Going home after Abdominal Surgery – Dos and Don’ts Dr Sanjay Dalmia, Consultant Surgeon, CMRI and Belle Vue Clinic MS FRCS FRCS (Intercollegiate) Dip in Lap Surgery Everyone is different, and our bodies all react and recover in different ways.
There are few hard and fast rules about what you should or should not do once you go home after surgery.
The important thing is to strike a balance -try not to be in too much of a hurry, but do try steadily to increase the amount that you do. Listen to your body, and do only as much as feels comfortable. Exact guidance will be given by your own doctor but these are general guidelines in most cases. Exercise and mobilisation You should aim gradually to increase your level of physical activity after you go home.
Start with a short walk and increase the distance as you feel able. By about 2-3 weeks you should be able to walk for much longer.
You can use stairs sparingly and then increase gradually. Always try to walk as upright as you can to avoid backache.
You may find climbing stairs tiring or uncomfortable at first. Try to sit in a chair which is high enough to rise from easily without putting strain on your abdominal muscles. A low sagging chair or sofa can mean that you sit hunched up and then strain your abdomen trying to get up. Try to sit with your lower back well-supported, maybe with a small cushion or a rolled up towel at waist level.
House work can involve a lot of bending and stretching and you may find this uncomfortable. Try to get help with house work, at least in the first few weeks after you go home.
You should avoid standing for long periods, movements that involve stretching and pushing or pulling.
You should avoid lifting heavy weights including shopping bags and children . If you need to hold children, try to let them climb onto your lap while you are already sitting rather than lifting them up.
Rest and sleep You will probably be surprised at how tired you feel when you first go home. In hospital you felt OK but now you feel tired. This is normal. You didn’t realize how little you actually do while in hospital. Your strength and stamina will gradually return. Try to plan a rest time each day, preferably on your bed. Let your family and friends know that this is important and that they should avoid disturbing you if possible. You may find sleeping at night difficult at first. This may just be because your normal routine has been disturbed. Or you may have some discomfort or restricted movement. It is not uncommon to still have some pain when you first go home. A mild painkiller, such as paracetamol, before you go to bed may help.
Diet Most patients after abdominal operations should eat a little less initially to reduce any bloating or discomfort. As long as they are opening bowels they will feel comfortable with diet. Plenty of fruits and vegetables will help. Though there is no complete restriction on eating oily foods but they are best avoided in early days. Exact foods to eat or avoid will partly depend on your operation and your doctor or dietician will be able to guide you. In India there is a significant difference in food habits of people and it is necessary that their medical requirements are tailored according to their cultural requirements as far as possible. Sometimes people eat too little thinking they are weak or too much thinking they need strength. Both these situations are best avoided.
Work and other activities The length of time you will need off work will depend on the operation you have had and the type of work that you do. In the era of minimally invasive surgery people are returning to work earlier than before in most cases. People with jobs that involve a lot of heavy manual work may need more time off than those with less active jobs, but even sitting at a desk all day can be very tiring after an operation. You may wish to consider going back to work part-time initially if this is possible. If you do heavy manual work you should not normally go back until you have returned to the hospital for your post-operative checkup at four to six weeks. You should not start to drive again until your strength and speed of movement are up to coping with an emergency stop. You should also make sure that you are not drowsy from any painkillers and that your concentration is good. Most people do not start to drive for at least four weeks, and some will take longer, depending upon the operation you have had. There is no set time for resuming intimate relationships. Many people take a couple of months before they feel comfortable about this, but it is really up to you to know when you feel ready.
Hygiene and wound care It is quite safe to get your wound wet after 4-5 days (unless you have been specifically advised not to do so). Either a bath or shower is fine, but do not have the water too hot at first. There is no evidence that adding salt to bath water helps with healing, and it may dry your skin. Your wound will go through several stages of healing. To start with you may feel tingling, itching or numbness. It may feel lumpy as new tissue forms and there may be some pulling as it heals.
If you notice an increase in pain, an increase in redness or swelling or you have a new discharge from your wound you should contact your doctor. It is a good idea to keep the wound covered until it is dry and healed.
You should not go swimming until the wound is completely healed. Getting back to “normal” Having an operation can be a stressful experience, physically and emotionally. When you first go home you are likely to feel tired and unwell for a while. Things will get better. Some people report that it takes them up to 3 months to feel completely back to their normal selves, others recover much more quickly. It is common to feel a bit low in the first few weeks and to become frustrated that you cannot do everything that you would like to do. Be patient!
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