The Hysterectomy Post-Op – Himani’s Story

I am 6 weeks post op now after getting a TLH (Total Laparoscopic Hysterectomy) done. Have read tons of blog posts, Googled on medical information and also found answers to my never ending questions that I was never prepared for in the first place, before going in for the surgery. This is an attempt to combine as much information about the hysterectomy post-op as possible based on the above reads as well as my own experiences.

First things first – its most important to find a good surgeon who can assess your situation and available options if any. In my case, after suffering with intense bleeding for about a year due to uterine fibroids, I was advised to have them removed. The medicines followed by GnRH analogue injections did not work. Now I had to choose between myomectomy (removal of fibroids from the uterus) or hysterectomy (removal of uterus itself), either laproscopically or otherwise. After meeting with 4 senior doctors and reading up the net, I figured that myomectomy is a more difficult surgical procedure and more importantly, does not offer any guarantee of the problem not re-occurring. Many people come back to the hospital later anyways for a hysterectomy (sometimes myomectomy gets converted into hysterectomy while you are on the operation table itself).
So after carefully weighing my options, I chose to go in for the latter, which in my opinion, is the only one time permanent solution available as of date. Then, there was a choice of partial or total hysterectomy (includes removal of cervix) as much as whether I should choose to keep the fallopian tubes or not. Most doctors today recommend total hysterectomy since it also eliminates any chances of cancer in the cervix in the future. I chose to keep my tubes even though they would have no more purpose to serve. My ovaries were absolutely fine so they were left intact.

So what I went in for is called TLH or Total Laproscopic Hysterectomy. I was lucky to have finally found a good doctor who was trained well in performing the surgery laproscopically (a camera is inserted inside and the image is magnified on a computer screen, which serves as a guide to the doctor to perform the procedure). I liked her also because she did not advise me to do multiple ultrasounds or a DNC procedure (which is considered so common today that the doctors forget that there is actually no need to perform this painful procedure in case of fibroids which are non-malignant 99.999% of the times. Infact, a DNC, which is like a biopsy, does not provide results for the malignant nature of the fibroid itself but for areas around it!). It is however recommended to have had a Pap Smear done in the last 6 months, as a precaution.

Not everyone qualifies for a TLH – this decision is again based on multiple factors, so get all the input possible from your doctor.

PRE-OP PREPARATION – Apart from the medical tests advised, please remember that you will not be able to bend, stretch, lift, climb, reach out and sit straight on a chair for a while. So finish as much of grocery, haircut, nail paint and pedicure jobs in advance. Also re-arrange important everyday stuff of use like medicine, crockery, food items, clothes etc on waist level height. It is best not to have any dependent people around you during this time. Most importantly, ask for as much help as possible for yourself, in the next few weeks.

The Key Recovery Period – in the first 6 weeks (or 40 days)

PRECAUTION – Stress reduction is the key here, literally. So do not engage in work, whether it is home cleaning, home management or your office work to the maximum extent possible and for as long as possible during this period of 6 weeks, specifically the first 4 weeks even if you feel fit enough to do so. I found it hard to concentrate on a movie let alone on work. Having a shower and washing/drying my hair was a huge job for the first 2 weeks. Do not hesitate to ask for help from Friends, family, neighbors and colleagues. If you are the let-me-do-it-my-way sorts, let go. Your doctor might give you clearance for after 2 – 3 weeks depending upon the kind of your surgery and your physical health, but remember that any lag may lead to Hernia. Just to give you a sense of what is it like, refer to the list below:

WHAT IS ALLOWED? NOT ALLOWED?

Allowed

Picking up pillows and repositioning them
Turning on dishwasher AFTER SOMEONE ELSE HAS LOADED IT
Folding laundry
Taking short, easy walks and gentle stretching
Asking others for help

Not Allowed

Vacuuming
Sweeping or Mopping
Carrying laundry across house to washer
Lifting, bending from the waist, reaching (to the top helf), driving
Lying around the house all day doing nothing (see above)
Bending to access oven or empty litter bins
Going out for grocery shopping
Pushing a shopping cart
Sitting on a chair for prolonged periods of time i.e. at computer
Opening windows, particularly the hard-to-open ones
Making other people’s problems your own
Picking tomatoes, weeding, and other such nonsense

Laughing will HURT for a few days, so you want to avoid it! Same for sneezing and coughing .. I kept taking one Vitamin C a day for two weeks to take care of that.

My best advice is to give yourself the best opportunity possible to heal right the first time. Don’t push to get back to work too soon. Sleep … walk … eat good food …. then repeat. Don’t worry, the work will be there when you are healed enough to do it. But don’t push your body and don’t rush the healing. Trust me … you don’t want to tear any of those internal incisions and have to back for more surgery! Be patient and gentle with yourself. Your body will heal and you will be back to work soon enough! 🙂

FOOD – is one of the most important elements that will aid in the internal healing process. Drink lots of water to detox and eat a protein-rich diet to build up the tissue in the surgical areas. Eat small to medium size potions of easily digestible foods every 2 hours. You wanna save up on as much energy for the repair action that is going on inside. Eat healthy and home-cooked food to the extent possible. Avoid cold and sour foods for the first two weeks since they slow down healing. Do not even dream about dieting or your looks, during this time. You got your whole life ahead to do that.

EXERCISE – No squats, no lunges, no weights, no ab crunches, no leg presses, no leg curls, no leg extensions for id say 6 wks….nothing that will engage your core too much, I think our cores can only handle isometrics (squeezing the stomach muscles in and tight while lying, sitting, or standing) & kegels are good. WALK WALK WALK, small distances, work up to some 10 min. walks then 20, then 30. Remember our number one focus is recovering from major surgery, we can get buffer later! Listen to your body ladies, u may not be able to stick to plans made for today or tomorrow. Just don’t do too much too soon even after you have got the clearance from your doc to do something.

Get off the couch after turning on your sides. Put pressure on your elbows while getting up and getting back in bed. Bend from your knees rather than your waist. It’s normal to feel a little lower abdominal heaviness or pressure. If pressure is building throughout the day, it means you’ve been on your feet too long. Get off your feet. Focus your energy on getting well and listen to your body because believe me it will let you know when you’re over doing it.

SLEEP – Be prepared to sleep a LOT, do not even try to argue with your body about this. I have had insomnia all my life and often can’t sleep in a dark quiet room in my own bed, but after my surgery I could sleep sitting up on my couch in the middle of the day with the TV blaring and people having a conversation two feet from me. Your body will need to heal and it will tell you in no uncertain terms when it needs to power down for a while. I had several naps a day for about a week, and still slept well at night. In case it is a problem to sleep lying down for the first couple of nights, a recliner or piles of pillows on the couch may prove really helpful. You only get ONE chance at a good recovery. Don’t mess it up!

DRIVING –The quick reflexes needed to drive a car and potentially need to hit the brakes can also put pressure on your abdomen and incision. Avoid driving completely for up to three weeks after surgery. Build it up gradually.

AVOID WEIGHTS, LIFTING HEAVY OBJECTS AND AB CRUNCHES FOR AT LEAST 3 MONTHS POST SURGERY!

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