Note: This post is going to detail my inguinal hernia repair surgery and my post-op experience. It is going to be specific, clinical and likely to be of interest only to other athletic men who are considering the surgery. For everyone else, I recommend skipping it.
Finding a weird lump
Several months ago, when peeing, I noticed a small bulge in my right pubic area. I pushed on in with my finger and it squished down flat.
It didn’t hurt and wasn’t discolored.
The bulge was about the size of a 1/4 piece of hotdog split in half. So maybe 1.5 inches long, an inch wide and 1/2 inch protruding.
My first thought was that I had gotten so lean that this was part of my lower abs. It was almost aligned with the lower V of my abs in my pubic area.
I figured I’d keep an eye on it.
It kept returning over the next few months.
I noticed this lump whenever I peed after swimming. It would popout when my bladder was full. I’d pee and then push it back in and it would disappear.
I was a bit concerned, but since it didn’t hurt and was small, I tried to pu tit out of my mind.
Using Google to diagnose it
Still, it didn’t feel like muscle. It felt squishy like I imagined my intestines would feel. So I googled “hernia” and read about inguinal hernias.
It sounded like I might have one.
I read that there was a 1%-3% chance it could become “strangulated” and require emergency surgery. Otherwise, I read that people can live with them for years.
I also read that hernias never get better without surgery. They cannot heal on their own.
Because I have no health insurance , I decided to ignore it unless it became too painful.
6 months later
I continued my hardcore workouts of intense calisthenics, gymnastics and swimming. The hernia now protruded nearly all the time. It would popout whenever I blew my nose, coughed or sneezed. If I had a full bladder or even had a full stomach it was popped out. Pretty much, it only stayed in if I pushed it in with my fingers and did nothing that caused me to hold my breath or strain.
I continued working out, but now had a constant feeling like I had a groin pull or a pulled muscle where my thigh connected to my hip crease. It was a nagging pull – nothing sharp and nothing needing pain killers.
Then it got worse. The “pulled muscle” began to bothering me when I played the drums. Just lifting my right leg to thump the bass drum made it ache for hours afterward.
I still had lots of strength in my leg, but would feel the ache continuously.
9 months later
I was 99% certain I had an inguinal hernia based on reading medical sites, masters swimming forms and CrossFit forums.
Also, I started having a constant nagging pain in my lower back on the same side as the hernia. It felt like the muscle pull had wrapped around my right hip bone and continued to my back.
The hernia location itself never ached. It was my groin, my hip crease and my lower back that now had a constant ache.
I decided to see a surgeon to confirm my diagnosis and get an estimate for surgery.
Then the Covid pandemic hit and we were locked down. All elective surgeries were cancelled for the next 2 months. I continued to workout and pushed my hernia back in many times a day.
11 months later
As soon as we eased lockdown, I made an appointment with a surgeon for a consultation.
He said it’s an inguinal hernia and that I needed surgery. He said he does 300-400 of these a year.
He said the surgery takes 20-30 minutes and that I’d be in and out in half a day. I’d be limited to walking and lifting a max of 10 lbs only for a week and then could do normal daily activity after that. (I tried to explain that my normal activity is much higher than most people’s but didn’t get clarification on what that meant for my restrictions and recovery).
I asked if he would use mesh. He said it depends on what he sees when he opens me up. He said he would try to pull the ends of the muscle together and sew it together without using mesh. If the gap is too big, he will use mesh to span the gap.
I got a self-pay price and scheduled surgery.
Pre-Op
I had no food or drink after 10 PM the night before. I arrived at 945AM for same day surgery 2 hours before my surgery was scheduled.
I was taken to pre-op where I was interviewed by the nurse, the anesthesiologist, the nurse anesthetist and the surgeon.
The surgeon drew on me with a magic marker. Then I was shaved with a buzzer. An IV was started with a saline drip.
It was only then that I asked the surgeon if he was doing laproscopic surgery. He said “No – I only do open surgery.” I was bummed because I’d read that lap surgery healed faster.
The anesthesiologist told me about her procedure. I asked if I was getting Versed and she said, “Oh no, that won’t be strong enough enough. You’re getting propofol. “
She explained I’d be completely unaware during the procedure and that if anything went awry and she couldn’t keep me out with propofol that they would intubate me and give me general anesthesia.
I said I’d rather be dead that get intubated and I could see her eyes go wide in panic. We discussed for a minute and I realized that without a DNR and living will, getting the paperwork to ensure this didn’t’t happen would delay my surgery.
At that point, my surgery was already 2 hours behind so I said, forget it – if things go wrong and I need general sedation then do it.
I hadn’t been scared of the operation until this point. I was confident that my surgeon was experienced and my anesthesiologist would knock me out. Learning this would be an open procedure requiring propofol made me think this procedure was a bigger deal than I had thought.
(Note to self – get DNR paperwork done in advance if there’s ever a next time).
Surgery
After a four hour delay because of backups from earlier surgeries, I am wheeled back to the OR. I’m given something to “take the edge off” in my IV and the anesthesiologist asks me if I feel it yet. I tell her no, I feel nothing and cannot wait for it to take effect because my head had been throbbing for hors from caffeine withdrawal, dehydration and stress.
Then she says, “Can you help us by scooting over from this bed onto the OR table?”
I remember pushing my heels and elbows down and shifting my body over to the table.
The next thing I am aware of is being wheeled down a hall and someone smacking me on the shoulder saying “Steve….wake up….it’s over and we’re taking you to recovery.”
She must have hit me and yelled several times because I remember just wanting to keep my gummy eyes closed and sleep. But I forced myself to wake up.
I recall absolutely nothing from the actual surgery. I heard nothing, felt nothing and saw nothing – no vague memories, no dreams, nothing. I was out. It is like that time period was removed from my life.
Post Op Recovery Room
I felt like I was really drunk. I was able to think, but my speech was a bit slurred. My eyes felt sticky and I wanted to sleep but I wanted to get out so I forced myself to sit up. I was dizzy.
I felt pain in my abdomen. It was a deeper burning ache than the pulled muscle aches I felt before surgery.
I felt very sluggish in my body and mind.
I asked for a Diet Coke to get some caffeine. I drank an entire can.
Within a few minutes, I asked the nurse when I could get out there. She called my ride.
They sent an attendant in to help me get dressed. I didn’t think I needed help and told him so. He ignored my comment, removed my IV and helped me get dressed. It turned out that I needed help because I could not bend forward at the waist due to pain. Pulling on my pants would have been impossible without assistance.
They got my pain meds from the pharmacy, got me in a wheelchair, gave me my discharge instructions and wheeled me out to my ride. I was not sent home with any antibiotics.
My neighbor drove me home. I tried to make conversation with him but I was pretty loopy. I remember everything from the ride, but also remember I had to focus and speak slowly to not slur my words and to also keep my mind on our conversation.
I got home, let the dogs out in the yard and ate some food.
I checked in with my mom and friends by phone and text.
Then I took a Percocet (as instructed by the nurses) and laid down.
First night
I slept as if I was still on anesthesia. No dreams and very little tossing and turning. I had expected to be feverish and frantic with pain all night and was surprised I was not. I woke in the middle of the night to pee and took another Percocet. Getting out of bed was painful but not nearly as bad as I expected.
Day 1 Post Op
Groggy from Percocet. I took 3 colace stool softeners because I was worried I’d get constipated from the anesthesia and pain meds. I had been warned that constipation and straining would be bad for the hernia repair.
I ate some food in the AM. I could only walk the dog a few feet out front and then had to lay down.
Pain was around a 3 out of 10.
Woke and took another Perc at noon. Walked around the house a bit. Felt loopy from the perc and laid down again.
Although it helped mitigate the pain, I don’t like how the perc makes me feel. It made me drowsy, unfocused and dizzy.
I spoke to the nurse who told me I was injected with a long acting painkiller called Exparel that should help me for 2-3 days. She suggested I take Tylenol and Advil during the day and save the perc for before bed and/or for day 4 after the long acting painkiller shot wore off.
Day 2 Post Op
I have been alternating Tylenol and Advil for pain every 6 hours. Stopped taking the Percs but also halved them in case I get breakout pain.
I cannot stand up straight. My stomach has been bloated since surgery because they fill it with gas for the surgery, plus I haven’t shit in 2 days.
I shit later this day but still feel bloated.
I walked about 3 blocks with the dogs (one block at three different times).
Took a shower and removed the dressing. It looks like I had half a ceasarean section with a four inch incision that is example where my hernia protruded along my lower pubic/abdomen V line. Not much swelling but still feel bloated.
Day 3 Post Op
I am sick of watching Netflix, reading and laying around. I am agitated from the Advil. I have a constant throbbing and burning in my hip crease, my stomach and my pubic area.
Basically I feel all the time like I was kicked in the balls and punched in the stomach.
I cannot lift my arms straight up without pain. I cannot twist without pain. I feel tightness and paid when I try to stand up.
Nonetheless. I force myself to walk more and try to stand up straight.
I realize now that there is no way I’m going to get back to normal daily activity after a week.
I can drive. I can walk, slowly. I can move around a little. Getting into the car requires me to slide in and lift my leg over the frame using my hands.
All of my movements are slow and compromised.
I hope by the time my staples are removed on Day 8, that I can walk for at least 30 minutes at a time. Right now, I limit myself to 5-10 minutes walks so I don’t overdo it.
As for doing real exercise like yoga, gymnastics or swimming – forget it. I fear it will be months.
Well, at least I no longer have to push my intestines back in with my fingers every few minutes. I believe that eventually, I’ll be able to get back to a high level of fitness. It just will take months not weeks.
Day 4 Post Op
I’m pretty sure the long lasting pain injection I received has worn off. On waking I feel decent but continue to alternate Tylenol with Advil to keep the swelling at bay and the pain under a 4.
I was able to walk several blocks today (slowly) with the dogs and almost stand up straight without pain.
I am seriously discouraged by my lack of mobility. I can barely reach up high without pain. Simple mobility exercises that involve my core, hips or spine are almost impossible because I immediately feel pain like my incision is being pulled apart. I’d say my mobility has dropped from 100% to 10%.
I am starting to lose my mind from basically doing nothing that requires physical exertion.
I did some laundry and some light chores. I walked around the block about 5 times with the dogs.
Otherwise I watch Netflix, read stuff on the Internet and am slowly losing my sanity.
The pain after 6PM is the worst. In order to lay down, I have to position my leg using my arms, otherwise the pain near the incision and my hip crease makes me gasp. Ice helps a little. Pain medicine makes me able to fall asleep eventually.
I am also seeing green/yellow bruising extending from my incision up towards my hip crease. That makes me feel good because when I saw this type of bruising after my wife’s multiple surgeries, it was a sign of recovery.
I have dark purple bruising in places no man ever wants to see bruising (my frank and beans). I’ve read that this is a common side effect.
Day 5 Post Op
In 3 days I get my staples removed and I can’t wait. I feel a constant pulling there and it feels like the staples are snagging on my skin.
There’s no question I have lost muscle mass and conditioning. I am trying not to overeat since I am doing absolutely nothing physical.
My stomach is basically f***ed from the surgery, the meds and my lack of activity. I feel bloated and distended all the time. Sometimes I feel queasy.
Advil, Tylenol and pain make me agitated almost all the time.
I know I have to wait for my body to heal. But it is making me insane.
I played the drums for the first time since surgery. I went really light using my right foot and didn’t go all out around the set. It went remarkably well and caused no significant pain.
Day 6 Post Op
Last night I didn’t take any pain medication after dinner. My hip crease and ab pain were there, but seemed manageable once I laid down. Since I get up to pee at least twice a night, I figured I’d take a Perc or Advil then if I needed it.
There’s no question I am putting 75% of my weight on my left leg (the non surgery side) to get out of bed or up from a chair. That’s OK for now.
The pain in the night was worst when getting up but otherwise settled down when I laid back down so I didn’t’t take anything until I woke up and popped two Tylenol.
I walked the dog long (30 minutes) for the first time since surgery this AM. I walked slowly and felt the burning/ache in my hip crease and near my staples but it felt good to walk more than a few blocks.
Maybe today is the day I have that “drop off the cliff” moment when my post op swelling and pain drastically reduce. Man, I hope so.
I am hoping when I see the surgeon in two days to have the sales removed that he says I can start swimming and lifting over 10 pounds and to be guided by my pain levels.
I do not want to rip my stitches so I am going to be very conservative.
Day 7 Post Op
Yesterday must have been “drop off the cliff day”! My pain and swelling have gone significantly down in the last two days. I walked for 1.5 hours today with just a little aching. Played the drums without pain too.
I was able to do my morning mobility exercises at about 50% of normal.
Day 8 Post Op
Now able to get out of bed and even lay on side and stomach with very little pain. I still feel a pulling in my right thigh and hip crease. Pain is about a 1-2 and is only being managed with Excedrin and Advil. My nurse suggested I continue icing until the swelling and pain is gone so I’ll resume icing a few times a day again.
This will be my last daily update. I will add other updates periodically as major milestones pass.
I had my staples removed today. My surgeon told me:
- I had a small hernia. It was not my intestines squishing out so he cut it off and it was just a hernia.
- The small tear was stitched together without needing mesh.
I asked lots of questions about activity to be as safe as possible so I don’t tear out the sticks and cause another surgery.
He explained (as he did in my first consult visit) that there is a small percentage of men who will have another hernia, regardless of how well the surgery, the rehab, the exercise levels etc. go. (I think it was 5-10%).
Otherwise he said it take 4-6 weeks for the majority of the surgery to heal. After that, the curve flattens. He said it would heal for months after that but the critical time period is 4-6 weeks.
During this 4-6 weeks, I need to avoid exercises that cause me to bear down on my abs or ones that have sudden movements that could tear the repair before it has healed.
I can walk and swim as much as I want immediately. If the pools open up next week, I plan to start lap swimming again so I can maintain one cardiovascular conditioning.
He said if I overdo these activities, I’ll get some additional soreness and can back off a bit.
Since almost all of my bodyweight exercises involve intense core activation and flexion, I am going to wait the full 6 weeks before resuming those activities.
He suggested no lifting over 20 lbs for a few more weeks.
He said I need to avoid anything where I can slip, fall or move violently. Lawn mowing might be OK, but I decided to hire someone to cover the next 4 weeks for me just to be on the safe side.
So, on one hand, I’m happy that my downtime will be limited to 6 weeks and that swimming is allowed.
I’m bummed that I will be missing yoga and the bulk of my workouts for the entire month of June.
But, I am trying to heal this for life. If I do this for 6 weeks and prevents a recurrence, it’s worth it. If I do this for 6 weeks and get another hernia, it was inevitable.
I’ll check back in with periodic updates.
Day 19 Post Op
I had a burning pain in the top of my right thigh where it meets my pelvis from Day 0 through about day 16. It felt deep and burning the first week and then felt like I had flailed the skin open with a whip the next 10 days. I kept checking the skin for injuries but there were none visible. Clearly this was from the surgery.
The burning pain left.
All my visible swelling and bruising is gone.
The scar is raised a bit. Underneath the scar it feels like I have a pencil sewn under my skin. The surgeon said that hard ridge will reduce in time.
Now I feel about as much pain/pulling as I felt before I had the surgery so it’s clear I am recovering. I am walking 2-3 hours a day at a fast pace with almost no discomfort.
My plan is to begin gentle calisthenics on Day 22. I’ll be doing squats, lunges, some crawls, and some leaning pushups and rows. Assuming it doesn’t cause pain, I’ll continue this for 2 weeks.
If all goes well, I’ll add real pushups and rows for weeks 5 & 6.
Then after week 6, if all goes well, I will begin transitioning into my full workouts. The pool is supposed to open after week 6 too. If it does, I’ll be swimming.
I expect to be sore and disappointed in my fitness and strength levels for a while after week 6 but at least I’ll be moving in the right direction.
Attitude-wise, I’m OK.
I have watched anything remotely interesting to me in these last 3 weeks on Netflix so I cancelled my trial membership. I’ve been drumming every day, with no pain in my hip crease. I am painting at least an hour a day as well to pass the time.
Day 21 Post Op – First workout was disappointing
I worked out for the first time today since my operation.
It was discouraging. Here are the highlights/lowlights:
Pre-surgery, I did an hour of hardcore ring or parallette work followed by an hour of fairly extreme gymnastic/calisthenics (handstands, cartwheels, leg circuit, twisting, hand balancing crawling etc.). Then I do 30 minutes of medium hard yoga based on ashtanga and then an hour of cardio later in the day (swimming if possible, biking otherwise).
This week, I am skipping all ring and parallette work on the assumption these are too ab intensive.
To ease my way back in I did a 30 minute light calisthesnic workout.
- Lunges went fine.
- Squats went fine.
- One leg pistol squats were a failure on the first rep – it felt like a knife was being pushed out from inside of my incision. That sharp pain came immediately at the bottom of the squat. I had no idea these caused so much abdominal bearing down. Bummer.
- Crawling exercises were OK.
- Crab walking caused immediate strain and burning pain in my left shoulder and bicep. I suspect this is from not doing these for 3 weeks. I never had pain like that before.
- Calf raises went fine.
Yoga was lame. I took it super easy, no full planks, a limited range of motion of upward dog leaving my pelvis and core on the floor, and very gentle easing into postures ranging from 50-75% of my normal range of motion.
I suppose the good news is that I don’t have continual stabbing pain from the one legged pistol squat attempt so I don’t think I tore out my stitches,
I am really disappointed overall.
The thought that I could get back to going at full intensity in 3 weeks seems like a pipe dream after today’s workout.
Day 22 Post Op – Mediocre
Did assisted pull-ups and chinups with my feet on a ladder going up and down a pyramid to 8 reps. Felt weak and awkward overall but not much pain. Attempted some parallette work keeping my feet or knees on the ground just to start putting weight on my hands again.
Mowed lawn in afternoon. Shoulders were quite achy.
Day 25 Post Op
Progressed to full ring workouts including front rolls, back rolls, tuck levers, and skin the cats (slowly). Did assisted pull-ups with feet on ladder.
Day 26
Some pain in lower abs/pelvis on both sides and scar pain too last night and today.
Did assisted pull-ups with feet on ladder but was tentative and afraid because I am worried I have reinsured my hernia (ripped out stitches?).
I am about 5 lbs overweight and feel flabby and weak.
Day 27
Pain in lower abs again on the “breakfast smile” both sides going across pelvis to hernia and to my worrisome “suspected” hernia on the good side.
Day 28
Did real pull-ups and chinups today pyramiding up to 8 and down. Added cartwheels to my ground workouts today!
Day 29
No pain from pull-ups yesterday. Full ring workout today without assistance.
Day 30
Full parallette workout. Real pull-ups pyramid to 8 up and down. Np plan other than continual lower pelvic/ ab pain.
Lower pelvis still oddly lumpy and some swelling.
I cannot eat as much as I could pre-surgery- I think this is from swelling that makes my stomach bloated.
Day 35
Hernia achy yesterday and today a lot. WTF? I hope I haven’t ripped it. Although I have a similar ache on my non hernia side so maybe it’s just residual abdomen surgery pain.
Up to 9 pullup pyramid.
Day 36
Started a new type of yoga called Prasara. It includes a lot of back bends and twisting unlike my previous forward folding dominant ashtanga yoga.
Day 38
Prasara yoga with lots of bridges has made my lower pelvis and scar pain go away. I think this has broken up the scar tissue or something.
Day 41
The pool opens in 2 days and I will be lap swimming for the first time since the Covid lockdown nearly 4 months ago. I can’t wait! I think I will drop a few pounds swimming but more importantly will get stretched out and lengthened from backstroke and freestyle. My scar and abs seem to be be almost 100% recovered. It still feels like a pencil was sewed in under my scar. The surgeon said that will recede over time. There is almost no pain whatsoever except for surface scar density a the skin level when it gets rubbed by my belt.
(Note- Pool opening delayed another 2 weeks due to Covid.)
Day 56 Post Op
Prasara yoga and TacFit, with plenty of bridges, scorpions and other back bending exercises has significantly improved my pelvic muscle area. I rarely have pain there from cramping even though I used to have pain there on both sides pre-surgery.
I am having deep pain under my scar the week. I think it is from swimming which I started 5 days ago. Swimming feels good overall, but I do feel some pulling in my hernia region.
I think it was probably good that the lock down prevented me from swimming until this week. I would have had a lot of pain had I attempted to swim back when I was “cleared” by my surgeon on Day 10 post Op. I can only imagine I would have suffered trying to swim when my abdomen was still swollen and lumpy.
I am focusing a lot on breathing through my exercises, keep my core stable through yoga type tension and not holding my breath when I strain. I am hoping that this will help prevent me from blowing out another hernia.
It could all be BS, but I’ve got to at least try.
I still have a “pencil” like ridge under my hernia scar. It is barely visible but I can feel it with my fingers. I suppose this may be there for a long time, possibly forever.