04/28/2006 09:39 PM
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toby459
Posts: 127
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Hi Robin....Are you having an Abdominal Hysterectomy, a Vaginal Hysterectomy, or a Laparoscopic Assisted Vaginal Hysterectomy? Each one comes with different degrees of post op pain, with the Vaginal Hysterectomy being the least painful, and the Abdominal Hysterectomy being the most painful, as the surgeon is cutting through the abdominal muscles. HOWEVER, these days even with abdominal hysterectomies, incisions are a bit smaller, and pain meds are better, so post op pain is more tolerable.
Usually, large symptomatic fibroids get worse over time, so you'll probably eventually need the hysterectomy anyway. Have it done now, before the fibroids get larger. Look at it this way - you said you suffer severe pain every single month, & it will last until menopause. After your hysterectomy, you will only have pain for a few days post operatively, and then NEVER again!!...hooray!!......As for the orgasms, the majority of patients DO continue to have the same sex life as before hysterectomy. Since you have very large fibroids, you will be much better off with having the surgery. Hysterectomies are fairly routine procedures, & I'm sure yours will go well....take a nice deep breath & relax, you're making the right decision. Hope this helped....Kim C. (Gyn surgical RN)
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03/02/2006 10:18 PM
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toby459
Posts: 127
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Hi KoKoM,
Sorry I am just getting to my email now at this late hour...hopefully by now you are in the bathroom from that delicious bowel prep that is now taking effect...let me reassure you, YES, it is typical to be told for ANY laparoscopic surgery that it might turn into an open surgery. The consent you signed should have said that. It's a "just in case"....HOWEVER, gyn laparoscopies RARELY turn into open cases. For example, if you have tons of adhesions in your abdomen & pelvis making it too difficult to perform laparoscopically, it will turn into an open case...please keep in mind this RARELY happens. I mean RARELY.....we have done MANY lap hysterectomies on a uterus as large as yours. If you are keeping your cervix and ovaries, your surgery should be scheduled as "Laparoscopic Supracervical Hysterectomy", and your consent should say the same thing, with the addition of "possible abdominal hysterectomy"......if your ovaries were coming out, you would read on the consent "possible bilateral salpingoophorectomy"........a TOTAL Laparoscopic Hysterectomy is removal of uterus and cervix. Removal of uterus, cervix, AND ovaries is scheduled Total Laparoscopic Hysterectomy with Bilateral Salpingoophorectomy. I'm sure your surgeon knows exactly what you are having done, but make sure you speak with him before your surgery and before anesthesia gives you any drugs....I'm sure he will put your mind at ease.....there should be no reason for him to take out the cervix and/or ovaries if he told you he wouldn't....usually if it's not on the consent form, the surgeon doesn't do it.....if he THINKS he might take out something else depending on what he sees inside, it will say so on your consent & it will read as "Possible __________"....ask to see your consent form tomorrow....I'm sure your mind will be more at ease......I HIGHLY doubt at your age he will take ovaries...I'm sure he will do exactly what he discussed with you....there's usually NO surprises.....I'm so glad to hear from you the day before your surgery, as I've been thinking about you for the last 2 days....I'm excited for you!!!....Good luck, and email us post op as soon as you get to a computer....Oh, and you were probably scheduled for an overnight stay just in case you feel wiped out from the anesthesia & you don't want to go home that night, as it's probably going to be a fairly long procedure because your uterus is so large....and it's normal to book an overnighter with such a large uterus just in case it turns into an open, but like I said, that RARELY happens....it sounds as if everything is proceeding as normal and as usual...nothing strikes me as being out of the ordinary here....good luck!!....my thoughts will be with you tomorrow.....Kim C.
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02/23/2006 10:45 PM
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toby459
Posts: 127
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Awww, KoKoM, you are such a sweet person. Thank you for your compliment. I feel so lucky to be able to work with & learn from such an experienced, skilled Gyn laparoscopic surgeon so I can pass the information on to help others. I can't wait to hear from you after your surgery! I'm certain you are going to be very pleased. As for lifting weights, I believe the time period is still 6 weeks, whether it's done laparoscopically or open. Both procedures still go through the fascial layer of the abdomen, in which case if you lift too early, you can get a fascial defect & end up with a hernia. You don't need that after going through all this. You will recover quicker & be able to do things quicker than patients having an abdominal hyster, but the weight lifting time period I believe is the same. So don't overdo it. I went to see a patient about 4hrs. postop, & she looked like she had nothing done! She was up walking to the bathroom & said she had minimal pain, very tolerable, & she said she didn't even need a Tylenol. I was surprised because she was a very obese woman. I went back up to see her about 2hrs. later & to my surprise, the nurses on the floor told me she was discharged! Another patient last week wanted to drive to Ohio (from Pa.) the same night after surgery. The surgery took a little longer than expected, as she had so many adhesions inside, so she opted to stay overnight & left the next morning. The surgeon told us that she made her drive to Ohio the next afternoon with no problem. Laparoscopic surgery is the way to go! I'm so excited for you. Keep us all posted. Big hugs to you!......Kim
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02/21/2006 11:19 PM
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toby459
Posts: 127
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Hi KoKoM,
I most certainly DO remember you, & I have been anxiously waiting to hear what the UOM said....A very skilled laparoscopic surgeon can safely perform the supracervical hysterectomy without robotics, however, there may not be any in your area. In which case I would say YES, go with the laparoscopic robotic surgery!!....Anything gyn laparoscopically is better than an abdominal incision. Less bleeding, less pain, quicker recovery. Now you mentioned he is leaving the cervix in place, which makes me want to ask you "how is he going to bring your uterus with fibroids out through the vagina?" Your cervix will be in the way. Unless he is taking out the cervix also. Just curious. Usually when the cervix is left in place (A supracervical hysterectomy), the uterus is chopped up by a Morcellating machine & brought out through one of the small belly incisions. You should not have more than moderate discomfort postop. Most of our patients go home either that evening, or the next day. BEST OF LUCK!!...I know you've been suffering for a long time now. I think this is the light at the end of your tunnel....Also, good job being informed & getting all those opinions!! More people should be as smart as you are!....When are you scheduled for surgery?......Kim
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02/21/2006 10:05 AM
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KoKoM
Posts: 13
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Hi I am 41 yrs old...About 2 mths ago I took a leave of absence from my job (6days a week 65hrs) to take care of my fibroids in my uterus. I had a myomactomy in 1999 due to a fibroids that was outside on a stalk of my uterus. I have never had the opportunity to have children and at this age it is not a good idea. I have always had bad pain and heavy bleeding my whole life with my menstral. I have never had endemetriosis or anything and always have been 28 days to the day. I am now experiencing more heavy bleeding and extreme pain due to the fibroids inside my uterus. I decided when I took my leave of absence to do a lot of research and go for other doctors for opinions. I should say that my primary doctor back in Jan of this year originally sched me for a Thermachoice baloon eblation with a d&c. From doing research I have learned that with this type of eblation it would not really work with my problem. So I saw four doctors for opinions...yes four. There were times I couldn't decide what to do because everybody has different opinions. The eblation may or may not work, the resection (they cut out the fibroids with an instrument thru the vagina) there are no guarantees & bleeding is a factor after the procedure and still no guarantee of them growing back, UAE is where they inject the fibroids thru the growing with a solution to try and shrink them..not sure about the bleeding and it is painful. The last doctor I saw which is a well known doctor at UOM does NON invasive surgeries for women. The only guarantee that these would not come back is to remove the uterus. My primary recommended as a last resort to do this but again with a 3" incision in lower abdomin and a long recovery. This doctor will do it lapiroscopic assisted w/robotics with four incisions: one at the belly button, one on each side and one lower abdomin. He will remove my uterus and fibroids after cutting them up thru the vagina. After he will use a bandaid to cover openings which I am happy about that. So I have decided to do this which is called a Supercervical Hysterectomy where they remove your uterus and I keep my ovaries and cervix. I was so confused about what procedure to do but after last months "painful" menstrual I decided this week that I can' live that way anymore. I would be so disappointed if I had chosen those other procedures and them failing. If I was younger and wanted to have children, then I would of definitely went with the a procedure to preserve my uterus. I just want my life back.
Kim, I know I have talked to you once before and you have been extremely helpful. You are a OR nurse and was wondering how painful this procedure is and recovery? Do you know a lot of women who have success with this procedure? Any details would be great. Thank you!
Thank you all for listening!!
KM
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