Ivor Lewis procedure

Hi Mtngirl,

I was very sore when I first came back from the hospital and my first two weeks consisted of walks from my bed to my recliner. Like your husband, the large incision in my back gave me the most discomfort. They spread the ribs apart back there to get to the esophagus and that stays sore for quite a while. I was fine with being left alone for a couple hours or some after a couple of days, but as long as I was taking opioid pain relievers (oxycodone) my wife did not want to leave me alone for long. I did not like the side effects of oxycodone, I slept all the time and felt like my head was wrapped in cotton, so I transitioned to Tylenol as quickly as I could and only took the oxycodone when I went to bed at night.

I had difficulty sleeping on my back on an incline, because my back was sore and I had always been a side sleeper. I used an incline pillow with a second pillow under my knees so I did not slide down the incline pillow at night. As I was also on a tube feed at night I did not get a lot of sleep the first few weeks.

Many people here have reported that they slept in a recliner for the first couple of months. Ultimately I purchased an adjustable bed and that was a good investment, much more comfortable than an incline pillow and much more range of adjustment.

My biggest challenge right after surgery was learning what I could eat and what things caused trouble. For the first couple months after surgery, any dairy other than cheese, or anything that had sugar in it would cause a “dumping syndrome” episode. I mainly had soft foods like scrambled eggs, macaroni and cheese, casseroles of various kinds, and smoothies. The smoothies were made with fruit, chia seeds, and protein powder. For example, one I liked was one banana, three large frozen strawberries, one tablespoon of chia seeds, one tablespoon of protein powder, and ice. I need to drink smoothies very slowly over an hour or so, I would put them in the refrigerator and just sip on them occasionally. Most of us who had Ivor Lewis surgery had dumping syndrome over the first few months. It is frustrating but it does get better with time.

Avoid nutritional drinks like Boost and Ensure, etc., they have lots of sugars and cause dumping.

I tried to walk a little bit each day, but I have to admit my first couple of weeks were about a block away from the house and then back. I got short of breath and fatigued very quickly during the first three weeks or so after I came back from the hospital.

I am sure they gave you diet guidelines but just in case:

http://www.upmc.com/patients-visitors/education/nutrition/pages/esophagectomy.aspx

And the infamous “dumping syndrome:

http://www.upmc.com/patients-visitors/education/nutrition/pages/dumping-syndrome-diet.aspx

The other thing people tend to forget to tell esophagectomy patients is that along with dumping syndrome comes feeling dizzy, rapid heart rate, and a very anxious feeling due to a drop in blood sugar caused by the digestive system calling for insulin.

So even though they did not tell me I could not drive, I did not drive for about a month after my surgery because I did not want to go far from the house until things settled down in my digestive system. Of course, I would not recommend driving while taking opioid pain medication, but I only took that for about the first week and then transitioned to Tylenol.

You both will have to be patient, this is MAJOR surgery and typical recovery time is between six months and a year. After I came home from my surgery I forced myself to eat 8 small “meals” a day. I say I “forced myself” because I was never hungry and food did not look attractive to me. I just viewed food as medicine necessary for me to get rid of my feeding tube and gain the weight I lost back. I ate on a schedule because I had no appetite. Now 8 years later I still eat 7 “meals” a day and I am still never hungry. But now I can eat almost anything in small amounts even ice cream and doughnuts, and cookies that were problems right after surgery. I just need to make sure the portion size is small and it helps if I eat something high in protein first.

It does get better, but it does take time.

Best Regards,

Paul Adams

McCormick, South Carolina

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
Eight Year Survivor

Life may not be the party we hoped for, but while we are here we might as well dance!

When they do an Ivor Lewis proceadure they typically have to spread the ribs, or sometimes break a rib, in order to gain access to the esophagus from the back. They also typically collapse the right lung for the surgeons to get the room they need to relocate the stomach, and form the anastomosis. So I assume the x ray will be to insure the right lung has fully expanded, that there is no pleural effusion caused by the lung tissue being irritated by collapse and expansion, and to insure the ribs have moved back into place appropriately. I had soreness in my right chest and back for about 10 months after my surgery. It was not terrible, on a scale of 1 to 10 it was about a 3. Even 8 years later when the weather becomes cold and damp that area still stiffens up and becomes sore. But Tylenol solves the problem.

One day at a time.

Best Regards,

Paul Adams

McCormick, South Carolina

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
Eight Year Survivor

Life may not be the party we hoped for, but while we are here we might as well dance!

paul61 said:

I needed to be "monitored" for about two weeks after Ivor Lewis

Hi Mtngirl,

I was very sore when I first came back from the hospital and my first two weeks consisted of walks from my bed to my recliner. Like your husband, the large incision in my back gave me the most discomfort. They spread the ribs apart back there to get to the esophagus and that stays sore for quite a while. I was fine with being left alone for a couple hours or some after a couple of days, but as long as I was taking opioid pain relievers (oxycodone) my wife did not want to leave me alone for long. I did not like the side effects of oxycodone, I slept all the time and felt like my head was wrapped in cotton, so I transitioned to Tylenol as quickly as I could and only took the oxycodone when I went to bed at night.

 

I had difficulty sleeping on my back on an incline, because my back was sore and I had always been a side sleeper. I used an incline pillow with a second pillow under my knees so I did not slide down the incline pillow at night. As I was also on a tube feed at night I did not get a lot of sleep the first few weeks.

Many people here have reported that they slept in a recliner for the first couple of months. Ultimately I purchased an adjustable bed and that was a good investment, much more comfortable than an incline pillow and much more range of adjustment.

My biggest challenge right after surgery was learning what I could eat and what things caused trouble. For the first couple months after surgery, any dairy other than cheese, or anything that had sugar in it would cause a “dumping syndrome” episode. I mainly had soft foods like scrambled eggs, macaroni and cheese, casseroles of various kinds, and smoothies. The smoothies were made with fruit, chia seeds, and protein powder. For example, one I liked was one banana, three large frozen strawberries, one tablespoon of chia seeds, one tablespoon of protein powder, and ice. I need to drink smoothies very slowly over an hour or so, I would put them in the refrigerator and just sip on them occasionally. Most of us who had Ivor Lewis surgery had dumping syndrome over the first few months. It is frustrating but it does get better with time.

Avoid nutritional drinks like Boost and Ensure, etc., they have lots of sugars and cause dumping.

I tried to walk a little bit each day, but I have to admit my first couple of weeks were about a block away from the house and then back. I got short of breath and fatigued very quickly during the first three weeks or so after I came back from the hospital.

I am sure they gave you diet guidelines but just in case:

http://www.upmc.com/patients-visitors/education/nutrition/pages/esophagectomy.aspx

And the infamous “dumping syndrome:

http://www.upmc.com/patients-visitors/education/nutrition/pages/dumping-syndrome-diet.aspx

The other thing people tend to forget to tell esophagectomy patients is that along with dumping syndrome comes feeling dizzy, rapid heart rate, and a very anxious feeling due to a drop in blood sugar caused by the digestive system calling for insulin.

So even though they did not tell me I could not drive, I did not drive for about a month after my surgery because I did not want to go far from the house until things settled down in my digestive system. Of course, I would not recommend driving while taking opioid pain medication, but I only took that for about the first week and then transitioned to Tylenol.

You both will have to be patient, this is MAJOR surgery and typical recovery time is between six months and a year. After I came home from my surgery I forced myself to eat 8 small “meals” a day. I say I “forced myself” because I was never hungry and food did not look attractive to me. I just viewed food as medicine necessary for me to get rid of my feeding tube and gain the weight I lost back. I ate on a schedule because I had no appetite. Now 8 years later I still eat 7 “meals” a day and I am still never hungry. But now I can eat almost anything in small amounts even ice cream and doughnuts, and cookies that were problems right after surgery. I just need to make sure the portion size is small and it helps if I eat something high in protein first.

It does get better, but it does take time.

Best Regards,

Paul Adams

McCormick, South Carolina

DX 10/2009 T2N1M0  Stage IIB - Ivor Lewis Surgery  12/3/2009
Post Surgery Chemotherapy 2/2009 – 6/2009 Cisplatin, Epirubicin, 5 FU
Eight Year Survivor

Life may not be the party we hoped for, but while we are here we might as well dance!

 

 i'm a very active 65 year old construction materials salesman. I'm on the road about 110 nights a year. I underwent Colon resection surgery 15 years ago and have had a wonderful life since. Beating the cancer doesn't worry me, but the IVOR Lewis surgery Sure does ! I'm determined to push thru this and hope to continue to work until I'm 70. If you adhere to the dietary restrictions, were your bodily functions fairly normal ? 

Jeasom said:

Surgery, Paul, your story gives me hope

 i'm a very active 65 year old construction materials salesman. I'm on the road about 110 nights a year. I underwent Colon resection surgery 15 years ago and have had a wonderful life since. Beating the cancer doesn't worry me, but the IVOR Lewis surgery Sure does ! I'm determined to push thru this and hope to continue to work until I'm 70. If you adhere to the dietary restrictions, were your bodily functions fairly normal ? 

Hi Jeasom,

Paul did a great job of letting you know what to expect. I had the Ivor Lewis surgery 6-1/2 years ago and I'm doing everything I did before the surgery. I was 61 when I had the surgery. I had a desk job at the time and went back to work about 6 weeks after surgery. The biggest difficulty I had in recovery was a rib that was fractured during surgery. That took a long time to heal. I learned that fractured ribs are fairly common with this this surgery. During my treatments, I was constantly warned that this was a "life-changing" surgery. Other than sleeping on an incline and eating smaller portions, I'm living my life just like I did before surgery.

Good luck with treatments and surgery. It sounds like you've got a great attitude and I think that's a major asset to recovery. There's going to be some rough days ahead, but there's definitely a light at the end of the tunnel.

Steve