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iluv2digiscrap's Blog
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My Pre-Op Questions (with answers) 11-28-2007 - 10:09 PM
1. Sleeping pill between now and surgery? Having trouble falling asleep.

No. But prescribed a Valium for night prior to surgery, for use only if I'm "climbing the walls."

2. What pre-op tests do I need to have done? When?

The day before surgery. Blood Type & Cross, CBC & Serum Pregnancy.

3. What type of prep do I need to do prior to surgery?

Eat last meal at noon the day before, consume clear liquids thereafter. At 6pm, administer Fleet Enema. Continue with plenty of clear liquids. Nothing after midnight.

4. Should I refrain from bikini-line shaving?

Yes, in order to avoid possible infection. If any shaving needs to be done, doctor will do herself in the OR and it will be minimal.

5. Will a sedative be given prior to anesthesia in pre-op?

Yes.

6. What type of incision will be used?

Bikini line, approximately 4-5".

7. What organs are you planning to remove?

Uterus with cervix, left fallopian tube, left ovary

8. Do I have the option to keep my cervix?

No, due to hx of dysplasia/LEEP and reported pain during sex.

9. How do you plan to close my incision?

Dissolvable sutures

10. Will a pathology report be done on the organs that are removed?

Yes, all organs are sent to path lab.

11. If only removing the left ovary, will I need some form of hormonal therapy?

Shouldn't be necessary.

12. How long will I be in the hospital?

If no complications, in on Tuesday, discharged on Thursday.

13. How will pain be managed in the hospital?

Either by IV push and oral meds for breakthrough pain - or by PCA

14. How long does the catheter normally stay in?

Until the next morning.

15. How long until I can eat solid food?

First solid meal will be the next morning. If I tolerate liquids well the same day as surgery, I may have crackers if I'm hungry.

16. How long will I be on bedrest in the hospital?

I will have to try to sit up at side of bed and move legs same night as surgery. May even have me try to walk, since I have the early surgery slot.

17. Should I pre-purchase an abdominal binder?

No, hospital provides a good one.

18. When will I be able to drive?

Not until at least 2 weeks. Not just for pain reliever purposes, but also to allow enough healing first. Also, 2-3 weeks for regular use of stairs.

19. When will I be able to return to work part-time?

Really doesn't recommend until 4-6 week frame, but possibly at 3 weeks. If I'm really feeling good and I think I'm ready after 2 weeks, I can call to be evaluated for an earlier release.

20. When will I be able to return to work full-time?

Not until after 6 weeks.

21. When will I be able to have sex again?

Not until at least 6 weeks. Wait for doctor clearance.
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6 Days to go... Pre-Op Appointments today 11-28-2007 - 09:56 PM
First of all, wouldn't you know, that meddling broad Aunt Flo decided to visit unannounced just before midnight last night? Just in time for my pre-op! How nice of her! Since I've been off my Loestrin this month, I've had no idea what my body was going to do. From my Loestrin cycle, my period wouldn't have started until Friday. But it came early... 2nd period of the month, and it's heavy, and watery with lots of clots, and bright red, and... OUCH! So, my wonderful doctor got to see me in all my cramping glory... all the more enjoyable because she did a pre-op pelvic. Bleah. She did one last evaluation for whether or not she could go in vaginally, but she says that my uterus is just up way too high. In fact, she said it's hard to believe that I've had 4 children given the height of my uterus and how well supported my vaginal canal is. Pressed on my uterus a bit, and then told me - out of sympathy - that she was going to stop, she could tell that I was in pain and that the palpating just made it worse.

THE GOOD NEWS

My endo biopsy results came back yesterday. Thank the Lord, there was no sign of malignancy. There were abnormalities, but they were all consistent with my diagnoses.

THE BAD NEWS

After reviewing my history and my current symptoms, my GYN has decided that my cervix must go. I'd really hoped to keep it, mainly due to what I thought were the sexual benefits of keeping my cervix. I didn't like the idea of my vaginal canal being shortened. However, since one of my complaints is pain during sex... and given that 13 years ago, I had a series of abnormal paps (dysplasia) and precancerous cells that were removed through a LEEP... my doctor feels that it's best for the cervix to be removed. She's blaming my cervix for pain during sex (and, I have to admit... it is deep penetration that causes my pain) and in every exam, the doctor has noted that my cervix is very tender). The only way I may have an SAH is if there are too many adhesions around the cervix, which may bar its easy removal.

QUESTIONS, INSTRUCTIONS, AND HOW THINGS WILL PROCEED

I asked about a sleeping pill, or maybe if I could take Tylenol PM the next few nights since I'm feeling anxious and having trouble falling asleep. She said no. All she was willing to do was give me a script for ONE valium that I may take the night before, if I'm "really climbing walls."

My doctor's going to do a bikini-line incision, which she indicated will probably be about 4"-5". She's going to close with dissolving sutures rather than staples, saying, "I don't want to torture your body any more than I have to."

As for prep, on Monday I'll go to the hospital for blood type & cross, CBC & serum pregnancy test. My doctor advises that I eat a normal, solid meal around noon. Around 6pm, she told me to use a Fleet Enema. She recommended against using the Phospho Soda because she believes it dehydrates patients too much, saying that she's seen women who use it for prep run into dehydration problems the day of surgery. She told me that I should drink lots and lots of fluids on Monday, before and after the enema... then nothing more after midnight. She did tell me NOT to do any bikini-line shaving... that she'll evaluate when I get into the OR, and if any shaving needs to be done, she'll actually do it herself (not even the nurse does it!). She recommended taking a shower that morning before coming in, and of course, no powders, perfumes, or deodorant.

They're going to give me a sedative in the pre-op room before administering the anesthesia, and then my surgery is expected to take anywhere from 1-1/2 to 4 hours. She said that my pain management will either be by IV push, with oral pain relief for breakthrough pain... or by PCA. So that's an unknown for me right now.

The hospital's going to provide my abdominal binder... she said that they use a really good one, and that I'll probably wake up with it on.

She also said that I may very well be up and moving that same evening - at least, sitting at the edge of my bed, and showing that I can move my legs. I can't have a solid dinner that night, but if I'm tolerating liquids, they'll allow me to start on crackers... and then I'll have solid food the next morning.

No HRT, because she's planning at this stage to just take the one ovary - she really wants to leave the right one, since there's been no pain on that side and she tells me that at my age, I'll be healthier if I keep it, citing a link to ovary removal and risk of myocardial infarction.

No driving for at least 2 weeks. No doing stairs regularly for at least 2-3 weeks. I asked about work. At first, she said, "4-6 weeks" and then I explained to her what I do for a living and that, if I go back early, I only plan to do a couple hours a day, maybe not even 5 days a week. She said she's not going to initially release me for even part-time work until minimum 3 weeks. However, if I'm feeling really well and I want to get back, she'll have my come in to see how I'm healing and she'll consider releasing me at 2 weeks.

AND THEN THE HOSPITAL/ANESTHESIOLOGY PRE-OP

The hospital also called me for my pre-op review with them for both anesthesia and the surgical department itself. I was reminded about a dozen times... ABSOLUTELY NOTHING BY THE MOUTH PAST MIDNIGHT... or surgery would be cancelled. They took a medical inventory, and then they walked me through what my day would be like. I was advised that, when I wake up in recovery (which I'm told I should clearly remember) there's very nice nurses who have wonderful things called pain meds and anti-emetics. If I hurt... or if I feel sick... DO NOT hesitate to let my needs be known. That's what they're there for. No need to experience pain more than I have to, and they have stuff to keep me from puking if the anesthesia gets to me.

And then... would you believe... the nurse asked me if I'm planning on spending the night at their lovely facilities? I said, "well... I'm having a total ABDOMINAL hysterectomy" and she said, "You'd be surprised. We actually do have some patients who go home after a TAH! They'd rather recover at home. Personally, I think they make it rough on the rest of us who want medical supervision during the initial recovery!"

Based on the hospital pre-op, I'm not so sure that I'll be up and walking that night, since I'm told that I'll be keeping my foley til the next morning.

The awesome nurse that did my hospital pre-op also had some special tips for me for my pre-op labs. She pointed out that while the hospital does the type and cross, my insurance might require the CBC & serum pregnancy to be done at their approved lab. IF that's the case, she says that they'll give me the non-hospital lab paperwork... and I should show it to the hospital lab personnel and ask them to draw extra blood there so that I may carry it to the other lab. If the first phlebotomist refuses, ask for another staff person. She said that there's no reason that I should be stuck extra times.

So now... there's nothing to do but wait til Monday, go in in the morning for my labs... do my prep... and arrive at the castle at 6:30am Tuesday morning. My pastor is going to meet us there, so he can be with DH and me in the pre-op room to pray with us and help comfort me while the sedative kicks in. Next thing I'll know, I'll be in the recovery room.

THE WORK FACTOR

Then there was good news from my employer (actually yesterday). I had been mentioning to numerous people that if there was any way that I could do some work from home during recovery, that I would like that. Partially because I'm hoping that if I'm able to work in some capacity, my boss won't be quite as rabid to get me back in the office and also because I feel guilty taking so much time away from our small office. I'd like to feel useful, and I think that feeling useful might assist with my recovery. So my boss came to me in the afternoon and said, "Since you're already going to be on the clock, how would you feel about writing some documentation manuals while you're at home - but only if you're feeling up to it?" So... not only do I have the option to do some work from home, but I'm going to be paid 100% for my time off. Not bad for a company that doesn't even have a medical leave policy. I'm so thankful that I became management and a salaried employee earlier this year. Now we'll just have to see how well my supervisor deals with the possibility that I might not be back after 2 weeks... she told me that she didn't wait for her doctor's clearance to go back to work, that "good grief, they wanted me to wait for 6 weeks!" *sigh* Well... baby steps... at least I have some options.

So now I've rambled forever... I just can't believe that it's almost time!

MY DOCTOR KNOWS HYSTERSISTERS!

Oh... and I almost forgot! My doctor said she was impressed with me, when I pulled out my list of questions today. She said I've really done my homework, so I mentioned the Hystersisters. She smiled and nodded, said she was familiar with the site, and that Hystersisters offers an EXCELLENT book for hysterectomy patients. So... kudos from my doctor!
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