Pls e-mail me if I have made any errors. I am not an OVCA patient - the facts are gathered from this board and from my mum who had given much insights. I know the norm is that the patient go for the surgery first to remove the tumors before embalking on chemotherapy. My mum had 3 session of chemo before the surgery. For my mum, this worked well because the chemotherapy had destroyed almost all the cancer that the doctors managed to get a optimal debulking. If mum went through the surgery first, the surgery would not have been so successful. So if the patient has advanced cancer, do check with the doctors which are the best options - in my personal opinion, if the chances of optimal debulking is too low, there is no point going through it because it may mean a second surgery later.
1. Check with the hospital whether there are any cancer support groups who could help. The support group could do an immediate follow-up after the surgery. It is important to seek help first even before any depression sets in.
2. Check which ward you would be warded. It may differ hospital to hospital. Some hospital may put you at the maternity ward. Some may put you at the general ward. If you are placed at the maternity ward, ask the hospital to put you where patients are undergoing operation for women problem. New mothers attract the most number of visitors. By checking which ward you would be placed at, you would be mentally prepared. For a young lady undergoing this operation, it must be devestating to be surrounded by babies.
3. If possible, get the earliest surgery slot possible in the morning. Why? A typical doctor can perform 10-15 surgeries per day. I would prefer the doctor to be fresh and alert to do the surgery especially since it is going to be a long one lasting between 3-6 hours. If there are any complications after the surgery, the doctor would most possibly still be in hospital.
4. Do have a check-list for a list of things you would want to bring. The list of things that is useful:
- 2 sweaters (it is really cold in the hospital)
- a few underwear, preferably with the type of material where it is difficult to get wet so you can wash and dry in the toilet (if you have a toilet within the ward and did not mind everyone seeing your underwear). They are more comfortable to wear compared to disposable underwear
- a few disposable underwear (for those who do not mind) because accidents would happen and the nurse may not get new underwear to you in time
- a few hard candy sweets - those you can bits and crunch and melt in your mouth type. Chewy sweets are strictly forbidden
- a few straws (for you to suck water)
- a few socks (cold in the hospital)
- sleeping pills (the ones you normally take)
- clothes to wear on the day of discharge - preferbly those dress wear by pregnant ladies. Pants not recommended
- a few sanitary pad - get those ultra slim without wings (important - WITHOUT wings). It is for use as a pad to press against the wound in the girdle (if applicable) and for vaginal discharge (personal preference whether you need the ones with wings or nor for vaginal discharge)
- a comfortable girdle - look for those which is soft with stretchable sides.
- bring the important medication you take every morning - e.g. high blood pressure (remember to check with the doctors whether you need to take in the morning)
- something of personal/religious significance to you to be placed next to the bed - it may be a bible, a cross, a koran, buddhist scriptures or even a photo of your family. Think of it when you feel alone in your bed - it would comfort you.
5 Shave 'down there' before you go to hospital. If you are the shy type, it would be distressing for you when a stranger shaves you.
Admission (day/night before the surgery)
1. After you check into the hospital, if possible, try to meet up with the doctor doing the surgery and review the plans.
2. Get to know the nurses, Check who is the best 'poker' in the ward and mentioned that you are afraid of needles (even if you are not). You would be put on drip the first few days after the surgery and a heavy handed nurse could really hurt you.
3. You would be prescribed a drink to clear your bowels. You would not be allowed to drink water the night before the surgery.
4. If the hospital did not provide, ask for a physiotherapist to teach you breathing exercises that will prevent lung congestion and leg exercises that improve blood circulation while you are bedridden. After surgery, you would have lots og phelgm - you need to spit them out and there is a 'special' technique to do so without hurting your stomach - if not, you risk lung infection and a long, long stay in the hospital. Alternatively, check with patients who underwent surgery - make sure you know the 'techniques' before the surgery.
5. Ask for sleeping pill/take your sleeping pill to sleep before the surgery. Don't make yourself to anxious.
1. Depends on your condition, you may be required to stay at the ICU for a few days
2. You may have a nasogastic tube in your nose to drain secretions from your stomach or bowel) or are receiving oxygen or a blood transfusion
3. You would be given morphine and a cocktail of painkillers to dull the pain. You may see 'funny' things (like people floating around). For caregivers, do not be alarm if the patient starts talking to thin air - this is morphine talk.
4. You would be given a button to press to auto-inject more pain killers to numb your pain. This is not a time to be a heroine - if in pain, take the painkillers.
5. You will have an IV line until you are able to drink and eat normally. You will also have a urinary bladder catheter. If you feel pain at the site where the IV line is placed - tell the nurse. The person who did the IV line must have done it incorrectly - if done correctly, it should not hurt. For caregivers, look at the place where the needles are placed into the veins, if the place turned red, called the nurse to change to another place even though there is no pain - it is a sure sign that the place is infected.
6. Depending on your condition, you would be wearing a girdle to 'support' your stomach. Hospital girdle can be uncomfortable (one size fits all) and my mum's hospital one is meant for someone one size bigger than her. If you are feeling better, you may want to switch to a more comfortable one if the hospital one is uncomfortable. It is best to wear the girdle for 1-2 months - my mum said she would prefer not have any accidents and spilt the incison open.
7. There is this cotton pad that press against your wound to protect and absorb the blood from the incision. It can be so bulky. When you feel better, you may want to use sanitary pad instead - just remember to get those ultra slim with no wings.
8. Start to take deep breaths and cough every 2-3 hours to get the phelgm out.
9. You will be extremely bloated after the surgery. Within 24-48 hrs, you would be encouraged to stand up straight and walk. You need to pass the gas out - this can be achieved by walking and taking gas medication.
10. It is impossible to rest on the first night - the nurses would check on you every half hour. Get sleeping pills to help you.
11. You may or may not be allowed to eat/drink after the surgery depending whether your bowel movements are moving. It may be a few days before your bowel movements start. Get a few ice cubes to suck - small ice cubes, it would help your mouth to get moist. Also - suck on those hard candy you bought - my mum's favorite is orange - it gets your sailva to start working and would kick-start your appetite.
12. After your bowel start moving, you would be on a soft diet. Try not to drink/eat too much because you would be even more bloated. If possible, get ginger tea which purportedly helped you to pass gas out.
13. You would be too sore to keep sitting up just to drink water. Place a light plastic cup next to you with a straw. You should be able to reach out to get the cup and suck the water up the straw without sitting up or waiting for the nurse to help.
14. You would only be discharged when you meet the following criteria - the hospital stay can be as short as 5 days to as long as 2 weeks:
a. able to pass gas
b. able to pass pass motion
c. able to eat and drink
d. no infection for wound
15. You would still be bloated after your discharge. It can take up to 2 weeks for the bloat to go away. To get rid of the gas - walk and lots of ginger tea.
16. Stitches or staples would be removed 7-10 days after discharge from hospital. Do expect brownish discharge from the vagina (that's why I ask you to bring sanitary pads).
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