As I write this, my surgery is over and I’m alive! It has been FIVE days since my da Vinci laparoscopic assisted total hysterectomy. Here’s what I had in layman’s terms: I had my uterus taken out — all of it including the cervix. It was done laparoscopically with the assistance of the da Vinci robot. My abdomen was insufflated with CO2 (carbon dioxide gas). I have four small incisions. My ovaries and fallopian tubes were left in.
I chose to have my cervix taken out because I didn’t want to have any more pap smears to contend with or possible spotting / light periods that some women have when they still have their cervix. That’s a bit mind-blowing for me — having a partial hysterectomy and still having a period. Plus there’s a process called morcellation that grinds up the uterus, taking the ground up contents pushing them down through the intact cervix expelling them out the vagina or through an abdominal incision. If any of those uterine cells have cancer there will be remnants left behind possibly causing cancer at a later time. Who would want that?!
I left my ovaries (and tubes) in because there is no history of ovarian cancer in my family and they are basically fine, other than being filled with old, old, old eggs — and only a few at that. I want the hormones these little guys are still producing even though their vitality must be fading somewhat as I’ve had to go on hormone replacement prior to this hysterectomy due to the night sweats, hot flashes and brain fog.
Now, on to surgery day. I had to be at the hospital at 5:30 a.m.! Somehow both my husband and I were not sleepy at this horrible hour. I checked in. I felt great. My pre-op nurse was fantastic! I was so lucky to get nurse J — she was the perfect nurse for me on this day. J happens to be the wife of my Gyn doing the surgery. J had such a sense of humor that I didn’t feel any anxiety as she kept me laughing. She too has never had children and could make jokes about being childless. This helped ease my mind because it’s nice to know there is at least one other woman in real life who didn’t think their life’s mission was to have children pushing that kind of agenda on me.
I picked my anesthesiologist a few days ahead of time and I’m glad I did because there is some reassurance in simply seeing someone you know with a smiling face that you can trust will take very good care of you. I like not feeling like just another number, just another patient. I’ll admit that I do like to feel just a bit special.
Dr. V (the anesthesiologist) asked if I wanted some versed in my IV as we rolled off to the OR and I told him no I didn’t want anything like that and wanted to be awake and conscious as long as possible to the last minute. We discussed my post-op nausea vomiting history … I have all the risk factors for being a post-op barfer. 😦
- past history of post-op nausea & vomiting (PONV)
- history of motion sickness
- abdominal or pelvic type surgery
- use of pre and/or post-op opiates
- female sex
For some reason non-smokers are at greater risk for post-op puking. I’m not really sure why this is … maybe nicotine is some sort of an antiemetic — that’s my best guess. But there is no way in hell I was going to start smoking before surgery to decrease my potential for PONV!
Dr. V. told me he was going to use as little gas as possible because that is what truly makes people have the most PONV and would be giving me mostly profofol (see link below). Dr. V. also placed a scopolamine patch behind my ear to prevent PONV and told me I could wear it up to a week, but that it would probably only be active for about 72 hours. I had a scopolamine patch with my last surgery and wanted it again.
I remember scooching over to the OR table. It was a skinny little thing and I only had an inch or so to each side of me. I asked the OR staff if this was a table picked out for my size and they told me it’s what they used for everyone with most people hanging off somewhat on both sides. (Just for your reference I am about 5’4″ and weigh 120 lbs.) I couldn’t imagine hanging off this little table and thought how lucky I was to fit.
Everyone was so kind to me in the OR the brief moments I remember them. I looked over and saw the da Vinci robot. My Gyn doctor placed the SCDs (sequential compression device) on both my lower legs himself! That impressed me because I thought only a tech or nurse would do that! Again, I have a great Gyn doc — I’m so lucky; he’s a wonderful doctor and man. Just so you know, the SCDs compress each leg at a set interval to keep the blood from pooling in the calves preventing blood clots — so they are uber important in pre- and post-op care!
The next thing that happened is that I was told I would feel a cold sensation in my IV and a mask was placed near my face while Dr. V. told me to breathe in the oxygen. That’s my last memory of the OR.
BAM! SLICE OF TIME AND LIFE REMOVED!
The next thing I knew I woke up in the recovery room, feeling a dull achey soreness in my abdomen while my mouth felt like the Sahara Desert. I kept looking up at my vital signs — yep, only a thing a nurse would do and everything looked great. I survived the surgery and all my vital signs were absolutely normal.
My biggest concern was my dry, dry, dry, dry, dry, dry mouth. I kept begging and yes, I was begging the PACU (post-anesthesia care unit) nurse for some ice chips. It became a battle with her not wanting me to throw-up and me wanting to rehydrate my Saharan oral orifice. Heh, heh, finally I won when Dr. V. showed up and I got his formal permission to get those ice chips! Good-bye sand mouth! I know that wonderful PACU nurse was only trying to keep me safe and do her job. 🙂
I got set up with a dilaudid PCA (patient controlled analgesia) pump and let me tell you that thing worked so well I wish I could have had it at home! My Gyn doc and I had discussed pain control during the pre-op appointment and I had explained that dilaudid had worked well in the past and that I never, ever, ever, ever wanted morphine again in my life. I had morphine in the past and it felt like my chest was being crushed and my life was being snuffed out … awful feeling.
I hung out in the PACU for however long I needed to until I finally made it to my room. I don’t know how I got from one bed to the other … maybe people transferred me? I don’t remember. I do remember having the nicest nurse in the world — and I truly mean that. If I could have drawn a picture and picked out her personality with the brains she had it would have been her. Lucky, lucky was I. I’ll call her nurse S. The night nurse was a different story, but I’ll write about that later.
When you have a major surgery you want a friendly person … you really, really do. A smiling face while you’re adjusting to your post-op status does wonders. 🙂
More about my post-op status in another post … stay tuned.