Post-abdominal surgery recovery requires a balance between rest and movement to facilitate healing. Early and safe mobilization is encouraged in modern surgical protocols, often starting within hours of the procedure. Movement is important because prolonged immobility increases the risk of serious postoperative complications. Moving stimulates blood flow, preventing the formation of deep vein thrombosis (DVT) and pulmonary embolisms (PE). Furthermore, early movement improves respiratory function, helping to expand the lungs and prevent conditions like atelectasis or pneumonia.
Preparing Your Body and Environment
A successful exit from bed begins with strategic planning and preparation. To manage pain during movement, time the attempt with the peak effectiveness of your prescribed pain medication. Waiting until the pain is severe makes deep breathing and movement difficult, often resulting in shallow breathing that can lead to lung complications. Before attempting to move, complete a series of deep breathing exercises, often using an incentive spirometer.
The incentive spirometer helps fully expand the lungs, which may be partially collapsed from the effects of anesthesia and restricted movement. To use the device effectively, inhale slowly and deeply, aiming to hold the breath for at least two to three seconds to maximize lung inflation. This exercise should be done ten times every hour while awake to prevent the buildup of fluid and mucus. Also, prepare the immediate environment by ensuring bed rails are secure or a sturdy chair is positioned nearby for support during the transition.
Primary preparation involves abdominal splinting, which supports the incision site to minimize strain on healing tissues. This is done by holding a firm pillow or tightly folded blanket pressed firmly against the abdomen over the surgical incision. Maintaining this pressure throughout the entire movement—from rolling to sitting and standing—significantly reduces discomfort. This support is also necessary when performing deep breathing exercises, especially if you need to cough to clear your lungs.
Mastering the Log Roll Technique
The log roll is a specific technique designed to move the body as one rigid unit, preventing the twisting or arching of the spine and the strain on the abdominal muscles that occur with a typical sit-up. To begin, move your body toward the edge of the bed where you plan to exit, bending the knees so your feet are flat on the mattress. The pillow for splinting should be firmly secured against the abdomen before the movement starts.
Next, the body is rolled onto its side toward the edge of the bed, moving the shoulders, torso, hips, and legs simultaneously, similar to a log rolling over. Avoid twisting or bending at the waist during this motion, keeping the spine in a straight line. As you roll onto your side, use the arm closest to the edge of the bed for support, placing the elbow firmly on the mattress.
To complete the transition to a sitting position, lower the legs off the side of the bed simultaneously while pushing the upper body up. The outside arm can be used to push down into the bed for added leverage. As the legs drop, their weight acts as a counterbalance, helping to propel the torso upwards into a seated position on the edge of the bed. Exhaling during this upward push helps manage internal pressure and reduce strain on the incision.
Moving Safely From Sitting to Standing
Once you are sitting upright on the edge of the bed, the next step is to check for any signs of orthostatic hypotension, which is a sudden drop in blood pressure that can cause dizziness upon changing posture. This is accomplished by “dangling” the legs, sitting on the edge of the bed for a minute or two to allow the circulatory system to adjust to the upright position. If you feel lightheaded, nauseous, or dizzy at this point, you must lie back down immediately, reversing the log roll process, and wait for the symptoms to pass before attempting to sit up again.
When you feel stable, use the strength of your legs and arms to stand up, avoiding the mistake of leaning forward and bending at the waist. Place your feet slightly apart and use your hands to push down on the bed surface or a nearby stable support, letting the leg muscles do the work to lift the body straight up. Maintain the splinting pillow firmly against the incision as you stand to keep the abdominal muscles supported.
Initial ambulation should be done with short, shuffling steps and only for brief periods, such as a walk down the hall and back. Listen carefully to your body; increased sharp or sudden pain, inability to bear weight, or unexpected bleeding from the incision are signs to immediately stop and call for a nurse or caregiver. To return to bed, the entire process is reversed: sit down slowly, perform a log roll onto your side, and use your arms to control the descent as you bring your legs back onto the mattress.