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Laparoscopic Supracervical Hysterectomy - LSH - Dixie Tracy's Story

From the Princess Stories Articles List

"Dixie Tracy and the Case of the Big Fibroid"

There are a million capers in the Land of Hyster. This is one of them.

It all began innocently enough. A casual question during the annual uterine interrogation. "Doc. Have you read about my latest case, 'The Mystery of the Invisible Truck'?"

"Describe this truck, Dixie."

"That's just it, doc, I'm never able to catch a glimpse of it - but I'm sure I've been run over by it. From the feel of things, it's a largish truck…"

"Hmmm, how often does this truck seem to, err, flatten you?"

"Well, doc, that'd be about every four weeks - here, take a look at my detailed records. Leaves me with quite the headache, too, what with being flat and all… Another clue is the long trail of blood."

"Yeah, Dixie, sounds to me like another sighting of BIG BROID! We don't have many answers about BIG BROID. It's common enough around these parts. Likes to hide in the most unusual places. Tries to give you the "broidian slip." Keep your eye out - we'll watch and see… Here, take these aspirin…call me in a year."

The years passed. Docs came and went, but BIG BROID hung on. Followed by the twin broids. (You've read about them, I'm sure, in "The Aching Hunchback of Notre Broidie" and "The Phantom of the Bladder.") Two years ago, I reported on "The Case of the Bloody Car Seat," similar in plot to "W Was for White Pants." Then, as insidious as the TV theme song, along came "The Broidie Bunch."

Finally, while researching the "Case of the 36-day period," I called in an investigative team of 5 doctors. Their verdict was unanimous - and hysterectomy was the most frequently suggested means of flushing BIG BROID out of hiding for good.

One of the investigative team members - the last to join, I might add - suggested we try a new route for this hysterectomy. I thought I'd heard it all - the TAH abdominal incision, with the usual 6-week recovery at home; the TVH, with shorter recovery and fashionable vaginal cuff; the TAVH, using laparoscopic visual assistance to aid the vaginal route. "How about doing the hyster entirely through the laparoscopic incision? It leaves only a couple tiny abdominal incisions - just a stitch or two. Usual recovery is two weeks. It's a newer procedure - my partner's done some - are you willing to try? It means a couple months on Lupron shots (2 of them, total) to shrink everything down - make for easier removal. We'll leave your cervix to support your bladder, and leave the ovaries, too, if you want."

"Well, doc, I just heard of this laparoscopic technique last night! A couple pals of mine, they call themselves the HysterSisters, had heard of this op. Sounds like a plan. When do we start? Now? Are you sure? As in, this minute? Okie dokie!"

My broids and I had been through a lot together. Seven years of heavy long periods, back pain, bladder pressure, swelly belly, and that vague tender-to-the-touch feeling two weeks every month. Nights spent tossing and turning in a vain attempt at finding "the comfortable position." Vacations ("uh, I think I'm just gonna stay in the hotel room this morning, honey"); white pants ("rats, I knew I shouldn't have worn these today"); the three-hour classes I teach ("ok, class, time for another break - and I get dibs on the bathroom"); and numerous nighttime jaunts to the bathroom. But all good things must come to an end, and the broids and I were about to part ways.

The Lupron did its thing. I'd heard horror stories about L's side effects, but they left me alone. In fact, stuff did start disappearing. Backaches and nightly bathroom trips were the first to be eliminated. Headaches didn't appear. Tummy flattened. And, oddly enough, the usual hot flashes and night sweats - were gone! THIS IS NOT THE NORM - but then, who's Normal? (Always thought it was a cycle on the washing machine.) It took two months, but finally…

The long wait was over. My pre-op had gone smoothly a few days ago - although we weren't certain if the lap hyst was a go. Might have to go LAVH, or even TAH, depending on what the doc found in the OR - my uterus was still just under my navel, but it DID shrink sideways. This shrinking made the ole' "Ute and the Broids” a bit more mobile, a fact my doc vigorously demonstrated. The last few days of waiting were filled with "what ifs" of a 2, 4, 6, or 8-week recovery. A night of catnaps, interrupted frequently by bathroom calls from magnesium citrate, and then my castle preparations began with a 4 a.m. shower, after awakening DH. This princess-to-be was on her way. The shower left me feeling good. Ready. I awoke DH, "time to go to the hospital, dear!" I dressed with care - a loose term, since all my clothes were quite loose. Leaned over DH (in bed) and gave him a kiss - "time to go, sweetie." Packed a t-shirt dress for my homecoming trip. Socks to keep the tootsies warm. Some cases (by Holmes, Wodehouse, Grafton, etc.) to review. Chap stick and a comb. Time to wake up DH.

As we drove down Grand Boulevard, cutting off to Division, I watched a Spokane sunrise of pink and gold clouds. "Open your eyes, honey." DH was at the wheel, and even though traffic was light at this hour, I preferred an awake driver. DH yawned, "I'm just dropping you off, right?" Dixie gave him THE LOOK. DH, now awakened, didn't leave until they wheeled me into the final pre-op area.

Hospitals, err castles, make me feel secure. Maybe that's nuts, but I used to work with a buncha great anesthesiologists. Their job was to live for you in the OR - breathing, quieting your nerves, and rendering you numb while maintaining your vital systems. Their job leaves no room for error - they do it or they don't. Who would take on such a task? Someone with self assurance, calm nerves, quick reflexes, and a sense of humor born of life's biggest pranks. For five years, from my office next door to the post-op unit, I lived in the intense but certain atmosphere only a hospital can provide. It feels like security.

DH and I chatted amiably with the pre-pre-op nurse for an hour or so. Took all the normal vitals. Put in an IV. Then, "broidal party of five" was off to the real pre-op room. On my journey I caught glimpses of the summer day unfolding - a bright blue sky promising a perfect day to come. Then the windowless operating suite, the real pre-op room, filled with surgeons, anesthesiologists, residents, nurses, and patients dressed in our surgical best. An anesthesiology debate took place for a few moments - to epidural or not to epidural, which was the question. Along comes the good doctor, my surgeon " let's do an epi with general." "Good idea, splendid, brilliant, what a mind!" They all chorused. I rolled over, was scoured with antiseptic, they found the right spot, and

I awoke to the surreal peace and frenzy of the recovery room. "Hi Dixie, we were able to do the lap hyst - you're in recovery, now breathe!" A quiet prayer of thanks. Then a quick body run-through. Toes - moveable. Lungs - deep breath ok. Fingers, gave 'em a wiggle. Lift up arms, thumbs up to nurses. Time to try the vocal chords. "Really, they did the lap?" "Yes, everything went very well."

Hmm, quick run-through of anesthesiology knowledge - you don't dream under anesthesia. Therefore, I'm awake. Therefore, I can trust what they're saying. Ok, let's just double-check. "Really, they did the lap?" "Yes, you're fine - went wonderfully!" I remember, vaguely, repeating this conversation another time or two. Then, I rolled on into my room. Back into the sunshine! And there was my own little overnight bag, resting at my feet on the bed. (Inside was the good-luck guard kitty my friend gave me the evening before to watch over me, purring to her ceramic self.) Even after anesthesia, my acute observational skills detected a moaning from the other side of the curtain - my roommate. She sounds like a world of hurt. I feel great.

Ah, I detect a new group of nurses. One final check, "soooo… they did the lap hyst, right?" Well a lady can't sleuth enough!

The nurses introduced me to my morphine pump, water pitcher, "get sick" bowl, and TV remote. I'm given a breathing thingamahooie - take a deep breath and, like the carnival strength test of old, make the "ringer" go all the way to the top. I'm a woman with a goal… My roommate, I discover, has a thing for the Jerry Springer style of TV - lots of people yelling at each other. Oh dear. In an hour and a half, I'm bored. Call DH but no answer - probably in the shower. Call my office, and tell them I'm ok. Twiddle thumbs. Push the morphine button. DH appears with flowers. Flowers appear from office. Between the morphine pump (I push it about 15 times on the first shift, 4 or 5 the next, and 2 the last) the TV remote, and my reading material, I pass the time. DH stays and chats for about 3 hours. Dinner is served, but not to me. By 10 pm I take my first walk. The nurse cleverly arranges my IV and pee bag. We shuffle to the door. Throwing caution to the wind, I push on, and walk across the hall. Phew! Time for a nap! Back to bed - lose my cookies (well, actually, cranberry juice) - the only time I feel sick. Apparently I'm putting fluids in, but my output is slow. Nurses check via stethoscope, and all's quiet on the bowel front. The night is spent napping and checking vitals every time I get dangerously close to actual sleep. Hospitals are not for sleeping.

The next morning my catheter and IV take a hike. I'm a free woman! Take a shower, of sorts, and find putting socks back on is an interesting trick. Within the next few hours I succeed at peeing like a big girl! Bowels are making glorious gurgling sounds, and I get to have breakfast. Toast never looked so good. Pass the toot test - another step toward recovery.

The nurses begin to hint that I might go home soon. They suggest taking longer walks. I call my track coach (DH), who arrives within the hour. Soon we're lapping the hospital floor. All my nurses are surprised at how rapidly I'm coming along - this lap hyst is new to most of them, and they love it! About 5:30 my doc appears, checks my incisions, tells me I have 2 internal incisions, and gives me my marching orders. I'm dressed in 2 minutes.

At home I go SLOWLY up and down stairs about 2 times. (Holding onto handrail. On the way up I take one step at a time with - "left, right, pause" on each stair landing.) I weigh myself, and have put on 18 pounds of water-weight in 24 hours! (Lose 8 pounds the first night, then 4, 3, 2, and then back to normal.)

My first day home I'm walking about the house slowly, with swelly EVERYTHING (nice 5-inch wide roll around tummy hips and bottom, swelly ankles, feet, knees, hands, cheeks, earlobes - well maybe not earlobes), but pain was 1 on 1 to 10 scale at worst, most of the time at a 0. Much easier getting in and out of bed. Up the whole day, but rest often on sofa.

Fri - got up easily. The waterbed has not been a problem - and I'm using my body pillow as a way to elevate my feet. Constipated, but that's my only complaint. No pain pills except Motrin until evening. Didn't even think about stairs (up and down a dozen times) - really, no problem. Mostly worried about having bowel movement the size of Rhode Island, so I called doc's office. They call in a new pain med prescription to my pharmacy, but forget to tell me. Eventually took mag citrate as I did prior to surgery, which emptied bowels again.

By Saturday I took a mile walk outside with DH - not fast, but not strolling, just a walk. Up for an hour or two after, then felt tired and napped an hour. Pain at 0 level. Swelling going down daily. Monday the doc's office calls back, and I discover the new pain meds were waiting for me all weekend. What's an operation without at least one small glitch?

I am doing better than I hoped in my wildest dreams. DH is wonderful - he changed the bed, goes to store, laundry, etc. It is odd to ask him to do so many little things - please hand me this or bring me that, etc. I make a sandwich 4 days post-op - phew! And heated up a frozen lasagna, but had DH cut it up.

My first drive around the neighborhood, at 10 days post, I only make right-hand turns. No crossing traffic for the detective. Two days later I master a 10-mile field trip. I can go to the STORE - whoa. Pick up one item at a time. Utilize the bagger's offer of "help to my car."

Finally, at my post-op, I get the ok to return to half days at work. After 7 days, I'm ready to go back to my full-time beat. My brush with Big Broid was over.

Respectfully submitted, Det. D. Tracy, Fibroid Investigations

08-05-2000 - 04:17 PM


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