The most important things in the first week after surgery are to keep your stools soft, drink adequate amounts of fluid (at least 64 oz. / day), and eat foods that are easily digested (oatmeal, scrambled eggs, fruit, rice, yogurt, etc) and nothing too greasy or spicy. It is common to be a little nauseated for the first couple days after surgery – this can be from left-over anesthesia effects, pain meds, the surgery itself, or a combination of all 3. We will send you home with nausea medicine which should keep it under control, so if it doesn’t and you have nausea to the point where you can’t drink juice or you’re throwing up, please contact us. Regardless of your age or digestive habits, you will need to take fiber plus laxatives (we recommend miralax) at least until you stop your narcotic pain meds (and sometimes longer), otherwise you will not be a happy girl! It is perfectly acceptable to take stool softeners or osmotic laxatives such as Miralax for several weeks after surgery. These are a different category than stimulant laxatives such as bisacodyl (Dulcolax) which should only be taken for short periods of time when absolutely necessary.
After you leave the hospital, if you live locally we will schedule you 2 postop visits in the office, at 2 and 6 weeks afterwards, and of course at any time if there is the need. If you live far away, we will make individualized arrangements for followup visits and generally will try to see you before you leave the area to go home. Some patients choose to come back to see us at 6 weeks postop, others will make arrangements to see their regular GYN doc in their hometown.
It has been our experience that patients with chronic pain often take longer to feel good after surgery than patients who undergo similar surgeries for non-pain indications. Therefore, please don’t expect that at 6 weeks after your surgery you will magically wake up and feel fine! Some endo patients feel great at 4-6 weeks after excision, but most can take twice that long. Our rule of thumb is that as long as you are progressing and feeling better week over week, things are on the right track. You may have days where you feel not as good as the previous ones, but as long as there is not a trend in the wrong direction (ie several days in a row of increasing pain or nausea) this is normal and okay.
If you are feeling good 10-14 days after surgery and then you feel terrible, the first question to ask is “what have I done lately?”. For most patients, once they start feeling better they decide to go out and about, and after a week or 2 of doing next to nothing, even the amount of effort it takes to go to Costco and get in and out of your car several times can make your pain increase significantly. If you haven’t changed your activity and all of a sudden are feeling bad, please let us know, especially if you have a fever, nausea, or other abnormal symptoms.
Please pace your activity after surgery- the first week or 2 it’s ok to take short walks, less than 15 minutes at a time. Between 2-4 weeks, you can start pushing yourself to walk farther and faster, but don’t lift anything heavier than 5 lbs. After 4 weeks postop, if you are an athlete and are accustomed to working out, you can slowly ease back into your athletic activities, but be very careful with abdominal work as it can aggravate your incisions and abdominal wall muscles. If it hurts, stop and wait a day or 2 before restarting.