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Vaginal Hysterectomy - TVH - Hematoma - T's Story

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Princess T's Story - TVH/hematoma



I had 3 medical opinions, all the same. My diagnosis was prolapsed (fallen) uterus, which was beginning to create a cystocele and rectocele (fallen bladder and bowel). The doctor was expecting to repair my pelvic floor in a total of 2-1/2 hour surgery, but when he removed the uterus, the 'celes corrected themselves (as he suspected they would) and pelvic floor was not as far gone as he thought it was, so not as much work there. He was done in 45 minutes. I had my surgery 3 weeks after my first symptoms and diagnosis. I think that was in my favor for the good surgical results.

Posted on Hysterectomy Support Board 4/14/99 >> I checked in at the hospital at 6:30am for 8:30am surgery. Last thing I remember is the anesthetist putting oxygen mask on me, and then I was in recovery and headed for my private room. The doctor said once he took the uterus, everything else went back to where it was supposed to be, so no pelvic floor repair needed. I have no external stitches and my ovaries looked great, so I got to keep them. In fact, I didn’t even get a morphine pain pump. They took catheter out in recovery.

There was pain when I would breathe. My ribs hurt; the doctor says it was from the position I was in during surgery (and just what WAS that position?). I have a little breathing machine to exercise my lungs and keep pneumonia away. I asked for medication from the nurses right away when I felt nauseous, so I didn't have any actual hurling. My doctor wasn't happy with my blood count. He said I didn't lose a lot during surgery, but they kept coming to take more to check.

I go up to use the restroom. I must have sat there for 30 minutes dangling my hand in water until I finally got a little tinkle. The nurse was not impressed and came back in with a catheter. She had a 5-gallon bucket when she got done (ok, maybe I'm exaggerating, but it certainly felt like that much relief!). After that I was able to go on my own.

I decided I would take a lap around the nurse station every time I got up to pee. Gas pains were awful, and I was bloated up like a balloon. The next morning I got to have a normal breakfast. Everybody and their dog come to check on me. I don't remember everything they said (instructions), but I hope I am doing everything right.

I got 2 prescriptions: Motrin for swelling and Percoset for pain. I am taking them religiously. The car ride home seemed way too bumpy (45 minutes). I used a soft pillow between the seatbelt and me. Anyway, I am home and resting. I look 6 months pregnant! I am parking my butt on the couch and napping whenever the mood hits me. Sitting upright is uncomfortable, and I am still awaiting a gold star for my poop card. The home nurse came out today to check on me and (what else?) take more blood! I am to take triple dose of iron every day to catch up on my blood loss. All in all, I am doing pretty well.

Posted on Hysterectomy Support Board 5/5(?)/99 Day 15 (Wednesday) post-op and I tried driving... still tender for me on the bumps, and I am thinking I have reached a plateau healing-wise. I am sort of bummed about that. I have been religious about taking the pain meds, iron tabs and stool softeners. I have to write them down to keep it all straight.

Day 16, I start the day with vomiting, fever, chills and diarrhea. Even my constipation moved (that was very painful!). I call the doctor's office and the nurse sends me to local clinic. When I arrive, my blood pressure is 88/58 and falling. Suddenly, I had five people working on me! My blood test shows I can back off on the iron tabs to one per day, and my white cell count looks good. Urine test comes back fine. I get an abdominal x-ray to check for bowel blockage and also make sure my liver hasn't shut down. I am shivering uncontrollably that the exam table is shaking! They keep me for a couple hours, pump 2 liters fluid into me to combat dehydration, and then send me home.

Day 17, I am feeling a little better, but still having the fever/chills routine. Day 18 (Friday), I am totally exhausted. I had gone to bed at 9pm and my hubby finally pried me out of bed at 11:30 a.m. Then I only went from the bed to the couch for more sleep; more fever/chills. We figure it is lingering flu-stuff from Wednesday. In middle of night, I get up for bathroom and feel a gush. It was dark brownish blood. Kind of scary. I had not had any bleeding since about 5 days post-op. I resolve to call the doctor in a.m. Why does this stuff always happen on the weekend?

Day 19 (Saturday), I am up, but very tired... sometimes during the night this week I would wake up in a pool of sweat, I was so hot. I have no energy or interest in anything. I am still having the fever/chills routine, but now also puffiness on abdomen. I imagined that the profile of my abdomen had changed, that right above my pubic hair and where my previous uterus had been, it was bulging. My entire abdomen area was very tender; I am nearly doubled over in pain when I walk. Saturday evening, I call advice nurse (we are HMO) and she says go to ER. I STILL balk at the idea (it is hour drive for us and we have young kids)... She said, "I would not be sending you if I didn't think it was an emergency". She says the words *blood clot*, *CAT scan*, and some other stuff I don't remember. We get to hospital about 8 pm. I ask for Gyn on call... I don't want a pelvic exam (I figure what can they possibly see when I am sewn shut?). Gynecologist on call is very good... he says maybe appendix or something not related to surgery and they will approach it with eyes wide open. They start with a CAT scan... I had to drink 2 bottles of red-syrupy stuff in 30 min. it was really gross. Scan took about 15 min and showed hematoma (collection of blood) the size of a tennis ball right where old uterus used to be. Next was very gentle pelvic exam; doctor wanted to confirm what it looked like in there for the upcoming surgery. A hematoma could evolve into a blood clot. It's now after midnight Saturday night; I am on oxygen and doctors start me on IV antibiotics, say they hafta get a handle on the septic situation before they can do any surgery, but they are shooting for Sunday noon surgery. I also get a morphine pain pump to help me with the misery I am in already. Surgery involves going into vagina, making an opening in healed-together tissue at top, draining all the old blood and leaving the opening for later self-healing. The whole thing would only take 15 min.

I was too miserable to worry about the surgery... had lots trouble with IV's (had 3 different ones in my hospital stay of 3 nights, blew out 2 different veins... ugh!). Post-op feelings from this surgery was less fog than post-TVH and a big feeling of relief (pressure-wise) in abdomen. I was pretty sick and weak from the whole septic episode though. I had to stay in hospital and continue IV antibiotics until Tuesday afternoon. After a few days of IV antibiotics, you get a *tin* taste in your mouth... everything (even the water) tastes tinny... makes for zero interest in food. Anyway, I am home now. I go for check-ups weekly until further notice. Get to do sits baths and start at beginning on pain meds, resting, etc. I am verrrrrrry tired. This complication will probably extend my medical leave from work. This whole thing was really scary for me... I had started this as a quick elective surgery and suddenly I was in a *do or die* (literally) situation.

Present time comments:

Things I learned: Don't blow off a fever thinking its hot flashes... Hot flashes were not an excuse for my 102.5 constant temperatures! My surgeon's nurse says in future, they will send all post-op patients to E.R. (not local clinic) for problems. Hospital is about 1-hour drive for us, and I was hesitant to go if I was just going to get fluids and sent home again. The hematoma infection was poisoning me... one doctor said similar to having chemotherapy (I've never had that before). Doctor says they don't really know what *causes* or *prevents* hematomas or blood clots, so can't they foresee them, and they were really caught off-guard by mine.

My personal opinion is that I should been walking more post-op (I was kind of a couch slug), but I'm not going to spend any time beating myself up over it. I would guess that it started growing very soon after the hyst. Today, 3 months post-op, I don't have any regrets having had a hysterectomy. We were done building our family, so that part of the decision was not an issue for us. The future of my health (uterus having fallen) was only going to be increasing discomfort with constipation, bladder infections, blood loss leading up to anemia, etc, and the final result probably still being the hysterectomy, so I am glad I did it before suffering for months or years.

Hope you can use some of this for other HysterSisters. There needs to be more positive info out there for the women who really NEED this surgery to improve their quality of life.

04-12-2003 - 11:29 AM


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