Activities of daily living (ADLs) are activities that individuals routinely perform to take care of their bodies. ADLs include bathing, showering, toileting and toilet hygiene, dressing, eating, feeding, functional mobility, personal hygiene and grooming, and sexual activity.[11] Being able to perform these tasks is necessary to live independently. However, one-third of adults with cancer experience problems with ADLs, and the most frequently compromised areas are functional transfers, functional mobility, and personal hygiene.[48]

 

ADLs After Surgery [1, 9, 13, 17, 51 67,69] 

After staging and debulking surgery, most patients are admitted to the hospital typically between 3 to 7 days. Your healthcare team will discuss activities to avoid or limit during your recovery.  Recovery is usually about six weeks. Your healthcare team may advise you:

• Not to bend, lift, twist, or stoop to allow your incisions to heal.

• Not to lift anything ten or more pounds. (A gallon of milk is about 9 pounds.)​​

• Not to push or kick any heavy objects with your legs or feet.

• Usually, ovarian cancer survivors can resume regular routines between 4 to 6 weeks after surgery.​

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Functional Transfers

Functional transfers involve moving your body from one surface or location to another. Common transfer locations include in/out of bed, in/out of a sofa, in/out of a wheelchair, in/out of a car, on/off a toilet, or on/off a shower chair or bench. Your healthcare team will instruct you to follow precautions after surgery to allow your incisions to heal. Learning proper transfer techniques will help you protect your abdomen and prevent injuries to caregivers or healthcare staff who may be assisting you.

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General Transfer Tips 

• Do not hold your breath.

• Protect your abdomen. Try not to twist your upper body.​

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Getting Out of Bed (From Lying on Your Back)

1. Place your pillow/cushion over your abdomen.

2. Bend both knees.

3. Roll onto your side like a log, all in one motion.

4. Use your arms to push your upper body up while moving your legs off the bed into a sitting position. (Always move as one unit as this causes the least amount of discomfort).

5. Keep your abdomen relaxed during the movements.

6. Sit at the side of the bed for a moment before you stand.

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Getting In Bed

1. Sit close to the head of the bed.

2. Hug your pillow/cushion.

3. Lie on your side, bringing your legs up onto the bed, all in one motion.

4. Keep your hips and knees together and roll like a log to lay on your back.

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Getting In and Out of Bed Using the Log Roll Technique Video[40]

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Getting In and Out of a Tub/Shower

• Using a tub/shower bench or shower chair when you shower will help you save energy and keep you safe. 

• Review the image below to learn how to transfer into a tub with a chair and grab bars.

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Getting Into a Car

1. The front passenger seat is usually the most comfortable.

2. Back up to the car and make sure you can feel the seat behind you.

3. Reach back to feel the seat.

4. To avoid twisting, you will then move your shoulders and hips together as a unit.

5. Scoot your hips backward if needed.

6. Bring one leg in at a time.

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Getting Out of a Chair

1. Bring one leg out at a time, keeping your shoulders and hips together as a unit.

2. When you feel balanced, push up from the seat into a standing position.

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Getting In and Out of a Car Video [49]

In this video, the occupational therapist demonstrates how to get in and out of a car after spine surgery. However, the principles are the same for ovarian cancer surgery, where incisions are made on the abdomen. Remember to move your shoulders and hips all in one movement to avoid twisting when entering and exiting the car.

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Getting Up From a Low Surface

• Avoid sitting in low, soft couches, chairs, or toilets as it is more difficult to stand up from these surfaces. ​

 

• You can use a toilet-seat riser or bedside commode if your toilet at home is too low. (A 3-in-1 bedside commode is versatile and can be used over the toilet to increase the seat height, as a shower chair, or simply as a commode.)

 

• You can use grab bars to pull your

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Functional mobility 

Functional mobility is the ability to independently move about places to complete your daily routines.

• Walk as much as you can unless you feel dizzy. Though moving around after surgery may be challenging at first, it is vital for recovery.

 

• Try to get up and walk around at least once every hour during the day. You may need to gradually increase the amount of activity you do until you return to your usual level.

 

• You may use stairs if your doctor approves and you can tolerate this activity.

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Personal Hygiene​

 Always follow instructions provided by your healthcare provider for after-surgery care.

• Shower when your healthcare team tells you may do so.

  • When given the ok to shower, perform this task every day.​

  • Ask someone to help you the first couple of times or until you feel more confident about completing this task safely on your own.

  • You may 

 

• Do not submerge your incisions in a bath or hot tub; use a sauna or go swimming until your healthcare providers tell you it is ok.

 

• Incision care:

  • Check your incisions daily for signs of swelling, redness, warmth to touch, drainage, or skin separation.

  • Your healthcare team may tell you to wash the incision site with soap and water. (They may recommend using Chlorhexidine or antibacterial soap to shower after surgery.) Pat dry the incision site and never rub or scrub the incision.

  • Never use lotions, oils, creams, powders, Peroxide, alcohol, or Betadine on your incisions unless directed by your doctor.

  • Confirm your follow-up appointment with your surgeon to remove any sutures or staples.​​​

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Dressing

• Wear loose-fitting, comfortable shirts to prevent twisting and turning your upper body when dressing and undressing. 

 

• To put on socks, shoes, and pants:

  • Do not bend to reach your feet.

  • Instead, sit down and rest your foot on the opposite knee (known as the Figure 4 Technique). ​

  • If you are not able to use the Figure 4 Technique, try using a reacher, sock aid, or long-handled shoe horn to complete lower body dressing.

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Eating

• After surgery (while you are in the hospital), your healthcare team may start you on a liquid diet and advance your diet to regular meals when you are able to tolerate more foods.

 

• When you discharge home, you should continue to eat a well-balanced diet to promote wound healing. 

 

• Taking pain medications can cause constipation. To avoid constipation:

  • Drink 6-8 glasses of water daily unless otherwise instructed by your doctor.​

  • Eat vegetables, fruits, and whole grains.

  • Drinking warm beverages such as tea or coffee may help with bowel movements.

  • Your doctor may recommend a stool softener or laxative.

  • Activity can also help prevent and ease constipation. Walking around your apartment or house will help.

 

Sex, Intimacy, and Menopause

• After surgery, do not have sexual intercourse until your healthcare provider tells you that it is safe to do so.

 

• Do not put anything (including tampons, douches, or sexual-enhancing items) into the vagina until your healthcare provider says it is ok.

 

• When you resume sexual intercourse, it may feel different, and this may affect you physically and emotionally. Talk to your healthcare team about ways to enhance sex and intimacy.

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• Explore new or alternate forms of intimacy such as cuddling, caressing, massages, holding hands, and going on dates.

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• If you or your partner has an infection or open sores, do not have sexual intercourse.

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• If both ovaries are moved, and you have not been through menopause, you will go into sudden/early menopause after surgery. You will not be able to get pregnant, and you may experience hot flashes, night sweats, dry skin and dry vagina, fatigue, loss of confidence, anxiety, and mood changes. Report these symptoms to your healthcare provider so they can discuss medications and options to help you.​

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• If you can get pregnant, talk to your doctor about reliable forms of birth control.

 

Self-care After Chemotherapy [67]

• Treatment can cause you to feel sick and lose your appetite.

  • Eat small meals several times throughout the day.

  • Eat bland and soft foods to prevent or reduce nausea and upset stomach.

  • Fully cook foods to eliminate bacteria and prevent infection.

  • Talk to your healthcare provider about ways to prevent or reduce nausea and vomiting.

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• Keep your body clean to prevent infections.

  • Take short showers (or baths if your healthcare team says it is ok) using warm water.​ Avoid using hot or cold water.

  • Using moisturizing soap and lotion (on intact skin) as treatment can cause skin dryness.

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• Mouth sores, dryness, and pain are common during chemotherapy. Talk to your healthcare provider about ways to treat these problems.​ The following may help to prevent and relieve mouth sores discomfort:

  • Use a soft-bristle toothbrush to brush your teeth after meals.​

  • If your gums bleed with normal brushing, use an oral swab instead.

  • Use regular and special mouthwashes according to the directions.

  • Only use dental floss if your healthcare provider indicates this is ok.

  • Examine your tongue and mouth for white matches, as this is a sign of a fungal infection. Oral fungal infections are a side effect of chemotherapy and can be treated with medication prescribed by your healthcare team.

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• Examine your hands and feet for rashes that can occur due to medication effects. Talk to your healthcare team about ways to prevent or ease these skin changes.

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• Notify your doctor if you have a sore throat, as you may have an infection and require treatment.

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• Try to exercise if you can tolerate it to keep your heart and lungs functioning properly. Walk as much as you can but be careful not to overexert yourself, which could cause you to feel dizzy and weak. 

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