HysterSisters Hysterectomy Support and Information
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Your Post-Op
Checkpoint 1-2
postop hysterectomy
Home From the Hospital

Time to Rest and Heal
Your Discharge Instructions

When you are discharged from the hospital, your doctor will give you written instructions for pain medications and symptoms that should prompt a call to your doctor or a trip to the emergency room.

In most cases you should call your doctor or head to the Emergency Room at your local hospital if you experience any of the following:

  • severe nausea/vomiting
  • increased pain
  • fever greater than 101 degrees for 24 hours
  • difficulty breathing
  • unusual bleeding
  • leg pain

    Always call your doctor's office with any concerns you have about your health.

    Caring For Your Incisions

    Some types of hysterectomies have external incisions that require tending. Discharge instructions from the hospital should contain specific instructions for caring for yours. If they do not, ask your surgeon or call his/her office.

    Vaginal Hysterectomy

    While a vaginal hysterectomy does not have external incisions, if you had anterior or posterior repairs, you may have an episiotomy-like incision; if so, the first thing to remember is to avoid sitting. For immediate relief, use a peri-bottle filled with water as hot as you can stand it to spray over the area every time you visit the washroom. If you were not given one when you left the hospital, a sterilized plastic condiment bottle will work just as well. Another option is to use a clean wash-cloth that has been thoroughly soaked in hot water.

    Laparoscopic Hysterectomy - Includes daVinci® Hysterectomy

    Usually the 4-5 small incisions of a laparoscopic hysterectomy can be covered with bandaids. Although your incisions are small, internal healing must still take place. Be sure to rest enough so your body can heal properly.

    SILS or LESS Hysterectomy

    Known as the "single incision" in the belly button folds, keep your incision dry and clean and covered with a bandaid until cleared by your surgeon for bathing.

    Abdominal Hysterectomy

    You may come home from the hospital with stitches (or staples) or your stitches may be removed before you leave the hospital and replaced with steri-strips. Generally, your incision should remain dry (or be dried carefully after a short shower) and covered loosely. A call to your doctor's office can calm your fears if your incision comes open. Be sure to rest and do not do any lifting. Overdoing things can stress your incision.

    Managing Pain Upon Discharge

    Upon discharge from the hospital, your surgeon will send you home with pain medication and instructions.

    Minimally Invasive Surgery

    Typically, minimally invasive surgery patients have little pain which can be managed with Tylenol or Advil-like products.

    Open Abdominal Incision Hysterectomy

    During the first week, it's important that you follow your pain medication instructions, taking your pills on schedule. This is to ensure that your pain will be manageable. Waiting or forgetting to take your pain medications may mean that your pain will increase and will be more difficult to "get on top of."

    Denying yourself the pain meds might sound heroic but your body will have a difficult time healing from the incisions and repairs if it's spending its energy managing the pain.

    Take your pain medications as instructed and call your physician with any questions or concerns.

    The Pain Scale

    The Pain Scale is a great way to communicate the intensity of your pain to your family and/or physician.

    Andrea Mankowski, software designer and endometriosis sufferer, devised this pain scale to describe her pain to her family and her physicians. Although it is designed to describe pelvic pain, it can in fact be used to quantify pain anywhere in the body. If you research pain on the Web, you can find many references to this method of quantifying pain. Feel free to print this out and take it with you to your doctor appointments or to the hospital.

    • 0: Pain Free. No medication needed.
    • 1: Very minor annoyance - occasional minor twinges. No medication needed.
    • 2: Minor annoyance - occasional strong twinges. No medication needed.
    • 3: Annoying enough to be distracting. Mild painkillers are effective. (Aspirin, Ibuprofen.)
    • 4: Can be ignored if you are really involved in your work, but still distracting. Mild painkillers relieve pain for 3-4 hours.
    • 5: Can't be ignored for more than 30 minutes. Mild painkillers reduce pain for 3-4 hours.
    • 6: Can't be ignored for any length of time, but you can still go to work and participate in social activities. Stronger painkillers (Codeine, Vicodin) reduce pain for 3-4 hours.
    • 7: Makes it difficult to concentrate, interferes with sleep. You can still function with effort. Stronger painkillers are only partially effective. Strongest painkillers relieve pain (Oxycontin, Morphine)
    • 8: Physical activity severely limited. You can read and converse with effort. Nausea and dizziness set in as factors of pain. Stronger painkillers are minimally effective. Strongest painkillers reduce pain for 3-4 hours.
    • 9: Unable to speak. Crying out or moaning uncontrollably - near delirium. Strongest painkillers are only partially effective.
    • 10: Unconscious. Pain makes you pass out. Strongest painkillers are only partially effective.

  • Post-Op Video - Weeks 1-2

    Home from the hospital? This video produced by HysterSisters.com provides you with answers to your questions and help for your surgery.

    Post Op Hysterectomy
    Post Op Vaginal Bleeding

    No matter what kind of hysterectomy you had, chances are you will need to wear a pad for a few weeks as there will likely be vaginal bleeding post-op. As your healing continues, the bleeding will be less and less red and become more brownish. Around weeks 3 or 4 you may pass some stitches.

    If your bleeding was lessening and one day you see much more blood and it is bright red, be sure to call your doctor's office. Lifting or doing too much may result in the tearing of stitches which could cause extra bleeding and slow down your recovery. This is another reason to take things easy and allow your body to heal.

    The odd odor you may become aware of can be a combination of things related to your hysterectomy. Healing vaginal stitches may be one of the culprits! Pain medications could also add to the odd odor. But remember: no douching allowed.

    Help Getting Out of Bed

    If you had open abdominal incision hysterectomy, you may find it difficult getting in and out of bed. Some women find getting out of bed so difficult they spend their nights in the living room recliner. Here are some tips that might be of help navigating the bed dilemma.

    Turn over to the side you are getting up from. Do not try to sit bolt upright as it hurts tons more. By turning to your side, you are using fewer front abdominal muscles and using more of the side muscles and your arms. So, go all the way over on your side; now, with your elbow on the bed, start to push up and at the same time put your other arm in front of you to help push you up to a sitting position (it is kind of like walking your arms along until you are upright). It helps to have your feet just about hanging over the edge also, but not too much or that stretches in a way that hurts. As you push yourself up, you need to drop your feet down.

    To get back down, you should do just the reverse. Do not let yourself flop back down straight. It really hurts; you have no control over how fast you are going and you will tighten up those abdominal muscles in a very jerky way trying to slow yourself down. OUCH! Again, this is the really hard way to get back into bed or on the couch. Instead, lower yourself onto your elbow, using the opposite arm in front of you to brace yourself going down on your side. Do not turn until you are all the way down and your knees are up on the bed. Once you are totally down and on your side, then turn over. To adjust yourself, bring your knees up a bit and dig your heels in and lift your bottom or hips to adjust yourself. Use your legs, not your stomach muscles if possible.

    Other great ideas: a kitchen chair next to the side of your bed can be used as a handle, much like a railing on the side of a hospital bed.

    Constipation

    If you are experiencing the normal constipation from your surgery, here are a few things HysterSisters recommends:

    • Use a stool softener instead of a laxative
    • Drink lots of water
    • Walk!
    • Eat foods that are full of fiber and encourage movements (Prunes, apples, bran)
    • Ask for your doctor's recommendation!

    Bladder Spasms or Infection

    During your hysterectomy, it is likely you had a catheter inserted for urine collection. Although the catheter is usually removed within a few days of surgery, your bladder may be affected by its use.

    Many women complain their bladders feel as though they have an infection. It may be that you have a bladder infection (especially if accompanied by a fever); however, many discover that the bladder isn't infected but spasming. Your bladder is irritated during surgery by being moved and also by the use of the catheter. It may take your bladder a while to get back to feeling normal.

    Check with your doctor on any concerns you have about your bladder. There are effective medications for bladder spasms or, if you have an infection, your doctor will need to put you on antibiotics.

    Insomnia

    Yes, having insomnia after your surgery is very normal. Perhaps it's the pain medications or perhaps it's your body's reaction to the shock of surgery. Whatever the reason, this is something to discuss with your doctor. You need to rest when you can. Struggling between insomnia and post-op nightmares is a challenge. Hang in there. Your body should get back to a normal sleeping pattern soon.

    woman with doctor
    Post-Op Hysterectomy Links

    Our Post-Op Discussions
    Our Post-Op Resource Links
    Our Post-Op Articles
    Help for Husbands

    HysterSisters Post-Op Articles

    Catheters?
    Feeling Lousy
    I'm Bored! Do's and Don'ts
    When Can I Take a Bath?
    What is this Weird Odor?
    Fifteen Things We Have Learned?
    FAQ for Family and Friends
    How Long Will I Hurt?

    More Post-Op Articles and FAQ

    Products We Recommend

    The HysterSisters Store has products selected and created just for you for your hysterectomy needs. Click here to visit the HysterSisters Store

    Free Booklet: What 100,000 Women Know About Hysterectomy

    Perfect Pocket Abdominal Binder

    Abdominal Binder

    More Products

    Recovery Hints

    Rest! Especially if you had abdominal surgery, expect that you will get tired just taking a shower. Expect fatigue to be your companion for a little while. This is the time to send your Super Woman cape to the dry cleaners. You won't be needing it for a while.

    Eat Right! Avoid gassy, constipating, spicy foods in your diet. Opt for the mild and healthy!

    Pillows!Pillows play an important part in the recovery of a hysterectomy patient. A pillow between your knees while sleeping on your side or pillow beneath your knees while sleeping on your back can help you find a comfortable position. Pillows will help to prop you up on the couch to help preserve your tummy muscles and soothe an aching back. Body Pillows can be helpful to help find a comfy place in bed.

    What is Allowed?

    Allowed

  • Picking up pillows and repositioning them-allowed
  • Turning on dishwasher AFTER SOMEONE ELSE HAS LOADED IT-allowed
  • Folding laundry-allowed
  • Taking short, easy walks and gentle stretching-allowed
  • Asking others for help-allowed and encouraged
  • Not Allowed

    • Vacuuming-NOT ALLOWED
    • Sweeping or Mopping-NOT ALLOWED
    • Carrying laundry across house to washer-NOT ALLOWED
    • Lifting, Bending, Reaching, Driving-NOT ALLOWED
    • Lying around the house all day doing nothing-NOT ALLOWED (see above)
    • Bending to access oven or empty litterboxes-NOT ALLOWED
    • Going to Wal-Mart for some bargain shopping-NOT RECOMMENDED
    • Pushing a shopping cart-NOT ALLOWED
    • Sitting for prolonged periods of time i.e. at computer-NOT ALLOWED
    • Opening windows, particularly the hard-to-open ones-NOT ALLOWED
    • Making other people's problems your own-NOT ALLOWED
    • Picking Tomatoes, Weeding, and other such nonsense-NOT ALLOWED

    Swelly Belly Information

    First of all, the term swelly belly is a HysterSisters-created word that refers to post-op swelling of the abdomen. It can occur in any type of hysterectomy procedure, but it seems to be more prevalent in abdominal surgeries. The current views are that swelly belly is caused by trauma to the abdominal tissues, gasses used during surgery, and/or fluids collecting in the tissues due to trauma during surgery.

    If you've ever sprained your ankle or been stung by a bee, you've probably had some swelling at the injured site. Same thing with swelly belly.

    What swelly belly is NOT is fat, or weak muscles (though they may contribute), or last night's lasagna collecting around your mid-section (though that can also contribute!).

    Swelly belly seems to make an appearance soon after surgery in most ladies (though not always all) and may hang around for several weeks or even months. It is exacerbated (made worse) by too much activity, lifting things that are too heavy, being on your feet too long, stuffing yourself into jeans that are too tight, and just generally overdoing it. It also seems to be worse in the evenings, after a long day.

    So, you ask, how do I get rid of it? You don't. It has to go away on its own!! Resting may help, not overdoing it, not lifting things that are too heavy, not being on your feet too long, whatever the triggers are for your case of Swellibellicus - that's what you should avoid. Sometimes a good support panty can help too, but again, make sure it isn't too tight, or it can make the problem worse. (Support panties work with swelly belly like putting a pressure bandage on a sprained ankle can take the swelling in the ankle down.) Occasionally, ice packs or a heating pad may help too, but check with your doctor first before using either. (Hint: Check the HysterSisters Store for support panties, ice packs and other tummy care products!)

    What won't help? Exercise, especially too soon, (though after your doctor has released you, it will help tighten up your abs). But the swelling in the tissue may not disappear with exercise. Dieting may not help either, though if you've got somewhat of a tummy to begin with, you may notice some improvement. However, once again, dieting will not get rid of the swelling in the tissues.

    So what's a girl to do? Just wear your belly proudly and don't sweat the small stuff. Swelly belly is just one of those things you may have to endure until your body has healed. A small price to pay for getting rid of painful periods, excessive bleeding, fibroid tumors, cancer, or whatever else was the reason for your surgery.

    P.S. If your tummy becomes hot or red or painful, please call your doctor. This is NOT normal and NOT part of the normal post-op swelling. Any unusual symptoms, or anything that you're not comfortable with, should be reported to your doctor immediately. Always better to be safe than sorry!

    P.S. HysterSisters recommends these Tummy Care Products to help provide a bit of support on your swelly belly.

    A Favorite "Move-Along" Recipe

    "Move Along" Gentle Breakfast

    Ingredients

    • • 1 pkg Apple/Cinnamon Instant Oatmeal
    • • 3 or 4 Stewed Prunes
    • • A sprinkle of All Bran cereals, to taste

    Instructions

    • • Prepare Instant Oatmeal in accordance with package instructions.
    • • In microwave, warm stewed prunes.
    • • Add the stewed prunes to the hot cereals.
    • • Sprinkle with All Bran cereals.

    This is a gentle, and surprisingly pleasant, way to combat extreme constipation. Repeat, once a day, until things return to normal.

    Managing Menopause

    After surgery it is normal for hormone levels to fluctuate whether or not you have kept your ovaries and whether or not you are using hormone replacement. If you have kept your ovaries, they may take some time to "wake up" after surgery and they may not function at capacity. If you have ongoing symptoms such as hot flashes, night sweats, moodiness and crying spells be sure to call your doctor. Perhaps a prescription for a low dose of estrogen to supplement your own hormones will help you feel your best!

    If you have had your ovaries removed, estrogen is usually the first hormone prescribed post-op. There are many choices! Discuss with your doctor which one you prefer:

    Hormone Article List
    Hormone Resources
    Menopause - Hormones Discussions. Menopause with No-Hormone - Discussions
    Menopause with No Hormones - Resources

    Thinking about Sexuality

    Your doctor should have given you instructions and rules regarding resuming sex. The rule is generally this: Nothing in your vagina until cleared by the doctor at your 6 week checkup. Many doctors also restrict external stimulation during recovery, so be sure to check with your doctor to find out exactly what is and is not allowed for you. During your 6 week checkup the doctor will check to make sure you are healing properly and if so, give you the "green light" to resume sexual activity.

    The "nothing in the vagina" rule is intended to protect you. Inserting anything into your vagina during the healing process allows bacteria to be introduced to your healing incisions and may lead to infection.

    HysterSisters has heard from more than one post-op woman who headed back for additional surgery suffering from torn stitches and/or ripped repairs because she did not follow instructions. Do you really want to take risks with your health after having major surgery?

    Be Fit!

    Walk! Drink Water!

    Your fitness plan during these two weeks is simple. Get out of bed after the first few days, take brief walks around your house, take a slow stroll down your front walk (try to avoid stairs!) and drink plenty of water.

    This sounds simple, -- and in a way it is -- but it is also very important. Getting exercise through walking, even when you'd rather be lying down will help you recover.

    For those of you that enjoy working out, running, weight-lifting or other rigorous exercise programs, your doctor will be able to provide you with a timeline of restrictions. Expect about 6 weeks to pass before you will be able return to your normal schedule (and ease back into it!)

    Be Encouraged!

    If there is ever a time to ask for help, this is the time. The smart HysterSister will understand that during these first two weeks post-op, the more help she can have, the better. Arrange with friends to bring meals. Find someone to drive your carpool. If you trip over dust bunnies, hire a housecleaner for a day to push the vacuum and clean the kitchen.

    Take time to rest. Trying to do too much when you should be lounging and healing will cause discouragement to rise up like a monster.

    Listen to beautiful music and bask in the glorious heart food it provides.

    Even if you had minimally invasive surgery, this is the time for you to heal. It's your sole job. Do it well!


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    The following is created and sponsored by Noven Therapeutics, LLC.

    Watch & Listen

    Dr. Michele Curtis shares information and tips for each phase of your hysterectomy journey. These videos are not intended to provide medical advice on personal health matters, which should be obtained directly from your physician.

    Dr. Michele Curtis

    Dr. Michele Curtis has been active in the practice of Ob/Gyn for over 20 years in both private practice and a teaching academic institution. Public health policy issues have been her passion—allowing her to be selected for a Robert Wood Johnson Health Policy Fellowship to work closely with the CDC and the Jacob’s Institute for Women’s Health. She is a sought-after national speaker, has served as the lead editor for two gynecologic textbooks, and has published on a variety of topics in numerous peer-reviewed journals. Her international work has focused on sex- and gender-based violence in times of conflict.

    About Noven

    Noven Therapeutics, LLC. is the specialty pharmaceutical unit of Noven Pharmaceuticals, Inc. Noven is engaged in the research, development, manufacturing, marketing, and sale of prescription pharmaceutical products. Noven is committed to developing and offering products and technologies that benefit patients, customers, and industry partners.

    Post-Op Checkpoint Weeks 1 & 2

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