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Indiana Pouchpouch ForFor PatientsPatients RecoveringRecovering fromfrom RadicalRadical CystectomyCystectomy:: IndianaIndiana PouchPouch ThisThis guideguide willwill explainexplain what what to to expect expect before, before, during during and and afterafter yyourour surgerysurgery andand hospital hospital stay. stay. These These are are general general guidelinesguidelines,, butbut somesome things things may may change change based based on on your your needsneeds asas aa patient.patient. Knowing Knowing what what to to expect expect and and being being an an activeactive participantparticipant inin your your surgical surgical process process are are key key to to a a successfulsuccessful recovery.recovery. If If you you have have questions, questions, please please do do not not hhesitatesitatee toto askask yyourour care care team; team; we we are are hap happypy to to address address your concerns! Please use the space for notes to write your concerns! Please use the space for notes to write down any questions you may have for your care team down any questions you may have for your care team and fill in your appointment information! and fill in your appointment information! A Guide to Your Daily Care Understanding Your Procedure: Radical Cystectomy is the removal of the entire ladder neary lymph nodes part of the urethra and other organs that may contain cancer cells he surgeon removes the bladder and surrounding lymh nodes For males the rostate is also removed For females the uterus cervix, falloian tues ovaries and art of the vagina are removed. In men the rostate seminal vesicles and art of the vas deferens are also removed. t the time of surgery, you ill receive general anesthesia hich means that you ill e deeply asleep and ill not feel any ain. t this oint you will have a reathing tue. Your doctor ill need to find a new ay to drain urine his will e done y creating an Indiana Pouch. Your intestine is made into a pouch that is connected to the stomach You need to ut a sterile catheter through the stoma into the ouch to drain the urine. >SURGEON’S BUSINESS CARD TO BE STAPL RE< Your Urological Surgery Team Urological Surgeon: ________________________ Your attending doctor i your urgeo at i i carge o your care and all care ecisio ll memer o your urology tea reor o your urgeo urig your tay you ill e ake care o y te urology eam Te eam or and commuicate cloely aout your care. Residents: _______________________________ eident are licened docor i eir ir o fift year o training Tey are an actie ar o your urology eam and ill roie a ig ar o your care Ti include helig e attendig octor wit oeratio erormig rocedure ritig orer and recribig medicatio Fellows: _________________________________ ello are ocor tat ae iished eir reidecy traiig and are ecomig secialists. Tey are a actie ar o your urology eam and will roie a ig ar o your care Ti iclude elig e attendig docor i oeratio erormig rocedures riig orer and recribig medicatios. Physician Assistant: ________________________ yicia ssia are licensed ealtcare roider wit special raiig at roies support to medical taff under e ueriio o a docor. Tey ca alo ceck your rogress address ueio and cocer and recrie medicie recriptios. Nurse Practitioner: ________________________ ure ractitioer ae adaced educatio and traiig o tae care o atient Tey ca orer te roide reatment and orer medicatio under ueriio o a docor Nurses: _________________________________ ure take care o your daily needs gie you medicie and el i treatment ure ca alo roie educatio and commuicate abou your care wit te Urology eam. Stoma Nurse: ____________________________ Te toma ure specialie i e care o e urostoy Ti ure ill roie informatio and eacig aout e care o your oomy efore and after urgery Ti ure ill mar ere your oma ill e efore urgery. Care Coordinator: _________________________ Te are oorinator ill meet i you after your urgery i e oital Tey will or i you your amily and e ealtcare eam o la or ome care or reailitation after you leae e oital Tey ca alo answer any insurance or fiacial ueio you may hae Visiting Nurse: ___________________________ Te iitig ure will come o your ome an el you care or yourelf and your iciio Ti ure ill el you and your amily lear e ew ill for care after urgery a well a el it ay ueio you may ave. Preparing for Surgery Before urgery your Urology Team ill cedule a re-oeratie testing appointment Ti aointment mu e witi 0 ay o your urgery referaly -4 wees efore. You ill meet i a ealt care roier to make ure you are ealty eoug o ae urgery and o receie aeeia Ti i here you ill receie your Pre-Op Appointent leara caroydrate ae drink o ake - our efore urgery You may Time: alo meet i a toma Locaion: ure if eeded. leae rig a comlete list of your edica- tions and suppleents icludig doe and freuecy Your Urology Team ill ell you ic medicatio o to akig efore urgery. f you ake apirin for a ear ondition cec wit your eart doctor eore maing any canges. If you tae edication tat tins your lood you sould sto taing it beore surgery Do not sto tis on your own ou ould onact te prescriing proier o a aout a pan for opping ti efore urgery Exape inlude Warfarin ouadin Pai oeno arelto Oter oo inning edication include oer-te- couner uprofen pirin and ee *If your blood thinning medications cannot be stopped, please contact your surgeon to discuss. o elp i recoery efore your urgery it elp to Exercie regulary Sop oing ereae alcoo inae We recoend at you atten our educational class on at o expect efore during and after your surgery. Ask your doctor’s office about getting sceduled for e Cystectomy Class. Notes One Day before Surgery: e beoe sue, you ay eat a you norally o te idnight o te ght beoe sure, you ay no eat any solid oods nluding candy, ewing m, ough os or mints. Plese onfirm your Surgery ormation sue te an arrival te by Surgery Dae: calling e la busines rrival e: ay before your surgery (f your urgery on a Surgery e: Monay pleae all e ray before: Brigham and Women’s Hospital: 617-732-7625 between :00PM an :0PM Brigham and Women’s Faule ostl: 617-983-7179 oion between :00PM and :30PM Notes The Day of Surgery Two to three hours eore or shedled surger time drin rin the Clearast arohdrate learfast drin that you ere ge at your Te: re-oeratie aontent rrie at he admittig earent at your scheduled time Allo ie for arig and raffic. ContactSupport lease hoose one contat Person person Th ero will e he oe to hel you for he fir few Nae: week after your urgery our urgeo will oact h ero Relaionship: afer urgery with a update. Phoe: Beore surger your urgal tea answer ay ueo that you ay hae You a ue he oe sectio hroughout h acket o rte o ay ueo a they arie. You ay hae a epidural placed y he aeheia eam. Th i a mall oft ue aed your ack The epidural elier edicatio hat will hep reue your pan. You l hae a intravenos IV) needle i your arm for fluid and edicatio o hel you relax. You l get pain mediations through he and/or epidral. Your ki e loed y either dissolvale stithes or staples. ter surger you e he reover room (PACU) for a niu of hour a you ae u fro he aeheia The U ea oify your coact ero whe they ca it you. After Surgery (In Hospital) After your proedure your surgial tea ill ae you rin small sips o liquid ou sould not eat any solid foos at tis tie. You ill wear ompression oots that sueee te otto of your legs to eep te loo floing is elps to preent loo lots fro foring. You ay also receie blood thinning injetions to preent loo lots. Da after surger you ill e on a lear liui (no solids) iet xamples inlude ater lack coffee lear tea apple uice cranerry uice an sports drins You ill get out of ed for ours, if possile ry to alk at least times wit assistane fro te edical staff ewing gu is enourage to elp get your syste ack to noral. Da after surger You an eat a regular iet as tolerated. Keep aling Wen you an tolerate foo or rin norally, you an tae pain medicine mouth. Your nurse will wor it you to ontrol your pain an isofort after surgery. Wile you are in te hospital te nursing staff ill ceck on you often to onitor Pain Vital signs Flui intae an otpt fro your new stoa 4- Das ter rger: You sould get out of bed and alk 4- times eah da for a total of hors his helps with or reover. You an leae te ospital one you an Eat al safely Tae pain eicine Most patients stay in te ospital for 5-7 das. Notes When You Are At Home Symptoms These symptoms are abnormal – please contact the Urology office or call 9-1-1 if you have any of the below symptoms: ot producin urine ever o more than 1 derees F Pain that doesn’t improve with medication Vomitin hest tihtness or shortness o reath Le swein If our stoma turns re or ue Do not panic – these symptoms are normal! Bruisin eelin tired ecreased appetite rreular owel movements Fluid eakae from urethra Mucus Blood titches dissove tents fall out eary Activity You should wal at st tims p y to reduce the ris o ood clots and compications You ma wa updown stairs Do ot lift mo ta pous run or strain for weeks his can strain our incision which can ead to a hernia Exampes include ut are not limited to: Groceries Laundr nants pets Do ot div fo wees o ot driv until yo off of pi medictio .
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