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Okay, I've hit the 4-week mark! Cleared for eating regular food (which, so far, is eating about 1/8th of what I used to eat, lol) and working out!

Any insights on what to start with, how much pain you experienced, energy, etc? My doctor recommended joining a gym that had fitness training, meaning a trainer would give me some advice on where to start, what not to do, etc. My doctor has a fitness expert that said, in a loud voice, "upper arms, inner thighs and booty - they are your goals! Don't focus too hard on the stomach, for now. Still needs to heal more!" Do you agree with that? I was hoping to start on my core, but it sounds like the core isn't quite ready.

I'd love some insights. Thanks!

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Yes, I agree. Join a gym and get a trainer. I joined the Y before surgery and found a trainer who helped me lose prior to surgery and after. We continue to work together. Right now, we are working on arms and upper back as well as agility training. Right after surgery, I'd do about an hour on an elliptical bike (I have bad knees - it was the most comfortable) and then do weights with machines. She set up a program for me.

My training now, 11 months out, looks very different. I fence 4-5 hours a week over 2 days, do TRX for an hour, Pilates for an hour, strength and agility for an hour each week. I have at least one rest day each week. Tuned up with my trainer this morning. Get recommendations from folks in your area for the gyms they like the best.

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Absolutely on letting the stomach heal some more.

One of the things that I have learned from the physical therapists while going thru orthopedics over the years is that the connective tissues - tendons, ligaments, and of special interest to us, fascia that makes up part of the abdominal wall, have a much lower blood supply than the muscle tissues that they support, which means that they heal a lot slower than the muscles. We may feel strong enough to progress and lift more, but the connective tissues disagree, which leads to tears and other such injuries. In our case (and in general for abdominal surgery) incisional hernias are fairly common and can be caused by something as simple as a sharp sneeze or cough (hence the frequent advice to have a small pillow handy for such occasions.) Most docs put a lifting limit on for six weeks or so; mine restricted abdominal work like sit ups and crunches for twelve weeks, which arguably is not conservative enough.

I did start back with some weights after three weeks, at about half the level I had been, avoiding abdominal work, using machines rather than free weights to isolate the core; it was more about reestablishing range of motion and getting moving again more than strengthening anything at that point. I started using the elliptical again, likewise more as a means of moving more things than just walking.

The Y is good, but as usual the trainers are quite variable. The best that I have found there are those who are working in becoming physical therapists, so they have the interest and curiousity to work to your unique needs, rather than just showing you how the machines work and egging you on.

If you can, take advantage of your doc's fitness guy to learn the trade offs on healing vs. strengthening after surgery. You might also talk to the doc about the possibility of a few physical therapy sessions with the same intent. My wife went trough a few such sessions after much muscle/strength loss resulting from plastics and subsequent blood loss and anemia that put her down for quite a while and she needed to recover basic functional strength. The PTs helped with that and were able to refer her to a trainer who was experienced with post surgical issues to do follow on work.

Short answer - take is slow and let things heal (although hernia repairs are can partially subsidize plastics later on....)

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2 hours ago, RickM said:

Absolutely on letting the stomach heal some more.

One of the things that I have learned from the physical therapists while going thru orthopedics over the years is that the connective tissues - tendons, ligaments, and of special interest to us, fascia that makes up part of the abdominal wall, have a much lower blood supply than the muscle tissues that they support, which means that they heal a lot slower than the muscles. We may feel strong enough to progress and lift more, but the connective tissues disagree, which leads to tears and other such injuries. In our case (and in general for abdominal surgery) incisional hernias are fairly common and can be caused by something as simple as a sharp sneeze or cough (hence the frequent advice to have a small pillow handy for such occasions.) Most docs put a lifting limit on for six weeks or so; mine restricted abdominal work like sit ups and crunches for twelve weeks, which arguably is not conservative enough.

I did start back with some weights after three weeks, at about half the level I had been, avoiding abdominal work, using machines rather than free weights to isolate the core; it was more about reestablishing range of motion and getting moving again more than strengthening anything at that point. I started using the elliptical again, likewise more as a means of moving more things than just walking.

The Y is good, but as usual the trainers are quite variable. The best that I have found there are those who are working in becoming physical therapists, so they have the interest and curiousity to work to your unique needs, rather than just showing you how the machines work and egging you on.

If you can, take advantage of your doc's fitness guy to learn the trade offs on healing vs. strengthening after surgery. You might also talk to the doc about the possibility of a few physical therapy sessions with the same intent. My wife went trough a few such sessions after much muscle/strength loss resulting from plastics and subsequent blood loss and anemia that put her down for quite a while and she needed to recover basic functional strength. The PTs helped with that and were able to refer her to a trainer who was experienced with post surgical issues to do follow on work.

Short answer - take is slow and let things heal (although hernia repairs are can partially subsidize plastics later on....)

Fabulous advice! I'm joining a gym with unlimited fitness training assistance, and they will give me a program to get started. I'll be sure you follow your advice. Thanks SO MUCH!!!

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