Yesterday I talked about the different surgeries someone with endometriosis may face, and what those surgeries do. Today I want to be a bit less technical and instead discuss what to expect as a patient and what you can do to make surgery and recovery as easy as possible.
Regardless of whether you are a public or private patient, you will have an absolute stack of paperwork. It is mostly to tell the hospital about your medical history, allergies, medications, dietary requirements etc, to ensure that they don’t accidentally kill you by giving you something your body can’t tolerate. It is really important to fill it out and return it in the time given, because you do not want to have your surgery delayed (possibly for many months in the public system) because you forgot to fill in some forms.
You will sometimes have a pre-surgical consult with a nurse or similar to ensure that you are healthy enough to have the surgery (sounds daft, doesn’t it, given that you need the surgery because you aren’t healthy!). I only had this in the public system – when I had my private surgery we just did it on the day. When I did it, it involved a weigh-in, height check, and a quick questionnaire. It pretty much all got repeated on the day anyway.
If you are working, don’t forget to arrange your leave. I would recommend at least a week, but if you have the leave available (which you probably don’t) and work can spare you, take two.
I recommend calling the hospital a day ahead of the surgery just to check everything is ok, and to make sure that there is no contradiction between any of the instructions in the informational booklet and what the hospital actually wants. Check where you will need to go and what you need to do when you get there. Confirm the surgery time. Ask about parking. If you are a private patient, double-check what you will need to pay on the day and what you will be invoiced for later, so you can make sure you have the money ready. Find out whether you should take your supplements and medications or not – some are not recommended prior to surgery.
The least fun part of the lead-up to surgery (even worse than the paperwork!) is the laxatives. You will have to drink a fun variety of liquids to empty out your bowels prior to the surgery. They all, without exception, taste vile. They also make you have diarrhoea varying from mild to lava-like, depending on the combination you get. Also, you aren’t allowed to eat for the last 12-24 hours prior to the surgery, and you may be on clear liquids or white foods only for a short period before that. It is important to comply with these directions, however awful, because you don’t want to put yourself through most of it only to have your surgery rescheduled because you cheated with a chocolate bar.
How to Prepare
- Wear loose, comfy clothes without any complicated buttons or zippers – you won’t have the energy to deal with that. If you are comfy in dresses, a loose maxi dress is the perfect option as there is no compression at all on your pelvis.
- Bring your phone and a charger. You want to be able to reach friends and family in the event of a complication, or even just to let them know you are ok. These are the only valuables I recommend bringing. Leave anything else precious at home.
- Bring something to read (not an expensive e-reader or Kindle). Hospitals involve an absurd amount of waiting and you want some entertainment other than whatever nonsense Sunrise is covering that morning (which the hospital TVs don’t play loud enough to hear anyway).
- Write down a list of all your medications and the dosage rates so you have it ready to refer to if someone asks.
- Bring a small, thin pillow or blanket. This sounds daft, but hear me out. On the way back home, you can slip it between your tender belly and the seat-belt, and it is a lifesaver at preventing painful rubbing or pressure. Whilst in the hospital, it’s something extra to cover you or rest your head against.
- Bring a friend or family member. Having someone to support you, to wait with you as you wake up, to help you get to the loo, to look after your stuff, and to communicate with doctors or nurses is incredibly useful. I cannot overstate this one. If you have someone, bring them.
- If you have long hair, tie it back into a comfy style that you can sleep in that will stop it knotting. I like braided pigtails, because they are easy to tuck up into the surgical cap and don’t dig into your head. A messy bun is another option, but make sure it is secure. You will probably be too sore after surgery to brush your hair that day, so brushing it before-hand and keeping it in a protective style will go a long way to helping you out after surgery.
- Don’t forget the maxi-pads and several pairs of knickers. You will probably bleed a fair bit after the surgery. That’s normal. Don’t panic. Do have pads and undies and plenty of them.
- Pack a small night bag with a toothbrush, toothpaste, deodorant, bedsocks and pjs, just in case they do need to keep you overnight. Baby wipes are also a smart move, because you have to be careful about getting your dressings wet post-surgery, and showering/bathing will be too much effort the first day anyway.
- If you have fun dietary requirements, like me, bring safe snacks. Hospitals, particularly public hospitals, sometimes do a terrible job of accommodating unusual diets (some a great, but that won’t help if you land in a bad one). Vegetarians or my gluten-free friends may be ok, but vegan, low-FODMAP, Jain, halal and kosher buddies, be prepared just in case. I remember one memorable occasion when all the hospital could offer my starving vegan self was an egg and veal sandwich. I challenge anyone to find a less vegan combination.
On the Day
Make sure you get to hospital nice and early on the actual day. Better to be bored and waiting than late and in a panic. You’ll generally meet with a nurse, who will do the final checks on your physical health and make sure you aren’t pregnant, and the anaesthetist, to make sure everything is ok for when they put you under. They’ll usually give you your little id bracelet at this point.
After your meetings (although possibly before) you get to change into the ultra-sexy hospital gown, cap, compression socks and paper slippers. Some generous places may let you keep your undies on for a little while, or more likely give you a weird papery nappy. Others will just get you to take them off. Bra too, if you wear one. This can be a pretty chilly outfit in an air-conditioned hospital, so do speak to a nurse about a blanket if you get cold. You may even get one fresh from the heating cupboard. Your own clothes and belongings will go in a locker.
When it is your turn for surgery, they’ll stick you in a bed and wheel you into an ante-chamber, where the surgical team will pop in and say hi, and the nurses and anaesthetist will get you kitted out properly with a cannula and whatever else you may need. They’ll stick little electrodes on your chest and give you a little finger-clamp too, for monitoring heart-rate. You should also get a blood-pressure cuff. Do try and go to the loo before this point, because once you’re all strapped in you really aren’t able to go anywhere.
Once you are decked out in this exciting hospital paraphernalia, they’ll wheel you into the actual surgery. They might shift you around a little, then the anaesthetist will pump the drugs into you and you’ll fall asleep incredibly quickly.
When you wake up, you’ll usually be in a ward with other groggy people in the same sort of position. Don’t expect to wake up quickly – the anaesthesia takes time to dissipate and you will feel exhausted for a while. Take your time. You may feel a bit loopy as well, and either too cold or too hot. If you don’t cope well with opiates, you may have to throw up to shake off the exhaustion and nausea you may feel. That used to happen to me with older-style anaesthetics, but thankfully whatever they use now is much better.
Once you are awake, they may wheel you into yet another room to recover more fully, or they may leave you where you are, depending on the hospital. Once you are relatively functional the surgeon will usually come and tell you what they found, what they did with it, and what they want to do next.
Nurses will usually be pressing food and a sugary drink on you by this stage. You will probably want it, because you won’t have eaten in a while, but don’t eat too fast as you might make yourself sick. Just eat normally.
If you are going to be staying overnight, they will take you off to the ward at this point. If you are being released that day, you can get dressed and toddle out, but be aware – they will not let you go unless you are with someone or going to be with someone. They certainly aren’t going to let you drive.
Recovery can vary rapidly depending on your body and the hospital. Definitely expect to have a very bloated abdomen – they pump you full of gas during surgery to separate your organs so that they have room to work. That takes a while to go down. You may find that the gas moves around your body and causes some pain, particularly in the shoulders. There’s not a lot you can do about that beyond trying to find a comfortable position and breathing through it. For my first surgery, this took nearly 10 days to go away and I couldn’t stand up straight without agony that entire time. After my second surgery, it was gone in 36 hours.
Generally you will have between 2-6 little incisions. I have had four for both of mine – one in my belly button, one down near the pubic region, and two off to the side down near my hips. These will be sore and tender, and will get really itchy as they heal. Pay attention to the aftercare instructions about when to take the dressings off. Thankfully, because they aren’t big incisions and no muscle gets cut, things like laughing, coughing and sneezing aren’t as difficult as they are with bigger surgeries. They will eventually fade to neat little scars, barring any complications.
As I said in my last post, pay attention to your body during the recovery phase. If things don’t feel right, or if you aren’t able to walk and sit relatively normally within that week, get thee to a doctor, because it could mean you have an infection. Trust yourself and your knowledge of your own body, and always seek medical advice if you aren’t sure.
What have your surgical experiences been? Do you have any other tips to offer?