Jeffrey Campsen, MD
Jeffrey Campsen, MD, surgical director of kidney and pancreas transplantation at University of Utah Health Care in Salt Lake City.
Each year, millions of Americans get abdominal surgery. If you are one of them, you want to get back on your feet as quickly as possible. But many things that patients—and hospitals—do actually slow down recovery and can even lead to uncomfortable, sometimes dangerous complications.
Exciting new trend: Many hospitals now employ “enhanced recovery after surgery” protocols (ERAS) for pre-op eating and drinking, pain management and post-op exercise. Results: Recovery time drops by more than one-third—that means you go home a few days earlier—and complication rates drop, too.
Whether your surgery is to repair a hernia, remove a gallbladder, treat colorectal cancer or have a hysterectomy…whether it’s traditional “open” surgery or minimally invasive laparoscopy…these steps can help you recover faster—and better.
Get walking as soon as possible. Aim for three or four daily walks. Movement allows the lungs to expand, reducing the likelihood of developing pneumonia, a post-surgery risk. It also gets blood moving in the extremities, decreasing the risk for blood clots, a potentially life-threatening complication.
It’s also important to protect your abdominal wound for at least the first four to six weeks after surgery to avoid getting a hernia. To do that, when you put stress on your core muscles, such as when you cough or laugh, push a pillow against your abdominal wall over your incision. This will help protect the incision.
If you’re taking narcotic painkillers, start cutting back. Your hospital may use nonopioid pain relievers and/or an epidural—a numbing injection—to help protect bowel function. But you may still be given narcotic medications such as codeine or acetaminophen/oxycodone (Percocet). Risk: These drugs slow intestinal functioning, leading to constipation, which is quite troubling after abdominal surgery and can delay recovery time. What to do: With your doctor’s approval, cut the amount of narcotics you take by half daily until you are off them completely.
Drink liquids—including coffee. Start drinking water and other liquids as soon as you’re allowed so that you can get off IV fluids quickly.
If you drink coffee, you can start that up as well—to ward off caffeine withdrawal symptoms such as headaches.
Important: Be sure that you drink plenty of water to avoid dehydration, which can cause constipation. Warning: Avoid carbonated drinks at least for the first week—they can cause gas and stomach discomfort.
Chew gum. After abdominal surgery, the digestive system becomes sluggish and can stop working for a few days. It can be uncomfortable and can prolong your hospital stay. In a study published in Archives of Surgery, abdominal surgery patients who chewed gum for five to 45 minutes three times a day after surgery, had a bowel movement one day sooner. Why: Chewing gum tricks the body into thinking it is eating, causing the digestive system to start working again.
Rock in a rocking chair. Sitting opens the lungs better than lying flat. But if you can spend part of your sitting time rocking in a rocking chair, the extra activity is beneficial. However, it’s best to get up and walk.
Before you leave the hospital, discuss with your surgeon what to expect during recovery at home, what your incision should look like as it heals and how to communicate if you have questions/concerns. Ask if you can send a photo (a “selfie”) of your incision if it is red, hot to the touch or has abnormal damage. You may need to use a secure patient portal. Call your doctor right away if you: Have a fever above 101.5°F, vomit, feel dizzy or think you might pass out.
If you do get constipated, before doing anything on your own, such as taking an enema, talk to your doctor about the best approach so that you don’t injure your incision.
You’ll be able to leave the hospital when you can walk, drink liquids, be off intravenous medications and fluids, and show signs that your digestive system and bowels are moving again. Keep walking every day, and start to eat easy-to-digest, bland foods—for instance, clear liquids, saltine crackers and Jello. If you do all right with those, move on to clear soups, such as broths…and then move on to more solid foods. Tips…
Don’t lift more than 10 pounds. For at least the first four weeks, straining your core abdominals risks causing a hernia or rupture of sutures. Walking and light exercise are usually fine, but if you feel pressure in the surgical area from any activity, stop. Listen to your body.
Go to your two-week post-op visit. Your surgeon will examine your incision area and, based on how well it is healing, will review what activities you can and can’t do.
Take the “stomp” test. Once they’re not taking narcotics and can walk around, most patients assume they have the all clear to drive. But a sudden stop could cause you to brake hard. To make sure you’re ready to drive, try the “stomp” test. What to do: Stomp on the ground with the foot you use for the brake. You’re unlikely to injure your incision, but go easy. Try a gentle stomp first, and if that doesn’t hurt try a harder one. If doing this hurts, the abdominal wall has not healed enough. It usually takes a few weeks before you’ll be able to drive.
