Patient guide

What to bring

• Ultrasound, CT and earlier test results, with the images themselves if you have them
• Reports of earlier operations, especially on the abdomen
• A list of all your medicines, including blood thinners, diabetes medicines and supplements
• Any drug allergies and past problems with anaesthesia
• Any history of heart or lung disease, diabetes, high blood pressure and smoking

Note down before the visit

• When the bulge or pain started and what makes it worse
• What it stops you doing day to day
• How much lifting your job involves

What happens in the examination?

For a hernia, the doctor examines the groin or abdomen while you stand and lie down, and may ask you to cough. Wear comfortable clothes. If you would like someone with you, say so.

What to ask

• What exactly is my problem?
• What happens if I do not have surgery?
• What are my options, and what are the risks and benefits of each?
• What kind of anaesthesia is needed?
• When can I go back to work and exercise?

This guide is general. If your doctor or hospital tells you something different, follow that.

Medicines

Do not stop any medicine by yourself. Ask ahead about blood thinners, aspirin, diabetes medicines and herbal supplements: which should continue and which need adjusting.

Fasting

Before anaesthesia you must not eat or drink for a time, because a full stomach is dangerous. Ask the hospital for the exact times and follow them.

Smoking and other illnesses

Stopping smoking before surgery helps the wound and the lungs, and the sooner the better. Blood sugar and blood pressure should be under control. If you get a fever, a cold or a skin infection in the days before, tell the doctor.

For the day of surgery

• Arrange someone to take you home; do not drive after anaesthesia
• Leave off jewellery, nail polish and contact lenses
• Wear loose clothes
• Bring your documents, test results and medicine list
• Arrange help at home for the first days

Before you sign the consent form

You should know what operation is being done, why, what the risks are and what the other options are. Ask anything you need to, then and there.

What is common?

• Mild pain and bruising around the cuts
• Bloating and a feeling of fullness
• Pain at the tip of the shoulder; the gas used to make room in the abdomen causes it, and it usually eases within a few days
• Tiredness and sleepiness after anaesthesia
• A little nausea in the first hours

What helps?

• Take painkillers as your doctor says, and do not wait for the pain to get bad
• Start short walks early; this helps the circulation and the bloating
• Eat light food and go back to normal meals bit by bit
• Drink enough, and ask the doctor about constipation, because straining puts pressure on the area

After anaesthesia

For the first 24 hours do not drive, use dangerous machines or make important decisions. It is best to have someone with you during this time.

What is not normal?

Growing pain, fever, repeated vomiting, redness or discharge from a wound, jaundice, a swollen leg or breathlessness are not normal. See the urgent signs.

Dressings

Wash your hands before touching the wound. Change the dressing as the doctor says, and keep it clean and dry.

Showers

Ask the doctor when you can first shower. A shower is usually better than sitting in a bath. Pat the wound dry and do not put cream or ointment on it unless the doctor has said so.

Stitches and strips

Some stitches dissolve and some need to be taken out. Ask which you have and when they should come out. Do not pull off the strips on the wound; they usually come away by themselves.

Drains

If you go home with a drain, note the amount and colour of the fluid as the doctor says, do not pull on the tube and keep the area clean. Do not take the drain out yourself.

What to report

Growing redness, warmth, swelling, pus or a bad smell, wound edges coming apart, bleeding that does not stop, or fever.

Help at home

Dressing changes, stitch removal and drain removal are among the support services. Call the support number to arrange them.

Recovery depends on the operation, the method, your age and your job. A number that was right for someone else may not be right for you, so ask the doctor for your own times.

Walking

Walk from the first days and do a little more each day. Complete bed rest does not help and raises the risk of a blood clot.

Lifting

After hernia or abdominal surgery, do not lift heavy things until the doctor says so. This includes buckets of water, heavy shopping and small children. When you cough or sneeze, press gently on the wound with your hand or a pillow.

Driving

Drive again when you can brake suddenly and wear the seat belt without pain, and when you are not taking medicines that make you sleepy.

Going back to work

Desk work is usually possible sooner and heavy work later. Describe your job to the doctor, and ask for a letter at the time if you need one.

Exercise and sex

Start light exercise when pain no longer gets in the way, and heavy exercise with the doctor’s advice. Go back to sex when you feel comfortable.

Go to the emergency department or call 115

• A hernia bulge that has suddenly become hard and painful and will not go back, especially with nausea or vomiting
• A change in the colour of the skin over a hernia
• Severe sudden abdominal pain or a hard abdomen
• Repeated vomiting with bloating and no passing of wind or stool
• Pain that has moved to the lower right of the abdomen and is getting worse
• Upper abdominal pain with fever and chills or jaundice
• A hard blow to the abdomen
• Sudden breathlessness, chest pain or fainting

After surgery, report the same day

• Fever or chills
• Growing redness, pus or a wound coming open
• Bleeding that does not stop with pressure
• Pain that painkillers do not ease, or that is getting worse
• Repeated vomiting, or being unable to eat and drink
• Being unable to pass urine
• Yellow skin or eyes
• Swelling and pain in one leg

If you cannot reach anyone or you feel worse, do not wait for an answer. Go to the emergency department.