TAH - With Appendectomy, Play by Play

I had to have a radical hysterectomy for invasive cervical cancer. When I first heard this would be my fate, I started searching the Web for information and I found HysterSisters right away. I have learned more from this website than I have from my doctor or her office. My doctor is a good surgeon, personable and competent, but the time I've been able to devote to learning the "real" ins and outs of this surgery I owe to HysterSisters, who I truly believe made my recovery easier.

Wednesday 7:30am
Arrived at hospital for 9:00am surgery. Was terrified but really more determined to get it done. I’d written affirmations before surgery and I repeated those over and over to myself to try and calm me down. It really worked! I would suggest anyone scared of the surgery itself focus more on recovery and the “after” rather than the actual surgery. You’ll be asleep for that, just think about getting back home and getting through it all and getting better.

I was taken back into prep right on time to change into the fabulously fashionable hospital pajamas and socks. They were pretty quick about bringing in the anesthesiologist, who looked like a real newbie. He started my IV and blood leaked everywhere so they got me some new warm blankets. I wasn’t happy looking at my messy arm and every nurse that came in after that was trying to clean the blood out from under the tape. I remember hugging my husband’s neck tighter than I’d ever held on to him as they were about to wheel me away. I cried and told him I loved him, and that was that. Next thing I know, I’m waking up in recovery.

One of the worst parts of this surgery is the cold prep room and the absolute fear we all have going in there and waiting to be put under…having the IV put in, signing the consent form, etc. If you can remain calm throughout this process you will do fine. Remember, keep focusing on the fact that you have to do THESE things in order to get it over with and move on to HEALING.

Recovery, 1pm
The first incision was made at 9:30am and by Noon the doctor was out talking to my husband. She left my ovaries, but took my appendix. This had never been discussed so we both were surprised. She said she takes the appendix when women are under 40. It’s not like I’m going to miss it, and I am glad I won’t have any problems with it later on, I just wish I’d had a little heads-up about it beforehand. Blood loss was minimal so I didn’t require a transfusion. Because of the appendectomy, my right side is a little more sore than my left. My ovaries seem "pinchy" and sore like they would get every month during ovulation and during my period, so those pains are not new.

The Recovery room was tough for me for several reasons. One, I woke up in pain of course. They hooked me up with my morphine PCA pump. If it helped relieve the pain, I didn’t know it. I felt burning and painful sensations where the incision is, and it seemed all the morphine did was make me care less about it and be dopey. But I guess that’s better than being stone cold sober throughout something like that. Two, a woman in recovery next to me seemed to be a nurse there at the hospital who had had some type of minor procedure done, and she wouldn’t be staying the night, she would just need a room for a few hours. That made me wonder why she couldn’t just stay in recovery for that time.

Well the recovery nurses were all over her, helping her, and in my weak, pained, morphine voice I had to call them over if I needed something because they were taking care of “their own.” I can understand them wanting to talk with her, but I could tell she was communicating very clearly and had not had the major surgery I had had, so I did get a little upset and felt like I was being ignored. I don’t need much in recovery, but when I need it, I don’t care to wait for it. I’ve had 3 surgeries this year, and I was used to having one nurse hang all over me at all times, and that wasn’t the case after the hysterectomy. Plus I had to wait 4 hours for a room, which had my husband worried sick and me frustrated. So that little portion of the day wasn’t good.

I had the velcro strap-on leg massagers plugged in to massage my calves and stimulate walking (to prevent blood clots); I had oxygen tubes in my nose; an IV on my right arm with fluids and meds going in, and an IV on my left arm that they set up while I was in surgery to be ready for a transfusion if necessary. I also had the On-Q pain management system threaded into my belly near the incision, with a plastic ball of the medicine hanging around (a nurse eventually put the ball in an On-Q bag that I could strap over my shoulder when walking around). I also had a Foley catheter. I was quite tethered. Thinking about it now, it sounds terrible, but in fact, you are just lying in a bed focusing on feeling better so all those things are tools in your recuperation arsenal.

My room, 4pm
I moved to my room and remember being doped up but in discomfort. There would be pain if I moved the wrong way, but mostly just heaviness and discomfort from all the poking and prodding. I don’t remember lying there HURTING, but rather being tired and feeling kind of icky. I think the On-Q system must really have helped with the massive pain after surgery because I wasn’t wincing that much or anything, and by the end of the day was quite talkative to the nurses on the night shift and my husband, who thankfully stayed with me that night. I am so glad I wasn’t left alone. I needed him for emotional support, and he also helped me get comfortable and moved stuff around for me when a nurse wasn’t in my room.

They took my vitals every 15 minutes for a couple of hours and then that dropped off. They were in throughout the night to take vitals, get blood (doc wanted a CBC to check for infection) and to empty my catheter. Everybody is right…having that catheter the first day/night is really helpful because you don’t have to get up to go to the bathroom.

Thursday morning
I was on a clear liquid diet but was NOT hungry. My appetite did not come back until Monday after Wednesday surgery. I’d nibble on crackers here and there in the meantime; I’d drink a few sips of broth, and I’d finish up grape juice or apple juice on my plate, but that was all I could handle. Vitals were taken, catheter was emptied, chatted with nurses. They kept the morphine drip in on Thursday and I only clicked it a few times, in all honesty, during the late afternoon and evening just so it might make me nod off.

They got me up for the first time. Ouch. It burns really bad and your abdomen feels all heavy. I made it out the door and a couple doors down in the hallway before turning back. I felt strong enough to walk, it was just the pain that got me. I was exhausted afterward but glad I did it. The biggest problem with it is lugging around the IV and pole, the Foley catheter and the On-Q system was strapped around my neck like a heavy purse. So getting out of bed is quite the production. Plus, they have to take the massaging leg things off.

Sleeping was my biggest problem. I’m not a good sleeper and I was exhausted from being awake. There was no comfortable position to get into and the nurses kept coming in for one thing or another…or the IV bag would beep…or someone else’s IV bag would beep…you get the picture. It was a rough night and I was alone because my husband had gone home to be with our daughter, so I passed the time watching television and poking around on the computer when I felt like it.

Friday morning
The doctor made her rounds and took out the On-Q system. It didn’t hurt, but it felt a little weird when the tubing was pulled out of my belly area. Again, not a lot of pain, mainly just a tender, swollen abdomen. Nothing I couldn’t handle.

Some time after lunch my IV started beeping because it had “infiltrated,” meaning the fluid was leaking into my arm. My vein was hard and a little sore. The nurse said she would call the doctor and see if she could just take the IV out, but she might need to start another one. At that point, I was ready to go home and didn’t know why I needed another IV. Thankfully my doctor got the call about the infiltration and said, “take it out.” This helped my state of mind tremendously because now I didn’t have the IV, I didn’t have the On-Q system…I was only tethered to the Foley and I had the massaging hose on while in bed. I started getting up A LOT on Friday afternoon and one of the nurses took off the leg things and never put them back on. I didn’t remind them because they had started to become restrictive and I knew I was up walking around a lot anyway. At that point, it’s easier to walk around without being tied to all the other stuff.

I was on oral pain meds, and I only had the Foley. I passed gas at 2:31pm and it hurt. You could feel the gas moving throughout the abdomen, like bad labor pains. After a day of gas like that, it stopped hurting when I passed it. I walked almost all night just to get my strength up and I think it helped a lot. I sat up in the chair in the room for a bit, too. I didn’t sleep more than 3 hours in 2 nights, and it was a broken 3 hours of sleep so I was really exhausted.

Saturday morning
I was ready to go home like you wouldn’t believe. No sleep, awakening from the morphine, not taking many oral pain meds, walking, passing gas, bored out of my mind. My doctor made the rounds but not until 11:45 and when she did, she cleared me to go home. My husband and I have never moved so quickly to pack up my personal belongings and get me into a wheelchair!

The drive home was really nerve-wracking. I was convinced every single person on the road was going to slam into our car, I wasn’t comfortable, and every little bump in the road shuddered throughout my body. Once I got home I experimented with different positions in the chair, bed and sofa. Didn’t find many, but being home was so wonderful. I'd rather pace my apartment than pace the cold, lonely hospital room.

Recovery
The worst part of all this has been comfort, or lack thereof. You have to experiment to see how many pillows you need, where you need to put them, what piece of furniture will help you relax the most. It takes a while before you feel like reading anything so I just watched mindless television. Wear slippery nightgowns and such so you can move around in the bed easily. I came home with the Foley and took it out Monday morning, then went to the doctor to have them see how much I could “void.” Since I didn’t fully empty my bladder, they sent me home w/ some small self-catheters. I was completely panicked about this prior to surgery and it turned out to be absolutely easy and painless to do. It was just an extra step in the bathroom and I only had to do it a few days. If any of you need assistance with this, I’ll give you the rundown on what it’s like. It's truly no big deal.

The other bathroom issue is the constipation. I had that for about a day and a half, but I’ve been taking a laxative and stool softeners and Gax-X at times and Tagamet when I felt reflux, and I’ve been able to have a BM here and there. It hasn’t always been comfortable, but I’m keeping a close eye on what I eat and what I take so I can manage that aspect of recovery. It may take a while for things to go exactly back to normal. Your body is just much more sensitive so you need to be sensitive to what you eat, and devising a drug combination that will help get you moving again.

I feel stronger and more alert 11 days out of surgery. The pain comes and goes. Sometimes it’s just discomfort and other times it’s all out pain. It really hurts at night before bedtime, feels all heavy and dense in my abdomen. Mornings are when I’m freshest and can sit up for longer periods of time. I can stand up straighter now than I could, which is helping with my back. Of course I get tired easily, but I haven’t really been doing anything to wear me out. My shower is the biggest event of the day. When I say I’m taking it easy, I mean it. I certainly don’t want to pull or tear something or cause bleeding or cause me to have to visit the doctor again and have some other thing done to me. Right now, I’m all about growing back together again in a safe, strong way.

I’d suggest you get lots of stuff to keep you busy during recovery…mindless magazines, movies, the remote control, a game system, puzzles or something and just go with lying around. When will there be another time for you to lie on your hump and have people wait on you? Enjoy it while you can, while your body gets stronger. And we’re all here for you if you need us. Visit with friends and such online, then let them stop by…hopefully with a meal…weeks later when you can have a little visit and not be drooly or sleepy or incoherent. Don’t try to do too much. We’ve all said it, and now I am living it.

Your body will fall into a schedule based on who is there to help you, who is in your household, and what is expected of you. Focus on the healing. What you’ll look like, feel like when it’s all over and you can safely say you came through this with flying colors. Best of luck to all of you.