TLH Fatigue @7 weeks post hysterectomy, UPDATED @ 1 year

I’m just lost right now. I was doing great for two weeks. It seemed like all the fatigue and tiredness I was feeling after surgery was gone, then it hit me on Monday like a wall. Couldn’t get off the couch even if I wanted to.

Went to the ER, did a bunch of heart and blood tests, talked to the surgeon and my primary doctor and nothing... everything’s normal. I even got cleared for all activity following my post-op. My surgeon said being tired this long was unusual and referred me to a rheumatologist. My primary doctor said I shouldn’t be this fatigue. But when I read the forums and articles on this website, it says otherwise... why is that? what am I missing here? FYI, kept both ovaries.

Nothing like this happened to me pre-surgery, so I have to guess it’s cause of surgery. Anyone else know what’s going on? I’m not sure how to make myself better and the doctors I’m seeing don’t either. Suggestions please? I’m so lost on how to deal with this.

Mildly sarcastic here - but has your surgeon had a hysterectomy? Mine was totally right on some things on healing but way off on some of the others that are perhaps more experiential

I didn't think I'd ever been really fatigued but, then, I was resting a lot. At 7 weeks, I went to the theatre for a matinee show. I watched the show, met a friend for dinner afterwards and got home about 8 hours after I left. I went to bed... and next thing I knew, it was 12.5 hours later. Booooom!

Have you been doing more this week - or resting less that might have caused it? If none of the tests are throwing up anything odd, I'd try resting up a bit - and trust the crowd wisdom on here. It really can't be that abnormal if so many people experience it. Hugs.

From nearly every woman’s experience I’ve seen here over the last six years, it’s all totally normal and both of your doctors are wrong. Period.

What you can do to help? The best thing you can do is rest when you’re fatigued. Don’t try to push through, doing so means your body will slam you down HARD in a very stubborn “I TOLD YOU I WAS TIRED!” kind of way.

It was my experience that through about 4 months, I needed an afternoon nap and if I didn’t get one? I’d get home at 5 and just collapse. My son and husband did everything, including waking me up to eat, then I’d sit on the couch for a bit and chat with them and go back to bed.

It passed. I want to say it was almost completely gone by 5 months post op, and only occurred after that when I had a really long and busy day.

Sounds like your doctors have never had major surgery themselves! The fact is fatigue is one of the last things to leave us, often lingering for 6 months up to a year. The article I like to share is Fighting Fatigue After Hysterectomy. Our articles are mainly written from the viewpoint of women’s experiences over the 20+ years our website has been around. However at the end of the article in a footnote is a link to a rather dry technical study which supports the 6-12 month timeframe.

This surgery is major and the body is totally focused on healing leaving little energy for anything else. As we start resuming real life, the same can happen. We go all day, and then have nothing left for the evenings. My coworker called it a fatigue wall, and boy, she wasn’t kidding! I hit a notable one at 10 weeks were I was in my pajamas by 7 PM with no brain power for anything but a jigsaw puzzle. I also hit a fatigue wall at seven months postop, which couldn’t be explained by anything. I hadn’t been ill, I’ve gotten enough sleep, so the only thing I can think of is residual fatigue from surgery.

What to do about it? Build in rest breaks throughout the day, rest when your body demands it, don’t take on too many extra things at this point… not packing your evenings and not packing your weekends. Use your downtime to recharge. And finally, have realistic expectations. Your body has been through a lot, so be kind to and patient with it. Your energy will return, but just give it time. It takes more than 7 weeks for most of us.

Hi Zoe,
I am almost 12 weeks post up and I still have some bouts of extreme fatigue. It often seems to come out of nowhere, literally fine one minute and exhausted the next and for some reason it still surprises me! After reading advice and info on this site and realizing this is normal I think it makes it easier to accept and rest when needed. Now I don't deal with guilt for not doing more on top of being tired.
I find it irritating when my doctor says I "shouldn't feel" a certain way because I KNOW he has never had this surgery
Please know you are not alone and that this is part of the process. Just keep taking care of yourself and please don't beat yourself up.

Thanks for all your replies. My doctors are both women, but they’re younger so may not have had the surgery themselves yet as some of you mention.

I really appreciate the support. I’ve been feeling like something is wrong with me because of their comments, but the fatigue is very similar to what happened to me the first few weeks after surgery so it makes sense that it’s cause of that.

Hopefully the fatigue will end soon and I’ll keep taking breaks.

I’m almost 9 weeks now... felt very depressed last night. I’m just really missing my old self, and sometimes it feels like I’ll never get there.

The past week and a half has mostly been the fatigue very slowwwwwly tapering off since the “fatigue wall” I hit a week and a half ago. I can’t walk much at all without feeling tired. It’s like how I felt at week 2 or 3. It’s not gone yet.

I’ve been continuing all the tests requested and suggested by my doctors who said it shouldn’t be because of the surgery. And so far, nothing is showing itself. All my tests have been normal. I took blood tests, a urine test, a bunch of rheumatology tests (including an ANA screen). All negative and normal. I don’t know where they’re going to send me next... I’m not even sure there’s anything else to check.

	Quote:
Originally Posted by Zoe5678 I’ve been continuing all the tests requested and suggested by my doctors who said it shouldn’t be because of the surgery. And so far, nothing is showing itself. All my tests have been normal. I took blood tests, a urine test, a bunch of rheumatology tests (including an ANA screen). All negative and normal. I don’t know where they’re going to send me next... I’m not even sure there’s anything else to check.

All tests are negative and results are normal, yet "it shouldn't be because of the surgery"? Here are some excerpts from that dry, technical article I mentioned:

...Fatigue is a common and often lingering postoperative symptom that may undermine the patient's ability to resume normal daily activities. In the Maine Women's Health Study, a prospective cohort study of 418 women undergoing hysterectomy for nonmalignant conditions, most patients (91%) reported that postoperative fatigue was a “medium” or “big” problem. Although the extent of postoperative fatigue has been shown to decrease with time after hysterectomy, continued fatigue for up to 12 months or longer may be problematic in some patients. Numerous factors (eg, anemia, pain, hormonal and metabolic changes, and psychosocial issues) may contribute to postoperative fatigue; however, the relative contributions of each remain unclear in most cases.

Further on:

Fatigue was experienced more frequently than any other symptom reported during recovery, with 74% ... of patients reporting moderate-to-severe fatigue within the first few weeks after surgery, compared with 63% ... experiencing pain, and 45% ... experiencing emotional instability (eg, feelings of frustration, depression). Sixty-one percent of patients ... said they continually or often felt fatigue during the first few weeks after surgery. Overall, fatigue was the most persistent symptom, lasting more than twice as long as pain (average of 10.7 weeks versus 4.5 weeks, respectively), the next most prevalent symptom. At 2 months post hysterectomy, 29% of patients were still experiencing moderate fatigue, and 12% of patients had severe fatigue. An average duration of fatigue of approximately 6 months was experienced by 34% of those with postoperative fatigue.

If what we have shared about post-op fatigue, if the collective experiences of women over 20+ years, if the excerpts above and if all the doctors' negative tests with normal results aren't adequate, what do you think you should do?

I think you'll need to get acquainted with Patience as your best friend. Otherwise you'll continue to beat yourself up over what quite a few of us have found to be the normal timeline in healing. Be kind to and patient with your body, it's been through a lot, and recovery takes longer than most of us expect.

I am 6 weeks post op and I feel the same way, thank god I work with a few people that have had the procedure themselves, that has helped me tremendously, they have told me about the long process after surgery, I have had other complications that my doctors claims have nothing to do with the hysterectomy, I believe that doctors see that the outside looks great so you should feel like nothing happened, on the contrary things on the inside take much longer to heal. I have found meditation has helped my so much because it helps my body and mind relax, YouTube has great videos that can help, also pamper yourself and rest as much as needed,

This thread has been really helpful, thank you.

I am approaching 6 weeks post op and feeling more normal and physically able, but went out for a longer walk today, still nowhere near normal dog walk length and needed to take the shortcut home. I did some household stuff online this morning and “stopped” early afternoon. It’s 7:30 in the evening now and I’m ready to go to bed.

I have a Drs call on Thursday to talk about returning to a very busy, mentally challenging job next week and I’m not sure I can. Once I am back, although I am working from home at the moment, the nature of the work means you don’t really have set on/off hours or tasks. We’ve been lucky in that the speed the op came about coincided with a natural lull in work. That’s now ending with our busiest time of the year being the next 6 weeks.

I never expected this level of fatigue and I worried that I am really going to struggle with what needs to be done in work and at home if this is the norm for a while.

My Dr does know though. She is the one questioning whether I am pushing too hard to go back too soon.