Pacing Yourself After Surgery

One of the hardest things in recovering from surgery and getting back into outdoor activities is knowing how to pace yourself. There are times in the months after surgery when there are clear lifting restrictions and guidelines, which provide easy-to-understand parameters for your activities. However, once those restrictions are lifted and you are feeling ready to get back to your normal sport routines, the path isn’t as clear.

Though it may seem like I am doing a lot of outdoor activities since surgery, I have paced myself very slowly. I started out with many short walks. When those felt good, I moved on to longer and steeper excursions. On the hike to Mt. Elbert covered in this video, my legs got extremely tired on the hike out, and I thought perhaps I had overdone it. Still, within three days, my sore muscles had completely recovered–a sign to me that the hike, though strenuous, was not at a level that pushed me too hard. By the next weekend, my muscles were feeling great and ready for a new adventure.

The following is a list of additional things that I am doing to prevent injury:

  • I always wear my Nu Hope hernia prevention belt when I do any outdoor activity beyond a short, flat-terrain day hike when I am carrying no significant weight (say 10-15 pounds).
  • I have my husband, Doug, help me lift my heavy backpack on to my shoulders. Once it is resting on my hips, I am better able to handle the weight without straining my abdominal muscles.
  • I use hiking poles to help with my stability as I get stronger.
  • I leave for hikes extra early to allow myself the ability to hike at a slower pace with more frequent breaks.
  • I pay very close attention to my body. So far I haven’t witnessed anything more than normal post-workout muscle aches. However, if I feel something more significant, I will back off and give my body more time to adjust to the next level of activity.
  • I am working with a physical therapist to strengthen my core muscles using very mild and low-impact exercises that are safe for the level of healing I am at.

My goal for the fall is carrying out a week-long backpacking trip with a few peak ascents. Hopefully with my training regime, I will be ready for this challenge.

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5 thoughts on “Pacing Yourself After Surgery

  1. Hey there – catching up on your recent posts and ran across this. You mentioned you wear a hernia belt when doing anything more than light activity. I’m just over six months post-op and wanted to compare notes on the impression you have for how careful we ostomates should be with respect to exerting our core.

    Do you wear the belt for prevention or to help with an existing hernia? I’ve been more active in the past few months than I have since I was a kid (if ever!) One thing I started again is some weightlifting and about a month ago I even started doing situps, leg lifts and crunches. Pullups still hurt a bit so I’m easing into those. But I do all this without any hernia protection.

    Again I haven’t had any problems so far, but this is always something in the back of my mind. The impression I’ve been left with when I’ve asked about hernias is basically “it’s always a possibility, but you shouldn’t worry.” So I don’t and I’m taking the attitude a strong core is itself a preventive measure. Thinking the facts that I’m relatively young, had a fantastic surgeon and uncomplicated recovery are working in my favor as well.

    Still at times I wonder if this attitude is a bit cavalier. So I’m wondering what impressions you’ve been left with and what your experience has been?

    Great blog! Keep having fun and enjoy the fall colors!!!

    1. Hi Matt,

      I am so glad to hear that you have been so active again after surgery. Thanks for the great question. This is actually on my list of things to write a post on in the future.

      I do not have a hernia. Still, getting either a parastomal or incisional hernia is one of the things I am most afraid of after surgery. However, I don’t let that fear stop me from pursuing the active things I love in a reasonable manner. I think the risk is a bit dependent on the individual as well. I had some complications with my incision healing after surgery due to a rare reaction the slow-dissolving internal sutures used in my abdominal wall. My surgeon said I had a slightly higher risk of an incisional hernia due to this, though it eventually healed really well so I am not sure if this is still the case. I wear the Nu Hope belt as a preventative measure when doing anything remotely strenuous. I am not sure how long I should use it, but since it is so comfortable, I figure I will just keep wearing it for now.

      The impression I got from my surgeon and stoma nurse is that hernias are a risk with an ostomy, and to be smart but not overly anxious about them. I was told by my surgeon that I would be able to do strenuous things like rock climbing and crunches eventually, but to be reasonable and listen to my body. So, the strategy I have adopted is to be cautious and ease back into things slowly. I have plenty of time and am incredibly happy to be out there doing anything at this point. I agree that a strong core is important to prevent problems, so I work to strengthen mine doing plank exercises with a stability ball and a few other exercises my physical therapist gave me. I haven’t done crunches yet. When carrying an overnight backpack this summer, I started with lighter weights between 30 and 45 pounds. On my most recent 8-day trip (which I am currently working on a video of), I was able to carry 54 pounds. My husband still helps me lift the pack on my back though, just to be on the safe side. Once it is centered on my hips, I can carry it no problem.

      In the beginning of October, I plan to start rock climbing again in the gym. I am going to start on super easy routes with huge holds and go from there.

      I would guess that there are many people who are more cautious and avoid certain activities altogether, and others who don’t worry about it at all. Again, my approach is to be prudent and careful, but not to let fear of a hernia stop me from doing the things I love. That is the reason I had the surgery in the first place… to get my life back!

  2. Hello Heidi….just discovered your site from a freind’s research. I’m new at this with my 9 mo old ileostomy…and have question not related to hernias but definitely in your area of experience. When you wear your backpack, do you cover your stoma with protection? I find I cannot cinch the waist belt up to offload the pack weight onto the pelvic area, since it comes directly across Jake (my stoma). What would you suggest I try? I’ve seen videos about stoma guards and armor advertized in Phoenix magazine, but they are pricy to blindly experiment with. I also was thinking about going to a custom pack maker, but am skeptical if I could find one sensitive to an ostimate’s special condition. Your enthusiam is shared by me who is living life more enthusiastically than ever before. Thanks for your website. Mike

  3. Hi Mike,

    Thanks for the great question. Fortunately, I knew about my surgery ahead of time and could plan a bit. I brought my backpack to my stoma placement meeting, so I was able to get a location that was a couple of inches below the waist belt of my favorite overnight pack. Because of this, I can go without a guard.

    I did, however, purchase this one right after surgery to protect my stoma from my car seatbelt: http://www.cmostomysupply.com/cm_html/p_stomspt.html. It is comfortable, but the belt on it doesn’t stretch much, so I find it doesn’t stay in place very well and rides up. I have a narrow waist compared to my hips though- it might stay in place better for a guy. I intended to try it for climbing and backpacking, but since I haven’t really had problems with my harness or backpack putting pressure on my stoma, I haven’t tested it yet.

    My friend Paul over at the site “Living Bigger with a Colostomy” did a review of the Freedom-Guard from StomaPlex. Perhaps if you contact him he could give you feedback on how this product might work for backpacking. http://www.livingbiggerwithcolostomy.com/2012/06/hockeygear-stomaguard.html.

    Getting a custom pack made sure sounds like a good idea too if the guards end up being too bulky. I would probably only want to go that route if I could meet with the designer in-person. It would be hard to describe your unique fitting needs with an ostomy otherwise.

    Sorry I couldn’t be of more help. The trial and error involved in finding what works can be so difficult and expensive. I have spent money on stuff that ended up not working for me, even though it works great for others. Ostomy equipment is such an individual thing. I used to get really bummed when I wasted money on something that I ended up not being able to use. Now I try to look at it differently. I am going to have this ostomy for the rest of my life. I might as well invest some money in trying to find the products that work best for me even if I get a dud once in a while:)

    Best of luck in finding a backpack system that works for you!

    Cheers,
    Heidi

    1. Hi Heidi,,,
      Thanks much for your reply…. I had been looking at Stoma Guards from Stomaplex and had visited “Livingbiggerwithcolostomy”…I was intrigued by the custom made guard, which I may eventually attempt. In the meantime I’ll probably try the “pure comfort stoma guard” from Stomaplex. Thanks for the link to the other site.
      Unfortunately, by the time I had surgery for a permanent ileostomy, I had already undergone 6 surgeries since I was i my 40ies and there was only one place to locate my stoma (Rodney)…. thus the need to explore creative backpack use options. I’ll keep you updated on what I find.
      A couple of my own suggestion for your readers…I do use “wraps” from ostomysecrets.com which work very well for supporting the bag and for activities such as swimming. I’ve tried the “Stealth belt” but find it more difficult to use.
      Just shows how diverse, unique and special we ostomates are.
      Really am happy to have found you website… your thoughts and the comments by others have been informative, encouraging, and comforting.
      keep hiking my home state…Colorado!
      Mike

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