients are shown only drinking, and then a diet is prescribed that completely excludes: milk, rye bread, cabbage, radishes and radishes, onions and garlic, spicy herbs, legumes, raw fruits and berries rich in fiber (apples, pears, grapes, gooseberries, etc.), as well as all kinds of nuts. Such a diet is referred to in some sources as a non-slag diet after surgery. We would like to note that in the official dietetics such medical nutrition does not appear ...

It is clear that the use of particularly harmful foods (fatty, spicy, salty and sweet) and all canned food is unacceptable. And what you can eat after the operation of this localization includes crumbly buckwheat and millet cereals, wheat white bread (from semolina flour), all sour-milk, lean beef and chicken. Fried food is taboo: everything needs to be boiled, stewed or cooked in a double boiler. Drinking should be plentiful to avoid problems with the bladder.

Diet after hysterectomy

The diet recommended for women after hysterectomy, as well as the diet after ovarian surgery, is not much different from the rules that have already been given above. However, a couple of days after these operations, the diet is completely different: no liquid cereals, slimy soups and jelly.

Firstly, the volume of liquid drunk during the day should be at least three liters. Secondly, food should help to loosen the intestines. To do this, in the diet menu after surgery on the uterus and its appendages, doctors introduce fermented milk products (low-fat kefir is especially useful), various cereal dishes (for example, crumbly cereals), weak broths and boiled meat, light vegetable salads (except cabbage) with sunflower or olive oil, fruits and berries (with the exception of grapes, figs and pomegranates). Meal regime - in small portions, from five to seven times a day.

For a long time remain banned: salty, spicy and fatty foods; almost all groceries; all fried; bean dishes; white bread, muffins and confectionery; strong tea, coffee, cocoa (and chocolate), as well as alcoholic beverages.

Diet after heart surgery

Diet after heart surgery involves a zero diet (0A) for the first three days. Then the operated patients are transferred to diet 1 after surgery (1 surgical), and approximately on the 5-6th day (as the condition) diet 10 or 11 is prescribed. Similar rules apply when a diet is prescribed after bypass surgery.

We think we should briefly characterize the mentioned diets. So, therapeutic diet 10 is prescribed for diseases of the cardiovascular system and is aimed at normalizing the functions of blood circulation and general metabolism. Its key features are a significant reduction in the consumption of salt, liquids (up to 1200 ml per day), fats (up to 65-70 g) and carbohydrates (up to 350-370 g), as well as the enrichment of nutrition with potassium and magnesium. The daily calorie content is the energy value of 2500 kcal.

The protein diet after surgery (diet 11) is used to increase the body's defenses and restore normal conditions, in particular in case of anemia, general malnutrition and chronic infections. In many cases, it is also prescribed to improve the quality of nutrition of patients with other pathologies, since this is a protein diet after surgery (up to 140 g of protein per day). This physiologically complete diet is fortified and high-calorie (3700-3900 kcal), which provides up to 110 g of fat and up to 500 g of carbohydrates. With this diet after heart surgery, patients eat five times a day. There are no restrictions on the culinary processing of food and its consistency, but in any case, fried and fatty foods are contraindicated even in the absence of any internal diseases.

The diet after bypass surgery is aimed at reducing blood cholesterol levels, and its recommendations must be followed constantly to prevent the deposition of cholesterol in the blood vessels.

The diet after bypass surgery limits the intake of fats and completely excludes all fried and fatty, as well as ghee and sunflower oil (only cold-pressed olive oil is allowed). The diet menu after coronary artery bypass surgery should include: boiled meat (lean beef and veal), beef liver, poultry meat, low-fat dairy products, white sea fish, legumes, vegetables, fruits, berries, nuts.

Diet after kidney surgery

According to experts, a diet after kidney surgery - in the case of ultrasonic crushing of the stones in it - is not prescribed, but it is recommended to eat light, steamed food, do not eat fatty and spicy food, and refuse canned food and carbonated water.

If the stones are removed by abdominal surgery, the patient needs a diet of zero after surgery, then a diet of 1 after surgery (return to the beginning of the publication and read the characteristics of these diets).

In the standard course of the postoperative period, on about the fifth or sixth day, doctors establish a diet for their patients in accordance with the therapeutic dietary table 11 (it is also described above).

But the diet after the operation of removing the kidney (after eating on the zero and first surgical diets) involves a balanced full-fledged diet with some well-founded restrictions. So, it is necessary to add less salt to food, reduce the number of meat dishes in the diet, eat black bread instead of white bread, drink kefir instead of milk. And there is no doubt that steam cutlets are healthier than fried ones, and stewed rabbit meat for a single kidney is better than pork kebab.

Various cereals, dairy products, vegetables, fruits - all this is possible. And all canned food, semi-finished products and food products with preservatives, flavorings and food colorings can only do harm. By the way, different reasons lead to the removal of the kidney, so the diet after the operation of removing the kidney is prescribed for each patient individually.

Diet after bladder surgery

All diets for surgical treatment of pathologies of the pelvic organs, including the diet after bladder surgery, prescribe food that is easily digested. Therefore, it is natural to prescribe a diet after abdominal surgery, that is, food with a liquid and semi-liquid consistency, with the restriction or complete exclusion of fats, salt, coarse fiber, etc.

The main recommendations of urologists regarding the diet after bladder surgery are reduced to more frequent and abundant water intake, as well as the need to avoid foods that contain oxalic acid compounds (oxalates).

Diet recipes after surgery

Do I need to give detailed diet recipes after the operation, in the sense of the same zero diet? It is unlikely, because while patients are eating slimy rice water or low-fat chicken broth, they are in the hospital ...

And outside the hospital, you will have to learn how to cook, for example, milk jelly. To prepare it for a glass of milk, you need a teaspoon of ordinary potato starch and so much granulated sugar.

Milk should be brought to a boil and pour starch diluted in a small amount of water (50-60 ml) into it. Starch is introduced with continuous stirring - so that the jelly is homogeneous. Add sugar and remove from heat. The principle of preparing all jelly is similar to this diet recipe after surgery.

And here is a tip for cooking mashed cereals - rice, buckwheat or oatmeal. In order not to bother with grinding the finished porridge, you need to grind the corresponding cereals and oatmeal almost to the state of flour. And pour the already crushed product into boiling water (or into boiling milk), while stirring. This porridge cooks much faster.

Diet after surgery is the most important component of rehabilitation after any surgical intervention. And now you know the basic rules of clinical nutrition.

The postoperative period after the installation of a pacemaker begins literally on the day of implantation. Immediately after the operation, the patient finds himself in the intensive care unit or in the corridor next to it (usually patients with more serious illnesses, for example, after a heart attack, get into the intensive care unit - and if there are no places, do not blame me).

Staying directly in the intensive care unit (or next to it) is not long: 2-3 hours, after which, most likely, they will be transferred to the general ward. In the first 2-3 hours of the postoperative period after implantation of the pacemaker, you will have to lie strictly on your back, your left arm (or right arm if implanted in the right chest) along the body or bent at the elbow on the stomach.

Ice will be placed on the bandage over the surgical suture - you will have to lie with it almost all the time. A doctor will come a couple of times to check on your well-being. After that, readings are taken, an x-ray is taken and the patient is transported (on the bed) to the general ward. It is better not to get up for the next two hours, after that you can go to the toilet or to the washbasin on your own.

First day after surgery

Formally, the patient remains lying down until the next day (for more details, both on the first day and beyond). However, this did not stop me from walking to the dining room (although on the first day after the operation, food will be brought directly to the ward, and they will also come in for dishes in the same way). However, I did not manage to walk for a long time - already after about 130 - 140 steps (I thought!) There was a feeling of weakness. I had to return to the room.

The most difficult stage after the operation is the first night. Firstly, at this time it will not be possible to sleep except on your back (and since I had implantation at 2 o'clock in the afternoon, and I lay down on the couch waiting for my turn at 12, then by the time of lights out - by 10 hours of the evening - I already managed to thoroughly lie down for myself everything that I could).

Secondly, while tossing and turning on the couch, I could think about a lot of things - and most importantly, how my life would change from now on, and how many habits I would have to give up. I was advised to use painkillers: it would be easier to fall asleep with it (there is some kind of sedative plus painkiller). But my wound did not hurt (fortunately, it did not hurt at all, doctors say that this is due to muscle training). Therefore, once again I did not inject "chemistry" into myself. I slept the next day, after lunch ...

Preparing for this stage is quite simple:

it is worth dealing with the device of the bed - it’s good if its back rises, if it doesn’t work out on your own - ask other patients or medical staff: it will be easier to sleep with a raised back;
do not think about the bad - a pacemaker, all other things being equal, is more reliable than many of our own organs, as for an active lifestyle - if you have been leading it up to now and it is important for you - it is more than accessible with a pacemaker;
and yes, do not worry about the things with which you arrived at the hospital - they will be delivered to the ward a few hours after the operation, they will be waiting for you already in the ward or will arrive after you.

Second day

On the second day, already in the morning, I could move freely. I felt a slight weakness, but with short transitions - from the ward to the post and from the post to the winter garden (60 and 30 steps), where I could sit down, I began to “disperse”. By lunchtime, I had almost fully recovered, only lack of sleep was felt. They say that it happens, but at that time I did not have such symptoms.

On the second day, relatives can still be allowed into the ward, although they are usually allowed only to bedridden patients. Walk to the dining room on your own. In general, I did not experience much discomfort, apart from the presence of a bandage on my left chest. The left arm was immobilized throughout the day. Here I was glad that I took with me not only a T-shirt, but also a jacket from a tracksuit with a zipper.

During almost the entire postoperative period, it is not recommended to raise the arm, where the pacemaker is implanted, above the horizontal, and for the first time 2-3 days, to immobilize it altogether. It will be very difficult to pull a T-shirt over your head - I only started doing this regularly for 4-5 days.

On the second day, they also offered me an injection of painkillers - and I refused it in the same way. On the same day, I was already allowed to sleep on my left shoulder, but I still preferred to sleep on my back, since I figured out how to raise the back of the bed - it became easier.

Preparation for this stage involves:

the need to take suitable clothes with you - something that can be pulled over the body without raising the “sore” hand;
for the first walks, flip flops and socks are suitable - if you are in the hospital in the cold season, then it is better to wear flip flops with socks - this is not entirely in fashion, but it is better than catching a cold;
the hospital is rather boring - take a book with you (you can ebook - there is no dangerous radiation from it).

Third day

This day is the last when painkillers are supposed to be injected, the first time is when the bandage is changed (hereinafter this will be done every day, except for weekends). In principle, if everything goes well, then the patient is no longer limited in movement, he can go downstairs and meet visitors.

I felt more or less well that day, but it was still difficult to stand for a long time (I wanted to sit down or lie down), walk. I think it was, but the operation to install it. And so far I have not ventured up and down the stairs (although more experienced patients already begin their walks on the stairs on this day).

In general, the day passed quietly: I walked around the floor - from the panoramic window with a view of the Volga and the terraces descending to it to the winter garden with panoramic windows on the entire Volga, read a book ("Dune"), delved into a mobile phone (already On this day, I began to answer correspondence at work and read industry news).

It was my first night that I tried to sleep on my right side, not only on my back. He even lay down briefly on his left side, but quickly turned over. I left such experiments for the future - for the second week after the operation.

On the same day, I began to bathe. We had a shower in the ward, with a removable gander - so it was easy to wash our legs, back, stomach, right arm without soaking the bandage. The left arm, armpit and chest, as well as part of the abdomen, had to be wiped with wet sanitary napkins. Unfortunately, I washed my hair for the first time only after I was discharged, at home.

Better stock up:

stock up on a small amount of money - hospital food will quickly get bored, besides, it is preferable to drink bottled water than from the tap (and the need to go down for a bottle of water is another reason to walk);
take the phone - for sure, you will want to talk to someone, but keep it when talking from the opposite side from the implantation site, but it is better to use a headset;
hygiene items - wet wipes to clean the body, soap.

Fourth and fifth days

To be honest, I don’t remember what day the pacemaker checks and various tests (blood from a finger, vein, urine) begin - it seems to be already on the second day after the operation, but, in general, this is a routine that takes an hour and a half - two day (taking into account all queues and waiting for dressing).

And I began to ask the attending physician about the limitations of life with an EX: everything was clear regarding the ban on weightlifting and contact-traumatic sports, etc. obvious things. However, questions remained regarding travel by public transport (tram, trolley bus), use of a headset with a mobile phone and an audio player, and other gray areas.

These days I started walking up and down stairs. First, one span, then two, and so on. By the time I was discharged, I had already climbed from the 0th floor to the 5th and went down several times (only 169 steps in one direction). At first it was scary, although there were no physical difficulties - it was scary to climb, at first I walked strictly next to the railing.

The same goes for putting on a T-shirt over your head - a start was made, but once again I was not transmitted. By the way, you need to dress from the “sick” hand - first we put it in the sleeve, then the healthy one.

At this stage you will need:

clean change of underwear - from underwear to T-shirts, pants, shorts;
towels (large and small) - for various procedures (a large towel spreads to lie on it, a small one to dry off): however, you can use hospital towels.

Sixth and subsequent days

On this day, I installed the wonderful program "Pedometer" (it is available for Android) and walked with it more than 10,000 steps (about 6.7 km) - although I did not install it in the morning, so the real distance was longer. Again, I did not experience any discomfort at that time. On the same day, I started climbing stairs for the first time with a small load - a 1.5-liter bottle of water.

Prior to this, “loaded” I went up exclusively in the elevator. The bottle was carried, of course, in the right - opposite to the "sick" hand. It was quite risky (as it seemed to me at that time), because. with a conditionally sick hand, I would not have dared to lean on the railing.

In the future, the load only grew - just before I was discharged, I had already walked almost 20 thousand steps (about 13.5 km), of which at least 800 were climbing stairs. On the sixth day, I painlessly put on a T-shirt over my head, freely bathed in the shower (however, without allowing moisture to get on the bandage).

Before discharge

On the eighth or ninth day, the bandage is removed, followed by the stitches. The scar cannot be wetted for another 3-4 days (until the last black “dots” fall off - it happened to me only after a week, but I started swimming earlier, trying not to wet the scar).

You may need to take additional or repeated tests, be sure to do an ultrasound, ECG (to assess the work of the heart with a pacemaker). But here you don’t have to think - the medical staff will tell you everything.

There may be problems with the healing of the suture, discharge may appear - then antibiotics are pierced or other therapy is prescribed. But, as a rule, on the 10th day - an extract. And the end of the postoperative period after the operation to install a pacemaker ...

Instead of output

The food in hospitals is now relatively normal - the portions are not large, but, given the extremely sedentary lifestyle, their calorie content is quite sufficient.

You need to take some money with you, a mobile phone, literature (sometimes there is a library in the hospital - with a quite good choice: apparently other patients leave), change of linen, towels and hygiene products (including a toothbrush - but I don’t think comments needed).

It is better to start walking in the hospital - it will be easier to track down possible discomfort and immediately stop it. Although, of course, an active lifestyle - only in agreement with the doctor.

Upon discharge, they will issue a pacemaker passport that you have been implanted and will be told. There will be more information on the Internet about the modes of its operation than the observing doctor will tell you - she (he) simply does not have time, there are other patients.

After intervention in the body of a sick patient, a postoperative period is required, which is aimed at eliminating complications and providing competent care. This process is carried out in clinics and hospitals, it includes several stages of recovery. At each of the periods, attentiveness and care for the patient by a nurse, doctor's supervision is required to exclude complications.

What is the postoperative period

In medical terminology, the postoperative period is the time from the end of the operation to the complete recovery of the patient. It is divided into three stages:

early period - before discharge from the hospital;
late - after two months after the operation;
the remote period is the final outcome of the disease.

How long does it take

The end date of the postoperative period depends on the severity of the disease and the individual characteristics of the patient's body, aimed at the recovery process. Recovery time is divided into four phases:

catabolic - an increase in the excretion of nitrogenous wastes in the urine, dysproteinemia, hyperglycemia, leukocytosis, weight loss;
period of reverse development - the influence of hypersecretion of anabolic hormones (insulin, growth hormone);
anabolic - restoration of electrolyte, protein, carbohydrate, fat metabolism;
a period of healthy weight gain.

Targets and goals

Follow-up after surgery is aimed at restoring normal activities of the patient. The objectives of the period are:

prevention of complications;
recognition of pathologies;
patient care - the introduction of analgesics, blockades, ensuring vital functions, dressings;
preventive measures to combat intoxication, infection.

Early postoperative period

From the second to the seventh day after the operation, the early postoperative period lasts. During these days, doctors eliminate complications (pneumonia, respiratory and renal failure, jaundice, fever, thromboembolic disorders). This period affects the outcome of the operation, which depends on the state of kidney function. Early postoperative complications are almost always characterized by impaired renal function due to the redistribution of fluid in the sectors of the body.

Renal blood flow decreases, which ends on 2-3 days, but sometimes the pathologies are too serious - loss of fluid, vomiting, diarrhea, impaired homeostasis, acute renal failure. Protective therapy, replenishment of blood loss, electrolytes, stimulation of diuresis help to avoid complications. Shock, collapse, hemolysis, muscle damage, burns are considered common causes of pathologies in the early period after surgery.

Complications

Complications of the early postoperative period in patients are characterized by the following possible manifestations:

dangerous bleeding - after operations on large vessels;
abdominal bleeding - with intervention in the abdominal or chest cavity;
pallor, shortness of breath, thirst, frequent weak pulse;
divergence of wounds, damage to internal organs;
dynamic paralytic obstruction of the intestines;
persistent vomiting;
the possibility of peritonitis;
purulent-septic processes, the formation of fistulas;
pneumonia, heart failure;
thromboembolism, thrombophlebitis.

Late postoperative period

After 10 days from the moment of operation, the late postoperative period begins. It is divided into hospital and home. The first period is characterized by an improvement in the patient's condition, the beginning of movement around the ward. It lasts 10-14 days, after which the patient is discharged from the hospital and sent for home postoperative recovery, a diet, vitamins and activity restrictions are prescribed.

Complications

There are the following late complications after surgery that occur while the patient is at home or in the hospital:

postoperative hernia;
adhesive intestinal obstruction;
fistulas;
bronchitis, intestinal paresis;
repeated need for surgery.

The causes of complications in the later stages after surgery, doctors call the following factors:

a long period of being in bed;
underlying risk factors – age, disease;
impaired respiratory function due to prolonged anesthesia;
violation of asepsis rules for the operated patient.

Nursing care in the postoperative period

An important role in the care of the patient after the operation is played by nursing care, which continues until the patient is discharged from the department. If it is not enough or it is performed poorly, this leads to unfavorable outcomes and a lengthening of the recovery period. The nurse must prevent any complications, and if they occur, make efforts to eliminate them.

The tasks of the nurse for postoperative care of patients include the following responsibilities:

timely administration of drugs;
patient care;
participation in feeding;
hygienic care of the skin and oral cavity;
monitoring the deterioration of the condition and providing first aid.

From the moment the patient enters the intensive care unit, the nurse begins to fulfill her duties:

ventilate the room;
eliminate bright light;
arrange the bed for a comfortable approach to the patient;
monitor the patient's bed rest;
prevent coughing and vomiting;
monitor the position of the patient's head;
feed.

How is the postoperative period

Depending on the condition after the operation of the patient, the stages of postoperative processes are distinguished:

strict bed resting period - it is forbidden to get up and even turn in bed, it is forbidden to carry out any manipulations;
bed rest - under the supervision of a nurse or an exercise therapy specialist, it is allowed to turn in bed, sit down, lower your legs;
ward period - it is allowed to sit on a chair, walk for a short time, but examination, feeding and urination are still carried out in the ward;
general mode - self-service by the patient himself, walking along the corridor, offices, walks in the hospital area is allowed.

Bed rest

After the risk of complications has passed, the patient is transferred from the intensive care unit to the ward, where he should be in bed. The goals of bed rest are:

limitation of physical activation, mobility;
adaptation of the organism to the syndrome of hypoxia;
pain reduction;
restoration of strength.

Bed rest is characterized by the use of functional beds, which can automatically support the patient's position - on the back, stomach, side, reclining, half-sitting. The nurse takes care of the patient during this period - changes linen, helps to cope with physiological needs (urination, defecation) with their complexity, feeds and performs hygiene procedures.

Following a special diet

The postoperative period is characterized by adherence to a special diet, which depends on the volume and nature of the surgical intervention:

After operations on the gastrointestinal tract, enteral nutrition is carried out for the first days (through a probe), then broth, jelly, crackers are given.
When operating on the esophagus and stomach, the first food should not be taken for two days through the mouth. Produce parenteral nutrition - subcutaneous and intravenous intake through a catheter of glucose, blood substitutes, make nutrient enemas. From the second day, broths and jelly can be given, on the 4th add croutons, on the 6th mushy food, from the 10th common table.
In the absence of violations of the integrity of the digestive organs, broths, pureed soups, jelly, baked apples are prescribed.
After operations on the colon, conditions are created so that the patient does not have a stool for 4-5 days. Food low in fiber.
When operating on the oral cavity, a probe is inserted through the nose to ensure the intake of liquid food.

You can start feeding patients 6-8 hours after the operation. Recommendations: observe water-salt and protein metabolism, provide a sufficient amount of vitamins. A balanced postoperative diet for patients consists of 80-100 g of protein, 80-100 g of fat and 400-500 g of carbohydrates daily. For feeding, enteral mixtures, dietary canned meat and vegetables are used.

Intensive observation and treatment

After the patient is transferred to the recovery room, intensive monitoring begins and, if necessary, treatment of complications is carried out. The latter are eliminated with antibiotics, special medicines to maintain the operated organ. The tasks of this stage include:

assessment of physiological parameters;
eating according to the doctor's prescription;
compliance with the motor regime;
drug administration, infusion therapy;
prevention of pulmonary complications;
wound care, collection of drainage;
laboratory tests and blood tests.

Features of the postoperative period

Depending on which organs have undergone surgical intervention, the features of patient care in the postoperative process depend:

Abdominal organs - monitoring the development of bronchopulmonary complications, parenteral nutrition, prevention of gastrointestinal paresis.
Stomach, duodenum, small intestine - parenteral nutrition for the first two days, inclusion of 0.5 liters of liquid on the third day. Aspiration of gastric contents for the first 2 days, probing according to indications, removal of sutures on days 7-8, discharge on days 8-15.
Gallbladder - a special diet, removal of drainage, it is allowed to sit for 15-20 days.
Large intestine - the most sparing diet from the second day after the operation, there are no restrictions on fluid intake, the appointment of vaseline oil inside. Extract - for 12-20 days.
Pancreas - preventing the development of acute pancreatitis, monitoring the level of amylase in the blood and urine.
The organs of the chest cavity are the most severe traumatic operations, threatening blood flow disturbance, hypoxia, and massive transfusions. Postoperative recovery requires the use of blood products, active aspiration, and chest massage.
Heart - hourly diuresis, anticoagulant therapy, drainage of cavities.
Lungs, bronchi, trachea - postoperative fistula prevention, antibiotic therapy, local drainage.
Genitourinary system - postoperative drainage of urinary organs and tissues, correction of blood volume, acid-base balance, sparing high-calorie nutrition.
Neurosurgical operations - restoration of brain functions, respiratory capacity.
Orthopedic-traumatological interventions - compensation for blood loss, immobilization of the damaged part of the body, physiotherapy exercises are given.
Vision - 10-12 hours bed period, walks from the next day, regular antibiotics after corneal transplantation.
In children - postoperative pain relief, elimination of blood loss, support for thermoregulation.

In elderly and senile patients

For a group of elderly patients, postoperative care in surgery is distinguished by the following features:

elevated position of the upper body in bed;
early turning;
postoperative breathing exercises;
humidified oxygen for breathing;
slow drip intravenous injection of saline solutions and blood;
careful subcutaneous infusions due to poor absorption of fluid in the tissues and to prevent pressure and necrosis of skin areas;
postoperative dressings to control wound suppuration;
the appointment of a complex of vitamins;
skin care to avoid the formation of bedsores on the skin of the body and limbs.

Video

The rehabilitation process takes from 3 months to 1 year after the operation, depending on its complexity. After 6 months, patients are advised to continue exercising on rehabilitation equipment under the supervision of an exercise therapy doctor or instructor in order to prevent recurrence of a herniated disc, for which a set of exercises is individually selected to create a muscular corset and improve blood circulation in problem areas.

The recovery period takes place under the supervision of a neurologist, who prescribes a course of drug therapy, recommends consultations of other specialists for more effective treatment.

Early rehabilitation period (from 1 to 3 months).

Do not sit for 3-6 weeks after the operation (depending on the severity of the operation).
Do not make sharp and deep movements in the spine, bending forward, to the side, twisting movements in the lumbar spine for 1-2 months after surgery.
Do not drive and do not ride in transport in a sitting position for 2-3 months after the operation (you can drive as a reclining passenger with the seat unfolded).
Do not lift more than 3-5 kilograms for 3 months.
Within 3 months after the operation, one should not ride a bicycle, play sports (football, volleyball, basketball, tennis, etc.).
Periodically unload the spine (rest in the supine position for 20-30 minutes during the day).
Wearing a postoperative corset for no more than 3 hours a day.
It is advisable not to smoke or drink alcohol during the entire rehabilitation period. Intimate life is not contraindicated.

Rehabilitation:

As soon as the patient is allowed to walk, he should consult with an exercise therapy doctor regarding the timing of the appointment and the complex of physiotherapy exercises, which depend on the volume and nature of the surgical intervention, as well as postoperative complications. A month after an uncomplicated operation, classes are shown in the gym (not in the gym!) Under the supervision of an exercise therapy doctor, without deadlifts. Beneficial swimming.

A month after the operation, in uncomplicated cases, you can start working (the question of the timing and specific work performed is decided in each case individually with the attending physician).

Late rehabilitation period (3-6 months).

It is not recommended to lift more than 5-8 kilograms, especially without warming up and warming up the back muscles, jumping from a height, long car trips.
When going outside in bad weather: wind, rain, low temperature, it is advisable to wear a warming belt on the lumbar region.
Wearing a corset, especially for a long time, is not recommended in order to avoid atrophy of the long back muscles.

Rehabilitation:

During this period, you can carefully, under the supervision of a physiotherapist, begin the formation of a muscle corset, doing exercises to strengthen the muscles of the back.

A healthy lifestyle, smoking cessation, regular exercise in the gym, swimming, bathing, limiting weight lifting significantly reduce the risk of developing herniated discs.

To prevent back pain, you should avoid: stress, hypothermia, prolonged monotonous labor in a forced position, weight lifting, sudden movements on cold, not warmed up muscles, the appearance of excess body weight.

In addition, at any stage of rehabilitation, acupuncture and physiotherapy can be included in the complex of rehabilitation measures.

Recommended set of exercises (one month after surgery)

At first, do 1 to 5 repetitions of exercises 2 times a day, increasing to 10 repetitions of each exercise 2 times a day.
Perform exercises smoothly and slowly, without sudden movements. If during execution you feel discomfort or pain, then do not do this exercise for a while. If such sensations become persistent, you should consult a doctor.
The intensity of the load depends on how you feel. As soon as pain appears, reduce the intensity of exercise.

Exercise 1. Lie on your back. Slowly bend your knees and press to your chest, feel the tension in the gluteal muscles. Relax the gluteal muscles. Keep your legs bent for 45-60 seconds, then slowly straighten them.

Exercise 2. Lie on your back, bend your knees, hands on the floor in different directions. Raise your pelvis off the floor and hold for 10-15 seconds. Adjust the holding time to 60 seconds.

Exercise 3. Lie on your back, hands behind your head, legs bent at the knees. Turn your legs alternately, first to the right, then to the left, touching the floor with your knee; the upper body remains in a horizontal position. Hold your legs in a rotated position for up to 60 seconds.

Exercise 4. Lie on your back, bend your knees, cross your arms over your chest, press your chin to your chest. Tightening the abdominal muscles, bend forward and hold in this position for 10 seconds, then relax. Repeat 10 to 15 times, gradually increasing the number of repetitions.

Exercise 5. Starting position on the hands and legs bent at the knees. At the same time, stretch the left leg and right arm horizontally and lock in this position for 10 to 60 seconds. Repeat by raising your right arm and left leg.

Exercise 6. Starting position: lying on the stomach, arms bent at the elbow joints, lie near the head. Straightening your arms, lift your upper body and head up, bending in the lumbar region, while keeping your hips off the floor. Hold this position for 10 seconds. Get down on the floor and relax.

Exercise 7. Starting position lying on the stomach, hands under the chin. Slowly, low, lift your straight leg up without lifting your pelvis off the floor. Slowly lower your leg and repeat with the other leg.

Exercise 8. Starting position: stand on one leg, the second, straightened, put on a chair. Leaning forward, bend the knee of the leg lying on the chair, and hold in this position for 30-45 seconds. Straighten up and return to the starting position.