Abdominal muscles after surgery

[Paleowoman]

For those of you who've had OHS via sternotomy or small-sternotomy, is there any effect on your abdominal muscles ? The reason I'm asking is that I think if I practice sit-ups pre op which strengthen ab muscles then it may be easier getting up and down after surgery. Logic tells me that abdominal muscles won't be affected by OHS but I'd rather hear from the voices of experience.

Anne

 

[clay_from_nj]

Only that you might have to go easy on your abs after surgery due to the drain tubes.

 

[RobThatsMe]

I have had two Open heart surgeries, and have continued my workouts through it all. I cannot lift as much as I used to due to some restrictions from my dissection, but as far as my abs go, no problems or issues. After surgery, you will have to start easy though, and only after you have been cleared to do so from your doctor. You need to be sure that your sternum has healed enough to but some stress on it. JMO.

 

[Paleowoman]

Oh I don't mean I want to work out after surgery (obviously I will do at some point), I meant that if my abs are strong now through exercise will that be helpful for getting up out of bed etc soon after surgery - I know I won't be able to push myself up with my arms because of my sternum.

 

[gerrychuck]

I can tell you from experience that nurses in post-op units get very crabby with you if you get up by essentially performing a sit-up with your abs; this DOES put significant stress on your sternum. Lowest stress on everything is to roll on your side, swing your feet off the bed (which then act as a counterweight) and come up sideways with as little assistance as possible from your top side arm. As a physiotherapist, I teach that technique all the time to my back patients, and it requires very little effort. Having said that, strengthening your abs in advance will make the process easier and is most certainly not a bad idea.

 

[T in YVR]

You use alot more than than your abs when you do sit ups. They won't be affected by the sternotomy, but many others are - especially those across your chest/pecs and around the side of your rib cage, as well as those across your upper back/shoulders/neck.

Its absolutely beneficial to get in as good a shape as you can before your surgery, and I too worked on my abs, did loads of sit ups etc. But in the near term after surgery (first 4 or 5 weeks for me), don't expect that doing crunches will help you get up and down that much better. Getting up and down can be quite hard, especially when you get home. They will show you some techniques in the hospital I'm sure (Rolling to your side etc, as Gerry said). And you get very resourceful when you can't really use your arms much on top of this (I would ease my leg over the side of the bed and hook my foot on something to help get leverage. Other people have tried ropes etc, but you can't really use your arms for quite some time). I found it easier to get up and down in the hospital because you can control the bed (raising lower the top/bottom etc). When you get home, its much tougher. But crunch away! It doesn't hurt, and I think it does help as you get a bit further into the recovery.

 

[Paleowoman]

I can tell you from experience that nurses in post-op units get very crabby with you if you get up by essentially performing a sit-up with your abs; this DOES put significant stress on your sternum. Lowest stress on everything is to roll on your side, swing your feet off the bed (which then act as a counterweight) and come up sideways with as little assistance as possible from your top side arm. As a physiotherapist, I teach that technique all the time to my back patients, and it requires very little effort. Having said that, strengthening your abs in advance will make the process easier and is most certainly not a bad idea.

I think I will have a big problem then when I get home as our bed is a futon mattress, just 3 ins deep, directly on the floor, so when I get out of bed I have to, in effect, be able to get up off the floor. The only way I can see to do that is by a sit up and then go over on to my knees and raise myself up from there ? As a physio do you have any ideas ?

 

[Debbrn]

Gerrychuck,

I was a pediatric ortho nurse and took care of a lot of post-op spinal fusion patients. I used the technique you mentioned as work so much it was pure reflex to use it after my heart surgery. That being said. The docs could not believe how easy I moved around. I had to teach both of my cardiologist the technique. They had never heard of it before.

Debbie

 

[AZ Don]

I think I will have a big problem then when I get home as our bed is a futon mattress, just 3 ins deep, directly on the floor, so when I get out of bed I have to, in effect, be able to get up off the floor. The only way I can see to do that is by a sit up and then go over on to my knees and raise myself up from there ? As a physio do you have any ideas ?

I'm sure you will be able to manage. I often see it said on this site to listen to your body in terms of how much exercise you can do, but I think it applies especially well for what you can do after surgery. You will find certain movements are painful and so you should avoid those movements. You will probably be told not to lift more than 5-10 pounds for a month, but I've read a couple articles about this guidance and how vague and unclear it really is. Here is a study that tried to examine the guidance in more depth, including measuring how much force was involved in daily activities (many of which Dr's will say you can do although they require a force exceeding their own guidance): http://www.sportsnutritionworkshop.com/Files/1.SPNT.pdf

What really stuck with me is the quote from this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2566917/

Cardiac surgery patients at a major Texas hospital are told on discharge not to lift anything heavier than a half-gallon of milk (about 4 pounds). The door to the cardiac rehabilitation facility in the same hospital requires a 14-pound pull to open, yet no patients have died or have even been injured from opening this door.

 

[Paleowoman]

Here is a study that tried to examine the guidance in more depth, including measuring how much force was involved in daily activities (many of which Dr's will say you can do although they require a force exceeding their own guidance): http://www.sportsnutritionworkshop.com/Files/1.SPNT.pdf

What really stuck with me is the quote from this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2566917/

Oh wow AZ - those studies are so good and so interesting - I am saving them to my laptop and printing them to take with me to hospital ! Thank you for posting them. I feel more positive already now yes

 

[gerrychuck]

I think I will have a big problem then when I get home as our bed is a futon mattress, just 3 ins deep, directly on the floor, so when I get out of bed I have to, in effect, be able to get up off the floor. The only way I can see to do that is by a sit up and then go over on to my knees and raise myself up from there ? As a physio do you have any ideas ?

That is definitely going to pose a challenge for you. As T notes above, a hospital bed is the ultimate because you can tilt the top half of the bed and make the distance you have to raise or lower yourself significantly less. In addition, the bed is higher than a normal bed, which makes the process of standing up from the bed (and sitting down on it) easier as well. So that's one end of the spectrum. A flat bed, with one of the newer extra deep mattresses (which is what I came home to) is next in line because of the extra height compared to a more traditional mattress provided by the thicker mattress. Third in order of preference would be a more "normal" mattress/box spring with typical height. A futon on the floor is at the far end of the spectrum; much more challenging to get down, and to get up. My main suggestion to you would be to make plans for a temporary alternate arrangement for a few weeks after you get home. Could be a box spring on the floor to raise the height of your futon, could be sleeping on the couch or in a recliner for a while, but I think you will find getting up and down off the floor will be a daunting prospect for the first bit after you get home. A little planning ahead could make life a lot easier for you post-surgery!

 

[T in YVR]

Also bear in mind that for some people (including myself) it was more comfortable to sleep in a reclined position (similar to the angle you might lie in if you were on one of those poolside loungers). I could not sleep on my side for about 3-4 weeks and I could only sleep flat on my back for short periods of time (flat on my back with arms by my side felt like it pulled at my scar and chest muscles). So be prepared to possibly sleep in a slightly more upright position for the first little while.

 

[Paleowoman]

A futon on the floor is at the far end of the spectrum; much more challenging to get down, and to get up. My main suggestion to you would be to make plans for a temporary alternate arrangement for a few weeks after you get home. Could be a box spring on the floor to raise the height of your futon, could be sleeping on the couch or in a recliner for a while, but I think you will find getting up and down off the floor will be a daunting prospect for the first bit after you get home. A little planning ahead could make life a lot easier for you post-surgery!

I will have to sleep on the sofa in the living room then…that shouldn't be a problem to arrange, just not as comfortable as I'm used to

 

[Rachel]

I will have to sleep on the sofa in the living room then…that shouldn't be a problem to arrange, just not as comfortable as I'm used to

Do what you need to do....just remember - it's only temporary!!!!

 

[Jkm7]

Pillows...... lots of pillows.
I learned from my first OHS how lots of pillows for me to nestle in provided the most comfort and made sure to have a selection of various sizes when I had my second OHS. They made a big difference in my being able to get comfortable and sleep.

 

[mbeard]

I so thank you for reminding me of the value of different size pillows. My husband just had back surgery so pillow sizes will help him too. And I know I must start breaking in new pillows right now.

 

[chaidell]

Strong abs are definitely useful! For me, the biggest advantage you'll have in the healing process, is getting off the Pain killers completely asap.

 

[AZ Don]

Strong abs are definitely useful! For me, the biggest advantage you'll have in the healing process, is getting off the Pain killers completely asap.

This just reminded me that in the hospital and shortly after there were some times that I didn't feel so well. Not that I was in pain though. I found that taking the painkiller at these times helped. Rx while in the hospital, ibuprofen once I was home.

 

[DebbyA]

Once you've mananged to get to the edge of the chair or bed, you'll find that strong leg muscles will help you rise from a seated position without putting weight on your arms--at least I did. I'm just a walker, too.