Inguinal hernia - time to recover?

so my surgery is set for May 7 and I just got a call from the surgery nurse with some more pre-op instructions. Only one took me by surprise. no analgesics or nsaids for 5 days prior. as someone who has taken at least 600mg/day (ibuprofen, usually 1200mg and often 1800mg) since my knee injury in 2014 this terrifies me.
They seem acutely interested in managing pain after the surgery but don't seem to give a fuck pre op. How important is this? Clearly emergency surgeries happen all the time when folks have taken ibuprofen and this is the first time in all my surgeries I have heard of this.

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Originally Posted by powdork

so my surgery is set for May 7 and I just got a call from the surgery nurse with some more pre-op instructions. Only one took me by surprise. no analgesics or nsaids for 5 days prior. as someone who has taken at least 600mg/day (ibuprofen, usually 1200mg and often 1800mg) since my knee injury in 2014 this terrifies me.
They seem acutely interested in managing pain after the surgery but don't seem to give a fuck pre op. How important is this? Clearly emergency surgeries happen all the time when folks have taken ibuprofen and this is the first time in all my surgeries I have heard of this.

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I'm not a doctor so no idea if this is valid, but I was told not to take anything that could thin the blood for a few days prior to the surgery as well. The exclusion list included fish oil, among others.

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Originally Posted by powdork

this is the first time in all my surgeries I have heard of this.

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It's been part of the pre-op instructions for the three surgeries I've had since 2007. Seemed pretty obvious to me why they would be concerned about things that could cause or contribute to uncontrolled bleeding. You can still take acetaminophen for pain.

I wasn't aware I could she just lumped all the analgesics together in the instructions. Aspirin I figured. I didn't know ibuprofen thinned the blood like aspirin. i've avoided acetaminophen long term since my liver is already under constant attack, but it works (haven't had much luck with aleve). I can go there for a few days and then i assume it'll be in whatever narcotic they give me after


edit- and damn that sucks no fish oil. i think. how do i get fish oil again? anyway, sucks i can't have it.

I've never told patients to stop NSAIDs and aspirin before surgery. (Maybe they were getting generic instructions from surgery scheduling with that instruction and I didn't know about it.) If someone is on aspirin for their heart or stroke prevention they should definitely not stop it for surgery. The anesthesiologist who does my epidural spinal injections doesn't mind NSAIDs and aspirin. I would say that the advice you got is cautious. Keep the Tylenol at 3 gm/d or less; a few days should be fine for your liver. BTW, there is an extended release acetaminophen --lasts 8 hours instead of 4. I eat the stuff like candy. Sometimes marketed as "arthritis relief".

I assume that by under attack you mean you drink a lot. I would cut way back (max one drink or beer/day) or stop before surgery--now would be a good time. The body works better when the liver works better--for one thing, when you drink a lot your liver detoxification mechanism is revved up, which means sedatives and pain meds during and after surgery are metabolized faster; ie they don't work.
For hernia surgery none of this is a big deal; for bigger operations it is.

As far as the fish oil this review of multiple studies found no increased risk of bleeding https://www.ncbi.nlm.nih.gov/pubmed/28552094 but the anesthetist doesn't want to smell your fishy breath.

I was supposed to have my easy surgery at 10 and be ready to go home at 1. Finally got wheeled in at 1 and was finished with the surgery at 4ish. Turned out she fixed 3 hernias and removed a lymphoma from the spermatic cord.
Pain was super bad when I got out I think at least partially because the presurgery oxycontin had already worn off since they gave it to me at 10:30. Also because it ended up being a lot more work in the area. I wasn't able to pee after so I stayed for a while and then around 11 they sent me home with a catheter. Errrg

Lymphoma? Woah dude. The hernia sounds like it was a blessing in disguise. Heal fast!

The nurse made it sound like a fatty deposit but id didn't get to talk to the surgeon cause after me she ended up with another 6+ hour surgery.

Just spoke to the doc. It was fatty tissue that might have had a lymph node in it

You probably passed out from anxiety as a result of pain. Cannabis and caffeine make anxiety attacks much worse. How's your blood pressure? Good luck.

Was an error in communication. Nurse said lymphoma, talked to doc today and she explained it was little fatty deposit but she thought there might have been lymph node inside.

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Originally Posted by 4matic

You probably passed out from anxiety as a result of pain. Cannabis and caffeine make anxiety attacks much worse. How's your blood pressure? Good luck.

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If you're talking about when i first passed out it wasn't really from pain. There was pain but mostly nausea. i was walking around the back of the car to lay down in the back to try and keep from throwing up and just passed out. BP is about 130/75
Regarding the marijuana however the nurse said part of the reason i was in so much pain after the surgery had to do with THC attaching to the same receptors as the hydrocodone.

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Originally Posted by powdork

Was an error in communication. Nurse said lymphoma, talked to doc today and she explained it was little fatty deposit but she thought there might have been lymph node inside.

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Maybe nurse said "lipoma"--as in lipoma of the spermatic cord, which isn't really a lipoma (benigh fatty tumor) but just a lump of normal fat. Hope you're feeling better soon.

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Originally Posted by old goat

Maybe nurse said "lipoma"--as in lipoma of the spermatic cord, which isn't really a lipoma (benigh fatty tumor) but just a lump of normal fat. Hope you're feeling better soon.

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that certainly could have been it. doc said it was a lump of normal fat that had something hard in it that could have been a lymph node.

off the opiates and onto ibuprofen and edibles. maybe i'll poop soon. :rolleyes:

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Originally Posted by powdork

off the opiates and onto ibuprofen and edibles. maybe i'll poop soon. :rolleyes:

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maybe

'twas a big day. pooped in the morning before heading to the clinic where the foley was removed and the bladder got it's chance to shine. feeling human again.

heading to my post op appointment in a few minutes. just got back from a quick tour since it snowed about 4" last night and i've been going crazy. still a little sore stiff and swollen on the side with the most work but everything is working fine. plus it's better to ask forgiveness than permission...

eidt - apparently i was 33 days too early (and climbing yesterday i was 34 days too early).

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Originally Posted by powdork

heading to my post op appointment in a few minutes. just got back from a quick tour since it snowed about 4" last night and i've been going crazy. still a little sore stiff and swollen on the side with the most work but everything is working fine. plus it's better to ask forgiveness than permission...

eidt - apparently i was 33 days too early (and climbing yesterday i was 34 days too early).

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I wouldn't worry about it. The hernia repair is as strong as it's every going to be when you get off the operating table. If you do too much too soon you'll hurt yourself but not harm yourself. But don't tell her I said that; my kid goes back to Barton next month and she might figure out the connection and give him a hard time. : -- )

kind of what i figured. She (the PA I met with for post op, not the surgeon) said the stitches would takes 6 weeks to heal and I was like whaaaaaaaat?

Skiing felt fine afterward but that night at work (6 hours on my feet) which was ok'd by the doc destroyed me.

this is the part that scares me now. Since that night at work two nights ago the side that hurts is the left side, which had a small hernia but wasn't the problem side. what scares me most is the intense pain with even a slight cough. And it's the feeling that the intestine is bulging against the mesh causing a searing pain that has me worried.
Should i be?

I had the same experience with a double inguinal hernia two years ago. I went in with an obvious hernia on the right and the surgeon said she would check the left while she was in there and repair it if she found one. She found one and fixed it. The pain after initial recovery was mind-bending on the left and nothing too bad on the right. It reached the point where I had to call a taxi to take me back to her office, which I crawled into. She said what does it feel like? I said it felt like she ripped me in two and she said basically that's what it was like. I was born with double inguinal hernias and had them repaired as an infant in 1956. She said there was a mess of scar tissue that she had to rip her way through to implant the mesh. She said that everything was fine and I should just be patient. And she was right. It did get better.

I have a hard time remembering how long it took because I experienced a much greater trauma about 3 weeks after the surgery when I collapsed while walking around my neighborhood 45 minutes after dinner and flatlined in the ambulance. I spent several days in the cardiac ward with all these docs telling me I'd had a heart attack until the cardiologist came in and said he didn't think so. Angiogram proved he was right--no damage and no blockages. I had collapsed with anaphylactic shock from an allergic reaction to something I ate. A year of testing at National Jewish led to the most likely culprit, saffron. I made paella that night like I had been doing every Friday for years. In retrospect, I do recall some weird chest sensations and syncope events after those meals but never connected it to a possible allergy. I've had none of those feelings since. It remains a mystery why it resolved without epi being administered but my thinking is that the quantity of saffron was really small and was likely buffered by the rest of the dish and the ice cream I ate for dessert. It caused a vaso-vagal response that collapsed one of my coronary arteries as I went into anaphylaxis. I remember one thing. I was trying to breathe and it was like I was in the vacuum of space. No air whatsoever would pass my throat. It was instantaneous, 45 minutes after dinner.

My heart is fine and I climbed and skied the Emperor Face on Torreys (14er...I lived in Colorado then) about 6 weeks after that incident. By then the hernia was fine as well. I still feel the mesh on both sides and sometimes get some flashes of pain but really it's ok now. That's just how it went for me. It was a rough spring that year.

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Originally Posted by telepariah

I had the same experience with a double inguinal hernia two years ago. I went in with an obvious hernia on the right and the surgeon said she would check the left while she was in there and repair it if she found one. She found one and fixed it. The pain after initial recovery was mind-bending on the left and nothing too bad on the right. It reached the point where I had to call a taxi to take me back to her office, which I crawled into. She said what does it feel like? I said it felt like she ripped me in two and she said basically that's what it was like. I was born with double inguinal hernias and had them repaired as an infant in 1956. She said there was a mess of scar tissue that she had to rip her way through to implant the mesh. She said that everything was fine and I should just be patient. And she was right. It did get better.

I have a hard time remembering how long it took because I experienced a much greater trauma about 3 weeks after the surgery when I collapsed while walking around my neighborhood 45 minutes after dinner and flatlined in the ambulance. I spent several days in the cardiac ward with all these docs telling me I'd had a heart attack until the cardiologist came in and said he didn't think so. Angiogram proved he was right--no damage and no blockages. I had collapsed with anaphylactic shock from an allergic reaction to something I ate. A year of testing at National Jewish led to the most likely culprit, saffron. I made paella that night like I had been doing every Friday for years. In retrospect, I do recall some weird chest sensations and syncope events after those meals but never connected it to a possible allergy. I've had none of those feelings since. It remains a mystery why it resolved without epi being administered but my thinking is that the quantity of saffron was really small and was likely buffered by the rest of the dish and the ice cream I ate for dessert. It caused a vaso-vagal response that collapsed one of my coronary arteries as I went into anaphylaxis. I remember one thing. I was trying to breathe and it was like I was in the vacuum of space. No air whatsoever would pass my throat. It was instantaneous, 45 minutes after dinner.

My heart is fine and I climbed and skied the Emperor Face on Torreys (14er...I lived in Colorado then) about 6 weeks after that incident. By then the hernia was fine as well. I still feel the mesh on both sides and sometimes get some flashes of pain but really it's ok now. That's just how it went for me. It was a rough spring that year.

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Scary. At least you're allergic to something that you won't run into very often, although I do like my saffron and it sounds like you did too.

mine too has healed well. in fact it's even been a while since I felt the mesh.

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Originally Posted by old goat

Scary. At least you're allergic to something that you won't run into very often, although I do like my saffron and it sounds like you did too.

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I'm also allergic to all tree nuts, so it has been a scary life all along. I don't go anywhere without epipens, though I did go out for that walk without that night. Never more.

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Originally Posted by telepariah

I'm also allergic to all tree nuts, so it has been a scary life all along. I don't go anywhere without epipens, though I did go out for that walk without that night. Never more.

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Given the price of epipens I could see someone having an allergic reaction and waiting to see how serious it was going to be. Hope yours are covered.

I live in Japan. Just got a refill plus two other meds for about $40. US health care is fucked.

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Originally Posted by telepariah

I live in Japan. Just got a refill plus two other meds for about $40. US health care is fucked.

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Fake news. Nah nah nah nah nah I can't hear you.

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Originally Posted by old goat

Scary. At least you're allergic to something that you won't run into very often.

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Ha, had to laugh at this ^^^, because of this:

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Originally Posted by telepariah

I'm also allergic to all tree nuts,

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Telepariah, that event you describe with the saffron, is that the one that happened just a few years ago here? Or a different event? I know you've had eventful life.

Saffron flatline was April, 2017.

it's only a matter of time before anyone searching for anything about saffron and flatline ends up here

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Originally Posted by powdork

it's only a matter of time before anyone searching for anything about saffron and flatline ends up here

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Posting in ALL CAPS

My work is done here. ;-)

Hello All,

I figured i would refresh this thread and share my experience for any of those who find it via Google like I did. I am four days in after double (both sides) inguinal hernias were repaired via a laparoscopic procedure. The doctor says i should be good to ski in the middle of December (about 3-4 weeks in) but we will see how it goes. I have heard as few as 3 weeks to skiing as as long as 8 weeks. For now, i will update you on my first four days.

We are very lucky to have good hospitals here in Cleveland, OH and the surgery went smoothly with a doctor that is very experienced in laparoscopic repair. Doing some reading on open vs. laparoscopic it seems like you want someone experienced to do the laparoscopic procedure. Even though it went smoothly once you have your wits about you post-surgery you realize everything below your belly button hurts. I think i underestimated the procedure given how many are done a year and how easy the doctors made it sound, but its painful. It felt like i just did 10,000 sit ups.

In the first few days i made sure to keep up with the pain pills to not let it get away from me. I alternated ibuprofen and Vicodin and then swapped to just ibuprofen after 2 days. I think whatever you do, moving is going to hurt and laying still feels pretty good.

I know i am supposed to walk as much as i can to help get blood flowing and to help with recovery, but for now i get pretty winded easily. I have done a few 0.4 mile walks and that's about all i can handle. Stairs are fine, its really standing straight up, stretching those stomach muscles and taking full strides that hurts.

Now on day four i have been better every day. it still hurts but that "10,000 sit ups" feeling is gone. I am now most focused on the swelling around the actual hernia sites and some lesser pain around the incisions. Still painful but im able to more of a normal human being.

I will re-post in about 4 weeks to give an update on longer recovery times. I hope by that time i am asymptomatic and can start training again in preparation for some January/February ski trips. I'm most afraid of hitting the slopes without my normal workouts and tearing an ACL, but ill check back and let you know how it goes.

The length of time it takes to get back to normal activity after hernia repair is highly variable. Hope the 3-4 weeks works for you. You'll probably hear from someone who was back to crossfit in a week and someone who was off desk work for 2 months. Good point about getting into skiing shape before you ski--you lose it a lot faster than you get it back. Good luck.

Hello All,

I figured I would give a 7 week update as we head into ski season. Unfortunately I havnt skied yet as we’re having a terrible year in the Midwest (again). I have however been working out in prep for an Alta/Snowbird trip in early Feb.

Bottom line is that I was back to normal activities around the middle of week 2 (working, travel, long walks) but it took til about week 4 to start any real physical activity and I didn’t start bodyweight leg workouts until weeks 5/6. Currently, possibly due to the bodyweight workouts I’m doing, I’m still feeling stiffness and soreness in the general area almost 2 months out. I don’t think it will keep me from skiing at all but I’m a bit surprised I’m not fully back. I have read that I can take up to 6 months to be fully there. Either way, the timelines you read online were pretty much right.

Even though there here is some soreness post 5 weeks it hasn’t stopped me from cycling, light running, body weight workouts, swimming, and jumping. I now look to skiing as well and will report any problems.

Bump. About 3 years after repair I managed to reinjure the hernia. It's small and doesn't really bother me, but I do have another one in my abdomen as well. I feel like I did it coughing but hard to say...I'm pretty active; ski tour, surf, weight train, don't really want to stop. 50th is coming up in a couple months and had some plans...

Birthday or anniversary? Either way, if it's not bothering you and not getting stuck feel free to wait on it until after your plans. Now about those plans--have you heard about this pandemic . . .

I assume you had an open repair as planned. Good chance that if you do have a recurrence they'll recommend a laparoscopic repair--that fixes the hernia from the back side, avoiding the scar tissue from the first operation. Can be done either way though.