After mouth and oropharyngeal cancer surgery

Your recovery depends on the type of surgery you have and your general health. 

You usually need to stay in hospital. The length of your stay depends on what type of operation you have. You might be able to go home after a few days. But some people will stay in hospital for up to a few weeks. You will need to give yourself time to recover once you are at home.

When you wake up after your operation

After the operation, you wake up in the recovery room. You will have one to one nursing care. The nurse looks after you until you are awake and well enough to go back to the ward.

Everybody is different when they are waking up after an operation. It takes some people longer than others to wake up. Some people remain very sleepy for a while afterwards. You may be in the recovery room for hours before you are ready to go back to the ward.

Back on the ward your doctor will see you regularly. Specialist nurses may visit you. They look after people who have had major surgery but do not need to be in the intensive care or high dependency unit.

Sometimes you may wake up in the intensive care unit (ICU) or high dependency unit (HDU) after your operation. This is so your doctors can keep a closer eye on you. This may happen if:

• your general health is poor
• the operation took longer than planned
• the operation was more complicated than the doctors thought it would be

In the ICU you have one to one nursing care. In the HDU you have very close nursing care. 

The staff in the ICU or HDU will speak to a member of your family or friends about visitors. But, you usually move back to the ward within a day or so.

Tubes and drains

When you wake up you might have:

• a drip (intravenous infusion) into your arm to give you fluids until you are eating and drinking again
• a breathing tube in your neck 
• a fine tube into your stomach (gastrostomy tube) or into your stomach via your nose (nasogastric tube) for liquid feeds 
• wound drains in your neck or near your wound
• a tube into your bladder (catheter) to collect and measure urine 

Talking after your operation

If you had surgery to your voice box, mouth, jaw, tongue or throat you will have problems talking after your operation. This can be frustrating and you may feel you have no control over things.

Staff will be aware of this. You will have a call bell close by so you can call for help if you need it. Your nurse can give you a pen and paper to write down what you want to say. 

The text function on mobile phones may also help. Your nurse may be able to provide a computer tablet while you are in hospital.

Breathing tubes

After your surgery, you might wake up with a breathing tube (tracheostomy tube) in a hole in your neck. The hole is called a stoma.

This is usually temporary. You breathe through the tube for 3 or 4 days. Then your doctor or someone from your healthcare team removes it. The hole then closes up on its own. You will have a dressing over the wound until it heals.This will be changed regularly. When talking or coughing, apply pressure with your fingers over the wound to prevent the air from escaping and to help the wound heal.

A few people will need a permanent tracheostomy. 

Pain

It’s normal to have pain for the first week or so. You have painkillers to help.

Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA). Analgesia is another word for painkillers. 

You get painkillers to take home. Your nurse will talk to you about:

• how often to take them
• when to take them
• what side effects you may get 

Contact your doctor if you still have pain or if it gets worse.

Eating and drinking

Whether or not you can eat or drink after your operation depends on your type of surgery. Any surgery to your mouth usually means you can't eat or drink for a few days. You have fluid through a drip and you can wet your mouth with ice or sips of water.

If you have a feeding tube, a dietitian will see you to decide how much liquid feed you need, until you are eating and drinking normally. 

Once your wound has healed you can gradually increase the amount you drink. You may need a swallowing assessment by a speech and language therapist before you start drinking. Soon you can start to eat a soft diet, such as soup or jelly, although some people may need longer to return to eating and drinking. Your dietitian will monitor this and gradually cut down your liquid feeds. 

Feeding tubes 

There are different types of feeding tubes. One type is a tube straight into your stomach called a gastrostomy tube. You have liquid feed into the tube until you are eating and drinking again. 

A tube into your stomach via your nose is called a nasogastric tube. It helps to stop you feeling sick. Later it will be used as a feeding tube.

Getting up

Getting up may seem very difficult at first. Your nurses will encourage you to get up and about as soon as possible after your operation. Moving about helps you to get better, but you will need to start very gradually. Your physiotherapist will visit you regularly after your operation to help you with your breathing and leg exercises.

Going home

You’ll need some help when you first go home. The dietitian and speech and language therapist will talk to you and your family about what to eat. It might take some time to find what works for you.

You’re likely to feel very tired for several weeks or a few months after your surgery. It helps to do a bit more every day.

Try:

• sitting for less time each day

• walking around the house a bit more each day

• building up to walking outside

What you can do depends on how fit you were before your surgery and any problems you have afterwards. Talk to the physiotherapist or your doctor if you’re unsure about what you should be doing.

Contact your doctor or specialist nurse if you have any problems or symptoms you’re unsure about.

Follow up appointment

You have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.

Possible problems after surgery

There is a risk of problems or complications after any operation. These include changes to eating, talking, and your appearance.