Getting Life Back to Normal After SurgeryJun 25, 2014
You’ve just had surgery and are ready to get on the road to recovery. How long does it usually take to heal? Transplant specialist Dr. Jeffery Campsen offers some advice. He suggests some simple tests to determine if and when it’s safe to drive a car, carry your grandkids or resume your golf game.
Interviewer: You just had a surgery. You might be wondering when can you get back to your life, the things you enjoy doing, your activities? We're going to find out next on The Scope.
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Interviewer: How long after surgery until you can kind of get back to your life the way it was before surgery? That's a question a lot of people have. We're with Dr. Jeff Campsen. He's a surgeon at the University of Utah Hospital. So, when can you get back to your life after surgery?
Dr. Jeff Campsen: Well, it depends on the type of surgery you have. Today we'll probably focus mostly on abdominal surgery because that's what I do. I'm a transplant surgeon here. Anytime you have some sort of incision that goes intra-abdominal, you have to heal that incision. Depending on your state of health, it can be shorter or longer. An average time length that a lot of people say with an abdominal incision is about one to two months, or even just 6 weeks to where you really want to let it heal and you try not to put too much pressure on your abdomen during that time.
Interviewer: Is it the skin that's the issue, that that's going to break apart, or is there muscular things underneath that need to heal as well?
Dr. Jeff Campsen: That's exactly right. It's the deeper tissues, what's called the fascia. The fascia needs to heal, and that's what you would get a hernia through. The skin heals fairly quickly, but the deeper tissues take a little bit longer to heal. That's what takes one or two months. Those tissues are basically what make up your abdominal wall. They're sewn back together, but then the stitches that we use, the deep sutures, will only hold up so long. Most of the time over time they get absorbed, so it's really your body reforming that abdominal wall.
Interviewer: Oh, so after surgery there's multiple stitches. There's the stitches inside of me, and then the stitches I see on my skin.
Dr. Jeff Campsen: That's right. You can have internal sutures or external sutures on the skin, but it's the deep sutures that are really what's prohibitive to getting back to your normal daily activities. Basically, lifting anything greater than 10 pounds, putting any kind of stress on you abdomen.
Interviewer: Wow. That's not a lot of weight. I mean, you can't go grocery shopping without lifting something that's 10 pounds.
Dr. Jeff Campsen: You can't. Most children are greater than 10 pounds, which really puts a damper on a lot of people, and just daily activities puts you in that position. But it's worthwhile waiting for it and letting yourself heal because then the end result is that you tear through those sutures or don't heal, and eventually you get an abdominal wall hernia, which then can be life-threatening and will need to be fixed at some point, adding another surgery onto what you've already had.
Interviewer: Wow. So it's very serious stuff.
Dr. Jeffrey Campsen: It can be.
Dr. Jeffrey Campsen: It can be extremely serious, and this is the one thing where it's a good idea to pay attention to your doctor.
Interviewer: All right. So what types of activities are OK and not OK?
Dr. Jeffrey Campsen: I think as you get further and further out, the activities open up more. In the first two weeks you have to be very conservative. You want to walk, because getting out of bed opens up your lungs and pumps blood back from your legs to your heart, so it keeps you from getting a pneumonia or blood clots. So you definitely want to get up, walk, and do activities around the house. You can still do desk work and different things like that. You need to be active to allow healing. After about two weeks, at two to four weeks you can start doing a little bit more physical activities. What I tell my patients is there's a little voice in your head that's probably saying, "Eh, that's not a good idea," and if that pops up, you should back away from it. Then after a month, you should start to push it a little bit. If it feels bad, don't do it. Wait a couple days. Try it again. If it feels good, move forward, because I'm not there with you, and you're going to be, basically, living this every second and you need to sort of use a lot of common sense on what to do and not to do, and basically really listen to yourself. The mantra is, "If it doesn't feel right, maybe give it a few more days."
Interviewer: Got you. When you say feel bad, you're talking about pain? Is that what you mean by feel bad?
Dr. Jeffrey Campsen: Pain, pressure. You know, you don't want to hear somebody call in and say, "I lifted something and I didn't listen to you, and I heard a pop."
Dr. Jeffrey Campsen: What you want to do is not get to that point, and so you're basically. . . If you're pushing yourself a little bit, you're starting to lift something heavy, you're starting to do some exercise, all the good things that we actually do want you to do, and you start to feel pressure on your belly, maybe back away and give it a little bit of a rest.
Interviewer: So, it sounds like if you just kind of pay attention to your body, you're going to have a fairly good idea of what is appropriate or not. Or should you do far less than what you feel is appropriate?
Dr. Jeffrey Campsen: No, I think if you pay attention to your body, you can pretty much do what's appropriate. It's just you really have to use some good common sense and listen to yourself and not push it too far.
Interviewer: Anything else that we should talk about? Anything that might surprise somebody about this topic? Anything that you feel like we forgot, or feel compelled to say?
Dr. Jeffrey Campsen: I think one whole different aspect is this also comes into the realm of when can I drive after surgery? I think driving comes back into your abdominal wall healing. It's not so much your ability to turn the steering wheel and press the gas pedal. It really comes down to: Is your abdominal wall healed enough to where you can stomp on the brake? You obviously need to be off your pain medications, because you can't drive on pain medications, but if you can stand straight up after surgery, whatever many days later, and take your brake foot and stomp on the ground really hard and it doesn't hurt your belly so bad that you are writhing in pain, then you can proceed to drive. The reason that is, is that most people can drive around. They can push on the gas pedal. They can work the clutch, all that kind of stuff, but if they get into a situation where they've got to stomp on the brake to stop their car rapidly, and they can't because it's painful to them, then they're going to get into a wreck.
This kind of goes into when is your abdominal wall healed enough that you can handle that? Everybody heals a little bit differently, and so it kind of comes into common sense.
So, if you can do that test before you ever get into the car, and you're successful, chances are you're going to be fine.
Interviewer: Should you avoid twisting, turning motions?
Dr. Jeffrey Campsen: This gets into. . . You know, it's springtime in Utah, and a lot of people are golfers. What we basically say to that is very similar to lifting and all the other things. You can turn and twist, but if it starts to put too much pressure on your belly, you need to wait. As you get two, four, six week out, you can do more and more.
The analogy with a golf club is maybe in the first 2 weeks just sort of use your putter, and in the two to four weeks, you can sort of use an iron and just do a half of a backswing. Then, maybe after six weeks to eight weeks, you can really do that full golf swing that you want to do. I think that sort of relates to, basically, what do you do with your abdominal wall, and any of that twisting and turning you can do more and more as you get further out from the sugary, but also the rule, again, is if I feel like it's painful, if it's putting too much stress on my abdominal wall, back off. Give it a couple days to rest, and then try it again in three or four days.
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