Intensive care
Following surgery you will return from the operating theatre to the Intensive Care Unit, which is located on Level 3 of the hospital. When you first wake up, you may be a little drowsy. The anaesthetic drugs take a while to wear off. You will be given pain relief intravenously during the early postoperative period. These can also make you sleepy. A stay in the intensive care unit allows your body time to recover its basic bodily functions (e.g. breathing, heart rate, blood pressure).
Most patients will have a breathing tube still in place attached to a breathing machine called a ventilator for the first 24 hours. You will also have a number of intravenous lines (tubes) in place, one in your neck and also attached to blood vessels in your arms. You will have a naso-gastric tube coming from your nose, a small tube to empty your bladder and a number of tubes draining fluid from your abdomen. Some patients will also have a soft rubber tube called a T tube draining bile into a bile bag. You will also be attached to a heart monitor, which will record your vital signs. The staff who work in an intensive care unit have been specially trained to see you safely through this period. Family will be allowed to visit once you are settled in intensive care. If you cannot talk, you will be provided with a message board to write on. As time passes, the I.V. lines and drainage tubes will gradually be removed. All tubes should be able to be removed in the days following the operation although if you have a T tube, this will not be removed until 6 to 8 weeks after the transplant.
The Transplant Ward
After a short stay in the intensive care unit you will be transferred to the transplant ward on Level 9. Once on the transplant ward you will be encouraged to mobilise as early as possible to facilitate your recovery. You will have regular chest physiotherapy to help with your breathing and you will also be given breathing exercises to do. If at all possible the nursing staff will assist you to get out of bed to shower by day two or three at the latest. Once the surgeons are happy that your bowel has recovered from the surgery, you will commence diet, fluids at first then on to a light diet and solid food.
Your sleep pattern may be disrupted initially. This is not uncommon after major surgery and a stay in the ICU, which can be noisy at night. The high doses of anti-rejection medication doses you are given in the first few days can also be disruptive to your sleep, but this usually settles down after a few days on the transplant ward.
Your daily routine will include, daily blood tests, showering, wound dressings, assistance with activities of daily living until you gradually become more independent. There will be regular ward rounds by the Transplant Team, which include Surgical and Medical Doctors. Your medications will be given intravenously at first, and then by mouth once you commence solid food.
Family and friends are encouraged to visit and their help and support plays an important role in your recovery. As you recover your health, you will be expected to become more active. This means spending more time out of bed, and walking a little more each day.
The hospital has chaplains from many denominations and religions. If you would like a visit from a member of your own religion, please let the ward staff know.
Recovery Time
The average stay in the Intensive Care Ward is 2 to 3 days. The average stay in hospital wards is 2 to 5 weeks, giving an average stay of 3 weeks. This may be extended due to complications. Most people, although well, take many months to get over the effects of the surgery and may not feel their normal selves again for 6 to 12 months.