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Safe stretching after surgery

The following two techniques aim to help you stretch your body safely after your operation.  You have complete control over how far your stretch and how long you hold the stretches. Together the techniques make a nice sequence which you can flow through if you wish.

1. Cat Stretch

Come to a ‘table’ position, kneeling position with your hips over your knees and your shoulders over your wrists – like a table. As you exhale (breathe out), pull in your navel towards your spine, rounding your back and as you inhale lift your tailbone and your head. Repeat.

Continue the movement, aligning the arching of your spine with your breath. take the opportunity to find a speed of movement that suits you. When you are ready you can return to neutral.

Recommended number of repetitions: start with 5 and build up to 20

2. Child Stretch

From the same starting position bring your big toes together and experiment with sitting your hips back towards your heels, resting your forehead on the floor. You might be more comfortable with your knees together or knees apart.

An alternative is to stack your fists one on top of the other and then rest your forehead on them. Try lengthening your back through your tailbone, Hold for a breath or two and come back to table.

Recommended number of repetitions: start with 5 and build up to 20

The sequence

You can put both movements together to form a sequence

  • Come to table – perform one cat stretch
  • Come to table – perform once child stretch
  • Come to table – perform one cat stretch
  • Come to table – perform once child stretch

Getting more ambitious, post surgery abdominal (diaphragmatic) breathing

This breathing technique will seem like madness just after your abdominal surgery. You’ll feel very bruised and deep breathing will be painful. However this technique has a number of benefits that make it worthwhile persevering with. Firstly your physiotherapist will want you to breathe deeply into the bottom part of your lungs to help prevent infection; second it is a very calming breathing technique and third it is a fantastic breathing technique to practice so that you can use it in very day life.

1. Place one hand on your chest and the other on your abdomen. Take a deep breath in and try to make the hand on your abdomen rise higher than the one on the chest (to help ensure that the diaphragm is pulling air into the bases of the lungs).

2. Breath out slowly.

3. Take a deep breath in and try to make the hand on your abdomen rise higher than the one on the chest again, hold your breath in for a count of 2.

4. Slowly exhale through your mouth and gently contract your abdominal muscles as if you were trying to squeeze all the air from your lungs.

5. Repeat steps 3 and 4 for a minimum of five breaths building up to 20 breaths.

Tip: If you are practising this technique in bed after surgery, place a folded towel on your tummy to help your belly feel ‘secure’.

Placing your hands on your chest and abdomen is to help you train your breathing and get to know the technique. Once you feel comfortable with your ability to breathe into the abdomen, you don;t need to use your hands.

The more your practice this technique, the more natural it will become to you.

Guidelines for post-op physical recovery exercises

At the moment I am posting a series of articles aimed at post-op recovery. I thought it would be a good idea to supply you with some common sense guidelines and checks for you to go through before embarking on any of the techniques described.

Make sure:

  • There is no reason why you should not practice the techniques – check with your nurse or doctor
  • Your bed-rails are up
  • Your drips and tubes are tidy, and that they won’t fall out, pulled or tangled
  • Your alarm button is somewhere safe and easily accessible – make sure it won’t get knocked on the floor
  • Your clothes and bed covers will adequately cover you

 

2 gentle moves to gently discover your abdominal muscles again

Post surgery, you might be thinking that you will never be able to use your abdominal muscles again. Turning over or getting out of bed might seem impossible now, but these two practices will help you to find you abdominal muscles after surgery and build your confidence in them. Try to practice them every day.

1. Pelvic tilt

In addition to helping you to engage with your abdominal muscles, this practice has the added benefit of stretching your lower back as well as activating your abdominal muscles.

a) Start by lying on your back and if possible come to a position where your knees are bent and your feet are on the floor or the bed. Put your hands on your hips and begin by pressing the back of your waist into the bed. When you first start doing this, this might be as much as you can do, and that is absolutely fine.

b) To move on, as you press the back of your waist into the bed, try to draw your navel in towards your spine.

c) For the third stage try to tolt your pelvis towards you as your press the back of your waist into the bed.

d) Finally you press down through your feet in order to lift your hips slightly off the bed.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions

2. Uddiyana Bandha

In Yoga ‘Bandha’ means ‘lock’ and this Uddiyana bandha is also known as the abdominal lock. It is a brace position for the abdominal muscles which has three subtle stages and as such is an excellent practice to use to get to know your abdominals again.

a) As before, start by lying on your back with your knees bent and feet on the floor or the bed. Put one hand below your navel (belly button) and one hand above. The emphasis here is on trying to do something rather than doing it – so it doesn’t matter if you have dressing in the way.

b) Focus on your lower hand. Try to draw in your abdomen, only pulling in your lower hand. The reality is that nothing will move, or the whole abdomen will move slightly. Remember, we are focussing on trying to do the right movement rather than actually doing it!

c) Focus on your upper hand. Try to draw in your abdomen, only pulling in your upper hand. The reality is that nothing will move, or the whole abdomen will move slightly. Remember, we are focussing on trying to do the right movement rather than actually doing it!

d) Now bring together both sensations – of drawing in both the upper and lower abdominals.

Hold for a moment.

Recommendation – start with 5 repetitions and gradually build up to 30 repetitions. You can also increase the length on of the ‘lock’ up to a maximum of 5 breaths but don’t try to hold for more than five breaths until you have fully recovered.

Vegetables that won’t destroy you if you have Crohn’s or Colitis (apparently)

Continuing the theme of food that won’t destroy you if you have Crohn’s or Colitis (Last week’s fruit post is here).

As before, my first port of call, and the inspiration for today’s post, was What to Eat with IBD: A Comprehensive Nutrition and Recipe Guide for Crohn’s Disease and Ulcerative Colitis by Tracie Dalessandro, who is not only a registered dietician with a masters of Science in nutrition, but also a Ulcerative Colitis and subsequently Crohn’s Disease sufferer. I extracted her list of ‘Vegetables that heal’ from chapter 2 below and ran then through the nurtient tool over here.

Tonight, I have just researched the following:

  • Beta-carotene / Vitamin A – improves resistance to infection, supports growth and repair of tissue; maintain health skin and mucous membranes (Need 5000IU per day)
  • Vitamin D – Needed for proper formation of the skeleton and maintaining the mineral balance in bones (Need 60oIU per day)
  • Vitamin C – Anti-oxidant, wound healing, formation of collagen and appropriate immune responses (Need 60mg per day)
  • Folate – necessary for proper cell division – especially in IBD patients (400mcg per day)

Here is the list of vegetables that heal, based on 100mg, cooked without salt, unless otherwise stated. Brocolli, Collard Greens, Arugula, Asparagus, Butternut Squash, Carrots, Peppers and Sweet Potato stand out as the the superfood here, but almost all the vegetables on the list have a role in supplying a important vitamin:

  • Acorn squash Vitamin A: 817IU; Vitamin C: 11mg
  • Arugula (raw) Vitamin K: 109mcg; Vitamin C: 15mg; Folate: 97mcg
  • Asparagus Vitamin A: 1006IU; Vitamin K: 51mcg; Vitamin C: 8mg; Folate: 135mcg
  • Broccoli Vitamin A: 1548IU; Vitamin K: 141mcg; Vitamin C: 65mg; Folate: 108mcg
  • Butternut Squash Vitamin A: 11155IU; Vitamin C: 12mg; Folate: 16mcg
  • Carrots Vitamin A 17036IU;  Vitamin K: 14mcg; Vitamin C: 4mg; Folate: 14mcg
  • Cauliflower Vitamin K: 14mcg; Vitamin C: 44mg
  • Collard greens (very soft) Vitamin A: 8114IU; Vitamin K: 440mcg; Vitamin C: 18mg;Folate: 93mcg
  • Endive (raw) Vitamin A: 2167IU; Vitamin K: 231mcg; Vitamin C: 6mg; Folate: 142mcg
  • Kale (very soft) Vitamin A: 13623IU; Vitamin K: 817mcg; Vitamin C: 41mg;
  • Lettuce Vitamin A: 8711IU; Vitamin K: 103mcg; Vitamin C: 4mg; Folate: 38mcg
  • Parsnips Vitamin K: 1mcg; Vitamin C: 13mg; Folate: 58mcg
  • Peppers (red) Vitamin A: 3582IU;  Vitamin K: 5mcg; Vitamin C: 171mg; Folate: 10mcg
  • Potatoes Vitamin K: 2mcg; Vitamin C: 13mg (skin on baked, 7mg boiled, no skin); Folate: 28mcg
  • Pumpkin Vitamin A: 4992IU; Vitamin K: 1mcg; Vitamin C: 5mg; Folate: 9mcg
  • Spagetti squash Vitamin A: 5224IU; Vitamin C: 4mg; Folate: 12mcg
  • Spinach Vitamin A: 10481IU; Vitamin K: 494mcg; Vitamin C: 10mg; Folate: 146mcg
  • Sweet potato Vitamin A: 19217IU; Vitamin C: 9mg
  • Tomato (without skin) (Raw) Vitamin A: 833IU;  Vitamin K: 8mcg; Vitamin C: 13mg; Folate: 15mcg
  • Yam  Vitamin K: 2mcg; Folate: 16mcg

Coping with work, life and painkillers

Back at my money-raising post I asked for some ideas about subjects I could blog about and Lucy suggested a post about coping with the effects of painkillers. So here it is folks!

The first thing to realise with painkillers is that they have a number of effects that aren’t technically ‘side effects’ because these other effects can be just as strong as the painkilling.

The second thing to realise is that what happens to you will be different to what happens to me, and both of us will be different to John over at Foul Bowel or any other person taking the drug.

The third thing to realise is that your experiences will change as your circumstances change, as you grow older, as you gain or lose weight or as your pain increases or subsides. For example Tramadol has worked fine for me as the step down from morphine in a hospital setting, I could happily take it and carry on about my business of lounging about, reading magazines and accidently overhearing my neighbours conversations with their visitors, but at home it was quite a different matte – I go quite loopy, quite bonkers.

So here you go….

1. Be aware of your body and your mind – developing awareness of your body and mind can help you understand how the medication affects you. You can do this by simply sitting quietly for a minute or two and focussing on your body and noticing it.

2. By being aware, monitor how the medication is working. Has the pain reduced? That is quite an obvious one….. What other signs and signals is your body giving you? Are you feeing drowsy or tired? Nauseous? Lively? Absolutely out of it? With new medication, it is worth keeping a note of how it makes you feel for the first few days.

3. Don’t rely on just one type of painkiller. By doing 1 and 2 above you may realise that you need a small toolkit of different painkillers for different occasions. For example, the pill that can kill your pain enough to help you get a good night of sleep might make you randomly fall asleep drowsy during the day. Talk to your Doctor or a specialised pain nurse / medic about the different options available.

4. With number 3 in mind, there are loads more painkiller options than you might think there are. Most ‘pick up off the shelf’ medication is a variation of Paracetomol and Ibruprofen, and many doctors in the UK will respond to the need for more intense pain relief by prescribing something like co-codamol or di-hyrdocodeine. However, there are many more options available and these might work better for you than the standard options (or you might have a weird and wonderful experience). If you are in the US, YMMV, please let me know!

5. Work out a dosing regime that fits with your work/life-style. For example, for me, taking a dose at 4am means that I get a few hours of good sleep, followed by a few hours of pain free work/life in the morning which is usually my busiest / most creative time. If I took a dose at 7am I would just fall back to sleep and the day would be a complete disaster as a result… You can use the ‘day sectioning’ technique to help you develop your regime, and you may resolve to use different medication at different times of the day / night.

6. Once you have worked it out, Stick to your dosing regime, as the general consensus from the medical community is that it is better to keep the pain at bay than to oscillate between in pain and pain free.

7. It is OK to cut back some activity when you are in pain. So do so. In a future post I will show you a good technique for working out what to do and what to let go.

8. Tell other people who need to know that you are in pain and taking medication. This is especially important if your medication affects your alertness, concentration, hand – eye co-ordination etc. You might think you are OK, but you’d be surprised….

9. Try to be ahead of schedule / super organised in general so that you can slacken off the pressure to accommodate your pain days.

10. Be absolutely amazing to other people in pain / on painkillers, be completely there for them – think of it as paying it forward, what goes around comes around or universal karma.

So there it is, my top ten tips for coping with work, life and painkillers.

Physical Recovery: Two fantastic moves for stretching your spine

1. Lying on the floor, if possible, or a bed, start by just lying with knees bent and feet on the floor/bed – wait a couple of minutes in this position until your spine settles.

2. Then from here, draw your knees onto your chest gently, until you feel your spine stretching. Again, take it slowly, let everything settle. Then, right hand on right knee, and left hand on left knee, as you breathe out squeeze your knees closer onto your chest, as you breathe in, extend your arms a bit and loose your knees away from your chest, then repeat for a few minutes.

3. Next try a supine spinal twist, knees bent and feet on the floor/bed with your arms out at shoulder height, drop both knees over to one side, and then the other. If you struggle with this, use your hands to help support your knees into position.

Have a go with these, take it slowly, and do a few minutes of each one, then go through them again – as the muscles release they will ‘let go’.