inguinal hernia recovery advice

[kylehorvath]

I AM NOT A DOCTOR, THIS IS NONPROFESSIONAL ADVICE AND COMMENTARY

Thanks for the post, it started a great place for people to learn about how to prepare, and how to gauge their recovery.

I just went in for an inguinal hernia repair, here's the specs:

Age:25
Body: 5'7" 140 lbs, healthy and fit
Surgery: Left inguinal hernia repair
Repair type: Incision, full anesthesia, with absorbable mesh and "plug"
Surgery duration: less than 2 hours
Recovery: Read on


I had the hernia for 2 years, didn't bother me too much. Climbed, hiked, biked, backpacked, skated, jogged, and all that other good stuff, didn't really affect me. With good diet (high fiber, smaller portions) it didn't evert too much. Big meals followed by standing up in a bar drinking out of a pitcher was a fail-safe way to make the hernia noticeable. On November 7th, 2013, I had it repaired. I read this post the night before, which helped my recovery thus far.


Day -2: Stopped drinking alcohol. Ate more roughage.

Day -1: No alcohol, no meat. All salad and fruit the day before. Nothing by mouth after midnight (no food or water)

Day 0: Got to the doc's at 0900. Got prepped for surgery. IV with antibiotic solution. Received a dose of something very relaxing about 10 minutes prior to surgery. Feel like a good, calm buzz. Put a smile on my face, that's for sure. Got wheeled away to the operating room around 1045, received full anesthesia.
1230: Came to in recovery room. Everything was spinning, felt like being cross-faded in my college years. That wore off pretty quick actually. Tenderness in the repair area. Pain 2/10.
1240: Took one hydrocodone/acetaminophen (NORCO). Drank .25mL water, 6oz of jello. Got wheeled down to my parents car, and was driven home. HAVE A DRIVER!
1445: Threw up just before I got to their place. Probably from the anesthesia. Tried to support the repair site as I yacked. Pain jumped to maybe a 5/10.
1530: Took 600mg Ibuprophen to prevent swelling. 1L water. 4oz prune juice. Ate some shredded wheat cereal dry. Walked 100m. Rested on the couch.
1600: 1 NORCO, 1 Docusate/Colace. Some water and shredded wheat.
1830: Had 1 cup of cooked quinoa. 5oz prune juice. .25L water.
1900: Walked. Sat at computer.
1930: Threw up again, knew it was coming.
2000: Rested and iced.
2050: Tortilla chips and saltines, probably should have started with this instead.
2100: 600mg Ibuprophen.
2230: Resting. First urination after surgery. Took 1 docusate and 1 NORCO.
2245: Went to bed, laying on my back. Elevated my testicles with a shirt between my legs to prevent the swelling I read about.

Day 1: 0300- Woke up to pee, took 400mg Ibuprophen. Full bowl of shredded wheat for breakfast with almond milk. Took Ibuprophen on regular but decreasing intervals to prevent swelling. Had docusate/colace twice a day with meals. Quinoa and yogurt for dinner. Bowl movement in the evening went well. Went on a few walks. One was up and down hills and a VERY steep driveway. Iced after walks with frozen corn.

Day 2: Shredded wheat and almond milk breakfast. Ibuprophen throughout the day. NO NORCOs. 2 Docusate. Went on a few walks, up and down hills. Iced after walks and during resting/TV time. Taped off area and showered.

Day 3: Smaller dosages of Ibuprophen (400mg in the AM, 200mg in the afternoon, 400mg before bed). Went on a regular paced walk, powered up steep hills, took it easy on the downhills. Can jog lightly and sprint up staircase. Iced a few times. Still haven't got the swollen nuts, hoping I won't get em!

That's where I'm at now. If anything significant happens, I'll repost!

IN SHORT:
Eat healthy the week before, get good exercise, and eat plenty of fiber the days before.
Have a driver pick you up. Be ready to throw-up, I've got a strong stomach but the twisty roads and the anesthesia made me yack. No fun.
Take a stool softener the first few days after surgery, it'll help everything slide out without pushing. DON'T push. Sneezing and coughing hurts, try to press against the area when you do.
Get out and walk around, increase as you feel more comfortable. Ice several times a day with something that conforms/contours to your area. Wear supportive underwear.
Don't eat foods that will make you gassy/bubbly.
I had what I think was a great surgeon and medical staff. She had been practicing since 1997, and didn't tug on my tubes while operating. Minimal swelling, minimal pain, and quick recovery!

 

[texlexic]

Thanks to all of you for posting your experiences. I found this forum in a Google search for ‘inguinal hernia surgery recovery’, and it has been more helpful than any others. I had surgery on my right side last Monday morning, and today is Friday 12/27 (my birthday, yay!) My experience since then has been virtually identical to that of 95% of the previous posters, but I have a couple of questions that I haven’t seen answered: 1) The right side of my scrotum seemed to be back to normal size immediately after surgery, but is now enlarged again, almost a big as before (my main symptom). Have I broken it again, or is this normal swelling/fluid? 2) My follow up appointment is in a couple of weeks, what should I ask besides that first question? Thank you again to all of you for your input. I am extremely encouraged to see that gently increasing activity is the way to go!

 

[alienator]

Thanks to all of you for posting your experiences. I found this forum in a Google search for ‘inguinal hernia surgery recovery’, and it has been more helpful than any others. I had surgery on my right side last Monday morning, and today is Friday 12/27 (my birthday, yay!) My experience since then has been virtually identical to that of 95% of the previous posters, but I have a couple of questions that I haven’t seen answered: 1) The right side of my scrotum seemed to be back to normal size immediately after surgery, but is now enlarged again, almost a big as before (my main symptom). Have I broken it again, or is this normal swelling/fluid? 2) My follow up appointment is in a couple of weeks, what should I ask besides that first question? Thank you again to all of you for your input. I am extremely encouraged to see that gently increasing activity is the way to go!

No one here can tell you why you have asymmetric scrotal swelling now. Call your doctor.

 

[A1an]

Thanks for the original post and thread, easily the most useful pages I've found.

42yo, otherwise healthy, 6'2, 170lbs, regular cycling, tennis, swimming until right side inguinal hernia last year (maybe hiking related). Initially diagnosed and treated as infection but once hernia identified was booked in for open mesh repair, which I had four and a half weeks ago.

Initially felt op had worked and was making clear progress, albeit slower than I hoped. Able to sleep comfortably on side after about four weeks, much easier getting up etc. But things seem to have plateaued/regressed a bit in the last few days. Still taking non-prescription anti-inflammatories/pain killers and having to rest up a bit more again.

Will consult doc but interested to hear if others have had these plateaus etc. in path towards recovery.

 

[mstrunn]

Urban, thank you for the great tips and I'm sure you have helped people; however, not to argue with you but if one truly has the Modified Plug and Patch tension-free technique, staying in bed for 2 days is not recommended nor needed. The nice thing about this surgery is less post op pain, a quicker recovery, only 1% chance of recurrance, less dissection and immediate mobility. One is encouraged to walk immediately after surgery, even up and down stairs, every hour if possible, plus icing, drinking fluids, more fiber and the other things you mentioned. The conventional surgical treatment had a lot of dissection, staples, tacks, wires and the muscles were sutured together causing tension, tension= PAIN, and bedrest was prescribed. The Modified Plug and Patch procedure takes 25-30 minutes under local anastestia and sedation.

 

[nahho]

Hi, all. Thanks to all in this thread for the helpful advice. For me this is Day 4 after my bilateral inguinal surgery, laparoscopic. I'm a nearly 44yo male, was riding 6,000 miles a year until my fall and collarbone break last August. We had a brutal winter here in Chicago, and certainly shoveling all the snow contributed to my hernias. I believe rehab for my shoulder after the collarbone break also contributed, as I began feeling a muscle pull along my right side, along my hip and under my ribs, when my rehab got intense. That led to a tearing feeling after a simple stretch in February on my right side, and then a similar feeling shortly afterward on the left. (In hindsight, I believe I had a small hernia on the left side for years, and only this year did it become a real discomfort.)

My surgery has gone very much as many have said in this thread: Morning surgery was easy, I was walking around the house that night but doing only very limited stairs. Did more stairs the next day, but also was most sore the next day, especially getting up and down from the couch; walking gingerly was fine. I had a burning feeling while urinating over the first 36 hours, I'd say, and the first BM came on Day 3 -- wasn't too difficult, thankfully. I am less sore today on Day 4, but I get tired easily. I'd like another BM.

In fact, that's my real reason for writing. In this and other forums I see very little mention of digestive issues. Before the surgery and over the winter I was developing bloating more than I ever had, and it felt tied to the hernias. Granted, I was getting winter belly fat and it was difficult to exercise. But the bloating was uncomfortable, at its worst feeling like it was tugging on my right hip and ribs. Some days I felt like I would collapse if I tried to hold myself up. Also note: I have scoliosis that raises my right hip and compresses things between my hip and my ribs, which my surgeon described as low (I have a short torso and long legs). Other days I didn't have this tugging feeling; before the surgery it was like which way today would the hernias be emphasized, left side or right side? I could press on the uncomfortable bloating area up high and feel it down on the corresponding hernia! I cut soda and limited dairy, and generally watched what I ate. In April when I got to cycling more, I had less of this bloating and only some of the tugging feeling, though it was still there even as I dropped weight. (I'm 6'1" 155-160 lbs.)

Now post-surgery, I'm having the bloating as pretty much expected -- there's gas and constipation, plus I'm not exercising. So I'm feeling this tugging on the hip a bit again. I've been sore as high as under my ribs, both sides, too. I know the inguinal ligament runs along the hip from the top down to the hernia site, so it certainly appears it's all connected. I know about the "healing ridge" effect with the swelling. But what about this bloating and tugging feeling? Anybody have it? What happens to the bloating long-term? Sometimes I hate how one thing leads to another and wonder when I'll be all normal again.

 

[nahho]

Update on Day 7 post-op: I'm a lot looser walking around, and the hernia sites are no longer kind of a radioactive half-sphere sensitive to every touch. But they do feel a little swollen still, even resembling the feeling of the hernias to some extent. That brings plenty of paranoia and checking down my pants to make sure no new bulges have arisen. The paranoia I understand is common.

The bloating has subsided somewhat but is still there. I really feel in the past couple of days that I had a right-side internal oblique muscle pull that led to the right-side hernia, because I still feel tightness in the lower-right abs, along the inguinal ligament, and up into my gut under the ribs. The bloating on the right side kind of tugs on it all, and that's annoying. Some bruising persists along the right inguinal ligament. I still get a little pain on the left side, but nothing horrible at all, just enough to make me paranoid.

I watched a Louis C.K. special, and that was difficult!

But I can certainly tell that the hernias are now contained because my lower abdominal area down into the groin is a distinctive upside-down triangle shape that I'm not sure I've ever had so sharply. That's comforting.

 

[nahho]

More updating, now that I'm on Day 11 post-surgery: I'm much more hopeful now and less paranoid of problems. As I said above, my right side has been uncomfortable, but now it feels more like kind of a logical discomfort -- it's clear that my "new" hernia was on the right side where I must have given my obliques and abdominal muscles a good yank to cause the hernia. The soreness on the right focuses around the hip, and that's inguinal ligament all the way. I'm at the point that I can do light stretches in that area to get a little relief. My bloating is starting to subside and is less uncomfortable overall. Meanwhile, my left side simply looks great. I can't believe it; it's better than it's ever looked my whole adult life. I still have a little swelling there, but I have more on the right side; I'm eager to see if my right side ultimately will look as good as the left. I've read people say here and elsewhere that sometimes you have to prod your surgeon for information. With mine a hernia surgery apparently is very routine, so he seems to think nothing is a big deal, just avoid heavy lifting and strenuous exercise, the pain and swelling will go down, yada yada. Two websites, other than this forum, have given the best, actual medically based and more specific advice. The Rhode Island Hospital, good with specifics ... http://www.rhodeislandhospital.org/services/surgery/minimally-invasive-surgery/patient-education-guides/inguinal-hernia/postop/lap/overview.html And the Beverly Hills Hernia Center ... http://www.beverlyhillsherniacenter.com/instructions-after-hernia-surgery.html This site is one of the few places online, maybe only two, that talk a little more about the connection of an inguinal hernia to the hip area, advising to start working on the core and the hip area as soon as two weeks after surgery. Right now, that is making a lot of sense to me, especially on the right side. I'm eager for next week, after the two-week mark. For now I know I can't push it too much yet, so I try to be patient waiting.

 

[nahho]

Hello, all, again. Well, I'm now almost exactly at the 3-week mark post-surgery. It's difficult to be patient. I've heard that I'd be pain-free after three weeks, but I'm not. Though I'm not entirely surprised. It's basically that the whole abdominal area is very delicate and it's easy to make it sore again.

I've had a numbness and/or burning sensation along my left inguinal canal; that's where the hernia had bulged before, and it appears some nerves can flare up on that side. That comes and goes depending on the day; today I don't have it. Instead the last couple of days I feel the swelling on the right side, near where my lower incision was and where probably the right hernia was -- it wasn't a bulge on that side. So this makes me worried, as this side's swelling seems slow to go down. But as urban0000 wrote a while back:

Quote: Last but not least after about 8-12 days of post surgery you will find a large protrusion under your skin where your incision is and its gonna feel just like your old friend Mr.Hernia.
Don't start freaking out like I did, OMG!!! OMFG!!!! my hernias back NOOOOOOOOOOOOOOOOOOOO!!!!!!
Its just a "Healing Ridge" and its gonna stay there for at least a month if not 3-6 months. Your fine and this is completely normal, very common and very understated by hospital staff.


Yes, sometimes I am, oh, hell, no, please say something's not wrong. Especially with the weather being so good now and I'm dying to ride. Urban gives me comfort. It has to be that healing ridge that I'm feeling; Urban certainly is not the only one to point out that out on the Internet -- but he's right: I wish the surgeon and his staff would have! I'm starting to wish I had seen an actual hernia specialist rather than a general surgeon, because I have the feeling the treatment would have been more well-rounded.

I might try riding around the neighborhood in a couple of days and see how I feel. I may need another week to rest and only walk. I did do a 4-mile walk a couple of days ago, and that went fine. The battle may be stretching (lightly!) the inguinal ligament and surrounding muscles, because I'm still quite tight there. I mush on.

 

[nahho]

Hello again, all. As the advice drops off in this thread once people reach the three- or four-week mark (one does get sick of dwelling on the injury at a certain point, right?), I hope you don't mind if I keep updating you on my progress in hopes that it helps others. I've passed the four-week mark and have started riding. I said above, after 3 weeks, that I hoped to ride around the neighborhood. Well, I did at the 3 week, 1 day mark and rode about 25 miles! I was surprised by the distance, but I wasn't surprised by the caveat: that I had to go slow, and I couldn't get out of the saddle for climbing or really anything. And I basically had to just push with my legs only -- if I had to start putting my body into it, then I was going too far. With that I had no unusual new pain in my surgery area. I felt that healing ridge big time, like a rock sitting in there. But I didn't feel like I had done any damage -- it felt much like having the hernia there in the first place. EXCEPT, the biking helped break up the healing ridge a little bit, so that I felt actually felt a little better the next day. Warm temps helped, too. Then at the 3 week, 5 day mark, I went on an organized ride that my charity team always does. I couldn't ride with my teammates, but I remarkably rode 50 miles in the country. It was flat but a little windy. I could push a little bit, and my speed improved a bit. I had planned on the 32-mile route, but halfway through I felt I could try for more. 42 was no problem, and 50 was a push not because of the surgical area but because I was just a little out of shape. Again, the ride loosened up the groin area, and the healing ridge dissipated a little more. This week, after the four-week mark, I've ridden twice, 43 miles and 36, both on a flat trail I regularly do. I was able to up my speed a little bit more each time. Maybe my inguinal ligament or nearby hip or ab muscles will get sore, and I still feel swelling, but the healing ridge is way down; I feel like I can actually *use* my ab muscles a little now. I'm not up to full speed, but there's a lot of hope and I'm feeling great about that. Tonight, after my work shift, I'm a little more sore. My surgical area, especially the inguinal ligament area, will tend to be more sore by the end of the day, even from just sitting. It's all still healing. That'll get me paranoid every once in a while, always checking the area, but there's progress in the swelling just a little bit day by day. I gather from others that I will feel a little something for quite a while, but at least I have my riding back, even if I keep it to every other day for the moment.

 

[nahho]

Five-week mark post-surgery now. I did a 58-mile ride over the weekend while visiting southern Illinois, and it was lovely. I felt good afterward and during, though I still have the same swelling feeling (the hernia ridge, as noted in my previous entry) in the hernia spots. I came upon one nasty hill that forced me to get out of the saddle, and it was OK; I kept in a light gear.

The healing ridge appears nearly gone, but I can feel it's still there. And I certainly still feel inguinal ligament and other hip-area tightness. It stubbornly persists.

I was tired the day after the 58-mile ride. I'm clearly still getting back in shape. Then on Sunday night, we drove back home and had many bags of things to load and unload. I got more sore from dealing with those bags, even though I left the heaviest ones to my wife, than from riding. I'm at the point where I can get sore from any easy strain. It's disturbing even if normal. On Monday I rode 25 miles and I was tired and still sore, but my wife was also tired from the weekend visit, suggesting my fatigue was not only from riding.

The worst thing I suffer at this point is the damned dull ache/slight burning feeling up my left inguinal ligament (I think it is), especially from just sitting up at work. Some nerve there must have been damaged from the hernia, and/or a mesh suture/tack is bothersome in that area, or something. I can feel a hard little spot along a ligament or tendon that seems to be right below my ab muscle; I think it's a normal part of my body, as I feel a similar thing on my right side though it's not painful at all on the right. In any case, this ache will be the thing I go back and ask my surgeon about if it remains at the same level after the six-week mark.

 

[nahho]

Six-week update:

In the sixth week I rode four days in a row at one point. I'm able to get into a cycling routine, which makes me happy.

I still have a slight healing ridge, especially favoring the right side, and soreness along the inguinal ligaments on both sides. If I ride too fast, I will feel more soreness. The first day of the four-day streak, in fact, I rode at what's a high pace for me right now, and I was sore on the right side to the point that I was paranoid I had done damage. Fortunately that subsided slowly over the subsequent days, when I rode at a slower pace. After I ride in any case, I will have less of that burning feeling along the ligament on the left side. A couple days I had big muscle tightness and weakness along my right hip, in retrospect probably related to that right-side soreness from riding too hard. The internal oblique on the right still seems to be recovering as part of all this.

Now after a couple days off the bike, I am less sore and tight. I still feel things, but it's slooooooowly getting better. In fact, the past couple of days I've felt I could actually use my abs and even do light groin stretches without it feeling like I could tear a muscle any second.

Also noteworthy: I feel more sore along the inguinal canal after sexual activity. The spermicidal cord is in there, after all! Or perhaps it's more the simple contracting of the abs.

So, there is progress, albeit very slow, but I'm riding OK. I have my big MS ride this weekend, but I'll probably do half of what I normally would do each year.

 

[nahho]

Seven-week update:

I rode 175 miles over my MS ride over the weekend. I did a century on Saturday! I'm very excited over this considering I didn't get one in last year for the first time in 10 or 11 years. My legs and body just felt good, and I got a lot of help pulling from my team, so I could pull off the 100.

I had stiffness over my lower abs at the beginning, but they loosened up as the ride wore on. It helped greatly that it was warm and humid out. Also, I could not ride with the fastest riders on my team. I averaged 16.2 mph riding the 100, and 17.0 for the 75 the next day; normally I'd go a little faster for the 100, but I'm still not ready to push for big speed just yet. And note that the terrain was very flat; we did have some wind.

After the rides I was no more sore than I would be ordinarily. I still have swelling over the hernia sites, but it continues to dissipate ever so slowly. Obviously pulling off this mileage gives me confidence for a recovery.

I should have mentioned earlier that I finally took the advice to ice my swelling areas after big rides, and indeed it works. Previously I have used Flector pain patches to help take the edge off pain, particularly the left-side nerve burning I sometimes get. That burning also is dissipating.

I found an interesting article and then an app doctors developed to predict post-surgery pain. The idea is, if you had a lot of pain when you had the hernias, the greater the chance you'll have pain after surgery to repair them. (Another reason not to wait for hernia surgery.) Here's a link on it: http://blogs.wsj.com/health/2012/03/28/new-app-to-forecast-pain-after-hernia-operations/

So I mush on, happy to be riding and getting better, if slowly.

 

[nahho]

Eight-week update: We had a week of warm weather here, and that helped loosen my abs and related things greatly. After a weekend of 82 miles total, with a few days of riding before that, stretching out my hips and abs gently each time, I felt great -- swelling down, pain nearly gone. I even did some light lifting to clean out the garage -- but rarely anything over 20 pounds.

Then there were a couple of tough days at work -- it's just a sit-down job, but sitting at work can be my most uncomfortable position especially when there's tension -- culminating with false fire alarms that had me walking briskly, once even jogging around the building. Somewhere I tugged on my left abs a bit, as my left inguinal ligament (or thereabouts) has been sore for a couple of days. Riding seven days in a row may or may not have contributed.

So, I'm reminded that I'm not out of the woods yet. I'm riding OK, still trying to get in shape, but I'm still not pushing the speed or tackling big hills regularly -- I can get out of the saddle but am being gentle about it. I still feel some swelling at the hernia sites. I'm disappointed I did something after I felt so good, and I'm disappointed it's still easy to bring back discomfort, but I'll be more worried about it if it still happens after the three-month mark.

 

[herniatalk]

Hi everyone, nahho specifically,
I noticed you mentioned Dr.Towfigh's Beverly Hills Hernia Center as one of your sources for information regarding instructions after hernia surgery.
I'm not sure if you know but Dr.Towfigh actually actively participates in a hernia discussion forum (www.herniatalk.com).. This might be helpful for you!
Either way, best wishes to everyone with their recoveries!
Thanks!

 

[nahho]

This is great to know. I will check it out! Especially because I've had a bad turn in the past few weeks, now that I'm at 11 weeks post-surgery. Starting at 9 weeks post-surgery, I've developed what so far is believed to be nerve entrapment resulting in a tremendous burning sensation in my left leg when I cycle. It's brought me to a standstill. On July 4 I rode 62 miles pretty hard, did a 25-miler on July 5, took the day off July 6, and then when I started riding July 7, shooting pain through my whole leg. Doctors so far believe this is referred pain from the groin area, which would be caused by a nerve trapped or pinched by scar tissue or the mesh. That pain in my left groin that I've had lingering, the surgeon said that isn't normal. It's like a pins-and-needles, slightly numb pain down to my testicle. Frankly, that I could handle though as I've written it's annoying. But this pain in my leg, it's hard to ride half my normal speed and sometimes any more than five miles. I await an appointment with a pain specialist to get a nerve block or do whatever else he prescribes. Let's hope I don't have to resort to another surgery to clip the nerve -- that wouldn't happen until I'm a year past the hernia surgery, the surgeon says.

 

[herniatalk]

Sorry to hear that. No problem, best wishes with everything!
I saw that you posted already

I'm sure she will get back to you very soon!

 

[Number3]

Believe it or not, I'm about to go under tomorrow for my third right hernia repair. First one was 14 years ago and the second one 10 years ago. Both times, I pushed things too early and severely weakened the repair. The doctor is saying 6 weeks without any exercise and I'm listening. It was good to read your posts to remind me what awaits. He is trying keyhole surgery as an initial technique so I'm hopeful of a quicker recovery. I'll keep you posted of the progress as I'll have a bit of time on my hands. Sad thing is was that we had a trip to the French Alps in 10 weeks. For all those keen to over push, this can be one of the consequences. Cheers

 

[nahho]

Good luck, Number3. 10 and 14 years ago, you had open surgeries, I take it? And with mesh?

The hypothesis on my leg nerve pain actually is now a degenerated disc in the spine -- a separate problem, though loosely related as the nerves that go through the groin also are in play. I'll be getting an epidural for the acute pain, then an MRI to examine my back more closely.

Though this is really unrelated, I'm starting to think my three problems -- collarbone break, hernias and now this nerve pain -- all are linked in a dominos-falling kind of way. Or like an old house -- peel away one thing, you find another.

My physical therapy, which involved new use of the internal oblique, may have contributed to my hernias (oblique is connected to the inguinal ligament and canal). As I recovered from the hernia surgery, while riding I may have put a little more pressure on my back, especially on hills. That exposes weak disc ....

 

[tottenham21]

Hi everyone, I just had my surgery 5 weeks ago, haven't gone to the gym or gone cycling since & I really miss it, everywhere I read & even my doctor said wait 6 weeks which will be next Wednesday but for some reason I'm very scared of re-injuring myself, I have changed my diet greatly so lost alot of weight but I would like to get back into the swing of things &get in better shape by toning up, thinking about starting to ride just around my neighborhood for a few miles and go back to the gym after my 6th week mark..this whole ordeal with the inguinal hernia is just a major pain in the ****.