Travelling After Surgery

Everyone needs a bit of time for Rest and Recuperation now and again – and that’s never more true than after you’ve gone through a stressful experience like surgery. It’s possible that you had to have emergency surgery in the weeks leading up to a long-planned holiday. Perhaps you’re just out of hospital and want to get away to relax and recover. But either way, it’s important to think about the practicalities before you book a trip.

Why is Travelling a Risk After Surgery?

There are lots of factors to take into account as your body heals after surgery. These include:

• Time to recover from the effects of sedation or a general anaesthetic.
• The effect of painkilling or other medication.
• Your body’s oxygen needs.
• The effect of flying on gas inside your abdomen – especially if you’ve had abdominal surgery.
• The impact of flying on the pressure inside your eye if you’ve had eye surgery.
• The risks of tissue swelling on a flight if you have a plaster cast.
• The risk of a clot on the leg (deep vein thrombosis or DVT) or the lung (pulmonary embolus or PE)

Your Oxygen Needs

Surgery places a strain on your body and your body will need extra oxygen to heal. If you have a post-op infection, this also increases your body’s requirement for oxygen.

Oxygen pressure in an aircraft cabin is lower at high altitudes. Most flights don’t go about 8000 feet – at this level, most healthy people don’t notice any difference and the concentration (saturation) of oxygen in their arteries is about 90%.

However, you may struggle with lower oxygen levels at this sort of height if you:

• Have chronic lung disease like COPD or Asthma
• Have anaemia
• Are elderly
• Are dehydrated (which can happen after surgery).

If this is the case, your team may advise you to wait for longer than average before you fly.

Painkillers and Travelling

If you’ve had surgery, there’s a reasonable chance you’ll need painkillers afterwards – especially if you have either external or internal stitches. You’re much less likely to need painkillers if you had a procedure such as a colonoscopy – a telescopic procedure to look at your bowel, which doesn’t involve the need for any cuts.

Other laparoscopic (telescopic) surgery like gallbladder removal and some other abdominal or joint surgery involves cutting only a couple of small holes to insert the telescope, and sometimes internal cuts or stitches. You tend to recover much more quickly from laparoscopic surgery than from ‘open’ surgery where part of your body is cut open to get to the area required. However, you may still need pain relief for a short time.

For minor surgery, you may only need simple painkillers such as paracetamol or anti-inflammatory tablets such as ibuprofen. These cause few side effects if used short term and shouldn’t cause drowsiness.

However, for more major surgery you may need stronger painkillers from the ‘opioid’ family, including codeine. These can all cause drowsiness, as well as constipation and some other side effects. They also carry a risk of addiction if used long-term. Do remember that you shouldn’t drive if you’re drowsy, and shouldn’t travel alone. Speak to your surgical team or your pharmacist about reducing the dose as soon as you comfortably can.

READ MORE: Travelling with Medication

The Effect of Flying on Gases

If you’ve had abdominal surgery, your bowels may not work effectively for several days afterwards. That means gas can build up inside your bowels, which may lead to bloating and wind. The gas inside your bowels will expand by about 30% at a cabin altitude of 8,000 feet. If you travel too soon, this could lead to bleeding or tearing open of internal stitches. That’s why it’s usually recommended that you don’t fly for at least 10 days after most abdominal surgery.

Some eye surgery involves injecting gas into your eyeball. This may be needed, for instance, in the repair of a retinal detachment, where the bubble floats over the detached area of the retina and helps push it back into place. Again, this gas can expand at high altitudes, increasing the pressure inside your eyeball (which can be dangerous). If you’ve had this type of surgery, your surgeon will advise you – you’ll have to wait longer (from 2-6 weeks after surgery, depending on the type of gas used) than with other types of eye surgery before you fly.

Flying and Clots

After you’ve had surgery, you may be more prone to getting a clot on the leg called a deep vein thrombosis or DVT. This is particularly true if:

• You’ve had surgery involving your lower limbs, pelvis or tummy.
• You’ve had major surgery.
• You have cancer.
• You’ve been immobile for some time (for instance, if you were generally unwell or frail before surgery or if you’re recovering from major surgery).

Symptoms of a DVT include pain, tenderness and swelling (usually of one calf). In addition, the skin over the affected area often becomes red and hot.

This clot can break off from where it formed deep inside your leg (usually your calf) and travel around your circulation to your lungs. If it lodges here, it’s called a pulmonary embolus or PE. A PE can lead to shortness of breath, sharp stabbing chest pain when you breathe, coughing up of blood, rapid heart rate and sometimes collapse or even death.

To reduce the risk of DVT and PE, it’s important to get up and about as soon as possible after your surgery (your team can advise how soon) and to stay as active as possible. You may be given medication (either tablets or injections) to thin the blood and reduce the risk of DVT. You may also be advised to wear compression stockings. Part of the reason for advising you to wait before flying (the length of time depends on the type of surgery – see below) is to reduce the risk of DVT.

Regardless of whether you’ve had surgery, it’s important to take simple steps to reduce your risk of DVT when you’re travelling, especially on long-haul flights or long car journeys.

READ MORE: Why Do We Wear Flight Socks?

Driving After Surgery

Even if you’ve had only very minor surgery under sedation or a general anaesthetic, you won’t be able to drive straight away. Any kind of general anaesthetic can make you groggy and impair your ability to react in an emergency. So you should always make sure there’s someone available to take you home – whether it’s a family member or friend. It’s best to get someone to accompany you, rather than just ordering a taxi.

How long you’ll need to wait after surgery before you drive will depend on several factors:

• Are you fully recovered from the effects of the anaesthetic? This usually takes at least a day and sometimes two.
• Are you taking painkillers which could make you groggy and affect your reaction time in an emergency?
• Can you sit comfortably in a driving position?
• Can you perform an emergency stop without damaging your operation wound?

Your surgical team can tell you how long it’s likely to be before you drive. But because any complications could delay this, always check with your team about whether you need a specific all-clear before you drive. And do start gently, with a short trip that doesn’t involve lots of stress or stop-start in traffic.

I’ve Had Surgery – How Long Do I Need to Wait Before I Travel?

The list below offers a very approximate guide to the length of time you are likely to be advised to wait after surgery before you travel. It relates to travelling long distances (usually over 2 and certainly over 4 hours), rather than short trips in a car or ambulance.

Do bear in mind that if you have underlying medical conditions or your procedure wasn’t straightforward, you may need to wait longer before travelling. You may be advised not to undertake even short-haul air travel for some time after your surgery. It’s essential always to check with your surgeon and to get the all-clear before you travel for any long distances, whether by plane, train, car or bus.