Here is the next instalment of my series on Endometriosis. In Part One, I discussed my recent surgery, and in Part Two, I wrote about some things I did pre-surgery that helped things go as well as they could. This one is about the initial post operative experience.
As I briefly mentioned in Part One, I woke up from my anaesthetic in a fair bit of pain. The staff were lovely, and were quite determined to get me down to no pain. Now this is something most FibroWarriors are unfamiliar with.
I am fairly lucky as far as my Fibromyalgia pain goes. If I’m good with my diet, supplements and self care, I generally function at a constant 2 or 3 out of 10. I know there are a lot of FibroWarriors that are having to deal with constant pain levels much higher than that. But the idea of getting my pain to zero, is kind of laughable. I am not good at lying to people at the best of times, but coming out of an anaesthetic meant that it was virtually impossible. So when they are asking me what level my pain was, I responded honestly. The difference is, that while I would have been happy for them to just get my pain down to a 2 or 3, they wanted it at one or zero.
I’ll be honest, they did not succeed, but the anaesthetic wore off enough for me to convince them that my pain was low enough to stop giving me drugs.
Tips for while you are still at the hospital
I don’t really have a lot of tips for post operative stuff while still at the hospital. Of course there are the things that should be common sense and basic human decency. Follow the nurses’ instructions, be polite even if you are in pain. Use your manners, and remember that ALL of the hospital staff are people doing their jobs. There is never an excuse to be rude or abusive, especially towards the very people who are trying to help you.
They will expect you to eat and drink (and keep it down), dress yourself (at least to the level that you normally can) and go to the toilet before they will discharge you. This isn’t them being difficult, it helps them to assess if you are okay to be discharged. If you can’t do any of those things, it might indicate that you need to be monitored for longer than normal. It might just mean you need a few more hours, or it could be an indicator of something more serious. Don’t kick up a stink if they want to keep you, they are recommending the best thing for your health.
Don’t be afraid to ask the nurses for help. If you need an ice-pack or a heat-pack , or your pain levels have gone up, or you feel nauseated, talk to them. They would much prefer to get you a vomit bag and you end up not needing it, versus you trying to fight through it and vomiting on the bed/chair/floor. Just be polite and make requests rather than demands.
Being discharged
Check that you understand the discharge instructions, ask questions if you need to.
Check if you need to collect any medications from the pharmacy. I was lucky that it was pretty quiet when I was being discharged, and one of the lovely nurses took my prescription down to the hospital pharmacy to be filled, so that it would be ready for the Knight to collect once he arrived.
If it is not already recorded on your discharge information, ask the nurses to write down what medication/s you have had and at what time/s. This will help you take your next dose at the appropriate time.
If you have a long drive home, use the bathroom – a full bladder is not a fun thing to have so soon after surgery.
Travelling home
I strongly recommend a cushion or a piece of foam for the car seat. Also a small soft pillow that you can place between the seat-belt and your abdomen. Make sure it is small enough to not interfere with safety, but enough to provide a bit of cushioning.
If you are prone to travel sickness, make sure you have a bucket or a bag just in case. If you do vomit – call the hospital for guidance.
At home
Check what time you are able to take the next pain relief medication. Write it down and set an alarm. Does it need to be with food? If so, have something ready like a piece of fruit or some yogurt or one of those tasty high fibre treats you made when following my pre-op advice!
For the next 48 hours (at the very least!) take your pain relief when the next scheduled dose is due. Don’t muck about with post surgical pain. There is a valid reason why your body is giving you pain signals, it’s to make you be still so you can heal. But we, as intelligent humans are able to make the decision to be still without having pain, so take the medication!
Post surgical pain is much easier to keep down if you take the doses as prescribed, rather than waiting for it to completely wear off then trying to get it back under control. If you wait until the pain is high again, you will often need to take more medications and at a higher dose than you would have otherwise.
Avoiding constipation
You will likely be prescribed some sort of opioid medication. One very common side-effect of opioids is constipation.
Trust me, constipation post pelvic surgery is something you want to avoid.
Here are some tips for helping reduce the chance of developing constipation:
- Eat high fibre foods. Lots of vegetables, whole grains (if you tolerate them) and fruit.
- Stay hydrated. Drink lots of water or herbal tea, and keep caffeine to a minimum.
- Add supplements that draw water into your stools – things like chia seeds and psyillum husks. See below for a recipe for a chia seed pudding that the knight has nicknamed “Pooping porridge”. It’s really quite tasty despite it’s name!
- Use a foot stool or “squatty potty” to place your feet on when you sit on the toilet – raising your knees above your pelvis helps to put everything in the right position so you can pass stool with minimal straining.
- Gentle massage of your abdomen and pelvic area – do this very gently and always in a clockwise motion to encourage things to move in the right direction. Not only will this help the movement of your bowels, it will help your body to get rid of the excess gas from the surgery that will have been left behind.
- If these things don’t work, talk to your pharmacist or doctor about stool softeners and laxatives or consider using a microlax enema. They aren’t much fun, but the longer the stool sits in your lower bowel, the more water will be drawn out of it, and the harder it will be to pass – so don’t leave it too long!
Pooping Porridge
- 1 apple
- 1/2 cup water
- 1/2 cup coconut cream
- 2 tbsp chia seeds (Australian metric tbsp = 20ml)
- 1 tsp psyillum husks
- spices to taste – I like cinnamon and cloves or vanilla
- Chop apple into small pieces and stew for 15 mins in a small saucepan in the water (you could also use pre-made stewed apple).
- Add coconut cream and gently warm
- Remove from heat and stir in remaining ingredients. Allow it to sit for a while for the chia seeds and psyillum husks to absorb the water. Adjust to your preference – add more water if it is too thick, more chia seeds if too thin.
- Serve with some nuts or extra fruit, or just eat it as is – enjoy!
Try it with different fruits such as mango, pear or berries.
In my next post, I’ll talk about movement, exercise, referred pains and trying to get back to normal.
Go back to Part 1, or Part 2, or forward to Part 4 and my recently added addendum.
