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View Full Version : time to heal, full stomach midline incision



quicklime
08-02-2010, 10:55 PM
I have done a fair job finding other bits of info thus far but now I'm stumped:

MC was stabbed. Lost their left kidney, in operating they had to do some exploratory, plus this was in 1990 or so, when the holes they cut were bigger. End result is they split him with a midline abdominal incision to check damage and remove the kidney.

1. How long with a midline like that until bandages come off?

2. How long might it bleed from stress before it is healed?

3. How long would a person be expected to be in crutches? In serious pain?


Thanks to anyone who can toss a few experiences in.

JulieHowe
08-02-2010, 11:34 PM
In 1987, I had my gallbladder and appendix removed at the same time. There was no need for crutches, although to this day I have a huge abdominal scar, and it was two or three months before the infected incision fully healed. I was also in the hospital for at least a week, something which rarely happens with gallbladder surgery today.


The pain was minimal, but I was a child at the time, and for months before the surgery, I had been in excruciating pain, so I never took any of the post-surgery painkillers the doctor prescribed, because the recovery pain felt great in comparison. This situation with pain probably isn't typical. I also had an I-told-you-so vindication, because for months, caretakers had insisted the pain was all in my head.

thothguard51
08-02-2010, 11:50 PM
'87 must have been a good year for gallbladder removal. I had mind done in 87 as well and they were worried about gangrene so they did a full abdominal cut - breast bone to belly button. I was in the hospital for a week then and they used surgical staples to stitch me back together. I was sore, but not to the point of extreme pain.

I was back at work in about 3 weeks, but it was years before I could say I was fully healed to the point I where I did not feel nauseous whenever wrestling with the kid and one of them would poke me in the stomach and think it was funny to watch dad double over.

To this day, I still have the scar, plus a new one. A scar that big does not complete go away. Thing is, until you get better, you don't know how sick you really were before the operation...

stormie
08-02-2010, 11:52 PM
My husband had surgery (most of his large intestine removed) with an incision going from his navel all the way down. This was in 2002. It looked like thick thread for the stitches. Right after recovery he felt like he'd been hit by an 18-wheeler. He was in the hospital eight days (he was in his early forties). Morphine barely touched the pain at first. They gave him a morphine pump so he could use it when needed, except I believe it's programmed not to allow the pt. to OD. After about five days, they put him on a somewhat milder pain killer, Percocet. After ten days he was on 800mg of Ibuprofen. No crutches, but he felt a lot of pressure in his abdomen for about two weeks after surgery. Hard to walk but he had to. Some leakage (a watery fluid) from the site even after ten days. The stitches came out about two-three weeks after surgery, then large pieces of gauze taped onto the site.

He made the mistake though of lifting something heavy during the second week of recovery. He ended up with a hernia. There should be no lifting for six months.

He was back at work three months after surgery.

quicklime
08-02-2010, 11:54 PM
'87 must have been a good year for gallbladder removal. I had mind done in 87 as well and they were worried about gangrene so they did a full abdominal cut - breast bone to belly button. I was in the hospital for a week then and they used surgical staples to stitch me back together. I was sore, but not to the point of extreme pain.

I was back at work in about 3 weeks, but it was years before I could say I was fully healed to the point I where I did not feel nauseous whenever wrestling with the kid and one of them would poke me in the stomach and think it was funny to watch dad double over.

To this day, I still have the scar, plus a new one. A scar that big does not complete go away. Thing is, until you get better, you don't know how sick you really were before the operation...


no crutches? And how long was the incision bandaged? Or was it never? How long until you could do anything even remotely resembling heavy lifting?

Thanks, both of you

stormie
08-02-2010, 11:56 PM
quicklime--we must have cross-posted. Drs. say six months of no heavy lifting when it's major surgery.

thothguard51
08-03-2010, 12:08 AM
no crutches? And how long was the incision bandaged? Or was it never? How long until you could do anything even remotely resembling heavy lifting?

Thanks, both of you

They had light gauze over the incision when I went home. I could not shower for several days, so wifey had fun sponge bathing me in the shower...

As far as lifting, nothing over 10 pounds if I remember right. I would say I was back to normal, lifting things in about three months. I was in my late 30's.

Now, for my quadruple bi pass, I was more like six months, and I was in my late 40's when that happened. Because my age was younger than most patients who have this work done, my recovery was quicker.

I remember both times, the night nurse woke me and told me I had to get up and walk. The more I got up and walked, the sooner I could go home. I was under drugs and afraid I was rather rude to her about what she wanted me to do...

"Are you f...n kidding me lady. Do you know what they just did to me today?"

An hour later I got up and walked to the door of the room and waved to her at the nurses desk and she smiled at me. God, it seemed to take an hour just to get out of the bed. Rolling over was no fun and then there was all the wires and bags and stuff.

What really hurt, and I remember to this day, is when they took the catheter out... I didn't scream, but wanted to, and even now I shiver when I think about it. I think the nurses take extra delight in this procedure...

Still, they were all wonderful people...

sheadakota
08-03-2010, 12:12 AM
just wanted to add that if they are removing his kidney- it would not be a midline incision-

For simple nephrectomy or open kidney removal:

You will be lying on your side. Your surgeon will make an incision (cut) up to 12 inches long. This cut will be on your side, just below the ribs or right over the last ribs.
Muscle, fat, and tissue are cut and moved. Your surgeon may need to remove a rib to do the procedure.
The tube that carries urine from the kidney to the bladder (ureter) and blood vessels are cut away from the kidney. The kidney is then removed.
Sometimes, just a part of the kidney may be removed
The cut is then closed with stitches or staples.
For laparoscopic (http://www.absolutewrite.com/forums/007016.htm)laparoscopic surgery:

Your surgeon will make 3 or 4 small cuts, usually no more than 1-inch each, in your belly and side. The surgeon will use tiny probes and a camera to do the surgery.
Towards the end of the procedure, your doctor will make one of the cuts larger (around 4 inches) to take out the kidney.
The surgeon will cut the ureter, place a bag around the kidney, and pull it through the larger cut.
This surgery takes longer than an open kidney removal. Most people recover faster and feel less pain afterwards.
you don't need crutches- you can walk are encouraged to do so- pain meds would be given to control the worst of it - but if all goes well a pt can be discharged in as little as 72 hours post-op

No bandages- just the steri-strips or staples-
no large bleeding afterwards- maybe some oozing from incision- but what do you mean by "stress?" No heavy lifting as already mentioned for several weeks-

quicklime
08-03-2010, 12:30 AM
simple kidney excision they cut through the back, from what I saw elsewhere it looked like for Grade V renal trauma they go in through the front because they check out what else is messed up.

maybe I'm wrong, but that was what I'd seen thus far looking into kidney lacerations

quicklime
08-03-2010, 12:31 AM
no lifting.....he's gonna need a buddy

JulieHowe
08-03-2010, 01:40 AM
no crutches? And how long was the incision bandaged? Or was it never? How long until you could do anything even remotely resembling heavy lifting?

Thanks, both of you

With a stomach incision, there shouldn't be any need for crutches - in fact, crutches would exacerbate the situation and might even be dangerous. In my case, the bandages were on for at least a month, and it may have been as long as two, because I had a bad infection in the incision area. I can't answer the question about heavy lifting. The bandages covering the infected area had to be changed several times a day, but I was able to take care of this myself.

debirlfan
08-03-2010, 02:50 AM
Back in the mid-90's, a friend of mind had his bladder removed on Apr 18th. He was in the ICU for several days, and seriously "out of it" for a couple more. A week after the surgery he was prowling all over the hospital grounds looking for someone to bum cigarettes off of. A day or two later he got out of the hospital, jumped in his car, and went fishing. If I recall correctly, that Memorial day weekend he was playing volleyball with his adult children. (No, the guy isn't normal.)

Linda Adams
08-03-2010, 06:59 AM
Also worth noting--even if the character feels better enough to work, the first couple of days back will be really hard. They might hit midday and suddenly be exhausted. They also might be dragging and overly tired even though they've had a lot of rest. I'm told this is a result of the anesthesia working through the system.

thothguard51
08-03-2010, 07:07 AM
Yep...

It takes time to build back up to a full day because you have been on pain med's and taking naps during the day for recovery.

Otterella
08-06-2010, 06:49 AM
My c-section was a standard low transverse cut, so it's not exactly the same, but similar. I couldn't walk for about a day or so, and could only walk with walker-type support for another couple of days. What was really hard was rolling over in bed. I couldn't do it without help for about three weeks.

I only had bandages on for a day or two, and the staples came out after a week. I had steri-strips on for about another week.

I was on a morphine drip for the first 24 hours or so (I think), and on percocet for another week. Most people take it for longer, but I don't like taking pain meds, especially with a baby to care for. I could hold the baby in bed, but not lift him up for a few days. Even then, I was told not to lift anything heavier than the baby for six weeks.

Beyond the simple incision healing, you'll want to be aware of what an abdominal incision does to the abdominal muscles. These muscles are responsible for a LOT more than we give them credit for, and any weakening will have a ripple effect through the body, especially the lower back. There are exercises you can do to help (google Tupler technique), and if your MC is in PT, you'll want to know more about that.

On the inside, there will be adhesions, which is what happens when scar tissue from one organ sticks to scar tissue from another organ. When I got pregnant again, I could feel these adhesions ripping as my uterus grew. Obviously, you're not going to have that from a stab wound, but you can still feel them if you bend or twist in certain ways.

Nearly four years later, I still have pain and numb spots from permanent nerve damage. It's especially triggered by mental cues, such as the pain and sadness of hearing that someone else had a c-section as well.

blackrose602
08-06-2010, 06:21 PM
My dad had major surgery following a near-fatal car accident in 1985. His stomach had gone through his diaphragm, partially collapsing his left lung, and his spleen was ruptured. Left pelvis also had multiple fractures.

Dad was in the hospital for just under two weeks, though it would have been one week if his fever hadn't spiked unexpectedly (turns out he got Hep C from the blood transfusion). He was on crutches and then a cane, but that was for the pelvis, not the abdominal surgery.

In the hospital, Dad had to hold a pillow over his stomach when coughing or laughing to ease the pain. He was on morphine for a few days, then gradually stepped down to ibuprofen while still in the hospital. By the time he got out, the incision was lightly wrapped and very sore. He'd go through phases of actively hurting (laying on the couch trying to not move), and phases of wanting to be as normal as possible. Within a few weeks he was basically back to his regular activities, including work and starring in a local play.

However, to this day Dad has trouble laying on his stomach for very long. For years he couldn't stand it at all. Now he can for short periods, but has to turn over within a few minutes. He says it doesn't "hurt" per se, it just really bothers him.

ETA: Dad had dissolving stitches, though a few worked their way out. He still has a half dozen staples in his diaphragm and, not relevant to your story but kind of interesting, he's regenerated two spleen stumps that function about as well as a full spleen.

GeorgeK
08-07-2010, 12:42 AM
In the setting of trauma a "stem to stern" midline incision used to be standard (xyphoid process to symphysis pubis). A kidney can certainly be repaired or removed using such an incision. An elective nephrectomy is not done in the setting of trauma which by definition is not an elective procedure. The surgeon will be looking for other trauma during the same surgery. Once CT scanners became standard by the mid 80's younger surgeons started doing more limited laparotomies with a high or low midline incision (running from xyphoid to umbilichus or umbilichus to symphysis). Now there are even protocols for laparoscopic assessment and treatment, in combination with high resolution CT's. It would depend on the year, the age of the surgeon and the capabilities of the facility what would likely happen.

Stem to stern, figure eating solid food in 1-2 weeks, and off narcotics in 6 weeks. Bolsters or buttressing sutures would also be common (big honking monster sutures roughly every 4 inches that go through the entire abdominal wall at least three inches from the incision that hurt every time you twist or bend. They will have all manner of aches and pains for about a year or more for which they will take non steroidals or rest, often only working half time for up to six months post op, with a lot of exhaustion and malaise. They also will likely have little to no libido for 3-6 months as well as sensitive guts in the sense of frequent bouts of mild diarrhea and or constipation.

Smaller or less invasive procedures will have shorter recovery times. The bigger the hole, the more hands in there rooting around, the longer the recovery.