Post-op Open Abdominal Hernia Instructions:

Diet:

Advance your diet as tolerated but be aware that for a day or so after general anesthesia, it is not uncommon to have nausea and even some vomiting.  This should not persist past the first 12-24 hours.  Start with a light, bland diet.  Avoid large, heavy, spicy meals – liquids/soups are an excellent first choice.  Until you are passing gas and having bowel movements any significant food intake will make you more distended and uncomfortable.  

Don’t hesitate to take something if you need help moving your bowels within the first few days (examples include prune juice, milk of magnesia, Sennakot, Miralax etc.)  If you are prone to constipation at baseline plan to start something like Miralax before surgery to minimize the aggravation of not moving your bowels.  Other common dietary issues after surgery include losing the taste for food and feeling full faster after you start eating – this will resolve in several days to a few weeks.

Activity:

Advance your activity as tolerated but recognize it is common to feel tired/worn down.  Every patient will recover at their own pace (a few days to several weeks).  Walking, going up and down stairs, riding in a car, and carrying out your daily activities are all acceptable.  Don’t drive for at least 24 hours and until you are not taking narcotic pain medicine and you feel that you could easily swerve out of the way or slam on the brakes with no hesitation.  This will take a few days at a minimum but could take upwards of a week or longer.  

In terms of lifting and aerobic activity please start slowly when you are feeling comfortable and gradually increase the amount, duration and strenuousness of whatever activity you are doing.  If you feel increasing pain then you need to back off and wait more time but in general it is very hard to “damage the repair”.  More commonly, if you overdo things, you will simply feel more post-op pain and perhaps set back your overall recovery (time to feeling normal).  

Pain Control:

You will have some discomfort at the surgical incisions which is best treated by a combination of medications.  Take Tylenol three times/day.  In addition, because much of the post-operative pain comes from inflammation, and assuming you have had no problems with ulcers, intestinal bleeding, kidney/heart problems, or your PCP told you to stay away from these medicines, take 600 mg of ibuprofen with a little something to eat 2-3x/day.  If you still have discomfort after these two medications then utilize the prescription pain medicine.  My recommendation is to use the narcotic at night to help get some sleep but avoid it as much as possible during the day.  Once the pain has improved a bit, stop the prescription medicine and continue with Tylenol and the anti-inflammatory as needed.  

The narcotic can have many side effects (nausea, dizziness, constipation are just a few) so the less you have to take, the smoother your recovery will be.

In addition, it can be addictive which is why you will generally only get one prescription for outpatient surgery.  (No refills)

Surgical Incision:

Your incision is closed with stitches placed beneath the skin that do not need to be removed.  Icing the incision the first day/night after surgery will help with pain and keep the swelling down.  You may shower over the outer dressing on the morning after surgery.  Please remove this outer dressing in 4-5 days.  If you notice that it is causing redness or irritation at the edges please remove it immediately.  When the outer dressing comes off, you will see a steri strip (or several of them) – you may shower over these as well.  Please let them fall off by themselves.  

It is common to develop a lump at the surgical site – the bigger the hernia was, the larger this lump may be.  Do not be alarmed, this is just fluid and will resolve over a period of a few weeks to months.  No intervention will be needed.  Sometimes the swelling may cause the overlying skin to become reddened.  In most cases this is not an infection but comes from pressure on the skin from the underlying fluid.  It is also extremely common to have bruising – sometimes this can extend well beyond the surgical site.  Do not be alarmed by this as it is normal and will resolve on its own.  

Symptoms to report:

Persistent nausea, vomiting.

Any fevers or chills – it is common to have a low grade temp for a day or two after surgery but anything higher than 102 F after a couple days post-op is abnormal.  

Any redness, increasing pain or drainage at your incision(s).  

The above list is not exhaustive and if you are at all concerned about a symptom then call right away to discuss things and find out the next step.

Follow up:

Call the office to schedule your post-operative visit.  I usually like to see patients back around 10 days which allows enough time for any swelling or bruising to resolve.  Please see me at whichever office is most convenient for you unless I pre-operatively directed you to come to a specific office on a specific day.