Things I didn’t know about fibroid surgery… until I had it

Fibroid header (1)

Open surgery is like giving birth

Or undergoing a C-section, depending on who you ask. In my case, removing my fibroids is very similar to having undergone a C-section. The wounds are pretty much in the same place, so my dietary needs and recovery times are very similar. If you come from a background where post-delivery confinement practices are a thing, then yes, this is where I am at now.

Both my mom and my mom-in-law insisted I wear sarongs at least for the first two weeks to prevent wound irritation, and both keep reminding me to move slowly so I wouldn’t aggravate the wound. In fact even the nurse at the checkup yesterday reminded me to get up and sit down slowly (as you can tell, I kinda fail at this).

 

Your innards will literally change positions

Due to the size of my fibroids, my bladder, uterus and various other organs were pushed very far upwards in my body. The removal of the fibroids (10 removed of various sizes! With one left behind because it was too deep in!) has resulted in these organs slowly moving back downwards and otherwise towards where they should be.

Emptying my bladder the first one week plus after the surgery resulting in some massive temporary crampings (which I still get now and then). According to my doctor, this is normal as my bladder is learning that it can completely empty itself instead of always “holding back some urine” which was something I did not realise was abnormal.

 

Lack of appetite within the first few days is normal

One of the most common things that can happen after abdominal surgery of most kinds is that your small and large intestine stop working for a short while. This is one of the reasons why my doctor was “waiting” for me to pass gas – the expulsion of air meant that my bowels were working.

In my case though, a mix of post-operative ileus and lactose intolerance actually stymied my bowel movements for a few days. At one point I even threw up, and it was at that stage my doc realised that while my large intestine was moving, my small intestine was not. He recommended I chew sugar-free chewing gum to trick my body into thinking that food was coming.

This worked, up to a point. By the end of the second day I could take water and some liquid foods. Also I was sick of chewing gum. I still have the second bottle of sugar-free gum staring at me as I write this.

 

Being grateful for bowel movements

Until I could not go, I didn’t really appreciate my bowel movements. Let’s just say that I’m glad it’s regular now.

 

Probiotics may be issued at the end of your hospital stay

Remember what I mentioned about the gut not quite working? In my case my doctor gave me probiotics to be taken after I leave the hospital, as my doc didn’t want to take the chance of me getting complications from introducing gut bacteria while I was in the hospital. This is actually a pretty important step as abdominal surgery can wipe out your gut bacteria due to antibiotics.

 

Massive exhaustion the first few weeks is normal!

Your body will be redirecting your food intake and nutrition towards healing the wound, so expect to feel massively sleepy the first few weeks. In my case, there is a literal difference between having and not having coffee on a daily basis. On days when I have coffee, I can usually stay awake for up to 5-6 hours straight. Otherwise I’d need to go in for a nap every few hours.

 

The back story:

So for those who don’t know, I was hospitalised back in July for my small mango. After three months on a GnRHA (aka Zoladex), I went back in about two weeks ago after Deepavali for the surgery to remove my fibroids.

First, the good news. When I went on Zoladex (it’s what I’m referring to, easier to type compared to GnRHA), I was also advised to avoid soy and factory chicken (think KFC) as these encouraged higher estrogen hormone level productions (from what I understood).

The treatment seemed to have worked, because the biggest fibroid went from 12.5 x 8.6 x 7.3 cm to 9 x 6 x 4.5cm. It may not look like much, but when you consider that the fibroids have been with me for years, the reduction is insane. Reducing the size of the fibroids meant that I would be a better candidate for keyhole surgery, which comes with much faster recovery periods.

However, due to the positioning of the fibroids, my doc decided to switch from laparascopic to open surgery during the procedure. This was due mainly because some of the fibroids were directly up against my organs – removing the fibroids via keyhole could damage said organs.

My hospital stay got extended due to stomach issues mentioned above. Having some Milo (with milk) triggered sensitivity in my bowels I did not know was possible, which ended with me throwing up whatever little food I had and then some.

On a good note, this gave my doctor the clue he needed to resolve my food issues, so while I was put on fasting, I was still on the IV drip to prevent dehydration.

Oddly enough, my IV hand was switched from my right to the left during my recovery period in the hospital (this was not as unexpected or bad as it sounds, it was just surprising).

What was odd about it was that I developed superficial thrombophlebitis two days AFTER the IV was removed. It manifested as a swelling on the back of my right hand that found relief with a cold compress. A week after leaving the hospital and many applications of Fucidin later, and it’s almost all gone. In fact the spot tends to itch now. Huh.

 

FAQ about fibroids

Note: there’s a gory photo of my fibroids laid out in a row in this section, which is why it’s hidden under a cut. 

While writing this piece, I asked friends and colleagues whether they had any questions about the surgery, and most of it boiled down to:

 

What causes fibroids?

In most cases, it’s a luck-of-the-draw thing. There seems to be no real trigger as to why some women get fibroids and others don’t, but it does seem like if your family has a history of fibroids you may also develop fibroids. Some papers (such as those quoted by Mayo Clinic) indicate that a variety of factors that can lead to fibroid development.

 

What are the symptoms of fibroids?

This one is a little hard to answer. For some women, fibroids make themselves known through painful periods, while others, like me, have no symptoms at all for the most part. In my case, the fibroids made themselves known when they outgrew the blood supply in my uterus and caused massive abdominal pains.

Sometimes fibroids go together with another common female condition called Polycystic Ovarian Syndrome. If you are planning to get pregnant and have painful periods, it may be a good idea to see a gynae and see if fibroids and PCOS may cause fertility issues.

 

What ARE fibroids?

They are benign tumours that comprise of muscle and blood vessels. As you can see in the pic below, they can also turn out to be pretty solid things.
Fibroids (1)

Is surgery the only way to remove it?

This again, depends on your own case. Some people, I have been told, have small enough fibroids that a hormonal treatment, diet changes and follow up checks are enough to make them disappear. For cases like mine, yes, surgery is the way to remove current fibroids, because yes, those bastards can come back in a couple of years (usually within 7 years which is where the diet change comes in).

 

Are there any permanent side effects?

This is something I should have asked the doctor but I kinda forgot. However, one of my friends also went for fibroid surgery when she was younger. In fact, her procedure was very similar to mine – started with keyhole surgery and then switched to open.

This left her with diastasis rectis, a condition where there’s a gap between your tummy muscles. It can manifest as a permanent belly pouch that doesn’t go away. There is a very good chance that I will also get this, as I’ve felt the empty space but I’m waiting for my wounds to heal completely before I do the exercise to check.

Fun thing: crunches can actually aggravate this condition, so avoid doing them to close the gap.

The other thing is that I’m on a slightly less restricted diet compared to the last three months. When I was on Zoladex, I was told to avoid soy and factory chicken completely. Now that the surgery is over, I can have the occasional soy and KFC noms, but not very often.

What can I eat?

Remember I said that it was like post-delivery confinement foods? For the most part I can eat a lot of things, but some of the foods I have been told to avoid include: 

  • No seafood for three months 
  • No pork bone-based broth and soups (pork cooked in chicken broth is ok, just no pork-based stock, which also means no BKT for a while sobs) 
  • No duck meat (which I love but rarely take because FINDING GOOD ONES ARE DAMN HARD – apparently it will make my wound itch) 
  • No lotus roots (also for three months)
  • Also weirdly, during the initial post-surgery week, no ham choy or salted vege soup 

I’ve been re-introducing coffee as mentioned into my diet slowly, and it’s turning out quite ok. Next thing to try is full dairy aka probably a cup of fresh milk. 

With all said and done, I’m thankful the procedure went smoothly. It’s mainly recovery now with some Nanowrimo thrown in. PS: thank you for reading my wall of text!

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