An upright chest radiograph should be obtained in the recovery room and, for patients with a pleural drainage catheter or small residual amounts of pleural air or fluid, daily. A full neurological examination should be performed as soon as the patient is sufficiently recovered from anesthesia. Adequate pain control is essential and may require a combination of intravenous and oral narcotics, nonsteroidal anti-inflammatory drugs, and muscle relaxants. Physical therapy should be initiated on postoperative day 2 with the initial goal of maintaining range of motion. Heavy lifting and strenuous activity using the arm are discouraged for 4-6 weeks and should be resumed based on the individual's progress in physical therapy. Any new or residual neurological symptoms should be assessed and fully documented at regular intervals.
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