What to Expect After Abdominal Surgery
Incision Care
· You may remove any gauze bandages 24 hours after surgery. If you had minimally invasive surgery, you will either have surgical glue or steri-strips on the incisions. Both of these usually stay on for about 10-14 days. Once the steri-strips start to lift, you may pull them off. If you have staples, these will be removed in the office about 2 weeks post operatively.
· It is OK to shower with plain soap and water 24 hours after surgery. It is ok for the water to spray onto your abdomen. After your shower, pat dry with a towel. The steri-strips will dry. Do not cover with a bandage unless you are directed to do so by your surgeon or the office (exposure to oxygen is good for healing).
· No submerging the incision for 3 weeks. This means no baths, swimming pools, hot tubs, etc. during this time.
· Do not put any ointments or medications (including scar treatments, hydrogen peroxide, and alcohol) on the incisions unless directed to do so by your surgeon.
· Itching, bruising, numbness, and pulling sensations are all normal after surgery.
· It is normal for the incision to be raised and feel hard to the touch. This is how the tissue heals and usually takes about 6-8 weeks to completely resolve.
· If the incision becomes red, increasingly swollen, hot to the touch, starts to have drainage or opens up, please call the office.
Pain
· You will most likely experience pain after your surgery. Pain is an expected part of the normal healing process and present even with minimally invasive surgery. The pain is usually most severe the day after surgery and will gradually lessen.
· The use of ice and relaxation techniques are helpful for pain relief.
· You should start taking Tylenol and Ibuprofen (aka Motrin) after surgery.
o Take 650 mg Tylenol every 6 hours while awake
§ Max dose of Tylenol in 24 hours is 3000mg
o Alternate with 600mg Ibuprofen every 6 hours while awake
§ Max dose of Ibuprofen in 24 hours is 3200mg
o The best course is to alternate these throughout the day (alternate between Tylenol and Ibuprofen every 3 hours).
- A prescription pain medication may be prescribed for a few days after surgery. Only take these if you are having severe pain after taking the Tylenol and Ibuprofen regimen. (If you are taking prescription pain medication you should not take Tylenol.)
- Severe pain is defined as pain that does not allow you to function (eat, breath deeply, walk, or sleep).
- The majority of patients are expected to be off prescription pain medications after the first 48 hours of surgery. Refills will generally not be given without an appointment for evaluation.
- By law, prescription pain medications cannot be electronically sent or called into the pharmacy.
Activity
- You are expected to be up and walking around after surgery. You should walk around the house for at least 15 minutes 3 time per day the first few days after surgery and gradually increase this every day after.
- You may go up and down stairs, perform light housework and cook as tolerated.
- NO lifting over 10 pounds for at least 2 weeks after surgery. This includes NO pulling or pushing objects over 10 pounds. The total length of your restrictions will be given to you at your post-op appointment (this varies based on the type of surgery you had). Most patients will have restrictions for at least 4 weeks after surgery.
- If you have small children, try to avoid picking them up as much as possible. We know that this may be unavoidable at times but it will help with your pain and healing.
- Bending over and light stretching are ok as directed by your level of comfort during the activity. These activities may cause soreness, which is ok. Avoid activities that increase your pain.
- Fatigue is expected after surgery and is part of the normal healing process. This typically will last for about 2-3 weeks.
- You may resume sexual activity when you feel up to it as long as it does not cause you pain.
- An acceptable rule to follow in regards to increasing your activity is to increase activity by 25% per week.
- 1st week: 25-50% of normal activity
- 2nd week: 50%
- 3rd week: 75%
- 4th week: back to 100% of normal activity
Bowels/Constipation
- Surgery can cause your intestines to be sleepy which may cause gas pain, bloating, and constipation. All prescription pain medications also cause constipation.
- If you are taking a prescription pain medication, it is a good idea to take a stool softener (Colace) while you are taking the pain medication.
- Drinking water, walking and taking fiber supplements are all helpful to prevent/treat constipation. If you do not have a bowel movement after 48 hours, try taking a laxative, such as Miralax or Milk of Magnesia. These products can take 1-3 days to be effective.
- If you are having diarrhea for longer than 24 hours, please call your surgeon’s office. Avoid taking Imodium (unless directed by the office to do so) as this may cause constipation.
Diet
- For most surgeries, you will not have a special diet.
- If you are placed on a soft diet – avoid raw fruits and vegetables, tough meats and spicy foods.
- You may get full faster after surgery, if so multiple small meals throughout the day are advisable.
- Drink at least 8 glasses of liquids daily to avoid dehydration.
- It is ok to start with a light diet the day of surgery and return to a normal diet the following day.
- It is normal to have decreased appetite for a few weeks after surgery. Some people even experience a change in taste for a short time after surgery.
- If you have persistent nausea past the 24 hours after surgery, please call the office.
Work
- Timing for return to work is different for everyone. This depends on your surgery and the type of work you do.
- Most people are advised to take 1-2 weeks off work. If you do return sooner, please limit your activity to about 50% of what you would normally do until your post op appointment.
- If you need documentation filled out for work, please bring this to the office. It typically takes 5 business days to process these forms. These forms will not be filled out at the time of surgery.
- General time lines for returning to work after surgery:
- Little to no lifting at work: 1-2 weeks
- Moderate lifting less that 10 pounds: 2-4 weeks
- Heavy lifting over 10 pounds: 4-8 weeks depending on your surgery
Driving
- Absolutely NO driving while taking prescription pain medications. You may resume driving 48 hours after you have stopped taking prescription medication.
- General anesthesia can impair your reasoning and motor skills for 48 hours so operating machinery (such as driving) or making business decisions is not advised.
- Make sure you feel safe to drive and can make quick movements in response to an unexpected situation.
Shoulder pain
- You may develop pain in your shoulder after minimally invasive surgery from the air placed in your abdomen during the procedure. We do our best to get most of the air out but some may persist. This is normal and will usually resolve in a few days.
When to call the office: 248-853-3100
- If you have a fever over 101 degrees F
- Shaking chills
- Pain that is increasing despite prescription pain medications
- Redness, warmth, or drainage at the incision site
- Increase swelling around the incision
- Persistent nausea or inability to take in liquids
- Inability or difficulty with urination
- Persistent shortness of breath or chest pain
For the speediest response, please call the office before 4PM Monday thru Thursday and 2:30PM on Fridays. After this time, response may be delayed based on the availability of the on-call physician (as they may be in surgery).
