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  #1  
Unread 09-16-2011, 07:20 PM
SAH check in

Supracervical Abdominal Hysterectomy. Keeping ovaries and cervix.

I haven't come across many post about this type of surgery. So if anyone is out there, I was hoping you could share your experience.

I'm schedule for surgery, October 7th at 9am. My surgeon informed me that because my fibroids are so big, I need to have a vertical incision. Honestly, other than one incision is up and down, while the other is across, I don't know the difference. Nor what to expect.

Looking for dialogue.
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  #2  
Unread 09-16-2011, 09:53 PM
Re: SAH check in

I had a SAH with horizontal "bikini cut" incision on 8/10. My older sister had a TAH with a verticial incision several years ago. The way I understand it, vertical incisions generally heal a little faster because they don't have to cut across the muscles, as they do with a horizontal incision. The only advantage (that I'm aware of) to the bikini cut incision is a less visible scar because of where it's located, covered by even a bikini. A vertical incision may be a little longer, I think, hence the necessity for it with an enlarged uterus. My sister's incision was six inches long, and I think mine is about five. Doesn't seem like a big difference to me.

Is that helpful at all? Maybe others who had a vertical incision will chime in. If you're looking on general recovery from SAH experiences, I'm happy to share mine.
  #3  
Unread 09-16-2011, 10:18 PM
Re: SAH check in

I had a SAH on August 3rd. I had a previous c-section, so the same scar was used (bikini cut). I had 3 big fibroids and a pretty enlarged uterus.

I'm not going to lie, it was rough. The pain was intense and hard to control in my case. I could not stand up straight for nearly 2 weeks. Sleeping was hard, could only sleep on my back. I could not sleep on my side until about 4 weeks or so after surgery. It pulled too much. I'm jut over 6 weeks out and I still swell, but it is getting better. I do get tired though and don't have my strength fully back yet.
Dr released me to normal activities on Wed. Said I can now lift up to 25 pounds, no more for about another 6 weeks. After surgery, no lifting anything heavier than a gallon of milk.

Best advise I can give you is to listen to your Dr and do not push yourself...even if you feel better!
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  #4  
Unread 09-17-2011, 06:41 AM
Re: SAH check in

  Quote:
Originally Posted by Fenchurch42 View Post
I had a SAH with horizontal "bikini cut" incision on 8/10. My older sister had a TAH with a verticial incision several years ago. The way I understand it, vertical incisions generally heal a little faster because they don't have to cut across the muscles, as they do with a horizontal incision. The only advantage (that I'm aware of) to the bikini cut incision is a less visible scar because of where it's located, covered by even a bikini. A vertical incision may be a little longer, I think, hence the necessity for it with an enlarged uterus. My sister's incision was six inches long, and I think mine is about five. Doesn't seem like a big difference to me.

Is that helpful at all? Maybe others who had a vertical incision will chime in. If you're looking on general recovery from SAH experiences, I'm happy to share mine.
Fenchurch42,

yes, your response is helpful. I wasn't aware of the muscles related to the incision. I'd like to hear more about that and more about your recovery would be helpful also.
  #5  
Unread 09-17-2011, 06:49 AM
Re: SAH check in

  Quote:
Originally Posted by philsphan11 View Post
I had a SAH on August 3rd. I had a previous c-section, so the same scar was used (bikini cut). I had 3 big fibroids and a pretty enlarged uterus.

I'm not going to lie, it was rough. The pain was intense and hard to control in my case. I could not stand up straight for nearly 2 weeks. Sleeping was hard, could only sleep on my back. I could not sleep on my side until about 4 weeks or so after surgery. It pulled too much. I'm jut over 6 weeks out and I still swell, but it is getting better. I do get tired though and don't have my strength fully back yet.
Dr released me to normal activities on Wed. Said I can now lift up to 25 pounds, no more for about another 6 weeks. After surgery, no lifting anything heavier than a gallon of milk.

Best advise I can give you is to listen to your Dr and do not push yourself...even if you feel better!
philspan, how was your pain controlled once you were discharged. Even though Ibuprofen works wonders, it upsets my stomach so I've asked that my Doc not prescribe it for me. However, she told me in the hospital, Ibuprofen is administered through and IV or injection and should not bother me, but once come home I'm wondering if other narcotics will be as effective.

It's going to be a challenge to sleep on my back too because I'm a side/stomach sleeper. I was also worried about getting in and out of bed. I've watched a few videos that I'm hoping will make it easier.
  #6  
Unread 09-17-2011, 06:57 AM
Re: SAH check in

FYI: I am a side sleeper too, but I have propped myself up with 5 pillows, (one is a contour pillow, that I stand on the end so it supports me from rolling side to side), I have a thin pillow that i cover my belly with and a big fluffy pillow that I wedge under my tush so i don't slide down the mountain behind my back. Also, I use a few light blankets, so I can regulate my body temp better when I feel hot or cold.

My surgery (TAH c left ovary removed) was a week ago, but it was a bikini cut also.
  #7  
Unread 09-17-2011, 07:13 AM
other questions I'm pondering

how are you position on the OR table. Flat? or will be legs also be in stirrups?

what will my belly look like say, a few months from now? I've heard due to the muscle loss there's no way to get the stomach truly flat again. Is that true? Due to the fibroids my belly" has me looking pregnant. Im sure once it's out I'll have some shrinkage, but I'm wondering what will become of the extra "fat". In addition to the vertical incision, what my belly will look like afterwards and is there anything I can do. Or should i buy stock in Spanx, lol
  #8  
Unread 09-17-2011, 07:23 AM
Re: SAH check in

I was placed flat, no need for stirrups when they go in thru the abdomen
  #9  
Unread 09-17-2011, 09:19 AM
Re: SAH check in

I had a different experience than the ladies above. I had a uterus that was labeled as "very large" in the pathology report. It was 20x18 cm or about 8x7 inches. My doctor promised me that he could so a bikini incision and he followed through on his promise. My incision is 6 and half inches long. If your doctor does a Pfannenstiel incision like mine, the skin is cut horizontally but your muscles are separated vertically so there is no cutting of the muscles. That made a huge difference in what I could do afterward since I had no restriction in bending.

Studies have been done as to which type of incision heals the best. The studies show that there is really no difference, however, doctors do have their opinions. I had two doctors tell me it was a good thing I was having a bikini as it healed better. I am happy my doctor did the bikini as I have the type of skin that scars badly and I would not have wanted that the scar that I have now snaking down my tummy. I may be way past my bikini days but I am the one that has to look at my body and want to be comfortable with it. The scar looks bad enough now (it is raised and red - they call it hypertrophic) but once my undies are on, I can't see it. I would have been very upset to have such a scar vertically. If you heal well, then it might not be an issue for you. I have seen vertical scars that have been gorgeous. I would trade my bikini scar in a sec for one of those beautifully healed vertical scars. In my case, I was happy with what the doctor did knowing what my skin is like.

As to pain, every lady that goes through this is different. I have an extremely low pain threshold and I don't *do* pain. I was totally shocked to discover that I had no pain at all when I wasn't moving. Lying down, sitting or standing, I had no pain! When moving, I had some pulling from the incision that wasn't pleasant and sneezing and coughing hurt! I consider myself one of the lucky ones as I was off the morphine pump the morning after surgery. I did use it continuously during the night because I was afraid of having to experience pain and didn't want any. The next morning, I waited for the first twinge of pain to push the button but I never got that twinge.

Barren asked about the tummy. Be aware that most of us come out of this surgery with a roll/shelf/pouch/whatever you want to call it that looks horrible. Mine is 98% gone on one side and 95% gone on the other. It is looking a thousand times better than after surgery. I am watching what I am eating and exercising so I am sure that is helping it too as well as with the tissues healing. I still have a very slight swelling above the scar but the overhang is gone, thank goodness.

According to my operative report, I was placed flat on my back while they did the prep and the incision, then they placed me in the Trendelenburg which was still flat on my back but with my head below my feet. That helps move organs out of the way so the surgeon can see better in there.

I am sorry for writing a book here but I tried to answer your questions in as much detail as I remembered from my own surgery.
  #10  
Unread 09-18-2011, 09:51 AM
Re: SAH check in

  Quote:
Originally Posted by Danni3ll3 View Post
I had a different experience than the ladies above. I had a uterus that was labeled as "very large" in the pathology report. It was 20x18 cm or about 8x7 inches. My doctor promised me that he could so a bikini incision and he followed through on his promise. My incision is 6 and half inches long. If your doctor does a Pfannenstiel incision like mine, the skin is cut horizontally but your muscles are separated vertically so there is no cutting of the muscles. That made a huge difference in what I could do afterward since I had no restriction in bending.

Studies have been done as to which type of incision heals the best. The studies show that there is really no difference, however, doctors do have their opinions. I had two doctors tell me it was a good thing I was having a bikini as it healed better. I am happy my doctor did the bikini as I have the type of skin that scars badly and I would not have wanted that the scar that I have now snaking down my tummy. I may be way past my bikini days but I am the one that has to look at my body and want to be comfortable with it. The scar looks bad enough now (it is raised and red - they call it hypertrophic) but once my undies are on, I can't see it. I would have been very upset to have such a scar vertically. If you heal well, then it might not be an issue for you. I have seen vertical scars that have been gorgeous. I would trade my bikini scar in a sec for one of those beautifully healed vertical scars. In my case, I was happy with what the doctor did knowing what my skin is like.

As to pain, every lady that goes through this is different. I have an extremely low pain threshold and I don't *do* pain. I was totally shocked to discover that I had no pain at all when I wasn't moving. Lying down, sitting or standing, I had no pain! When moving, I had some pulling from the incision that wasn't pleasant and sneezing and coughing hurt! I consider myself one of the lucky ones as I was off the morphine pump the morning after surgery. I did use it continuously during the night because I was afraid of having to experience pain and didn't want any. The next morning, I waited for the first twinge of pain to push the button but I never got that twinge.

Barren asked about the tummy. Be aware that most of us come out of this surgery with a roll/shelf/pouch/whatever you want to call it that looks horrible. Mine is 98% gone on one side and 95% gone on the other. It is looking a thousand times better than after surgery. I am watching what I am eating and exercising so I am sure that is helping it too as well as with the tissues healing. I still have a very slight swelling above the scar but the overhang is gone, thank goodness.

According to my operative report, I was placed flat on my back while they did the prep and the incision, then they placed me in the Trendelenburg which was still flat on my back but with my head below my feet. That helps move organs out of the way so the surgeon can see better in there.

I am sorry for writing a book here but I tried to answer your questions in as much detail as I remembered from my own surgery.

Thank Danni for such a detail description. Just a few follow up questions.

First, how did you handle wound care? Did you use anything to minimize scarring? I have stretch marks from childbirth, so I'm not too concern about keeping things pretty. Scaring is not a really a huge issue for me, as taking steps to keep the incision clean and healing properly. I've heard and read about infections too. What are the possible causes? Could it be related to showering? My doctor suggested that I could as soon as Im ready, even the next day; however, my mother (who's not a dr, LOL) doesn't think it's a good idea.

I've planned a better diet and exercise around my surgery and thereafter too. I'm just wondering what my belly will look like once these fibroids are out. If I can liken my thought to women that have C-sections, there pouches never seemed to go away and in some cases got bigger. I'm never inquired about if they took measures to handle it, but I always thought it was related to the incision and muscle loss. However, I also seen C-section women belly's flat as a pancake.

my second question. in your experience, do you feel your pain was lessen when you laying down, sitting and standing because of techniques you used, i.e. how you positioned yourself getting out of bed? I'm practicing that now, before surgery so I can be ready to go.
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