Know When Your Symptoms After Surgery Are an Emergency

When Your Recovery From Surgery Isn't Normal

Once you have been discharged from the hospital after surgery, you will need to know when your recovery has changed from a normal recovery to one that may need medical intervention.

If you have any of the following symptoms in the weeks following surgery, be sure to call your surgeon or family physician for further instruction. You may be asked to report to the emergency room, or your physician may feel that your symptoms can be managed at home.

The important message is not to ignore a change for the worse during your recovery, unexpected symptoms/complications, or other issues that are different than what you were told to expect.

Fever Over 101 Degrees

A slight fever is not uncommon after having surgery, but a fever over 101 degrees may indicate that you have an infection. A fever that does not respond to treatment with acetaminophen or ibuprofen is especially worrisome and should not be ignored. If you have a fever, particularly a high fever or one accompanied by chills, report this change to your surgeon. 

Unexplained Leg Pain

One of the major risks of surgery is the development of blood clots in the legs, a condition known as deep vein thrombosis (DVT). These clots can be very dangerous as they can travel through the bloodstream to the lungs or brain, causing difficulty breathing, a stroke, or other problems.  The legs are the most common place for a blood clot to occur after a procedure, but they can also happen in other areas, so don't ignore unexplained swelling or pain.

 

Pus, Drainage or Streaks from Your Incision

Small amounts of clear drainage may come out of your incision in the days after surgery, but fluid coming from the incision that looks like pus or smells foul is a sign of infection. Red streaks on your skin that move away from the incision can also be a warning sign of infection.

Infection is typically accompanied by fever, but many medications used after surgery are known to reduce fever, so don't assume a lack of fever means a lack of infection.

Your Incision Begins to Pull Apart

If your incision begins to separate, your surgeon should be contacted immediately. Cover the wound with a moist bandage or clean piece of cloth, then seek medical attention. This complication may be prevented by holding pressure on the incision when coughing, rising from a chair, or sneezing.

There may be tiny gaps in your incision, especially with movement or the loss of a single suture or staple, but a larger gap should be addressed with a phone call to the surgeon's office, at the minimum.

Inability to Urinate or Have a Bowel Movement

Contact your surgeon’s office if you are constipated or having difficulty urinating. Straining to have a bowel movement or urinate can increase the pressure in your abdomen and put stress on your incisions, and these symptoms can be signs of more severe complications.

Do not use over-the-counter remedies without your surgeon’s approval.

If you are unable to urinate at all for more than six hours, this is considered an emergency and a trip to the emergency room is necessary.

Bloody, Very Dark or 'Tarry' Bowel Movements

These are signs of blood in your stool and should be reported immediately unless your physician specifically explained that you may experience some blood in the stool in the days immediately after surgery.

Coughing Up or Vomiting Blood

These are signs of a potential medical emergency, where blood is in the stomach or lungs. Contact your surgeon or seek medical attention immediately. Blood in vomit may look like used coffee ground, and may be more black than red. 

Severe, Unexplained, or Uncontrollable Pain

If your pain was manageable after surgery but then becomes significantly worse or uncontrollable with no clear explanation, there may be a surgical complication. Pain is typically the worst on the second or third day after surgery. If your pain is improving daily, then suddenly becomes significantly worse for no apparent reason, this is a red flag and should not be ignored.

Difficulty Breathing

A change in your ability to breathe is a significant problem after surgery and may indicate a serious problem, such as a blood clot in the lung. Do not ignore any problems with your breathing that begin after surgery. Seek medical attention.

Inability to Eat

If you have been discharged home to recover, your surgeon believes that you are able to obtain adequate nutrition from your diet. If that is not the case, your ability to eat changes or you cannot keep food and fluids down, your surgeon should be notified.

Increasing Weakness, Inability to Care for Yourself

If you seem to be getting weaker instead of stronger after your discharge from the hospital, or you are not able to care for yourself, your recovery may be in jeopardy. Be aware that you should slowly be getting stronger after your procedure, not having increasing difficulty with normal activities.

The Worst Headache You've Ever Had

If your doctor hasn’t told you to expect a severe headache after your procedure and you do not normally suffer from severe headaches, you should seek medical attention. A severe headache can be caused by a blood clot traveling to the brain after surgery.  In fact, surgery or no surgery,  a severe headache or "the worse headache of my life" always means medical attention should be sought. 

Sources:

What Happens After Heart Surgery. The American Heart Association. 2007. http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300447.pdf

 

 

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