I’m sitting to write this on my 43rd birthday, five days after my hysterectomy, and for the first time in 30 years I am not in pain. While I haven’t been consciously aware of pain, four days post op I realized the profound absence of pain.
In the weeks (and years) leading up to my surgery, I wanted to read this very post. I looked. I scoured. I didn’t find it, so I did what Maya Angelou (and my father) both suggest: write the thing you wish to read.
This list may not be useful or interesting to you, so feel free to skip it. But in case it is, it’s here - free for you and everyone - to use as inspiration for the ‘stuff’ that has made this experience as gentle as possible. I’m not trying to presume that I did this ‘right’ or that you ought to do anything/everything that I did, but enough folks have asked me that I’m including everything I can think of while it’s still fresh in my mind.
THE NARRATIVE
I had a laparoscopic hysterectomy because of stage 4 endometriosis, which had manifested as endometriomas on both ovaries (the right was significant). While the original plan was to leave the left ovary, it was significantly compromised by the disease in my belly and could not remain. My regular OB/GYN felt that my case was too complex for him to confidently address, and he referred me to a specialist. My surgery took five hours, and I did not have any operative complications. I have elected to use HRT to replace estrogen to delay menopause and invest more time and energy in cardiac and bone health, both are impacted by drastic drops in estrogen.
The day of my surgery I recall quite a lot, beginning in the post-op recovery area. My surgeon gave me a scopolamine patch to help with nausea, a medication which was originally used as a truth serum. It’s possible I was my nurse’s favorite patient or least favorite patient, as I believe I spoke to him constantly. Asking about my respiration rate. My nourishment. If I could have a cracker. His philosophy on post-surgical pain medications. Probably a thousand other things, sufficient that he was happy to have a dear friend help me to the bathroom as I fought my way back to lucidity. My doctor suggested I keep it on through dinner, and then consider taking it off, and I kept it for 24 full hours. It was - without question - the worst part of my experience, although I’d still choose it over nausea and vomiting.
I recall the drive and stopping by the pharmacy to pick up the estrogen patches. In no uncertain terms I told my person to walk in, address the pharmacist directly, and not leave without the patches. The tech gave him trouble, asking for patience, and I think the pharmacist took pity against the potential rage of surgical menopause and made sure he was out in 15 minutes with meds in hand.
I think I dozed - the scopolamine has my memory very fuzzy. I slept sitting mostly upright on the couch, with an ice pack on my belly and a heating pad on my shoulder.
The following day I had two visitors - a nurse friend and a doctor friend - which helped my person feel safe running an errand or two. He took more dog food to our friends who were watching our pup, and picked up some groceries that felt important. These friends each brought food and sat with me, and I only vaguely recall our time together. I’m glad I was not alone for any of my first 48 hours, and I’m grateful that our friends took our dog so that my person did not have to focus on her (we live in a condo that does not have a dog door, so she has to be taken out to the bathroom and for exercise). These friends sent home the Squishmellow and some instant soup, as well as a giant jar of marmalade that can be used to make tea. All of these things were important! A neighbor left a ready-to-oven meal outside of our door.
My childhood BFF came the next day, and I don’t recall where my person went. Maybe this was when he went to the grocery? Or when he picked up the dog? She brought so many things - a glorious blanket, some books, and lots of individually packaged snacks and sweets that could have lasted for weeks. I had no appetite to speak of, but so much thirst. My person kept my water filled and brought a Nalgene to keep in the basket, and I went through several a day. The pretzels were key in accompanying the medications, as were brothy soups.
We had our first official meal delivery Saturday, and gratefully received meals for several days in a row. While so many people were keen to feed me, I believe that first week was most critical to feed my person. If you’ve never provided care for someone 24/7 it is impossible to predict just how taxing this is, and how easy it is to forget to eat in service of the caregiving.
Sunday I took my first shower using the shower chair and many extra towels. My person put several inches of warm water in the bathtub and placed a towel over the chair. I was able to wash my hair using the handheld shower, and was also able to keep the water from landing on my incisions, which were very sensitive. It was a team effort multi-towel dry situation with cozy pants and a robe right away. I got very cold very fast. It was also cold outside, but I went immediately to the electric blanket where it took me several hours to warm up. This appears to be a typical experience. Three days later I took my second sit down shower, and two days after that I did my first stand-up shower keeping my back to the water at all times.
My recovery process has been overwhelmingly positive. After listening to the advice and experience of others, I elected to set a very conservative healing path and now create a very comprehensive post here. My intention is to consolidate and share wisdom and resource, not to convince your decision making process or pretend that I am an expert. I’m a medical anthropologist by training with a career of supporting people through antepartum experience, and I’ve had precisely one hysterectomy.
THE LISTS
CLOTHING
Boho harem pants - these have a very wide, very forgiving waistband that can be above incisions or at least minimize pressure on the incision sites. They also have tight ankles to prevent tripping hazards and a pocket for a phone. I personally found that pulling my normal lounging pants up above my tender belly brought the crotch too close for my comfort, so harem pants are made for this.
Grip socks - I received this set of six which are far superior to those supplied by the hospital and help me to feel safe when I get up and am a little woozy or sleepy. Having multiple sets was really wonderful to diminish the need for constant washing.
Magic underwear - Again with the waist band being incredibly forgiving. I’m not typically a fan of disposable items, but this one would be the number one disposable item I would choose. Works with all manner of disposable sanitary pads.
High-waisted, cotton crotch boy short underwear - For when the magic underwear is no longer needed, these have the advantage of not bunching or pushing on incisions or tender nethers.
Front closure tops - bras, sweatshirts, etc. I personally did not find that this was terrifically helpful, but others I surveyed thought these were essential, so I leave it to you!
Crocs - easy on and off, no slip, and very light I wore these on the day of my surgery and on several walks up and down the hall.
COMFORT
Foam pillows - these felt important to me as I arranged and rearranged myself. This is a great time to locate all of the pillows in the house, the yoga bolsters, spare cushions from patio furniture, stuffed animals, whatever. Adjusting and tucking so that the abdomen didn’t have to do the work.
Heating pad - I received a small heating pad which felt useful for the shoulder/neck pain of the CO2, and also used it to warm up after showers or during the very cold weather we had. Auto off is important, as is moderation with temperature. Some folks have mentioned that this felt useful on their abdomens after surgery but that was most definitely unappealing to me.
Ice bag - this one is the quentissential 1950’s era classic which I used constantly for a week. I tied a handkerchief around it because by itself it was a tad too cold, but I do believe that this guy helped me avoid big pain meds.
Electric blanket - it was -10 outside and 60 inside after my surgery, and while your circumstances may vary, it was lovely to have the blanket on top of or under my legs (and nowhere near my belly) to add heat that I wasn’t making on my own.
The Squishmallow - I cannot believe that I am writing this, but goodness it’s an essential which I received as a gift. Some small pillow. It let me create distance between the ice on my belly and the electric blanket over me. Allowed me to rest a cup of tea on my belly. Helped me to brace my incisions when coughing or sneezing.
Wedge pillow - we already had this on hand, and it did make an excellent base for my pillow fort once I moved to the bed.
BATHING & HYGEINE
These shower wipes were lovely. I did not take a shower for several days, even though I was medically allowed, so instead I used no-rinse wipes.
Bending over the sink did not feel interesting to me, so I used face wipes instead and they were perfect.
Yoga blocks or squatty potty - I read this on a discussion board and improvised with yoga blocks. I don’t know that I’d recommend purchasing if you don’t already have them, but I do think that they deserve an honorable mention. Gut motility can slow down with surgery, and with medicine, and with bizarre dietary modification.
NOURISHMENT
Cranberry juice - because I was catheterized during my surgery and because I have a history of UTI, it felt important for me to empty my bladder with great frequency AND to have some cranberry sips during the first week.
Yogurt - while it probably isn’t the ideal food to have with medicine, the tubes of yogurt are very easy small snacks and require no caregiver cleanup.
Pretzels - I had a bag of pretzels in with my medications and forced myself to have 8 pretzels if I was taking medicine without a meal.
Applesauce - pouches of applesauce were recommended to me to accompany medication, so I’m passing that along here.
Protein powder - normally I’m not a powder person, but I am glad that I found one I liked to add to my post-op instant oatmeal. Easy to eat, some fiber, a little extra protein.
Nalgene - to mitigate caregiving burnout, I strongly recommend having a large nalgene of water near you so that you need less frequent refills. I drank a truly remarkable quantity of water every day. I also had sports drinks, which are not usually my preference, but that’s what I had a taste for.
Straws - I think it is easier to swallow pills with a straw, and I recommend either a silicone straw or a bunch of bendy straws with which to drink your water.
Hard candies - my mom swears by white tic tacs for throat tickles, and they are probably worth getting and keeping in the basket. Sore throats are common after surgery, and hard candies that don’t sit against the roof of your mouth are good.
Mint gum - if you’re waking at 1am to take meds, eat pretzels, and go to the bathroom, gum might give you a few moments of teeth scrubbing before heading back to sleep. Some folks suggested this to help get rid of trapped surgical co2.
Ginger chews - nausea is my nemesis and I had these in my basket even though I did not really use them.
Nothing carbonated - normally when my tummy is upset I love sprite or 7up so I bought a case and wow did my body not want anything carbonated. At all.
Paper plates and bowls - I am a fastidious re-user and recycler and not a fan of waste where waste can be prevented and I encourage you to consider how judiciously using paper plates and bowls for a week or two might soften the burden of dishes.
MEDICATION-ISH
Just as a reminder, this is a retrospective of my experience, not a prescriptive list of things I think others should take or use.
I took my meds as scheduled, with alarms to wake me for the first 72 hours. While I was prescribed narcotics, and had them filled, I did not need them*. I alternated ibuprofen and acetaminophen as recommended by my surgeon. After the first 72 hours, as my pain was never intense, I stopped setting an alarm for the acetaminophen but continued the ibuprofen until my first post op appointment with my surgeon.
Colace - recommended by my surgeon, and I took it three times on non-consecutive nights. I probably would have been ok without it, but I read somewhere that it can be useful at dispersing the CO2 so I gave it a go.
Zofran - this anti-nausea medicine is one I have taken previously and prefer despite my own experience of the side effects. I was glad to have it in my basket at the ready, and was fortunate not to need it.
Chloraseptic spray - I didn’t have this and wish I did. If you already have it you might find it supportive. I ended up gargling salt water to help heal some minor mouth scratches that happened while I was intubated, but the spray probably would have improved my experience a bit more.
Incentive Spirometer - we already had an incentive spirometer at home from a previous chapter of life, and I was grateful to have it as a way to measure the effectiveness of my breathing.
Thermometer - I was asked to monitor my temperature periodically and so this guy was in my basket.
Bp cuff - if you have a reliable one, maybe you gather it around, but I wouldn’t purchase one unless your provider asks you to. As my ovaries were removed and I was on HRT, I wanted to check in to see how my body was responding.
Pulse oximeter - this gave me good peace of mind, and was also an easy way to measure my heart rate. We didn’t buy one, but we keep ours with the thermometer so it was in the basket and ready for duty.
*I have since delivered them to the sheriff’s office in my community, which accepts and recycles all manner of prescription medication so that it can be disposed of safely. Medications should not be redistributed or flushed down the toilet!
SAFETY
Cell phone & bonus battery - I borrowed two phone charging batteries that I could have near me so that my phone never ran out of battery. It had my medication alarms and felt important to be able to call out for the first few days. Our home is small enough that my person could easily hear me from any room, but if you are in a larger or louder space it might be nice to reach them via phone if needed. Similarly, others have suggested a buzzer or bell or horn in case you want to summon your person but don’t have sufficient power in your voice.
Shower chair - we already owned a shower chair, and so I used it for my first two showers. While I was free to shower as soon as the next day after surgery, I didn’t shower for three days, and then another three days. I found that I felt too cold. I was glad to have the shower chair, but could have done without it. I’ve heard from others that having a hand rail was equally useful
Handheld shower - in our rental home we don’t have a handheld shower, and I gratefully received a new shower head as a gift. It made showering in the chair possible, and was also useful to keep the water off of my incisions.
Stairs - we live on the third floor of a building that has an elevator, so I never had to navigate stairs alone. Hopefully you can have access to a nesting place and bathroom that are on the same floor and you can navigate stairs only with a witness or support for the first few days.
THINGS BEFORE
Address (and update) my advanced directives and power of attorney - the only actual advice I will directly give you in this entire piece. If you do not have one, get one. It can be free. Speak with the hospital where you are having your surgery and they can support you in creating a medical power of attorney. You can destroy or revoke it later.
Tell your medical power of attorney your wishes. Tell a few of your friends. Connect them. Let them confer. My surgeon had questions in the middle of my surgery. Do this for sure. Even if you’re just reading this listicle for fun. Go get you some legal medical POAs.
I lifted weights. I know, my seventh grade gym teacher (who has likely been deceased for decades anyway) is ROLLING OVER. Maybe you will not need to lift the weights, or maybe it is not the right idea for you, but I did lift weights every other day for six weeks AND I upped my daily step goal to 15,000 and emphasized cardio health. Clearly this is something you ought to consult your doctor or PT or personal trainer about, but this is what I did to mitigate the wasting (which I have done some of!).
Pelvic PT Prehab - Lucky for me, my primary care doctor recommended that I find a pelvic PT for ‘prehab’ who could assess me and give me some action items before surgery so that she is ready and waiting for me after surgery. If this is a thing you want to do as well, ensure your person is a pelvic PT, even if you regularly work with another one for something else.
Exceptional oral hygiene - this was also recommended by my primary care doctor. I got a new toothbrush and became a flossing fanatic. Maybe you’re already doing A+ in this realm, but if not, it’s a great time to start, particularly since the first few days post op may be less-than-stellar.
I washed absolutely all of the laundry, the towels, the sheets, the everything. I restocked the soap dispensers and put an extra roll of TP on the back of each toilet. If you have the financial capacity to do a little extra, this is a miracle for you and your caregiver.
I told other people how they could help me. I have done the caregiving in the past, and what I learned from that experience was not to be a hero at all ever, and when someone asked how to help, I had an answer ready for them.
- I created an Amazon wish list so that people could mail me things that I needed.
- I created a secret page on my website with a list of local places that we could pick up food to eat (and people sent these gift cards, and this has been so wonderful).
- I wrote down our favorite take-away orders into my phone notes so that I could easily copy/paste if someone offered.
- I ordered groceries for pick-up a few days prior, and saved my favorite items to a list so that I could easily re-order and have someone bring groceries out to my car in the weeks post.
- I asked a friend to coordinate a meal train and sent her a giant list of who wanted to help as well as when we might want and need help.
- I asked a friend to be near the hospital during the surgery in case my person found that useful or needed a break.
- I asked other friends to be standing by their phones to receive calls if needed.
- I asked my person to communicate with ONLY TWO PEOPLE so that he was not juggling all the questions, and each of those folks told a few folks phone tree style.
- Gratefully received coordinated and heroic supports of freezer filling, guest hosting, dog wrangling, and more things I’ll remember later.
- I told neighbors who live in my building so that they could know I was having surgery, and many offered help with the dog and help with food. One came and sat with me for an hour so my person could sneak away and buy me a birthday cake.
I hope that no one feels obligated to help, and also I hope that we can normalize asking for the help and support that we need.
BOWEL PREP
The literature is mixed regarding whether a bowel prep is advisable before a hysterectomy, but even the ACOG position paper on ERAS defers to surgeon preference. My surgeon preferred, and so I did. In case yours does (there are very good reasons TO and very good reasons NOT TO and the ONLY reason that matters in your case is what YOUR surgeon says), these are my tips:
Two days prior I was asked to eat a limited diet. Since I got to do this day twice, as my surgery was rescheduled the first time, I have a little more refinement! I had scrambled eggs, pumpkin pie, and tofu as my predominant foods. I wanted fiber and not too much dairy and not too much of substance, and I was happily full and I love pumpkin pie.
Clear liquids I chose included Gatorade frost (no food coloring), chicken broth, strained chicken soup, yellow Jello, and Sprite. The sweet and savory are nice to alternate, and it does feel useful to have the mouth feel of the Jello.
Based on her Instagram Video, I share Romanwell’s additional suggestions of: wet wipes for every bathroom visit, Vaseline after each bathroom visit (be liberal with this stuff!).
I had no trouble with the process my surgeon prescribed, which used only over the counter medications and was far gentler than I’ve heard others experience with the full strength prescription stuff. If you are going this route and you’re offered prescription meds, you could surely inquire as to the rationale of one methodology over the other.
ROUTINE AFTER
I got up to pee and walk every hour on the hour that I was awake. I did not set an alarm, I just noticed when it was a new hour and made my way. At night, my alarm would wake me every three hours to take medicine, and I would also get up to pee at the same time. I did not do bonus laps in the night time! It was very helpful to have my person support me with my medication reminders for the first 72 hours.
As I’ve suggested in my caregiver course, I use a small spiral notebook to document important things like medication dose and time, temperature, etc. I always write the person’s name at the top and the date so that if needed I could easily hand it off to a hospital worker to catch up on what was happening. In my opinion, this is most important during the first 72 hours, but I encourage you that as you keep taking medicine, continue to document it. You think you will remember, but you won’t.
I took medications at 10, 1, 4, and 7. My person often stays awake until 1am, so it was easy for him to make sure I took that dose. I regularly wake up at 7am, so only the 4am was the tricky one. I sent all of my phone alarms and would just turn them off and then on again, labeled with which medication to take.
Because boredom is real and laughter is taxing after abdominal surgery, we re-re-watched The West Wing. It has many seasons and only a few episodes that have laughing moments. For me, it was medicinal.
As I work for myself, I decided to take three weeks off from all client-facing work. In week one, I did not touch my computer. In week two, I opened my computer for five minutes each morning to address essentials, and typed most of this with my thumbs on my phone, which is more comfortable for me to use, in fits and starts. I am absurdly lucky to have had the chance to do this. I have also asked for and received as much frigging help as possible. It has been easier than I expected. The challenges were not the things I predicted. The only thing I can promise you is that your experience will vary. If you’re prone to worry, I can encourage you to consider investing ten percent of your time in disaster and contingency planning, and 90% of your time imagining that your outcome could be even better than you imagine.
Mine has been.
I’m wrapping this up nine days post op (and will continue to add as new ideas come to me), and I’m sure I’ve included too much and not enough all at once. I don’t even know if this is a useful, but enough folks have asked me in the past week that it’s here for you, and you’ve made it to the bottom, and you deserve a gold star.
A NOTE FOR YOUR PERSON
If you have a person (or a group of several people who might take turns) who is your primary support, know that this will be A LOT of work for them, and that they will need support as well. They will need meals and breaks and people to complain to and ask for empathy and clarification.
****ALL CAREGIVERS NEED ONE HOUR EVER SINGLE DAY WHERE THEY ARE NOT THE SOLE CAREGIVER**** please arrange for neighbors or friends to be on board to provide this respite. It is essential. It may not seem like it, but it will save so much fatigue. Plan this for the first few days AT MINIMUM.
The Caregiver Course I created is a quick, free resource that does not engage with my marketing efforts. It has a methodology for non-medical folks to support people regardless of their surgery or healing process. I add to it periodically.
I hope this was helpful or interesting.
Onward,
K
PS: If this was helpful to you, please consider sharing it with others, or subscribing to my [virtual latte] as a free or paid member. I am on the path to medical school, and paid subscribers are helping to make that possible.
PPS: If you’d like to read more about this, you might like my post How to Be Selfish.