Post- Laparotomy Worry... Incisional Hernias?

[ec82]

Hey ladies, and to anyone reading this!  I'd like to ask a question that's been worrying me, and at the very end, I've included an update on my recovery from an ovarian cyst removal via laparotomy, re-opening the sutures due to a complication, and my new best pal, the KCI Wound Vac!


Has anyone gone through an incisional hernia from a laparotomy?  If a small one forms, does it progress fairly rapidly to a full-blown one with a noticeable bulge produced?  Or can small, visibly undetectable ones maybe go away on their own?  

Before my surgery to remove my two ovarian cysts, my doc said that with my "bikini cut" (horizontal) incision, it reduces the chances of an incisional hernia greatly, compared to an up-and-down vertical incision.

What are some general recovery tips that you have heard, in terms of restricted activities and how one must move their body, to avoid incisional hernias and strain on the abs?

It's been 3 weeks since surgery and starting last week, I was pretty careless, maybe straining a tad during a not-so-great bathroom moment or two, and sitting up in bed or getting up , instead of rolling over or something.  

If I'm sitting/leaning in a chair, should I be bracing my abs, pressing my hand or a pillow against my tummy to get up?  
Or should I be wearing an abdominal binder still?  
I've been trying to remember to at least prop myself up, thinking that pushing myself up using my arms on the armrests of the chair is better than just sitting up, hands-free, or do I need to be bracing/adding-pressure to my tummy while getting up as well?


PLUS yesterday, I was so happy to see my boyfriend and roommate that I forgot, and lifted my roommate's male cat (he has to be a little over 10 lbs) for five seconds until my boyfriend reminded me that I shouldn't be doing that.  ARGH!   (I couldn't help it-- the cat was dressed in a grey, waffle-knit tee with "Bad To The Bone" embroidered on it, borrowed from a friend's pet doggie!!)


I also read in another thread that not being careful during one's ~6 week recovery period can result in more adhesions, too?  

I want to start being healthier (one blessing with my surgery is that I am no longer a SMOKER as of 3 wks!), and I wonder when I can exercise, jog on the treadmill, and do stretching things like yoga classes, without risking this hernia!  Since I read on online health resources that incisional hernias can develop even months to a year after a surgery!




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Just an update on my cystectomy recovery!

So far:
12/24:  laparotomy (bikini cut) was on Christmas Eve, out of the hospital on 12/26?

12/31:  hematoma was drained (no anesthesia needed as the incision site is numb and boy, was it ghastly to see the doc cutting open the sutures and pushing black, thickened blood out, and swabbing INSIDE with q-tip soaked in HYDROGEN PEROXIDE).  start of daily nurse visits and wet-to-dry dressings 2x a day, as i am to heal this wound open, and not closed, to lessen chances of infection and to heal from the inside up

1/8:  KCI WOUND VAC!!!!!!!!!!!!   HUZZAH!   Google it!  Nurse is only required to visit/change my vac-dressing three times per WEEK!  Great for post-hematoma wounds like mine, or dehiscence



Just some really cool things I learned, that I hope might help other gals.....


********If anyone has an open lap wound like me, requiring a wound care nurse's daily visits to your house, try asking your doc/nurse about using "Aquacel" dressings, which only require dressing change 1x per day instead of standard wet-to-dry dressings that require 2x per day changes!   AND a wound vac, I think, is deemed as a piece of "Durable Medical Equipment" (DME) with at least my insurance company (Cigna), and my wound qualified for use of a vac!  Ask your doc about one, if you are left with an open lap wound like me, due to a hematoma problem or a dehiscence!

********************Unless you are allergic to these things, it is a GREAT idea to get the flu vaccine after surgery!!   Lessens your chances of catching something horrible that'll make you cough/sneeze and endanger your healing abdominal muscles!!   I actually got the regular flu vaccine and the H1N1 flu vaccine last week!

****************************For ladies on birth control, my doctor kept me off of it during my hospital stay, since it BCPs can increase chances of developing blood clots, especially since I was pretty much 90% bed-ridden.   My recovery...I was pretty mobile (able to get up on my own, grab a snack from the kitchen or use the potty, and go back and forth to my room to grab a book or something) in week 2, and my doc said I could start BCPs again, if I wanted to do so.


Just to mention, this forum was such a reassurance to me, before I had my surgery and after I had my surgery.  There's so many different experiences that I was able to search through, and find some ladies who've been in the same boat as I am in, now.  I'm thankful for this forum, and I hope that both the silent readers and the active posters will continue to gain much from this, as I have!!  

[wannasmile63]

I have had incisional hernias after my hysterectomy, (in 2001 when uterus and cervix only removed). I had bikini laparatomy for that surgery, but the hernias were caused by the force of a seatbelt in a MVA 12 months after surgery. That shows how weak the inside incisions are. I had to have a large mesh inserted to repair hernias, which in turn, made the surgery I had 8 weeks ago BSO, very complicated, and had to have 3 surgeons on hand to get through mesh before starting BSO, done similar to debulking, as stage 1A OVCA detected from pathology, and then mesh had to be repaired again. I could not stress enough how important it is, to really care for your inner incisions, and don't put any stress on abdomen for as long as possible. I have now had 6 abdominal surgeries, and each one is made more difficult because of all the previous ones. You definately do not want mesh inserted to repair incisional hernias. Take care..

[teddybears4ever2]

I'm still healing from mine. It has been 6 months, and I do not have a hernia. Those bumps you feel are more than likely the an muscle that has been torn.

[ec82]

Shoot, I forgot to add, that every now and then, I keep getting freaked out by a few immediate areas around my incision feeling hard to the touch and slightly swollen.  Is this scar tissue?  It doesn't hurt-- it's in the numb area of my skin, as it's on one end of the incision.

I saw something on the hystersisters site with someone posting that the hardened "ridge" of skin around the incision was scar tissue?

[KMMILLER]

I found after my c-section and again after my laparotomy that the best way to get up from a reclining or sleeping position is to put both hands under one knee and pull up.  The knee does all the work so you don't use your core muscles and put pressure on your incisions.  Works like a charm!  Also, use a stool softener day one until you are no longer sore so you aren't straining during bowel movements and causing pressure on your incisions.  Pain meds cause constipation.  I don't know why doctors don't tell patients these things!!!