Hey there.. been through that surgery. Its not pretty for the first few days (frankly I looked like i'd been hit by a truck) but as long as his health is good he will get through it and to be honest it's the easiest of ALL of the treatments to bounce back from.
It's good they are doing a neck dissection. I would be almost certain that node is cancerous - plus a neck dissection is a stop gap of sorts.
a second primary is rare...
When they did my surgery they removed a 1/3 to half of my tongue, and the floor of my mouth up to my molars essentially they rebuilt my gums on the inside of my teeth.
Now about the surgery.
He will come out of surgery with a trache (likely) usually the first day or two it is a trache that does not allow for talking or breathing through anything except the trache. I think they do this to limit the amount of activity in the mouth. They want to minimize any possible damage to the surgical site. By day 2-3 they will switch it to a fenestrated trache which he will be able to breathe through his mouth and nose with and speak. This will stay in for two days more (likely) then they will remove it if everything looks good. He will have stitches in his arm (from his donor site, and a dressing from a second donor site (where they remove a superficial layer of skin to cover the wrist).
He should have a catheter mine was removed day two as I was up and about and could go to the bathroom. He should also have an NG tube - it will likely come out day 8-9 depending on how he is doing with intake (food - fluids). I heal relatively fast so I was out by day ten but they didn't want me to have food until day 8 to give my tongue time to heal. He should try to stick to softish foods for the first week or two after the hospital. I did omeletes, eggs, smoothies, puddings. Anything bulky i washed down with a drink of water or almond milk on my good side. He will have stitches in his neck (mine were hidden - bless my surgeon). He will be swollen, (lymphnodes carry lymph fluid away from the area, no nodes? Fluid build up) this is from the lack of nodes and interruption in the lymphatic pathway and of course the surgery and healing (blood etc rushes to the area to try and heal the damage) The swelling will go down some once he his healed then when he's been cancer free for a while he can go for lymphatic massage to help build new pathways and drain the fluid. Sometimes I still get a little swollen but for the most part I am "normal".
He will have an IV in - mine was in my foot - they removed it after day three when I asked them to stop the pain meds. I wasn't in pain really - my neck and cheek were numb from the surgery so other than weirdly uncomfortable from the swelling and numbness I was okay.
He should have a suction machine nearby. This is for cleaning his trache of the goop (you drool a lot - another way the body tries to heal you) so I would suck on it. I also put a cloth on my pillow so I could drool into it while I slept - gross but it was better than drooling all over myself. They also use it to suction out the trache... YEAH that REALLY SUCKED - no pun intended. I HATED THE TRACHE and the suction the most. Once the fenestrated trache was in and I didn't need to be suctioned as much I was good to go.
By the time I went home all I had was a bandage on my wrist (they removed the staples the morning I was leaving) a bandage on my leg, and a bandage covering my trache hole (which healed within two weeks)
When they do a neck dissection it tends to damage the muscle in your neck and shoulder. I needed physio for this as I couldn't life my arm and my range of motion was shot. If he starts doing passive exercises he should quickly regain it. Mine is 98-99% normal. Just a tad weaker than the other and only because I have been a lazy ass about working out.
Stretching his neck will help as well. I massage the muscles in the area too.
All in all it was a much faster recovery than radiation and chemo.
He should have something to write with and write on as it's likely he won't be able to speak for a few days.
Tell him he will get through it. It's a daunting surgery but with a good surgeon and plastics guy he will be OKAY.
Ideally he is being treated at a comprehensive cancer center. Hugs and best of luck to you both.
