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Corpsman's Vaginal Hysterectomy Story Corpsman's Vaginal Hysterectomy Story

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Unread 08-04-2017, 01:59 PM
Corpsman's Vaginal Hysterectomy Story

Corpsman's Laparoscopic Hysterectomy Story

Laparoscopic Hysterectomy
Age at Surgery 42
Location: West Allis, Wisconsin

After 10 years of successful use of Mirena IUD, from ages 31-41, when I had a 3rd consecutive IUD placed in April 2016, (same brand, same Doctor), my body just did not tolerate it. I tried for 5 weeks to make it work, had position and placement verified by Doctor and Ultrasound, but I was in constant crampy pain. I had it removed and the doctor did not recommend trying it again based on experiences with other patients. He explained that this just happens to some women. It even took several days for the cramping to ease after removal. Unfortunately, the days of no periods ended almost immediately. 2 weeks after removal, the first period happened. It was heavy, long, painful and repeated approximately every 10-14 days. I had a strong family history of women needing hysterectomy for bleeding, fibroids, adenomyosis and pain before their early 40's. I wanted to save myself the grief, so I pursued an endometrial ablation. After undergoing endometrial biopsy before it was done, I had the procedure (Novasure) in July 2016, along with a tubal sterilization.

About one month after the surgery, I developed the agonizing episodes of lower left quadrant pain. It was deep, sharp and completely took the wind out of me. I saw my doctor immediately. At first we thought it was still post op pain, he gave me a few more pain pills and said to see him if it didn't resolve in 2 more weeks. During this time I also had a CT scan at the Emergency room that revealed a dermoid cyst on my ovary. The pain didn’t resolve, so a pelvic ultrasound was performed. Other than some "functional cysts" on the ovary, things seemed normal. By October 2016, my pain was now daily. I ended up needing narcotics frequently for pain. My Doctor suggested Lupron injections to see if my pain had any relationship to my cycle, and to see if I was having post ablation syndrome. However, I declined due to the possible exacerbation of migraines and asthma that could occur. We agreed together that further imaging was not going to be as valuable as getting another look to see if an adhesion or something had developed. Another surgery was scheduled for December 2016, an exploratory laparoscopy. By the time I had surgery, I was also having pain on the right side at times. I had signed the consent for a possible hysterectomy if any reason was found for it, but none was. At my request, the left ovary was removed based on it not appearing very healthy. It had a huge "bag" attached to it that turned out to be hemorrhage product for a hemorrhagic corpus luteal cyst, and several other cysts. The right ovary looked OK at that time. The surgeon also mentioned some dilated blood vessels to the offended ovary. We really thought this would relieve the pain. However, my surgeon also told me that if it didn't, we would have to try Lupron. I really tried to be positive and figure we had gotten the source of the pain.

After a few weeks, I was back in his office, now with pain on both right and left sides as well as persistent recurrent bouts of uterine cramping. I seemed to be able to track a pattern to the cramping, but not the ovarian pain. I consented to trying the Lupron and got my first 30 day injection in late January. I did two consecutive shots, as you can really not even tell if it's working until a month has passed. I got about a 75% decrease in overall pain, the cyclical cramping was the most responsive. The ovarian pain persisted, as did the need for narcotics. At this point I insisted on a hysterectomy. My physician agreed, albeit cautiously and letting me know that he couldn't guarantee the outcome because my pain never totally went away with the Lupron. He was worried that my pain might be from some other source. Like many women in our situation, I just knew where it was coming from.
My Doctor requested that I see a urologist for an evaluation before we booked surgery. I saw a urologist specializing in female pelvic floor dysfunction who was also a board certified Uro-Gyn. She gave me the most thorough exam I've ever had and could find no GU cause for my pain. She also found no evidence of prolapse or need for urinary surgery or repairs. She indicated I probably had overactive bladder and gave me a list of medications to ask my Doctor about. She actually advised against surgery. She did not recommend hysterectomy with removal of remaining ovary, claiming I'd have more scar tissue and "no sexlife" afterward. She tried to push me to go have pelvic floor therapy "to see if maybe I had issues I don't even know about". This seemed like a ploy to make money, so honestly my second opinion wasn’t very useful. Since my pelvic floor was fully intact with no problems and that is not where my pain was, I saw no point in this. I leaned on my 14 year relationship with my doctor at this point. My surgeon did not agree with her position either and we agreed to schedule surgery. Since I had no bowel symptoms, he spared me the GI work up.

My surgery was scheduled for 9 AM on 5/25/2017. I arrived at 7:00, and as with all my other surgeries, spent most of that time in the waiting room. Actually, my case ended up starting late even though the room was available early because the nursing staff was too short handed to get my admission done. Finally, about 8:15 I was taken to a "pre op" room. I had all my surgeries at the same hospital, so I knew the drill well. They had me wipe my whole body down with these odd anti bacterial wipes. They had me change into a gown. The anesthesia doctor came to see me, and indicated they had hoped to start me early, but now they couldn't since none of my nursing care had been done. I tried to take it all in stride and remember that nothing was going to change the outcome. He ordered labs and started my IV. Then the lab tech came, followed by the Nurse and my Doctor both at once. He and I signed my consent forms, and then she quickly processed my admission to the hospital. Finally, at about 9:10 AM, they let me say goodbye to my husband, and wheeled me away to the OR.

In the OR, it was a small space, with tons of equipment and tons of people. I was not given anything before going into the OR, which was different than my prior two surgeries, where I had been. I knew what to expect, so I didn't worry about it. I had asked my Doctor in the pre op room if he would please hold my hand while they were putting me to sleep, because he was always right next to me anyway, and I've never felt more alone in a room full of people than when having surgery. The staff had me scoot myself onto the OR table and ensure my bottom was in the right spot on the table. They attached huge padded leg stirrups to the table but I was not put in them until I was asleep. My Doctor held my hand and said "cold hands but warm heart"...a mask was placed over my nose and mouth and the anesthesiologist told me "I'm pushing the medications for anesthesia now, you will feel them in about 20 seconds." This time, I actually coughed a few times and felt a warm shudder. That was the last thing I remembered.

The next thing I became aware of was the nurse in recovery telling me to take deep breaths and my Doctor coming in to tell me "Everything went great, I will see you in the morning". I woke up pretty quickly, and I could see the clock, I asked what time I came out of surgery, and it turned out I was awake about 10 minutes after this time. Previously I had taken much longer. I had some issues with the recovery room nurse not really understanding how much pain I was in and trying to argue with me about the fact that I was being admitted (she didn't think I was). I had discussed a PCA pump with my Doctor at my pre op appointment. She argued with me about that because she didn’t see an order, but I was with it enough to insist she call the Doctor while he was still there. She tried to argue "Well, maybe your Doctor decided things didn't look that bad when he was in there and decided not to order one". She was weird to say the least. I insisted she call, she complained but ultimately complied, and came back saying "You were right, he did say you are supposed to have one, but he forgot to put the order in.". I was very glad I was able to advocate for myself at that moment, because this hospital doesn't allow family in recovery. She also made some strange comments about "at least you are going to have a nice long weekend off work" as it was memorial weekend coming up. I'm not sure she really paid attention to the type of surgery I'd just had done...because when I said I'd be off work for 6 weeks, she was stumped by this. This was by far the oddest recovery room experience I've ever had. My pain got up to a 10 a couple of times during it because my RN was just very distracted. At one point I had to ask another RN for a dose of pain meds because mine wasn't coming back to check on me. I was happy when it was time to go to my room, about 90 minutes later.

The PCA pump was in place before I left recovery, so I was able to control my pain every 10 minutes as needed. The first 12 hours or so, I was hitting that button more frequently than not. Ibuprofen 800mg was offered to me within an hour or so of arriving on the floor. That did more for me than I realized because I became very aware when it wore off about 6 hours later, but I couldn't have more until 8 hours. My first night was rough, I didn't get much sleep. I had SCD stockings on, a catheter in place, an IV with a PCA pump on it, oxygen and an oxygen saturation monitor, so getting up would be an ordeal. I also asked for a heating pad, which is a pumped with warm water circulating through it. The RN's were awesome and always gave me an extension to call from my hospital phone to reach them directly if needed, which I loved because it limited having to put my call light on and wait for someone to answer. They had told me to let them know when I felt ready to get up. I did this about 8 pm that night, and the RN let me do what I wanted. I decided to wash my face and brush my teeth and walk in the hallway. I actually did two laps around the unit, which they said was awesome. I paid for it a few hours later though pain wise. I ended up staying 2 nights, which was no surprise, I had discussed it with my physician before surgery that I would likely need a second night make sure pain was well under control due to the high level care needs of my special needs children at home. It was very important I was well enough to go home and not in a weakened state from uncontrolled pain as my home life is chaotic on a good day. Sending me home sooner wasn’t even a consideration though because I hadn’t yet switched to oral percocet, and he heard no bowel sounds and I hadn't passed gas yet, both necessary for me to go home. I spent the day working on that. I requested my catheter out after breakfast. Once I got that out, I started getting myself up to the bathroom a lot with many "false alarms" due to bladder trauma. Once I had a couple of successful rounds of percocet, they PCA pump was discontinued and I was taken off the oxygen and oxygen monitor. They asked me to wear the SCD compression devices whenever I was asleep. It was then easier to start getting myself up, without all the equipment. The day got progressively better, I napped on and off, and got my own ice a couple of times, which involved a good walk. My husband brought my daughter to see me that evening, and about 10 min into it I was overwhelmed and having pain, so they didn't stay long. That worried me about going home. That night was actually worse than the first though because the gas set in. The nurses were attentive and I had ice, heat, gas medication and we tried various positions. Once the gas got moving, I passed enough to make the room smell like a zoo exhibit!!!! I really was glad I wasn't home for my family to witness that! The second morning, my Doctor came in, was satisfied that I was passing gas and able to use only the oral pain medicine, so he signed my discharge orders. My husband picked me up around 1 pm, so I made sure to nap and have lunch first. We had a 45 minute car ride home, so I made sure to take a final dose of pain meds before leaving the hospital.

The first few days home I slept a lot. I used ice packs on my stomach and heat on my back. When the gas pains from the laparoscopy would hit, I would put a heating pad on my stomach, lie on my side and draw my knees up until it passed. My Mother had traveled in from out of town to help my husband with the kids. I stayed in my bedroom a lot for the first few days. Just getting up for the bathroom and meals was enough. The first 3 days or so I needed the Percocet 2 tabs every 4 hours and the Ibuprofen 600mg every 6 hours. By the 4th day, I was able to drop to 1 tablet sometimes. My Mother left on day 8, and my husband stayed home for a couple of days to get the children on and off their school busses and just be available if I needed anything.

Around day 10 I was feeling pretty good. I was trying to heed advice from friends and not overdue anything just because I was feeling better. I was taking less and less of the percocet, but keeping up the ibuprofen. That weekend the weather was getting warm and my husband was installing our window air conditioners. I did not do any lifting, but had to mind the kids and retrieve items to help my husband, which meant lots of stairs. I think this became my undoing. Over the next 5 days, my pain went from controlled and almost off of pain medication to out of control. I was in communication with my Doctors office. Labs were ordered to check for a UTI. I also developed a lot of tea colored discharge and more bleeding. The pain caused me to have to go back to 2 percocet every 4 hours. I called the Doctor on the Friday, the 14th post op day. I was instructed to be seen by the on call physician, who was actually the assisting surgeon during my case and thus familiar with me. She examined me but found no issues with the vaginal cuff. She ran blood work and gave me more pain medication and told me to be on bed rest when I got home for the weekend. She wasn't sure why I was in pain, but didn't see any obvious signs of infection. I did the weekend of bed rest as prescribed. The on call Doctor had told me to call if things got worse over the weekend and the on call would have me go to the ER and have a CT scan. They did get worse, but when I called, I got the run around by the triage nurse, who actually refused to call the on call physician for me and seemed to think that I was out of line by asking them to, even though I was doing exactly what the Doctor told me. I made a complaint about this to the practice. I decided not to go to the ER though, I really wanted to be seen by my own practice. On Monday I called my Doctors office right at 8:00 when they opened. I spoke to the nurse, who booked me in with my own Doctor for that morning. The Doctor decided to admit me for a CT scan and pain management and more labs. So day 17 I was back at the hospital. This time I was on an orthopedic unit because there were no beds available in the women's pavilion. I didn't care, I just needed pain relief. I got IV meds, IV fluids and a CT scan with oral and IV contrast. The next day my Doctor came in to say that my CT was normal, no sign of abscess or infection, but my labs looked like I did in fact have a bladder infection. He ordered antibiotics and pyridium for my bladder. I started to get my pain a bit more under control late that evening, but not enough to go home. I stayed a second night for antibiotics and pain control.
The re-admit definitely set me back 1-2 weeks in my healing. I felt like I was starting all over again. My Doctor did tell me a couple days later that that culture didn't grow anything, so I didn't have to finish the antibiotics if I didn't want to. I told him that the discharge had almost completely dried up and the pain reduction seemed correlated with the antibiotics, so he said to go ahead and finish them. At this point I was over 3 weeks post op, and it seems I began the constant dance of 3 steps forward and 2 steps back. About a week after getting out of the hospital, the pain seemed to be increasing again. Thankfully my conversations with other hystersisters let me know that lots of us experience increased pain in the third and fourth weeks.

When I saw my Doctor for my post op, which I moved up to 4 1/2 weeks, I was in so much pain. At that time my Doctor examined me again, indicated everything was healing perfectly and we surmised I was just having a rough recovery because of what I had been through to get there. He prescribed one more round of percocet and told me I'd have to wean from that because he couldn't give me more. He did think with time it would get better and better. He recommended half days when I did decide to return to work. I still struggled alot with pain and needing intermittent doses of percocet until my return to work at 6 1/2 weeks. I was also told at this time to wait 8 weeks for intercourse. Truth be told I'm 10 weeks now and I'm not ready to go there yet. I'm a bit apprehensive, but I understand that is normal.

My biggest challenge by far has been how slow this has gone. At 10 weeks and feeling much better, but it was a long road getting here, and patience runs out the closer you get to that magic 6 week mark when you are "supposed" to be feeling better. I went back to work half days at 6 1/2 weeks, but was only able to do 3 half days the first two weeks, increased to 17 hours the 3rd week. This week I managed (3) 8 hour shifts, but it wore me out completely. I am only part time, so this satisfies my required hours. Honestly, full time would be stretch for me right now after such a difficult recovery. I still get tired easily, but I'm back to most normal household and life activities. Driving finally doesn't do me in (up to an hour) and I have managed my grocery shopping, a county fair with the family for a few hours, and setting up a swimming pool for the kids. I can lift around 20 lbs now.
It's been a long rodeo to get here, but at 10 weeks, I can say I'm glad I had it done. The pain I went in for this surgery for is gone and has never been back. My core is getting stronger everyday, as is my back, and 1 week ago, I realized that I made it through a 7 hour work day plus hour commute each way without a booster dose of Tylenol. I now take OTC meds as needed. Most days I need 1 or 2 doses, but it's directly correlated to my activity level.

My pathology report turned out to say I had chronic cervicitis, so I'm really glad I didn't leave my cervix, because it's likely that was the root of the left sided intense chronic pain. My right ovary had just as many problems as my left previously had, which had developed since the surgery 5 months earlier. I am on a small dose of estrace daily and as far as hormonal symptoms go, I have never felt better. All the symptoms of perimenopause, are gone for me. I actually feel like I have more stable hormone levels without my ovaries on my HRT, so I wonder if maybe I wasn't producing enough estrogen before.

Explore all your options, but trust your gut. You know your body better than anyone. If you don't like what is suggested to you, seek alternate opinions, but ultimately trust your own intuition. In the end you are probably correct about what you believe you are feeling.

When planning surgery, don't try to be a super hero in recovery. Try to avoid planning it when you know you have a trip in the next 6 weeks. Others may try to treat your leave as a "vacation" and try to invite you to trips and getaways, politely decline if it's prior to 6 weeks, you are going to be a lot more tired than you could ever imagine. The effort to travel to these events will wipe you out and there will be no enjoyment. We women go through so much, between periods, pregnancy and loss, child bearing. We become so "tough" that we tend to think this will be just another minor notch in our womanly belts, but this surgery often brings the toughest amongst us to our knees for awhile. Allow others to help you, and advocate for help when you need it. When I was having a tough time, I reached out to my priest for meal assistance, he made one announcement in church and I had meals and groceries so plentiful I had to hold people off for a few weeks! It proved a God send. When you are past the first couple of weeks, you will seem pretty normal to people, and they will assume you are all healed, be sure to not allow them to push you to overdo things. In time, you will get there, but you need to be driving the boat on how fast you resume your activities.
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