TAH/BSO/cysts/adhesions 7/12/12

This was my 3rd abdominal surgery

2/78 - one cyst removed
7/07 - one cyst & part of one Fallopian tube

so I pretty much knew what to expect. Generally, anyway.

Cysts came back by 2008 and doctors started to nag me about getting a hysterectomy. I refused, believing menopause (I was 51) would basically cure the problem.

By late 2011, my periods were shortening and getting less painful, but the cyst pain started to get annoying again. In early March 2012, I had severe cyst pain and diarrhea and a urinary tract infection all at once. I went to a new doctor and was sent for a sonorgram. A 3cm cyst had grown to 12cm in a year. *Groan* My new gynecologist said exactly what everyone else had been saying for 4 years - I should have a hysterectomy.

As I was 55, in pain from cysts, and still having regular periods, I finally agreed. This was about 3 weeks after my "system breakdown" and I was starting to feel somewhat human again. My husband and I had a long-planned (and paid for) vacation for June, we decided I'd have the surgery in early July.

In the meantime, being unemployed, I focused on improving my health, upped my daily walking and was much more careful about what I ate. After getting back from an amazing trip to Alaska, I got ready for surgery by setting up the house to be as "post-op friendly" as possible, running errands and filling the freezer with microwaveable food. I drove to the hospital, as I knew it would be weeks before I could drive again (my husband is a saint, but he really doesn't like to drive).

The pre-op area in the hospital was, frankly, patient-hostile. At my last surgery, in another hospital, all the pre-op stuff was done in your room. In this hospital, I was put behind a curtain somewhere and no one talked to me for a long time. That gave me lots of time to get overly anxious. I finally left the curtained area and used the bathroom. When I went back, I left the curtain open and way-layed the next nurse who came by. When I asked for specific things, this hospital was very helpful, but the pre-op area was especially tough to deal with.

I broke down while talking to the anesthesiologist about my terror of waking up while intubated (after the 2007 surgery, I'd woken up in recovery still intubated), and she promised me that would't happen this time. That was somewhat reassuring. I was wheeled down to the operating room, talked briefly to my doctor, and was out really fast just after 7:30am.

When I woke up, I was extremely nauseated, but realized I wasn't intubated (YAY!), so I mumbled "Nausea" and someone injected anti-nausea meds in my IV. Someone put my glasses on, and I saw it was about 12:15. Wow, I was out a long time. As the anti-nausea drugs started to work, they wheeled me into recovery The doctor said everything went well but it took a long time as they worked on my adhesions. The one nice thing about the recovery - there were windows, so you could see a little daylight.

I was in recovery maybe for 2 hours then taken to my room, which turned out to be on maternity. I didn't realize that right away, but then heard crying babies. Played around with my bed and the TV, was on morphine but no morphine pump. I was a little under-medicated, but it really wasn't that bad. I mentioned to a nurse that, if she had time, I'd really like to get out of bed briefly later in the afternoon if that was OK. She said she'd see if she had time.

My husband stopped by to visit (I'd told him to go to work rather than hang out), and the nurse came back to help me sit in a chair. Yes, it's hard to do when you have a catheter and IV, and yes, you're sore, but I think it's a really good thing to do. After about 10 minutes, she helped me back into bed. We watched Jeopardy, and I did OK, all things considered.

The main thing I don't like about the first night after surgery is the necessity of the pneumatic boots. I think there's got to be a better way for people who will only be in bed for a day to prevent clots. In 1978, they gave you vitamin K shots to help prevent clots and I got decent sleep. I got no sleep at all that first night.

The morning nurse got me off the pneumatic boots and the catheter really early - maybe as early as 6am. I had to wait another hour to get the IV disconnected, but could walk to the bathroom and was walking the hall of the ward by about 8am. Still wasn't allowed to eat, but had all kinds of drinks, including a technically illegal carton of milk.

My doctor wasn't going to be back in the hospital until Sunday, but I was hoping to be discharged on Saturday (after two nights rather than three). Despite my lack of sleep, I felt pretty well, and the doctors who checked me in the meantime agreed. The weird thing was, most of the pain was not around the vertical incision, it was to the left of the incision. I felt like I had "phantom ovary pains."

Family came over for a while, I kept walking when they weren't around. I slept maybe 1-2 hours Friday night.

Got to eat a really awful breakfast Saturday morning, and nagged the nurses, who all agreed I was doing fine, to get a doctor to check me out.

And then, I had my only post-surgical breakdown in the hospital, when a nurse said that the doctor on call had left. I cried for a few minutes, got myself cleaned up, and said I really wanted to see the doctor. When I walked, I noticed that area to the left of my incision always felt very heavy and a little sore.

The on-call doctor did come back and we talked a little. He glanced at my incision, said it looked OK and said, "You're going to walk out of here if I don't sign you out."

"Well...I'd rather be signed out so I can go home and get some sleep."

And so, he did.

Called my husband and asked him to get back to pick me up. Sadly, he was in the middle of some errands so he had to finish those, bring food home and then he could get me. That took about 1 1/2 hours. In the meantime, I put in regular clothes, and got my prescriptions (for Percoset and mega-Ibuprohen).
When he got me, we went to the big grocery store, I went to the deli and got dinner while my husband went to the other end of the store and filled my prescriptions.

Slept a solid 6 hours (which is good for me) my first night home.

Spent the next couple of days resting. I was allowed to take showers so I did. Walked a little, and still had funny feelings on the left, especially when I walked. Had a follow-up with my doctor on Tuesday. He took one look at my incision and said I was having trouble. He started to manipulate it, which hurt, and said I had a problem with my incision and would need to get it packed. Daily. He said I had to come back and see him on Friday. And take an antibiotic for at least 10 days.

I had another breakdown. I can't look at incisions, but it was hardly hurting, so the news I had a problem with it was stunning.

I started getting visiting nurse care, once a day, the very next day. The first nurse told me I'd probably need care for 3 weeks (in reality, it looks like it will probably be 4 weeks).

On 7/19, a week after surgery and about an hour after the visiting nurse left, I noticed the area to the left of the incision that had always felt funny, was swelling, red, dry, hard and hot. Oh boy. Had a panicked hour and felt like crap. Called my doctor's office and the visiting nurse's office. The doctor's office said to take my temperature and don't go to the ER unless my temperature went up. While my temperature went up about 2 degrees over the evening, it never went over 100.

The next day, the doctor did an even more aggressive cleaning of my wound. He said the red patch was cellulitis, and I had to keep watching my temperature. He said to stop walking outside for a few days, which I did. I stopped pushing myself to do anything and pretty much sat on my recliner for a few days and watched movies.

On Monday, I had a follow-up with my surgeon's associate. I knew the cellulitis was starting to improve, and I was starting to feel half way human again. She cleaned the wound and cleared me to do a little walking again. She did, however, extend my antibiotic prescription for another 10 days.

By Tuesday night, I was feeling well enough that my husband took me out to dinner and we went to see The Dark Knight Rises.

So for the rest of July, I made very gradual progress, my incision improved, and I got out of the house a little more. Walked a little every day.

By early August, I've felt really very well. A little brain foggy, but can move around without major pain. And I was cleared to drive on August 1, just about three weeks after the surgery.

I'm pretty optimistic, now that the end is in sight in terms of the extra wound care. Visiting nurse care was extremely helpful, and I plan to write a letter praising the nurses once it's all done.

If I knew I'd have these kinds of problems after the surgery, I'd probably still do it all over again. I was pretty much off of pain meds about two weeks after the surgery (and off of Percoset after a week). The last two weeks, I've taken less pain medication than I used to take during a period or during a cyst flare-up. Have had warm flushes in the evening and overnight, but that hasn't been so bad. And, I'm back up to walking about 2 miles a day. Regularly. Couldn't even do that during some of the cyst flare-ups.