What to Expect the First Week After Your Open Myomectomy
Hi! As you may have noticed if you've been on Instagram or Twitter, I'm back from medical leave! My operation was a success insofar as they were able to remove all my fibroids, and my quality of life has been exponentially better ever since. Of course, that doesn't mean the healing process was easy.
There's a lot I wish I had known about the days immediately following my surgery, so I kept notes on some of my thoughts during that time to share with you.
Whether you have an impending myomectomy or you're researching for a friend or loved one, I hope this post helps you. Disclosure: This article contains links to products I purchased (or recommend purchasing) to help with recovery.
In the Week Prior to Your Myomectomy
It is impossible to overstate how important it is to spend the week or so before your procedure planning ahead and doing all the things you won't be able to do for the next 6 weeks. Clean as much you can (because vacuuming, stretching to reach high places, and even carrying laundry baskets will be impossible).
If your home has two levels, bring everything you'll need downstairs as climbing a flight of stairs multiple times per day is not the way to heal. Order pillows and cushions to prop yourself up since your abdominal muscles won't be able to support you for awhile. Also order easy-to-clean nightgowns (none of the fancy stuff!) and slip-proof socks to wear around the house.
Personally, I wish I'd ordered some of those mesh post-surgery knickers as well. They were wildly comfortable, especially as my myomectomy incision was too sensitive for even my usual cotton or bamboo briefs at first. Sidenote: whatever knickers you wear, make sure they're high-waisted. You don't want seams and waistbands irritating your cut.
Remember to buy and prepare food ahead of time. Meal prepping (or Seamless) will be your best friend. Also make sure if you're freezing meals to defrost at home later (especially if you'll be alone), that they don't weigh more than 5 pounds.
And keep in mind that even when you start to feel okay (which might be sooner than you think!), you'll still tire easily and won't have the endurance that that even basic meal prep and cooking often takes. Honestly, you might want to get some paper cups and plates as well because, once again, doing dishes means standing for most folks (please ignore this advice if it doesn't apply to you).
Take care to put your hair in a style that won’t require tending. I put my hair into cornrows because there wasn't time to get braids, but if you're a Black woman for whom braids (or other protective styles) is an option, I 100% recommend it. Washing, combing and styling my hair was the last thing on my mind. Honestly, I likely wouldn't have been able to do it even if I wanted to.
Finally, if you work, ensure that your time off is filed with the appropriate person and that any paperwork which needs to completed is done. In addition, if your spouse or partner is using taking time off of work, make sure their paperwork is filed as well. You likely won't have the physical strength or mental energy to do anything time-intensive or detailed for weeks after your procedure.
It's Surgery Day!
You've already heard this multiple times, but it's super important not eat or drink the night before the surgery. Your swallowing and coughing reflexes don't work if you're under anesthesia. That means if you happen to vomit, there's a possibility of it going into your airways and creating serious problems.
I did not have to have a bowel prep before my myomectomy (but I know a lot of people do). I was also told that I could have a glass of water until 4:00am, but I chose not to.
My surgery had a 7:30am start, which means I needed to be at the hospital by 6:00am. Wherever you live, keep traffic and travel distance in mind, and make sure you already have your route mapped out and your preferred mode of transportation established before the day of your operation.
In pre-op, the nurses started an IV for me, drew some blood, and changed me out of my street clothes into a hospital gown. I remember starting to feel a bit nervous, so they gave me some aromatherapy as well to help calm me down.
As I was waiting for my surgery time, all the doctors, nurses, and medical students who would be in the operating room during the time of my procedure came by to personally introduce themselves. This is the perfect opportunity to ask any remaining questions you might have, even if you’re worried they'll sound foolish. (For example, I kept asking if I would wake up during anesthesia; for some reason I was oddly fixated on this.)
In the hospital where my myomectomy was done, I walked under my own power to the operating theatre. Once, there, I laid down (I was strapped to the table, so you may want to expect this), and was introduced to everyone again. After that, the anesthesiologist told me that he was injecting with something that would make me a bit loopy. The last thing I remember is my surgeon telling me that everything would be fine.
The drop into anesthesia is shockingly sudden. One minute you're there and fully awake. The next minute, you're not. As this was my first surgery, I think I expected a sort of gradual drifting off, but it was like a light switch flipped. I was unconscious almost immediately.
The Recovery Room
Truth be told, I don’t remember much about this part of the day. I just remember being on a stretcher and being in massive amounts of pain.
The recovery room is where you're taken immediately after surgery to finish waking up from anesthesia and for the doctors and nurses to ensure you're okay immediately post-procedure. In my case, recovery only allowed 2 people in my space at a time, which is something to keep in mind if you're going to have more than two people with you.
Back to the pain...I remember being in so much pain, I couldn’t even articulate that it was pain. My brain almost couldn't process the level of pain I was feeling. Once the nurse realized how much pain I was in (and that the morphine drip was not compensating for it in a timely fashion), I was given a bolus (essentially a large dose of morphine) to knock out the pain so my actual morphine drip could start doing its job.
I was on my IV morphine drip for a day. With the drip, you press a button at set intervals to administer your own morphine. Don't try to tough it out. You want to stay ahead of the pain, so push that button as often as you need to. If it's too much (for example, your breathing gets depressed too often - which happened to me) your nurses will tell you and make the appropriate adjustments.
In addition to the morphine drip, I was also connected to various monitors (heart rate, breathing, etc.) and tubes (catheter, IV, etc). I was not connected to oxygen during my recovery as my O2 levels were fine, but I do know of other people who were.
You'll also be given what can best be described as compression sleeves for your legs. Mine were inflatable and inflated every few seconds or so to help prevent blood clots. It's not the most comfortable sensation, but in a veritable buffet of uncomfortable sensations, it's not that bad.
Oh! One more thing...morphine will make you itch like a fiend. No one told me that, but I practically wanted to scratch my skin off.
The First 3 Days After Surgery
The day after the myomectomy, my morphine drip and catheter were both removed. On that same day, I started opioid painkillers (by mouth), ibuprofen, acetaminophen, stool softeners, anti-nausea meds, and my own regular prescription medications (though I brought my prescriptions with me, I didn't use my own drugs; the hospital provided them from their pharmacy). I was still on saline IV, as well as a clear liquid diet (jello, broth, water, etc).
Those first couple of days are mostly a blur. I slept a lot, but there are frequent wakeups for vitals, blood draws, pills, pee checks (because they need to make sure your bladder is working), or just because someone’s come to check on you and make sure you’re all right. Your doctors should also be coming regularly to inspect your incision and general health and well-being.
In my hospital, nurses would come and introduce themselves at the beginning of each shift and also say goodbye at the end of each shift, so that was another wakeup. Fortunately, they're completely used to people being woozy and out of it, so don't feel like you need to be chipper and alert with each and every wakeup.
This is important! Take your anti-nausea meds and your stool softeners. Opioids can make you both sick to your stomach and constipated and neither is good for you. Another tip? Don’t be afraid to say when something isn’t working. The first anti-nausea medicine they gave me still had me retching into a trash can (not fun when your belly muscles have been sliced open).
My family advocated for me to receive something different and stronger, and after a very long nap, I woke up nausea-free and with an appetite again. Your family (or whoever happens to be with you) can and should be your strongest advocate, especially since you may not be able to speak for yourself.
Remember to move slowly and take advantage of assistance. The nurses will show you how to get in and out of bed and walk safely. You’ll likely need help getting in and out of bed, using the bathroom, showering, and all the other things you may have taken for granted pre-surgery. I know I did.
Once you’re in your room, the little comforting things you brought from home matter. I brought my favorite velvet caftan and I’m so glad I did. It kept me warm, and also covered me up when I was practicing walking in the hallways (PS: Walk as soon as possible. It’ll hurt, especially at first, but it helps more than it hurts). However, don't bring anything that you can't wash when you get home because hospitals have a lot of diseases (obviously).
Finally, you should know that laughing, coughing, and sneezing will make you feel like your stomach is being ripped open. A small pillow you can hold across your abdomen will help with, but not completely alleviate, the pain.
Once You Get Home
My myomectomy was on a Friday and I was discharged the Monday after once my doctors were confident everything - including my appetite, bladder, and bowels - were in good working order. For me, that was exactly the right amount of time. You can tell when being in the hospital is starting to hurt more than it helps, and I was right at that point when I was released.
Because I live in NYC, we caught a taxi to get back to our neighborhood. Let me tell you, the cab ride home was brutal. You will feel every bump, every piece of gravel, every pothole, ever sewer grate...all of it. Use that same pillow you held against your stomach while coughing to hold against your stomach on the car ride home. It helps.
Even if you happen to live in a city with public transit, I would not recommend taking that home if you're able to avoid it. You will be weak and tired and in pain. Getting home as soon as possible is the goal. By now, walking may not hurt as much, but stairs still will. I had to climb one step to get out of the taxi, and I cried.
Even if it's not far, just getting inside your home will probably exhaust you. That’s okay. Listen to your body and nap. In general, you may find that basic tasks wear you out even when you begin to feel "better." Eating is tiring. Bathing is tiring. Using the bathroom is tiring. Getting out of bed is tiring. Talking is tiring. Watching a movie is tiring. That’s all normal and fine.
Your body is doing the hard work of healing from major, invasive surgery. Sleep when you feel the need and don’t feel guilty about it. However, also remember to walk. Up and down a hallway in your home or just across the room is fine to start.
I slept on the couch my first couple of weeks (we have a modular couch that lets you rearrange the cushions). My husband purchased a memory foam topper topper to give added cushion and support and make it feel more like a bed. As far as pillows, I also purchased an armchair pillow and a leg wedge pillow. Both were necessities those first few weeks at home.
I was sent home with the same prescription medications I’d taken my last day in the hospital. For me, setting up a series of recurring alarms in my phone helped with staying on my pill schedule (remember: you want to stay ahead of your pain).
I kept everything on a easy-to-reach elevated tray by the couch: pills, phone, reading material, glasses, water...whatever I wanted to have on-hand. Small note: even though you might feel like a celebratory drink, keep in mind that opioids and alcohol don't mix.
Remember that your focus, your #1 priority post-surgery, is healing and that you only get one chance to do it properly. I felt much better than I anticipated sooner than I expected so I had to remind myself that my myomectomy was RECENT and it would be only too easy to have a setback through recklessness or carelessness. You don’t want to have a slip and fall or accidentally lift a heavy item and undo all your progress.
I didn’t wear binders or binding panties that first week (or any week since). I did request a bunch of mesh panties from the hospital, and I was so glad I did as I bled for about a week after my surgery. Once the mesh panties ran out, I wore my own high-waisted ones (made from natural fibers).
Again, remember that your body is traumatized and even though some things will feel painful and super sensitive, other things may feel numb or desensitized. For example, I couldn’t sense urgency in my bladder for several days, which means I couldn't feel when my bladder was full. Once I realized that, I set reminders in my phone of when to go pee. There’s no shame in doing what you need to do.
After the First Week
Surprisingly, after my first week at home, I felt much more like myself. A weaker, slower, version of myself that was afraid of stairs, coughing, and laughing, but still like myself. I could already see the swelling start to go down, and my body felt like it was my own again.
I was terrified of having a myomectomy, but once I got over those rough first few days, I was happy. I had 21 fibroids in my uterus, and now they were gone. I’d made it. Every week after the first one just got better and better.
Still, give yourself time to return to your regular level of activity. Celebrate your small accomplishments. Walking a hundred feet down the street is a big deal after surgery. Walking a block is a big deal. Taking that first flight of stairs on your own is a big deal. These are all major milestones. Try not to get frustrated by your short-term limitations.
Your incision will still be very sensitive. For me, that meant pants were not an option. Once I was confident I wasn't bleeding anymore, I wore my Catherine D'Lish nightgowns around the house. They were incredibly soft and soothing against the skin (while also making me feel a little bit cute).
I would never presume to speak for anyone else and their recovery, and as someone who is not a medical professional, I am in no position to give medical advice. I am only sharing my own personal experiences. But I hope this post helps make that first week a little easier to understand and to perhaps know what to expect.
Have you had a myomectomy? What would you recommend for people facing this surgery?