Supracervical abdominal hysterectomy - recovering well

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Supracervical abdominal hysterectomy - recovering well

Supracervical abdominal hysterectomy - recovering well

Date : 05-06-2008 - 05:32 PM - Readers : 202

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Hi,

I had a supracervical abdominal hysterectomy (SAH) about two weeks ago. I see fewer posts about this procedure and thought I should relay my experience.

I am 42. My husband is my only family here in Alabama. My extended family all live in Virginia. My husband has been very helpful and supportive. My extended family has been supportive by phone.

I had a single largish fibroid in my uterus. It was discovered in during my pelvic exam in 2007. I had an ultrasound, and we decided to just watch it. I was seeing my family doctor for my exams and she didn't seem very concerned. I should also note that I had been bleeding heavily with my periods for a few years.

I decided to schedule my annual exam this year with a gynecologist. I consulted with some friends, and chose a young female gynecologist that a coworker recommended. A blood test in the office showed that I was quite anemic. After examining me and feeling where my uterus was sitting in my abdomen, the doctor pretty quickly made it clear that she thought I should have an abdominal hysterectomy.

I had been feeling very tired and listless. I honestly thought I was depressed, and that's why I couldn't manage to do more than was absolutely necessary. Having an explanation for the way I was feeling was wonderful! I felt so much less worried just knowing that there was a reason why I felt bad. Initially, I really welcomed the idea of the hysterectomy, and feeling better.

The iron supplement the doctor gave me made me feel a litter perkier right away. I was taking Repliva, a prescription supplement. It did not make me constipated as I hear is the case with most iron supplements. It did make me nauseated sometimes, and I found it best to take it before bed for that reason.

At my second appointment, when I went back for an ultrasound, I had been taking Repliva for almost a month, and I felt a lot better. I had had a heavy period in the meantime though, and my hemoglobin numbers had not improved, much to my dismay!

I was still full steam ahead, ready to have a hysterectomy. We scheduled a pre-surgery appointment.

At the presurgery appointment, the doctor asked me whether I preferred to keep my cervix. It was as though a penny dropped at that moment. I didn't know how to answer the question. I didn't know how to decide. The doctor gave me pros and cons of course, but the question made me very aware that I had not done due diligence. I needed to educate myself a bit before agreeing to major abdominal surgery.

I started reading on hyster sisters. I also found lots of great info by going to medline. http://www.nlm.nih.gov/medlineplus/...roids.html#cat3

I scheduled an appointment with my family doctor to discuss the pros and cons too. She is about my age, and had a hysterectomy herself about a year ago.

I also talked again to my gynecologist. In the end I decided to move ahead. I needed to take the time to carefully consider what I was about to do, to make peace with it. Because of the anemia and the pressure on my bladder, I had to do something, and the other options weren't very appealing to me in the end.

Talking to my family doctor was part of the decision to keep my cervix. She was able to look back over my history of pap test results and confirm that there hadn't been anything in the results that would point toward cervical cancer risk for me.

Given that, I decided to keep my cervix, mainly because I wanted to keep any healthy body parts I could. The gynecologist indicated too that keeping it provides better support. She also said that she doesn't have to move the bladder as much when the cervix is kept.

My surgery was around noon on a Wednesday. I took off the Friday before to do some preparations, but worked the day before to keep my mind occupied. I slept late on the day of the surgery. I was nervous!

At the "castle" I dressed myself in a hospital gown (which I initially put on backwards) and ted stockings - very supportive white thigh high stockings. These help with circulation/prevention of blood clots.

The plan going into surgery was that I would keep my cervix and keep my ovaries as long as they were healthy. My doctor wanted my okay for her to decide whether to do a vertical or horizontal incision on the operating table.

Well, the surgery took the expected amount of time - somewhere between an hour and two hours. I was, of course asleep, and do not remember.

My uterus was removed, but not my cervix or ovaries. I did have a cyst on one ovary that was removed. I have a vertical incision. It was closed with staples. The incison runs from just below my belly button to just above my pubic bone.

When I woke up in recovery, I was in pain. It was similar to the level of post-op pain I felt after sinus surgery and laparoscopic gall bladder surgery. As soon as I expressed that I was feeling pain and told them where I was on the pain scale (I think I told them I was at 8) they gave me a morphine pump. The morphine pump helped right away.

For the first 12 hours, I was in bed with oxygen, an IV, catheter and pain pump. I also had sleeves around my legs that inflated and deflated. I believe these are to help prevent blood clots in the legs. I had never had a catheter, and thought it might be uncomfortable, but I was not even aware of it. I had ice water, and when I asked for it a frozen popsicle and a 7-Up. I wasn't allowed a straw for my drinks for fear that it would increase gas. More on that later. I slept a lot, but I was also able to make calls to my mom and dad, and siblings to reassure them that I was doing okay. My husband stayed with me overnight, which was reassuring.

There was a gauze pad over my incision. There was some drainage from the incision onto the gauze. The nurses checked it every time they checked on me. I also had a sanitary pad, which the nurses checked. I was bleeding very little.

On the day after my surgery, I was disconnected from all the stuff. I was switched to oral pain medication. I was concerned that removal of the catheter would be uncomfortable, but it was not. The nurse told me to take a deep breath when she removed it, but it was not at all uncomfortable. That was a relief! I could move around. My first time out of bed was a trip to the toilet. I called a nurse because I figured they would help me out of bed, but not really. I kind of had to figure that out on my own. I raised the head of the bed to a sitting position and my husband helped me up from there. Standing did make me more aware of my incision, but I won't say that it was terribly painful. From that point on, the nurses were keeping up with my fluid intake, and how much I urinated. There was a largish collection cup fitted onto the toilet for me to pee in. A tally was kept on the white board in my room.

Later that same day, I put on my robe and walked down the hall and back. They encouraged me to walk, but not too far that first day. My first walk, I walked very slowly and sort of shuffled my feet. I think I went for three short walks that day, and I was walking a lot more normally by the end of the day.

I was also able to take a shower that day. It felt good to get out of the ted stocking and hospital gown, shower and put on my own clean gown and undies. I had read the advice from this list to buy briefs (the underpants that come all the way up to the belly button) in a size or two larger than I wear normally. By that time, my incision was not longer seeping, so I just had my underpants on over the incision which was closed with staples. I had brought my preferred sanitary pads from home, and I wore one for the next 24 hours, but I was not bleeding vaginally any more.

The hospital had a room service like menu. I could order the food I wanted when I wanted it. I ordered breakfast, but really wasn't very hungry. I ate my toast and few bites of an omelet. I ate a little more lunch and cleaned my plate for dinner.

By the end of day 1, I felt pretty relieved that the pain/recovery wouldn't be as bad as I thought. I felt pretty chipper and sent my husband home for the night. His sleeping accommodations the night before had been pretty uncomfortable.

I rested pretty well for most of the night, but towards morning, I started having gas pains. Boy, it hurt. I called the nurse and she brought gas medicine. It still hurt. I had not yet passed gas. The doctor came in and everything looked good except that I hadn't passed gas. She ordered me a dose of milk of magnesia and a suppository. Ughhh. The good news was that I would be able to go home "in a while" after I passed gas. Not long after the double dose of medicine, my husband arrived. He had left me feeling good the night before; he didn't expect to find me curled in a ball whimpering. He arrived with lovely latte for me. I was feeling pretty green, and I promptly threw up from the smell of the coffee. Nature did take its course eventually. I walked a bit, and did eventually start passing gas. It was a big relief! The ordeal left me quite tired though. I took a nap and had a shower and lunch before I asked them to let me go home.

Apparently, I was right on schedule. The forms they gave me at release explained that the second day was the day that is most typical for gas pain. Further, it explained that until you start passing gas you shouldn't drink from a straw or drink carbonated beverages. I had been advised about the straw, but not the carbonated beverages. I had several sodas before I started passing gas. I might have had less pain if I had avoided those. Also, I might have chosen different foods the day after sugery if I had known what the day after that would be like! Why did I think a salad for dinner was a good idea?

I had my first bowel movement right after arriving home from the hospital.

I also want to add a note about medication in the hospital. I have to say, the dispensing of oral pain meds seemed a little haphazard. My doctor had prescribed motrin and percoset for me for after the hospital. She advised me to take them on a schedule to stay ahead of the pain. I was advised to particularly take the motrin on a schedule because it would keep swelling down which keeps pain down. The hospital nurses didn't seem to want to give me the pain meds on a schedule. They wanted me to call for the pain meds and tell them where I was on the pain scale each time. That was frustrating. And they gave me lortab, not the meds the doctor had told me to expect. I told the doctor about this on the second day, and she got it straightened out. It is worthwhile to know what to expect, to make notes about it and to share notes with caretakers who will be with you. Question what doesn't seem right.

At home, I have at minimum gone outside for a brief walk each day. I usually walk about six blocks. At most, I have done this walk three times in a day.

During my first week at home, I did walk too far one day. I could tell I had walked too far - my incision was smarting - but I hadn't brought my phone and I still had to get back home - probably 6 blocks. I walked back very slowly. There was even a little section where I had to go up a hill. On the hill, I walked slowly and stopped about every 10 feet. It was a stupid thing for me to do. I haven't gone that far again, and I always take my phone now.

My husband was able to arrange to work at home last week. That meant he was here to help me get up and get my breakfast and lunch for me, as well as make dinner.

This week, he is going in to the office. He did come home at lunchtime yesterday to check on me, and I think he will work at home tomorrow to break up the week and give me some daytime company.

A week and half out from the surgery, it isn't a problem for me to fix my own bowl of cereal, or make a salad or sandwich for myself. I can recognize though that it would be different if I had to fix cereal or sandwiches for a family.

When I first came home from the hospital, it was still uncomfortable to stand from a sitting position. I was most comfortable in our wooden rocking chair. I could rock forward in the chair to give me a boost getting up. After being home about a week, I felt comfortable getting up from the sitting on the upholstered furniture when I remembered to put a pillow behind my back.

The most difficult thing was getting in an out of bed, with getting out of bed being worse. My husband helped me at first. I was able to get in bed by myself after a few days at home. I welcomed help getting out of bed for at least a week. I learned to help myself by bending my elbow while I was lying on my back. I would roll over onto my already extended bent elbow to help me get up.

I needed help getting dressed the first day or two at home. I couldn't bend over to put on panties, socks or shoes very well.

My staples were removed a week after the surgery. The staples did not sit flush with my skin. There was a tent like bend in the staples. Wearing even loose pants was uncomfortable with the staples. I would put on loose exercise wear for my walks, but I was more comfortable wearing gowns while in the house.

I thought ahead and bought myself a few extra night gowns, but did not think ahead about pants. My tummy isn't terribly swollen, but I am a ways away from putting on my usual jeans and other fly front pants. Now that I can wear loose fitting pants, I don't have many. My husband is doing my laundry every few days because I have so little I can wear. Wish I had thought of this ahead of time. I am still wearing the big briefs, not my usual undies.

My appetite has been good. When I was first home from the hospital, salty and sweet flavors seemed intensified. I wanted really bland food for a couple days. Now I am eating a variety of foods. I have been trying hard not to overeat and indulge in a lot of treats while I am not moving as much as usual.

I have been sleeping well. I have been having especially vivid dreams. I have been attributing that to the percoset. The dreams haven't been upsetting, just unusually colorful.

In my normal adult life, I have rarely napped, but I have been napping, usually around 4:00. I can tell when I try to do too much, because I am terribly tired the next day. The day after I went for three walks, the day after the long walk, the day after two consecutive days of brief shopping excursions were days when I was especially tired.

When you largely feel pretty good, it is hard to know your limits, but your body will tell you!

I can't believe how much I have written. All in all, the gas pain the second day after surgery were the most painful part. Otherwise, recovery has definately not been as painful as I expected it might be. Hope this is helpful to someone. Wishing you well....

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