Choosing and Recovering from a Laparoscopic Hysterectomy
In October on 2016, after years of intensely heavy and painful periods, I had a laparoscopic hysterectomy. I’d tried everything else: birth control pills that had nasty side effects, a Mirena IUD that I bled out during a client meeting, an endometrial ablation that didn’t work, acupuncture that was also fruitless. By the time I had my hysterectomy, I was pretty thrilled to say goodbye to my uterus. And it improved my life dramatically.
But deciding what kind of procedure I needed was tricky. And once I did decide, I had a hard time figuring out what recovery would be like and when I could plan to go back to work. I’m sharing my experiences here to make it easier for anyone considering a hysterectomy. (Insert your favorite standard disclaimer on my not being a doctor and this not being certified medical advice.)
It’s important to know that there are two kinds of hysterectomies: 1) Abdominal surgery, which involves a large cut across your lower abdomen and is similar to a c-section (but they take out your uterus instead of a baby). It’s pretty major surgery and involves a couple of days in the hospital, plus a recovery period of many weeks or even months. 2) Laparoscopic surgery, which involves four or five small incisions and surgery performed by robot. It’s outpatient surgery for most women, it’s less risky infection-wise than abdominal surgery, and the recovery can be pretty quick. Also, the scars are smaller, if you care about that sort of thing (I 100% do not).
When I met with a gynecologist to consult about a hysterectomy, my uterus was enlarged. Because of the size, she insisted it would be impossible to remove my uterus through a laparoscopic incision, and she scheduled an abdominal surgery. I’m a listserv of women in business, and when I posted an off-topic note that I was looking for advice on managing the surgery, one of the other members asked her sister, a gynecologist, to weigh in. The sister was across the country from me, but she thought laparoscopic surgery would work for me and urged me to get a second opinion. I was skeptical at first, because the original surgeon’s logic seemed sound, But I wound up going to see a laparoscopic specialist, and she was very clear that I was a good candidate for laparoscopic surgery.
*It was a really, really good decision to get a second opinion and have the laparoscopic surgery.* I was able to have a less risky, less invasive procedure with no tradeoffs. I am now pro-choice and pro-second opinion.
In searching for info about recovering from a laparoscopic hysterectomy in particular, I heard and read a big range. Everything from the woman who ran a marathon a week after surgery to one who wished she’d taken more than six weeks off from her job. I assumed I’d fall somewhere in between — much like Kronda Adair, who has a very helpful post on her recovery. Plus my doctor said to expect two to three weeks.
In fact, I turned out to be more on the immediate-recovery end of the spectrum. Although I’d been worried about getting into our walkup apartment the night of the hysterectomy, it was no big deal. Less than a week after the procedure, I was feeling pretty normal. My partner, who’d delayed a trip in order to take care of me, was disappointed there wasn’t more to do. Friends who stopped by in the first days afterward wondered openly if I’d actually had surgery.
I was pleased with that outcome — but I still wish I’d known more beforehand. Here are some notes about recovery that may be helpful if you’re facing the same procedure. (My hysterectomy included taking out not only my uterus, but also my cervix and fallopian tubes, which is where doctors now believe ovarian cancer starts. We left in my ovaries, so I wouldn’t go into early menopause; if you have your ovaries out, recovery will include hormone-replacement therapy and/or adjusting to a new hormonal balance.)
Get a few pairs of cotton panties two sizes too big (and ideally with flimsy elastic). After the surgery, you don’t want anything pushing on your abdomen. The hospital will send you home in one suitable pair. I needed a week’s worth.
Get some leggings that are too big (or maternity leggings). See above. Also, they have to fit over the ridiculous granny panties.
Have maxipads (or period panties) on hand. After the surgery, you can’t put anything inside your vagina for about eight weeks, so your arsenal of tampons isn’t going to help when you have bleeding from the surgery. Bleeding from the incision where my cervix had been removed didn’t start until a full week after the procedure, and then it was formidable. Though it didn’t hurt at all, it was like having a two-and-half-week period for which I couldn’t use tampons.
If you don’t want to go home from the hospital braless, bring a camisole with a loose shelf bra or maybe try a front-closing bra. Twisting around to get the back hooks lined up just isn’t gonna happen hours after a robot has wandered through your torso.
If you want to leave the hospital the day of the surgery, make sure you can get your meds that night. My surgery was first thing in the morning, and I was planning to go home by the end of that day. Though I saw plenty of nurses all afternoon, the first doctor who checked in on me showed up around 6p and said he’d sent the prescription for my painkillers to my pharmacy. That would have been great, except my pharmacy would likely be closed by the time we got home. Opioid prescriptions cannot be sent to two pharmacies, so he had to do some work to get mine rerouted to a pharmacy near the hospital, which my partner then ran out to while I was getting ready to leave. In the end, we got home well after our pharmacy had closed and were glad we’d filled the prescription near the hospital. Would have been easier to work that out ahead.
If your surgery is at least a few months off and you want to get in shape for it, work on your core muscles. At the time of my hysterectomy, I’d been exercising regularly for less than two years, and I wasn’t hardcore about it (um, I’m still not). But I’d focused on core strength, and that boosted my recovery a lot. First, I was pretty aware of my abdominal muscles; that alone helped me gauge my own recovery. Second, I started off relatively strong, so the surgery effects didn’t take me below zero. Lots of women talk about being unable to tie their shoes for weeks. I could tie shoes the day after my hysterectomy, #ActualBrag. A week after surgery, I felt like I could go back to Pilates classes. Everyone says you’re supposed to take it easy after this procedure. I wasn’t sure what that meant, but hitting an exercise class seven days after getting off the operating table seemed unlikely to qualify. I waited two weeks to go the gym and three weeks to go Pilates. (I later learned about transverse-abdominal breathing and realized I could have started that sooner.)
Plan not to lift anything more than 10 or 20 pounds for six weeks or so. This will be more complex if you have children of a pickup-able age (I don’t have any kids) or if your job involves heavy lifting (mine requires lifting a 13-inch laptop and some earbuds). But I did have to make sure I wasn’t on point to walk our large, energetic dog for a while, and I had to cancel a trip for which I would have had to haul luggage around.
Opioids cause constipation; take that very seriously. This isn’t fun to talk about, but key info: I went four days without pooping, including the day of the surgery, and it was the worst part of recovery. Here are the salient lessons:
Know that pain meds can have a bunch of other side effects. I seemed to have even the rare ones: fitful sleep and weird dreams, chills, hot flashes, total loss of appetite for seven days, depressive feelings, runny nose, blurry vision and more. Weirdly, my fingernails stopped growing for a week. On Days 2, 3 and 4, I felt like I had a mild flu, or like I was a junkie. Wish I’d known beforehand that the effects of the pain meds would be harder on my system than the actual surgery.
Have some digestion-friendly foods on hand for when you do want to eat: applesauce, steamed broccoli, brown rice. A smoothie of kefir, an apple and a little water gives your fiber, probiotics and hydration all at once.
Drink a lot of water. Helps with pretty much everything.
Miscellaneous. I found long walks made me feel better, starting on Day 2. Showering every day made me feel more human, too. Nearly two weeks after the procedure, when I was otherwise feeling fine, the skin around my abdominal incisions got red and super itchy. This was an allergic reaction to the adhesives used on the incisions; over-the-counter Cortisone cream helped a little.
The notes from the hospital about how to handle recovery suggested trying light movement, like “cooking, dusting and clerical work.” The hospital was built after 1952, so I’m not sure what’s up with that recommendation. But since my job involves working from home on a laptop, it can’t be a bigger strain than clerical work. By Day 5, I was working part-time, no problem. On Day 7, I found a local women’s shelter where I could donate the boxes of tampons I’d never need again. On day 8, I didn’t run a marathon, but I did cheer one from the sidelines, and I felt pretty good that my recovery had been so smooth.
Choosing and Recovering from a Laparoscopic Hysterectomy
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