Hernia Surgery: 2. Weeks one and two

On Friday August 26, 2011, I had open left inguinal hernia repair. In the months leading up to the surgery, I’d read a lot of information about it, and was concerned to find mostly negative experiences from those who had the procedure. I decided to document my progress during the first four weeks following surgery, the period after which my surgeon said I would be fully recovered.

The day after

On the day immediately following surgery, a Saturday, I had quite a bit of discomfort on waking up. Getting out of bed from a half-prone position was probably the most difficult and time-consuming part of being active, but walking had its discomforts. Going downstairs was also fairly painful. I took ten milligrams of Ketorolac for pain and swelling.

I started eating normally right away, but changed my diet to one of mostly fibre, including fruit, vegetables and whole grain. I increased my water intake to at least ten glasses per day. This was essential to maintain bowel function, which, if interrupted, would be quite painful.

At 10:00AM, or about twenty-four hours after the surgery, I removed the dressing. The wound had bled somewhat throughout the preceding day, and the dressing was blotched on the outside. I understood that to be quite normal, and it had stopped bleeding entirely by the time I removed the dressing, so I wasn’t concerned.

My activity was seriously reduced on the day following surgery. The pain was more severe, perhaps a six out of ten. The local anesthetic had completely worn off, and I was not going to take the Percocet prescribed to me. I needed to keep moving, though, to ensure a quicker recovery time, and so I walked when I could, and moved around the backyard somewhat.

At some point, I needed to move my bowel. Unfortunately, I hadn’t anticipated that the manipulation of the bowel during surgery would lead to a disconcerting halt in peristaltic activity — not quite ileus¹, but something too close to it to be encouraging. Any kind of straining was perfectly out of the question, as the pain was excruciating. It wasn’t painful at the site, but in an area about five centimetres above the highest point of the incision. That seemed worrisome.

There were more than a few frustrating and fruitless visits to the bathroom, and the scenarios I was imagining for the future were not pleasant. Warnings in the literature I received from the hospital, together with the totality of despair brought on by some (ill-advised) online reading of patient experiences, conjured up images in my future of an intimate afternoon with the surgical equivalent of a corkscrew. I was not happy. As a safety measure, I started taking the Docusate Sodium tablets as prescribed, though potentially they would not activate for another three days.

Happily, all was resolved by day’s end, at least for the time being.

By the time I went to bed, I had needed all four doses of Ketrolac, for a total of forty milligrams for the day. The pain, once again, was not always excruciating, but it was bad enough to medicate.

The rest of Week One

I was feeling cooped up already by the third day, a Sunday, and Alex took me to Bronte Creek Park. I couldn’t walk very far. There was terrible cramping in the area five centimetres above the wound. I couldn’t walk upright, and couldn’t keep moving for more than a few minutes. Unhappy, and shuffling around like a ninety-year-old, I aborted the walk in the park, Alex’ face all drawn with worry.

What seemed to accompany pain in this area was an extreme feeling of bloat. I had never felt so completely bloated before. Although I also have IBS² and thus experience bloating, this was unlike anything I’d ever gone through. With what I could only deduce was pressure from bloating at the interior surgical wound, the pain was the worst I had experienced yet — at least a seven out of ten. Walking became harrowing. Three steps were all I could manage before having to stop, half hunched-over like an osteoporosis patient.

I decided that perhaps the Ketorolac was to blame for the bloating, and so my first ten milligram dose on Sunday was to be my last. I also refused to take Advil, or any other NSAID. In total, I took eighty milligrams of Ketorolac over three days before stopping all medication. I even stopped taking the Docusate Sodium.

The bloating continued nonetheless. Frustratingly and frighteningly, bowel function did not improve over the weekend. Finally, on Monday, it returned completely to normal with the help of psyllium cereal.³

We tried the park again on Monday, but the pain and bloating were unbearable. There was also severe pain near my left hip, far above the surgical site. It seemed distressingly unrelated to the wound or the hernia site, but was just as intense. At times, it was excruciating, and made walking very difficult.

As an avid hiker, one who can easily walk twenty or twenty-five kilometres without stopping, who loves the outdoors, who loves trekking the Bruce Trail, being debilitated in this way, even temporarily, was depressing. I decided to stay away from my beloved Bronte Creek Park until I was well enough to walk properly.

Each day brought minimal improvement. I could walk more quickly, and by Tuesday or Wednesday, I was walking the stairs normally, albeit slowly. In the evenings, I forced myself to walk around the block. It was uncomfortable, but it helped me to improve. Sometimes while walking, I found that if I held my hand gently but firmly against the part that hurt the most, I could walk more easily.⁴

However, progress seemed too slow. The bloating and cramping continued. It seemed to be minimally getting better, but at least it wasn’t getting any worse. When September 2nd came around, seven days after surgery, I wasn’t as far along as I’d hoped, although I had started driving again that day.

Week Two

We tried the park again on Sunday September 4th, but we didn’t get far due to rain. On Monday, I seemed to relapse somewhat. The bloating and cramping was really terrible, and I was feeling stranded at home. Out of frustration more than anything else, I decided to go to Bronte Creek Park in the evening, on my own. Alex was a little worried, but I decided I just had to start moving a little further.

It was a complete success. The bloating, cramping, and pain began as badly as ever, but I kept walking, making my way into the woods. As I searched for and found my beautiful mushrooms, I relaxed quite a bit. The pain eased. I got caught up in taking pictures, and enjoying the autumnal solitude of the woods, which I’d been haunting for thirty years. I felt home. The trees, the leaves, the mushrooms, what summer songbirds were left, the other animals, were all important in helping me forget the discomfort and get moving. It was activity that ultimately healed me of the cramping discomfort I was going through. I was out for more than an hour that evening, and I returned home rejuvenated. I repeated the trip and stayed out longer the next evening.

Follow-up with surgeon

On Tuesday September 6th, eleven days after surgery, I had a follow-up appointment with Dr. Prodger to remove the staples. The pain and cramping were normal, he told me, and so long as it wasn’t getting worse, it would eventually dissipate. I asked about the site of pain a few centimetres above the wound. He said it too was normal, as was a hard lump I found under the skin in the area, where, it seemed, scar tissue was forming. The pain near my hip was probably a result of bruising where the local anesthetic needle was inserted in an artery after I was put under general anesthetic. He said that overall, the expected swelling in the whole area was far less than what is usual, and that I could return to all normal activities, including swimming.

Needless to say, it was very encouraging. I was sure I would start swimming again shortly, and I did, in week three.

But swimming that soon was probably a mistake.

1. A morbid obstruction of the bowel caused by a halt in the natural waves that pass food through the digestive tract. [↩]
2. Irritable Bowel Syndrome; a chronic, usually lifelong condition that causes some bloating and bowel dysfunction, and which is thought to be activated by mood and diet. The instance of IBS I have is mild to moderate. [↩]
3. I used Kellogg’s All-Bran Buds with Psyllium. I’d recommend anyone having this surgery to use it, and to start eating it a day or two before surgery. A third of a cup in milk once a day is sufficient. Drink a full glass of water during the meal, and finish the entire box over the course of two weeks. Surprisingly, it was one of the best things I did to help myself recuperate, aside from walking. [↩]
4. This is known as “splinting” the hernia site. It should also be done by hugging a pillow snugly against the area when coughing, sneezing, or vomiting — none of which, by everything in the universe that’s good, I had to do during all the time of my recovery. [↩]