Total Abdominal Hysterectomy - 4/18/08: Be kind to yourself!

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Total Abdominal Hysterectomy - 4/18/08: Be kind to yourself!

Total Abdominal Hysterectomy - 4/18/08: Be kind to yourself!

Date : 05-09-2008 - 10:41 AM - Readers : 134

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In about 2004 I noticed a change in my menstrual cycle where my mostly tolerable cramps started getting much more intense and my cycles started getting shorter. I mentioned it to the nurse practitioner at my yearly physical, who jotted it down in my chart and mentioned that I might be premenopausal.

In 2007, sex with my husband progressed from slightly uncomfortable in the Summer to being “no, absolutely NOT!” by December. My menstrual cramps were actually waking me up at night when the 10:00 PM Ibuprofen wore off around 1:00 AM. I’d take another 600 milligrams and lie awake until it took effect. When I mentioned this to the nurse practitioner that December, she recommended I have an ultrasound. I did, and the voicemail she left me 2 weeks later said cheerfully “everything is fine!”

Just to give you an idea of my medical history, I’d had a laparoscopic tubal ligation in 1986 at age 22. I had a laparoscopic gall bladder surgery with complications in 1992. In 1999 I had an ectopic pregnancy that ruptured – and was resolved through laparoscopic surgery as well.

I wasn’t “fine” though, and since the nurse practitioner hadn’t even asked me to call her back, I found a different health care provider. Getting married has its benefits and one was really fantastic health insurance. The other is a most excellent husband who works at home. This would prove helpful during my recovery. Not because he was cleaning and cooking, but because he would keep me from doing anything stupid. We refer to each other as The Voice of Reason and the Voice of Binky. Guess who I am.

Since I’d had 3 previous laparoscopic surgeries and what was going on inside me was such a mystery, my new, wonderful GYN opted for a TAH. Since I’d a miserable time with anesthesia both in recovery and with nausea, we agreed to do an epidural with a twilight anesthesia.

My only complications in surgery were that the epidural didn’t work – luckily I don’t remember this at all – and they had to put me out completely but pretreated me for nausea, so I handled it ok. I did tell my GYN at one point “if you find any money in there, we split it ok?” Yes, I have a twisted sense of humor.

She found the following: My left ovary was adhered to the side of my uterus. I had adenomyosis and a golf ball sized fibroid. My right ovary had endometriosis cysts.
I had adhesions associated with endometriosis and an ectopic pregnancy.

I don’t remember the recovery room at all – but I’m told I quizzed my surgeon about getting up and kayaking, which led to a 40 minute discussion with my husband where she emphasized what I could and could not do.

I remember being in the bed and getting instructions on the Dilaudid pump. Friday night I remember watching the clock trying to figure when 8 minutes went by and I could press the button again – but I couldn’t keep track of when the 8 minutes had actually started. I remember being in pain, in sort of a removed way.

I also remember the darn alarms going off because they were giving me oxygen and the percentage of saturation kept getting too low. I was supposed to be breathing through my nose, but my allergies had kicked in, and I was getting too congested. I also tend towards a really low heart rate – my resting HR is in the mid 50s and my BP is normally low, 105/70, which caused some panic as both were even lower – until I explained to the night nurse that I might not be a skinny mini kind of girl, but I ran 3 miles a day. I was walking with my husband that evening, dragging everything but the oxygen along and had some of my “fluid diet” as well. I'm really glad I'd brought a nice jumbo light cotton robe that allowed for the IV tubes and covered me up.

I also remember being a little peeved because the nurses woke me up all night long when they checked on me!

Saturday morning – out with the catheter and I was taken off the IV pump by 10 AM. By 11:30 AM I was in the shower. Around 2:00 PM I was cranky and my back hurt from the awful bed. When the attending physician showed up, I attempted to convince him to release me right there and then. His statement of “it might not be prudent” made me laugh as the mechanic who works on my vintage Mercedes Benz often says the exact same thing in response to one of my more kooky ideas. I did take it to heart though – and deferred to his better judgment.

Once I was ok to eat “real food” by that evening, my wonderful husband brought me a great meal from my favorite health food restaurant and walked with me until late evening. I was also happy to be able to urinate normally and passed a lot of gas. I had some light bleeding, but it was normal according to the nurses. I’d also developed an allergic reaction to the compression stockings in the form of a rash and against recommended practice, removed them and the Intermittent Pneumatic Compression (IPC) device.

DVT – or deep vein thrombosis is a significant risk in gynecological surgery, which is what the compression stockings and the IPC prevent. In hind sight I do not recommend doing this. If you have sensitive skin or develop heat rashes, please mention this to your doctor prior to surgery.

I had a pretty tough Saturday night. I had pain down my back and legs, possibly from the epidural, certainly from the bed and could not find a comfortable position to sleep in. The night nurse was wonderful and understood that I didn’t want any heavy painkillers but gave me a half dose of Darvocet. She also let me walk as much as I needed.

Sunday morning I was counting down the minutes. The attending came by at about 9:30 and said I was ok to go. I was in the bathroom simultaneously changing and talking to my husband on my cell phone asking him to come “spring me” as the attending wrote my prescriptions for Darvocet and Ibuprofen. I felt pretty good, not energetic but not really in a lot of pain. I tossed my book and my shower kit and toothbrush into the duffle bag I’d brought (leaving it on the floor!) and was waiting in a chair dressed in loose clothes and sandals.

When my husband and I stepped up to the nurse’s desk in our “civilian clothes” they asked “can we help you?” The nurse shift had changed and they didn’t even know I was a patient! I signed the discharge papers and we headed home.

The ride home was not the easiest. For some reason my husband brought his truck. Potholes hurt! But we did stop so I could get a latte and again to drop off my prescriptions.

Sunday evening I mostly napped and stayed in bed. Monday I migrated to the couch and we walked around our properly slowly and gently. Tuesday, I split my time between the computer, the couch and we went out for dinner. I was taking a Darvocet at bedtime, an occasional 600 milligram Ibuprofen mostly for back pain and already starting to chafe at the restrictions. I was constipated and taking a stool softener and really didn’t have much of an appetite. I quit taking the bedtime Darvocet by Wednesday as well as the Ibuprofen.

The smartest thing I did was have a housekeeper come on Thursday!

The Saturday after my surgery I went to a BBQ and even though I didn’t eat much, was happy to spend a few hours with my friends. I had – and still have a swollen belly, but I found something that still looked good on me, put some makeup on and entirely forgot that I was uncomfortable for an afternoon.

Sunday I was back on the couch. Not in pain, but tired. Happily though, any bleeding and discharge had stopped entirely.

The following week got better – I was driving that Friday, 5/2. I went to the mall, to my PO Box and to get a haircut. We had dinner out and I came home and slept.

I’ve been getting out a little for easy errands since, coffee beans, my PO box, the farmers market for some fish and vegetables for dinner (not exceeding 10 lbs!). Today is my week 3 appointment and every day I feel better. I plan to start walking on Monday at the gym. I will say, walking from the bottom of our long steep driveway to the top of our stairs – I’m tired. I’m worried about gaining weight. I’m worried about losing condition. I still am constipated and don’t have any real appetite. I also don’t have a sense of a full bladder, just discomfort, so I just go a lot.

I'm really glad I chose to do this while I was off of school for two semesters between programs. Even at 44 and in good physical shape - I don't think I could handle a full load of classes right now.

But I feel better every day!

I wish I had found HysterSisters sooner. I wish my GYN had a brochure for this resource as it would have been helpful prior to my surgery as well as during my initial recovery. I found HysterSisters totally by accident because I was feeling like a slacker that I’d not gone back to the gym to walk on the track inside the gym, as soon as I could drive. I was feeling bad that I’m not doing much around the house and that I’m tired!

No one has the same recovery. I am a health sciences student and I’ve had much anatomy and physiology, microbiology, women’s health, nutrition etc. I’ve learned the human body is an amazing thing, but reading here really emphasizes how we all handle surgery differently.

So be kind to yourself!

Get people to clean your house (I didn't want to over burden my husband). Get take out for dinner. Send the kids to camp, grandma's or a friend's house. Ignore the laundry. Sit on your back porch with a book and paint your toenails (or get a friend to do it!). Talk to your friends on the phone. Watch garbage TV

Just be kind to yourself!

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