Discharge instructions include the following: 

Daily activities

• You may feel weak for two-three weeks after the operation
• Activity after surgery is recommended. You are encouraged to gradually return to all of your normal activities. It is possible from the discharge day to go up and down the stairs, walk outside, travel by car (not drive). You may feel some pain as you resume activity, this is normal
• You should not lift anything over 3-4 Kilograms or practice sports for at least four weeks 
• You should not drive a car (especially if you take analgesics or benzodiazepines) until your healthcare provider gives you permission to do so
• It is possible to return to a normal sexual activity, when you feel confortable

Diet

• In the first week after surgery, you may experience loss of appetite, especially after pancreaticoduodenectomy. This is normal. Eat five small meals a day, and do not force yourself to eat excessively. It is common for patients to lose weight compared to their weight before their illness. It is expected you to start regaining some of the lost weight by two months after surgery
• In the first period, your diet should be low-fat and relatively rich in carbohydrates, because it may be difficult for your pancreas to digest fat
• You should drink at least 2 liters of water per day
• After left pancreatectomy with splenectomy, you may feel pain in the upper left quadrant, radiated to the left shoulder, when eating. This is normal, and the pain usually disappears within few weeks
• You have been bedridden and on analgesic drugs. This may cause constipation. Apart from drinking 2 liters of water per day, a stool softener/laxative should be included with your daily medications
• Some patients may experience maldigestion. This is the poor absorption of food, resulting in loose stools that are greasy, pale and tend to float. The production pancreatic enzymes needed for digestion of food will be reduced after surgery. They will need to be replaced with long term treatment using pancreatic enzyme capsules with food. You can ask your doctor for dosage or you can call us

Wound care and drains

• Your wound should be healing well by the time you leave hospital. You may still have some bruising, swelling and numbness, but this is quite normal and may take some weeks to improve
• The incision site should be kept clean and dry (clean with chlorexidine or amukine). The staples used for the surgery will be removed at a post-op visit. It is possible to have shower when staples have been removed and drain tracks are closed
• When you are allowed to bathe or shower, carefully wash the incision with soap and water. Afterwards, put on clean, new bandages. Change your bandage any time it gets wet or dirty
• If your drains are still in place, you should annotate the output and the effluent quality on a daily basis. Empty the drain bag thereafter. You should also check your body temperature twice a day

Medications 

• You may have been given antibiotics to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider
• Take your medicine as directed. Call your general pratictioner or our medical staff if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine
• Low-molecular weight heparin should not been discontinues until three weeks postoperatively 
• Impairment of glucose metabolism may be normal, even those who were not diabetics. You should monitor your blood glucose. If hyperglycemia persists, it may be necessary to be seen by an Endocrinologist and to modify your diet or take some antidiabetis drugs
• If you had a history of diabetes, or you underwent a total pancreatectomy, it is important to provide a diabetes treatment plan that includes frequent blood sugar monitoring and insulin therapy to help decrease the risk of high and low blood sugar

When to call doctors

• You can always contact the on call medical staff or our ward nurses. Telephone numbers are indicated in your discharge letter (ward: +39 0458124427, +39 0458124363; ward medical office: +39 0458124060, +39 0458124671; nurse manager: +39 0458124425; secretary +39 0458124553)
• Seek care and contact us if your general conditions worsen; if you have pain, nausea or vomiting that is increased or not controlled by your current medication; if your body temperature is greater than 38.5°C; if you have pus or a foul-smelling drainage coming from your incision or from drain tracks; if you have increased pain or redness at your incision site
• If your drains are in place, call us if the drain output increases substantially, and if foul-smelling light brown or brown effluent or pus is seen