One Month Post Surgery

Prior to this surgery, I'd never been admitted to a hospital (the worst thing I'd ever done was break my big toe and wear a boot for a few weeks) so to say I was a bit anxious about this whole surgery thing would be an understatement. Now that I've made it through, I have this to say: Nurses and nursing staff are amazing people. They made my hospital stay so much better than I thought it would be. They made sure my pain was under control. They helped me in and out of bed to use the restroom even when I called them 15 minutes after they had checked on me (I don't control the call of nature) without any rolled eyes or sighs. They answered all of my questions no matter how silly they seemed to me. They encouraged me at even the smallest improvement (like when I was finally able to get back into bed without someone lifting my legs up for me). If you are a nurse, thank you. If you know someone who is a nurse, thank them.

I also want to say thank you to the amazing friends, family, and neighbors who have helped us in so many ways: one friend did a 3-hour round-trip drive to get my mom to our house from the airport shuttle, another friend did a 2-hour round trip drive + a stop at the supermarket to take my mom and I to my doctor so I could get my 22 staples removed, friends and family have sent me items to help me throughout my recovery from blankets to a giant book of sudoko puzzles to a box of candy, local friends brought us so much food that my husband didn't have to cook dinner for more than a week, and my mom was able to come down and stay with us for 8 nights thanks to support from my aunts and uncles to check-in on my dad the entire time. We are extremely grateful (I'm especially grateful my mom was there to take care of me), I am determined to pay it forward, and I promise we'll return your dishes soon. 

In terms of writing about the surgery and post-surgery, this was a hard post to write. It's now a month post-surgery because I simply wasn't able to write a blog post earlier. In fact, I started writing this post last week, but since I can't sit for long periods of time, it's taken me a week to get through it, especially since I couldn't figure out how to do an update of the past month. I kept writing extremely long posts, deleting them in favor of a short post, which I'd then also delete because it didn't really provide any information. In short, I've been torn between writing a play-by-play post (and who wants to read that?) and something that gets the main details out there but probably wouldn't be very useful for anyone searching for information. So here's my compromise: a post of "What I wish I had known before my laparotomy/abdominal myomectomy." It's still long, but I hope it's useful to those looking for information as to what to expect.

Preparing for Surgery

• Do whatever your doctor tells you to do in terms of medicine, alcohol, eating, etc. (I was not allowed to have alcohol or any medicine except Tylenol for 2 weeks prior). However, I'm extremely grateful that the majority of my pre-surgery workouts focused on legs and arms. Post-surgery it's impossible to use abdominal muscles for a long time, and I relied heavily on my legs (to wiggle up higher on the bed or to get into a standing position) and on my arms (to pull my entire body up into a sitting position, to lower myself down onto the toilet while holding onto a railing, to push myself up into a sitting position). If I hadn't been working to strengthen those muscles, everything would have been a lot harder.
• If there are items you use on a daily basis -- shampoo, soap, razors, pens, snacks -- put them on a table or shelf at a level you can reach without bending.
• Pack a bag for the hospital. The contents will vary depending on the number of days you'll be there, but here's what mine included (and I used everything)
  • Toothbrush/toothpaste: The hospital provided this, but I like to use my brands
  • Eye mask for sleeping: If someone doesn't shut off all the lights when they leave, you're stuck with those lights on. Hospital rooms are also full of glowing dots and machines. Once I started wearing my eye mask at night, I slept much better.
  • A way to play music: I wasn't able to comfortably read or watch tv until my 3rd day in the hospital, which doesn't leave much to do. Playing music on my phone helped to keep me calm (I have a playlist full of classical music), and was especially comforting at night when I was alone in a strange room and not feeling so hot. If you'll be in a shared room, make sure to also bring earphones.
  • Phone charger with extra-long cord: The closest outlet was behind my bed, and without the extra-long cord, I wouldn't have been able to reach my phone to charge/remove it without assistance. This way I could warp the cord around the side of my bed and charge as needed.
  • Slippers: 24 hours after my surgery, I was being helped to sit up in a chair and then eventually do some walking around the hospital floor. The non-slip socks they provided were (a) much too large, and (b) not very warm. I enjoyed wearing my minion slippers while I shuffled around the floor with the assistance of my husband and a shoulder-high walker. Note: make sure your slippers have something on the bottom that makes them non-slip or you won't be allowed to wear them.
  • Comb/brush: I have long, thick hair which I put into braids before surgery. Two days after my surgery, it was a mess and making me nuts, but I was able to re-braid my hair (I wasn't sure I'd be able to easier raise my arms that high, but it wasn't a problem).
  • Notebook & pen: You'll think of questions at all hours of the day and you won't remember them when the nurse or doctor comes by, which is when a notebook full of your questions will come in handy.
  • Clothes to wear home: You want REALLY loose pants or a skirt that will rise to at least your belly button. You definitely will not want any pressure around your midsection or bikini line. Slip-on shoes also made life easier. 
  • Sanitary napkins: The hospital will give you these, but they're usually the super thick and uncomfortable kind. I'd recommend bringing some thin super pads with you... you'll be much more comfortable.
• Put aside the items you'll need for the car-ride home:
  • A pillow for the car ride home: You'll use this both to buffer your stomach from the pressure of the seat belt and to provide support when you have to cough, sneeze, or laugh. Of all of those, trying not to laugh has been the most difficult.
  • A blanket for the car ride home: Unless it's 80+ degrees when you leave, like it was when I was discharged, you may feel more comfortable tucked into a cozy blanket.
  • Towel or a pee pad to sit on: This isn't because you won't be able to control your bladder (I hope), but more in case there's so much bleeding it goes through your sanitary napkin. You definitely do not want to get that on your car. The waterproof/absorbent pad also relieved a lot of stress the first few nights I was home because I didn't have to worry about bleeding on my sheets. I've been told that those puppy-training pads will also do the trick.
• Make sure to have lots of loose pants -- even regular yoga pants were too tight for the first three weeks after surgery -- and also to have underwear that goes to your belly button and is at least one size larger than you'd normally wear. Also make sure these are easily accessible and at least at waist-high level before you leave for the hospital.

At the Hospital Before Surgery

• You'll have to repeat your name and birth date a gazillion times. Just go with it.
• You'll need someone to help you with the anti-bacterial cleansing cloths, if that's something your hospital does. I received 6 wipes once I was brought back to the prep area: one for my neck to my bikini line, one for my two arms (shoulder to finger tips), one for my groin area, one for my legs (thigh to toes), one for my butt, and one for my back. Since every inch of you needs to be wiped down, someone else will need to get your entire back.
• Bring something to keep you entertained/distracted because there's a lot of waiting.
• Don't get the IV in your dominant arm. I'm left-handed and had the IV in my left wrist, which made it nearly impossible for me to use for any sort of action that required me to put weight on or bend my wrist and made it very difficult to pull myself up/out of bed in the hospital (the "exit" was on the bed's left side). On the plus side, the rail in the bathroom was on my right side, so my right bicep got a good workout.

At the Hospital After Surgery

• It will take some time to come out of the anesthetic fog, and it's okay to fade in and out of sleep. I vaguely remember a nurse sitting next to me in the recovery area, hearing someone beyond the curtain say her mother is on the phone, and then my nurse got up and had a conversation with, I presume, my mother. It's pretty hazy after that except for seeing my husband next to my bed a while later (or maybe soon after -- I have no idea).
• Your throat may be sore from being intubated (mine was not), but I was told that's normal.
• Having a catheter is uncomfortable. It felt like I constantly had to pee but could not. They left the catheter in until the next morning, which makes sense since I doubt I could have gotten to the restroom even with assistance. Having the catheter removed wasn't painful for me, but I've heard it can be painful. It felt like removing a hard-to-remove tampon, which isn't pleasant, but not terrible. Peeing, on the other hand, hurt like a b**** for several days, and I was told it was because of the catheter.
• The leg compression wraps are to keep you from getting blood clots while lying still for so long. They made me a little nuts that second night because I couldn't cross my legs, they made an annoying constant humming sound (or maybe that was the bed), and they made my legs super hot and itchy. I was not a fan.
• Take the pain medicine even if you're not in tons of pain. This is the one piece of advice that everyone I talked with told me to do, especially since I have a high pain tolerance and try to forego medicine. The idea behind this is that if you take the pain meds when the pain is small, you'll be able to keep on top of it. If you wait until you're really hurting, you'll have to wait for the pain meds to kick in, and that time waiting will be miserable.
• Not all pain medicine may agree with you so pay attention to your body. I did fine on IV morphine, but once I was switched to norco, which is an opioid pain reliever (hydrocodone), I did not do so well. The first time I was given norco was after I had done my first shuffle around the hospital floor and right before I ate my first full meal (chicken tenders, broccoli, and a coke) in 36 hours, so I attributed the hot flash + dizziness + nausea to the exertion related to those two activities, and lay back to take a nap. It was only after the second dose several hours later that I realized something was wrong. I got extremely dizzy -- only a step below vertigo -- and nauseous. When I explained all this to the nurse, she agreed with me that it must be the medicine. Although she was able to give me an anti-nausea medicine through the IV, there was nothing she could do for the dizziness. The evening's pain control was switched to 800mg of Motrin, which I tolerated perfectly fine. No opiates for me ever again.
• Even if you're starving, start small and work your way up. I wish I had done that. The evening of my surgery, the nurses brought me chicken broth and water, and I asked for saltines because I was HUNGRY from not eating in more than 24 hours. That all went fine (even if I was uncomfortable because it's impossible to eat soup in a reclining position and sitting up was painful) and was put on a normal adult diet starting with breakfast. However, the food services hadn't gotten the change order early enough and they brought me vegetable broth and apple juice for breakfast. I should have just gone with that, but instead I sent my husband for a bagel and cream cheese and cut-up fruit. I ate about half of that and regretted it soon after. The gas pain after surgery is almost unbearable and the pain meds can't do anything about it. It felt like there were knives in my stomach and a tight band being pulled tighter around my ribs. This is common (that didn't really make me feel any better physically or emotionally), and will only go away once you start to pass gas. Which does not happen right away. In my case took two agonizing days before I was able to pass gas. Speaking of ...
• Try to start moving as soon as the nurses say you're allowed. The gas build-up from surgery won't dissipate easily if you lie in bed the entire time, and the only way to get things moving is to get moving yourself. As soon as I was able (okay, as soon as the nurses thought I should get up), I started to do shuffling laps around the hospital floor with the assistance of a shoulder-high walker and my husband. Once I was up it wasn't too hard to shuffle. It was the getting up/down that was (and still is) difficult. 
• Forget modesty or embarrassment. The nurses are going to want to know how much you pee. The toilet in my hospital room's bathroom had a bedpan in it, and each time I went the nurses would have to record the amount. I've never seen people so interested in my pee before.
• When in the bathroom, do not push or strain. That will do bad things to your incision. It's very difficult to do this, especially since the anesthetics and pain meds make you constipated. The nurses started giving me a stool softener as soon as I was admitted to the hospital, but even so, I've never gone so long without a bowel movement and hope I don't have to repeat that anytime soon. It's extremely uncomfortable (that tight band feeling) and quite frustrating. If I had known how bad it would be, I would have asked for raisins with each of the meals the hospital served me. Or I would have sent my husband out to get me some raisins. 
• Also in the bathroom, you'll see lots of blood. Not from the incision (hopefully), but in your pee. I believe they told me only to worry if there were clots larger than a quarter. 
• Hospital food may be questionable, so if you have someone with you, send them to the cafeteria or somewhere else to bring you back things you want to eat (once you're able to actually digest food properly). If you have food allergies or religious preferences, check your food carefully before eating. One breakfast I received included the food ticket that say "No pork or shellfish" at the top, and including "2 pieces bacon" as one of the line items. 
• Before being discharged, ask the nurse for some packs of disposable/maternity underwear. It's incredibly comfortable to wear over the incision site and will be the only thing you want to wear under your loose pants/skirts for several days, if not longer.

At Home

• I'm extremely grateful that my doctor is conservative and had me stay in the hospital for 3 nights. Going home on Friday instead of Thursday made a huge difference in my confidence level of being able to get along at home with help, not to mention being able to tolerate the 4-hour drive home from the hospital. I was sent home with orders to continue taking Motrin (my doctor changed that to Extra-Strength Tylenol a week later) and a stool softener until they weren't needed anymore.
• I'm under orders to remain minimally active for 6-8 weeks. This means no exercising (obviously), no activities that use my abdominal muscles (I was told this included vacuuming), no bending (anything that is below my knees is out of reach), and only short walks are allowed. 
• Did you catch that? Anything below my knees is out of reach. This means having help at home makes all the difference in the world. I was lucky that my mom was able to stay with me that first week at home while my husband went to work, and that my brother sent me a grabber to help me get those out-of-reach items, but getting socks on without help is still difficult a month later.
• I'm also under orders not to lift anything heavier than 10 lbs for 6-8 weeks, which is fine, because things that used to be incredibly light now feel impossibly heavy.
• It hurts to cough, to sneeze, to hiccup, and to laugh. I was able to avoid coughing for a while (my poor husband has endured a ridiculous amount of throat-clearing sounds), and avoiding laughing sometimes makes me feel like I'm not participating in conversations, but it's that or feeling pain.
• Be ready to sleep on your back for a long time. I'm a stomach-side sleeper, and have been since I was a baby, so sleeping on my back at home was not fun. It took about a week until I could sort of sleep on my right side (buffered with lots of pillows for support), and almost three weeks until I could sleep on my left side without pain. Once I could sleep on my sides I slept much better, but I often end up on my back because of the pain anyway. It does help significantly to use one of those bed-rest pillows with arms to help stay in a semi-reclining position instead of lying flat on the bed, because it's almost impossible to get up from lying flat without assistance.
• It took more than a week for me to be able to eat a meal without feeling an intense pressure around my stomach/chest and then falling asleep for at least an hour, sometimes two. Even now, a month post-surgery, I'm still napping more than I have since I was a baby, but I can at least manage to hold off the post-meal snooze for an hour if necessary.
• The area between my belly button and the incision is numb. This is because the doctor had to cut through nerves and muscles, but it's an incredibly weird feeling that nobody warned me about. It's also incredibly dry and needs to be moisturized frequently (just the belly area, not the incision site because that's off limits).
• I wasn't able (nor allowed) to sit at a desk to work until two weeks after my surgery. Even then, I was told to only sit for 30-45 minutes at a time so my uterus wouldn't heal in a scrunched up position, and also to avoid blood clots (that made me rethink my normal working and binge-watching habits). 
• I was told I could drive short distances, like around the corner, and only if I was confident I'd be able to respond to the road as quickly as I would normally. I didn't feel comfortable driving until 20 days after my surgery, and even then, it's not fun. Twisting to see behind the car or look at traffic before making turns is painful if I turn more than just my head. 
• Expect boredom and frustration. Until week 3 post-surgery, the only time I got out of the house (other than to see Black Panther, which was completely worth the pain from sitting still too long) was to go to my OB-GYN to have my staples removed (that barely hurt at all) and to do a shuffling walk up and down the street (that has since expanded to a slightly faster-shuffling walk around the block). After a few weeks, I finally felt strong enough to have visitors and started to ask friends to come by, ignore the fact that we'd converse as I lay on the couch instead of sitting on the couch, and not to mind that I would be dressed in pajamas. A month later, I'm back at work, but only have the energy to do an hour or so of work each day before I need to take a nap and spend a while lying flat-ish on the bed, and I'm still unable to sit long enough to play board games with someone. I feel like I should be able to do stuff like load the dishwasher or put sheets on the bed, or hang out at a pub with friends, but I'm physically unable to do so. When I folded the laundry the other day, I felt like I had completed a huge accomplishment. I did manage to get out of the house for a few local events starting toward the end of last week (Week 3), but only for a short while. It exhausted me to be out and shuffling about, but it was definitely worth it.

What's Next?

I'm supposed to call my fertility doctor the first week of April to figure out next steps. I'm guessing I'll have some kind of check-up to make sure my uterus has healed thoroughly and correctly, and then it's onto Round 3 of IVF, which I'm guessing will be sometime in April or May. At least I won't feel the needles going in since my belly is completely numb and probably will remain so. That's a silver lining, right?