New mom C-section question!!

SmilingBluEyes · Jul 8, 2005

Things we tell our patients:

For 6 weeks, lift nothing heavier than your baby. Also, don't overdo physical activity or work. If you increase your pain level or lady partsl bleeding, your body is saying "slow down!!!". Listen to it.

Watch for fever greater than 100.4/oral (although you are pretty well past the stage where infection would set in, normally).

Watch for foul smelling/cloudy discharge from the wound or lady parts. It is normal to notice a slight yellow or serous drainage from the wound site and on the steri strips. You do need to be observing the wound daily (with the help of a mirror, if needed). If heat, redness or foul discharge are noted, or the wound appears to "come apart", beat tracks to the ED or your OB right away. Such complications are rare, but serious.

You can begin a walking program as soon as you are comfortable----usually within a week or two. Just start walking as much as is comfortable. Regular exercise and fresh air are good for you and the baby. AGAIN, do not overdo. If you become very tired or are in a lot of pain, you are overdoing it. No strenuous exercises involving abdominal muscles until you are cleared. Usually about 6 weeks.

NO driving til cleared by your OB. Believe it or not, many insurance companies will not cover you or you can be in trouble if you DO drive before cleared, and get into an accident/wreck. This has as much to do with the pain medications you had during the operation and in recovery (narcotics) as it really does the physical act of driving. Be sure you are cleared to drive before you DO!!!!! Usually this is about 2 weeks, rule of thumb.

Drink 8-10 10oz glasses of WATER every day (do not count coffee, tea, milk, etc). More if you are breastfeeding, if possible. (I often counsel 12 oz of water to drink each time you nurse, to be finished when you are done nursing). You need to replenish fluids in the postpartal phase, and a csection recovery is not different in this area.

SLEEP WHEN BABY SLEEPS. Sounds like a no-brainer, but if you are like me, you are tempted to use this time to catch up on housework, laundry, etc. Don't be tempted. The sleep you get at night is fragmented and incomplete. For complete restoration and healing, you need your sleep. Get it when you can, e.g. when baby is. Turn off the phone/and put a sign on the door, if needed. Your sleep is too important right now!

Make sure you follow up with the doctor within 2 weeks of your surgery. He/she will examine your surgical incision and breasts and ask how things are going. Don't miss this important checkup!

Don't forget that all-important follow-up schedule with your pediatrician for the baby, too.

If you are having problems breastfeeding, be sure to contact a La Leche League counselor'/leader (http://www.lalecheleague.org for a leader near you) , or call the hospital and ask to speak with or see the Lactation Specialist.

Make sure your bowel movements are regular. If not, you may not be getting enough water or may need a stool softener. We often recommend Dulcolax and lots of fruit juices/fiber after the patient goes home. Often, narcotics will slow down the GI system enough to cause MAJOR problems with constipation---this can be insidious and not noticed until severe discomfort and problems have arisen. Don't let this happen to you!

Have the number to the OB department handy. That way, if you have questions "after hours" or don't want to bother your OB later at night, you can always call them for advice and instructions on what to do "if".

HTH!!!

CONGRATULATIONS TO YOU and YOUR FAMILY on your blessed addition!

TweetiePieRN · Jul 8, 2005

Things we tell our patients:
For 6 weeks, lift nothing heavier than your baby. Also, don't overdo physical activity or work. If you increase your pain level or lady partsl bleeding, your body is saying "slow down!!!". Listen to it.
Watch for fever greater than 100.4/oral (although you are pretty well past the stage where infection would set in, normally).
Watch for foul smelling/cloudy discharge from the wound or lady parts. It is normal to notice a slight yellow or serous drainage from the wound site and on the steri strips. You do need to be observing the wound daily (with the help of a mirror, if needed). If heat, redness or foul discharge are noted, or the wound appears to "come apart", beat tracks to the ED or your OB right away. Such complications are rare, but serious.
You can begin a walking program as soon as you are comfortable----usually within a week or two. Just start walking as much as is comfortable. Regular exercise and fresh air are good for you and the baby. AGAIN, do not overdo. If you become very tired or are in a lot of pain, you are overdoing it. No strenuous exercises involving abdominal muscles until you are cleared. Usually about 6 weeks.
NO driving til cleared by your OB. Believe it or not, many insurance companies will not cover you or you can be in trouble if you DO drive before cleared, and get into an accident/wreck. This has as much to do with the pain medications you had during the operation and in recovery (narcotics) as it really does the physical act of driving. Be sure you are cleared to drive before you DO!!!!! Usually this is about 2 weeks, rule of thumb.
Drink 8-10 10oz glasses of WATER every day (do not count coffee, tea, milk, etc). More if you are breastfeeding, if possible. (I often counsel 12 oz of water to drink each time you nurse, to be finished when you are done nursing). You need to replenish fluids in the postpartal phase, and a csection recovery is not different in this area.
SLEEP WHEN BABY SLEEPS. Sounds like a no-brainer, but if you are like me, you are tempted to use this time to catch up on housework, laundry, etc. Don't be tempted. The sleep you get at night is fragmented and incomplete. For complete restoration and healing, you need your sleep. Get it when you can, e.g. when baby is. Turn off the phone/and put a sign on the door, if needed. Your sleep is too important right now!
Make sure you follow up with the doctor within 2 weeks of your surgery. He/she will examine your surgical incision and breasts and ask how things are going. Don't miss this important checkup!
Don't forget that all-important follow-up schedule with your pediatrician for the baby, too.
If you are having problems breastfeeding, be sure to contact a La Leche League counselor'/leader (http://www.lalecheleague.org for a leader near you) , or call the hospital and ask to speak with or see the Lactation Specialist.
Make sure your bowel movements are regular. If not, you may not be getting enough water or may need a stool softener. We often recommend Dulcolax and lots of fruit juices/fiber after the patient goes home. Often, narcotics will slow down the GI system enough to cause MAJOR problems with constipation---this can be insidious and not noticed until severe discomfort and problems have arisen. Don't let this happen to you!
Have the number to the OB department handy. That way, if you have questions "after hours" or don't want to bother your OB later at night, you can always call them for advice and instructions on what to do "if".
HTH!!!
CONGRATULATIONS TO YOU and YOUR FAMILY on your blessed addition!

Thank you for your response! I always like reading your reponses to people's questions because you are so knowledgable in your field. Is it ok for the incision to be pink in some sections...not red but pink. The pink part is not more painful than the rest of the incision either. The whole incision seems warm, but not hot...is this ok? I think that because the staff at the hospital knew that I was an RN they maybe assumed I didn't need as much teaching.

Thank you so much in advance!! -TweetiepieRN

SmilingBluEyes · Jul 8, 2005

Thank you for your response! I always like reading your reponses to people's questions because you are so knowledgable in your field. Is it ok for the incision to be pink in some sections...not red but pink. The pink part is not more painful than the rest of the incision either. The whole incision seems warm, but not hot...is this ok? I think that because the staff at the hospital knew that I was an RN they maybe assumed I didn't need as much teaching.
Thank you so much in advance!! -TweetiepieRN

This sounds like a normal healing process to me. Pinkness and warmth are normal. Out and out redness and heat are a bit more concerning. There IS an inflammatory process going on there, just in healing, so you will find some pinkness. But if the incision suddenly changes appearance or emits more copious discharge, it would not hurt to have it looked at. It sounds like yours is healing very normally and well.

And you hit on a good point where I needed a reminder. We must not assume just because a person is a medical professional, we are "off the hook" in our teaching. Thank you for reminding me. Discharge teaching is important for EVERYone. I am sorry yours was scanty. You are probably right; they probably assumed you knew all this and did not want to "insult" your intelligence by going over each point with you. Or maybe, they were so busy, there was little time for more thorough teaching. That is why each time I enter a patient's room, whether it be for an assessment or to bring her water, I use it as a "teaching moment". It's amazing what you can cover, and what a person can learn, in short "bites" versus 30 minute lectures. I am sorry you were shorted this way. We all get busy and I imagine I have neglected to teach some important things along the way. We all need reminding how important the teaching role is for us as nurses.

And thank you for the kind words! Again, congratulations to you and your family. Take care of yourself and enjoy this special time together.

JAHJF · Jul 10, 2005

Hey there. I had a primary c-section on July 1st. I was only given instructions as to not use stairs, no lifting anything heavier than baby, monitor the incision. Are there any other things I should be doing or not doing? I am an RN, but the funny thing is...when I am the patient it's as if my brain does not function as a nurse :) Also, is it normal for the incision to have a very small amount of yellow drainage on steristrips? ANY ADVICE WOULD BE APPRECIATED!

I had a c-section back in April and I never saw my RN on discharge day, she let her senior year nursing student do my assessment/meds/and discharge instructions (not the best for the patient); I didn't think of my questions at the time but on the ride home when I realized that she hadn't mentioned at all how I should care for the incision??? I'm a cardiac nurse. Here are some hints I wish I had know.

Let the house go if you have too, don't over do it, and take any and all help offered (esp if you have small children) and if all else fails, ask for help.

Eat well and sleep well. (sleeping in a recliner can help)

Gas-X is your friend. :) So is your pain med, if you need it. (Aleve can help also).

Steri-strips will turn yellow and they can irritate the skin around your incision if they don't come off after about a week (some of mine were still stuck at 2 weeks and I took them off). When they start coming loose in the middle of the strip (over the incision) or on one end, take it off after you shower and its wet.

Keep the incision dry, use a hair dryer after your shower.

Report anything with the incision that your concerned about and if it turns out to be nothing, be thankful, not embarassed.

Pedal edema can hurt, keep your feet up when sitting on couch, etc.

Hope this helps some, let me know if I can answer anything else. :)

BETSRN · Jul 10, 2005

Thank you for your response! I always like reading your reponses to people's questions because you are so knowledgable in your field. Is it ok for the incision to be pink in some sections...not red but pink. The pink part is not more painful than the rest of the incision either. The whole incision seems warm, but not hot...is this ok? I think that because the staff at the hospital knew that I was an RN they maybe assumed I didn't need as much teaching.
Thank you so much in advance!! -TweetiepieRN

Taking Motrin (600-800 mg) will help as well with the healing and inflammatory processes going on. Our docs use the 600 q 6 and the 800 q 8 hours. It will do more for you than any narcotics.

TweetiePieRN · Jul 10, 2005

I had a c-section back in April and I never saw my RN on discharge day, she let her senior year nursing student do my assessment/meds/and discharge instructions (not the best for the patient); I didn't think of my questions at the time but on the ride home when I realized that she hadn't mentioned at all how I should care for the incision??? I'm a cardiac nurse. Here are some hints I wish I had know.
Let the house go if you have too, don't over do it, and take any and all help offered (esp if you have small children) and if all else fails, ask for help.
Eat well and sleep well. (sleeping in a recliner can help)
Gas-X is your friend. :) So is your pain med, if you need it. (Aleve can help also).
Steri-strips will turn yellow and they can irritate the skin around your incision if they don't come off after about a week (some of mine were still stuck at 2 weeks and I took them off). When they start coming loose in the middle of the strip (over the incision) or on one end, take it off after you shower and its wet.
Keep the incision dry, use a hair dryer after your shower.
Report anything with the incision that your concerned about and if it turns out to be nothing, be thankful, not embarassed.
Pedal edema can hurt, keep your feet up when sitting on couch, etc.
Hope this helps some, let me know if I can answer anything else. :)

Thank you! Good tip about the hair dryer...I just got out of the shower and I think right now I will go back and do that!! I am an oncology nurse so I too am not familiar with c-section aftercare. This is why I love allnurses!! Always a helping hand just a keystroke away!! :)

SmilingBluEyes · Jul 10, 2005

Jahjf offered some excellent advice. Glad to see others jump in

And Betsy is right; regular use of Motrin (as your dr permits) will do a LOT more to heal the inflammatory process than narcs. Narcs are good if you are intensely uncomfortable/for night use. At this point, I would bet you are pretty much past the need for too much medication. Keep up the Motrin, if you can, for at least 2 weeks' post-op. It will help a LOT.