Hysterectomy Surgery in Covid times? Any advice for post-op?

[ChicagoNDMom]

Your lips will be very dry/chapped post op. Be sure to bring chapstick even if you don’t regularly use.
Say yes to help for meals/laundry. Freeze some meals.
You will do great!

[dogmom]

I work/worked in a pre/post op area so I think I can answer a lot of your questions. (I’m currently working in an area that has been changed to a COVID surge ICU.) Even during the summer/early fall when we were allowing one visitor a day it didn’t include visitors for the procedural areas. Since there are so many day surgery and other procedures it just adds a much larger pool of people going through the hospital with potential exposure. Also, there is no where for the family members to actually wait in the hospital and be socially distant since the waiting rooms don’t have the space to do so. The burden to screen an extra 150-250 visitors a day was too much. The PP are correct, we are all pretty practiced at his by now and have the flow worked out.

My observations from working in the recovery room for four years is that there is very little you actually NEED in the post-op phase besides glasses, dentures, hearing aids and phones. I think people pack a bag more for anxiety and having things familiar than any actually need. If you wear glasses you may be able to take them into the OR and they will put them in a glass case for you and put them in a chart vs. putting them in a bag with your clothes. (I find in general those of us who where glasses tell you to keep them, those who don’t get all worried you can lose them and don’t understand how not being able to see clearly adds to your anxiety.) That way you can see up until you are in an OR. I think the only other thing that people really miss is their phones, especially if their surgery is delayed and they need to wait for longer than a couple of hours. I recommend brining your phone and putting it in the bag with your clothing, that bag doesn’t get lost in my experience. So if things do get delayed I’ve had aids go get the phone for people or at the very least make sure the family is updated about the delay. I also always offer to call and update family members of delays, etc. As far as after the surgery most people are groggy, just glad it’s over, and as soon as they can drink, eat some, have their pain relatively controlled, can get to the bathroom we are getting them into their car to go home. In general people basically healthy people like you are better off sleeping in their own bed. Since we don’t have family members with patients we go over the instructions on the phone and they are printed out. There aren’t a lot. When to take your pain meds, when to take the dressing off, signs to call the doctor for, and stay on top of potential constipation.

To prepare for the surgery I would suggest practicing some mindfulness and breathing techniques to reduce anxiety. Like strategies for childbirth you need to actually practice it beforehand to be of any real use. I’m also a believer in a little drugs pre-op go a long way. I’m pretty chill about surgery, but when I had my spinal fusion I asked for a couple of Ativan from my PCP. I took one the night before and one on the way into the hospital, because who wouldn’t want to take the anxiety down a notch before surgery. Most providers are going to think, “thanks for taking care of yourself” not “she’s an addict”. You don’t have to do so, but it’s not a bad idea.

The surgeon will call your designated person after the procedure, because you won’t remember any conversations for a while after the surgery and the surgeon will be into the next case when you can remember. (I usually get asked several times after the OR, “is the surgery over?” several times before it sticks.) If you are going home you might not see the surgeon until the follow up appointment. If you don’t see them it meant everything went fine.

Laparoscopic hysterectomies usually go well, and even open ones do well except for older individuals. There are a few issues with gynecological and abdominal surgeries. Sometimes people have scaring, and now much depends on how people heal. Yo can get it from surgeries or endometriosis. We call them adhesions. You have no idea how much someone has until you open them up or look with with scope, they aren’t visible on imagining. So it’s not uncommon for someone to have a longer procedure and the surgeon has to spend extra time “lysing adhesions” which basically means slowly and carefully cutting away the scar tissue that can bind things up and make it harder to remove whatever is getting removed. Sometimes you have loops of intestines with scar tissue adhering to them and almost sticking them together (hence the term adhesions) and taking that down can prevent future problems. Like a said, not uncommon and not dangerous, just tedious.

The next two issue are unique to gynecological surgeries: severe nausea and bleeding. Females of child bearing age have a higher chance of post op nausea and vomiting, and mucking around with the female parts just makes that worse for some reason. So a common reason I see for hysterectomies to stay overnight instead of going home is they are a later OR time, they took longer because of adhesions, they can’t keep fluid down and it just gets to be 11 at night and it’s a crappy time to send someone home after surgery. Also, everyone once in a while these surgeries just bleed and keep “oozing” just like some women bleed more after childbirth. It’s not nearly as common, but unless you are a Jehovahs Witness you will be fine also. This might also keep you overnight.

I’m not sure if you are the one asking about issues a while ago or not, but I will repeat my advice. Most women I know who have a hysterectomy due so after years of issues and usually get a lot of relief from it. So it definitely can be a quality of life issue. I could write a lot more about pain control, recovery, etc. Feel free to message me.

[KrisM]

DH had surgery in early January. I was able to go and wait in the waiting room. We weren't sure that would happen. DS1 also had surgery in January. That's a little different since he's 16, but I was able to wait for him too. These were at different hospitals. For DS I was the only person in the waiting room. I was only allowed because of his age. For DH, there were quite a few of us waiting. Chairs were well spaced.

For both hospitals, I was sent a text at various points. When DH went to surgery (I saw DS go), when surgery started, when it ended, when they were in recovery, how recovery was going. For DH, the surgeon then called to talk to me and give me instructions. I wish I had known that and I would have been more prepared to write down notes. I did have a chance to talk to the nurse at the very end though. For DS, the surgeon came to me in the waiting room to tell me how it went. I was able to go to recovery for him so did get a lot of info from the nurses then.

I expect during the times no visitors are allowed the texting and phone calls do a great job of keeping everyone informed.


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[smilequeen]

I had outpatient surgery (breast reduction) in December. My husband drove me there and was not to leave the area until I went home, but he was not allowed in to pre or post op. He sat in the car the whole time because he was on calls for work and needed the privacy, but they had a waiting area if he wanted. I did not really need anything at all. I had my phone, I don't wear glasses, etc. Pre-op was a little boring but they moved pretty fast and I had the first surgery of the day anyway. In post op I was tired, out of it, mostly napping. I was completely unaware of the passing of time really. My surgeon called my husband after surgery and then he texted to check in on me that evening. I don't have experience with exactly what your recovery would be like, but I will say to take all the help you can get and take the downtime you need. Do NOT push yourself to recover faster than you are. In fact, as a mom, I say milk it a little. My boys have never so willingly done absolutely everything I asked of them

[NCGrandma]

I work/worked in a pre/post op area so I think I can answer a lot of your questions. (I’m currently working in an area that has been changed to a COVID surge ICU.) Even during the summer/early fall when we were allowing one visitor a day it didn’t include visitors for the procedural areas. Since there are so many day surgery and other procedures it just adds a much larger pool of people going through the hospital with potential exposure. Also, there is no where for the family members to actually wait in the hospital and be socially distant since the waiting rooms don’t have the space to do so. The burden to screen an extra 150-250 visitors a day was too much. The PP are correct, we are all pretty practiced at his by now and have the flow worked out.

My observations from working in the recovery room for four years is that there is very little you actually NEED in the post-op phase besides glasses, dentures, hearing aids and phones. I think people pack a bag more for anxiety and having things familiar than any actually need. If you wear glasses you may be able to take them into the OR and they will put them in a glass case for you and put them in a chart vs. putting them in a bag with your clothes. (I find in general those of us who where glasses tell you to keep them, those who don’t get all worried you can lose them and don’t understand how not being able to see clearly adds to your anxiety.) That way you can see up until you are in an OR. I think the only other thing that people really miss is their phones, especially if their surgery is delayed and they need to wait for longer than a couple of hours. I recommend brining your phone and putting it in the bag with your clothing, that bag doesn’t get lost in my experience. So if things do get delayed I’ve had aids go get the phone for people or at the very least make sure the family is updated about the delay. I also always offer to call and update family members of delays, etc. As far as after the surgery most people are groggy, just glad it’s over, and as soon as they can drink, eat some, have their pain relatively controlled, can get to the bathroom we are getting them into their car to go home. In general people basically healthy people like you are better off sleeping in their own bed. Since we don’t have family members with patients we go over the instructions on the phone and they are printed out. There aren’t a lot. When to take your pain meds, when to take the dressing off, signs to call the doctor for, and stay on top of potential constipation.

To prepare for the surgery I would suggest practicing some mindfulness and breathing techniques to reduce anxiety. Like strategies for childbirth you need to actually practice it beforehand to be of any real use. I’m also a believer in a little drugs pre-op go a long way. I’m pretty chill about surgery, but when I had my spinal fusion I asked for a couple of Ativan from my PCP. I took one the night before and one on the way into the hospital, because who wouldn’t want to take the anxiety down a notch before surgery. Most providers are going to think, “thanks for taking care of yourself” not “she’s an addict”. You don’t have to do so, but it’s not a bad idea.

The surgeon will call your designated person after the procedure, because you won’t remember any conversations for a while after the surgery and the surgeon will be into the next case when you can remember. (I usually get asked several times after the OR, “is the surgery over?” several times before it sticks.) If you are going home you might not see the surgeon until the follow up appointment. If you don’t see them it meant everything went fine.

Laparoscopic hysterectomies usually go well, and even open ones do well except for older individuals. There are a few issues with gynecological and abdominal surgeries. Sometimes people have scaring, and now much depends on how people heal. Yo can get it from surgeries or endometriosis. We call them adhesions. You have no idea how much someone has until you open them up or look with with scope, they aren’t visible on imagining. So it’s not uncommon for someone to have a longer procedure and the surgeon has to spend extra time “lysing adhesions” which basically means slowly and carefully cutting away the scar tissue that can bind things up and make it harder to remove whatever is getting removed. Sometimes you have loops of intestines with scar tissue adhering to them and almost sticking them together (hence the term adhesions) and taking that down can prevent future problems. Like a said, not uncommon and not dangerous, just tedious.

The next two issue are unique to gynecological surgeries: severe nausea and bleeding. Females of child bearing age have a higher chance of post op nausea and vomiting, and mucking around with the female parts just makes that worse for some reason. So a common reason I see for hysterectomies to stay overnight instead of going home is they are a later OR time, they took longer because of adhesions, they can’t keep fluid down and it just gets to be 11 at night and it’s a crappy time to send someone home after surgery. Also, everyone once in a while these surgeries just bleed and keep “oozing” just like some women bleed more after childbirth. It’s not nearly as common, but unless you are a Jehovahs Witness you will be fine also. This might also keep you overnight.

I’m not sure if you are the one asking about issues a while ago or not, but I will repeat my advice. Most women I know who have a hysterectomy due so after years of issues and usually get a lot of relief from it. So it definitely can be a quality of life issue. I could write a lot more about pain control, recovery, etc. Feel free to message me.

dogmom, very helpful, as usual. Re: improvement in quality of life, I had an open hysterectomy years ago because of extensive endometriosis. The next morning a resident came in to ask about my pain and he was clearly startled when I said I had less pain the day after surgery than I had had the day before ... but it was definitely true! Fortunately, the surgeon took his time clearing out the adhesions as well as all the visible endometriosis. (At that time, they were doing various more limited procedures laparoscopically but not complete hysterectomies—but I wouldn’t have been a good candidate anyway, with all the "clean up" required.) I never regretted for a moment having the surgery.


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[Kestrel]

OP here!

dogmom - thank you for taking the time to write that out. Very helpful information. I am one of those who must have my glasses - I am prone to vertigo & motion sickness and I'm afraid missing them would add to post-op nausea.

My other concern is distance. We are 90 minutes or so from the hospital, and the hospital is telling us no one can come in. So - either someone has to wait in the car for who knows how long, or head home - more than half of that drive has no cell service. (Everything here is still closed; so no coffee shop/restaurant or anything like that.) I'm thinking DH should just go home and wait for the phone? He's mad he can't wait at the hospital. Also, the ride home with 5+ miles of gravel and dirt road is not something I'm looking forward to.

[SnuggleBuggles]

My dh had a procedure in November. It was about 5 hours. I sat in the parking garage. I occasionally turned my car on to warm up. It wasn’t ideal but I didn’t want to go home. It would have stressed me out to not be immediately accessible.


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[KrisM]

Waiting is waiting. If he was going to sit in a waiting room and wait, why not the car? I spend so much time waiting in the car these days - 3 kids in a row at the dentist is over 2 hours, 2 kids in braces, etc. I would much rather wait in my car and nap, read a book, catch up on paper work or whatever. I'd prefer that over 6 hours of driving (3 to drop off/go home and 3 to pick up/go home).

[carolinamama]

If I were having surgery, I would choose to have DH wait in the car over driving home. I'd do the same as the waiting spouse. It's best to have an advocate closer to you IMO.

[dogmom]

OP here!

dogmom - thank you for taking the time to write that out. Very helpful information. I am one of those who must have my glasses - I am prone to vertigo & motion sickness and I'm afraid missing them would add to post-op nausea.

My other concern is distance. We are 90 minutes or so from the hospital, and the hospital is telling us no one can come in. So - either someone has to wait in the car for who knows how long, or head home - more than half of that drive has no cell service. (Everything here is still closed; so no coffee shop/restaurant or anything like that.) I'm thinking DH should just go home and wait for the phone? He's mad he can't wait at the hospital. Also, the ride home with 5+ miles of gravel and dirt road is not something I'm looking forward to.

Honestly the best advice I can give is rent a hotel room the night before in town, especially if you are the first case. That way you don’t have to get up in the dark to get there and your spouse has somewhere to hang out until check out. When I had surgery once I actually walked over to the hospital on my own and he stayed at the hotel. It will also give you a nice evening to relax, watch the TV, I guess get takeout since you won’t want to go to restaurants. That is if there is someone that can watch kids with COVID. I completely understand it isn’t ideal for your husband not to be there. But part of it is this whole thing makes him feel like he has no control and he’s worried about you. It will give him something to fixate his anxiety on.

They will load you up with anti nausea drugs in the OR. They should offer you a scopolamine patch that will help also, but give you a dry mouth. Will they let you drink in the morning? After Hurricane Maria we changed our protocols and people can drink clear liquids in the morning up to two hours before. It helps a lot not to start the case being dehydrated from finding IV, to using less IV fluid, to blood pressure not being to low, and I swear it decreases nausea. Get freeze pops (the squeeze ones in a tube) for home. Even if you have nausea I find they are great way to trickle fluid into you with just enough sugar to keep you from puking. Definitely mention motion sickness to the anesthesia person and insist on your glasses then. Also, see if you can get your surgeons office to give you the standard post op meds before your surgery. Our gynecological surgeons preorder everything so you can pick it up and have it at home before you go in since you live so far away, one less thing to do on way home. The ride home sucks, it it’s doable. I work in Boston and I can’t tell you how many times I discharge home an 80 something couple to freaking Maine and they are, “oh, it’s fine, we have our rest stops planned!” Can’t keep those old Yankees down.