Medical and Nursing Care in the Inpatient Care Units
In the ICU, you will see some equipment by your bedside. These are used to monitor your heart, respiratory rate, blood pressure and the oxygen saturation. A team of doctors and nurses will take care of you and also answer any questions you may have.
You may be nursed in the ICU for about one to two days. The length of stay may vary depending on the rate of your recovery. Please inform your family members that the visiting hours for ICU is similar to the general wards - 12 noon to 2 pm and 5 pm to 8.30 pm. However, the number of visitors will be restricted to two visiting you at the bedside. When your condition has stabilised, you will be moved to the High Dependency area of the general ward.
Relief of Post-Surgery Discomfort
You will experience some pain at the site of your surgery. Medication will be given to you to relieve any pain or discomfort. The medication may be administered through any one of the following methods:
- Patient Controlled Pumps
- Epidural - where medication is released through a fine catheter inserted into your back
A tracheostomy (small opening in the trachea at the front of the neck) is usually performed as part of the operation to facilitate excision of cancerous tissues and reconstruction of jaw or oral cavity. A tracheostomy tube is inserted to maintain a clear airway and to facilitate suction of secretion. This tube will be removed when the wound has healed in one to two weeks.
Wound and Skin Care
The dressing over your wound will be removed 24 hours after the surgery and the wound must be kept clean and dry. Drainage tubes will be inserted near the operation site to prevent any accumulation of fluid or blood in the wound. These tubes will gradually be removed when the amount of fluid has decreased.
You will not be allowed to eat or drink through your mouth for at least a week or two to allow the wound to heal. An intravenous drip will be inserted into your hand or arm for one or two days to provide you with adequate fluid and medication to keep you comfortable. Feeds will be given through a nasogastric tube that is inserted via the nose into your stomach on the second or third day after surgery, to ensure that you have adequate nutrition.
If you experience any difficulty in swallowing, the Speech Therapist will assist you to regain your swallowing ability. Initially, you will only be able to drink and consume soft food.
A urinary catheter may be inserted into your bladder during the operation, to assist you in passing urine and also to monitor your urine output. You may experience an urge to urinate with the tube in position, even though your bladder is empty. The catheter will be removed once you are well enough to attend to your own toilet needs.
You may have to pass motion using a bedpan in bed if you have not started ambulation. Please inform the nurse if you require any assistance.
It is not easy to breathe deeply and cough after surgery, due to the discomfort that may result from your incision. The Physiotherapist will assist and teach you to perform deep breathing and coughing exercises. This is to help you cough out any secretions that may have collected in your airways during surgery, to prevent any chest infection from developing.
You will not be able to speak immediately after the operation because of the tracheostomy and surgery. You may wish to communicate by sign language or through writing. Pen and paper will be provided.
You speech may also be impaired as the surgery involves the oral cavity, tongue or jaw. The Speech Therapist will help you to overcome the problem during your recovery period.
While lying in bed, you will need to turn on your sides and move your legs at least once every two hours. Such activity helps to stimulate circulation and speed up your recovery.
The level of activity will be increased slowly and by the fifth day, you may be allowed to sit on a chair by the side of the bed. The Physiotherapist will assist you to resume walking in preparation for your discharge from the hospital.
Length of Stay
The average length of stay for patients undergoing head and neck surgery is usually between five to fourteen days. However, the length of stay may vary with each individual.