How to heal like Wolverine in only four short payments

October 2, 2012 10:43 AM

Abdominal surgery in four weeks - how best to prepare my body to heal quickly?

I'll be having a laparoscopic cholecystectomy in 4 weeks, and want to use the time to best prepare my body for a speedy recovery.
The laparoscopic cholecystectomy is effectively outpatient surgery and involves making a few incisions in my abdomen for cameras and tools, including one in ye bellybutton, and inflating me like a balloon.
If there are complications, the surgery becomes a basic tummy-opener with a more difficult recovery of course.

I'm a middle-aged, overweight woman. The gallstones are a little painful sometimes, and I'm having a lot of right-lower back pain from sitting in most chairs or doing any kind of bending for more than a few minutes, especially from the shoulders. Slouching over my keyboard in my home office chair is the only non-pain position, but not great general-healthwise.

- Losing some weight, check. This is happening naturally as a result of the gallstones: little appetite and little to no fat in my daily diet.
- Generally trying to get some exercise, check. Walking for an hour or so a day and I have an exercise bike and wii fit.

Questions:
- Would extra abdominal exercises be good or bad for ease of surgery and ease of recovery?
- What else should I be doing?

posted by L'Estrange Fruit to health & fitness (20 answers total)

Really up your protein. You need protein to heal....get a good multi vitamin too... Won't help as much as high quality protein but it can't hurt.... Good luck!!
posted by pearlybob at 10:48 AM on October 2, 2012

If you smoke, now would be a good time to quit or take a break.
posted by kamikazegopher at 10:57 AM on October 2, 2012 [1 favorite]

The big thing the doctors are going to want you to do after the operation, especially if they do have to convert to open surgery, is breathe, deeply and often (using an incentive spirometer). This is a big deal both because it helps get your abdomen back up to speed and because it wards off post-surgical pneumonia, which sucks (speaking from experience here). I'm not sure how much you can do to up your lung capacity in less than a month, but it would make things easier during your recovery.
posted by Holy Zarquon's Singing Fish at 10:58 AM on October 2, 2012 [2 favorites]

Thanks for the reminder on smoking! I am indeed a smoker (only for the last few years but still) and cutting/down quitting is on the list.
posted by L'Estrange Fruit at 11:02 AM on October 2, 2012

I had this. I did nothing to prepare and recovery for me was fairly fast. I was up and doing things normally within 4 or 5 days. Within two weeks I had no issues at all.

There is an unpleasant side effect to cholecystectomy, if you're one of the 20% of so that get it. (*raises her hand*) If you happen to be one of those people, you might mention that they make a one gram tablet of Colestipol to your doctor. They also make powders, but those are horrid. I bring it up because my doctor had no clue and it wasn't until I seen a specialist awhile later that they prescribed it.

That medicine made a night and day difference to me.

(I am jealous of all these websites saying that this eventually goes away. It hasn't for me, and it's been years)
posted by royalsong at 11:15 AM on October 2, 2012

There's a protein drink for that. I used to chug this just to keep my skin in good condition...expensive, but it works!

Juven: Rebuilds muscle, supports tissue building

Juven is a unique blend of three key ingredients: Revigor™ (a source of HMB), arginine, and glutamine. These ingredients play an important role in building tissue. Building tissue is important to support repair of skin after injury, surgery, or wounds. Juven has been clinically shown to enhance collagen formation in as little as two weeks1. Collagen is a building block to promote tissue repair of the skin after injury, surgery, and wounds.
posted by doreur at 11:20 AM on October 2, 2012 [2 favorites]

I have had the stomach-opener type abdominal surgery twice, and I think the #1 thing that will help your healing is to remove post-operation stressors. So, is there someone who can take care of meals or cleaning the house or getting the kids to school or doing the laundry, etc etc. Whatever responsibilities or needs that exist in your life - is there someone to take care of it? Or multiple someones who can do a little bit each?
posted by BlahLaLa at 11:26 AM on October 2, 2012 [1 favorite]

I'm not too familiar with cholecystectomies, but I have had laparoscopic surgery twice. If your doctor hasn't mentioned it, the gas (CO2?) that they pump you with to spread your organs out and improve visibility during surgery? That gas has to go somewhere.

For me -- and others -- the gas migrates up to the shoulders and neck, gets trapped in the muscle tissue, and results in pretty intense pain that Vicodin or whatever doesn't really address. Some people don't have this problem, according to my surgeon. I had zero abdominal pain, and the laparascopy wounds were trivial.

If I had known this before, I would have learned some tai chi or light yoga positions to get my upper body moving (in a low-impact way) and get some of that air out.
posted by lunalaguna at 11:37 AM on October 2, 2012 [2 favorites]

I have heard that massage for post surgery has some people with that gas pain that lunalaguna mentions. If you can afford a massage, call around now to schedule someone who has experience working on post surgical clients. (because you probably won't want to lie on your stomach or have them even look at your stomach.)

Better to have it scheduled in advance than to be trying to find someone who can squeeze you into their schedule when you're feeling desperate.
posted by bilabial at 11:53 AM on October 2, 2012

When I had my laparoscopic cholecystectomy my surgeon told me to get OTC gas reliever in extra strength if I couldn't expel the gas. Worked great. Also, drink lots of water.
posted by govtdrone at 12:25 PM on October 2, 2012

I had no special prep (had mine done as an emergency due to gallstone pancreatitis), and I walked 2 miles the day after surgery, and was running 5 miles within 3-4 days.

The doc credited my aerobic condition with my fast recovery time. So, certainly do the walking! I also think that it had a lot to do with me moving around as much as I could tolerate after surgery.

Like most others, only real issue was the CO2 gas got stuck in my shoulder and it hurt pretty bad.

I am SO GLAD that I got the surgery though. I didn't realize how bad I was hurting (with my 200+ gallstones) until I knew what it felt like to feel normal.


I would be VERY CAREFUL with dietary changes that may induce gallbladder attacks (protein should be fine, but stay away from fat).


And I am one of those like royalsong who has the "unfortunate side effect". In my case I've been able to mitigate it completely by eating a whole foods plant-based diet that's low in fat and zero cholesterol (a small amount of nuts / nut butters are OK but generally I avoid all oils and all animal products). Like in Forks Over Knives, basically. It's made me a lot healthier in a number of other ways too, and I wouldn't give it up now even if it were not for the "unfortunate side effect". I do take the pill if I'm going to a party or something and want to indulge a little.
posted by robokevin at 12:44 PM on October 2, 2012

I had a laparoscopic cholecystectomy in December and didn't do anything to prepare. I healed very quickly, so I think some of it comes down to luck.

Two unexpected issues I noticed after surgery: I had extreme shoulder pain for 2 days every time the Vicodin wore off. The worst part though was the nausea that began about a 24 hours after surgery and lasted about 24 hours. The surgeon told me it was normal and was even able to predict down to the hour when he thought it would go away.

Besides the shoulder pain, I had very little pain and stopped taking the Vicodin after just a couple of days. I felt weak for about 2 weeks afterwards though. They told me I could go back to work after a week, but I took two weeks. I wouldn't have been strong enough to go back after a week even though I just have an office job.

As someone mentioned above, make sure you have support after the surgery - someone to bring you food or help you out around the house. Having help from my family made my recovery very easy. Also, don't hesitate to call the surgeon if you have problems. When I experienced the extreme nausea, I called the surgeon even though it was Christmas Day and he was really able to put my mind at ease.
posted by parakeetdog at 12:45 PM on October 2, 2012

Quitting smoking (which has serious effects on healing) and being aerobically fit are probably the two most important things you can do. Afterwards, really seriously with dedication not overdoing it will do remarkable things for your recovery. You won't get a medal for going running 3 days later, nobody's going to give you big cash prizes for lifting/exerting beyond the recommendations of your surgeon.
posted by Lyn Never at 12:55 PM on October 2, 2012

FYI: the shoulder pain (Kehr's sign) that some people experience after laparoscopic surgery is referred pain. The gas that is used in insufflate the abdomen doesn't physically migrate to the shoulder/neck, but it irritates the diaphragm, which is perceived by the patient as shoulder pain. Not everyone gets it, but when it does occur it goes away in 1-2 days.

The co2 also doesn't actually enter your intestines, ie, you can't fart it out. the vast majority of it is released at the end of surgery, the remainder is absorbed by the lining of the abdominal cavity.

There really isn't much you need to do to prepare yourself for this surgery. Just make sure you are set up to take it easy afterwards: have some pre-made meals, do your errands ahead of time, etc.

And while the unfortunate side effect royalsong linked can occur, it is much more common to experience constipation. Colace is your friend.
posted by maryrussell at 12:58 PM on October 2, 2012 [3 favorites]

If you tend to get nauseous from anesthesia, tell your doctor or nurse. They may give you a transdermal patch of scopolamine which in my experience HELPS GREATLY.
posted by capnsue at 2:54 PM on October 2, 2012 [2 favorites]

I second the transdermal patch! You don't want to be vomiting with stomach incisions. I had a giant ovarian cyst removed laparoscopically back in April. I did nothing to prepare except worry and fret a lot. I was dreading the post-surgical gas pain and had...none. I also had very manageable post-surgical pain, probably a 5 on a scale of 1-10 and that was immediately after the surgery. I managed it well with Vicodin and ibuprofen. I had one incision that hurt 50x worse than all the others; I came to the conclusion that the doctor had installed a joystick in that one. Also, seconding Colace. Pushing in that particular manner will be kind of uncomfortable. Some extra pillows might be nice. Your incisions might pull in odd ways when you lie down and pillows add extra support.

I over did it the day after my surgery because the pain was so much less than I was expecting, but paid for it in soreness the next day. Try to stay IN or ON your bed for at least 3 days after your surgery. Sleep is healing; do a lot of that.

The biggest problem I had was post-surgical ITCHING. I had skin glue on the little incisions and it itched SO BAD. I washed with Aveeno soap and put a thin layer of hydrocortisone cream between the incision. Finally, if you have the melting stitches? Um, sometimes your body will reject them and push them out instead of dissolving them. I want to save you the freak-out I had when I thought my guts were coming out my belly button. It happens, it's no big deal, don't pull on it. It'll fall out on its own or your doctor can cut it.

Good luck!
posted by Aquifer at 6:24 PM on October 2, 2012

I had that surgery 2 months ago. I hope yours goes as well as mine -- it was way easier than I expected in most ways.

Yes, strengthening up your abdominal muscles a bit ahead of time should be helpful, but also work on your legs. Your abdominal muscles will be mostly off-line for a few days after the surgery, and you need to move yourself around using other muscles, mostly your legs.

Practice standing up from a chair without using your arms or your abdominal muscles. This is hard the first time you try to figure it out -- it requires placing your feet just right, slowly scoonching up to the front edge of the chair, and using mostly the strength of your legs to stand. If you use your arms at all, that engages the abs, which say OW STOP.

And give some thought to how you will get in and out of bed the first few days. If your bed is low or otherwise a little awkward to get out of, set up a sofa or recliner for sleeping. Moving around is really hard for a day or two, but it gets better fast.

Get a padded toilet seat now. You'll probably only need it for a day, but you're gonna need it ALL day. Right next to the toilet, put everything you might want or need to sustain yourself for hours -- sweater, blanket, pillow, soothing music, meditation tapes, audiobooks, water or something else to sip, and a note to yourself: "This WILL get better, very soon."

Have some pants (including underpants) that are too big around the waist, or use some old ones and clip away the front of the waistband. You'll be swollen and tender around the belly for a few days. Oh -- if you have cats, keep a folded towel with a piece of cardboard inside fastened over your stomach at night, cause guess where they'll jump?

Go through your house, and notice anything you need on a daily basis that's stored up high, or way in back, where you have to stretch to get it. Stretching will be out of the question for a little while, and life will be less annoying if you have the things you need within easy reach.

About the pain from the CO2 -- just as they were shoveling me out of the ambulatory surgery unit, the nurse grabbed me by the shoulders, looked me deep in the eyes, and said: "Tomorrow, there will be a few hours when you will think you're having a heart attack, but you're not. It's the pain associated with the gas, which you'll feel in your chest, shoulders and neck. There is nothing you can do about it, but it will go away." She was right. All I could do was rock and moan -- it seemed to help, and it passed the time. It's important to know that this doesn't mean that anything has gone wrong. Warn the people around you not to freak out, cause there's nothing they can do about it either. A few hours, and it's gone.

Deep breathing is my go-to strategy for dealing with pain or stress or anything difficult, but it was challenging in the day or two after the surgery. Deep breathing moves the abdominal muscles which OW. So I sort of just imagined the deep breathing (long, slow and shallow), which helped.

Check to make sure that your regular doctor (not the surgeon) knows when you're having the surgery and is available to give you any medical support you may need in first few days (like if the particular painkiller they give you just doesn't work for you). I found out too late that my regular MD was away that week, and the emergency contact # that the hospital and surgeon gave me was about as helpful as calling the cable company. I had a troubling complication from my autoimmune stuff and found myself without effective support, and almost had to call 911 to go the ER on the weekend. Bad planning. Have a backup in place, just in case.

And here's another pleasant surprise -- I automagically lost a chunk of extra weight starting right after the surgery, because my food preferences changed. With my digestion suddenly functioning better, I found myself wanting and enjoying healthier food.

Good luck!
posted by Corvid at 8:33 PM on October 2, 2012 [2 favorites]

Thanks everyone!

I don't have to worry about stress or helpers, thank goodness. And I've never had general anaesthesia before so I get to discover my nauseation level on the day, woohoo.

I especially appreciate the cat-deflection advice as that is a worry! I have one cat in particular who likes to stand on my abdomen to gaze lovingly at me, and another who likes to sleep on my chest so as to better put her ass in my face.
posted by L'Estrange Fruit at 11:19 AM on October 3, 2012

Those are my cats, exactly. I held the towel in place with a couple pieces of paper tape (well away from the incisions) and a slightly snug old t-shirt on top. The cat sisters could stomp around on me all night and I barely felt it.

Don't worry too much about the possibility of nausea. Many people have none at all. If you do, the docs know how to banish it quickly in most cases.

Another thing: plan to avoid laughing for a while. People with good intentions may try to make your time more pleasant by providing funny movies. That's almost cruel -- it was most of a week before it was safe for me to watch YouTube again. You want a hilarity-free zone for at least a few days.
posted by Corvid at 12:24 PM on October 3, 2012

Thanks everyone! Surgery was yesterday morning. Surgeon and nurses were awesome. On morphine pills now, lotta lotta pain. Picked up a cane with my morphine, best purchase ever.
Tea tray over stomach to protect from kitty attack.
posted by L'Estrange Fruit at 1:01 AM on October 30, 2012