Outpatient LAVH ?

Hi - I have been scheduled for a LAVH (taking left ovary, possibly right) on January 23rd and have some questions. I hope they don't sound silly - okay, here goes first question - my dr's office called me and said that the insurance is listing it as Outpatient surgery but has approved 2 days??? The woman I spoke with (in billing for the dr) said this is the first time she has heard of it being an oupatient surgery. It bothered her so much she asked around and no one thinks it should be outpatient. She said she did get it approved for up to 2 days. I am so confused???Does that mean the hospital will think it is only an outpatient surgery? Will they try to rush me out of the hospital because it is listed as outpatient?

I have Blue Cross/Blue Shield. I am questioning what I should do next? If anyone else has heard of this please let me know.

Second question - I have had several surgeries in the past three years, all using a general, and have become severly ill, vomiting/dry hvs (sp)...I am so afraid of being sick to my stomach after surgery. The last surgery I had I was outpatient, I was released while vomiting/drowsy and sent home to deal with the "gas" which my dr used during surgery. He told me it was going to "rise up to the shoulders" but I felt like I was slowly being choked. I could not breathe - just short gasps - and was so scared I called the dr. Do they use this "gas" during a LAVH?

This website is wonderful - I have felt so alone trying to deal with these issues for the last three years and wish I would have found this website earlier.
Thanks
Debbie

Hi dwitt,

I don't know much about the insurance but I would sure be asking BC/BS some questions if you are not sure. I am scheduled for TAH/BSO so I am not familiar with how insurance deals with LAVH. However, I am sure there are some sisters here with some better knowledge than I.

Regarding vomiting from the general, I have the same problem and talked with my Doc about it. Make sure your doctor knows and the anethesiologist knows so they can give you some med for it. My doc said they would give me something to help with that.

Good luck with your surgery. I am sure all will be fine and these wonderful sisters will come along and help with your questions. Take care

Hi there! I wanted to respond and hopefully reassure you on some things.

I too have Blue Cross/Blue Shield (the pcp plan) and had a LAVH in August. Mine was considered outpatient too! I asked about that and was told that if you are in the hospital less than 24 hours, it is considered outpatient, even though the surgery is at the hospital and you have a room. If you need to stay longer, then you can. I had surgery on a Monday at 11 am and was discharged on Tues. around noon.

I had had surgeries in the past and was also very sick and throwing up. I was very scared that would happen here too. I told everyone I could and they gave me some meds(pepsid and reglan) before surgery and IV meds after. I never got sick!!

I had a LAP done years ago and remember the gas. It was nothing like that this time. I think they do use it but I didn't have any problems. I had a bowel prep prior to my surgery and maybe that helped. I didn't have any of the gas problems people talk about.

I wish you luck with your surgery. Mine was fine. I had a very uneventful surgery and recovery, very little pain, very little "swelly belly". The hardest part for me was waiting and then around 4 weeks post-op when I was tired of being tired and not being able to do the things I wanted to! At 8 weeks, I started taking horseback riding lessons and have been at it ever since!

I am sooooo glad I had this surgery! I LOVE it!!!

Christy

s, Debbie! I had an LAVH/LSO (left ovary removed - I also chose to have my cervix removed) about 9 months ago.

As far as insurance goes and what they "call" the LAVH, I can't help you at all. You may have to ask your doctor's office and your insurance group *exactly* what they mean by outpatient surgery that is approved for 2 days. If it was me, I'd want to know, too.

Before I had surgery, I was concerned about post-op vomiting, too. I had never had surgery before. I told my anesthisiologist about my concerns at my pre-op appointment, and he told me he would give me something to prevent that. He did and I was fine. Please talk with your doctor and your anesthesiologist about your past experiences and your concerns about the LAVH. They should be able to find ways to help you.

I was told that recovery from an LAVH would be easier and somewhat quicker than a TAH (which my gynecologist said *might* be necessary if he found something in there that he didn't expect) and mine was. The only problem I had - and I caution you about this - is that by the end of the first week post-op, I felt *so* good that I started to overdo. One example is that I reached up on tiptoe to get into a high cabinet (what was I thinking!) and pulled internal stitches near my navel - owww!! I had pain for three weeks because of that and put my recovery back quite a bit. Please don't do that to yourself! I also found as I progressed through recovery that since I could not directly bend over, I could slowly squat down and back up again to retrieve something I'd dropped.

I had to be careful how much weight I picked up during the first six weeks - your doctor will advise you. My husband went with me up and down the stairs for a while until I felt stronger, and I had someone with me during my short daily walks. Whatever makes you feel better is great.

After the first couple of days at home post-op, when I used the stool softeners I was given by my doctor (with little relief), I used a tip from this site. I had about 3 or 4 "bite-sized" prunes with a buttered bagel and a hot cup of tea each morning for breakfast and some salad with my lunch each day for quite a while and that really worked for me.

Use the strength in your legs to push on your heels to turn over in your hospital bed and at home, and also to get up from a sitting position. I found that helpful, as well as having a "tummy" pillow. I love my tummy pillow! I had brought my bed pillow and an extra with me to the hospital but I didn't have a little pillow. The nurse saw me trying to hold my tummy when I coughed and she got me a "coughing" pillow they give to the C-section moms. Any little pillow will do. It feels so good to have it against your tummy, especially the side you'll have your ovary out on. I also used it between my tummy and the seat belt when I was driven around.

I hope all goes very well for you!

s,

Sue

Hi Debbie,
Here's a few links you may want to check out. Since you are having an LAVH, regional anesthesia such as spinal or epidural with less side effects, no grogginess, or barfing may not be allowed due to the gas used for an LAVH but you can ask about post op pain relief. Some women get pca pumps with pain meds in them which can make them sick so I opted for an epidural to be put in for post op pain relief.

You may want to ask your dr if an LAVH is your only choice for the way to go for surgery? With my TVH I had no laproscope, no external cuts, and was allowed spinal anesthesia instead of general. I was one that was very sick for three days after general so I didn't want to chance that. If you do have general make sure you tell the anesthesiologist. I got some zofran in my I.V. prior to surgery and I was fine. Good luck.

gasless lap?
https://www.hystersisters.com/vb2/sho...ht=gasless+lap

nausea after surgery
https://www.hystersisters.com/vb2/sho...ghlight=nausea

LAVH outpatient
https://www.hystersisters.com/vb2/sho...ghlight=nausea

epidural vs. pca
https://www.hystersisters.com/vb2/sho...ghlight=spinal

Hi Debbie

I am having surgery Monday Jan 6 (lavh) uterus and cervix removed keeping my overies unless trouble pops up in there.

I too have Blue/Cross Blue Sheild and will be going to a womans hospital as a outpatient. Doctor promised that he wouldn't let me go if I wasn't it up to it. Ask your doctor and call your insurance company if you have any doubts at all.

Good luck to you, I am sure everything will work out just fine.




rroettger1965

Thank you all for your replies. It seems I've been so worried (about every little detail lately) but after reading your replies, I am at ease. I've spoken with doctor about the general and I have spoken with insurance co (who has since sent me a letter approving up to 2 days)...

It is really hard to believe that so many other women have been through this. I've always thought that it was just me... maybe other women didn't feel this way. It is really good to know that I'm not alone.

Thanks to everyone for understanding and supporting.
Debbie

Hi Debbie. I'm afraid this isn't an answer or very good response to your original questions. I am sched for LAVH on Jan 30. I have blue cross/blue shield HMO. So, now after all the info that you received from others, do you think I should follow up with BC/BS to find out what they are considering my surgery? I think I prob should. I haven't been to a pre-op yet. I hope your surgery goes well. I've also gotten sick with the generals and remember throwing up during the wee hours of the morning afterwards. I didn't even think about that aspect of all of this until I read your comments. So - although you were looking for help, you accidently helped me, too. HA! Now I have many new questions to add to my lengthy list of questions. Good luck. Lots of hugs!
Michele

Hi Debbie: My surgery was on a Monday and I went home on a Wednesday. I also had a bladder sling. As for nausea.....i was afraid of it after but had meds to stop it. But wouldn't you just know it.....the morphine in the pca pump almost did me in!!! The first time I pushed it I thought I got sick from the a general....but then the second time the in my head went on and I said oh nurse......please give me something by mouth....and no more I am over 9 weeks post op and feel great. I will be thinking of you on the 23rd. See you on the post op side.

LaDonna

Hi Michelle -

I am Sorry for causing you MORE worry, I really didn't mean too...

You should call BC/BS or have your doctor's office call them. After I had my doctor's office call - I had a letter within a few days (from BC/BS) telling me they would cover up to 2 days. In the initial call they said they considered it an Outpatient Surgery....they were very easy to deal with and very understanding. Really no problems getting it extended to 2 days.

I was worried about the general anesthesia because of past experiences....my doctor said I should mention this to the hospital during my pre-op visit and during admission. They could give me something to coat my stomach and help to avoid getting sick....this eases my mind (only a little bit)....

We also talked about the gas they insert to do the lap/surgery. He said it isn't as bad as I had during the other surgery because the gas will actually "escape" through the three incisions he had to make to do the surgery...meaning I won't have as much left inside me to cause problems..

Good luck with your surgery and I'll be thinking about you.
Debbie


La Donna -

Thank you soooo much for the info/advice on the morphine pump....I will definetly remember this during my hospital stay....
It is such an inspiration to hear you are feeling "great"....I can't wait to see you on the "post-op" side.
Debbie