Women's Health: Hysterectomy

WHAT YOU SHOULD KNOW

Risks

IF YOU'RE HEADING FOR THE HOSPITAL...

Before You Go

• The Week Before Surgery:
• You'll probably need to stop taking aspirin and ibuprofen; the doctor will tell you when. If you're taking aspirin for your heart, don't stop without asking the doctor first. Also ask whether you can take any over-the-counter medicines.
• Your doctor will tell you whether you need to have blood drawn.
• The Night Before Surgery:
• Your physician may suggest you take a sleeping pill.
• Just before surgery, you should not eat or drink anything (even water). Your doctor will tell you when to begin fasting.
• Call Your Doctor If...
• You have a cold or flu or are running a high temperature. The operation may need to be postponed.
• The problems for which you are having the hysterectomy get any worse.

When You Arrive

• Check with your doctor before taking insulin, diabetes pills, blood pressure medicine, heart pills, or any other medication on the day of surgery.
• Do not wear contact lenses to the hospital. You may wear glasses.

What to Expect While You're There

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Blood Tests: You may need blood taken for tests. It can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• Chest X-ray: This is a picture of your lungs and heart that will help the doctor during the procedure.
• Heart Monitor: (Also called an electrocardiogram [e-LEK-tro-KAR-di-o-gram] or EKG). Three to five sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen or to a small portable box (telemetry unit) that shows a tracing of each heartbeat. Your heartbeat will be carefully monitored throughout the operation.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• Pulse Oximeter: With a little clip connected to your ear, finger, or toe, this machine measures the oxygen in your blood.
• Enema: To clean out your bowel prior to surgery, you'll be given a liquid in your rectum.
• Douche: To reduce the chance of infection, your vagina will be washed with a disinfectant.
• Anesthesia: This medicine will make you comfortable during surgery. Depending on the type of anesthesia, you may be awake during the operation, or completely asleep. You and your doctor will decide which approach is best for you. There are three possibilities:
• Spinal Anesthesia: With this type of anesthesia, a pain-killing medication is injected into your spine. It will leave you awake during surgery, but numb below the waist. Feeling will return in about 2 hours.
• Epidural Anesthesia: This approach requires insertion of a tiny tube into the spinal area. The tube is left in place so that you can be given additional pain-killing medication, if needed. As with spinal anesthesia, you will be awake during surgery, but numb below the waist.
• General Anesthesia: This type of anesthesia puts you completely to sleep. It is given either as a liquid in your IV or as a gas through a face mask or endotracheal (END-o-TRA-kee-ull) tube placed in your mouth and throat.

During Surgery:

After Surgery:

• Sanitary Pad: You'll need to wear a pad for a while after surgery. Nurses will check to make sure you are not bleeding too heavily. To prevent infection, the pad should be changed frequently.
• Oxygen: Your body may need extra oxygen as you begin your recovery. It is given either through a plastic mask over your mouth and nose or through nasal prongs. If the oxygen dries out your nose or the nasal prongs bother you, tell your nurse, but don't take off the oxygen on your own.
• Deep Breathing and Coughing: These exercises help prevent a lung infection after surgery. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum from your lungs and keep them clear. You should deep breathe and cough every hour while you are awake, including any time you spend awake during the night.
• Hold a pillow tightly against your abdomen to help reduce pain from your incision. Take a deep breath and hold it as long as you can. Then push the air out of your lungs with a deep strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Incentive Spirometer (spy-ROM-uh-tur): This piece of equipment helps you take deeper breaths. Put the plastic nozzle into your mouth, take a very deep breath, and hold it as long as possible. Then blow as hard as you can into the mouthpiece. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
• Activity: You will need to rest in bed until you are feeling better. Even in bed, however, you can still exercise by lifting one leg off the bed and drawing big circles with your toes, then repeating with the other leg. Another good exercise is to lie on your side and pretend to pedal a bike. Such exercises keep your legs strong and prevent blood clots from forming. Stop when you become tired. The doctor will tell you when it's OK to get out of bed. Call a nurse before getting up for the first time. Later, if you feel weak or dizzy upon standing, sit or lie down right away. Then call a nurse.
• Eating: When your doctor can hear bowel sounds (stomach growling) through a stethoscope, you'll be able to eat. You will probably get ice chips first and then liquids (water, broth, apple juice, or soda). If you do not have problems with the liquids, you'll then be allowed to eat soft foods such as ice cream, applesauce, or custard. If these foods agree with you, you can return to a regular diet.
• Bowel Movements: Regular bowel movements can be difficult after surgery. Don't strain if the stool is too hard. Walking will help to stimulate the bowels. Eating foods rich in fiber, such as fruit, bran cereal, and beans, will also help restore regularity. Drink plenty of liquids; prune juice may help make the stool softer. Or, if your doctor approves, you can take an over-the-counter fiber laxative.
• Foley Catheter: This is a tube that is sometimes inserted into the bladder to drain your urine. The catheter may make you feel as though you have to urinate. Relax and the catheter will drain the urine for you.
• Don't pull on the catheter because this could cause injury.
• Don't kink the catheter; this will stop the flow.
• Don't lift the bag of urine above the catheter. If you do, the urine will flow back into your bladder, possibly causing an infection.
• The catheter will be taken out when you can urinate on your own.
• Strict Intake/Output: Your doctors will probably want to know how much fluid your body is retaining. They may also need to know how much you are urinating. Nurses often call this "I&O."
• Keep track of exactly how much liquid you drink.
• Ask your doctor whether it's OK to use the toilet.
• Medicines:
• Antibiotics: These medicines help prevent bacterial infection. They may be given by IV, as a shot, or by mouth.
• Pain Medicine: To ease pain after the operation, your doctor will probably prescribe medication to be given by IV, as a shot, or by mouth. Tell the doctor or your nurses if the pain won't go away or keeps coming back.
• Anti-Nausea Medicine: This medicine calms your stomach and controls vomiting. Your doctor may suggest you take this medication at the same time as your pain medicine, which sometimes upsets the stomach.
• Stool Softeners: These medications make bowel movements softer so you won't need to strain.

After You Leave

• You may use heat to reduce pain and swelling. Heat brings blood to the injured area and helps it heal faster. Use a heating pad (turned on low) or a hot water bottle, or sit in a warm water bath for 15 to 20 minutes out of every hour as long as needed. Do not sleep on the heating pad or hot water bottle; you could get a burn.
• When you bathe or shower, carefully wash your stitches or staples with soap and water and then put on a clean, new bandage. You should change your bandage any time it gets wet or dirty.
• You'll need more rest after surgery. Increase your activity slowly and rest whenever you feel you need to. Start exercising slowly as soon as you feel stronger and do more as you get better. Exercising makes the heart stronger, lowers blood pressure, and keeps you healthy. Your doctor will tell you when it's safe to start lifting heavy objects.
• Eat healthy foods from all the 5 food groups---fruits, vegetables, breads, dairy products, meat and fish. A balanced diet will make you feel better and have more energy. It also aids healing.
• Drink 6 to 8 large glasses of liquid each day. (If you are on a fluid limit, follow your doctor's advice.) You may take water, juices, and milk, but cut down on caffeinated beverages such as coffee, tea, and soda.
• Your doctor will tell you when it's safe to start driving, when you can go back to work, and when you can resume having sex.
• Always take your medicine exactly as directed. If it doesn't seem to help, let the doctor know, but keep taking it until told otherwise. If you've been prescribed antibiotics, be sure to use them up, even if you're feeling better. If a medicine makes you drowsy, avoid driving or using dangerous machinery.

Call Your Doctor If...

• Your abdominal incision is swollen or red, or you see pus coming from it. This could mean it's infected.
• Your stitches or staples come apart.
• Your bandage becomes soaked with blood.
• Your vaginal pad gets soaked with blood every hour for several hours.
• You haven't urinated for several hours.
• You feel burning when you urinate, or need to urinate frequently.
• Your bladder doesn't feel empty after urination.
• You have a smelly discharge from the vagina.
• You have a high temperature.
• You develop itchy, swollen skin or a rash. (You may be allergic to your medicine.)

Seek Care Immediately If...

• You suddenly have trouble breathing or develop a chest pain. You could have a blood clot in your lungs, or might be allergic to a medicine you're taking.
• You get shaking chills.