This topic is about understanding when it's safe to start gentle core exercises after having open ostomy surgery. A caregiver is concerned about their brother, who is three weeks post-surgery for Crohn’s disease, and is unsure whether he should continue with the exercises provided by the hospital, especially since they cause pain and sometimes bleeding. The caregiver is looking for advice on whether to push through the discomfort or rest, and how to determine the right time to resume these activities.

Here are some helpful insights and advice:

1. For the first four to six weeks, focus on basic mobility. This includes taking frequent short walks, standing and sitting, and doing breathing and coughing exercises. It's best to wait for the surgeon's clearance before starting core exercises.

2. If there is pain or any bleeding, it's important to stop the activity immediately and contact the surgeon if these symptoms persist. It's crucial to listen to the body and not force any movement.

3. Open surgery requires a longer healing time compared to laparoscopic surgery. It's normal to experience moderate incision pain when twisting, sitting up, or coughing, but the pain should not be constant or worsening, nor should there be bleeding.

4. Over-exerting early on can slow down recovery and increase the risk of a hernia. However, doing nothing at all is also not beneficial. Aim for gentle movement only.

5. Avoid lifting anything heavier than a kettle or a gallon of milk until the surgeon gives the all-clear. Even leaning into a dishwasher can put a strain on the abdomen.

6. When it's time to reintroduce exercises, usually after five to six weeks, start with the gentle moves from the pamphlet. Begin with very small sets and gradually increase them. Strengthening the core slowly can help prevent future parastomal hernias.

7. Applying Vitamin E to the scar can help soften the tissue and improve flexibility.

8. If the guidance from the hospital was brief, it's a good idea to call the surgeon or ostomy nurse for personalized timelines. Aftercare details can vary between private hospitals and the NHS.