About Me: Female, 54, Nashville, TN, member since Feb 2009
I live near Nashville, Tennessee. I joined this forum while recovering from a laparotomy on 1/16/09 to remove both ovaries/tubes and a benign grapefruit sized fluid-filled cyst that was still growing (10 cm+). In medical technical terms, I had a BSO, or bilateral salp
[More]ingo-oophorectomy along with the cyst removal via laparotomy. My pre-surgery CA-125 result was 34 (normal range is zero to 35) but surgeon still was worried that I was in the "high side of normal" and gave me 85% to 90% favorable odds of not having cancer. Well since something like 95% of cysts are benign, I was not too happy that I had 10% to 15% chances of being in serious trouble.
All this took place a month before my 49th birthday. Losing ovaries made no noticeable difference. I had already completed menopause at age 46. This is the longest I had been put out of commission due to medical issues: 6 weeks out of work, but even longer to feel truly healed. I've never had surgery of this magnitude in my life and the pre-op stress nearly killed me. I am a huge chicken when it comes to doctors and hospitals.
I still cannot believe I've been through a procedure like this and I hope to help others dealing with the fear and stress now. I feel it is something I owe to others for the wonderfully successful outcome of my own surgery, the massive prayer support I received, and the outpouring of concern I received from friends worried about me. As much as I tried to avoid needing surgery, I have to admit I feel so much better for having it done. It has made a huge improvement in my life.
If only this did not directly (or indirectly) lead to the end of my employment. I will wonder for the rest of my life if my illness contributed to this since I was a stellar employee up until my medical leave. I am still seeking the right job for me, preferably as an Administrative Assistant.
Here is my Laparotomy story for anyone that wants to know what to expect if your doctor has recommended similar surgery.
I had no idea I had a cyst. It was found during a gynecological exam. Doctor pressed on pelvic area and thought the uterus was enlarged. Sent me for both types of ultrasound where the cyst was discovered. Nothing was wrong with the uterus. Took the CA-125 blood test then was referred to the best gynecologist/oncologist in town: the doctor's own mother was a patient of his. Cyst was discovered in mid-December, gyn/onc appointment was Jan. 13, 2009, and surgery was 3 days later. I spent many hours with the gyn/onc on the 13th discussing all the surgical options. This is when all questions should be asked, so come prepared to that pre-surgery appointment with all your concerns!
I had open surgery with a 4.5" vertical incision from below the belly button downwards.
Remember, this description is for a laparotomy. Laparoscopy hospital procedures may be a bit different. Recovery times for laparoscopy will be shorter, but do not be fooled by what doctors tell you....it will take much longer to heal than advertised!
First of all, remember that this is routine for the doctors/hospital. It is a major life event for you, though, and it is easy to be scared. I was downright terrified and it turned out better than expected. My own gyn/onc performs several surgeries like this a day, 3 days a week. Seek out the most highly recommended and experienced doctors. A botched surgery will cause more problems than no surgery at all.
Three days prior to surgery day, I had my pre-op tests at the hospital, which include chest x-ray, blood work, and EKG of the heart.
The day immediately before, it was the awful laxative process--a total clean out--and I started that day on a clear liquid diet only. My laxative was GoLYTELY®, the unflavored version. Not everyone goes through this process, but a surgeon that wants the patient completely cleaned out will request it. I suspect this is if the surgeon anticipates making repairs to bowels. Absolutely DO NOT eat or drink anything after whatever hour they tell you prior to surgery. Not following this order can be fatal because of the digestive paralysis caused by anesthesia. I may never be able to use that laxative again. Just thinking about it makes me gag now. If you can get a flavored version, ask for it. The unflavored version is horrendous.
I had to wash with a disinfecting soap the night before and the morning of the surgery at home. Especially on the stomach area where the incision would be.
Upon arrival to the hospital, they had me remove all clothing (they tell you don't arrive wearing jewelry, makeup, lotions, powders, deodorants, etc.) and that includes eyeglasses. Someone has to hold them for you. I was put into a paper hospital gown and non-skid socks, then put in a bed with a sheet to cover me in the first staging area, and later the second staging area. The gown was attached to a hose like an old fashioned hair dryer and warm air came into the gown to keep me warm. It was 3 degrees outside on my surgery day.
I was given a pregnancy (urine) test! Duh, I completed menopause, folks! In my situation it was a waste of time, and I told them, so, too, but for them it was required procedure. I was also given a blood thinner injection to the right thigh. At this point I was taken to the second staging area, which is off limits to all vistors...just you and the doctors.
Here they put in an IV line into the back of my right hand--I am left-handed so I asked for this. I met with the surgeon and anesthesia staff and talked about a variety of issues. Note: be sure to confirm what type of surgery you are there for if they do not ask. This is the last chance to make sure they have not confused you with someone else.
I have heard some women complain about post-op nausea. My anesthesiologist put round adhesive disks behind both my ears telling me it will prevent nausea. Must have worked because I was never once nauseous. I left them there for nearly a week after surgery, not wanting to lose the benefit they were obviously providing me.
I had no idea they were starting to put me to sleep. They added something to the IV line and I was gone without even beinig aware of it. One moment later (to me, at least), I was waking up in recovery. No memory of what occurred or awareness of how much time has passed. The first thing I remember was my name being called, that the surgery was over (It was? I didn't know they even started!), and being told they did not find any cancer. Best. News. Ever.
When I woke up, I was connected to a urinary catheter. Not very comfy but no problem as long as I stayed still. Easy enough, I was two whipped to move anyway. I learned later it was a wonderful thing to have since no way was I ready to get up to pee for myself. Still on IV. There was an oxygen line at my nose (no, not inside). Once they felt I was awake enough, they wheeled me in the recovery room bed to a regular private room. Around this time I noticed that my clothes had changed. I was in a cloth, backless hospital gown now. I looked at the clock and around 3 hours had elapsed since the time I was unaware they were putting me to sleep and the time I woke up.
They added a morphine pump (self-dosing) to my IV once in my room. I was told to follow the digital display on the machine and it will tell me when another dosage is available. It means pushing a dosage button, which is on a wire like a wired remote control, and it just stays as close to you as possible always within reach. It is impossible to overdose, since the button will not work if it is pressed before another dosage is available. I think I ended up receiving two full syringes worth. One emptied, they replaced it with a second one. After that, they stopped morphine and switched me to painkiller pills, I think it was a codeine/tylenol pill. Note: Stay ahead of the pain, at least in those first few days by staying on schedule with the meds. Even on meds you will be aware of the pain but not so much that you cannot sleep or cannot tolerate it.
I was awake all night that first night in the hospital. Something about the anesthesia. Nothing tasted right for days, and I was still on a boring liquid diet for Day 1/Night 1. Oxygen was taken away that first night.
They put self inflating stockings on my legs (feels like a blood pressure device that inflates and deflates) and I had to deal with this disturbing sensation ALL NIGHT LONG. Another reason for no sleep! It was to prevent blood clots while still bedridden.
I was expected to breathe several breaths into a device that helps clear my lungs from the anesthesia and prevent pneumonia. Had to do this regularly, like every hour. They would check blood pressure and body temperature several times a day, even in the middle of the night. I learned that If you do not keep regular with the breathing exercises the body temperature may start to rise which is not good...it could even keep a person in the hospital longer than desired.
The next day (Day 2) they upgraded me to clear foods plus liquids like Jell-o, sherbert, and a variety of clear drinks. Urine catheter got removed (barely felt anything, so no worries). Now I had to walk to pee! Sometime during this day they took a blood test.
That first move out of bed was NOT fun. They taught me how to roll out of bed, holding a pillow to my stomach. Getting back in bed was not fun either, but I figured out the least painful maneuver very quickly.
What should you bring with you to the hospital??
Pack a small suitcase with:
1. A comfortable robe that covers you well. They'll insist on getting you to walk the day after surgery and you'll still be in that awful hospital gown.
2. Bring your own slippers (non-skid soles only...those floors are too smooth for anything else).
3. If you want out of that backless hospital gown, bring your own comfy nightgown (not too long since bathroom trips are going to be challenging). You don't want anything with elastic around the waist just yet so PJ bottoms really don't work at this point. You won't be able to wear this until the IV is removed, though, at least not without nurse assistance.
4. The hospital may provide some type of stretchy panties, but bring your own supply as well. Panties....oversized is better, with a high waist (far from the incision line).
5. Not sure if you'll need it or not, but sanitary napkins (NO WINGS) are good to have, just in case. If not, hospital will supply if needed.
6. Bring an electric razor if you want to shave (anything but the private areas) while in the hospital. They won't want you using razor blades because of the risk for cuts/infections. They may try to talk you into an assisted shower Day 2, but I opted to sponge bath myself whenever I worked up the ability to walk for a pee. The idea of trying to move for a shower was too much.
7. They may keep you in stockings the whole visit, but if not, warm socks should be in the suitcase.
8. Bring makeup, deodorant, soap, toothbrush, toothpaste. They'll supply soap, toothbrush/paste, shampoo (small stuff like in a hotel), but you'll probably want your own stuff.
9. Bring something to read. The TV channels in your room probably won't be very exciting. Although it may be hard to concentrate while still on pain meds.
10. Bring something comfortable to wear for the ride home that does not put pressure on you from the waist down and from the hips up. Loose elastic or draw string pants are good, or a dress.
During Day 3, the were strongly focused on my ability to pass gas and have a bowel movement. It could have occurred as soon as Day 2, in fact. I learned I would not be discharged until these grand events occurred. Morphine pump #2 went empty and now I was only on pain pills. Surgical dressings were removed on Day 2 and incision was exposed and uncovered.
My incision was closed in a unique way. Not sure others will have this, but wanted to share: No staples! Stitches were all internal and the exterior was glued together with skin bonding glue. It all dissolved or peeled off on its own with no assistance from me. No followup visit to the doctor to remove stitches or staples. I only had a followup for him to check on how I healed. No seepage/drainage or ickiness as far as the incision/scar is concerned. When they took off the surgical dressing (just rectangular gauze with tape around the borders), The incision was all dry and clean and remained that way. What a great way of doing things. I was very impressed.
I was told that as soon as I passed gas, I would be upgraded to solid food. Passing gas and bathroom movements had to be done cautiously. The muscles used to go to the bathroom were all inflamed and sore and affected the incision/stiches if I strained. My appetite for solid food was terrible and it took time time to even like my favorite foods again. I lost several pounds shortly after getting out of the hospital, in fact.
Gas pains post-op can be worse than the incision/surgery pains. They gave me chewable medicine for the gas. Did not really help much, though. Walking, walking, walking is what moves the gas out. But I had no energy for it. I walked slow or slightly bent over like a 90 year old for several weeks.
The IV port remained in my right hand the entire hospital stay, even when I was no longer getting IV. It was removed just minutes prior to discharge.
I went home the morning of Day 4. Could probably have gone during Night 3, but it was a Sunday. Sometime prior to discharge they gave me the great news that the full pathology report was complete and it also confirmed NO CANCER!
For the drive home.....make sure there's a small pillow in the car. You'll want it for your cautious roll into the seat and to hold to you for the drive home. You can use the seatbelt, but put it over the pillow. Any bumps in the road will HURT, so keep that pillow close to you.
At home, the worst part is learning how to get in and out of bed. I was more comfy on a couch with a lot of pillows around me during the day, but still moved to the bed at night. Someone will have to do most of everything else for you, especially where it requires lifting 5+ pounds. You'll be discharged with prescriptions for pain killers. Use them, but if you can, ween off them quickly. It will prevent constipation, because you do not want to strain. Anti-gas medicine can also cause constipation, so don't overdo it there either.
Follow the post-op instructions they give you about what you can do/not do in the next week, two weeks, etc. Don't be in a hurry to do any restricted activity too soon. It could affect your healing process adversely.
You'll be sore, but so relieved to have the surgery behind you, you'll hardly notice.
Once home, the best thing you could have done is prepared for this recovery period. May want to avoid stairs completely and set up a place for yourself on a single floor if you have a 2-story home. Again, you will not be able to lift anything 5 pounds or greater (that is a LOT of stuff on the do-not-lift list), so reduce sizes of whatever you use regularly that is heavy (laundry bottles, beverage containers, etc.) You will not be able to bend, stretch, stoop, push, pull, or do housework like vaccuuming. Keep things you need in easy reach and not in upper shelves/lower shelves where you can't get to them. You'll also want PILLOWS nearby at all times to protect your stomach. Hold them to your stomach whenever you feel an urge to cough, sneeze or laugh. They will all hurt tremendously without it.
Don't expect to be able to sleep in any position other than on your back for the first month. Sleeping on the side is likely going to hurt too much.
If you had that "I look pregnant" bloat to your body prior to surgery, expect it to be considerably worse after surgery. This is temporary. Disturbing, yes, but temporary. The reality is that many of us lose weight and bloat, but it will take a few weeks of recovery time first.
Lessons learned #1: I didn't know how sick I was until this thing was removed and I got a chance to see what normal" was again. I was so de-energized, gaining weight and bloat, constipation, losing hair, in pain after eating, unable to sleep properly due to pain.....and I just thought it was age related. Well, being 49 feels a whole lot better now that I don't have a cyst!
Lessons learned #2: Even if the "factory is closed" that's no excuse to stop visiting the gynecologist for yearly checkups. I could have caught this thing much earlier and it's a very good thing that after a prolonged wait (3 years) I still had a benign cyst.
Lessons learned #3: This is a very common problem and when we face it, we are very much the same with our fears and anxieties. Fear of cancer. Fear of surgery. Fear of not waking up from anesthesia. We are all different and yet we are all the same. Don't be afraid to ask your doctors questions, questions, questions. You are trusting your life and health to them and the least they can do is answer you. I can tell by the questions asked here that patients are not getting enough useful information from their doctors.
So what did the surgeon do exactly, besides the BSO? While I was still sound asleep in the recovery room, he told my husband "I don't know how she went to the bathroom" because of all the pressure the cyst was placing on the bowels. He also did an exploratory of bowels, liver, kidneys (they do a "wash" and it indicates if any cancer is present). All clear. The reason for the gas pains post-op is because they use carbon dioxide gas in the abdominal cavity so they can get a better view of what's going on inside there. They press it out before closing you, but they don't get all of it. The rest has to either be broken down/absorbed, or work its way out of your system (passing gas). It can get the abdominal area very distended and painful (I thought my organs would explode a few times from the pressure!) I never thought gas could hurt so much, and it took nearly 8 or 9 weeks for me to be completely free of it all.
Doctors can make some diagnostic mistakes prior to surgery. They know you have a cyst but may not know all details about it accurately. They thought my cyst was on my right ovary. They discovered in surgery that it was on my left. What happened is it got heavy enough to fall down behind my uterus and was somewhat centered back there.
Mostly, be sure to get as much information about YOUR condition from your doctor as possible. We try to help you understand "what's wrong with me", but none of us are doctors, have your test results or the medical education to understand them. We give it our best interpretation based on our own experiences. I learned a lot about ovarian cysts in the past few months. More than I cared to ever know.
I am post menopausal and bleeding off and on. I broke my wrist last march and had surgery. I cannot bear the thought of having an ovarian cyst and going through surgery again! The fear of surgery, the recovery, the MEDICALS BILLS afterwards!
I was just reading all about your story and your surgery, you really are full of helpfull information. I have a few questions if you wouldnt mind answering them. For the past few months I have had a strange feeling in my lower abdomen. It actually feels hard, I feel the need to pee alot but never actually pee a large amount. Its a constant pressure and i am so bloated, i can barely fit into anything. Also in the morning I can see this mass pushing out of my abdomen. I just got blood work done today and I am going to an ultra sound at 530.. I was wondering if you ever felt like this. ( I have history of ovarian cysts as well)
Thanks for the information, MarieMichele. My surgery was pushed to 12/09/10, so wish me luck! By the way, I see that your cyst was about the same size as mine are. Did you ask for your ovaries to be removed?
Thanks for the detailed info on the hospital experience and going home. I now know what to pack and have ready at all times: a pillow! I will have a 30 cm cyst removed so expect that with time I will feel like a different person. Thanks again.
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