Prep for Laparotomy

[kittycoo8]

I recently posted this on the Women's Health Community board before I discovered the Ovarian Cyst Comm. Clare83 was kind enough to already respond. I would be most grateful for additional advice.

"I would like advice on preparing for recovery time after my laparotomy. I am scheduled in two weeks to have a 7 cm dermoid cyst removed along with my right ovary. I have scheduled two weeks off from work, but really need to return within two weeks. I have a 10 year old daughter who will be on spring break and my mother will be with us during this time. My mom is not able to do much physically, but will be here for emotional support for my daughter and myself. I want to be sure I prepare everything in advance so that it will be easy for them to help me. Any advice for preparations or shopping lists?  :)  Thank you!"

[MarieMichele]

Two weeks to recover from a laparotomy is definitely not enough.  I recovered at home for 6 weeks and it was barely enough.  My first week back to work (after 6) was painful for me and gradually got better in the following weeks.  I'm at week 10 now.

Stock up the house with as many groceries as you can fit in the refrigerator and pantry/cabinets that will not spoil and stock up on perishables to a lesser extent.

Forget carbonated beverages or any food that routinely gives you gas.   You are going to have a LOT of gas trapped inside you from the surgery and the gas pains can be worse than the incision soreness.  Stock up on anti-gas medicine like Gas-X.

Medicate before the pain returns, especially during the first week, but don't overdo either.  The meds will cause constipation (so can the Gas-X), and you don't want to have a hard time in the bathroom since movements have to be done gently.  All the affected sore areas are involved when you make a bathroom trip.  If I felt I might have a hard time, I added a little bit of fiber to my diet.  Docs also recommend a laxative like Mike of Magnesia (but I didn't ever need to resort to this).

Get any other routine errands done that require you to drive somewhere.  You really won't want to commute at all during those first two weeks.

VACCUUM all your floors now while you still can.  10 weeks from surgery, and I still cannot vaccuum (regrets that I didn't think ahead!)

Start converting to smaller/lighter containers on everything that is heavy (laundry detergent, beverages, shampoos, etc) unless you have someone that is going to do ALL the lifting for you.  If you can get the routine stuff into containers that weigh under 5 pounds, you won't be so dependent on others to do everything.  

If you are used to squatting low or reaching high for routine objects, move them to a more reasonable access height now.  You won't be able to squat or stretch and some things may be off limits if you don't move them now.  

Get some kind of wheeled cart so you can push things around rather than carry them and lift them.

Get a fresh roll of Saran Wrap or other plastic food wrap.  While my doctor didn't include this in his suggestions, a coworker who had a lot of past surgeries did.  For the first few showers (can't take baths yet) you may want to wrap your middle with plastic wrap to minimize the water/soaking your incision receives while still healing.  It will still get some water contact regardless, but like I said, this minimizes it.

You are going to need to stock up on small pillows if you don't have them now.  My recommendation is the small rectangular travel size (looks like a bed pillow, but about one-half the bulk).  You'll need one in the car (wear between belly and the seatbelt), one for your favorite sitting area (or even a bed pillow for this) and one for the bed.  You'll be needing to hold a pillow to your abs when you move for a few weeks to minimize the stress/pain you feel when changing positions.

If you like to wear pants, forget jeans for quite awhile.  You'll need either drawstring pants or loose/soft elastic that lands ABOVE the belly button so that you don't get pressure on the healing lower ab area.

Stock up on whatever amuses you when you are bored.  Whether it's books, DVDs, games, puzzles......you will have a lot of time on your hands sitting or lying around.

Best wishes to you.  I sincerely hope you can work out a better arrangement with your employer for a LONGER recovery time a home.  You may even get doctor's orders in this regard.

[cirella]

Wow, can't really add too much to what MM has told you but, in addition to most of these things, I pre-made some meals like lasagna and stuff that are easily frozen and microwaved.  

Ask your GYN if you can take Mirlax daily b/c that won't give you any problems.  The gas from surgery isn't the same as gas in your intestines.  They use it to blow up your belly so the best way to get rid of that is a little movement.  Walk as soon as you can after surgery and by walk I mean gently.  And, don't stay in one position too long in the bed.  Moving your arms around helps, too, b/c it seems to lodge in that area for some reason.

MM is right, stay on your pain med schedule for the first couple of days but be realistic about it.  If you think that a Tylenol/Advil combination will help you then try it.  It will help with the constipation.  

I agree that 2 weeks is NOT enough to recover enough to go back to work.  Full recovery will be a while but, I guess depending on your job, you should ask for more time.  Are you at a desk?  That will help but watch the bending, twisting and lifting.  You really do more with your stomach muscles than you realize.  You don't want internal scar tissue, believe me!

Please ask your doctor about all these suggestions and ask him/her for a longer "get out of work" pass just in case your work needs proof.

Good luck and hope everything goes well.

[MarieMichele]

LOL.  I love my typo.  I meant Milk of Magnesia not Mike of Magnesia!

Cirella is right about the walking.  That helps to move the gas.  Also some light rubbing/massage of the abs (not on the incision, but all the areas around it or where the gas pains are concentrated).  Keep yourself hydrated with liquids to flush out everything you experienced from the surgery and keep those bathroom "movements" moving.

Have tea on hand.  Get ginger to add to the tea (I just used powdered ginger or crystalized ginger--but that one is expensive).  Ginger tea is supposed to help with gas...and even if it doesn't, it's soothing and good for you (esp. the ginger).

And for what it's worth.....I have an easy desk job and I STILL needed that 6 week recovery time.  My first week back....it meant being "vertical" all day, whether sitting, walking, standing, and my belly was in pain by day's end, not to mention the fatigue I felt.  I didn't know how much I was going to miss the afternoon nap until I was back on a full day's schedule at work.  Ugh.

You will notice your energy levels are reduced significantly after the surgery and it takes weeks to be back up to speed.  May want to have a good multi-vitamin supply on hand as well since your appetite will also take time to return....and food won't taste very tasty for several days, either once you are cleared to return to solid food.

You may also feel emotional and crying for no real reason.  That's normal.  You're not crazy.

All the jokes about hospital food being mainly Jell-O?  Well, it's true.  I hate Jell-O!!

[kittycoo8]

Update.....
Thank you everyone for answering my post. And, yes, I will be out of work a minimum of 4 weeks (so naive!). My surgery is scheduled for Thursday, this week, and I am getting really nervous. I'm waiting for Kimmery to post as she had surgery last Thursday--- Let's hope she's well and will be posting soon.

[Grandmere68]

Hi,

I'm back from the hospital and am recuperating from laparatomy last week.  My cyst (about like a cantaloupe) was encompassing the left ovary and was benign.  I had general anaesthesia with an epidural spinal as well.  Made me very comfortable in the hospital.  My incision is shorter than expected, from belly button down, and had stitches and glue, no staples.  Best hospital experience I've ever had.  Great team and care.  I am healing slowly at home.  

[kimmery]

Hey Kitty! Kim here...

Thanks for all the sweet notes -- it's really nice to know that others are thinking of you when you're not feeling so hot.

So... had the surgery last week and am now healing at home.  :)

It actually went better than expected. I had been told that ultrasounds showed a softball sized dermoid on my right ovary and that it was likely that I would lose the ovary... I had processed it and was ready to let it go -- imagine my surprise (and delight!) when they told me they had been wrong! The growth ended up being on my uterus and not even on my ovary after all, so I got to keep my ovary!! They are biopsying it and I should know in about ten days what exactly it was. Has anyone ever heard of a dermoid or a growth resembling a dermoid growing on a uterus before? I'm a little bit confused as the doctor kept calling it a dermoid but I thought dermoids could only grow on your ovaries?

Apparently I also had a lot of scar tissue which the surgeon removed (yay for that: I'm hoping it will greatly reduce the pain I had been experiencing). The only unpleasant part was that due to the placement of the growth I ended up with more and bigger incisions than are typical for laporoscopy. But I'm impressed they were able to do it laporoscopically at all. Apparently it was attached to the back wall of my uterus.

I'm very interested in hearing tips from others avoiding the development of scar tissue. I'm normally a very active person and naturally push myself and I'm a little worried that I've been doing things that perhaps I shouldn't be... like vaccuuming today. It started to hurt after a few minutes and I had to stop ;-)

The suggestions the women have made above are fabulous. :) In addition to the recommendation for stretchy pants that reach above the belly button, I'd recommend loose yoga drawstring pants, and underwear that either reaches above the belly button or that is super loose and super low. I have been wearing really old, stretched out underwear since the surgery lol. I actually got my period right after the surgery and the hospital gave me these awesome cottony stretchy underwear (ugly but comfy!) to wear. You might bleed a lot after the surgery. Because all I could do was lie down for almost three days I had to double up on maxi pads. You won't be able to wear tampons due to the risk of infection.  

Stool softeners are essential. You can get them from your doctor. Also, prunes are great.

In terms of your healing time it sounds much better that you have given yourself more time to heal. I might have mentioned before but I had a csection (laporotomy) with my daughter and it took about 3 weeks before I was really able to get around.
Better to give yourself the possibility to take extra time if you need it.
Feel much better right now. The first few days were a tad rough -- I don't react well to pain meds but even worse than that was the gas pain (not intestinal). The CO2 was dreadful. Moving around does help to disperse it but it also can worsen pain when it's first moving through your system so be prepared. Before getting up I'd eat some rice chips or apple sauce and take a pain reliever and wait for it to kick in before I got up. Learnt that lesson early lol. I also used my magic bag; would heat it up and place it on my upper abdomen and neck. Helped a lot with the pain. Ask for some good pain relievers (that are the least likely to cause nausea) just in case you have a similar reaction, although you might not. I'll keep my fingers crossed for you :)

Another thing to remember is that in addition to the gas you will have swelling that will put pressure on your abdomen and stomach. It kind of feels like being pregnant in that I sometimes found it difficult to breathe deeply or to eat or drink a lot at once due to the pressure. I found the pressure contributed to nausea and that trying not to eat or drink too much at once helped reduce it.

I hope this helps! I read that you are feeling quite nervous about surgery, god knows I was too!  I hope it helps to tell you that that waiting is probably the worst part and that it will soon be over and all you will need to do is work on healing... When I went in I just tried to remember that these doctors do this everyday and that they really know what they are doing.

Let us know how you are doing, and if you wanna talk please do send me a message! I was really ancy the week before my surgery and found I really couldn't think about much else... and god knows I'm just lazing around right now and could use the company :)

I'll think of you on Thursday and be sure to send you good vibes. What time are you going in? Good luck, and let me know how it goes!

Kim
xoxo

[kittycoo8]

Well, I made it through the surgery and will live to tell the story.... hee, hee, hee. I had surgery last Thursday and just returned home today, Sunday. The doctor, as planned, removed a 7 1/2 inch dermoid cyst on my right ovary. She ended up removing the ovary and tube along with it. She also did a D&C and Hysteroscopy. That was the planned part... when she examined the left ovary, guess what was there? Another cyst! It was about 1 1/2 inches and she was able to remove it without the left ovary! Thank goodness!  Before I left the hospital today, the pathology report was complete and stated that both were benign dermoid cysts.... with all of the 'stuff' in them. I ended up with a 5 1/2 inch smiley incision which is burning right now. All in all, today, I feel pretty good considering what I went through a couple of days ago. Will post more later but just wanted to say thanks to all of the posters throughout the years. They say 'knowledge is power', and because of this website/forum, I am ready for the days ahead. Thanks everyone!

Kittycoo.