BEING OVERWEIGHT AFFECT HYSTER RECOVERY TAH/BSO

[thecips]

I NEED TAH/BSO ON DEC 13TH.I HAVE HAD CYST ON OVARY FOR 6 MONTHS NOT GOING AWAY BUT SEPTATION IS GETTING THICKER BUT CYST STILL SAME SIZE ABOUT 3 INCHES.I WOULD LIKE TO KNOW ABOUT POST OP PROBLEMS AND IF THERE IS ENDO WHAT DOES THAT MEAN. I AM POST MENOPAUSE HAD BLEEDING AND A D&C FOR POLPYS IN AUGUST.HAVING THIS DONE SO CLOSE TO CHRISTMAS BOTHERS ME AND I AM MOVING INTO A NEW HOME ON 11/28.I AM NOT IN THE BEST CONDITION I AM OVRWEIGHT AND ALREADY HAVE DEPRESSION,PANIC ATTACKS AND ANEXITY DISORDER.THE THOUGHT OF HOT FLASHES AGAIN I CAN'T TAKE.THEY WERE HORRIBLE FOR THE PAST 4 YEARS. AND WHAT IS WITH ALL THIS BOWEL PREP. 64 OZ OF GATORADE AND ALL THIS OTHERS STUFF IS OVERKILL I THINK.MY GYN/ONC THINK I MIGHT HAVE ENDO.
ANY INFO YOU CAN GIVE BE WOULD BE GEATLY APPERCIATED.NEEDLESS TO SAY I AM SCARED ABOUT THE SUGERY AND BEING UBDER FOR 3 HOURS.
THANKS
LINDA

[Machelle Seibel, MD]

A. There are several things to comment on.  The first is why the bowel prep.  Surgeons often ask for the bowel prep before a hysterectomy to protect you if there is a complication of accidentally cutting the intestines.  If the bowel is “cleaned out” ahead of time, there will be less risk of infection if the surgeon accidentally cuts the intestine and has to repair it.
B. Being overweight is a slight increased risk for surgery.  There is a higher risk of infection in the incision, a higher risk of blood clots, and a higher risk of pneumonia after the operation.  There is also a higher risk that the incision could have a hernia, depending on how heavy a person is.  This doesn’t mean that these problems are likely to occur.  It means that these problems are slightly more common for people who are overweight than for people who are average weight.
C. One thing you can discuss with your doctor is whether you are a candidate to have your surgery by laparoscopy.  That is a belly button incision with typically three small 1 inch incisions in the lower abdomen.  It is possible to do a hysterectomy and remove the ovaries that way, even in an overweight person and the recovery is faster.  If your oncologist thinks this is cancer, he/she may be unwilling to try a laparoscopy.  But they might look first by laparoscopy and if it looks benign, they can consider continuing the laparoscopy.  They could agree with you that if it isn’t easy to do that way, you would allow them to change the operation to a laparotomy which is the larger incision. It is worth a discussion.
D. If the above isn’t an option, you can either get a second opinion or you can wait until the new year and have more time to move into your new home and to enjoy the holidays without being a short time post op. For many conditions, waiting another month will not affect the outcome.  While you are waiting, begin taking a multivitamin and iron tablets from the drugstore to build up your blood count because having a TAH/BSO will cause you to lose some blood and it is best if you can build up your blood count ahead of time.  Good luck on your procedure.
Machelle M. Seibel, MD