>> When you awake from surgery, you will wake
up in the Cardiovascular Center Intensive Care Unit, also known as the CVCICU.
Your loved ones will be able to visit you based
on your medical condition and unit visiting policies.
You will be in the CVCICU for approximately three to five days.
Your length of stay is determined by how well you progress after surgery.
It is hard to breathe on your own after lung transplant.
You will be hooked up to a mechanical breathing machine,
also known as a ventilator, that will be breathing for you.
The ventilator helps you until you can breathe on your own.
Once you are able to breathe on your own, the breathing tube and NG tube will be removed.
The pulmonary artery catheter may be removed one to two days after surgery.
Your arterial line will be removed before you are transferred from the CVCICU.
You will have chest tubes in place.
You may also have drains, as well.
The chest tubes help drain any excess fluid from your chest cavity.
These make it easier to breathe and keep the lungs inflated.
The number of chest tubes you have depends on whether you had one or two lungs transplanted.
These will be removed based on your chest X-ray
and once there is little drainage coming out of your chest.
Expect to be up and walking soon after surgery.
While this may be painful, it is important for you to maintain your strength
and exercise your new lung as soon as possible.
Getting out of bed and walking will decrease your chance of getting pneumonia
or developing blood clots in your legs.
Once you are stable, you will be transferred to the Step-down Unit.
Remember that you are in partnership with your transplant team,
and we need your active participation with many things as you heal from surgery.
First, let's talk about how you'll feel after surgery.
You will probably have an epidural catheter placed in your back for pain management.
When this comes out, you will feel pain at the incision site.
Pain after this surgery is normal.
This is a big surgery, with muscles being cut and ribs being surgically fractured.
You will be given strong pain medication to keep you comfortable.
You will probably experience nausea.
After surgery, you will be taking a lot of new medicines
and frequently these will make you feel a little bit nauseated.
That is important to understand.
Many patients report feeling this funny discomfort
under their ribs, beneath the incision.
Some call it pain but the sensation is due more to tightness than pain.
The layers of the incision swell as they begin to heal.
This swelling contributes to this tightness.
Oftentimes the sensation lasts for many months.
Even though everything is working fine and the lung functions are normal,
you may still have this tightness underneath your ribs.
It is something you may have to get used to.
Your surgically fractured ribs will also be sore.
The number of ribs involved depends on the exposure needed by your surgeon.
Your surgeon may need to remove a portion of your rib, as well.
That's important to understand, too.
You may experience swelling because you're getting so many fluids after surgery.
Whether it's in your arms or legs, this is a common occurrence.
But over time, it resolves.
These are all normal sensations and outcomes from surgery.
Now, let's talk about what you need to do to recover.
You must use your incentive spirometer every day.
Using it will help teach your lungs how to breathe deeply again.
You will need to practice with it four times an hour every day,
taking 10 deep breaths at a time.
This will also help you learn how to cough again.
Coughing will help you clear secretions from your lungs
and prevent pneumonia from developing.
You will also have drains to collect any fluid from your chest.
You will learn how to empty your drains and measure the output.
As you start to heal, the output will go down.
Barring any complications, you will be discharged in seven to 14 days,
depending on chest tube output, medication understanding, walking ability,
and how well your new lung is functioning.