When you awaken in the ICU, the sights and sounds around you may be unfamiliar. Your recovery will be monitored and managed by highly skilled critical care nurses.

The tube in your lungs will remain in place to help you breathe deeply and prevent pneumonia until the anesthesia is completely out of your system. Because this tube passes through your vocal cords, you will not be able to talk while it is in, which will make communicating a challenge. The nurse will ask you “yes” and “no” questions and help you write messages on a notepad. When the tube is removed, you will be asked to do exercises, such as coughing and deep breathing, to keep your lungs clear.

You will have “squeezing devices” or sequential compression devices on your legs to promote the circulation of blood in your legs while you are on bed rest. This helps to prevent the formation of blood clots in your legs.

You will probably look different to your family: you will be pale, possibly swollen and will feel cool to their touch. This will improve after just a few hours in the intensive care unit. You will also still be sleepy and may not remember the first time your family visits.

A typical stay in the ICU is one to four days. Several times each day, various members of the transplant team will make rounds to monitor your progress. Please do not be alarmed at all of the attention you will be getting. This is normal and necessary for a safe recovery.

You will then be transferred to the surgical floor where our nurses and physical therapists will help you regain your strength, teach you how to care for yourself when you go home, and prepare you for discharge from the hospital. If all goes well, you can expect to spend five to seven days on the surgical floor before your discharge. During your recovery you will have both “good” and “not-so-good” days, but over time, you should get stronger and begin noticing differences in your body and abilities. Keep in mind that no two liver transplant patients recover at the same pace. You are an individual and comparing your progress with that of another transplant patient may only confuse and frustrate you. As you move closer to the time you will leave the hospital, your activity level will be increased. You will be encouraged to walk daily. Eventually, you will be able to venture outside the hospital. You will also be expected to know how and when to take your medications.

Deep Breathing and Coughing

Deep breathing and coughing will help expand your lungs and remove lung secretions that have settled during your surgery. A respiratory therapist will show you how to use an incentive spirometer, a device that will help you take deep breaths. It is a good idea to take the incentive spirometer home with you to use the first four to six weeks after surgery.

Coughing may be painful, since you will have an incision. The nurse will teach you how to splint (decrease the pain by holding a pillow or your hands over your incision). Ask the nurse for pain medicine so you can breathe deeply and cough more easily and effectively.

Exercise and Activity

You should begin to increase your physical activity soon after your surgery. A physical therapist will be available to you. Once you are feeling better, generally the third or fourth day after surgery, you should begin walking in your room and the hallway. Each day increase the time and distance you walk.