After Surgery Care

• You may have a sore throat from the breathing tube that was in place during your surgery.
• You may feel sick to your stomach and tired from the medications you were given during and after your surgery. Tiredness can last up to 6 or 8 weeks.
• You may have some bruising and tenderness in the area of your operation.
• You may have numbness in the armpit and/or your upper arm.
• Feelings of tightness, heaviness, tingling, burning, or more sensitivity are also common. Gently rubbing and tapping the area can help get rid of these sensations.
• Your surgeon can prescribe you medication (gabapentin) for these feelings if they are bothering you.
• You will have a tube or drain near your incision (cut).

Deep breathing and coughing:

• Do deep breathing exercises as soon as possible to keep your lungs clear after surgery.
• For the first 2 days after surgery take 10 deep breaths 4 to 5 times a day.
• After your deep breaths, cough 2 to 3 times.
• Coughing up a bit of sputum (saliva and mucus) after surgery is normal.

Movement:

• It is important to move your arm after surgery.
• DO NOT cradle your arm against your chest.
• For the first 4 to 6 weeks following surgery:
  • DO NOT lift anything over 10 pounds.
  • DO NOT do any heavy pushing, pulling or repetitive movements with the affected arm(s).
• Before your operation, a physiotherapist will see you before you leave the hospital and will show you exercises that you need to start 24 hours after surgery. These exercises are shown near the end of this booklet.

• You will have dissolvable stitches underneath the area where you had surgery.
• Several strips of thin tape will be placed on top of the area where you had surgery. These are called Steri-Strips.
• The area will also be covered by a large gauze dressing. At the site of the drain, you will have another smaller dressing.

• You may take off the outer dressings 48 hours after surgery.
• You may shower 48 hours after your surgery.
• If the incision is covered with paper tapes (called Steri-Strips), then leave these Steri-Strips in place for 10 days after your surgery.
• After 10 days, you can take off the Steri-Strips while you are in the shower (the water makes them easier to remove them). They may come off on their own before 10 days. This happens to many people and is not something to be worried about.
• A small amount of blood on the dressing or Steri-Strips is normal.

• You may have some mild pain or discomfort following surgery.
• You will be given a prescription for pain medicine before you leave the hospital.
• Be sure to fill your prescription for pain medicine as soon as possible so that you have it available if you should need it.
• Take your pain medicine exactly as it is directed so that you can have good pain control.
• If you are still having pain after taking your pain medicine or you have concerns about your pain medicine, call the Melanoma Site Nursing Team at 416-480-5000.

• Restart your regular medicine after surgery unless your surgeon has told you not to.
• If you normally take Aspirin (acetylsalicylic acid) or a blood thinner (such as Coumadin), ask your surgeon when you can start these medicines after surgery.
• If you have any questions about your other regular medicines, please contact your family doctor.

You may become constipated after surgery. Constipation can happen for many reasons. Certain medicines, a change in your diet and less physical activity can all lead to constipation.

• Drink a lot of fluid after your surgery.
• Use a stool softener, such as Colace. This is available at a pharmacy.
• Or, use a laxative such as Senokot, which helps the bowels to move. Take 1 to 2 Senokot tablets twice a day as needed. Senokot is available at a pharmacy.
• Eat prunes or drink prune juice.
• If these don't help, please call the nursing phone line at 416-480-5000.

• Scar massage helps to get rid of the sensitivity, tightness, and itchiness around the scar.
• It also helps to soften and loosen the scar area so that you can move your shoulder better.
• You may start scar massage 4 to 6 weeks after surgery, once the incision has healed.
• Scar massage should be done for 2 to 3 minutes, 2 to 3 times a day.

• Put 2 fingers on the scar area.
• Move your fingers in an up and down zigzag pattern one way across the scar and then move your fingers in circles the other way across the scar.