Going in on 11/29 and still have lots of Qs.

A little about me...

I am 37 years old. Mother of 4.5 mo. old IVF/ICSI twin girls :-) by cesarean section. I am going in on 11/29/04 for a total abdominal hysterectomy. They will remove my ovaries, tubes, uterus and cervix. I have had endo for the past 11 years and have had 4 lap surgeries (micro, laser and cryo surgery) and two endometriomas removed. I also have had cervical dysplasia on and off since I was 22 years old and had 4 cryo surgeries for it. Also my mother had adenoma uterine and cervical cancer at 54 years having a vaginal hysterecomy. She is a cancer survivor and is now almost 60 years old :-)

I am pain free at this time due to my recent pregnancy and decided that this was a good time to undertake the inevitable.

I am not afraid in the usual sense as I have been through many surgical proceedures as well as the ones mentioned above. I am however starting to get a bit nervous. I am afraid that I might not make it through it very well. I am very tired due to the recent cesarean and taking care of two babies, but since I now have insurance this is a good time...some of the risks that my physician described are quite scary...

Questions...

My physician will be giving me a pump for the pain...he did not do this for the cesarean. Any experiences with the pump?

My physician suggested an enima...why is this necessary? I have heard that some people have them and others don't.

Also they may give me the option of having either general anesthetic or an epidural...Any pros or cons that any of you have experienced regarding this? Has anyone on here ever had an epidural during this proceedure?

I have discussed HRT with my OB and he assures me that I am a good candidate for hormone therapy. Both of my grandmothers have had breast cancer (and my paternal grandmother passed away from it) and I am a bit scared of taking the HRT because of this issue.

Regarding menopause symptoms...I have been on Depot Lupron injections twice before for six months each time (for the endo) and have experienced extensive menopause symptoms (the worst being vaginal dryness, burning and bleeding). What is everyone's general opinion regarding HRT? Has anyone tried bio identical HRT? My OB didn't think this was necessary. I am 37 now and he said that he will have me stay on HRT until I am 52 or so.

Another worry is that my sex drive (which is already very low) will decrease even more. After complete bed rest with no sexual relations, during my pregancy, due to a complete placenta previa and preterm labor...this has put a strain on the bedroom dept.. Can people take testosterone to increase libido after a total hysterectomy?

I am sure I have more questions but can't think of them right now so here is the Last big question fresh on my mind...

I am afraid that I won't feel feminine any more or appeal to my husband in the same way. Any feedback on this issue?

Thank you ahead of time to the answers to my questions!

Sincerely,

Nicole

Hi Nicole,

to Hyster Sisters!!

While I'm sorry that you are facing surgery, I am glad that you found HS and posted. I'll do my best to answer your questions, and I'm sure that others will be along to share their experiences, too.

First of all - will you have help at home for several weeks? If you are already tired out from the pregnancy and taking care of the babies, you'll be even more so after your surgery. This is major surgery, and you are only going to have one chance to recover properly from it. You mentioned that you are doing it now because you have insurance. Is the insurance ending soon?

	Quote:
My physician will be giving me a pump for the pain...he did not do this for the cesarean. Any experiences with the pump?

I had a morphine patient controlled pump (PCP) that worked very well - I don't remember doing it, but my DH and DD said I never let the little button out of my fist. The pump was removed the following morning, and I went home with prescriptions for pain meds.

	Quote:
My physician suggested an enima...why is this necessary? I have heard that some people have them and others don't.

I also had to use a Fleet's enema the night before - since every one of us has a slightly different surgery, our doctor's bowel prep instructions are tailored to each individual. Why don't you call his office and ask why he has ordered it for you?

	Quote:
Has anyone on here ever had an epidural during this proceedure?

There are several members who have had an epidural instead of general anesthesia. If you do a search (the link is at the upper right, under the banner ad) for epidural, you'll find lots of threads discussing it.

	Quote:
Has anyone tried bio identical HRT?

I'm on Estradiol, which is a bio-identical estrogen, and for me, it is working fine. I had also tried Premarin, but never could get the dosage right.

	Quote:
Can people take testosterone to increase libido after a total hysterectomy?

and

	Quote:
I am afraid that I won't feel feminine any more or appeal to my husband in the same way. Any feedback on this issue?

I don't have any personal experience with testosterone, but I'd like to suggest that you read some of the Hormone Jungle Articles.

Please also be sure to read the Pre-Op Hints and the Post-Op Hints. They are full of great advice that will help you to prepare for your surgery and recovery.

I hope you'll continue to read and to post any questions that you may have - we'll do our best to help.

S

Hi, Nicole! We have the same surgery date--Monday! Mine's at 10:45. Good luck to us both!

I have a lot of the same questions as you do. I will respond, though, to your question about anesthesia.

I DO NOT want to be awake during the surgery. My doctor recommends that I have BOTH an epidural and a general. That way the pain control post-op is really good without making you so "out of it" as you are on the morphine pump. I was a little scared about the epidural, but I understand they just give you a little "bee-sting" shot to numb the area for the epidural and that it's not bad at all.

Anyway, I think I'm going to take my dr's recommendation, but I'll discuss it first with the anesthesiologist. Right now I'm suffering from PMS cramping; if I start bleeding on Monday the cramping will be worse, so probably the first thing out of my mouuth will be "give me the d@#! epidural"!!!

Hi Gals- I had the epidural and general anesthesia. I don't remember getting the epi as the anesthesiologist had already given me something in the IV to make me relax (the last thing I remember). I had almost no pain the day of surgery as I was still numb for a few hours. I did have a pump with something other than Morphine that also helped. The only draw back to the epi that I had was some facial itching the following day which they gave me Benadryl for. But overall I think it helped the pain. Good luck to you!

Hi,

You will definitely need some help with your twins. I am sure they are a handful even when you feel your best. I had the bowel prep and asked my doctor why. He told me it is easier if they are all cleaned out to move them out of the way so no chance of knicking them during surgery. The morphine pump is great. I also did not let it out of my hand. Told DH and Mom to press button if I fell asleep. I orginally asked for epidural because I feared going to sleep. Not sure why have had many surgeries. A few days before surgery I talked to Anesthesia and DR and told them make it easy on everyone and just do general. As far as the HRT I kept both ovaries and DR says I don't need them. Wishing you a fast and speedy recovery.

Kelly