Patient Education and Surgical Guide
At Merrimack Thoracic and Esophageal Surgery, we deliver compassionate, personalized care-from surgical prep to recovery-so you stay informed and confident throughout your journey.
Before Surgery
Stop Smoking & Alcohol
- Quit smoking at least 3 weeks beforehand to help your lungs heal.
- Avoid alcohol for the entire day before surgery.
Medication Management
- Review your medications with your surgeon. Some may need to be paused (e.g., blood thinners, steroids, diabetes meds, herbal supplements, ACE inhibitors/ARBs).
- Patients on GLP-1 agonists (e.g., Ozempic) should stop 7 days pre-op and use clear liquids only in the 24 hours before surgery.
Pre-Surgery Checklist
- Set up transportation to/from surgery.
- Stay active and walk as advised.
- Practice deep breathing daily.
- Shower with antibacterial soap for 3 days leading up.
- Follow any bowel prep or fasting instructions you’ve been given.
The Day Before Surgery
- 10 PM: Stop all solids, dairy, gum, candy.
- Midnight: Stop all liquids too (except any essential medications).
- Hydrate earlier as directed, and get a good night’s sleep.
The Day of Surgery
Bring with you: Photo ID, your medication list, and CPAP if used.
Arrival:
- Arrive 2 hours before your scheduled surgery.
- Meet your surgical and anesthesia team, finalize paperwork, and receive any pre-op meds.
- Follow signage or ask for help-there’s assistance at every entrance.
After Surgery
Recovery
You’ll may start in ICU or PACU, then move to our dedicated thoracic floor for monitoring, chest tube care, breathing support, and getting mobile.
Pain Control
- We aim for tolerable-not zero-pain levels, with minimal opioids.
- Medication emphasis is on non-opioids like Tylenol and NSAIDs.
Pain Control After Minimally Invasive Lung Surgery
Small incisions often yield gentler recovery, and here’s our approach:
- Non-opioid meds: Regular acetaminophen & anti-inflammatories.
- Intercostal Nerve Block (ICNB): Long-acting numbing around the incision, placed at surgery’s end. Fast, safe, and proven to lower morphine need.
- Erector Spinae Block (ESP): Sometimes given before surgery for broader pain control across rib levels.
- Cryoanalgesia: Nerve freezing for longer numbness-used only in selected cases due to potential tingling or burning sensations and no demonstrated early pain benefit.
Why Not Rely on Opioids Alone?
They can cause side effects like nausea and constipation. Our approach-targeted nerve blocks combined with non-opioid drugs-helps you heal faster, feel better, and stay mobile.
Key Takeaways
- You’ll cough, breathe deeply, and walk-often the same day.
- Pain is managed intelligently, not eliminated.
- Each treatment is tailored to you, not one-size-fits-all.
- Our goal: keep you safe, comfortable, and independent.
Going Home
Discharge Needs:
- Eating and drinking normally
- Pain control on oral meds only
- Safe walking
- No infection concerns or alarming drainage
Call Us If:
- Fever exceeds 101°F
- You’re short of breath
- Swelling in your face, neck, or legs
- Wound drainage is thick or foul-smelling
- You’re having severe, unrelenting pain
Follow-Up:
You’ll see your surgeon about 2-3 weeks after discharge.
This guide is informational-your situation may require a personalized plan. Please follow medical advice from your surgical team.