Hysterectomy on your horizon?

Some lovely positive response has occurred with the "COMFORT ZONE," a section of Women's Health Forum.

This week a post came through from Lucille Narkiewicz and offers some first hand comfort on the topic of surgery and hysterectomy. Interacting and education and removal of fear can benefit so many. The "COMFORT ZONE" allows people to share experiences whether surgery, childbirth or life's trials. If you have traveled a storm ridden road to get to where you are today please share your experience with the women (and men) of the world wide web. It is by far the finest way to empower others through learning, living and experience. Thank you Lucille, Katie and Tracy for relating your personal experiences and helping the women of WHF in this pioneering effort to self-help. The topic of self-help and comfort is not limited to hysterectomy, please feel free to share experience with infertility, pregnancy, birth, breast cancer or a topic you feel would help someone in a similar situation.

By Lucille Narkiewicz

If you have just been told that you may need to have a hysterectomy, what are you feeling? Frightened, uncertain, vulnerable, angry, out of control -- don't panic. I don't think anyone could have had any more of a negative reaction than I did when I was told, "you should probably think about having surgery." Never having had surgery of any kind and only having been hospitalized for my children's birth, I cannot begin to explain how upset I was upon hearing this. Consequently, I would like to share some of my experience with you.

WHERE DO YOU GO FROM HERE?

I had many questions when I was given this news and I would have liked to talk with someone who had recently had this surgery, but couldn't find the right person. Some people I knew too well and some others not well enough - but in any case I had no way of knowing if any of them wanted to talk about their surgeries. Hopefully, I may be able to fill a gap for you.

BEFORE THE SURGERY

There could be any number of reasons why your doctor thinks surgery may be necessary. Now is the time to take a step back and reexamine what has brought you to this point in time. Once you've done this, you need to ask yourself and your physician, whether it be your primary care physician or your gynecologist, or both, for that matter, exactly why you need this and exactly what they mean by hysterectomy. Hysterectomy means different things to different people. It can mean the removal of just your uterus, your uterus and cervix or your uterus, cervix and ovaries. There are also different types of surgical techniques. I can only comment on an abdominal hysterectomy since this is the procedure that was used for me. There are some diagnoses that definitely require surgery and, if this is your situation, you should not put it off. Your physician should be the best judge of this and be willing to tell you why. There is plenty of literature giving statistics as to how many women will have hysterectomies in their lifetimes but I'm not going to comment on these. You should definitely ask if there are any options. It is surprising nowadays the choices you may have if you just ask. You may, however, be limited by other factors such as insurance coverage, the expense to you and the distance you would have to travel for a different procedure than what your own doctor has recommended. Whatever decision you finally arrive at has to be one that you are comfortable with. You are the one who will be living with this decision and all the consequences of it.

ASK QUESTIONS

In addition to what is meant by the surgery I think this is a good time to ask some personal/professional questions of your surgeon; for example, how long have you been a surgeon? How many surgeries of this type would you say you have performed? Would you consider yourself to be conservative when it comes to this surgery? What would you suggest if I was your sister, mother or daughter? If this person is secure in his/her knowledge and capabilities, he/she will not have a problem answering all of your questions. I have to admit that my son was the one who suggested that I ask my surgeon some of these questions. Remember this is your body and you have a right to ask as many questions as you need to. Be sure to write down your questions if you don't think you'll remember all of them and bring someone with you to listen with you. I found this to be a great help to me.

This is a serious operation, no matter which organs are removed. As with any surgery, there can be complications. It is very important that you have a surgeon who has enough experience and who is performing this surgery often enough to keep up his/her skill level but not so often that he/she will forget that each patient is an individual who needs listening to. You need to feel that, if and when you go into the operating room for the surgery, this person will respect your wishes while at the same time doing what he/she knows is best for you in your particular situation. Even though I was basically a wreck beforehand, by the time the day of my surgery arrived, I had complete confidence in my surgeon and was comfortable with my decision as having been the right one for me. I also knew, after much discussion with both of my doctors that this was a necessary operation and I knew that, no matter what, my surgeon would do what was necessary and best for me while at the same time keeping in mind our previous discussions.

AFTER THE SURGERY HOW WILL YOU FEEL?

Like I said before, I can only comment on an abdominal hysterectomy, since that was the type of surgery performed on me. If this is the type you have, you will probably have a considerable amount of pain, in the area of the incision, for at least the first couple of days. You will not only experience some pain from the surgery but also some pain from the gas and bloating experienced when one has abdominal surgery. Of course, you will be given pain medication to help manage this, which is a plus, since this will enable you to get up and about soon. Walking around is one of the best ways to gain some relief from the gas and bloating. Get out of bed as soon as you are told that it's okay and walk, albeit slowly, up and down the hallways. With things the way they are nowadays, if you have no complications, you will probably be going home no more than 3 days after the operation. That is the average that most insurers will pay for this surgery. When you first get home you'll have to experiment with how to get up from a chair, out of bed, off of the toilet, etc. Everything will be difficult at first. Some of the worst are sneezing, coughing or laughing. You will probably be surprised, however, how much difference a day makes. You will most likely feel stronger every day and once your staples or stitches are removed, you will begin to feel much better. You will probably have a numb sensation above and/or below the area of the incision. This will probably go away with time but it's nothing to worry about. It has to do with the fact that the nerves are cut and it takes time for them to regenerate and connect. This doesn't affect anything as far as how you are feeling. If you are employed outside of your home it will be a number of weeks depending on the type of surgery, before you are able to return to work. Everyone is different so don't get discouraged. I honestly believe that a positive attitude helps tremendously.

I read many different articles saying that it could take up to one year for a woman's energy level to be what it was before the surgery. I honestly feel that, after only a few months, I was back to my old self. Yes, I felt tired once in a while, but I felt this way once in a while before the surgery. I no longer have the pain, which was bad enough at that time for me to seek the advice of my physician and decide to go ahead and have surgery, and am now able to sleep at night without tossing and turning to find a comfortable position. I also feel much better now than I did before because I've made some lifestyle changes which I hope will help me to be healthier.

WHAT ABOUT SEX AFTER SURGERY?

You will definitely have to abstain for a period of time. Your surgeon will tell you when it should be all right to resume sexual activity. You should realize, however, that there are some changes that have occurred and even though you may feel ready, it may take some time for things to return to the same level of sensitivity as they were before. There is so much literature on this subject (much of it negative), that it made me wonder if there was anyone out there still enjoying sex after having had a hysterectomy. I don't know if I would consider this a myth, but I think that the only people talking about it are the ones who are complaining. I feel that for me it's at least as good as before, actually it's better since there is no longer any pain associated with orgasm.

HORMONE REPLACEMENT THERAPY

Lastly, something you may need to think about, depending on the extent of your surgery, is hormone replacement. At the time of my surgery I was of the opinion, and I still am, that less is better, in other words less organs removed the better it would be for me. These organs are in our bodies to serve a purpose and this purpose is not only to conceive and bear children, but also to produce hormones throughout our lifetimes. The levels will change, and although our bodies may need some help along the way; this is not the same as having to take hormones because we aren't producing any of our own. Hormone replacement therapy is another decision that should be made by being as informed as you can be. There are new drugs, both natural and synthetic being developed all the time. You should definitely discuss this with both your primary and OB/GYN doctors before making your decision. There are many benefits but also many risk factors involved, and I think that each person is different and should be treated as such. When you come right down to it the decision is yours -- remember it's your body and you are the one who will be dwelling within. I still have my ovaries and they are still functioning so that it hasn't become necessary for me to make this decision at this time. I've been tested and my levels are such that I still am not menopausal. I do know, however, that when I do decide, I will have to feel that this is what is right for me. In the meantime, I have adopted a healthier lifestyle by exercising (weight bearing ones), taking multi-vitamins (containing calcium and vitamin D) on a daily basis and trying to eat right. Hopefully these things will help.