The NHS is wonderful – but it’s not very good at explaining (and I’m not good at listening when I’m in a bit of a panic). So here’s all the things I’d wished I’d known before I’d got going on surgery for endometriosis.
- You get paper knickers to wear under the surgical gown. And, afterwards, you get some extraordinarily comfy massive mesh knickers to wear, and a massive sanitary towel. They may or may not remember to stick the sanitary towel into the massive mesh knickers. They won’t warn you that it’s probably not stuck in. This will cause Problems when you go to try to do a wee so that they’ll let you go home. It will fall out and land in the pan, and then you’ll have to ask for another….if you’re still dehydrated at that point, and trying not to faint, it gets really complicated.
- On the subject of the Sanitary Towel – really should have bought some of my own, instead of having to send N out shopping.
- It is perfectly possible to be freezing cold in a hospital. Ask for a blanket. They have spares, and they’d rather you weren’t going blue for any reason. Ask for help putting it round your shoulders. That was a waste of a cup of tea…
- You’ll go up a whole dress size, easily, with swelling. This does not make jeans a sensible post-operative option. Trackie pants. Or wandering round with your flies undone…(I only had the previous days’ morris jeans with me). The swelling started going down on day one (the sticky bits of the dressings wrinkled), but I’m only now starting to feel like I’m “merely” pre-menstrual-bloat level on day 4. Hardly surprising – I felt like I’d been steamrollered. And, internally, I had!
- You’ll sound like Ena Sharples for the first couple of hours after you come round. Your tongue will be white. Intubation is bloody brilliant for keeping you alive – but drying. At some point in the next 24 hours, you’ll start coughing up some gunk. Persist with this (stitches notwithstanding). You need to Get It Out or you will have a chest infection. Gunk in and of itself isn’t a chest infection (do not panic). But you don’t want it building up.
- If you’re asthmatic, give up on the idea of doing your peak flow for a day or so. I hit 360 on my first attempt, and the FEV reading wouldn’t work at all. It really hurt to do that, and I thought I’d ruptured something. Not worth it. Usually, my peak flow is 530. Getting the inhaler in will also be troublesome for a bit. But nothing like as bad as the peak flow.
- You will get a catheter during the operation. If you’re lucky, someone will mention it beforehand (in my case, it was the anaesthetist, in passing). There are Implications. After surgery, everyone is obsessed with you going to the loo, and having a wee. OBSESSED. They fail to point out (and you’re kinda groggy), that your bladder, in addition to having been denied any liquid for some hours and having been emptied three times owing to nervousness before going in, has been completely emptied with the catheter. Which has then been removed. Result? One traumatised and bruised urethra, one bladder that feels like it’s full but isn’t, and one dehydrated body that will take as long to rehydrate as it generally does after a long sweaty run. If I’d realised that, I’d have taken on rather more liquid than two cups of water and a cup of tea before trying to wee. Then I probably wouldn’t have nearly fainted, and needed to be wheeled back to the recovery ward, and would have gone home sooner. My blood pressure dropped to 96/54 as part of that little episode and that was after I wasn’t feeling quite so faint.
- Drink. Lots. From the moment you come out and you’re compos mentis. Tea. Squash. Water. If the water’s not the sort of temperature that you like (it was lukewarm. I find that horrible. My Mother in Law hates chilled water and would have loved it), then ask for something colder. You need to get at least a litre in before you try to pee. Really.
- Also, it will be like peeing knife blades. For me, this continued at the beginning of every single attempt to pee for the rest of the day until, oddly, I removed my surgical stockings, at which point it all magically calmed down. I drank lots and lots of water and squash. That it was mostly just at the beginning of each pee suggested trauma rather than UTI.
- Check where the loos are on the way home. There was a ghastly section of the M25 and the M3 which had no services. I almost exploded. I’d taken the hydration too far. And I had this utterly traumatised bladder…every bump was agony. Thank heavens for Cute Overload.
- If you’re worried that you’re prone to UTIs (and I had a totally ghastly one in 2011, which needed 3 different antibiotics, so I am paranoid), have some Urine Testing Strips on hand. You’re looking for the presence of nitrites and leucocytes. The nitrites are what the leucocytes poo out. The leucocytes are the bacteria: so if you just have leucocytes, this does not mean you have a UTI. Your doctor will look for both. Do not worry about the presence of blood: it’s impossible not to have blood in your pee when you’re on your period/post operative bleeding. This gives you a nice indication as to whether you need to bother the out of hours doctor or not. If you want to get really professional about it, pee into the loo, then into whatever you’re collecting it in, then finish off the pee in the loo. This is a mid-stream sample, and means you don’t get extra leucocyte readings from the bacteria that live outside the urethra. It’s more accurate. If in doubt – go to the GP, or the out of hours. They will do the same test, and if you ask nicely, will explain it all to you.
- Obviously, you all know how to empty your bladder properly? Do it. Because it will help prevent a UTI. Rock back and forth when you think you’re done, stand up and sit down – and there will generally be a little more. Repeat until there’s not a little more. Congratulations! Your bladder is now definitely empty!
- Your digestion will grind to a halt for about 24 hours (not a lot of food on operation day for starters), and then get all post-antibiotic on you (eek!). Have live yoghurt and acidophilus tablets to hand (I’ve got strawberry flavoured ones from Holland and Barrett). Have Canestan in stock if you’re often affected by antibiotic-induced thrush.
- Dressings can come off after 24-48 hours. The leaflet may say to bath and shower normally. My tame ob-gynae, Jo, suggests NOT having a bath for a week, as she reckon’s the bath is very much the easy way to introduce bacteria into your wounds. She is keen on leaving them uncovered. You can trim the stitches if they catch on things. Dissolving stitches apparently take up to 3 months to dissolve. And they itch. Your GP can advise about removing them, and send you to the practice nurse if need be.
- Have sanitary towels in stock at home. If you don’t usually use them, Think about the order to remove the paper that protects the sticky bit. Big piece first, then the wings. Not the other way round. Muppet.
- Bleeding may be erratic. And has been much heavier than most of the periods of the last five years. My poor uterus. Sanitary towels need changing about every 3 hours (I use a mooncup normally, with reusuable panty liners, so the STs have been a shock to the system, and I need to remind myself of what any fule kno). Stock up on baggies, and if it’s hot, empty the bin daily.
- No-one will be able to agree when you can start exercising. I’ve been told a week (er no, not up to that), a month, 2 weeks, and “after the bleeding has stopped”. I’m getting ansty – so I’m aiming for “when I’ve not wanted to take any painkillers for a couple of days” with “and the bleeding’s mostly stopped”.
- (Mum’s idea this). Get some supportive knickers/tights – the type that hold everything in – but in a size or so up. Based on her experience of a caesarian, and the wonderful belt thing she bought from Mothercare – (some sort of girdle, I gather), this helps hold everything in place, and means you don’t panic about pulling anything. You also don’t put yourself in the position where you’ll pull your stitches out. TK Maxx generally have cheap shapewear.
- Your bellybutton may migrate sideways. I’ve had more work done on my right side than my left. It’s a bit more swollen on that side. My bellybutton looks really weird (quite apart from the stiches). It’s also without its ring for the first time since 1998. I’ve not yet been brave enough to find out if the ring will go back in. I’ll give it a week or so.
- Bruises will randomly pop up. In all sorts of shades. This vindicates both the swelling and the feeling internally steam-rollered.
- Walk lots. Keep moving. It will help the CO2 dissipate. It will help the swelling go down.
- Energy levels will be all over the shop. Try not to overdo it. Rest as needed. Equally, don’t underdo it. Eat lots of protein and green stuff to keep energy levels up. Don’t ignore the carbs. Avoid the alcohol. It’s like training for a race.
- Emotions will be all over the shop. Poor N. Yesterday was very tough for five minutes in the morning, and the fallout took most of the day to wear off. Many cuddles were required.
- You won’t roll about the bed at night. Sleeping on your back all night gives you backache. Memory foam toppers are the biz. And your partner will be thrilled that you’re not throwing yourself round the bed like you’re trying to run a marathon during the night.
- Your partner may be a gifted nurse. But they probably aren’t. So try to articulate rather than hoping they’ll guess from your grey pallor and general floopy demeanour.
Here’s hoping that this will have the desired result. Any which way, it feels like a Good Thing to have sorted out.