It can come as a shock in the early days and weeks after an abdominal wall surgery just how difficult getting around and even getting comfortable to sleep can be. Patients are usually sent home with one or more drains and an abdominal binder and told not to lift anything. However, they still need to lift the weight of their own body to get into bed, out of bed, walk to the toilet, and more. If you didn’t know, the abdominals are involved in EVERY movement.
These surgeries can include diastasis repair (abdominal muscle separation), a hernia, or a tummy tuck.
Something a recent patient told me was how many pillows she needed to feel comfortable in order to not feel as though she was pulling her abdominal stitches and causing pain. She needed 3+ pillows under her head and a pretty substantial cushion under her knees to get comfortable. And for several weeks following the surgery, she was unable to get out of bed on her own. In honor of this patient, I am writing this blog post because she is most certainly NOT alone and this experience has been lived by many before her and will be experienced by many after.
The following is a list of some key points to help in the recovery process
1. Abdominal Binder. An abdominal binder will be needed to help support the entire abdominal wall for the first several weeks. There are many types and the cost varies greatly. Ask your surgeon if they have a recommendation or chat with your pelvic therapist for their favorites. When wearing your binder, you should not feel an increase in downward pressure on your pelvic floor… This is a sign that it is too snug.
2. Getting into and out of bed. Log rolling is the ONLY way to get in and out of bed. You can also try and place a small pillow or yoga block between your knees to brace and help keep your body from twisting while rolling to your side.
3. Breathing: Breathing is the first thing you can work on to re-establish connection to your core muscles. You can place your hands on either side of your rib cage and focus on rib cage expansion with breathing. Place your hands on your belly to focus on belly breathing… as you inhale, your belly should expand, as you exhale/blow out your belly should contract or draw back towards your spine. At first, do groups of 5 and slowly work up to 1-3 minutes of breath work.
4. Early gentle core exercises: While laying on your back with pillows, you can do slow heel slides one leg at a time sliding one foot away and then back towards you. Another beginner indirect core exercise is single knee fallouts. Starting with knees bent and touching, you slowly let one knee fall out to the side without letting your body/pelvis rock to that side and then bring it back to the start position touching the other knee. Repeat in groups of 5 each leg to start and see how you feel.
5. Working towards laying with less pillows as your body allows. You will get quite used to your mountain of pillows. After 3-4 weeks, start trying to lay with fewer pillows and eventually work towards laying with only one pillow under your head. Your neck and spine will thank you and your abdominals do need to get used to being in a neutral length again.
6. Coughing or sneezing can be an unwelcome visitor in the early days and weeks after surgery. It will be essential to splint by pressing a pillow into your stomach to prepare for a cough or sneeze. Folding at the hips and keeping the torso longer vs collapsed can also help you better manage the pressure and not feel like you will also leak urine.
7. Hydration Hydration Hydration (and electrolytes, magnesium and minerals). Healing is a three legged stool that includes the physical, cellular, and emotional. Your body cannot heal without proper hydration and essential minerals like magnesium. Adding electrolytes to your water (preferably without much sugar) can be a game changer in how well you recover and how well you feel. Favorites include LMNT brand and the Adrenal Cocktail by Jigsaw Health. I recommend taking a scoop of the adrenal cocktail with a small cup of orange juice. It is the perfect combination for the adrenals that includes whole food vitamin C, Redmond’s Real Salt, and potassium and happens to be an excellent electrolyte without any fillers or sugar.