Those of you who know me know that I (unfortunately) spend most of my time on The Mary Dell Show discussing my various chronic illnesses (neurogenerative disease, liver disease, heart disease, ad nauseum). Today, however, I want to discuss a slightly more acute situation--surgery.
Last Thursday I had a laporascopic hysterectomy during which my uterus was yanked out through my vagina.
"Laporascopic" surgery is a less invasive surgery than the old cut-'em-up hysterectomies. My doctor explained that I'd have two small incisions in my abdomen through which the ovaries would be removed, and the rest of the kit and caboodle would be, as I said, yanked out from below.
"Do you have any questions?" Dr. V asked.
I didn't have any questions. I'm a medical librarian, and in my hubris I thought, "I've got this."
I'd already done the de rigeur quick overview on the procedure on one of my trusted sites for overall medical information written for the patient (listed at the end of this article). I'd heard a lot about laporascopic surgery while working at a non-profit health education agency over the years, and I never heard much or anything about post-surgical pain.
Here, now, is a real-life example of how reading or hearing about something does not necessarily prepare one for an experience like this.
I'd figured with the minimal cutting involved, this hysterectomy wouldn't be nuthin'.
I was wrong.
Don't get me wrong; I've no doubt this new, less invasive surgery is light years better than the old way.
But it ain't nuthin'.
Neither the doctor nor several nurses I saw told me about a couple of possible issues that might follow the surgery. On Day Two, my shoulder started to hurt like a muv, as my brother used to say when we were kids. Later that day, my rib cage was so tender it hurt to breathe. The pain was worse on my right side, and I wasn't sure whether it might also concern my liver, since I do have chronic liver disease.
Okay, then, back to the Web--a quick and dirty Google search: "laporascopic hysterectomy rib pain."
Bam.
Common side effect of abdominal laporascopic surgery, I'd learn. What the doctor didn't mention, and I hadn't picked up on in my reading, is that the body is pumped full of carbon dioxide (CO2) after the patient is put under. This gives the surgeon more room to get to the target organs without nicking anything else in the process, since the CO2 blows up the abdomen something like a balloon and spreads the innards apart.
Apparently, some post-surgical procedures are done to suck as much of the CO2 out of you as possible, but they don't get it all. And it sits there in your abdomen and starts making your body hurt in fairly predictable ways.
I actually did track down patient information from one clinic that mentions the potential for chest, shoulder, and abdominal pain after a laporascopic hysterectomy.
I wonder why, in my case, neither the doctor nor the nurses mentioned this possibility. What if I hadn't felt comfortable doing a quick Google search to find out why it was happening? Couldn't that pain and difficulty breathing been frightening for someone with heart disease? I mean, I have heart disease (cardiomyopathy), but mine is very mild. Still, it's disconcerting when one can't breathe.
Perhaps the health care professionals, in all their wisdom, don't want to put ideas in a patient's head, thinking that if they don't know it's a possibility they won't feel it. Well, that's bogus. I didn't know, and I definitely felt it.
It just amazes me at this point in health care that something so frequent that it's nearly to expected is not mentioned in the patient education done before a routine but serious surgical procedure.
Other than that, I can't really complain about the care I got, though I hesitated to go to the hospital in the small Appalachian city near my home. A friend had recently had a botched surgery to fix a hernia there, and other patient stories abound about the place's quality, or lack thereof.
In the end, though, I opted to stay local. In my next episode, I will discuss the factors leading up to that decision when you're Down the Rabbit Hole in today's health care system.
By the way, it's now Day Six after the surgery. The shoulder pain lasted only one day; the under-ribs pain ended after Day Four; and now I just have a sort of ache or cramp in my lower abdomen. The pain pills take care of that, but I don't feel like dancing a jig, I can tell you that.
I'm still amazed there isn't more patient education on the pain to expect after a laporascopic hysterectomy. This pain is acknowledged in the medical litereature (for doctors), but I haven't found anything about it in the patient education materials online.
Yet the fact that it's real can be attested to by the numerous patient forums in which this problem is discussed. This is just one more example about how the patient comes last in today's health care. Patients are left to find this information out from other patients--not necessarily the most informed source.
With all the talk about patient-centered care, this should NOT be the case, but that's the problem right there: it's all talk; "patient-centered care" means little to nothing in the actual delivery and reception of health care except in the individuals who inherently bring this orientation to their delivery of care. Many times, these individuals are nurses, but some doctors also show this trait. What's clear is that it isn't something the entire system focuses on to any real degree.
But you'd think they'd come up with complete patient care information for something as routine as a laporascopic hysterectomy.
Last Thursday I had a laporascopic hysterectomy during which my uterus was yanked out through my vagina.
"Laporascopic" surgery is a less invasive surgery than the old cut-'em-up hysterectomies. My doctor explained that I'd have two small incisions in my abdomen through which the ovaries would be removed, and the rest of the kit and caboodle would be, as I said, yanked out from below.
"Do you have any questions?" Dr. V asked.
I didn't have any questions. I'm a medical librarian, and in my hubris I thought, "I've got this."
I'd already done the de rigeur quick overview on the procedure on one of my trusted sites for overall medical information written for the patient (listed at the end of this article). I'd heard a lot about laporascopic surgery while working at a non-profit health education agency over the years, and I never heard much or anything about post-surgical pain.
Here, now, is a real-life example of how reading or hearing about something does not necessarily prepare one for an experience like this.
I'd figured with the minimal cutting involved, this hysterectomy wouldn't be nuthin'.
I was wrong.
Don't get me wrong; I've no doubt this new, less invasive surgery is light years better than the old way.
But it ain't nuthin'.
Neither the doctor nor several nurses I saw told me about a couple of possible issues that might follow the surgery. On Day Two, my shoulder started to hurt like a muv, as my brother used to say when we were kids. Later that day, my rib cage was so tender it hurt to breathe. The pain was worse on my right side, and I wasn't sure whether it might also concern my liver, since I do have chronic liver disease.
Okay, then, back to the Web--a quick and dirty Google search: "laporascopic hysterectomy rib pain."
Bam.
Common side effect of abdominal laporascopic surgery, I'd learn. What the doctor didn't mention, and I hadn't picked up on in my reading, is that the body is pumped full of carbon dioxide (CO2) after the patient is put under. This gives the surgeon more room to get to the target organs without nicking anything else in the process, since the CO2 blows up the abdomen something like a balloon and spreads the innards apart.
Apparently, some post-surgical procedures are done to suck as much of the CO2 out of you as possible, but they don't get it all. And it sits there in your abdomen and starts making your body hurt in fairly predictable ways.
I actually did track down patient information from one clinic that mentions the potential for chest, shoulder, and abdominal pain after a laporascopic hysterectomy.
I wonder why, in my case, neither the doctor nor the nurses mentioned this possibility. What if I hadn't felt comfortable doing a quick Google search to find out why it was happening? Couldn't that pain and difficulty breathing been frightening for someone with heart disease? I mean, I have heart disease (cardiomyopathy), but mine is very mild. Still, it's disconcerting when one can't breathe.
Perhaps the health care professionals, in all their wisdom, don't want to put ideas in a patient's head, thinking that if they don't know it's a possibility they won't feel it. Well, that's bogus. I didn't know, and I definitely felt it.
It just amazes me at this point in health care that something so frequent that it's nearly to expected is not mentioned in the patient education done before a routine but serious surgical procedure.
Other than that, I can't really complain about the care I got, though I hesitated to go to the hospital in the small Appalachian city near my home. A friend had recently had a botched surgery to fix a hernia there, and other patient stories abound about the place's quality, or lack thereof.
In the end, though, I opted to stay local. In my next episode, I will discuss the factors leading up to that decision when you're Down the Rabbit Hole in today's health care system.
By the way, it's now Day Six after the surgery. The shoulder pain lasted only one day; the under-ribs pain ended after Day Four; and now I just have a sort of ache or cramp in my lower abdomen. The pain pills take care of that, but I don't feel like dancing a jig, I can tell you that.
I'm still amazed there isn't more patient education on the pain to expect after a laporascopic hysterectomy. This pain is acknowledged in the medical litereature (for doctors), but I haven't found anything about it in the patient education materials online.
Yet the fact that it's real can be attested to by the numerous patient forums in which this problem is discussed. This is just one more example about how the patient comes last in today's health care. Patients are left to find this information out from other patients--not necessarily the most informed source.
With all the talk about patient-centered care, this should NOT be the case, but that's the problem right there: it's all talk; "patient-centered care" means little to nothing in the actual delivery and reception of health care except in the individuals who inherently bring this orientation to their delivery of care. Many times, these individuals are nurses, but some doctors also show this trait. What's clear is that it isn't something the entire system focuses on to any real degree.
But you'd think they'd come up with complete patient care information for something as routine as a laporascopic hysterectomy.
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