Advice to soon-to-be hysterectomy patient

meownsmile, BSN, RN · Aug 9, 2005

Toradol works very well for the hysters i take care of. Some have the marcaine infusers into the incision, some dont. I dont really see a difference, however if you arent able to take something oral like Darvocet with the Toradol, you may want the infuser.

CrunchRN, ADN, RN · Aug 10, 2005

Those pumps work great, and you can go into the office to have it removed. Everyone who had one in our old office absolutely loved it.

**RosesrReder, BSN, MSN, RN** · Aug 10, 2005

Hello and welcome to the family of allnurses. You will be in my prayers. Good luck to you.

Ashera, LPN · Aug 14, 2005

Hey Gypsy!

Your experience-to-be sounds exactly like mine - same op same age and everything. Mine was at age 48 - 4 years ago. I'll share a bit of my experience and how I coped.

First - and this was important to me - and it sounds like you're doing the same - I educated myself on everything possible. Hystersisters - can't say enough good about that site. I made lasting friends - one I still email all the time and we feel connected like we've always known each other....

But - I wanted the ol' control over this - and had a good doctor. I am not big on narcs either - but knew I would need something after I got home. And home was the goal - not being in the hospital.

I had a total ABSO - I was a difficult surgery as I had adhesions all over my colon, bladder, ab wall etc - lots of cutting and internal suturing. I fought for a while about leaving the cervix - doctor won - said he would not be leaving anything that could possibly cause future surgical needs. I agreed. I also gave up the ovaries - and I am so glad I did. As you weigh the pros/cons and opinions - consider this. When you start with a clean slate - YOU control the hormones you add back - you don't have the weird amounts your own body might be producing - and the fluctuation - and then have to guess what else you need. And for me - deciding to not have silent ovaries sit there through the next 30 years with those risks was worth it.

I immediately went on the Vivelle Dot - transdermal - bio-identical - and easy and it's worked beautifully. I knew I wanted it placed right after surgery - and had one on hand - Some drs want to 'wait' and then you will go through an immediate and horrible hot flash - (my Vivelle was delayed til the next day - I can remember the most awful hot flash in recovery) So make sure you discuss now with your dr about your desire to be immediately covered with hormones should you elect to remove your ovaries. Decide now what estrogen or hormone replacement you will use. I know HRT is a big debate - but it's the combination of progesterone/estrogen that is implicated - not bio-identicle single estrogen. I also occasional do a compounded testosterone cream but didn't add that til my own system stabilized quite a while past surgery.

Pain - I insisted on SUTURES instead of ab staples - which for me would have left scars of little pinpricks where they went in. the fine suture line has all but disappeared - and it is low and over a couple of other ab surgeries from the past. Also, I've seen staples pull apart and leave a courser scar. I came out of surgery - with dissolving sutures covered with steri-strips which fell off after a week or two. Cleaned with 1/2 hydrogen peroxide and water for the first week -

I never had pain from my suture site - and I don't remember intense itching at all. Where my pain was more than anything - was bone pain - my back ached terribly - lower - and my hips were very painful for a few weeks, lessening as time went by. almost like my hinges were sprung - Found out it was due to the position you are in during the surgery - almost like a frog with your legs way up and flexed against your body - So I needed more NSAIDS afterwards - and remember also having a script for Flexeril.

I did have on hand Tylenol with codeine but only needed it for a couple of days before I used only regular Tylenol.

In the hospital - I did have a PCA - the first couple of days were very horrible for me - and I did use morphine. But that was it - just two days of bad pain and then I wanted no more of the big stuff. And I didn't want anything big and heavy when I left on the 4th day. I wanted my own space,l my own bed, my own silence and a lot of sleep.

Do lots of stool softeners - and no gassey foods. And remember, you heal from the outside inward on this procedure. Don't be a hero - baby yourself and be a good nurse to you. You will get all this advice on HS site. We sometimes think we are super-human, or somehow above needing to slow down - and I've found I'm my own worst pt - but not in this case. I DESERVED to slow down for a few weeks after this.

I 'feathered' my nest in advance - stocking my freezer with lots of nutritious comfort foods - I read a lot - had about 24+ books piled up on extended loan from two different libraries. I asked a couple of friends to bring me a few meals - and leave them and run! I I had the remote by my bed - I bought new egyptian cotton sheets and two new pillows -

I am single - and had two sons - the older one was a senior in HS - the younger one went to stay with dad/stepmom. The older one also - but came by after school to 'help' - I wanted to be totally by myself - which a lot of people prefer not to be - but I do so much better without 'help'. Family and friends did not like this idea but it way MY decision. MY surgery, MY recovery and I knew I could call them immediately if there was a problem.

You will be fine! You will better than before physically! You will feel good, heal beautifully, and be very glad you did this. It won't happen overnight - be gentle with yourself - LISTEN to your body...and you will know exactly what you need to do. Remember that the pain you experience will be very, very short lived - and you will be able to cope - no matter what drug or how you deal with it. You are strong...You are a woman...and a nurse - and if those things don't make you a strong person - nothing will!

Sorry this was so long and rambling - sudafed and caffeine too early does it everytime. Let us all know how you are doing!

Pamela

Homesick Gypsy · Aug 15, 2005

Hi Ashera,

Thanks for your response. I'm curious about two things - if your hyst was abdominal, why did they have you in the lithotomy position? Also, what kind of anesthesia did you have?

Thanks,

Homesick Gypsy

Hey Gypsy!
Your experience-to-be sounds exactly like mine - same op same age and everything. Mine was at age 48 - 4 years ago. I'll share a bit of my experience and how I coped.
First - and this was important to me - and it sounds like you're doing the same - I educated myself on everything possible. Hystersisters - can't say enough good about that site. I made lasting friends - one I still email all the time and we feel connected like we've always known each other....
But - I wanted the ol' control over this - and had a good doctor. I am not big on narcs either - but knew I would need something after I got home. And home was the goal - not being in the hospital.
I had a total ABSO - I was a difficult surgery as I had adhesions all over my colon, bladder, ab wall etc - lots of cutting and internal suturing. I fought for a while about leaving the cervix - doctor won - said he would not be leaving anything that could possibly cause future surgical needs. I agreed. I also gave up the ovaries - and I am so glad I did. As you weigh the pros/cons and opinions - consider this. When you start with a clean slate - YOU control the hormones you add back - you don't have the weird amounts your own body might be producing - and the fluctuation - and then have to guess what else you need. And for me - deciding to not have silent ovaries sit there through the next 30 years with those risks was worth it.
I immediately went on the Vivelle Dot - transdermal - bio-identical - and easy and it's worked beautifully. I knew I wanted it placed right after surgery - and had one on hand - Some drs want to 'wait' and then you will go through an immediate and horrible hot flash - (my Vivelle was delayed til the next day - I can remember the most awful hot flash in recovery) So make sure you discuss now with your dr about your desire to be immediately covered with hormones should you elect to remove your ovaries. Decide now what estrogen or hormone replacement you will use. I know HRT is a big debate - but it's the combination of progesterone/estrogen that is implicated - not bio-identicle single estrogen. I also occasional do a compounded testosterone cream but didn't add that til my own system stabilized quite a while past surgery.
Pain - I insisted on SUTURES instead of ab staples - which for me would have left scars of little pinpricks where they went in. the fine suture line has all but disappeared - and it is low and over a couple of other ab surgeries from the past. Also, I've seen staples pull apart and leave a courser scar. I came out of surgery - with dissolving sutures covered with steri-strips which fell off after a week or two. Cleaned with 1/2 hydrogen peroxide and water for the first week -
I never had pain from my suture site - and I don't remember intense itching at all. Where my pain was more than anything - was bone pain - my back ached terribly - lower - and my hips were very painful for a few weeks, lessening as time went by. almost like my hinges were sprung - Found out it was due to the position you are in during the surgery - almost like a frog with your legs way up and flexed against your body - So I needed more NSAIDS afterwards - and remember also having a script for Flexeril.
I did have on hand Tylenol with codeine but only needed it for a couple of days before I used only regular Tylenol.
In the hospital - I did have a PCA - the first couple of days were very horrible for me - and I did use morphine. But that was it - just two days of bad pain and then I wanted no more of the big stuff. And I didn't want anything big and heavy when I left on the 4th day. I wanted my own space,l my own bed, my own silence and a lot of sleep.
Do lots of stool softeners - and no gassey foods. And remember, you heal from the outside inward on this procedure. Don't be a hero - baby yourself and be a good nurse to you. You will get all this advice on HS site. We sometimes think we are super-human, or somehow above needing to slow down - and I've found I'm my own worst pt - but not in this case. I DESERVED to slow down for a few weeks after this.
I 'feathered' my nest in advance - stocking my freezer with lots of nutritious comfort foods - I read a lot - had about 24+ books piled up on extended loan from two different libraries. I asked a couple of friends to bring me a few meals - and leave them and run! I I had the remote by my bed - I bought new egyptian cotton sheets and two new pillows -
I am single - and had two sons - the older one was a senior in HS - the younger one went to stay with dad/stepmom. The older one also - but came by after school to 'help' - I wanted to be totally by myself - which a lot of people prefer not to be - but I do so much better without 'help'. Family and friends did not like this idea but it way MY decision. MY surgery, MY recovery and I knew I could call them immediately if there was a problem.
You will be fine! You will better than before physically! You will feel good, heal beautifully, and be very glad you did this. It won't happen overnight - be gentle with yourself - LISTEN to your body...and you will know exactly what you need to do. Remember that the pain you experience will be very, very short lived - and you will be able to cope - no matter what drug or how you deal with it. You are strong...You are a woman...and a nurse - and if those things don't make you a strong person - nothing will!
Sorry this was so long and rambling - sudafed and caffeine too early does it everytime. Let us all know how you are doing!
Pamela

Ashera, LPN · Aug 15, 2005

Even in an abdominal - you will be put in a lith position for part of it as they will have to access lady partslly after removing the uterus/cervix, for what I assume is to create the 'lady partsl cuff' and either close with sutures or staples.

I was told this post-op a few weeks later when I still had c/o of joint pain.

I just found my op report and read it - and now being a nurse, found it fascinating! It talked about being put in supine position - and all the work that was done - and then it talked about my adhesions and all the work done on the bladder - I did scan it for mention of position changes and did not actually see any notations - but there was notes written as to stitches and the subQ dissolving staples to close off the lady partsl cuff - this was inside the lady parts so I would assume the position was changed for this.

Ask your surgeon if this will be the case in your particular surgery.

My anesthesia was versed first - and only noted as general anesthesia in the notes I've kept. I do know I had a morphone pca afterwards. I remember that it infiltrated the first night,or maybe the second - and it ws removed and I then had iv demorol.

First couple of days will be the hardest - but then it will get easier.

Don't forget to have surfak or colace ready. Bowel movements will hurt. Have your pillow ready everywhere in the house where you will go to hold against your tummy.

Hope this helps a bit more Gypsy. Let me know any more specific questions by PM's -

Pam