I will be using proper names for female body parts and bodily functions in this post. There will also be pictures of my belly after surgery. It's going to be long because I want to get the whole story out in one post. If any of these bother you, please skip this post.
So, twelve days ago I had my surgery (to read why, go here
). A total hysterectomy and oophorectomy. He removed my uterus, cervix, ovaries, and fallopian tubes. He cut the parts away laparoscopically using a DaVinci robot and delivered them vaginally. He then sewed up the top of my vagina to keep everything inside from falling out. I think that's the gist of it.
This is a picture from the internet of the DaVinci robot:
|DaVinci Robot - cool looking, huh?|
And this is what it looks like in action:
|DaVinci robot in actual surgery, but not my surgery|
The surgeon is that guy over on the left with his head in a box who looks like a ref watching instant replays in a football game (I'm pretty sure that's not what he's really doing). That piece is separate from the robot. Some of the internet pictures have it up close to the robot, some have it across the room. No idea how close it was during my surgery, obviously. The surgeon uses controls to maneuver the robot and do the laparoscopic part of the surgery (kind of like the crane game). The advantage to using the robot instead of traditional laparoscopic surgery (according to my surgeon) is that with the robot he has full 360 degree rotation and with traditional he only has 180 degree rotation. My feeling was this -- if he's the one doing the surgery I'd like him to use the method he is most comfortable with and has the most faith in. I trust that he knows better than I do.
And this is how it all went down.
I went in the Friday before my surgery for a blood and urine test. They look for anything that could be a reason not to do surgery or a situation to monitor. They do a pregnancy test -- because, duh, taking my uterus. At this time a nurse also reviewed my health and medication history. I signed several forms, including one that said I understood that after my surgery I wouldn't be able to give birth anymore. Apparently, some women haven't understood this in the past. Oops.
I got a call later that night telling me there was a questionable result on my urine test. It was possible that I had an infection, but not definite. The nurse asked if I had any of the symptoms of a urinary tract infection, as she named them. I didn't. She said they were incubating a sample and would let me know if there was a problem, but it was probably just a contaminated sample. Like maybe I touched something I shouldn't have in the collection process. Anyway, I never got a call back on that so I guess it turned out okay.
My surgery was on Monday, June 30. I was to be at the hospital at 11:00am to begin the whole process. Shortly after we arrived (my husband and I) they took us back to pre-op. The nurse came in and went over the flow of the process with us. Pre-op, holding, operating room, post-op, room. They had a board with the estimated time of things and I was instructed to let them know if the time passed and things hadn't happened as she explained them. I think that was an important thing for me. I tend to be extra patient and would probably just wait. The surgery did start later than expected, but she had come in and told us it would and gave us a revised time, which was accurate.
She then reviewed the pain scale. It looked something like this:
She asked me where on this pain scale I would normally take something for the pain. I said probably around a 6 or 7. She said that wouldn't work in the hospital. They want to know when my pain is about a 4 or 5. I'm pretty sure I looked quite incredulous. I said I would do my best to pay close attention and tell them at that point, but I sometimes don't notice it at that level (due to my chronic pain, I've had to learn to ignore most pain). They took more blood and urine to test. She hooked up my IV. She hung an antibiotic on the IV post and said they would start that when they started my surgery. And we waited. How long did we wait? I'm not sure. We got there at eleven. My surgery was scheduled to start at twelve thirty. It was pushed back to one forty-five because the one before me went a little long. I don't know how long the nurse's stuff took. They took me back to holding at about twenty after one (if I'm remembering correctly, which no one should really count on). My husband gave me a kiss and we went our separate ways.
In holding it was just a nurse working at a computer and me. The room looked like it could hold several beds, I'm guessing six or so, but there weren't any others in there for most of the time. This is where my surgeon and anesthesiologist met with me prior to surgery. It's also where I presented this picture to my surgeon, who left it with my chart so the anesthesiologist and nurses could see it:
I explained to my doctor that I was pretty sure this was the creature that was chewing and clawing it's way from my body. I wanted to make sure he recognized it when he found it. He, the anesthesiologist, and the nurse each got a chuckle out of it.
Both doctors explained (in their separate visits) what they were going to be doing. They asked if I had any questions. They were both very kind. They both seemed sincere in their concern for me. My heart felt calm in their presence. I felt safe in their hands, which was very important to me.
I spent about fifteen minutes in holding, give or take a few minutes (there were clocks visible everywhere so I could keep track). Then they wheeled me to the operating room.
I don't remember a ton about the operating room. I remember thinking it had a lot of equipment in it. It also seemed like there were a lot of people in there. They put my bed up next to a narrower bed and had me skootch (totally a real word) over to the smaller one. There were no rails on this one like there had been on the other one. I had a slight feeling that I could fall off. But not for long because then they put a strap over my hips and secured me to the table. The anesthesiologist told me he was giving me something in my IV to relax me (although I was amazingly calm, much more so than I expected to be). Then someone, I'm guessing it was the anesthesiologist, told me they were going to give me oxygen and put a mask on me.
The next thing I was aware of was a man trying to wake me up in post-op. I was very nauseous and worried that I would throw up, which was a concern I had prior to surgery. I told whoever the man was waking me up that I felt like I was going to throw up and could he give me something. He told me he'd already given me three things for nausea (if I remember correctly) but would give me something else. He also handed me a cool blue bag with a round plastic neck in case I did throw up. I kept this bag with me throughout that first day.
Through my still sedated haze I could see that there was a clock on the wall. I fought through the medication to clear my vision enough to read it. My daughter is on a mission and only gets to communicate home through email once a week. I knew she would be doing so some time between 4:00pm and 5:00pm. My other daughter was supposed to email her info on how the surgery went as soon as my husband got word and called her. I wanted to make sure we hit that window. I knew the surgery was supposed to take a couple hours so we might be cutting it close.
When my vision cleared enough to see the clock I saw that is was about four fifteen. I asked the man if my husband had been given an update and explained to him why it mattered how quickly it was done. He said my husband had been told and he would go find him to see if my missionary daughter had been told. He came back shortly to report that communication had gone back and forth with my missionary daughter and she had the info. Then I relaxed a bit.
I was moved to my room shortly after that. We passed my husband in the hall, who joined us. I think he waited in the hallway while they got me situated in my room.
He stayed with me until about eight that night, when I sent him home to sleep. I wanted him to be rested when he took me home the next day. My three younger kids (15, 17, 19) and a friend who's like our kid visited. My parents visited (after receiving permission). They can sometimes be stressful for me, but I understood that they needed to see that I was doing okay. Their visit was short and nice. And I was doing fabulously! Every nurse commented that they just don't usually have people who are that happy on their floor. I guess I threw off the anesthesia quicker than most. And because all the anxiety I'd had before surgery was gone, I was very happy. I had pain, but that I can handle.
I pretty much asked for the meds on schedule. They gave me morphine to begin with. I think that was every two hours. Then they added something else; I want to say Tramadol, but I'm not sure. Whatever that second one was, it was longer between doses. Six hours maybe. I was on a clear liquids diet, which was fine because I was still nauseous. I got strawberry jello and a couple things of grape juice. And water. The nurse warned me to sip, no matter how hungry/thirsty I was. Good advice! I didn't want anything coming back up.
After my husband left I played hand solitaire and tried to find something to watch on TV. I don't generally watch commercial TV, so it was tough. I found a channel with old shows and watched some Murder She Wrote and later watched O, Brother, Where Art Thou? I also went for four laps around the nurses station. The nurse walked next to me, but I was stable enough on my feet to do fine just holding the IV stand. The nurse was thrilled with my efforts; she said usually she can't convince people to even get out of bed and try walking.
I barely slept, which I knew would happen. I listened to an audio book of Harry Potter on my mp3 player (I always listen to Harry Potter when I sleep because I am such a light sleeper; it's my white noise). The nurses did their best to keep the interruptions to a minimum and keep the lights off to help me sleep. It just wasn't happening. When the phlebotomist came in at 3:00am to draw my blood I was awake. (I guess my hematocrit had been low prior to surgery and they wanted to check that).
I had a little trouble with my catheter. I still felt like I needed to go to the bathroom, which is a sign that it's not in right or is kinked or something. And there wasn't as much output as would be expected from what I was drinking. The nurse worked with it a couple of times. It worked okay for a bit and then struggled again. The other nurse had told me that since I was doing so well she would take the catheter out at six if I wanted her to. Otherwise, they'd wait until I woke up. I said six would be great. It ended up that the nurse was in my room around five for something else, medication or IV or something. I asked when she could take the catheter out. She thought for a second and then said she could do it right then if I wanted. I definitely wanted! So she took it out and told me I had seven hours to pee on my own. If I couldn't by then they would do a scan and see if they could figure out what was wrong.
On the information board in the room they write what the goals are for the patient. The main goal was pain management. Then she added "urinate by noon." I can honestly say I don't think I've ever had peeing as a goal. I had no problem meeting that goal. I was able to pee all by myself within an hour or so of her removing the catheter.
She switched me to a soft solids diet some time during the night. After the catheter was removed I was finally able to get a few hours of sleep. When I woke up I ordered breakfast. I was so excited to be on a soft solids diet because it meant I could have milk! Milk is what I usually use to soothe my nausea at home, so I was glad to have it. I had pancakes, hashbrowns, two cartons of milk, and some tapioca pudding. I wasn't a fan of the tapioca, but I ate everything because it had been so long since I'd had real food (fasting for surgery, of course). I showered and put on a clean gown and underthings. I went for another walk, without an escort. Five laps this time. I also asked for something other than morphine, since it was making me itch. They added Percocet in its place (every four hours). And the nurse applied an estrogen patch to my abdomen, to wear for seven days before switching to pills.
My husband and oldest daughter (23) came over around nine. My 19-year old daughter is a nanny and brought the kids she cares for to visit.
My doctor had told me I would get to go home after one night in the hospital. Since I've taken care of many family members and a few friends while they were in the hospital I knew it wouldn't be until after the doctor made his rounds, which are usually done in the morning. We hadn't heard anything by about noon so we asked our nurse to check on it. He said he'd seen my doctor on the floor so he didn't know why he hadn't come to see me. My nurse came back shortly and said the doctor had started his rounds but was interrupted by an emergency. He would return when that was taken care of.
He came around one. As he washed his hands I asked, "Did you get him?" (meaning the creature). After only a slight pause he said, "Yeah, I ran him out of there." He said he'd been getting a report from the nurse and been told I was hopping all over the place. A wonderful report. He asked how I was doing (fabulous!) and gave me instructions. He asked if I had any questions. I had typed my questions into a text message to myself in my phone so I wouldn't forget.
I asked how much it mattered if the pain meds made me itch (Percocet does a little). He said as long as I could breathe okay, he wasn't worried about it. And he said I could take Meclizine (which I had at home) with the Percocet for the itching if I wanted to.
I asked about yoga. I have been wanting to start, but was waiting until after my surgery because I'd been hurting so much. He said he didn't want me doing anything straining. Yoga is out for a while.
Then I told him I have a high tolerance for pain and since I have chronic pain I just usually ignore it. I asked him how much I needed to respect this pain. He said my toughest struggle would probably be wanting to do more than I should because I felt so good. We agreed that I would take the pain meds on schedule for 72 hours rather than according to my pain. I agreed to not do dishes or laundry for two weeks. I agreed to not lift anything over 15 pounds or spend too much time on my feet.
The nurse asked the doctor if he could take my IV out then, if he was done with it. The doctor said yes. But I'd been watching the clock and I know how things go as someone leaves the hospital. It was almost time for my next dose of IV pain meds. I asked if we could wait fifteen minutes and give me that last dose before removing it. The doctor said that would be a good idea.
He left. I got packed up. The nurse gave me my last dose and removed the IV. I got dressed. The nurse came back with discharge papers. He said someone had to accompany me out but I didn't have to ride in the wheelchair if I didn't want to. That made me very happy. I hate being pushed in a wheelchair, especially when I feel fine. I signed all the papers and got the ones he was sending home with me. The nurse shook my hand and thanked me for making his day fun.
Soon a lady came with a wheelchair. I told her the nurse had said I didn't have to ride in one. She said I could just put my stuff in it then, which is what I did. As we walked to the elevator she asked what I'd had done. I said, kind of embarrassed because of how well I was doing, that I'd had a hysterectomy the day before. She said, "Wow. You're doing great!"
The valet brought us our car and we were on our way.
I had amazing nurses the whole time. In fact, everyone I interacted with was awesome, right from the first phone call. Seriously, I couldn't have asked for kinder people.
I was sent home with a prescription for Percocet, prescription Ibuprofen, estrogen pills, and a stool softener (which was actually over the counter). I took them on schedule for three days. I took my last Percocet Friday morning, four days after my surgery. I took the Ibuprofen (one at night and one in the morning) through Sunday.
Monday afternoon I got a call from the surgeon's office checking on me. How are you doing?
Great! Any trouble urinating?
Nope. Doing great. Any trouble with bowel movements?
Nope. You're able to go okay and without straining?
Yep. We don't want any straining because you could pull your stitches.
Nope, no problem. And how's your pain management?
Great. What are you taking for the pain?
Nothing. Really?! You're not taking anything?
Nope. And you're great?
Yep. Well, okay. I see you're already scheduled for your follow up and you say you're great so I guess we're done.
I've really been so much better than I expected to be. My friends and family have been amazed at how well I am. One friend said I seem so much better, they must have gotten something that was making me sick.
And I do feel so much better than I did before surgery. Did it cure the problem? It's hard to know for sure because there is still some pain in the same area that was hurting before because that's where they cut parts of my body out. But I think so.
And this is what it looks like after:
|July 2, two days after surgery|
They make four incisions for the robot, including one in my belly button. The incisions have surgical glue on them. I think the doctor said the glue was over stitches, but I could be wrong. It might have been in place of stitches entirely. I never saw any stitches. That white thing on the lower right is the estrogen patch. To do the laparoscopic surgery they inflate your abdomen so they can see everything and maneuver. I have no idea how long it takes for all of that air to leave, but my belly definitely still felt swollen for several days.
|July 3, three days after surgery|
That bruise on my belly button got bigger and darker for a few days. The surgical glue started pulling up around the edges by this time.
|July 9, nine days after surgery|
The bruises are mostly gone by this point. I took the estrogen patch off that morning, but the skin there was a little sensitive so I decided not to worry about the glue left behind from the patch until the skin there healed a bit. The surgical glue is gone from everywhere except my navel. It didn't rub enough to loosen it and that area was a bit tender so I left it alone. You probably can't tell, but the incision on the left isn't healing quite as quickly as the two on the right. It's possible that I might have encouraged that glue off a little sooner than it was ready. Don't do that! If you do, it's possible that the wound will weep a little and glue itself to your clothes and then when you move quickly you will tear off the scab and start bleeding and it will hurt. Don't ask me how I know this is a possibility.
|July 11, eleven days after surgery|
Bruises almost completely gone. Surgical glue gone. Skin under patch healed enough to scrub clean.
Oh! I forgot to mention vaginal bleeding. I expected to bleed more. I wore a pad for a few days (no tampons allowed because of the danger of infection). The day of surgery I had some bleeding. Not much though, like a light to moderate day of period bleeding. The second day it was less. By the third day I wasn't really bleeding anymore, just had some pink when wiping. By the fourth day I was done. It's kind of crazy that there wasn't more blood. I bled a lot after having babies; I kind of thought it would be like that as things healed. I guess it makes sense that things would heal much faster when they do it surgically and sew things up and cauterize them.
I am still on the same restrictions I was given when I left the hospital. I see my surgeon Monday for my two week follow up. At this visit he will check my abdomen to make sure that's all healing well. We will also discuss which restrictions I still need to live by and which can be lifted. I see him again around six weeks post-op. At this visit he will do a vaginal exam to make sure everything is healing properly there, that I haven't pulled any stitches, and that nothing is falling out. He expects that all restrictions will be lifted at this appointment except for one. No vaginal penetration until eight weeks post-op.
I'm really feeling great. I'm so glad to have it over with. Everyone who took care of me was fabulous. I even received a thank you card from the nurses who took care of me thanking me for letting them care for me and wishing me swift healing.
I can't imagine anything in the whole process going any better. And I'm so grateful!