Hi,

My Dad has decided to do the ND. You might recall he declined it back in Sept. Because some nodes remained large after treatment; dr's have been suggesting the ND. Recent scans are good; no changes.

Doing a bilateral ND (leaving in muscle per my Dad's request). Also biopsy around the throat area and removing the waddle (dulap) under chin.

Questions: My Dad clears his throat, coughs and spits up phlegm (like I'm sure you all do). Can you do this right after the surgery? and if not then what the heck do you do?

Are you bed bound the first night?

At what point can you get up and walk around; use the bathroom?

Much pain and discomfort? (he has a high tolerance for pain. Main issue is the coughing and phlegm. He's claustraphobic so I know that concerns him.)

Were you in ICU after? (they want to keep him there one night because of sleep apnea).

Anything else to add would be appreciated.

Thanks!
so much anxiety

Lisa,

I had a left side neck dissection (along with a partial glossectomy) when I was 39, and I was absolutely bed-bound and in ICU for 24 hours. They told me ICU was standard procedure for post-surgical head and neck patients so I could have close observation during that period.

As I recall (this was 18 years ago), they started to get me up walking around day 2 or 3. I was in the hospital for 4 days.

I didn't have the phlegm problem at that point because I had radiation after surgery.

Cathy

I had a modified radical neck dissection last August - I was 52 at the time and in very good health. I had 42 or so lymph nodes removed from the left side of my neck. I also had a tonsil removed at that time.

After the procedure and recovery room I went to my semi-private room - no ICU. The cut went from under the front of my chin back to my ear then down my shoulder. I had two drain tubes - one high and one low.

The after-effects of tonsil surgery really hurt, but the ND didn't feel too bad - probably due to a lot of numbness from my left shoulder up through the left side of my head (a good amount of which is now gone). I think I stayed in bed the first day, but was up and about the next day. I left the hospital 2 days after surgery (surgery was Tuesday morning and I checked out Thursday before noon).

I don't see how the ND will cause trouble with removing phlem.

The recovery from the ND has been a little slow, although not terribly difficult. I took long daily walks after release from the hospital, even with the drains still in place. Stitches and drains came out 6 days after surgery. It took a long time to loosen up the neck muscle that was cut during the ND, with some stiffness remaining (I still do daily neck stretches). My left shoulder gets fatigued fairly easily and still droops a little - but it too is getting better with daily exercise.

I had both my tongue and ND surgeries the same day so my experience is a little different. The neck was not much of a problem, but because they had to do the tongue, I needed a trach tube to breath in case the tongue swelled to much and blocked the airway. I was on an ICU step-down floor because they needed nurses who were accustomed to dealing with trach tubes (that was probably one of the worst things to deal with). It turned out the trach tube did help because the first few days my tongue was so swollen that it did not fit inside my mouth. My neck is stiff on the dissection side and stretches are a daily routine for me as well.


Jim

Hi Lisa, Jack was in a private room across from the nurses station but it a floor that was used to ND patients. They want to get you up as quickly as possible post surgery and I think they had him in a chair that night. He had a foley catheter at first but that was removed later that night and then he was able to use the bathroom.

There are suction machines with a tube at the end to clear the secretions in his mouth in the hospital. They set it up for Jack as soon as he got to his room. You just put it in your mouth and it sucks up the mucous. Most people don't need it at home, they are able to cough it up and spit it out.

Hard to tell on the pain, it's such an individual thing, but if he's having any he should ask for medication. They usually monitor that closely. Jack was in overnight and released the next day. Some people stay for 2 days - it depends on how your Dad does. Having him stay in ICU overnight as a precaution for sleep apnea isn't a bad thing, they have better ratios of nurses to patients so he'll get more attention.

The drains in the neck are annoying but easy to empty and the wound care consisted of dabbing the suture line with a mixture of saline and peroxide and then applying a thin layer of bacitracin oinment with a sterile q tip. There wasn't any dressing on it. It will probably be staples and it looks really weird but heals really well.

Jack's scar goes from behind the ear to the middle of his chin and also down the top of the shoulder - he did have the muscle removed. You really can't see it unless you're right on top of his neck - and if they're that rude....I think it looks great. It will look awful at first but give it time. Swelling takes several months to resolve and there's physical therapy for many patients.

One year later no one would notice unless he pointed it out. Hope it all goes well for your Dad.
Regards JoAnne