After Endometriosis Surgery

As we have stated, often times our patients are the best conveyors of what to expect come surgery, as they are the ones being operated on. For this reason, we at the Seckin Endometriosis Center always like to take the time and effort to talk with our patients about their surgical experience. A key component to this is learning about our patient's experience following surgery. We, therefore, will ask our patients a bevy of questions, including: How have their symptoms been relieved following surgery? What pain or discomfort, if any, did they feel following surgery? How did they go about relieving these post-surgical symptoms? Etc. While we will, of course, inform our patients well before their surgery of some of the post-surgical symptoms that can arise and how they can manage them, we like to hear from each of our patients individually of their own experiences. Remember, not every patient is the same. So of course, not every patient will go through the same post-surgical experience. By listening to each of your stories, we are learning from you and able to pass on this knowledge and insight to future patients. Thus in order to best explain what can occur post-surgery, we have provided a blog post from one of our patients below.

How to best recover post surgery (patient’s perspective)?

“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. The Seckin Endometriosis Center is one of the leading experts in endometriosis surgery and was the founder of the Endometriosis Foundation of America. They performed my last endometriosis surgery and by working together we were able to come up with great tips that were helpful during the healing process.

• Use the over counter remedy, Gas-X®: The Seckin Endometriosis Center performed my fourth abdominal laparoscopic surgery and I only wished I had had this kind of personalized care for my first three surgeries! 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.
• 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 removed from their bowels and rectum. 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.
• 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 down my food and ten minutes later, I was throwing it all backup. 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.
• 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. 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.
• 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.
• 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.
• 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.
• 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 surgery with the Seckin Endometriosis Center, by my third-period post-surgery, I felt incredible, better than I had in years and before any other surgeries.
• 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.
• 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!”

What are the universal takeaways of this story for post-surgery prep?

• Over the counter medication: This can be helpful to reduce shoulder and back pain often caused by the gas used to fill the abdominal cavity following laparoscopic surgery. Discuss with your surgeon what medications could be right for you.
• Stay hydrated and consider a mild stool softener: Following endometriosis surgery, especially in cases of bowel and rectal endometriosis, there can be delays in passing a bowel movement. Thus it is crucial to stay hydrated and a mild stool softener could be worth discussing with your surgeon. Stray away from suppositories, laxatives, and enemas.
• Light diet: Give your bowels and body the rest and time it needs to adjust post surgery. Thus it is a good idea to eat lightly for your first few days post surgery.
• Use a heating pad: Patients often find a heating pad comforting even prior to surgery for their endometriosis symptoms. However, a heating pad will be exceptionally helpful come post-surgery for any muscular aches or pains.
• Stay active, but give your body time to rest: While you should give your body time to rest post-surgery, you should also try and get up and move around a bit within 24 hours of your surgery. This is why it is so crucial to stay physically active prior to surgery if possible. However, do not overdo this! Right after surgery, simply walking around the house is enough. Do not try and walk miles. Stay where you are most comfortable.
• Follow wound-care instructions: Suture repair can often go overlooked by surgeons, but we pride ourselves in taking great care in our suturing in order to ensure near scarless results. Nevertheless, it is important to keep your wounds clean and keep an eye out for any signs of infection, such as inflammation, pain, etc.
• Be emotionally prepared: Post-surgical healing is never an easy process and it is, of course, different for every patient. Often times, a patient’s first period following endometriosis surgery can be painful. But again, keep in the faith and trust in your surgeon when they tell you this is a normal aspect of post surgery recovery. Most of our patients will report this pain, but then tell us that after their second or third period that their pain has been relieved, even better than prior to surgery. Thus it is important to be emotionally prepared for any of the ups and downs following endometriosis surgery.
• Give us a call! 212-988-1444: Remember, we are here for you! If you are experiencing any symptoms that you think may be abnormal to post-surgical recovery and that were not mentioned by your surgeon, give us a call. We want our patients to feel comfortable in what they are experiencing post-surgery so that they can remain on the right path to recovery. It is also through your voices and concerns that we are able to better advise our patients in future cases. So never hesitate to call us if you truly are concerned.

What are our post laparoscopy instructions?

• First and foremost, if you decide to go to an Emergency Room, please make sure to go to Lenox Hill Hospital 100 East 77th Street; this is VERY IMPORTANT! Our team only works at this hospital and can thus can only strictly treat you here. If you call 911, an ambulance may only take you to the closest hospital, not the hospital you specify.
• Please take any post-op medication that was provided, as instructed.
• Avoid spicy foods for the first 3 days after surgery. Stay on a clear liquid diet until you are able to pass gas.
• Start walking around as soon as you get home, cautiously. Wear loose, non-binding clothing for comfort.
• No heavy lifting or abdominal exercises of any sort for 2 weeks.
• No driving for at least 5 days. Get plenty of rest
• No douching, tampon application, tub baths, swimming, or sexual intercourse for 2 weeks. You may shower and wash your hair the morning after surgery.
• The following are post-surgical symptoms that are normal can arise within the first few days of surgery. If any of these complaints last longer than their specified times, please contact us:
  • Vaginal bleeding, usually lasting up to 2 weeks following surgery.
  • Abdominal tenderness, usually lasting 1-3 days after surgery.
  • Lack of bowel movement should last no more than 72 hours after surgery. If it does please call us.
  • Shoulder pain, usually lasting 24-48 hours after surgery.
• You should contact us at the office if:
  • If you experience severe pain or any kind of emergency, please call the office.
  • If you develop vaginal bleeding heavier than a menstrual period, persistent nausea, fever, vomiting or increasing pain not relieved by your medication.
  • If your temperature is greater than 100.4F, notify us.
  • If you have any other questions please feel free to contact our office at any time.