To Charlene

[Guest guest]

Hello my dear,

Try not to worry, being nervous for a surgery is completely normal. We all

feel scared, even those of us who have had surgeries before get nervous and

anxious about the idea.

Here is what you will probably expect from your surgery. I have had two

abdominal surgeries and this is what my experiences were like.

After you arrive at the hospital they usually have you sign a pile of papers

to sign your consent. You may have to wait in the waiting room for a while.

Then they lead you to the pre-op room where you put on your hospital gown

and get into a hosp. bed. Here the nurses will ask you lots of questions.

You will find that many of the questions will be repeated by several people

(nurses, technicians, doctors) because it's the hospital's system of double

and triple checking. Usually they ask the typical health history type.

Then you will have someone put in your IV. It will go either in your hand

or your forearm, wherever they find the best vein. If you are needle

squeamish make sure you ask for them to use Litocane before they put the IV

tube under your skin. This will numb the area. After you are hooked up

they may start the saline solution fluid through your IV or just flush it

with some fluid. It will feel cold at first. But they may wait and do this

until after you are in the OR.

This is the time a nurse may give you some anti-anxiety pills. You have to

request this through your doctor. Ask for Valium if you know you'll be very

nervous. This calms your nerves and keeps you from having a rapid heart

rate. So if you are interested in this kind of med, call your doctor's

office before your surgery to request it. And if you have requested it and

the nurses don't give you any, be sure to ask. It is your responsibility to

ask as many questions as you can while you are at the hospital.

Now it is another time of waiting. Your surgeon and OR nurses are prepping

the OR for your surgery. So that may take a while before you are wheeled

in. It is a good idea to have a family member with you while you wait in

pre-op. Having a loved one there to comfort you helps the time go faster.

Then when it's time, they come and wheel you into the Or. They may ask you

to climb onto the OR table or they may lift you themselves. The OR table is

small and hard, not fluffy and therapeutic, don't be shocked. It is designed

to come apart and adjust to many different body shapes.

Now depending on the kind of anesthesia you requested (general or epidural)

your surgery will be very different. If you are receiving a general then the

doctors will talk to you for a few minutes in the OR and then the anesthesia

will be put into your IV and you will fall asleep. It's fast! And you won't

remember a thing until you wake up in the recovery room. If you requested

an epidural, you will get very sleepy but you may be slightly aware of

people in the room. You most likely will sleep but you won't feel a thing.

They will insert your epidural either in the pre-op or the OR.

The next step is waking up. It used to be common to feel your surgical pain

before you were even completely awake. My first ab. surgery in 1990 was

like this. But these days they inject local anesthesia into the site of the

surgery so when you wake up you feel much less discomfort. My last surgery

in 2000 was so much better. I woke up and felt sooo glad that the procedure

was over, and there was no pain.

It may take several hours to wake up. Once you are coherent so that the

nurses can ask you questions they will wheel you to a hospital room. Here

you will still be attached to your IV. They will continue to put pain meds

in your IV and administer saline so you don't dehydrate. You will be pretty

sleepy the rest of the day. And depending on how your body handles meds,

you may have some nausea or a headache. This is the time when your family

can come see you again.

Rarely are abdominal myomectomies just a day surgery. When going through

the abdominal wall your surgeon will have to stretch or even cut your

abdominal muscles. They fill your abdominal cavity with CO2 gas to help

elevate the uterus. These techniques open the organs up to the environment

of the OR. There is a higher risk of infection with ab. myomectomies vs.

vaginal myos, but everything is sterile so that is not a worry. But most

doctors want you to stay at least one or two nights so they can monitor your

healing and your mobility.

You may have an appetite that evening. They will keep you on soft foods for

the first day. This means the beloved Jell-O and vegetable broth!

Hopefully by the morning you can eat a regular breakfast. Don't worry,

hospital food has gotten a lot better in the last decade.

Usually after the first night the nurses get you out of bed to walk. You

will have a urine catheter that they inserted while you were under

anesthesia. This will be removed after you are able to get up and to the

bathroom or at least a portable commode. That first attempt to sit up in

bed is the hardest. All your stomach muscles are sore and your uterus is

swollen. Your incision should be covered with bandages or surgical tape so

it does not rub on clothing or sheets. But when sitting up be sure you have

help. It may take several tries. Use slow breathing to help you get to

your feet. Take small steps and then sit again. It is important that you

stand, but walking can come with time. You will get to the point on your

second day that you will be able to walk down the hall and back. Most

doctors won't release you from the hospital until you can prove your

appetite is back and you are mobile enough to walk from the bed to the

bathroom.

It is important that you plan to have some comfortable clothing to wear

home. Before your surgery, shop for some draw-string cotton pants, a

sweatshirt that zips up the front, and some slippers that stay on your feet.

You won't want to pull anything over your head or bend down to tie shoes.

Then you can put these things in a bag so your family member can have it at

the hospital for the day you go home.

Your doctor has to see you before you leave. When you get the okay to go

home. They have you dress and then they push you out to your car in a

wheelchair. You will have your pain med prescription to take home, maybe

your family member can take you home first and then go to the pharmacy

afterward.

Pain pills will follow your IV removal. Usually the IV stays in for a few

hours after you are moved to your room from recovery. You may have an

automatic pain med machine that puts meds into your IV without you asking it

to. But if you need more sometimes you can push a button to ask it for

more. Then after you are able to stomach some food they will usually take

your IV out and start you on pills. It is important that you keep taking the

pills when required. The nurses will keep on top of it for you, but if you

feel some pain, be sure to tell them so they can ask your doctor for a

different strength or at least give you a higher dose if you need it.

And if you have never been a patient in the hospital before it is important

that you know how often the nurses check on you. They take vital signs and

check your pain levels so often you may feel like you can never sleep. You

may wear an automatic blood pressure cuff that comes on every half hour.

Nurses will take your temperature too to make sure there is no fever or

infection. They may have you wear an Oxygen monitor on the end of your

finger. It does not hurt, it just measures your blood level of oxygen. But

know that even throughout the night you will be checked on by the nurses.

So you probably won't sleep deeply even if you have your pain meds keeping

you comfortable.

Your incision should be a few inches wide if not smaller. These days most

surgeons use dissolvable stitches that are under the skin's surface so you

won't have to have them removed. But you will notice your skin change colors

over a period of a few weeks. You may have redness at first, then some

yellow coloring and then red again around the incision site. You may have

some dark bruisy colors too, it all depends on where the fibroid was removed

and how much blood is lost during the healing process. Some blood may come

to the surface under your skin and cause these colors. And after a few

weeks your incision may be itchy. Nerve endings heal and can be irritated

by metabolic waste products which causes itchiness.

Be sure that you have help lifting anything over 10 pounds. You need to

give yourself at least six weeks before you lift or shove anything heavy.

Take those big checkbooks out of your purse if you are one to carry tons of

things! Every little bit of lightening your load helps.

Well, I hope this long novel has helped you better prepare for your surgery.

Every surgery and hospital is a little different with how they do things,

but these are the most straight-forward steps to having an ab. myomectomy.

Good luck with your procedure, and if you have any more questions (general

or specific) please ask. Let us know how you feel afterward when you are

ready to sit and type again.

Best wishes and POSITIVE ENERGY your way!

Hugs,

Sonja