Pain Management Following HIPEC Is the Same As After Any Ovarian Cancer Surgery
- Pain management is a priority for both you and your doctor and is a huge component of trying to speed up recovery
- Movement helps alleviate post surgery pain, so the sooner you're up and walking the better
- Doctors try to reduce the use of narcotic pain killers when possible, so you’re not too woozy to get out of bed
- Movement is effective in reducing the risk of blood clots
The chemotherapy is administered during the same surgery a patient has to remove the cancer, so essentially the experience is not that different for the patient, says Dr. James Lilja, gynecologic oncologist at Bay Area Gynecology Oncology in San Jose. "We’re going to make a vertical incision. We’re going to look for all the tumor, no matter where it might be, and we’re going to eliminate it.” Patients will then spend 90 minutes with a pump hooked up to the abdominal cavity, where doctors close the skin over two tubing sets to circulate the sterile, heated chemotherapy solution throughout the abdominal cavity.
Read More"Generally we encourage people to use what’s called an epidural catheter like pregnant people get," Dr. Lilaj says. "We can leave those in for three days and they can relieve a significant amount of pain after the procedure.
"For patients who can’t get those, we can do what's called a tap block where we inject a local anesthetic in the muscle layers that lead to the incision, and that can provide a certain amount of relief. And of course, we always have opiate narcotics to relieve pain if needed. So generally, pain is fairly well controlled."
The Goal of Pain Management Is to Get You Up and Moving
Pain relief is essential to the healing process, but so is mobility. Which is why doctors prefer to steer clear of narcotics, if possible, since they can leave patients too woozy to get out of bed.
The goal of pain management is to get patients up and moving around as soon as possible after surgery, even as soon as the day of surgery. Being mobile makes a huge differencenot just for managing postoperative discomfort, but to encourage a faster return of bladder and bowel function. Moving may also lessen the chance of developing complications such as blood clots.
According to Dr. Lilja, a subcutaneous injection of blood thinner can lessen the likelihood of blood clots. "We [also] apply sequential compression devices onto the legsthey're the little wraps with Velcro that squeeze the legs periodically to keep the blood flow going," he says. "But really, walking is the biggest thing. When you walk, your muscles contract, which moves the blood around the best." So we try to get patients moving around as soon as possible. To keep the motivation up, he says, "we ask family members to crack the whip to help patients get out of bed!"
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