The therapy team which includes Physiotherapists, Occupational Therapists and Integrated Therapy Assistants will come to see you the day after your surgery. The aim is to help you regain independence and to prevent post-operative complications through breathing techniques, early mobilisation, and exercise. The therapy team will also advise you on the best ways of moving to minimise pain.
Staff uniforms
Physio - white tunic with navy piping
Occupational Therapist - white tunic with green piping
Integrated Therapy Assistant - pale blue tunic with blue piping
Integrated Therapy Assistant - dark green tunic with white piping
The therapy team will be following the ICOUGH principles for your recover after surgery:
Incentive spirometry
Coughing
Oral healthcare
Understanding
Getting out of bed
Head of bed elevated
Incentive Spirometry
The day after your operation, your physiotherapist will listen to your chest and provide you with an Incentive Spirometer. During surgery the tiny air sacs in your lungs can become sleepy and do not open as effectively. Using an incentive spirometer helps to re- open these air sacs as well as giving you feedback on how you are progressing during your hospital stay.
To use the Incentive Spirometer effectively:
Your incentive Spirometer comes in two separate mouth pieces. The chamber and the mouthpiece. You can attach both the mouthpiece and the chamber together.
Sit up right when using the incentive spirometer as your lungs will expand better in this position.
Ensure you make a tight seal around the mouthpiece and then take a steady breath in.
When you take a breath in, you are aiming for a long-sustained breath to raise the three floats.
If you breathe in too fast, the ball will shoot to the top.
If you breathe in too slowly, the ball will stay at the bottom.
Please search the link or use the QR code for further support https://www.youtube.com/watch?v=t91jXG6jJlg
Your physiotherapist will advise you how regularly you need to use your incentive spirometer.
Coughing
It is important after surgery that you can cough effectively. If you have had an open surgery, it is important to support your tummy when coughing. We recommend using a rolled towel or pillow to help support your muscles. Your physiotherapist will teach you the best way to use this.
If you are struggling to clear mucus off your chest, we will provide you with further breathing techniques to support with this.
It important that your pain is well controlled so that you can take a deep breath and cough effectively to prevent the risk of developing a chest infection after your surgery.
Please ask the nursing staff if pain is stopping you from deep breathing and coughing.
Oral Hygiene
The risk of a chest infection is increased by bacteria living in your mouth, which can travel into your chest and cause an
infection. You should brush your teeth or dentures twice a day with a fluoride toothpaste for at least 2 minutes. You should also floss your teeth every day and use an antibacterial mouthwash twice a day. It is best to use the mouthwash 10-15 minutes after brushing your teeth.
Getting out of bed
The physiotherapy team will aim to support you out of bed as soon as possible, usually the day after your operation. Getting out of bed early helps to ease wind pain, improve bowel function, and prevent complications. You will be taught to roll onto your side and then push up into sitting using your arms. This helps avoid excess strain being placed on your tummy muscles after surgery. We will initially help you with this technique. The ward staff also know this technique and can help you to get out of bed and into a chair. The aim is for you to sit out for at least 6 hours a day.
Posture/Head of the Bed
Whilst you are resting in bed, it is important to avoid lying completely flat to help give your lungs more space to expand, which will help with your breathing and reduce your risk of developing chest infections after surgery.
Early mobilisation
As well as sitting out, early mobilisation promotes independence and helps you return to normal daily activities. It also helps to ease/prevent wind pain, prevent chest infections, and blood clots. You will be encouraged to mobilise 4 times a day, aiming for at least 60 metres each time. You may be required to complete a stair assessment prior to discharge, which will be discussed with you.
Core and Pelvic Floor Exercises
If you have had a laparotomy (open procedure) and/or a stoma formation, which may be reversable, you will require to complete pelvic floor and core strength exercises. These exercises aim to strengthen your abdominal and pelvic floor muscles after surgery to prevent secondary complications such as incontinence or hernias. It is advised to avoid heavy lifting for at least three months after your surgery.
Your physiotherapist will provide you with both core strength and pelvic floor exercises to tailor to your current needs.
Please use the below link or QR code to access core strength exercises:
https://www.coloplastcare.com/en-GB/ostomy/lifestyle/sport- and-exercise/l2.7-4-great-abdominal-exercises/
If you have had a stoma, you are advised to try and avoid heavy lifting completely following surgery and into recovery. If it is unavoidable with your occupation, you can be measured and fitted for a support belt by your community stoma nurse. Please speak to the stoma nurses on your ward for further information.
Please use the below links or QR codes on activity and advice following a stoma.
1. Exercises following Stoma
https://meplus.convatec.co.uk/activity/
2. Colostomy UK advice and support
https://www.colostomyuk.org/
Sleeping
You may find your sleep is disrupted following your surgery. This could be due to pain, the ward environment, change in routine, or fear of leakage of your stoma.
Sleep is important to aid recovery both in body and mind. How well you sleep effects your recovery, concentration, mood, and energy levels.
Everybody has their own sleep routine and being aware of some basic sleep hygiene techniques can be useful:
- Try to keep to your normal routine.
- Make a note of any concerns or worries before settling down for the night. This can serve as a reminder of questions you want answering by the doctors, nurses, or therapists so you have a clear mind.
- Avoid using smart phones or tablets as you wind down for bedtime. The light emitted from the screens has a negative effect on sleeping.
- Try to ensure your stoma is emptied and secure before sleeping.
- You might find it more comfortable to sleep on your back or side. Use a pillow to support your bag if necessary.
You can find further information on sleeping from Colostomy UK: https://www.colostomyuk.org/information/sleep/
Planning for home
The decision that you are ready to leave hospital is based on several factors. There are different services available to support with your discharge from hospital, which your therapist will discuss with you.
Once you are home
Exercising after Surgery
Most patients having surgery will require some advice and exercises on discharge so you can continue your recovery at home. Your consultant will advise you on what activities are safe to do and what needs to be avoided after surgery. Your therapist can provide you with information on returning to activity.
Please use the below links or QR codes to find out about community services available to you:
Rochdale Residents: Older Adults Activities - Your Trust (yourtrustrochdale.co.uk) This is a self-referral service.
Oldham Residents: Exercise Referral Scheme | Oldham Community Leisure (oclactive.co.uk). This service requires a referral from a health care professional so please liaise with your therapist for further information
Bury Residents: Bury Live Well Service - Bury Council. This is a self-referral service; however, a health care professional can also refer so please liaise with your therapist for further information.
Driving
You must be able to perform an emergency stop and have full lower limb movement and power. We normally advise waiting 6 weeks after your surgery. When you feel able to drive, obtain permission from your doctor and inform your insurance company.
Date of Review: January 2025
Date of Next Review: January 2027
Ref No: PI_SU_1670 (Oldham)