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SHARING IS CARING
TAH - Robyn's Diary
From the Abdominal Hysterectomy Stories Articles List
Robyn’s hysterectomy Diary (TAH on 23rd February 2005)
Tuesday 22nd February
Very nervous, fear of unknown etc, plus not eating and ‘Fleet’ laxative all a good combination! Naturally didn’t sleep too well on Tuesday night.
Wednesday 23rd February
Morning of op, just as nervous if not more so, as op imminent. Assistant surgeon Janine came in half an hour before op to say would be between 9 15 and 9 30, so rushed to shower and to put on body stockings (very graceful items like tight suspender stockings, to help prevent blood clots evidently a hazard with any op). Anaesthetist had come by earlier and I had talked about anti-nausea medication and some kind of relaxant to calm nerves, which he was very good about and I had taken of both about an hour before they wheeled me away. Rhys was there by the time they came to take me away ha ha, and I didn’t realise it but was getting groggy. Have a hazy memory of being wheeled on bed through elevator doors, then introduced to operating theatre staff including seeing surgeon John Doig fuzzily whizzing across field of view, then next thing, same moment in continuity of consciousness it appeared, was very fuzzily trying to see as woke up in recovery ward. This time consisted of asking feebly for water or pain killer (on a morphine drip, not far from left thumb) and feeling very needy of basic things, hit for six as it were. Then before I knew it was back in the gynae ward room, trying to take in what had happened. Events are a bit of a confused blur at this distance of three weeks out (or maybe it’s just me and how my memory works!) but I rapidly found out that the operation had had to be abdominal, with a nice big vertical cut from the top of the pubic bone to just under the belly button. Apparently the uterus that was ‘delivered’ this way was the size of an 18 week pregnancy, enlarged by fibroids, some as big as a large grapefruit. I got the feeling the surgeon had derived some satisfaction from removing the hulking thing, which clearly was better out than in. An interesting detail was the insertion of a screw device to get a grip on it in order to remove it! Then the cervix was taken out vaginally as per an LAVH, which had been originally scheduled for me, with my ovaries being left in.
What was a somewhat strange feeling at this stage was the drain tube coming out of the vertical incision, the cut was stitched in about three places, with steri-strips across the gaps, but there were still some open gaps one of which was where the drain tube was coming out of. So weird, surreal almost, to be opened up like that yet be perfectly ok and safe-feeling. At that point my left hand and arm were all taped up with lures, one for IV and one for morphine, and later one for an insulin drip as I’m type 2 diabetic. There was a catheter tube coming out attached to a bag also, surprisingly this was ok and reasonably comfortable. So I was feeling very tied to the bed and tied to the machines going ping. I slept fitfully on my back, (snoring loudly so I was told!) for most of the afternoon, sleeping off the anaesthetic, and emerged in early evening still very groggy but slightly more awake.
I couldn’t sit up, and was urged not to try, so lay on my back turning my head from side to side as the need to change position arose. I realised later that the hardest thing about this early time was going from relatively mobile and active before the op, to being laid out flat on my back unable to move or sit up to clear my head, totally out to it and groggy from the morphine and anaesthetic, and incapacitated with hurty bits and incisions. Perhaps right there is the reality of what everyone says about this being a major operation, I think that although I’d been through an anaesthetic and ops in years before, for a laparoscopy, a tubal ligation, and a knee operation, the feeling of being overwhelmed and out of action that I had on waking up from the abdominal hyst was nothing like I’d experienced before. It kind of blew me away with how immobile I was, and deep inside I longed with every part of my being to be up and active and well again, as I had been just a few hours before. It almost felt like I had died, but I could still see life going on around me through a sort of bubble or plastic wrap window, there but out of my grasp. I grieved with the sheer difficulty of achieving that just then, and every bit of progress afterwards was cheered on towards that goal, and setbacks were very discouraging (ovaries in action?).
Thursday, 24th February
Well needless to say things didn’t stand still, and by the next day, in an effort to clear my head a bit, I had swapped the morphine drip for codeine phosphate tablets, and voltaren and paracetomol, and was feeling a bit more alert. Later that morning the catheter and drain tubes were removed, without any discomfort just a slightly weird slidy feeling – hooray! Then later in the afternoon everything else was detached except the lures and the IV drip and stand. I was actually able just after lunch to sit up, very dizzily, on the bed, and slowly, slowly and oh so carefully, stand up and then inch my way along the corridor to the toilet, holding on to the IV stand as I went. A women in one of the other rooms said as I passed at 3 cm/hr, “I know that feeling!”.
The wound in my stomach was gurgling some loose bloody fluid whenever I got up for a bit, so the nurse would change it regularly. They were not worried saying it was not unusual for such an incision to seep, but wanted to keep an eye on it.
As the day went on, at one stage the reality of the difficulty of how I was feeling must have set in, or it may have been combined with hormones from upset ovaries too, but when the nurses were there, something triggered me off and I just howled with the awfulness of it all. I am a big wuss at the best of times, but the adeno had really gotten a hold before the op, and one of its more unpleasant effects is to be easily stressed, so I found it all much harder than someone without adeno might have. The nurses were so very kind to me, held my hand and understood I think how hard it can be at that stage. But once I’d got it out of my system I found things easier.
By the evening I was getting it sussed, and sitting up in bed was not difficult, though progress along the corridor was still inch by inch. When I stood up I could feel everything in there sliding to the bottom of my pelvis, such a weird loose feeling, but not painful or anything, except where the stomach incision was taking weight. I noticed it was easier to hold the incision site with both hands across the stomach, to ease the pressure of the wound when walking. Along with the other women in the ward who’d also had hysterectomies, about 6 of us in all, we could be seen walking up and down the corridor holding our wounds, like ghosts or lost souls in the night in our nighties, easing gas or walking off sleeplessness, or just walking!
My partner Rhys came several times today. I found I really had no resources to put into showing appreciation of his being there, though of course I did appreciate it deeply. I was still so flattened by my experiences that all my energy was spent on just existing through it, I think. Although several sets of visitors came, I don’t think I was really fit for visitors.
I had some trouble sleeping once again, and got only patchy sleep of bits of 2 and 1 hours I think. The ward was very good about setting up a night atmosphere, no lights and quiet when checking up on patients, but still the unfamiliar environment, the strangeness of everything that had happened with the surgery and how I felt about it, plus the pain and need for regular meds, all combined to make sleep difficult. The pain was not bad really, and well contained by the medications so I never got to experience it in its full glory. It would rank as some have said, like moderate period pain.
Friday, 25th February
This morning the lures were removed – hooray! Always a positive moment that, when you are truly free at last of the machines. I found that I would probably have to stay another day, due to the seeping wound, where I had been hoping to leave today. So the rest of the day was mainly spent resting, getting up to go to the toilet (every couple of hours!), and trying to achieve the holy grail, passing wind or preferably a motion, in order to prove that your bowels were ok after their ordeal. To this end some women took peppermint tea, and the nurse gave out Metamucil or kiwicrush, depending on their fancies. Eventually in the later part of the day I achieved this blessed state, but although this was a good thing, I still had really bad gas pains from constipation, for the rest of that day and all the next too. I found out from the night nurse, who was really helpful with advice and information, that the poor old intestines get roughly handled during the surgery, held out of the way and clamped. They move their contents along by a wave motion or peristalsis, and when handled this motion can stop, so after the surgery they need time to restart and get back to normal, hence constipation and painful gas are a common condition at this stage. The codeine phosphate I was taking for more serious painkilling also caused constipation, and I tried to get off them as soon as I could later when I got home.
Actually the gas on the Friday was pretty excruciating at one point, thereafter more bearable. But was spoiled my enjoyment of life properly was the nausea that seemed to accompany the gas. I’m not sure if it was solely due to the gas, or part of the getting up and walking around while the bowels did their settling thing over the next few days, but it was almost constant nausea and quite a miserable experience. Once again I had much trouble sleeping on Friday night, making the third night with poor sleep, so I was getting fairly exhausted by this stage.
Saturday 26th February
Well, bowel motions were just splendid. This fascination of everyone, patients and nurses, with bowel motions and whether you are going properly, is kinda comical, only matched by the interest of new parents in their babies’ habits. But I was allowed to go home, and boy was I keen! I was still nauseous, but it was somewhat abated. By Saturday morning all the women still left were feeling well enough to conduct a very pleasant social life in and out of all the rooms, and it was a really nice atmosphere in the corridors etc. But we all said goodbye sooner or later, and I was so glad to see Rhys, and inch my way, now at about a speedy 8cm/hr, to the exit doors.
When I got home, everyone was there to show me all the mod cons installed for my convalescence, (new shower, TV in bedroom etc), and I was overwhelmed. More visitors, and it was so nice to be home and realize how lucky I was to be in the heart of friends and family, how much they cared. But also the gas and nausea were still present, and I was also easily tired, not being able to sustain more than half an hour’s activity really. I spent Saturday wandering around from loo to bed to outside briefly, and holding my wound, like the same lost soul routine as in hospital, where I think I really should have been still. I was pretty miserable, and couldn’t spare any joie de vivre for my loved ones. They could see how off I was, but it was a question of time really.
Saturday night I was so paranoid about sleep and the lack of it that in fact I didn’t sleep at all, and about 5 in the morning asked Rhys to take me to the afterhours medical centre for a sleeping pill. I was a mess! Couldn’t sleep, really hungry but too nauseous to eat, totally exhausted. Doc gave me a sleeping pill, a $52 one for the privilege – should have stayed home! One the way home I asked Rhys to stop at a 24 hour dairy and he bought a thickshake for me, which was the only thing I felt I could eat! So I finally slept for an hour or two.
Sunday 27th February
Much the same story on Sunday but I was feeling a little more settled at home, and I managed to stay on the net long enough to find some really useful information about one of the things that had made it hard for me to sleep. When I’d tried to drift off to sleep, I felt as I had just after the anaesthetic, that I was suffocating and couldn’t breathe properly, which apparently is a side effect and why they put in the oxygen tube for a while. You’re not really suffocating, just breathing shallowly, but it was a feeling that made it hard to relax for sleep. I found that not only during the surgery do they give the intestines a hard time, they also clamp the stomach muscles out of the way, rather than cut them, which explained why I did not have too much trouble sitting up and moving up in bed from early on – it did not feel like my stomach muscles had been cut. They were however, understandably, very sore. This soreness I realized I had mistaken for the feeling of not being able to breathe very deeply also. Once I realized this, I was able to relax properly as the breathless feeling came on me when I was falling asleep, and for the first time for a few days, slept properly that afternoon for a couple of hours. I said to Rhys afterwards, when he mentioned that he’d come in and was so glad to see me asleep, “Did you see me sleeping!” That was a turning point I think, and although the nausea and gas continued for a day or two more, the rest I caught up on made a huge difference to how I coped, and I felt much more settled at home.
Monday 28th February
I worked out a combination in the end to treat the constipation, of prune juice, eating lots of fibre, and yoghurt, that helped a lot. Later I switched to kiwifruit instead of prune juice, which is less drastic in its effects. Once I came off the codeine phosphate, and replaced it with the anti-inflammatories voltaren and paracetamol, which apparently together can be as effective as codeine but do more good to the wounds, then the constipation really cleared up and everything was chugging along just nicely. By the end of Monday , I was beginning to feel more like part of the living world and less like the lost soul of the hospital corridor!
Tuesday 1st March
Tuesday was the first day I felt really normal, and the world began to take on a shine again. One thing I really had missed was some sexual time with my dh, so we spent some time doing stuff that didn’t include anything orgasmic for me, or penetrative, but oh it was so nice to be intimate with him, really back in the living world, and best of all, it felt like a stream had been unblocked as far as my responses went, so nice to see, and something which as of the date of writing three weeks post-op, has stayed and not diminished. So if for nothing else, apart from removing the big lump of a uterus and its fibroids, the op would have been worth it for this benefit alone.
Today too I went for a 5 minute walk up the street, as I had been doing so far, and for the first time I was able to walk in a normal lifting fashion, and not in the mincing one it had been so far! Encouraging progress all around.
Thursday 3rd March
Walking continues to improve, slight nausea every now and then, but not impairing. Walked 10 minutes up the road, felt good. Bedroom time of innocuous nature continuing, but we mutually decided that while he was satisfied, she wasn’t, so dh did the ‘O’ deed for me very cautiously and it was just great, with no great soreness or repercussions – hooray! That put a new light on the whole outlook, and one step closer to normal relations!
Second week, till Wednesday 9th March
Walking time steadily improving, up to 20 mins, getting freer movement with each walk, as well as more of my energy available each day. The healing wounds took up a lot of energy initially, but each day was better, so I could do things for an hour or so before needing a rest, then more activity. By the end of the second week, I had a go at a short drive, and it was just fine, within the confines of my free energy. I could now sit up at a desk for fairly long periods, an hour say, and from about Sunday was only using paracetamol for painkiller. Also by the end of the week I was caught up with sleep and could always look forward to a good night’s rest. As well, after two weeks of bedroom activity that included orgasms but no penetration, and aware that it would be another 4 weeks till the surgeon gave the ok, dh and I decided that this was just a bit too much deprivation, and tried anal sex extremely cautiously and carefully. (And for those who feel squeamish at this point, I would say that we had done this plenty in the past pre-op, it’s a common thing for hetero couples to do!). My verdict was that I was not particularly sore afterwards, and essentially no ill effects, (not mentioning all the good effects!), which is curious when you think about the fact that vaginal sex needs to be kept at bay for four more weeks.
Third week, till Wednesday 16th March
My walking time has slowly built up to around 50 minutes, going slowly and steadily on level ground, and for most of the past week I have felt completely normal. I can now spend most of the day doing stuff, nothing too heavy, needing a short nap in the middle. I can sit at a desk for as long as I wish, and am only using the paracetamol sporadically. If it wasn’t for the presence of the wound scar, which is mostly uncovered and looking really well healed, I would almost not think I had had an op recently. The last 3 days were those of what would have been a period I think, and I have felt extra tired, so have rested more. But on the whole, I feel more energy each day, and I’m looking forward to seeing what other benefits the op will bring.
03-16-2005 - 01:46 AM
SHARING IS CARING
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