Monday, October 2, 2017

4 weeks post op, a review of my recovery so far

Recovery for me has had its ups and downs.  I will be 4 weeks post op tomorrow 10/3/17. 

5 dpo (days post op) I kept feeling like I wasn't able to fully urinate, my bladder seemed painful, but it didn't feel like a UTI.  I sent my surgeons office an email at 7 dpo asking if I needed to be worried or if it was just post op pain.  They felt that it was best to get check for a UTI. So off to my general doctor I went.  My husband took me to the appointment because I was still on pain meds and not able to drive yet.  My leucocytes and white blood cells came back high but no bacteria yet, but she felt with my history of UTI's and kidney infections it was best to treat with Cipro antibiotics.  They sent the sample to see if anything else ended up growing.  By that evening I was having excruciating back pain, just like a kidney infection, I tried to let the Cipro do its job and held off until the next morning when I decided an ER trip was necessary. They did a cathed urine sample to check for sure on infection but it was negative. My leucocytes and white blood cell count was still high though. The doc suggested it was sepsis, kidney infection and that my surgeon probably damaged my ureters when excising the endo....I was totally freaking out!  I doubted seriously that the ureters were damaged, this is why I went to see a specialist, but the ER doc was convinced it was that, and was irritated I hadn't seen a surgeon here.  After a CT scan to rule out that damage, the doc came back in, said everything is fine, keep up with your pain meds and go home.....What??????????  What about the sepsis,white blood cells and leucocytes, he evaded answering the question except to say my fever wasn't high enough....So then why even mention sepsis?  Anyhow I headed home kept up on the antibiotics and did lots of resting. Then I got my CT scan report....I had fluid at my cervical cuff, and the diagnostics said it was a likely postoperative seroma but the scan didn't show signs of abscess. The doc didn't even mention this, and it could have been the reason for the bladder issues and elevated white blood cell count.  I emailed the surgeon and he confirmed that it was normal for how many days post op I was and that it would likely go away on its own. Just to watch for fever.

I also during the 1 week mark added crazy breast tenderness to the mix, which lasted a few days.  I think it was about the time I would normally have had a cycle.  But I have never had them be so tender, like I needed to have absolutely nothing touching them, clothing was extremely painful.

At about 12 dpo I started feeling so much better, my pain was almost gone and I was able to start weaning off pain meds.  All the pain I had before surgery was gone. Things were looking up.  Then that next week I started to have bladder spasms, like crazy!  I couldn't sleep through them and was out of pain meds.  I called my local GYN pretty sure it was surgery related and thought maybe it was best to get seen.  Took them 2 days to call back.  By then I had starting taking uristat which seemed to have helped.  When the nurse called, she said, that the Dr. had just had time to go through my surgery notes and pathology, wow you really had a lot done and a lot of issues didn't you, that surgeon found a lot.  Ummm yes, this is what I keep trying to tell you all.  So now apparently they will take me seriously. She said that the bladder spasms were normal after that much surgery and to keep taking the uristat and to call if it didn't subside in a few days.  It did thankfully subside, although I notice if I am too active it will still spasm a bit.

I continued to be a little better each day, I still feel like I have a sex drive, which I was worried about. I am not cleared for sex until at least 8wpo (weeks post op).  But I feel desire for my husband which is reassuring.

I have not had any bleeding except right after surgery.  I had some pink discharge at about 21 dpo but suspect that is from dissolving stitches and/or from doing too much.

26 dpo I have had some crazy ovary pain starting in the evening, and mostly on my left side.  I also have had an insanely itchy scalp (which is a premenopause symptom). I fear my ovaries are angry and I don't know when they will get to working again.  They didn't work well before and the drilling was a last ditch effort to have me keep them as long as I can, I am only 38 and don't want to lose them and start HRT (hormone replacement therapy).

During this recovery I still have a very swollen belly which is definitely worse towards evening.  I am obeying my doctors orders about not lifting over 10 lbs, except once when I forgot and picked up my cat....I am trying not to bend and am not pushing, pulling or twisting.  As I feel better though it is hard to remind myself I am not allowed to do these things.  Putting on socks and shoes is a nightmare, lol. Bending is not comfortable for my swollen belly and we are now not warm enough for flip flops and dresses anymore.

27 dpo,I can say now that all of the original pain (except for the ovary pain) is gone.  I feel so much better, I didn't even realize how bad I was feeling before surgery.  I still tire very very easily, and I have to remind myself that though my tiny external incisions are just now almost healed the worst was on the inside and it is still very much healing.  My bowel issues (mostly diarrhea) are completely gone, my acid reflux is gone, my back pain is gone, my inner thigh pain is gone and my RLS (restless leg syndrome) is much less.  I thought the RLS was completely gone but the cipro seemed to aggravate it.  A lot of meds and foods aggravate it for me. But the every day RLS is gone, which I had no idea might be endo related.

The kids sometimes forget that now that I am home and not in bed a lot that I still need help.  But they are good kids and with some reminding they get things done.

My husband has been amazing, I can't even begin to describe how much he has been there for me, how much he worries for me, how much he helps me and how much he loves me! I am very lucky to have him in my life.




Pathology Results from Hysterectomy and Endo Excision

I got my pathology results back a few weeks ago and wanted to share some of the findings.

The uterus did not come back with a positive adenomyosis diagnosis, which can be missed unless they sample the entire endometrium. The pathology did say the the myometrium was slightly trabeculated and from what I have read this can be indication of adeno. Results showed benign endometrial polyps (a relief they were benign because unlike fibroids they can be malignant)  and a proliferative endometrium. Although I do not fully understand the proliferative endometrium results on the pathology as it is a phase in the menstrual cycle.  A normal endometrium in the proliferative stage is 2-3mm thick, mine was 5mm thick.  My uterus was indeed enlarged, normal weight is about 60 grams and mine was 148, with enlarged dimensions as well.  A lot of doctors recommend hysterectomy when the uterus is larger than 100 grams in weight, which I am not sure how this would be accurately measured prior to hysterectomy.

Even without a clear adenomyosis diagnosis, I do not regret the hysterectomy.  Polyps were reason enough to have it done as they reoccur/multiply and come along with a chance for cancer. Pain was located there, along with crazy heavy, bleeding cramping and clots. I was done having children and felt no need to try and keep it.

Info on Endometrial Polys http://www.cmdrc.com/menstrual-disorders-fibroids/endometrial-polyps/

The endometriosis was confirmed by pathology in all samples taken.  I can't tell you how gratifying this was, to finally have a reason for the my pain. I want to take the results and slap the doctors who didn't believe my pain with them!!!!  If you have endo or other pelvic issues you know how frustrating it is to find a doctor to take you seriously and not just think you are a drug seeking crazy person!

Endo was in the left peritoneum, over the left ureter, plaque and infiltrating with some adhesions to the ureter. This tracked down into the left pelvic cul de sac at the lateral aspect of the rectum. Right side peritoneum, right pelvic cul de sac endometriosis, right mesosalpinx endometriosis and an infiltrative mass in the perirectal fat on the right side which was confirmed to contain endo.

The Mesosalpinx endo I believe is why I felt like I always had right ovary pain, especially during my period. I always assumed this was just due to the PCOS. I had countless docs note my right ovary tenderness in my chart, always saying we will just keep an eye on it.

It will be interesting to see how my ovaries do after all of this and if they can give me a few years without HRT.

The endo that tracked to my rectum and the perirectal mass explained my digestive symptoms, and pain during defecation especially right before my period. 

The ureter endo explains why I always thought I was getting a bladder infection right before my period.  Often with blood in my urine. Doctors would find no bacteria, see blood and treat me for a UTI regardless.  I can't say how many years I had this happen before I figured out for myself that the symptoms like a UTI went along with my menstrual cycle and that is was not an infection needing treated.  But since no doc wanted to listen that it was menstrual related, I chalked it up to "periods" and just knew to have uristat on hand for the pain.

Oddly the surgeon didn't note the ovarian cysts or ovarian drilling in his reports, but we clearly saw him do it on the video of the surgery.

Surgery Details and Update with Dr. Duke

Surgery was 8/2/18.  Hubby and I drove over the night before surgery. No bowel prep made it nice! We arrived at the hospital at 7 am.  Pap...