a couple of tips

If you’re having gynecological surgery – granted I’ve only had laparascopic surgery so I can’t say that this will generalize to laparotomy surgery – here are a few things I’ve learned.  I’ve had three, one in 2002 which definitively diagnosed the long suspected endometriosis, one in 2007 which added a diagnosis of adenomyosis, and one just a few weeks ago which removed my uterus, cervix, fallopian tubes, shaved a bit off an ovary, removed multiple endo lesions including resecting the left uterosacral ligament (which apparently was affected by the endometriosis).

1.  Find an experienced surgeon.  Do not assume that just because your GYN doc says that s/he can do this surgery, s/he is the best person to do it.  S/he is not necessarily.  The GYN who did my first surgery left several sites in place because she was not skilled enough to remove them.  My next surgery was with a doctor who had made his name as a fertility specialist/surgeon.  Much better results in surgery and much better at diagnosing and treating endo than the generic GYN.  (addition):  I’ve had some luck by cross referencing google scholar searches (in this case, for recent articles on endo and laparoscopic surgery) for authors with my home state’s affiliation.  Yes, lots of false hits but it’s a decent way to get a sense of what doctor or group of doctors close to you are working on what you’ve got.  I also have had good luck asking around. This works best if you are asking people who have what you have.  My New England Outback doc was a double hit – recommended by a friend with endo and who also happened to be someone I had found via the internet search I described above.

2.  Even if the doc says you don’t need to do it, do a bowel prep before surgery.  I didn’t before surgery 1, nor did I get stool softeners.   Oh my god did  I regret this.  This most recent surgery, I decided I didn’t have time to do a prep and since my intestine has a pretty quick transit time these days, I figured I wouldn’t need it.  I was wrong.  General anesthesia, people fiddling around with your intestine, and narcotic pain meds will slow your bowel down to a standstill.  Do a mini-prep.  You can ask your doctor or (probably better) the nurse at your doc’s office for a recommendation.  This is not the huge colonoscopy prep!  You don’t want that, no one wants that.  This is just something to make sure you’re not holding a full bowel going into surgery.  And take the colace/stool softener afterwards and if they don’t offer it, ask for it.  Straining to go after abdominal surgery is a horrible thing that can be avoided or at least lessened if you prep and if you take the stool softeners.

3.  They will tell you, or they may tell you, that you can use a heating pad for comfort post op.  I and a friend who also recently had a hysterectomy both found that ice was better, at least initially.  Not long periods, and not everywhere.  But for that one super sore spot (for me, just under the incision at my navel), ice was my friend.  Heat was good later, after a few days.  When I strained myself though, I still found ice was good.

4.  Don’t strain yourself.  Stupid little things like reaching down to pick up something off the floor or turning to get something off the end table while I was sitting on the couch did me in.  You do not have the flexibility you are used to.  Memorize that and turn your full body, not just your top half, when reaching for something.  Don’t bend or lean down or you may regret it.  And definitely do not plunge the toilet.  No, that’s a big fat no-no (it probably goes without saying but since I was stupid and prideful enough to have done it rather than ask my husband for help, I figured I’d mention it).

5.  Plan rest breaks.  Even if you think your activity level is still low, for that first week to two post op, plan to just stop and lay down for a while every couple of hours.  If you don’t, your body will force you to later.

6.  Drink a lot of fluids.

7.  Medicate and write down your doses and times in a notebook so you will know when it’s time to medicate again.  For the first week or so, I found it was crucial to stay ahead of the pain.  You can play stoic later and try to wean yourself down by extending your time between doses or cutting the dose down, but for the first week or so, please just take the meds.

8.  Set boundaries on visitors and well wishers.  People may want to help out, and that’s great.  If you’re lucky enough to have close friends and family who want to show their support and love, tell them that they can bring over food, go grocery shopping for you, bring you reusable hot/cold packs, get you a gift certificate to Audible.com or Amazon, pay for a month of netflix (watch instant rules!), be available to take you to the doctor if you need it, ferry books and videos to and from the local public library for you, or let you borrow their iPad/iPod or other very portable electronic device.  They are not to come over for prolonged visits though.  Hosting, even hosting from the couch, takes energy and that’s energy you need for you.

Relatedly…

8b.  The couch is YOURS.  No one else’s.  You do not need to share.  For your mental health sake, you need to NOT be confined to bed, which means you need to have access to the couch (or a recliner) and the bed so you can get a change of scenery in those first few very low activity days.

9. Do not be shy about calling your doctor.  If you feel funny, if you feel better then much worse, if you have a question, call.

10.  When you’re ready to shower, I do not recommend trying to wash your hair at least for the first few days post-op.  If you have bars or a shower chair, you might try it with some degree of safety.  The reason for this caution is that when you close your eyes and tip your head back, you may suddenly discover just how unsteady you are.  The environment of a soapy, slippery shower stall or tub is not a good place to discover this.

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1 Comment

  1. Excellent list. Glad you found a good doc. Heal fast!

    M

    Reply

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