DAY SURGERY – LAPAROSCOPY, HYSTEROSCOPY, ENDOMETRIAL ABLATION
Take it easy for the first 24 hours following your surgery. Begin eating gradually – start out with liquids and wait 30-45 minutes. If there is no nausea, advance your diet to solid food, as tolerated. By the first day after surgery, you can do the activities you feel able to do. By three to four days after surgery (or as directed by your doctor), you may resume all of your normal activities with the exception of sexual intercourse.
Your pain post-operatively should be minimal. You may notice a dull ache at the puncture site. Some patients may experience muscular aching, usually in the neck and shoulder region. Discomfort or pain is usually relieved by minor pain relievers, such as Tylenol or ibuprofen, or medication prescribed by your physician.
You may feel sleepy, light-headed or dizzy for the first 12-24 hours after surgery. This is normal. Please have someone with you for the first 24 hours after surgery to assist you, as needed, when you are up and walking. Do not drive or operate any mechanical or electrical equipment for 24 hours after surgery. If you had a general anesthetic, you may experience some minor generalized muscle aches or a sore throat for 24-48 hours.
You may bathe on the first day after surgery. Remove bandaids and wash your incision with soap and water. Pat the incision dry. You may notice some spotting at the incision site. This is normal. If so, you may reapply a clean, dry bandaid over the incision. If there is heavier bleeding, apply gentle pressure over the site with a clean towel. If bleeding does not stop after application of pressure, notify your physician. If you have steri-strips (thin white strips covering your incision), these will loosen and fall off over the next 5-7 days. If they do not, you may remove them after 7 days.
Unless your doctor has told you otherwise, your sutures will usually dissolve and do not have to be removed. Avoid lifting heavy objects, rubbing or irritating your incisions, or putting traction or tension on your incision for the first week following surgery to allow the incisions to heal.
You may have vaginal bleeding or spotting for the first week or so following surgery. Do not douche, use a tampon, or have intercourse until your doctor indicates that it is okay to do so.
NOTIFY YOUR PHYSICIAN IF YOU DEVELOP:
- Fever of greater than 100.4 orally;
- Abdominal pain not relieved by medication or that is increasing in intensity;
- Persistent bleeding from the incision site (heavier than spotting and unresponsive to light pressure;
- Persistent nausea and vomiting;
- Persistent light-headedness or fainting spells.
HOSPITAL SURGERY – MAJOR PELVIC SURGERY – HYSTERECTOMY, VAGINAL REPAIRS
After surgery it is very important that you take care of yourself in order to achieve a speedy recovery without complications. For the convenience of our patients who have had major pelvic surgery, we have provided a list of general instructions to be followed after your operation until your first post-operative visit to the doctor. This list is a general list only. Please be aware that your doctor may give you other special instructions not included here, depending on the procedure you have.
Day of hospital discharge: When you return from the hospital, you will have had enough exercise and enough excitement for the day. It would be advisable to rest for the remainder of the day – no visitors. Generally it takes from four to six weeks from the time you have had an operation until you have completely returned to normal. Recovery is a progressive process and you will feel better and stronger day by day. Upon returning home, for the first week some rest each day is extremely important and you may gradually increase the amount of activity each day. Strenuous work, lifting more than 10 pounds (i.e., a gallon of milk or the phone book), and excessive social activity should be strictly avoided.
Walking is the best exercise for you and by the time you go home, you may be up and about for several hours each day. However, walking for frequent short periods, with intervals of rest in between, is better than remaining on your feet continuously for a single prolonged period of activity.
Lying down provides the best type of rest. Long periods of sitting in a chair or crossing of legs are to be avoided. By the time you go home, you may climb a single flight of stairs once a day. By the end of the second week, you may ride for short distances in a car and take longer walks. By the end of the third week at home, you may drive the car for short distances. You may go shopping by the end of the fourth week.
In regard to general activity, it is important to be sensible and do things in moderation. If there is any doubt as to whether or not you should be doing something, then the best advice is not to do it. Most patients can return to work about six weeks after their surgery. Occasionally, this may be accomplished in a shorter period.
By the time you go home, your operative wound should be healing well on the surface. However, you must remember that the healing process is a continuous one and the scar does not begin to strengthen until about twelve days after your surgery. The scab which forms will gradually come away by itself. When vaginal surgery has been done, suture material may be noted on the perineal pad from time to time (anywhere from two to six weeks after the operation) as absorption and healing take place. If any special care of the wound is indicated, your physician will discuss this with you.
Exercise, other than walking, to improve the tone of the abdominal musculature should not be done for six weeks.
A diet high in protein and viatmin C is essential for good wound healing. You may eat whatever you wish, unless instructed otherwise. However, be sure that your diet contains adequate amounts of lean meat, fish, eggs, green vegetables, whole grain breads and cereals, and citrus fruits.
Constipation should not be a problem if you re-establish proper habits. However, pain medication can cause constipation. Include 6-8 glasses of water daily, some fiber in your diet (such as whole grain breads and cereals), and adequate intake of fresh fruits and vegetables. Dried fruits (such as figs, dates, and prunes) or prune juice are often helpful for relieving constipation. Walking is also helpful. Over the counter Dulcolax may be taken. If you still have constipation following these recommendations, call the office.
Should special measures or medication be indicated for bladder function, you will receive full instructions and the necessary prescriptions before leaving the hospital. You may go home with a catheter. Occasionally, after leaving the hospital, patients may experience burning, a sense of urgency, and frequency of urination. If you experience any of these symptoms, call the office for instructions.
After hysterectomy and certain vaginal operations, you may experience vaginal discharge and/or bleeding. Normal post-operative bleeding lasts from several days to several weeks after surgery. After the first couple of days the bleeding turns into spotting – normally dark red, but some occasional bright red spotting is not cause for alarm. On most instances, the bleeding stops for good. Occasionally, at 2-8 weeks after surgery, there may be some bright red vaginal spotting due to dissolving suture. The timing will depend on the type of suture that was used and how quickly it dissolves. This may be spontaneous bright red spotting (it is rarely ever heavy) or it may happen after intercourse or physical activity. Perineal pads should be used during this time for any discharge, spotting, or bleeding. Do not use tampons.
However, if you experience heavy bright red bleeding, or you must change your pad more than once per hour, please notify your physician. Sometimes, bleeding can occur at other times (even up to years later). Most often this is caused by granulation tissue. This is not serious, but should be reported to your doctor so the source of the bleeding can be confirmed and treated.
Douching should not be done unless you are specifically instructed to do so.
Of course, if you have had a hysterectomy you will no longer menstruate, although you may see some spotting for a few weeks. Other operations involving the uterus, tubes, or ovaries may interrupt the schedule for your menstrual cycle. It may take up to a month or two before your periods resume a regular pattern. If you have had your ovaries removed you will experience instant menopause and may be offered hormone replacement therapy.
By the time you leave the hospital, all or most pain will have disappeared. You may still have some soreness that will usually respond to simple measures such as using a heating pad or taking ibuprofen or Tylenol. If you have had vaginal surgery and still have discomfort, you can soak your perineal area in tepid water for 10-20 minutes several times per day (by running 5-6 inches of warm water into the bathtub or using a sitz basin that will fit into the opening of your toilet – these can be purchased at most drug stores).
Provided you do not feel too weak or tired, you may take a shower or wash your hair at any time that you desire.
You should refrain from having sexual intercourse until after your first follow-up office visit. Your doctor will indicate when it is safe to resume sexual activity.
If you do not already have a post-operative office appointment, please call the office and make an appointment for about two weeks after your surgery. You will be examined and will have the opportunity to discuss any problems or concerns you might have. If staples are used, you will need an appointment 5-7 days after your surgery. Additional appointments for return visits will be given, as indicated.
After leaving the hospital, call the doctor if you have:
- Severe chills or fever greater than 104. degrees orally
- Frequency and burning with urination
- Excessively heavy or prolonged vaginal bleeding
- Swelling, redness, or tenderness around the wound
- Foul odor