You’re back home and feeling relieved that your surgery—major or minor—was a success. As the last vestiges of anesthesia or IV pain medication wear off, you realize that you were fairly woozy when you left the hospital or at least distracted by the tumult of the discharge process. And now that you’re propped up on your familiar sofa and feel an unexpected twinge of pain, you realize that you don’t really remember all that information about “complications” the nurse warned you about when you were discharged. And that piece of paper with a list of reasons to call the surgeon’s office? Suddenly the descriptions all seem very vague.
Are you in trouble?
It’s important to know what’s most likely normal and what could be a sign of trouble when you’re recovering at home, especially when you’re an outpatient and are healing away from the watchful eye of nurses and doctors. Of course, any complications or side effects will depend on the specific type of surgery you had. But Alana Elise Sigmund, MD, internist and perioperative medicine specialist at Hospital for Special Surgery in New York City, has some guidelines.
Suggestion No. 1: After an outpatient procedure, you may still feel groggy when you’re discharged, so ask the person picking you up to take notes. That way you’ll know what your surgeon recommended.
Then use this surgery side effect checklist to quickly recognize a variety of roadblocks on your path to recovery…
Side Effect: Drainage
Normal: What’s a reasonable amount of drainage—fluid that leaks from the incision after surgery—depends on the type of surgery, and your surgeon should give you a time frame for when yours should slow down and then stop.
Not normal: If you notice drainage increasing, call your doctor. Generally, the fluid should be clear or light pink. If it turns yellow or another color, this could be a sign of infection. If the fluid develops an odor, pick up the phone.
Side Effect: Redness and Swelling
Normal: Some redness and swelling around an incision is a normal part of healing. You should see it decrease as you heal.
Not normal: If redness and/or swelling gets darker or starts to spread, you could have cellulitis, an infection in the deep layers of skin and the tissue beneath it, or a surgical site infection that needs to be treated with antibiotics.
Smart tip: If you’re concerned or are just unsure, snap a picture of the area with your phone and see if you can send it to the doctor.
Side Effect: Pain
Normal: It’s almost impossible not to have any pain after surgery and, depending on the type of surgery you had, it could be worse on the second day. But you should start to feel a little better every day after that. If you need pain medication, make sure you take no more than directed.
Not normal: If you feel a sudden and big uptick in pain, that’s a red flag, and your doctor needs to know right away. Another reason to give a call is if you just don’t feel that your pain is fading over time.
Side Effect: Fever
Normal: People often run slight fevers for about two days post-op. If you suspect you have a fever, take your temperature. If it’s less than 101.4°F, check again about four hours later to make sure it’s going down.
Not normal: If your temperature reaches 101.4°F or higher and occurs two days or more after surgery, there’s a greater chance that the fever is due to an infection, especially if you have other symptoms like painful urination or a bad cough. Call your doctor.
Side Effect: Lower Leg Pain
Normal: Post-op leg cramps—when the muscle seizes up—are common and often are caused by abnormalities in electrolytes, the various minerals in your body fluids, and you should certainly tell your doctor about leg cramps. You might need nothing more than food and water. If that’s not working, reach out to your physician’s office.
Not normal: There’s another reason you might have leg pain after an operation—and it’s a more immediate concern. Pain in your lower leg or calf could be a sign of deep vein thrombosis (DVT), a dangerous type of bloot clot that can break free and block an artery in your lung—a potentially fatal condition called a pulmonary embolism (PE). Surgery can raise your risk for DVT. If you have calf pain postoperatively, call your care team. Your doctor may order an imaging test, such as ultrasound, to diagnose a DVT and, if one is found, will then treat you, typically with a blood thinner to dissolve the clot.
ALWAYS CAUSE FOR CONCERN
There’s no “normal” for some post-op reactions. Here are symptoms that definitely require prompt action…
If you feel short of breath but can still speak in full sentences, alert your care team by phone. The problem may be related to your surgery or another condition you have, like asthma or allergies. But if it’s so bad that you can’t get out a sentence, call 911. Sudden trouble breathing can be a sign that a DVT has broken free and that you’re experiencing a PE.
What do you know about DVTs and PEs? Take our quiz.
Normal post-op bleeding can happen after some operations such as sinus surgery. Your doctor should have told you if you’re likely to bleed after your procedure and, if so, how much bleeding to expect and when it should stop. If bleeding wasn’t mentioned or if it seems different than what was explained to you, contact your doctor. If bleeding is profuse, of course, call 911.
Shock in medical terms is when the body doesn’t have enough blood flowing to its organs. Severe blood loss is a major cause of shock, itself a life-threatening emergency. Symptoms of shock can include:
- Rapid heartbeat and rapid breathing
- Pale skin and sweating
- Weak pulse
- Unusually cool hands and feet
Call 911 if you think you could be in shock!
Surgery can stress every system of the body, including the heart. The risk of heart problems after most types of surgery is low for most people, but you’re at greater risk if you had major surgery and already have heart disease. In the days after surgery, if you feel pain or any strange sensation in your chest, one or both arms, your jaw or even your stomach that isn’t obviously a normal result of the surgery, call 911. You could be having a heart attack.
Special note for women: Women often hurt in other places like the arms, jaw or even the nose.
Learn more warning signs of a heart attack here.
It’s not uncommon for patients to develop an irregular heart beat rhythm called atrial fibrillation (AF) a day or two after an operation. It’s often related to the amount of intravenous fluids you’re given to support your blood pressure during surgery, and some people may be especially susceptible to AF. If you develop AF, you might notice that your heart is racing or you might feel short of breath. Call your doctor, because AF raises your risk for stroke. Your doctor will let you know whether it’s best to go to the office…or to the ER to determine whether you are experiencing AF.