Post-hysterectomy recovery

April 21, 2009 9:46 AM

I'm going under the knife for a full abdominal hysterectomy (due to massive fibroids) in a month. What will my recovery be like?

I will be keeping my ovaries, unless they take one that looks to have a cyst. I'll be in the hospital for 2 nights, and apparently I will have staples for a few days after the operation.

What will recovery be like during the first week? The second? I've read that it will take around 6 weeks to feel 100%. How much energy will I have before then? I want to make the best use possible of my recovery time (besides recovering, which is of course my #1 priority.) I'm not planning to run a marathon or anything, but will I have energy for more sedentary pursuits?

YANMD, I'm just looking for those who've experienced this and can tell me what it was like for them.

posted by cereselle to health & fitness (31 comments total)

I've had major abdominal surgery wherein I was reassembled with a combination of internal degradable stitches and external staples. I had the staples removed after a few weeks, which was largely painless - they work well to close wounds, but skin doesn't really adhere to them. They are removed with a tool that looks like a conventional staple remover, by the way.

You'll probably feel a bit off as your abdominal muscles heal, but that goes away. Surprisingly, neither the wound nor the surrounding area hurt at all - though I also couldn't feel my right thigh, so that might have been temporary nerve injury that you won't get. Other than that, I was comfortably laying down, sitting, standing, walking, etc.

If the incision will be where the waistline of your clothing hits, a good way to disperse some of the pressure from clothes is to fold a wide, doubled piece of gauze over the waistband where it touches the staples.
posted by Inspector.Gadget at 9:55 AM on April 21

I know this isn't your question, and I am only bringing this up because your surgery is not for a month.

and I don't want it to seem like I think you haven't explored all the options, but I've had quite a few friends with fibroids and/or cysts and it seems like the overwhelming response from the medical community is hysterectomy.

But it doesn't have to be that way. I have a friend who had a fibroid the size of a zucchini and she found a doctor who made a vertical incision and successfully removed the fibroid -- so no hysterectomy and a much less traumatic surgery.

Again, I don't know your situation, so I am sorry if I overstepped, but I wish you the best and a speedy recovery.
posted by nnk at 9:55 AM on April 21 [3 favorites has favorites]

I had my ovaries out about 5 years ago, and it was done with a big abdominal incision. (i'd had a vaginal hysterectomy several years before that)

i had staples for about 10 or 12 days. if you can avoid sneezing for that time, i highly recommend it. for the first few days, moving and coughing were difficult -- coughing is a bit easier if you have a firm pillow to brace against your abdomen. after that, i had occasional sharp pains when i moved too far or too fast, and then no pain except when i sneezed.

my surgery was done after i was admitted out of the ER having felt sick for a couple of days previously, so i'm not sure if this led to me having a slightly rougher recovery than a more planned surgery. i was in the hospital for three days, i think. for the couple of days after i got home, i had *no* energy. walking from one room to another room took an effort. noodling around on the computer and passively consuming media was okay. once i got thru the initial post-opiate reboot of my digestive tract, i had no problem with input/output.

i had to be sure not to get the stapled area wet, so i felt kind of skanky until i got a nice long hot shower.

i was still walking slow after two weeks post-surgery. i remember working from home for a while, too.

in the case of both my hysterectomy and the abdominal ovary removal, it took me 6 weeks before i felt remotely back to normal. i had penetrative sex about 6 - 8 weeks after my hysterectomy, and things felt a little weird (no cervix), but were otherwise fully functional.

after the hysterectomy, i noticed i seemed to have a larger bladder capacity. i assume this is because the bladder has a bit more room to stretch out or something.


good luck with your surgery.

feel free to mefimail me if you have other questions you'd rather not put on the green.
posted by rmd1023 at 10:14 AM on April 21

I just helped someone recover from this. I know a couple of other folks who went through it in the last few years.

You may lift "your glass and your ass," as my RN-friend told me. That is all you may lift for two weeks. Do not pick up the kids. Do not pick up a bag of groceries. Do not pick up anything heavier than a glass of water. Do not bend down for anything. If there is a hundred dollar bill on the ground, pick it up with a stick. If you have milk, have someone pour it into quart-sized containers, rather than picking up a gallon at a shot.

Wear something so you and anyone with you may see your calves. This is so they can check for swelling caused by clots. So, capris or anything that can be pulled up easily.

Do move around regularly. Once every hour or two, the nurse told me. Go to the bathroom, take a shower, get something from the fridge. Get a new book off of the shelf which is at shoulder height.

Have books, crosswords, and things which do not require much thought handy. You will want to chill out. You are not going to be energetic, at all. Six weeks is about right. More if you smoke.

Drink liquids and eat meat, since you'll be down some blood. Have some fiber. Have some fruit and veggies. Those pain pills tend to gum up the works. Yes, you're going to want some pain medication. No, just because you are feeling less pain does not mean you get to do housework.

No hugging, no situps, no driving, no crunches, no twisting again like you did last summer. Wear flats. Sit on the part of the couch by the armrest — you'll need the help getting up and sitting down.

Your sedentary pursuits should be reading, watching TV, chatting on the phone, napping, and nothing more strenuous than knitting or dealing cards. Your body will tell you when you're ready to do more. After it does so, wait a week anyway, and do half as much as you think you want to. This is not a casual surgery.
posted by adipocere at 10:15 AM on April 21 [2 favorites has favorites]

This is great information, timely too. My wife just got diagnosed with fibroids last week after being felled in massive spasms while visiting her folks. She'll likely have to have surgery, but was advised in Canada before she came home to Houston that it would likely be keyhole.

All the post-operative care info is coming in very useful. Please keep it coming.

cereselle - good luck with your surgery, best wishes for a speedy recovery.
posted by arcticseal at 10:23 AM on April 21

I donated my kidney, which is way less huge than a hysterectomy, I'm guessing, and there were about 3 days of big pain, mostly because I hated the pain meds' nausea so much I skipped them, and after that it was all about getting over the anasthesia. I would just ... doze off. I felt fuzzy and brain damaged. I suggest not driving for a couple of weeks longer than it feels like is necessary. My attention span and focus wasn't there even when I otherwise felt pretty good 5 weeks later.

Other than that I was good for walking around within a week. Within 2-3 weeks I went back to work for 3 hours a day. Eventually I felt good enough that it was hard to remember not to pick up that bag of groceries or vaccuum (which will wreck your incisions).

I felt fine in 6 weeks but didn't fully recover until about week 10, meaning at week 10 I realized I hadn't felt 100% even though I thought I did, if that makes sense.

Awesome tip the clinic gave me: don't let your scar see the sun for a full year, and it won't turn purple. That works for white people. I have no idea about any other skin types, but I'm guessing they're the same. My scar hardly shows even though it's pretty large.
posted by small_ruminant at 10:31 AM on April 21

A relative of mine had a hysterectomy and appendectomy combined about 10 years ago. She, due to her weight, had to have the incision across, rather than down. It took her 6 months to get back to normality. She was very grateful for a downstairs toilet, and slept on the sofa for the first couple of nights. To this day, if she overworks, she can feel the incision site "pulling". She had a full hysterectomy - uterus, ovaries, cervix, etc. She was in her mid 40's when she had the surgery.

A friend of mine also had a hysterectomy, but in her case, they went in through her vagina. Her recovery was measured in weeks, rather than months. About 3 months after the surgery, she was back at work, lifting 4-5kg boxes down of shelving that was above her head. I don't know how much of her reproductive organs were removed. She was also in her early 40's.

Don't lift anything unless it's absolutely necessary. As in, you grabbing your child to flee the burning house. Getting up and making a drink may leave you tired, breathless and in pain. you'll probably do it once, but I doubt you'll do it twice. Your body will definitely let you know when enough is enough. Listen to it.
posted by Solomon at 10:35 AM on April 21

A dear friend of mine had fibroids out via abdominal surgery (not laparoscopic) on Friday (as in, four days ago). No hysterectomy (and as one of the earlier posters mentioned, you might want to be sure that the docs are sure that you need to have it--I'm no doctor and I have no information on this whatsoever).

She was released Sunday and is resting at home. She's on pain meds, but a total superstar and is up and about, and has taken a brief walk outside for the past couple of days. She spoke to a bunch of women before her surgery and was told everything from a three-week recovery to an eight-week recovery on full bed rest. I think it all goes to show that everyone is different, and no two procedures or recoveries are the same. That said, other than the 20-minute walks back and forth to Starbucks and the visits to the bathroom, she is fully ensconced on the couch and is just watching TV and does not plan to do anything but that until her doc gives her the green light. No heavy lifting, and she needs a hand to get off of the couch. She is exceedingly worn out at this point, and dozes off frequently, but can't get great sleep at night. She's eating a healthy diet, and had solid foods the night she had the surgery.

Whatever you do, be gentle and listen to your body. And your doc!

I wish you the best of luck and a speedy recovery.
posted by Admiral Haddock at 10:40 AM on April 21

This is helpful so far! Thank you!

Re fibroid removal without hysterectomy-- my dr. told me it was possible, but I requested a hysterectomy, because a) I have a LOT of fibroids-- my uterus is the size of a 4-5 month pregnancy, and b) I don't have kids and don't want 'em. If I have to have abdominal surgery, I want them to just take the thing and be done with it. There's a chance that the fibroids can come back if they leave it. Bleh.

I am not one for housework on the best of days, so this gives me a good excuse to avoid it. :) I am hoping to get some sewing and quilting projects done if I'm able to sit up for extended periods. Mainly I'm concerned about whether or not I'm going to sleep all day every day for weeks on end.
posted by cereselle at 10:43 AM on April 21

Oh- probably TMI, but I found it really helped to press in on my abdomin with my hands when I did any clenchy thing like pooping. I'm not sure why, but I think it had to do with the incision wrecking the muscle wall so there was nothing to clench against? Anyway. Try it and see.
posted by small_ruminant at 10:51 AM on April 21

When I had my total hysterectomy the one thing my surgeon told me that helped a lot was to take an anti-gas product with at least 180 mg of Simethicone when I got home.
posted by govtdrone at 10:58 AM on April 21

Oo- that would have been a good idea. There's air that just floats around and feels weird (and a little painful) until your body finally absorbs it. It's the wierdest thing.
posted by small_ruminant at 11:02 AM on April 21

My best friend underwent the same surgery a couple of years ago. She discovered Hyster Sisters website where she got tons of great tips and information, especially items to pack to take with you to the hospital and to wear post-op - like larger sized undies that will accommodate the bandages. Silly, but who would of thought of that on their own?

Her recovery was about 6 weeks, at least that's how long she was off work. She was able to get some disability money during this time, too.

Best of luck to you and wishing a speedy recovery!
posted by socrateaser at 11:11 AM on April 21

What I thought was weird was not the pain, there really wasn't any, but the feeling that my insides were going to fall out as I would walk around the house. Oh yeah! I also slept in my recliner for a few days when I got home becasuse I was afraid I would tear out the stitches trying to get out of bed.
posted by govtdrone at 11:15 AM on April 21

Start taking stool softeners and fiber supplements a day or two before your surgery and keep right at it at least until you've had your first bowel movement. I had laparoscopic surgery to diagnose my endometriosis. Obviously, that's a way smaller deal, abdominal wall intrusion-wise, than a full incision for a hysterectomy (although my doctor did say I would have more discomfort than normal because she had to get a burly male nurse to pull with all his might at my abdominal muscles until they would lift up).

Still, the combination of abused abs and pain meds meant that my first post surgery poo was almost nightmarishly painful. I can't imagine how horrible it would have been if I hadn't been on stool softeners at the time. I only wish I'd doubled the dose.

I also concur about the firm pillow to hold against your stomach when you cough or sneeze. Those muscles will need all the support they can get.
posted by mostlymartha at 11:25 AM on April 21

I had a rough surgery - it took longer than they expected due to various complications. Lost a lot of blood, then got pneumonia. I spent three nights in the hospital. I was hooked up to a patient-controlled morphine drip for the first day. It was hard to get up and moving, but it's very important to be on your feet for short walks (like, once down the hospital corridor with someone holding your arm and dragging your IV pole for you, that short) as soon as you can.

Once home, my very first Vicodin didn't agree with me. So I switched to ibuprofen, which ended up being more than enough. I felt recovered mentally way before I was up for doing anything more strenuous than dragging myself to the breakfast table. Seriously, do not lift anything, do not drive, and avoid stairs if you can. You become very aware of how vital your abs are to everyday life when you suddenly can't use them.

I felt well enough to work from home part time after 2 weeks, and back to full time after 5. (It's a desk job.) I was insanely bored, which contributed. But every person is different. Take the time you need, and remember to keep moving with gentle walks and such.
posted by expialidocious at 11:26 AM on April 21

Thirding the pillow to hold against your abdomen.

I was 17 when I had mine, so I think my healing time was affected by my youth. If I had it now (I'm 34), I'm sure I'd take longer to heal. I do remember laying on the couch for a week or two, then feeling well enough for walking around the house, then around the neighborhood. I started college about six weeks later but had to have someone carry my books for the first week (I also got a temporary disabled parking pass - definitely check into that).

You're not going to sleep all day for weeks on end unless there are other issues. I doubt sewing etc will be a problem after a week or two as long as your doctor okays it. I can't imagine having done housework, but then again I was a lazy teenager to begin with.

Also, as I'm sure you've figured out, you will have a nasty scar. 17 years later, it's still visible, but normal looking, as far as scars go.

Best wishes.
posted by desjardins at 11:34 AM on April 21

Oh yes! One more thing. You are going to want to take a shower as soon as you get home so before you go to the hospital make sure you have everything ready. When I got home I sat down for about 10 minutes then I went and showered to get the hospital stink off of me. I was exhausted but that was the best shower I ever had.
posted by govtdrone at 11:35 AM on April 21

she needs a hand to get off of the couch

I found it really helped to press in on my abdomin with my hands when I did any clenchy thing

Seconding these too. It's going to be really hard to get upright without help for the first week.
posted by desjardins at 11:37 AM on April 21

I had kind of the opposite surgery -- one ovary removed, still have everything else -- about ten years ago. I was a spry lass of 26, which I'm sure had a lot to do with how quickly I bounced back, but...I bounced back kind of quick in terms of energy and general not-feeling overall-poopy.

I don't recall having had problems with bm's, but what people say about avoiding sneezing/coughing/laughing? Yeah. My parents and then-boyfriend all picked me up at the hospital, and my father and then-boyfriend are both the kind of people who crack jokes when they're uncomfortable or uneasy; so one or the other of them cracked some kind of joke and I started laughing and ow. Having a pillow handy to press against your incision when you have to cough or laugh or sneeze can help brace those muscles and help you a lot, but it still smarts.

I stayed at my boyfriend's place for a week after the surgery so he could look after me -- that week of taking it easy helped a lot, and I started returning to work after that. I still walked around a little hunched-over after that, but not because of pain, but because it felt like the stitches from the incision weren't letting me stand up all the way. I think it was another couple weeks before I walked upright. I didn't feel up to lifting anything heavy for about a month after. As for exercise, I was in the hospital for 2 days after surgery, and the doctors were encouraging me to take short walks the whole time I was there; my boyfriend also took me for walks around his block while I was staying there.

(Speaking of my boyfriend and "exercise", that reminds me of another thing I ran into; my doctor told me that we had to wait 6 weeks before I could have intercourse again, and you may get told something similar. To that I would add that, since we were in our 20's, we tried just about everything else as far as sex goes during that week I was there, and...erm, let's just say that the strength of the female sexual response can be sufficient to make you painfully aware of any incisions or stitches in the abdominal area, so you may also want to lay off that for a week or two as well.)

The only other things I remember were that for a week or two, it was uncomfortable to lie on my stomach (which was how I felt most comfortable reading, usually, so I was thoroughly grumpy about that for a couple days), and that for about a week or two I was unable to bend at the waist to do things like tie my shoes. I don't mean I tried to do it and it hurt -- I mean I was unable to. I would sit down, go to bend over, and my body simply would not respond in that way whatsoever. Scared the crap out of me the first time, but whoever was with me said "oh, yeah, I heard that can happen, that's temporary," and within a week later I was fine again, but it was just plain weird.
posted by EmpressCallipygos at 11:53 AM on April 21

I've MeMailed you.
posted by essexjan at 11:55 AM on April 21

I had a c-section and am emergency hysterectomy (needed due to unbelievably massive bleed out) on the same day - April 24, 2008.

Between a terrible labor, the unplanned second abdominal surgery within 3 hours of the first, and coming home to a new baby I was desperately attempting to nurse, my recovery might have been off-the-charts horrible by comparison.

But all in all: the first 7-10 days were horrific. I couldn't even roll over in bed, or lift myself out of bed. I got dizzy whenever I stood up. I couldn't hold my 6lb 14oz daughter. I couldn't walk myself to the bathroom. I was not allowed to shower or bathe. I continued to bleed fairly heavily for almost a month, sometimes apple-sized clots. I required 2 percocets about every 6 hours. I could not eat. For this time, plan to have someone with you almost all the time who will help you with EVERYTHING.

Afterwards, things got better VERY quickly, much more so than I anticipated. The emotional challenges succeeded the physical (feeling "castrated") and I sought some help dealing with them. Within my doc's limitations and advice, I resumed simple exercise as quickly as I could (first just walking for 5 minutes, then slightly longer, etc.), and by the end of 6 weeks I could run, have intercourse without pain, and carry on activities.

The things I didn't expect: It was almost the full 6 weeks before I could comfortably drive. I continued to bleed for a long, long time. I woke up in pain a lot during the night. But, like I said, after the first week, the recovery was fast.
posted by bunnycup at 11:59 AM on April 21

I also found HysterSisters to have useful info about recovery, and also about things to bring to the hospital with you.

My number one tip: get a big foam wedge like this one to keep your upper body raised while you're lying down. It makes getting up much less painful, and you can do more things from your reclining position.

After the surgery, many (most?) women have a lot of puffy swelling, aka "swelly belly," which gets worse at certain times of the day. Any jostling, say from walking or from riding in a car, hurts quite a bit. A support panty helps a lot -- Bali makes a cotton one that's comfortable, and it doesn't have to be tight.

Don't drive until you're able to slam or step on the brakes very hard.
posted by wryly at 1:04 PM on April 21

I haven't had this done, but my mom did a couple of years ago due to a very large fibroid. It seems that the more immediate post-op recovery has been covered by people who have had the procedure themselves, but I will say the one lingering effect my mother has now is an unusual senation/numbness at the incision site. My boyfriend, who had abdominal surgery, and his sister, who has had 2 c-sections both have this at their incision sites as well, so it seems like it's not just specific to the hysterectomy, but to abdominal incisions in general. She did also say that it felt odd in her abdomen for a while after the surgery as her organs settled in a slightly different configuration (not a major change, of course).

My mom is very happy with her choice. She'd had a fibroid that grew to be quite large over the course of ten years and the symptoms from that made it worth getting the surgery. She had her ovaries taken out as well, and the side effects she has the most complaint about are from the hormonal issues (she is on HRT now since she would still be pre-menopausal), not from the surgery itself.
posted by fructose at 3:02 PM on April 21

last spring i had four large fibroids removed (about two-clenched-fists-size), though i kept the uterus. my incision was the horizontal "smile" sort. some recommendations drawn from my anecdotal evidence:

1) be in the best shape you can possibly be before the surgery. i had spent a couple months getting my house and garden in shape in preparation for the surgery, since i knew i was going to be out of commission for six weeks; in fact, the day before i went in, i spent the whole afternoon double-digging a new planting bed! i had also regularly nordic-tracked my tuckus off. i think (though IANAD, or physical therapist, for that matter) the fact that my muscles were in pretty good shape helped me get up on my feet and moving around more quickly than i might otherwise have.

2) if your pain is manageable with ibuprofen (and it might be; it's a really individual thing), get off the morphine/derivatives as soon as you can, particularly if they tend to make you dopey and sleepy (dwarves!). they just make me nauseous (not a dwarf), so i asked the nurse to discontinue the drip the morning after my afternoon surgery, and i was up and perking around (okay, not really, but feeling alert) sooner than the woman in the bed beside me who had had her surgery earlier than mine and was all about the pain meds. it's not a moral or ethical thing, so if you need the meds, take them and don't feel bad, but if you can ditch them early, do; i really believe it helped me.

3) be very kind to yourself and follow doctor's orders. you will probably feel MUCH BETTER at some point (for me it was about week 3.5) and be tempted to do more than you should. don't do it, man! i managed to resist the siren song of the garden (housework, for some reason, never sang to me . . .) and by the time my doc signed the release at week 6, i was well and truly healed. also, don't feel bad about sleeping when you're sleepy; your body has had a big hole punched in it; rest and let it do repairs. NO GUILT!

all that being said, everyone heals differently, every surgery is unique, and this is not a competition (heh! competitive abdominal surgeries. heh heh! okay, patrish; not really funny.)

good luck and good healing.
posted by miss patrish at 4:22 PM on April 21

I am guessing this is truly abdominal, versus Laparoscopic or Laparoscopic with Robotic assist. Abdominal hysterectomies take longer to heal, more of a scar, more muscles cut. Follow doctor's orders, don't be afraid of pain medication, you will need it. Remember it's easier to prevent pain than stop it. You may need a stool softner, also. (Pain medications can constipate you, plus it takes awhile for your intestines to start working again and you may (consciously or unconsciously) be afraid to have a b.m.. Don't forget to cough and deep breathe. As soon as you can move around, do it! The sooner you start moving you start to decrease the likelihood of pneumonia! Splint your abdomen with a pillow when you cough, it helps. That said, have a pillow with you for the ride home. Make sure the person driving tries to avoid bumps.

Best of luck to you!
posted by 6:1 at 4:50 PM on April 21

My wife found this web site very, very useful:

http://www.hystersisters.com/
posted by HuronBob at 4:57 PM on April 21

i had my left ovary and 6 lbs of benign tumor removed in august 08. everything else is still there.

a lot of the more immediate 6-week stuff has been covered, but i had some major emotional up and downs over the 6 months after; crying, depressive jags, almost breaking up with my very loving boyfriend, didn't feel right at all. energy levels were another thing that were extremely slow in coming back - i still don't feel at the same level as i did a year ago. i get tired much more quickly than before and get exhausted doing the same things i routinely did last year (running errands, visiting friends, writing, etc.)

i believe this was also mentioned above, but my scar (horizontal) still doesn't have feeling to it - i don't like to touch it or have it touched. i do not feel it pulling in weird ways, i work out, bike, do crunches like normal. for healing, try bio-oil - cvs sells it and my gyno said she believes it's more effective than plain vitamin e for healing scar tissue.

when i had this surgery, i was 22 and in pretty good shape - the doctor did mention that my strong abdominal muscles contributed a lot to healing - but it really threw me for a loop. i had expected to heal much quicker due to my age and physical condition, but major surgery can affect you in weird ways.

i did get a lot of quilting and knitting done however ... and the whole three seasons of weeds. i sunbathed (my scar has not turned purple thank god! and i am white as white can be), played on the interwebs, read (stockpile some library books beforehand, not in a pile so you can pick them up), slept A LOT, watched crappy daytime tv, rented movies, etc. that was all i really felt up to for the first two weeks.

best of luck!
posted by chickadee at 6:12 PM on April 21

oh, and also, they thought this tumor was a fibroid, and planned to remove it laparoscopically (all that was showing on the ultrasound was a big ol'mass of something), but after seeing what it was, the doctor opted to do the horizontal belly button to bikini line.

i was really hoping for a two week recovery, not six!
posted by chickadee at 6:16 PM on April 21

This isn't likely to affect you, but just in case...my mother wasn't allowed to drive a stick shift for several weeks after hers. That was 15 years ago though; things may have changed.
posted by hootch at 7:44 PM on April 21

iirc, i was good to drive once my staples came out.
posted by rmd1023 at 5:00 AM on April 22