I am finally writing my fourth (and I think last) instalment of posts about my surgery for endometriosis earlier this year. It’s been a long time coming, but that is in part because I have been incredibly productive in other areas of my life – yay! But that is a whole other post.
Previously, on Living With the Fibro Troll….
In part one of this series I talked about what endometriosis is, and how the hospital system works in Australia and what to expect prior to surgery.
In part two I gave some advice for practical and helpful (I hope) things to do in preparation for surgery.
In part three I talked about the initial post operative period both in the hospital and at home.
EDIT: I added an addendum recently to include a book and a support group recommendation.
***
This part is about the more extended post-op period. The first few days are not much fun, but if you keep on top of your pain relief, manage not to get constipated and make sure to rest, in some ways they are easier than the next couple of weeks.
Our society seems to have gotten into this “just power on” mentality. The idea that you should push through the pain and that taking time to rest is somehow “wasting time”. Everyone, especially FibroWarriors or anyone with chronic health conditions, needs to ditch this idea. Particularly post surgery.
Your surgeon might give you instructions to “go back to light duties” within a few days after surgery. This is fine advice, but doesn’t take into consideration that chronic illness suffers often have prolonged recovery times from ANYTHING and also often have less conditioning so will take longer to recover.
Do not expect to be able to go back to your regular routine straight away. It can be weeks or months before you are back to normal and it can take several cycles for your period to normalise.
GIVE YOURSELF PERMISSION TO REST!
The little incisions on your abdomen might not look like much, but they are just the access points. Your abdomen has been inflated and stretched and poked around in. Endometriosis lesions were removed, and they can be from anywhere and could be extensive. All of those excision sites need to heal.
If, like me, you have endometriomas removed from your ovary/s, then your hormones may be affected. In fact, you will have increased cortisol to deal with whether or not your ovaries were involved. You have to process the anaesthetic drugs and the pain relief drugs.
And then you still have to deal with the FibroTroll. The FibroTroll doesn’t take holidays, not even if you have surgery. So rest. Then rest some more. Even if you are bored witless. Rest.
***
Move your body.
This kind of sounds like that opposite to what I just wrote, but I am NOT saying to go for a run or to start lifting weights.
However, some movement is essential for healing. Your lymph system does not have a pump like your vascular system does (your heart). You need to move so that your lymph can move also. This is super important for your immune function.
Set a timer and every hour – stretch. Stretch your arms, point and flex your feet and make circles with them, roll your shoulders, turn your head gently from side to side. Give yourself a gentle massage, and if you have someone willing, get them to massage your lower legs with firm strokes up your legs. While they are down there, there’s a reflexology point between the ankle and the heel that when pressure is applied can help some people with uterine pain.
As you heal, SLOWLY increase your activity. Keep your timer for every hour, and every second time, get up and walk a short distance. By short, I mean wander slowly around the house, maybe go out to the letter box if you have a low-set house and you live in a regular sized suburban property. Then GO BACK TO RESTING. If you have to do household tasks like cooking and cleaning, do it in stages and rest in between. This counts as movement, and will use energy. Allow for that.
***
Dealing with referred pain.
Your body is an amazing, complicated, confusing thing. It will heal those incisions that were made in your skin. There will be a small scar, but it will heal. It does, however, sometimes do some strange things.
Remember how I mentioned that the surgeon will fill your abdomen with gas so they can see what they are doing and get to the bits that need removing? Well, they do the best they can to remove that gas at the end, but they generally won’t be able to get all of it out.
There’s no need to panic about this,that gas won’t get into your vascular system and kill you. It is outside your organs and has to slowly work it’s way out. In the meantime it feels very strange to roll over and have this gas bubble it’s way around your abdominal organs to rest at the highest point it can get to.
The really strange thing about this gas is, that when it lodges up under your diaphragm, (a big, flat muscle that separates your chest from your abdomen and helps you breathe), you get a referred pain in your shoulder. This is thought to be because of irritation to the phrenic nerve which innervates your diaphragm.
There’s a few things you can do to help your body get rid of this gas and relieve the pain caused by it.
- Drink plenty of fluids
- Avoid constipation (see part 3 for my “pooping porridge”recipe)
- Gentle massage of your abdomen – always in a clockwise direction
- Drawing your legs up to your chest when lying flat on your back, if this does not cause you excessive pain.
- Heat packs
- Gentle walking
- Lying on your side when resting – the gas will move to the highest point, hopefully reducing the irritation of your diaphragm
- A drug called simethicone (marketed as De-Gas in Australia) – check with your Doctor first.
- Getting off the opioids as quickly as you can – opioids slow your intestinal system and you want that moving to help gas movement.
***
Getting back to normal
Time. Really, this is my biggest advice post surgery. Give yourself time.
It’s really hard to do. And if I need to have surgery again in the future, I will need to write this down in big letters and put it somewhere I will see constantly.
Healing will happen. Your body is an amazing, self healing machine. You didn’t grow those endometriosis lesions in a couple of weeks. Give yourself longer than that to recovery from surgery. If you break a bone in your leg, you don’t expect to run a marathon 6 weeks later. The bone might be healed, but you would give yourself time to recondition that leg and allow it to build up strength.
Do the same for yourself post endometriosis surgery. That broken leg would have been in a cast or pinned, or otherwise kept immobile. Your incisions from surgery will probably heal in 6 weeks, but you can’t rest your entire abdomen for that time. Your intestinal system keeps working, your ovaries develop follicles and ovulate, your uterus will most likely shed it’s lining at least once, if not twice in that six weeks. Your bladder will fill and empty many times. Nothing will be immobile in there.
Practice compassion towards your own body. Give it kindness and good nutrition. And most of all give it TIME.
***
I hope this series has been of some help. If you are about to undergo surgery for endometriosis (or anything else) good luck and I hope you heal quickly and the surgery achieves the desired outcome.
I linked them at the start, but to save you scrolling back to the top you can go back to part one, part two, and part three, by clicking on those links.
