Pelvic Adhesions

Adhesions are really common after pelvic surgery but they don't necessarily have to cause you problems or impact your fertility. Some doctors will perform an HSG (hysterosalpingogram) a few months after a myo for women wanting to try to conceive but mine thought we should just see what happened for a few cycle on our own. We were able to conceive and have implantation in my uterus so no problems there for me.

Adhesions & Pelvic Pain
What Women Need To Know About Prevention and Treatment

Pelvic Adhesions

Pelvic Adhesions - Their Role in Infertility and How to Prevent Them
PDF brochure from RESOLVE

Reduction of Adhesions

Asherman's Syndrome

Pelvic Abnormalities: Pelvic Adhesions (photos)

International Adhesions Society
(they are also conducting a survey of patients regarding informed
consent forms with regards to mention of adhesions)

Adhesion Related Disorders

Chronic Pelvic Pain
(includes some info about how to minimize adhesion formation)

Pelvic Adhesions
(fairly clinical and scientific information about adhesion formation and prevention in a Powerpoint presentation)

Pelvic Pain Needing Treatment

Wound Healing and Scarring - Sutures

Prospective clinical trial of SprayGel as a barrier to adhesion formation: an interim analysis.
(there are other media that can be used to prevent adhesion formation as well, if you are interested continue searching on these terms:
"pelvic adhesions barrier agents")

How long to take off for recovery post myomectomy

I was out of work for 3 weeks and then returned part-time at first and then worked up to full time. I did that in part to try to allow my body to focus on healing, all that thinking we do takes up valuable energy that the body could use to help heal itself. Also, it isn't comfortable as you are swollen and have lots of aches and pains in the first 6 weeks or so. It isn't too bad though, manageable really. It depends on many things --

* if you lose a lot of blood or go in anemic then healing will go slower, and you may be fatigued longer
* if you are in good shape your body should be able to heal you more quickly,
* if you eat really well you should heal better,
* if you really do take it easy for the time you are off you will heal better
* if you have any complications such as the incision opening then it will take longer
* some people say that the more quickly you are able to start walking again regularly that it can help promote healing -- but you can't do anything like yoga or running for at least 6 weeks.

4+ Weeks Post Myo

Another report on how I'm recovering -- hopefully this helps people who are considering the procedure.

I retured to work part-time one week ago. I got tired and sore by the afternoon and was sure to go home. During the rest of the week I noticed that day by day I had more stamina and less pain -- it seems that the pain picks up if my body needs a rest. I was able to work almost a full day on Friday without any problem and then my uterus where I had the incision started aching so I headed home. In contrast, my first shopping trip 8 days post-op I felt lightheaded and really tired after a couple hours out of the house. My second shopping trip 18 days post op I was out for a few hours on my own and got really tired and flushed feeling -- that's when you know you need to head home.

Saturday I took it easy, just doing light housework and cooking plus lots of knitting. Yesterday I went shopping for several hours and it was only after I tried on a bunch of different pants (after having been out for some time) that I started feeling achy. I handed over the items I was going to purchase to my partner to carry and then went home. I was feeling a little tired but I wanted to get a tree for Christmas so I drove out to do that and just had the staff carry and load it for me in to the car. I took a rest when I got home and finished stringing popcorn for the tree and then after making dinner I decorated the tree and vacuumed downstairs (I had my partner bring the vacuum downstairs for me).

Every day I'm feeling more and more myself. The pain from the adhesions behind my incision in my skin seem to be breaking up a little bit and I think my skin might be adapting/growing to that situation as well. I still haven't had my period but hopefully this week. When I had my d&c for my miscarriage in July it took 50 days to get my period, I think my body tends to take it slowly and get everything back in alignment before it continues.

I had sex once so far and it wasn't bad at all -- we did it spooning, on our sides which takes all pressure off of my belly. The only reason we've only had the one go is because our sleep schedules are different so I'm tired when he's just getting interested (sound familiar anyone?).

I'm all stuck together

I try to be good and take care of myself during my recouperation from surgery and !@#$ it seems like my skin has healed by bonding itself to my fascia. A couple people have told me this will go away, another one says that she is still dealing with this leftover from surgery. I'm so upset about it because there is this pulling sensation when I move. I need to be able to move without pain, I'm a dancer. Why didn't anyone tell me this was a possiblity? I'm so bothered by it I want to hurt myself.

I'm going to have to try some serious deep tissue massage to see if we can clear it out and it is going to be painful. It's going to stay painful unless I do it though. Argh!

14+ days post op

So I had my post-op visit yesterday morning and everything was good, she said I looked great. She said removing my retained POC was very difficult because of the fibroid and that there was no way for my uterus to expel the tissue on its own based on how the fibroid was positioned filling the interior of the uterus. So my prospects for a normal vaginal delivery were probably slim to none since my uterus couldn't contract well, or at least I would have had a complicated delivery. I was sooooo uncomfortable when I was pg with the rapid fibroid growth and the pregnancy having to grow off to the side because that was the only way my uterus would move, next time should be a lot better.

My doc also said that my uterus will be enlarged for a while, shrinking back some but that it would never be the size of a normal unpregnant uterus since the fibroid made the muscle wall have to grow larger. Maybe I'll be extra fertile now though, the interior of my uterus will be one vast space with lots of room for an embryo to settle in.

She said I could remove the steri strips in the shower or bath, I just pulled them off carefully when they were dry, the adhesive was already starting to go. Uncovering the incision though made it burn more, I think this is partly due to my nerves regrowing right now --
they have to cut through some in the skin there and they may or may
not grow back completely. I had to take the 600mg ibuprofen and after an hour that wasn't helping so I took a percocet and it really helped take the edge off the pain. My father said he had that same burning sensation as he healed from his triple by-pass a few years ago. The incision looks great and I don't think that it will show that much at all in a few months.



She agreed that starting trying to conceive (TTC) again in February
sounded like a good idea and that we should try for a few months on
our own before going back for any more fertility consultations. After having way too much medical attention over the past 6 months (due mostly to the pregnancy/miscarriage) and way, way too many blood draws for my liking, now I'm in a holding pattern and it feels so strange to be told that I'm healthy and back on my own. Not that I liked being not well but you do sort of get adapted to fitting in the medical care when things go wrong. Yeah to be healthy again though!

Oh and I guess it was around 11 days post op that I started to feel
more myself and I've been less fatigued and able to do more around
the house, tidying up, cooking, light cleaning, etc.

Recap of my pre- and post-surgical treatment

The day before my surgery I did go for acupuncture. I like my acupuncturist and my body responds well to his treatment. He said that my nervous system was a bit overactive -- but that was to be expected.

I've been taking the arnica since the day of surgery, at least 2 times a day now. I took the phosphorus C the night before, and started on Traumogen (vitamins to aid healing from Thorne) the night before as well. I had no nausea from the anaesthesia, and I only threw up twice, once from the PCA meds and once from the percocet. I've been taking iron with C and Traumogen every day since my operation 2-3 times a day.

I did have some bruising around the incision as I was healing, but that's gone away now, as has most of the swelling. I hope this doesn't freak you out but I've been taking photos of my incision as I'm healing and thought you might be interested.



On day 3 you can see that my belly is very round. Two days later a lot of that swelling has gone away and the bruising showed up. The colors got pretty bright and multicolored by day 7, as bruises often do. By yesterday the bruising is gone and the swelling is mostly just above the incision.

Oh, I've been also doing some Qi Gong breathing, deep breathings to fill my lungs -- at least once a day. And you want to make sure that you stay connected to your uterus after you are out of surgery and think about sending it healing energy -- I guess some people disassociate from their wounded parts sometimes and it interferes with healing. Read this article about Qi Gong and surgery, I found it very interesting.

Medical Qigong Therapy & Surgery

Post op, stay away from cookies, candy -- simple carbs. I found that my body didn't want them anyway. Drink cranberry/pomegranate/grape juices to help prevent a bladder infection.

I also did guided imagery with the help of a CD my fibroid sister Deborah sent me in a care package. I told people about my surgery and asked them to pray for me and send healing thoughts. I also tolds people when and where I would be treated, and when to expect me home with my phone number so people could call. I felt very supported and warm for the days before and after my surgery.

You can get through this too.

Preparing for surgery with homeopathy/naturopathy

I was directed by my naturopath to take phosphorus c, a homeopathic remedy, prior to having the surgery to help my body with nausea from the anaesthesia.

Homeopathic arnica was advised to help deal with the swelling and bruising. I am supposed to start taking this several days beforehand and several friends swear by it.

She also recommended Rescue Remedy from Bach's Remedies, flower essences, to help deal with the stress prior to the surgery. And Gelsemium 30c, 2 pellets as needed for anticipatory anxiety.

These "meds" are at worst sugar pills and quackery, at best they work wonders. They should not interfere with the procedure or anaesthesia and if you believe they will work then placebo affect or not they will provide you with some relief. I think I'll give them a go since I've got nothing to lose.

I will also be taking Traumogen, a vitamin supplement that helps aid the body with nutrients that aid in healing tissue.

Here are some links about natural medicine and surgery to check out:

Homeopathy and Surgery
http://www.drfeder.com/general-health/healing-surgery.htm

Surgery Recovery Program
http://www.naturodoc.com/library/surgery/surg_recovery.htm

Laparoscopy - how to prepare for your surgery
http://www.endo-resolved.com/laparoscopy_advice.html

Is Arnica montana safe to take after plastic surgery?
http://www.eclecticphysician.com/archive.php?action=Nbr&Nbr=235

About Keloid Prevention Post Surgery

When I was facing surgery I was freaked by the prospect of having a
scar; I did cancel my surgery so I've not had to deal with that yet. My father who went to medical school told me that they use steroid shots in the scar, even a year or two later and it can help soften the scar and make it less noticible. It is mentioned in the first article link below as the oldest treatment but it does have some drawbacks.

You probably are looking for anectodotal things that others have experienced but at the very least here are a few links for you to look at. You should talk to your doctor, and if your surgeon isn't interested in treating you then you might consider seeing a dermatologist or plastic surgeon instead. I don't know how that kind of post-op care works with the myo surgeon, plastic surgeons specialize in minimizing scarring though. Maybe others could offer more informed advice.

Keloid and Hypertrophic Scar

Keloids And Hypertrophic Scars - AOCD

Keloid

Treatment of Hypertrophic Scars and Keloids: A Multi-faceted Approach

Prevention of Hypertrophic Scars and Keloids by the Prophylactic Use of Topical Silicone Gel Sheets Following a Surgical Procedure in an Office Setting