Advice following abdominal surgery

Introduction

The aim of this booklet is to give you advice on exercises that will (following your operation) aid and enhance your recovery.

The lungs following surgery

After your operation the lungs can be affected by the anaesthetic, pain and immobility. Many people find they have a cough after the anaesthetic and it is important that you start to clear any sputum (phlegm) immediately after your operation. If any sputum remains in the lungs, this is the ideal environment for infections to develop.

It is important that your pain is sufficiently controlled to take deep breaths, cough and move around. Most patients will have a button they can press to control their pain relief. If you do not have one or still have pain, it is important you speak to your doctor, nurse or physiotherapist.

Deep-breathing exercises

You should start deep-breathing exercises straight away after the operation. While doing the breathing exercises, try to sit as upright as possible and ensure your pain is well controlled.

1. Take a slow, deep breath in through your nose if possible.
2. Hold the breath for the count of three.
3. Gently breath out through your mouth.
4. Repeat this four times (do not do too many at once as this may make you lightheaded).

Aim to do one to two sets of five deep breaths every waking hour.

‘Huff’ and cough

It is not harmful to your wound to ‘huff’ or cough after the operation. To make your ‘huff’ and cough stronger and more comfortable, you can use a pillow or towel for support over your wound. To loosen the sputum you may wish to do a huff before a cough. This is a breath in followed by a forced breath out through an open mouth (as if steaming up a mirror).

It is vitally important that you cough as frequently as is required to clear your sputum.

Bed mobility

We advice and encourage patients to sit out in the chair/mobilise as soon as possible after your operation (this may be as early as the same day or day after your operation). The ward physiotherapists or nurses will help you with this initially.

The most comfortable way of getting out of bed initially is to bend up your knees with your feet flat on the bed, then roll onto your side. Once you are on your side, put your legs over the edge of the bed and push up through your elbow.

Circulation exercises

It is important to start circulation exercises immediately after the operation to help with swelling and to prevent blood clots. Move your feet backwards and forwards briskly 10 to 20 times every 30 minutes. Try also circling your feet, and squeezing your buttocks together to increase your circulation.

Abdominal exercises to start from day two after your operation

1. Knee rolling

Lie on the bed, with your knees bent up and feet flat on the bed. Gently roll your knees together to the right side, then the middle, then to the left. Repeat this 10 times, three times a day. This exercise will also help with relieving trapped wind.

2. Pelvic tilting

Lie on your back, with your knees bent up and feet flat on the bed. Gently pull in your tummy muscles then tilt your pelvis up to flatten your lower back. Hold it there for two to three seconds, then gently relax. Repeat this five times, three times a day.

You can increase the number of repetitions as you feel able. It is important not to overdo it though.

If the exercises are causing you any pain or discomfort, stop them immediately and ask your physiotherapist for further advice.

Getting mobile

Walking is an excellent form of exercise after your operation. The benefits of walking are to promote independence, reduce the risk of developing chest infections and blood clots. Try to gradually increase your walking daily. Your physiotherapist will do a stairs assessment with you prior to discharge if required.

On discharge

Rest is important as well as exercise in the initial stages after your operation. It is common to feel tired for some time after the operation, and you may wish to have a rest in the afternoon. Let your family and friends help with daily activities where required and try to pace your activities evenly throughout the day. It is important to avoid extremes of exercise to prevent strain on the healing wound (ie: heavy housework and lifting, bending or pushing, or heavy gardening) for 8 to 12 weeks.

Try to increase the length of time you spend walking every week. At around week six you should aim to be walking between 30 to 45 minutes (only if you were able to do this before the operation). From six weeks you can start to do low-impact exercise such as swimming and cycling on the flat. At around 12 weeks after the operation you should be feeling back to normal (obviously this may vary dependant on your operation and circumstances).

Who do I contact for further advice or questions?

Surgical physiotherapy team: 01223 245151

Bleep: 159 032