Last month’s blog detailed types of Inguinal or groin hernia repair. This month will cover hernia surgery recovery and frequently asked questions about postoperative care.
Most hernia operations are performed as an outpatient. This means that you are brought to the hospital or surgical center by a family member or friend and admitted. Once admitted, you will eventually meet your nursing team, anesthesiologist, and your surgeon. This is a time when the procedure will be reviewed, and you will have an opportunity to ask any further questions or express any concerns you may have.
Next, you will go to the operating and be given whatever anesthesia was agreed upon or determined by the type of surgery you are having. Following the operation, you will be carefully monitored in the recovery area before you are discharged and sent home with a family member or friend.
If your procedure requires an overnight stay, then after the recovery area, you will be taken to your room where you have have nursing staff help you with aspects of your initial recovery, and your surgeon will see you that day and/or the following day. A decision for discharge to home will be made by your surgeon when appropriate.
The following are common hernia surgery recovery questions:
- Are there any dietary restriction?
- What if I have problems with constipation?
- What restrictions are there to my activity?
- When is it safe to take a shower or bath?
- When is it safe to drive?
- My incisions are red or bruised. Are they infected?
- Why is there bruising in areas other than where the incisions are.
- What kind of pain can be expected?
- When will there be a follow up appointment?
Are there any dietary restriction?
Most people after hernia surgery are able to resume their usual diet within 24 hours. Some people may experience residual nausea from the medications given for anesthesia, but this should resolve by evening. If you are experiencing mild nausea, or have no appetite, then it is recommended to stay on a bland diet until those symptoms resolve. Also, on occasion, heavy or fatty foods may take longer to digest. Listen to your appetite, and if its less than normal, don’t feel you have to eat a full meal.
Constipation, and what to do:
Constipation occurs after surgery as a result of the medications given for pain control by the anesthesiologist. It can also occur as a result of taking certain pain medications such as Percocet or Norco or Vicodin. These medications work because of an opiate component that dull the pain but also slow the gut.
Constipation can also occur because it may be harder to strain to evacuate when having a bowel movement. This is usually as a result of discomfort at the surgical site that is worsened when straining.
If you are having problems with constipation, any over the counter laxative, usually in liquid form works best. This would include Miralax or Milk of Magnesia. Stool softeners do not work well after surgery, especially after you are feeling constipated. Certain pills, such a Dulcolax or Senna can cause spasm or painful cramping and should be used carefully. If the problem persists, or you have other hernia surgery recovery questions, please call our office.
Restrictions to your activity:
It is important to move about as much as you can. Though it is tempting to lay still after surgery, this will lead to stiffness, and greater difficulty and pain when getting up and about. Unless otherwise instructed the following activities are safe:
- Going up and down stairs. Use handrail for stability as needed
- Lifting or carrying objects up to 10 pounds
- Bending, or carefully stretching as long as there is no undo discomfort
- Walking, as much as is comfortable.
Try to avoid the following activities:
- Working out with weights, or strenuous aerobic workouts, at least for the first week
- Any core type workout. Avoid exercise that specifically stresses the abdominal muscle and the are of surgery.
- Any kind of repetitive impact activity, such as running or jogging, that would shake the abdominal muscles.
Taking a shower or bath:
Most incisions are closed with absorbable suture (stitches) and covered with either thin tape (steri-strips) or glue (dermabond). These are waterproof at 24 hours after surgery. You may shower 24 hours after your operation. The incisions can usually be submerged in water by day 3 after surgery. If there is a different kind of would closure used, you will be instructed accordingly.
A decisions to drive has to be carefully made. If you are taking medications for pain, then you should not be driving. Furthermore, if you cannot comfortably turn or twist to look over your shoulders or operate the break in an emergency, you should also not be driving. There is no specific timeline to being able to drive, and this varies with the individual. Most people are able to drive 2 days after robotic surgery or a week or two after open surgery.
Incisions, Bulges, Bruising, Redness, and Infection
It is not unusual to have redness at the incision site the first few days after surgery. Sometimes, if there is a significant amount of manipulation at the incision site during surgery, the area will be red or bruised. Although it may look like an infection, most infections do not occur until 5-7 days after surgery. If you concerned, you should call the office for advice. Usually, the redness will remain stable or improve over the first several days after the operation.
A bulge can also be present at the incision site. This is called a “healing ridge”. This bulge is not scar tissue, or a recurrent hernia, and will go away after several weeks.
Bruising can happen in areas other than the incision site. This can be significant when someone is taking a blood thinner or anti-platelet medication. As long as the area is not expanding or has pain associated with it, it will resolve in time. Any concern, however, regarding your hernia surgery recovery, please call the office.
Finally, though uncommon, a wound infection needs to be addressed as soon as possible. Antibiotics are routinely given during surgery by the anesthesiologist. Most procedures do not require antibiotics after discharge. If a wound is infected, it may have:
- Increasing redness spreading out from the incision
- Increasing swelling or fullness
- Worsening pain rather than improvement
- Warmth to the touch
- Drainage of fluid from the incision
Please call your surgeon immediately if there are any of these signs.
Pain after surgery is an individual experience. The magnitude or severity of pain is difficult to predict and also varies with type of hernia repair, its location, and its size.
The average person will need stronger pain medications for 3 or 4 days and then will use an anti-inflammatory such as Ibuprofen or Naprosen for several more days. The stronger medication usually as an opiate component, and would include medications such as Percocet or Norco. Note that these opiate medications can contribute significantly to constipation after surgery.
Generally, with movement, gentle stretching, ice, and time, the pain will subside within a 1 to 2 week period. Some people will have faster recovery and some will take longer. This is all normal and will be monitored carefully during follow up appointments.
Follow up visits:
A follow up visit will be scheduled between 7 to 14 days after surgery. The purpose of this visit is to look at the wounds, assess how things are healing, address any questions, and plan more defined return to usual activities.
If there is any concern prior to that first appointment, or if something doesn’t seem like it should during your hernia surgery recovery, please call for advice and an earlier visit is always available.