Recuperando-se da Cirurgia de Câncer

A recuperação pós-cirúrgica depende do tipo de procedimento que será feito e do seu estado de saúde geral. Antes da cirurgia, é importante pedir orientações ao médico sobre os cuidados que se deve ter durante o período pós-cirúrgico, e também sobre os cuidados que se deve ter alguns dias antes da realização da cirurgia. Especialmente quando a recuperação é feita em casa, é importante saber exatamente como e quando fazer os curativos, como deve ser a alimentação, o repouso, o retorno ao trabalho e os exercícios físicos, pois, geralmente, estes cuidados variam de acordo com o tipo de cirurgia que foi realizado.

Anestesia

A anestesia impede que você sinta dor por um determinado período de tempo. Dependendo do tipo e da extensão da cirurgia, também podem ser usados outros medicamentos. Em alguns casos, é possível escolher o tipo de anestesia a ser administrado.

  • Anestesia Local. É usada em cirurgias menores, como biópsias em áreas próximas à superfície do corpo. O paciente fica acordado durante o procedimento e geralmente sente apenas uma pressão durante a realização da biópsia.
  • Anestesia Tópica. Neste procedimento a anestesia é friccionada ou pulverizada sobre a superfície do corpo em vez de ser inserida por via intravenosa. Por exemplo, um spray é usado às vezes para anestesiar a garganta antes que um cateter seja inserido até o estômago ou pulmões.
  • Anestesia Regional (Raquidiana ou Peridural). É um tipo de anestésico usado em cirurgias mais simples, onde o paciente pode permanecer acordado. Esse tipo de anestesia bloqueia a dor em apenas uma determinada área do corpo, como um braço, uma perna ou toda região inferior do corpo (abaixo do abdome).
  • Anestesia Geral. Este tipo de anestesia é indicada para cirurgias mais complexas e de grande porte. O paciente entra em sono profundo, muitas vezes o procedimento é iniciado injetando um medicamento por via intravenosa no paciente. Na anestesia geral, o paciente  é geralmente intubado e respira com ajuda de aparelhos e é monitorado quanto a frequência cardíaca, frequência respiratória e pressão arterial durante toda a cirurgia até acordar.

Os pacientes que realizam anestesia local, podem ter alta hospitalar logo após a cirurgia. Os pacientes que fazem anestesia regional ou geral são encaminhados para uma sala de recuperação, 
onde permanecerá até cessarem os efeitos da anestesia e possa ser transferido com segurança para o quarto do hospital.  

Cateteres e Tubos

A garganta pode ficar dolorida por um tempo se você foi entubado (tubo endotraqueal). Também pode ser inserido um cateter (cateter de Foley) na bexiga para ajudar a drenar a urina que é coletada numa bolsa. 

Drenos Cirúrgicos

O paciente poderá ter drenos cirúrgicos saindo da ferida cirúrgica na pele. Esses drenos permitem a eliminação do excesso de líquido que se acumula no local da cirurgia. Eles serão retirados assim que pararem de coletar o líquido, geralmente alguns dias após a cirurgia. Isso pode ser feito ainda durante o tempo de internação hospitalar ou, mais tarde, no consultório médico.

Alimentação

Você pode não sentir fome ou sede, mas essa é uma parte importante do processo de recuperação. No pós-cirúrgico, os primeiros alimentos devem ser de fácil digestão, em pequenas quantidades e com poucas fibras para diminuir o volume das fezes e para que o paciente não tenha que se esforçar para evacuar. A primeira refeição deve ser líquida porque o paciente ainda deve se sentir nauseado devido a anestesia. Uma sopa de legumes batida no liquidificador ou um suco de frutas com bolacha pode ser uma boa opção. A partir do segundo dia, pode-se introduzir alimentos cicatrizantes para facilitar a recuperação, como iogurte, carnes e frutas ricas em vitamina C.

Exercícios Físicos

Sua recuperação após a cirurgia depende de muitos fatores, incluindo seu estado de saúde geral antes do procedimento e a extensão da cirurgia.

Seu médico provavelmente tentará fazer com que você se mova o mais rápido possível após a cirurgia. Ele pode incentivar você a levantar da cama no mesmo dia da cirurgia, embora isso possa ser difícil no início ajuda a acelerar a recuperação e faz com que seu aparelho digestivo se mova. Também ajuda à circulação e previne a formação de coágulos nas pernas. Mas, se estiver sentindo dores, comunique seu médico, para que ele possa prescrever a medicação adequada para controlar a dor.

Sua equipe médica o incentivará a fazer exercícios respiratórios, que o ajudarão a respirar melhor, reduzindo também o risco de uma infecção pulmonar (pneumonia).

Alta Hospitalar

Após se alimentar e caminhar, você pode começar a fazer planos para a alta hospitalar. Entretanto, isso depende de outros fatores, como os resultados da cirurgia e dos exames realizados no período pós-cirúrgico. 

No momento da alta, seu médico prescreverá alguns medicamentos para tomar caso você sinta dor. 

Antes de sair, certifique: 

  • Como você vai fazer o curativo em casa.
  • O que precisa estar atento e comunicar o médico imediatamente.
  • Quais são os limites de suas atividades, como dirigir, trabalhar, levantar, etc.
  • Se existem restrições como dieta, medicações relacionadas à dor, etc.
  • Que medicamentos tomar e periodicidade.
  • Para quem ligar se surgir algum problema.
  • Se será preciso fazer algum programa de reabilitação (atividade física ou fisioterapia).
  • Quando será seu retorno ao médico.

É importante entender que o resultado completo de sua cirurgia depende de sua total recuperação cirúrgica. Portanto procure ajustar sua rotina nos primeiros dias em casa as suas novas necessidades e as alterações em seu corpo. Certifique-se de que todas as suas dúvidas foram respondidas antes de sair do hospital, e em caso de dúvida não hesite em entrar em contato com seu médico.

Quando ligar para o Médico após a Cirurgia

Neste momento, você provavelmente estará mais atento a seu corpo do que jamais esteve em sua vida, sentindo todas as mudanças físicas. Verifique se você sabe como entrar em contato com seu médico depois do horário comercial, nos finais de semana e feriados.

Alguns efeitos colaterais da cirurgia são temporários, mas outros podem ser um sinal de problemas sérios. Informe seu médico, imediatamente, caso ocorra qualquer um dos sintomas abaixo após a cirurgia:

  • Febre > 38o C.
  • Hemorragia.
  • Calafrios intensos.
  • Dor intensa, que não melhora.
  • Falta de ar ou problemas para respirar.
  • Problemas para urinar.
  • Quaisquer outros sinais mencionados pelo seu médico.

Não hesite em informar seu médico sobre quaisquer novos problemas ou preocupações que você venha a ter, para que ele possa identificar a causa e, se necessário, iniciar o tratamento imediatamente.

Fique atento também no pré-cirúrgico.

Fonte: American Cancer Society (19/04/2016)

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