As you may know, today was my pre-op appointment with my gyno for my September 21st laparoscopy/excision surgery.  I had previously prepared a bunch of questions, to which he answered all that I asked!

First of all, let me share something he wanted me to press upon myself…and all of you.  Positive thinking is powerful.  I need not be nervous about my surgery (or my recovery).  Just tell myself that it will all work out.  That my recovery will go well.  That everything is going to be okay.  That is one of the most important steps I (and all of us) can do for ourselves.  Embrace positive thoughts.  Shoo away the negative.

I also gave him a printout of my pain diagram.  He lit up when I handed it to him and said he wished all patients would give something like this to their doctor.  If you’d like, I can send you a blank template for you to fill in (using Photoshop or some other imaging program)…or I can do it for you (with your direction, of course).

We have to be at the hospital at 8:45am on September 21st, and surgery is scheduled to begin at 10:45am.  The day before consists of not eating any meat.  Dinner will be a clear liquid diet (can we say “broth?”) and no food or drink (including water) 9 hours before surgery.  At 6pm, everyone’s favorite: the fleet enema!

Okay…now where’d I put those questions?  And FYI, these are the answers he gave me regarding my specific situation.  His answers may not suit your situation 😉  I just wanted to share with you.

**

• What to expect after cystoscopy?  Any possibility I’ll stay overnight?  I’ve read that a sensation of burning pee is a temporary side effect; anything else?
  • I may experience burning pee for the first 24 hours.  If I continue to have burny pee after 24 hours, call him as I may have a urinary tract infection.  There’s always a small chance I’ll have to stay overnight, but won’t know ’til I’m awake and processing.
• Please remember I need a latex-free operating room
  • When the hospital calls me for my pre-op interview this week (or as late as Monday), I’m to remind the nurse.  Also, he assured me that hospital staff will continuously ask me my allergies…and joked they’d but a big red band around my forehead if need be.
• What’s the worst case scenario?
  • I also didn’t ask this direct question.  He had previously stated to me today that the best case scenario, in his eyes, is that they don’t find anything.  If he finds Endo lesions, he’ll cut them out.  If he finds adhesions, he’ll cut those out and free them. He’ll repair my anatomy as best he can.  And he’ll smooth over a barrier medication over the lesion and adhesion sites in an attempt to reduce their recurrence.
• Would you take my uterus and ovaries, if needed?  If so, please don’t use a morcellator.
  • I decided not to ask this question.  I know he’ll be conservative and not haul out my uterus without first having an in-depth conversation
• Will there be pictures and/or video of the procedure? What about of the exterior of surgery: the table or outer-abdomen ports?  I’m so curious!
  • There will be pictures; no video, and its all internal.  Nothing external.
• Anything you can do to lessen the gas pain that occurs in my right shoulder? Tilt my head? Warm gas?  Expel more gas before closing me up? What are the complications of any of these methods?
  • He does tilt my head already.  Did it for 2014 surgery, too.  It may not always help with the trapped gas and shoulder pain.  He will do everything he can on his end to expel as much of the gas as possible.  He confirms that heating pads are the way to go in handling the pain on my end during recovery.
• How long do you expect the surgery to last?  Any way someone can update my Mom and Jim as they wait in the lobby once surgery begins?  Last time they expected surgery to last 1.5 hours and it lasted 4; nobody updated them on status and it was stressful and worrisome for them.
  • It should only last 1-2 hours.  I asked if it was longer to please have someone step out and inform my mom and Jim.  He said of course.
• Any other prescriptions post-op besides Naproxen Sodium?  If so, can we fill them early?
  • He wrote me a prescription for Percocet.  I don’t like pills, so I’m going to refill my Naproxen Sodium before surgery, too.  He said the Naproxen is for mild to medium pain.  The Percocet is for heavy pain. He knows I don’t like to take pills…so hoping this goes well.
• I know you found Endo on my diaphragm from our first surgery.  Is there any way to verify through this upcoming surgery that you’ve removed it all?  Or is that a thoracoscopy?  Thoughts about my liver Endo?
  • He can only remove what he can see.  A thoracoscopy is incredibly complex and requires a multi-disciplinary team of surgeons and skills. If the Endo turns out to be only one or two lesions on the unseen side of the diaphragm, you risk life-long harm (difficulty breathing, etc.) to remove a small problem.  The same goes for bowel resection: requiring multi-disciplinary teams, a bowel surgeon, and the potential for life-long bowel issues.  He also mentioned there are times where surgeons can’t do anything to remove Endo (when it’s inside the bowels).  Do the pros outweigh the cons?  Of course, if he is in there and suspects it is extensive on my unseen portions of my diaphragm, we’ll have long conversations during my post-op.  And he’ll remove all of the Endo that he finds during my laparoscopy.
• Can you also examine the outside of my bowels?  I’ve read that if you have Endo in your Pouch of Douglas you’re very likely to have it on your bowels.
  • He will look everywhere.

• Anything I can do to make your job easier on the Big Day?
  • I wish you could have seen his smile with this question.  Two things : 1) Relax and 2) smile.  I can do those.
• After surgery, shall we restart taking continuous birth control?
  • I can start taking it right away if I so desired.  As soon as I was up and getting around.  OR I can decide to stay off of birth control pills for a month or two and see how I feel without them.  He says that birth control pills are theorized to help with Endo symptoms, but there aren’t any studies proving it keeps Endo at bay.  I’ve asked him to provide more info on that.  So I have a decision to make : To BCP or not to BCP.
• Last surgery, I couldn’t lift my right leg to get into the shower for a few days.  Is that normal?
  • After describing that there wasn’t any numbness, tingling, or difficulty walking, he presumes it could have been some muscle extension issues.  But I’m all good now, so I felt kind of foolish asking this one…
• Any “best” way to sleep while recovering?  Last time propped up on some pillows seemed to be the least painful.
  • Another one I felt rather foolish asking, but I did.  So, he suggests that since the trapped air is wanting to travel upward to escape (thus causing the shoulder pain), perhaps I should try laying down flat…this was the gas can settle around my abdomen rather than rise to my shoulder.  I’m terrified, but will try it.

 **

Signed all the paperwork. Peed in a cup.  Sacrificed four vials of blood. I’m ready! And so is my wonderful surgeon!