Part Two: Major Surgery & the Swimmer

Last week’s post detailed the symptoms and the non-invasive treatments that I tried before deciding to have a hysterectomy. Today’s post, part two of a three-part series, covers what I experienced pre-op and those first few months post op, and how I was affected as a competitive swimmer.

Disclosure: This may be icky reading for men or kids!

Before surgery could be scheduled, a few tests had to be performed. Each would check for possible conditions that might explain my symptoms, and if positive, may require treatment beyond surgery:

Ultrasound: Fibroids, some quite large, were seen. This could explain much of the heavy bleeding.

Uterine and cervical biopsies: These were done to rule out cancer. Thankfully I was negative on both counts.

Blood tests: A thyroid problem was eliminated. While borderline anemic (monthly heavy blood loss over the past few years was taking a toll), I was deemed healthy enough to undergo surgery without prior treatment.

The most peculiar part of preparing for surgery was not knowing exactly what was wrong, and thus attempting to make the best pre-op decisions to hopefully cover all potential situations while in surgery. We knew fibroids were part of the problem—removing the uterus and thus all fibroids would certainly eliminate heavy bleeding. But fibroids didn’t explain the shattering pain I was experiencing. My doctor suspected endometriosis (uterine tissue spreads beyond and outside of the uterus and sheds blood each month) or adenomyosis (uterine inner-lining tissue migrates into the muscle of the organ) as both would explain the pain and a heavier than average blood flow, but she wouldn’t know for sure until she was inside and could see.

Beyond selecting da Vinci assisted surgery (a robot-aided method that offers greater precision with fewer small incisions and thus a much quicker recovery phase), I wanted to go through menopause on my own steam if possible. So we came up with the following plan: Remove anything disease-riddled that I didn’t need, but leave anything that was healthy (hopefully this would be at least one ovary because removing both would force me into early, artificial menopause and hormone replacement, a very tricky treatment to get “right” for your own body.)

The most unsettling part of my pre-op planning was scheduling a major procedure without having any idea of cost or insurance coverage. Occurring at the peak of ObamaCare billing changes, no one (either insurance or hospital reps) knew how my surgery would be billed. I was quoted a range between $2,000-20,000—a stressful element prior to being admitted.

Luckily, everything else about my surgery went better than “smooth.” I was even called in a few hours ahead of my original admitting time because my surgical team was ahead of schedule that day. Going in during the morning instead of the afternoon was really helpful as I was already feeling tired and dehydrated from the “no food or liquids” restriction that began at 6 p.m. the evening prior, and my anxious, “waiting around” time was reduced.

My entire team was unfailing kind, thoughtful, considerate, professional and reassuring at every stage. For example, I’d never been in a hospital before, and due to my allergies, I was most afraid of reacting to the anesthesia. But my anesthesiologist said that he had carefully reviewed my chart (it was flagged for allergies) and that he would sit behind my head to monitor me through the entire procedure. I also love how my team, knowing that I was a swimmer, saw my suit tan lines and elected to make incisions below my tankini line to prevent visible scarring for ensuing seasons!

Two and half hours later I was through, and without complications. Afterwards, my team kept telling me how wonderful my swimmer body did, with my heart rate never blipping over 60bpm. Diagnosis? All three conditions—fibroids (inside and outside of the uterus), endometriosis, and adenomyosis. As such, just about everything was removed—uterus, cervix, fallopian tubes, and one ovary. I reacted to only thing throughout, the latex tape used to hold all my tubes in place. (Since then I haven’t been able to tolerate latex, so I’ve gone all silicone per goggles and caps.)

My anesthesiologist did his job well because I only remember answering a few questions about swimming while on the OR table, then nothing until waking up in the recovery room. After being helped to a huge armchair, I promptly curled up in it like a cat and slept. My nurse was charmed, she said she’d never seen any one do this, but I was small enough to, and for whatever reason it was the most comfortable position for me at the that time.

During my pre-op prep planning appointments, I was offered the option of going home same-day if they were no complications. Day of, although pretty out of it, I still wanted to go home as I knew I’d sleep better there than in the hospital.

Not staying overnight was still the right decision for me even though the walk from the car to my front door was easily the worst physical challenge of the entire procedure. At the time, I lived in the far corner on the second floor of a very large building. My pre-op walking exit time was at least ten minutes; post op there were just too many corridors and turns—three halls still to go I was down on my hands and knees throwing up. Yep, pretty embarrassing. But, with only bile and water in my stomach, I was back to toddling to my door within a few minutes.

Probably because my pelvis was so riddled with painkillers, my second worst physical event during the first 24 hours post op was a raging sore throat from breathing tube insertion/removal. I sucked on ice chips constantly. This did not help reduce my bathroom frequency (they pump you full of fluids before and during surgery. I had to go the bathroom every freakin’ 60 minutes that first night.) While I ran a 101 fever that first night (I subsequently learned this was actually good—my immune system was kicking into high gear), I was back to 98.6 by morning.

My sister warned me to not only write out a painkiller schedule (brain fog!) in advance, but also to stay on it because one could quickly reach an “intolerable” pain level those first few weeks if you fell a bit behind on doses. I was prescribed a crazy amount (well, to me) of painkillers, but I only used the massive-dose (600mg) Ibuprofen tablets three times a day.

Truly, my physical recovery during the two months of restrictions went well. I had no complications. My right incision took longer than my left to heal, but as it was the entry/exit incision, this was typical. I was up and walking day one, and increased my time slightly each day. I was allowed to drive, take the stairs, ride a stationary bike and jog very lightly after four weeks. My pain level was close to 100% manageable.

One of my biggest physical issues was fatigue (I slept A LOT. As in, out like light by 8 p.m. every night. And that was after a daily two-hour afternoon nap… And I had many days when I was utterly wiped out.) Certain movements were very uncomfortable for months as well, such as twisting my torso, crossing my feet/legs and wearing a seatbelt. In many ways, however, recovery was easier than living with the symptoms—while I faced some serious physical limitations right after surgery, I could sense that I felt so much better underneath now that the crazy, exhausting, painful cycle had stopped.

My mental/emotional recovery was a bit rockier. Before surgery, I assumed I’d have all this extra free time to catch up on reading, TV, desk tasks, and more. Yet, pretty bad brain fog made it difficult for me to focus on anything beyond the lightest of reading/viewing material. And then there was the lack of swimming. Not being outside every day and competing during my favorite season, long course meters, was very tough. I definitely had some very bad phases, including my lowest point one morning when I was so out of sorts that I went back to bed for the day after being up for only a half hour and cried.

Once cleared to swim after two months, I started with an easy, mixed back/free 1,000 every other day for about two-three weeks. My typical, daily pre-op total was between 4,000-5,000; now just a 1,000 was exhausting. And, I had to use the ladder to get out of the pool for the first three months because my core was weak, weak, weak.

“Streamlining,” always a weakness for me before surgery was now a joke. I couldn’t really activate or control my core those first few post-op months, so pelvic tilting on turns wasn’t happening—I felt like a big, ungainly, slow blob off the walls. Also, I felt a lot of pulling on both sides of my pelvis while swimming all four strokes. Not a painful sensation, just a constant restrictive tugging.

While it was exhilarating to be back in the pool those first few months, I also veered into depression because I was comparing then/now too much. Prior to surgery I did 200 fly sets; now I could barely do a 25 fly. I felt winded in the pool all the time even though I added anywhere from 30-60 seconds to all intervals. I had to greatly reduce yardage, both set amount and per day. I definitely over did it at first. I paid for that by catching more colds and viruses that fall-winter than normal.

And, I had another set back—another two weeks out of the water only a month after being cleared to swim, while I had stitches in my back. During my annual skin screen that September, a suspicious patch was removed. Luckily, it was benign, but it was incredibly frustrating to be “grounded” again so soon after getting back in the water.

As for weights, although I was cleared to lift light (5-15 pounds) two months post-op, weights and swimming proved to be too much during those first few post op months. My first goal was to get back to more of a norm for me in the pool—daily swims between 3,000-4,000. After that, and only when I had energy to spare, would I add weights.

Three months post-op, I still had a long way to go, both in basic recovery and in the pool. But even at my rockiest both physically and mentally, I never second-guessed having surgery, not for a second. For one, it was easier building back than continuing indefinitely on the downward spiral I had been experiencing leading up to surgery. Second, I knew that while I had a lot going on at the moment, I also was starting to have flickers, just a few strokes at a time, of feeling good—better than I had in years—in the pool, which gave me confidence that I would fully recover, and maybe even come back stronger.

Next week: Part Three: Major Surgery & the Swimmer One Year Later

Next week: Part Three: One Year Later

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Part Two: Major Surgery & the Swimmer

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