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pteroducktyll · 9 months

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FtM Hysto Recovery + Tips (Plus general tips for dealing with low/no spoons or recovering from any surgery)

I haven't been on Tumblr for years, but recently re-joined to check out art, as I start to work on getting my idea for a graphic novel off the ground (as well as getting serious about improving my art again). However, I'm hoping these first few posts get found by an entirely different audience. This is being written in 2023.

I'm going in for a laparoscopic hysterectomy on Thursday (today is Monday) and want to share my experience, as much as spoons will allow, so that other people can hopefully benefit in the future. I, personally, have struggled to find things online that fit my situation as a trans man with a history of pre-cancerous pap smears, abnormal bleeding, PID and ovarian cysts (but not PCOS). Although hysterectomies for "GRS" or gender affirming surgery purposes are easy to get where I live, mine in particular is primarily being done to avoid cancer and to stop the abnormal bleeding and random debilitating pain that comes out of nowhere every few years and upends my life for weeks/months. So if you're someone facing the prospect of a laparoscopic hysterectomy, regardless of your gender identity, and have a history of medical issues (but not PCOS or endometriosis) in your reproductive region, this blog may help you! Or, alternatively, if you're a trans man looking to get a laparoscopic hysterectomy, whether or not you've had issues in that region, this might help you, too!

It should be noted that this is written from the perspective of someone in their 30s with a complicated medical history, including Type 2 Diabetes and a very rare kidney disease (which has an average life expectancy of 29 years for men, but we aren't sure how it affects trans men), so the pre-surgery process I've been through is not the typical one. I also have chronic pain and know from my past experiences with very severe pain that a) I have a low tolerance for any pain beyond what I deal with day-to-day and b) I have a high tolerance for opiate pain medication, which means it takes a higher dose for me to address the level of pain that a lower dose would address in someone else. These both affect the length of time that I'll likely need to be on painkillers, and how functional I'll be while I'm on them. This, in turn, affects how quickly I'll be able to do things like return to work and driving.

I should also note that although it's common in some places for this surgery to be completed as day surgery, my jurisdiction almost always keeps people in overnight; this is because it takes almost 24 hours for the anesthetic to work its way out of your system, and until it does they won't have a true indication of your pain levels and, therefore, won't be able to make sure it's adequately controlled before sending you home. It's much easier (in my experience, and according to the doctors!) to stop you from having pain in the first place than to get it under control once you do.

Also, I live with my partner and a roommate, and my retired parents are about 90 minutes away and have a guest room. My support network isn't huge, but it's high quality. My partner managed to get 3 days off work for my surgery and the 2 days following, and after that is on a light workload for about a week in case she needs to take care of me. She also has a lot of flexibility with her job, and her boss really likes me, so if there are complications or she needs to spend more time at home to look after me, I don't think it's completely out of the question. All of this is to say that I'm going into this surgery from a very privileged place, in terms of not having to do much to look after myself in the aftermath. My surgeon did advise me, however, to take 1 week (for sure) off work if I could, and that I may need a second week. My work consists of two research jobs that draw heavily on my brain power, but don't require me to move around at all, especially as I work from home, so the issue is the painkillers, rather than actual healing time. Other jobs will require different amounts of time off work.

Because I'm neurodivergent and like to have as many details as possible about ... literally everything, I'm going to make this as detailed as I can. Essentially, I'm hoping to share everything I know and experience without leaving anything out. If it's too much detail for you, I'm going to be doing my best to include useful headers.

Notification of Surgery & Lead-up

I received notice about my surgery just over a month before my surgery date; it was around June 26th that I was emailed and told my surgery would be on August 3rd. I had previously met my surgeon in January, and was told it would be a 6-8 month wait until surgery. Between that appointment and being given my surgery date, I'd had bloodwork done, as well as an internal ultrasound. I've had several internal ultrasounds before and while they are far from pleasant, they are not as dysphoria-inducing for me as they are for other trans men, I'm sure. I am more physically uncomfortable during them than mentally/spiritually uncomfortable.

In the notification email, my surgeon sent additional attachments; about 200 pages of information from a) their office specifically and b) the health authority [one document about hysterectomies, one document about recovering from surgery in general]. These documents answered most of my questions, and also had instructions about fasting, pre-surgery instructions (there's a special sponge I have to buy and use the night before surgery and the morning of surgery) and recovery information. The documents were very generic, and because they came from different sources, the information was sometimes contradictory. I, personally, took the information on board in this order of trustworthiness:

Things my surgeon had said in-person during my consultation appointment in January

Things included in the information from my surgeon's office directly

Things included in the documents from the health authority

If there were contradictions that seemed extremely important (e.g. one document said to wash everything my face with the special sponges, while another said, in all caps, to absolutely NOT wash my head or face with the sponges), I followed-up with the surgeon's office or the most appropriate person (e.g. pharmacist).

Pre-surgery Appointments

Because of my medical history (diabetes and Alport's Syndrome), I had an extra step in here. My surgeon required me to have a consultation with my internal medicine doctor's clinic (but not with my specialist) to get the all-clear and make sure my risk level wasn't too high. This doctor made some assumptions about the medications I'm taking, which led him to think I had both diabetes and a heart condition, which would have put me in a much higher risk category. Because of that, he ordered extra bloodwork, and an ECG, and booked a follow-up with me for a few days later. That initial appointment with him ended on the assumption that the surgery likely would be postponed. However, the bloodwork and ECG all came back fine, and at the follow-up he gave me the all-clear and said my risk wasn't very high at all.

I had a few other pre-surgery appointments.

One was with the surgeon. In my case, the doctor actually doing my surgery is a resident colleague of the surgeon I initially consulted with. Now that I had a specific date for the surgery, and my life situation had changed a bit since the consultation (e.g. work), I asked to meet with the surgeon to ask questions that had come up since the initial consultation, and so that I could meet the person who would be cutting into me and make sure I was comfortable with her. She answered all my questions really well, and it turned out I was more comfortable with her than the original surgeon. This was a quick 5-10 minute talk, but I highly recommend asking for it, even if your surgeon hasn't changed. You'll have another chance to talk to your surgery just before being wheeled into the OR, but you'll be nervous and may be medicated by then, and it's just nice to have this conversation ahead of time and in an environment where you can look at a list of questions you've written down, and actually pay attention to the answers.

The hospital required another two appointments before surgery:

The pharmacist

About a week before my surgery, the pharmacist called for 5-10 minutes to discuss my current medications, supplements, vitamins and holistic medicines (if I were taking any) and to find out what time of day I take them at. Easy peasy.

2. The anesthetist

Exactly a week before my surgery, the anesthetist called to discuss the operation itself and the anesthetic. I'm not sure if the doctor I talked to will be the anesthetist who is actually in the room with me, or if it was just her job that particular day to call and get the information that will get passed onto the one who will be in the room. She was very nice, and explained the method of anesthesia, as well as how I'll likely feel when I wake up, etc. She also saw on my chart that I have a history of chronic pain, and zeroed in on my back and shoulder. She asked if there are any positions that make me more comfortable, and then explained the position I'd be in for my surgery -- tipped back toward my head -- and that this sometimes gives people back and shoulder pain even if they don't have any to begin with. She said my arms would be alongside my body, fairly tight to it, and I said that would be fine. I practiced laying them beside my body later that day and promptly discovered that's actually pretty painful for one arm, but I'll mention that when I get there and hope for the best! If I was having the conversation again, I'd answer by saying I wasn't sure how that would feel but that I'd practice it before the surgery day to see, and then ask who I could talk to if it turned out there's a better position or if that one wouldn't work. Ultimately though, the surgery should be 1.5 hours to 4 hours at most, so I'm not overly concerned. What you should take away from this if you're having this surgery and don't already have back/shoulder pain is that you might wake up with some, but that it should go away in a day or maybe a little less. This type of surgery also requires the surgeon to inflate your belly with gas in order to make room for the scopes and so that they can see what they're doing. That gas can stick around for a day, sometimes two, according to the anesthetist and can be a little bit painful or uncomfortable. I can't remember anything else that came out of this conversation.

In terms of pre-surgery appointments, that was it.

Tips and Tricks for Being Prepared

The next little bit is information I acquired through talking to my therapist (who's had several laparoscopic surgeries!) and many hours of research online, as well as living as a person who often has few spoons.

Get your first 1-2 weeks of meals planned and ready in advance. For me, this means I've picked up a large number of cans of Alphaghetti-type foods, and I'll be buying as many frozen meals as I can but have VERY little freezer room because my partner and I share with our tenant. Other options include things like HelloFresh, identifying nights when it will be easier for your partner if you order food in (if you can afford to), making big batches of food leading up to surgery while you're well and then freezing them, creating a list of meals you'd appreciate friends bringing over [remind them to bring them in disposable containers, so you don't have to feel guilty when it takes you weeks to get the containers back to them!], etc

Buy some Depends/adult diapers. I bought store brand (Life brand, specifically, which is Canadian) ones. The only ones I could get were maximum absorbency unless I wanted to pay twice the price for name brand ones, but I suspect I could do with a minimum absorbency one. I bought the underwear-style ones. In the store brand, they don't look very underwear-like at all, but if you have more money to spend, some of the name brand ones look convincingly like underwear! I also bought 'Unisex' ones, but would have bought womens if the unisex ones weren't an option; I suspect the mens' might have a built-in bulge area that would be awkward for me. The point of the adult diapers is that their 'waistband' is not a traditional waistband -- it's about 8" tall, very thin, and crinkle-cut so that it doesn't put pressure on your skin. This will stop you from having clothing pushing on your incision sites. BONUS is that they ARE absorbent, so you won't have to also wear pads to deal with discharge (which can, apparently, last for 6 weeks). Try the Depends on for a day a few days before surgery. Yes, it will be awkward and you'll feel silly. I am literally sitting in bed, with nothing wrong with me, wearing nothing but an adult diaper and a tee shirt while my partner's at work. But this has 2 purposes: 1) chances are you haven't worn these before, and you want to make sure you've got the most comfortable ones you can in terms of fit and style; 2) if you've worn them once already, it'll be familiar when you go to put it on when you're ready to leave the hospital; you'll know which side is the back and which side is the front, and the 'weirdness' of wearing them will be less unsettling. You're going to have other weird stuff going on, this doesn't have to be yet another weird thing happening!

If you live alone or your partner doesn't (or can't) change the sheets, layer sheets on the bed. That's right, layer your mattress with bottom sheets. That way, you can peel the top one off and have a cleaner sheet beneath it. It won't be the same as being able to sleep on a fresh, clean sheet straight out of the cupboard or dryer, but it's going to be better than the one you've slept, sweat or, universe forbid, bled on.

Get a LEAKPROOF (truly) travel mug with a handle. After surgery you'll have maybe one comfortable position to lay in. You're not going to want to get out of that position to retrieve your water, but you're also going to need to be drinking a lot of water (it helps you recover, and also helps get your bowels moving again). Being able to lose your water in the bed is a luxury, but a necessary one. I got mine at Winners for pretty cheap.

Get a nightie or onesie. I usually sleep naked. I don't really own pyjamas -- when I need to cover up to sleep (like when I visit friends or travel), I throw on a pair of joggers, or boxer briefs. But those both have waistbands and, remember, we're trying to avoid waistbands. I ordered a sleep shirt from Oodie, which was on sale, but still expensive (I paid around $60, including 1-2 business day shipping because I didn't think of it until the last minute), as well as a halloween one-sie from Old Navy that's apparently leftover from last year's halloween stock. I'm expecting the onesie to be way too hot, but I need something I can wear out in public in case I have to get groceries, or pick something up at the pharmacy, or stand outside because the building's burning, without exposing myself. I also borrowed a robe to go over the sleep shirt when I leave the hospital.

Have whoever's picking you up bring 2 pillows. One goes between your abdomen and the seatbelt, and you sit on the other one.

Have whoever's picking you up bring fast food. When you leave the hospital you're going to either be ravenously hungry or feel like you never want to eat again. Either way, fast food is going to be the one thing you didn't realize you needed so badly in your life until that moment. Your body's going to be craving carbs and fat, and fat is also what's going to help your pain pills kick in.

Have ice cream, chips or other junk food on hand. This is mostly so that you have something to eat when you take your pain pills. Fatty foods help opiates work faster; as someone who takes them several times a month for chronic pain, I've sometimes noticed a difference of -hours- between taking them with fatty foods and taking them on their own.

Get a walking aid. We use our abdomens for everything. If you don't already have something like a cane, pick one up. Keep the receipt though; if you don't end up using it, you can usually take them back. With that said, my therapist said it's at about the 2 week mark when you feel like you actually need one. If you don't have a cane but you have walking/hiking sticks, dig them out and keep them handy.

Grab some baby wipes. You can get laparoscopic incisions wet, but that doesn't mean you're going to feel like you have the energy or endurance to shower right away. You're still going to want to keep your pits and bits clean.

If you take daily medications, organize them in a pill organizer. Things can get confusing when you're on painkillers, or when a partner is dishing out your meds. You know exactly how many you take, and how often, so the best way to approach this is to get a pill organizer and get all your doses for a week ready before your surgery. Monday AM, Monday PM, Tuesday AM, Tuesday PM, that kind of thing. There's nothing worse than being on painkillers and trying to remember if you've already taken That Very Important Medication You Can't Miss or not. Or, worse, not even realizing you've missed something that can give you withdrawal symptoms, and suddenly waking up a few days after surgery feeling worse than you've ever felt in your life and wondering if you need to go to the ER, only to have it turn out that you missed your meds.

Buy something for yourself that you can look forward to. I bought a video game that I've wanted for a couple of years that was finally on sale. I haven't touched it, and won't until sometime after surgery when I feel up to it. Giving yourself a little reward when you're going through something hard is always nice.

If you're diabetic...take a minute before your surgery to remind your partner/anyone you live with/anyone who's going to be looking after you about how and when to check your blood sugars, what numbers are abnormal for you, and what to do about them. Being ill or recovering from a surgery can really throw your diabetes out of whack, even if it's well-controlled beforehand, and recovering from surgery might make you feel a lot of the same symptoms you'd feel from a hypo/hyper or DKA, so make sure you (or someone else) test your sugars regularly and have things on hand to deal with abnormal or worrying results.

Take your phone everywhere. Painkillers (and pain) can make us unsteady. As someone who's taken a fall and had to wait hours for my partner to wake up and find me and help me back to my feet (and then bed), I don't recommend it.

These are the things I know about pre-surgery, but I'll try to update...eventually if I learn anything new post-surgery.

#transmasc #trans guy #trans man #transmasculine #ftm trans #surgery #medical stuff #hysto #hysterectomy #disability

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