Laparoscopic surgery using excision to remove endometrial implants is seen by many expert endometriosis surgeons as the best way to treat endometriosis. Although laparoscopic surgery is one of the least invasive types of surgeries, it is still not an easy procedure to endure. Healing from the surgery takes time and requires a lot of fortitude on the part of the patient. Dr. Seckin is a leading expert in endometriosis surgery and founder of the Endometriosis Foundation of America. He performed my last endometriosis surgery and together we came up with great tips that are helpful during the healing process.
1. Use the over counter remedy, Gas-X®: Dr. Seckin performed my fourth abdominal laparoscopic surgery and I only wished I had had this advice for the first three! During laparoscopic surgery, your doctor will fill your abdominal cavity with gas in order to lift the abdominal walls away from the cavity to get a better view. After the surgery the gas remains, and this can cause intense shoulder or back pains. Gas-X® helped me tremendously after my last laparoscopic surgery. Simethicone, the active ingredient in Gas-X®, is a powerful medicine that breaks up the surface tension of trapped gas and allows your system to deal with it naturally. Ask your doctor if Gas-X® would be right for you. It made a huge difference for me.
2. Use a mild stool softener such as Colace: I hear so many women talk about the terror associated with having their first bowel movement post-surgery, especially women who have just had endometriosis on their bowels and rectum removed. To compound this issue, narcotic pain medications often prescribed to relieve pain can also cause constipation and eating a diet high in fiber immediately following surgery is not advised. Drinking at least 64 ounces of water a day will help with this issue. Although stronger suppositories, laxatives and enemas may not be advised post-surgery, ask your doctor if a mild stool softener such a Colace, can be taken post-operatively. Colace can help ease the strain and pain associated with your first bowel movements.
3. Keep your diet light for the first few days: I remember the day after my appendectomy, my first laparoscopy, I was very hungry. For my first meal post-surgery, my parents brought me over a dish from my favorite Italian take-out restaurant. I eagerly gobbled my down my food and ten minutes later, I was throwing it all back up. If you haven’t experienced it, vomiting right after abdominal surgery is quite painful and unpleasant. Through trial and error I learned that for the first few days post-surgery, it is so important to eat lightly. Broths, Jell-O and other easily digested foods will help get you back on track. Also may I recommend using this post-surgery period to start following an endometriosis friendly diet to try and make the impact of the surgery last for longer.
4. Keep your heating pad close: A heating pad is every endometriosis patients’ best friend, including after surgery. After all of my surgeries, I found that my body was achy in other places besides my abdomen. I was quite surprised the first time I found out that during surgery, the doctor may contort your body into crazy positions in order to find the best position to operate. I thought the position I was in when I went under anesthesia was the position I stayed in throughout the surgery! The physical stress of the operation combined with the stress on my other muscles trying to compensate for my hurt abdomen, would cause my back to hurt. The heating pad can help tremendously with these aches and pains and also can help relieve your swollen abdomen.
5. Benefits of moving around: It is important to start moving around 24 hours post-surgery. Small walks to the bathroom or around your bed can actually help you heal faster. Keep in mind, in the beginning, doing something little like getting up to go to the bathroom can be exhausting, but it will get easier. A little bit, goes a long way.
6. Don’t overdo it: Less than a week after abdominal surgery, a friend of mine decided to take a walk into her small town. Before surgery, walking less than a mile wouldn’t have been an issue for her. Feeling a little bit better after taking it easy for most of the week, she thought it would be okay. I remember getting a panicked call from her asking me to come pick her up half-way there. She felt horrible. Whether it be exercising, vacuuming, or lifting, make sure not to overdo it and get your doctor’s approval first. Your body is using most of its resources to heal, so doing anything too taxing on top of that can set your recovery back, or even worse, cause internal sutures to burst. Resting for so long can be discouraging. Don’t be disheartened, you will be back to your normal life in no time.
7. Keep an eye on your incisions: If closed properly incisions should appear healed within a week, and then it takes about 6 weeks for them to heal completely. If incisions seem overly swollen or if they seem to be infected, schedule an appointment with your doctor to have him/her check them. During one of my surgeries with a less than helpful surgeon, one of my incisions reopened through no fault of my own. My doctor did not want to hear about my post-surgery issues and advised me to pack it with gauze daily until it healed, which took weeks. The scar the incision left was atrocious and I was angry at not only his lack of skills, but his disinterest in any follow up care.
8. First period post-surgery is always bad: After my first endometriosis surgery I was not prepared for the incredibly painful period that came right after. It was unlike any pain I had felt on my worst days battling this disease. I was terrified that during surgery the doctor had broken my reproductive parts and now they were somehow detonating in my abdomen. Little did I know this was completely normal. During excision surgery your doctor works on every part of your reproductive parts, cutting and scraping all of the endometriosis away. Naturally there is a lot of healing that has to take place to feel completely better. That healing does not fully happen within the time of your next cycle. So as your reproductive parts start to work again, keep in mind they are still tender. After my last surgery with Dr. Seckin, by my third period post-surgery I felt incredible, better than I had in years.
9. Don’t Be Afraid to Call Your Doctor: I feel as endometriosis patients we have a long history of not having faith in our medical professionals to help us. How could we? For years, so many professionals have dismissed our pain or admittedly have had no idea how to best serve our medical needs. Sometimes I feel like we have a “Why even bother?” attitude when it comes to reaching out. As exhausting as it is to muster the strength post-surgery to be your own advocate and fight for your health, I am begging you to do it! If you feel in your gut that something is wrong with you, give the doctor a call, even if it is midnight. If it is two weeks later and you feel like something is wrong, call anyway! Remember you are not only a patient, but a client. Certainly if you experience fever, nausea, vomiting, chills, difficulty urinating, extreme pain in your legs or abdomen or difficulty breathing, call immediately.
10. Keep the Faith: I remember one of my surgeons telling me that some people go back to work a few days after surgery. I was NOT one of those people, nor have I met one of those people yet. It took me three full weeks to get back to my regular schedule. I was feeling great by the fourth week then got my period and was devastated again by pain. I remember crying, feeling so disheartened, because just as I thought I was better, I was sick again. But I eventually felt better and then I felt amazing, better than I had in years. This surgery is emotionally and physically draining. The good news is that excision surgery helps so many women feel so much better. They feel as though they get their lives back. My hope is that you will too!
Please feel free to add any tips you have found to be helpful post-surgery in the comment section below. As a community, standing together, we can help each other fight this terrible disease. Know you are not alone and that you are ENDOSTRONG.