Diving after appendix removal video laparoscopy

[miketsp]

Last Monday (Sep 10) I had to have my appendix removed. When the pain hit on the Sunday I realized immediately what it was and went straight to hospital. Spent the night in hospital and operated at 6:30AM Monday - video laparoscopy. No complications (I already watched the 22 mins DVD of the procedure) and I was getting up and out of bed to go to the bathroom 2 hours after surgery. Released from hospital 24 hours after surgery and went back to work (desk job) same day.
Today, 6 days later, swelling has subsided almost to normal. Pain level has subsided to the point where I can sleep on my back or on either side without any painkiller.

Now, I have a dive trip booked Oct 12 (one month after surgery) and need to decide now if this will be OK or not.
Max depth for this particular trip will be 25m. Most of the diving is 10 - 20m.
My one concern is the effort to don and doff my 7mm semi-dry - generally the most tiring part of the dive.

My personal feeling is that 1 month (another 3 weeks from now) will be more than adequate.

I have a return consultancy with the surgeon next Wednesday to check progress.

Any comments? Any specific question I should ask the surgeon when I see him (he's not a diver, I already checked)?

 

[DocVikingo]

Hi Mike,

Given an otherwise healthy & fit individual without operative complications, post-laparoscopic appendectomy healing takes only about 7 days. The primary concern is that the abdominal wall muscles are sufficiently healed to handle the forces of hauling and doffing/donning gear.

With the laparoscopic procedure gas is introduced at the surgical site. Typically the surgeon endeavors to release the gas when the procedure is complete. If CO2 is used, as it usually is, any remaining amounts are quickly absorbed into the bloodstream. In cases where air or nitrogen is applied, the gas could be around for about a week before it completely disappears. By Oct 12, this obviously isn't going to be an issue.

The chances are extremely high that you’ll be good to go by mid-Oct, but your doctor, who is intimately familiar with your general state of health & fitness and the particulars of your healing, is the one to make the call. As to what to ask him, the questions are in the discussion above.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

 

[lv2dive]

Given an otherwise healthy & fit individual without operative complications, post-laparoscopic appendectomy healing takes only about 7 days. The primary concern is that the abdominal wall muscles are sufficiently healed to handle the forces of hauling and doffing/donning gear. ...your doctor, who is intimately familiar with your general state of health & fitness and the particulars of your healing, is the one to make the call. As to what to ask him, the questions are in the discussion above...

When I had this surgery I asked three times before I got an answer I believed. The first time the doctor told me I could dive as long as I felt well in two weeks. The second time I asked him, I was more clear with him that I wasn't talking about the most typical diving you might think of (I dive steel doubles in caves) and he still said, two weeks would be fine. The last time I asked him about it, it was in person I and showed him how I got in and out of gear and was specific about how much it weighed. He suggested four weeks would be better, for the donning-doffing/getting to the water reasons as discussed above. If I had been diving a single aluminum tank I would not have hesitated to dive two weeks after surgery, though.

I guess my point is, being very specific is good, especially with a non-diving doc. I was having a bit of trouble believing the two-weeks and I'm glad I kept asking.

 

[DocVikingo]

I guess my point is, being very specific is good, especially with a non-diving doc. I was having a bit of trouble believing the two-weeks and I'm glad I kept asking.

Good point.

Regards,

DocVikingo

 

[vladimir]

I was having a bit of trouble believing the two-weeks and I'm glad I kept asking.

I bet if you asked him again you could have gotten him up to six weeks. Sometimes they tell us what they think we want to hear if there's no added risk involved.

 

[DocVikingo]

I bet if you asked him again you could have gotten him up to six weeks. Sometimes they tell us what they think we want to hear if there's no added risk involved.

Why Vlad The Impairler, do you have a cynical side?

Regards,

Doc

 

[TSandM]

Assuming you have passed the immediate post-operative period with no complications, the only big risk you are taking by diving "too soon" is the risk of creating a hernia at the umbilical trochar site. (The other sites are really too small to have significant risk of hernia.) If you are young and otherwise healthy, and have no conditions that would slow or preclude healing -- no infection, no diabetes, no steroid use, no chronic cough, etc. -- a month may well be sufficient. We usually advised six weeks to heavy lifting after abdominal surgery, but that was using traditional incisions. At a month post-op, I'd try to get other people to do as much of the gear-schlepping as I could, though . . . it's very annoying to have to go back in and have a hernia repaired.

 

[lv2dive]

I bet if you asked him again you could have gotten him up to six weeks. Sometimes they tell us what they think we want to hear if there's no added risk involved.

No, it wasn't like that... although as I was writing I was wondering if anyone would take it that way. I dive just about every weekend, the weekends I'm not doing "real" dives I'm diving in an aquarium - so it wasn't what I "wanted" to hear.

The dr was giving me conflicting advice - don't lift anything greater than 20 lbs for 4 weeks, but it's ok to dive after 2 weeks. I didn't go into it above but since I wasn't clear: The third time, I was specifically asking the dr if carrying tanks weighing in excess of 100 lbs was the same thing as lifting? and by carrying, I meant, on my back? Also IIRC I was chatting with someone on this board at the time (cough, TSandM <G>) and I believe that may have prompted me to ask again... we both thought two weeks might be a bit short when it came to trotting steel doubles around - for the exact reason noted above. Given that the dr's concern was also the hernia risk- he advised four weeks once he realized where I was coming from.

Them after all that - at the end of the day, I think I waited three weeks and dove with lighter-than-usual tanks that first weekend back... and got help with stages and deco bottles for a couple of weeks.

 

[richl025]

Assuming you have passed the immediate post-operative period with no complications, the only big risk you are taking by diving "too soon" is the risk of creating a hernia at the umbilical trochar site. (The other sites are really too small to have significant risk of hernia.) If you are young and otherwise healthy, and have no conditions that would slow or preclude healing -- no infection, no diabetes, no steroid use, no chronic cough, etc. -- a month may well be sufficient. We usually advised six weeks to heavy lifting after abdominal surgery, but that was using traditional incisions. At a month post-op, I'd try to get other people to do as much of the gear-schlepping as I could, though . . . it's very annoying to have to go back in and have a hernia repaired.

Speaking as a general surgeon, this advice is spot-on!

 

[TSandM]

Speaking as a general surgeon, this advice is spot-on!

I used to BE a general surgeon . . .