How to restore lung function after surgery?

As you approach lung cancer removal surgery, you may be worried: Will the loss of a lobe affect normal breathing? I’m not sure if I’ll be able to do the physical activities of gardening, working, or playing ball.

To give you some reassurance, most patients who have had only a lobectomy, or less than a lobectomy (e.g., only the tumor and a small amount of normal tissue), can return to their preoperative level of lung function with appropriate exercise. However, to achieve this, you also need to understand the following:

Early postoperative exercise helps restore lung function

After surgery, the remaining lung tissue fills the entire chest cavity like a balloon to replace the function of the lost lung tissue. For this to happen, three conditions need to be met:

1) The remaining lung tissue needs to be fully inflated and not “curled up” due to adhesions;

2) Avoid infection as much as possible to avoid compromising alveolar ventilation;

3) The pleural effusion should be absorbed as completely as possible to avoid compromising the mobility of the lungs.

If the remaining lung tissues are not exercised, it will be difficult to make them expand completely when they “stick together”. This is why preoperative and postoperative respiratory training is so important. For postoperative respiratory training, please read the “extended reading” section; for preoperative respiratory exercises, we have a separate article.

In addition, appropriate exercise is also helpful to promote the absorption of pleural fluid.

What kind of exercise should I choose to get out of bed early? How much exercise is appropriate?

Early movement out of bed facilitates the removal of chest drains.1 The type of exercise and amount of exercise should be chosen based on your physical condition and preoperative mobility. Your doctor has the following recommendations:

1. Mode of activity

First, the way of activity is generally based on aerobic exercise. The first thing is that aerobic exercise is not “oxygen intake while exercising”, but even, sustained exercise. The first thing you need to do is to take a look at the results of your workout. It can improve lung capacity, promote the circulation of body fluids, so that the body to maintain a healthy state. The company’s main goal is to provide the best possible service to its customers.

In contrast, anaerobic exercise focuses on building muscle strength and explosive power through high-intensity training, such as push-ups, pull-ups, and lifting dumbbells. These activities are not effective in stimulating cardiorespiratory fitness and therefore are not the most urgent need for postoperative patients.

2. Activity level

The amount of activity should also be “moderate”, too much can cause discomfort and too little can affect the exercise effect. You can assess yourself according to the actual situation. It is recommended that you exercise for 1 to 2 hours a day, with “a little panting” and “a little sweating” afterwards (because “sweating without exercising in hot weather” doesn’t count). This intensity of exercise will not increase the burden on your heart, but will also fully mobilize your body.

Sometimes, your doctor will adjust your activity level based on a review. Some patients are very active, but their chest fluid is still being absorbed slowly. In this case, it is encouraged to increase the activity level again, or to extend the duration of activity each day.

Everyone’s physical condition and postoperative recovery status is different, so exercise should be flexible and not “rigid”. If you are not feeling well on a particular day, or if it is a foggy day, or if the weather is too cold or too hot, you can reduce the amount of activity and just stay indoors. If you have a special condition and your doctor says so, you should follow the instructions to ensure safety.

Extended reading

Postoperative breathing exercises

1. 6 hours after general anesthesia and when fully awake from anesthesia

You are in a semi-recumbent position, and your healthcare provider assists you with balloon breathing exercises.

Select a suitable balloon with a volume of 800 to 1000 ml, inhale deeply, then hold the balloon inlet and exhale as hard as you can, blowing the gas in your lungs into the balloon until you can’t blow out.

Please be careful not to leak when practicing, and so on, 3 ~ 5 times/minute, 3 ~ 4 times/day, with 5 times/minute as the target.

2. First day after surgery

If your vital signs are stable, you can do appropriate bed activities with the assistance of your healthcare provider and perform relaxation exercises with breathing: inhale when your head turns from the left to the right and exhale when your head turns from the right to the left.

You can also rotate the arm or shoulder with breathing: inhale when the arm is facing backwards and the shoulder is rotating backwards; exhale when the arm is facing forward and the shoulder is rotating backwards.

3. Day 2 post-op

The provider will assist you with an effective cough and sputum.

Usually done in the morning after waking up, at night before going to bed and 30 minutes before meals, the cough should not be too long. Each session lasts 15 to 20 minutes, twice a day.

4. Breathing exercises

After an effective cough, your healthcare provider will assist you with abdominal-lip retractor breathing exercises to the point where you feel slightly tired but not breathless.

1) Abdominal breathing exercises: Lie flat on your back with your muscles relaxed and one hand on your chest and the other on your abdomen. Inhale, breathe in through the nose, try to hold up the abdomen, the chest does not move; exhale, exhale through the mouth, while contracting the abdomen; slow exhale and deep inhalation, breathing 7~8 times/minute, 10~15 minutes each time, training 2 times a day, increase the number and time after proficiency, you can take it as a breathing habit.

2) Lip retraction breathing training: Inhale through the nose, exhale through the mouth; pout when blowing, as if whistling, evenly and slowly, while the abdominal cavity slowly retracts, feeling all the gas exhale from the body, keeping the exhale time twice as long as the inhalation time. Each “inhale and exhale” lasts about 10-15 seconds, and is done in 2-3 sets of 10 minutes each day.