When should you call Dr. Frey?

 

Call any time of the day or night, including on weekends and holidays, if you have any of the following signs or symptoms:

• A temperature over 100.5°F (38°C)  

• Heavy bleeding (soaking a regular pad in an hour or less)

• Severe pain in your abdomen or pelvis that the pain medication is not helping

• Chest pain or difficulty breathing

• Swelling, redness, or pain in your legs

• An incision that opens

• An incision that is red or hot

• Fluid or blood leaking from an incision

• New bruising after leaving the hospital that is large or spreading. A little bit of bruising around an incision is normal

• Nausea and vomiting

• Heavy vaginal discharge (spotting and light discharge are normal)

• Skin rash

• Unable to urinate at all

• Pain or stinging when you pass urine

• Blood or cloudiness in your urine

• Non-stop urge to pass urine, but only dribbling when you try to go

• A sense that something is wrong

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What phone number should I use to call Dr. Frey? 347-658-2662.

 

Rest

After surgery, resting in bed watching Netflix or reading your favorite book or magazine is the way to go. You should NOT be working, not even remotely. Stress is bad for healing. Wear sweat pants or pajama pants. Taking naps during the day or resting when you are tired is just fine.

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Rest is important BUT getting out of bed and getting around is important too. Take walks outside if possible. Out of bed to the chair at least every 2 hours. Getting out of bed and moving around helps the circulation and your breathing. 

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Chew gum for the first 5 days after surgery. Chewing gum helps the intestines get going. 

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How do I prevent nausea?

The best way to prevent nausea is to eat frequent small meals. It is especially important to eat something before taking pain medication. What can I eat?

• Frequent small meals

• Eat high protein foods:

•  Beans and lentils 

• Nuts, including nut-based milk 

• Eggs & Dairy products (Greek yogurt is very high in protein) 

• Chicken and other meats

• Eat foods that are rich in vitamins that promote healing:

• Bell peppers

• Dark, green, leafy vegetables like kale and spinach

• Broccoli

• Sweet potatoes

• Carrots

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Pain Management:

After Surgery It is normal to have some pain. The goal of taking pain medications is to make you as comfortable as possible while keeping the risk of bad or bothersome side effects as low as possible. We want you to feel comfortable enough to get up, wash, get dressed, and do simple tasks in your home. The following recommendations are general guidelines for taking pain medications.

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Medications:

• Ibuprofen is the main medicine you will use to manage your pain.

• You may add Acetaminophen if ibuprofen alone does not manage your pain.

• You may also get a prescription for Ultram, Neurontin, Percocet or Vicodin. These medications should be added as needed to reduce pain that is not adequately relieved by ibuprofen and acetaminophen.

• If alternating Ibuprofen and Acetaminophen does not relieve your pain, add the pain medication.

• Adding ice is also very helpful and can be used any time.

• It is normal for your incision to be sore for up to 6 weeks. 

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Gas pain:

It is common to develop occasional crampy pain and bloating in the abdomen after surgery. This is caused by gas building up in the intestines. The discomfort is usually temporary and will resolve after passing gas or having a bowel movement. Some patients are helped by nonprescription medications (eg, simethicone [Gas-X]).  

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Sleep:

You should be sleeping at least 8 hours day after surgery.

You may be given Valium to take at night for sleep. 

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Do I need to keep using the incentive spirometer?

(You may not have received one, especially if you had outpatient surgery.) Using the incentive spirometer while you are in bed in the hospital helps prevent the small airways in your lungs from collapsing and helps prevent you from getting pneumonia. If you stay in bed the first day you get home, continue to use the spirometer once an hour, the way you were taught. Once you are up and moving about, you will automatically breathe more deeply on your own and do not need to keep using the spirometer.

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How do I care for my incisions?

• For incisions inside your vagina:

 -Incisions inside the vagina are closed with dissolvable stitches. When they dissolve you may see little bits of suture material that look like thin pieces of string on your underwear or on toilet tissue after wiping. This is normal.

-Do not put anything inside the vagina, including tampons or your fingers.

-Do not have vaginal intercourse for two weeks.

-Do not douche.

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• For incisions on your skin:

--you may shower starting 24 hours after your surgery.

-Put Aquaphor on your incisions twice a day after your bandages come off. 

​-Your stitches are absorbable; this type of suture does not need to be taken out. Sutures under the skin or inside the vagina do not need to be removed.

-If you had laparoscopic or robotic surgery, you may have one to five small incisions on your belly. These incisions may be closed with stitches or they may be closed with a special kind of glue. The stitches are absorbable and do not need to be taken out. Sutures under the skin or inside the vagina do not need to be removed.

-Tape strips may be removed gently at home (if they have not fallen off) approximately one week after surgery. Soaking the strips with a warm, wet cloth or taking a shower may make the strips easier to remove.

-The way your scar looks will change over time and may not reach its final appearance for up to a year.

-The area may feel either numb or sensitive to touch, which is normal.

-Your incisions will heal best if they are kept clean and dry: To clean the incisions, first wash your hands, and then get your hands sudsy with soap and gently wash or let the sudsy water run down over the incisions.

-Shower or tub bath is fine.

-Dry the incisions with a blow dryer, but it must be on a low-heat setting.

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What kind of vaginal bleeding is normal?

Spotting of pink or red blood from the vagina is normal. Brown-colored discharge that gradually changes to a light yellow or cream color is also normal and can last for up to 8 weeks. The brownish discharge is old blood and often has a strong odor, this is okay.

 

Bowel Movements:

• Starting as soon as you get home, take 17 grams of Miralax (one capful) once a day to keep your stool soft and prevent constipation. It is important to prevent constipation after surgery. Your stool should be as soft as toothpaste. If your stool gets too loose, cut back to using Miralax.

• Go for short walks. Walking and being active will help you have a bowel movement.

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Constipation is common after surgery and usually resolves with time and/or treatment. Constipation means that you do not have a bowel movement regularly or that stools are hard or difficult to pass. Constipation can be made worse by narcotic pain medications.

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A common approach to constipation after surgery is to take a laxative (eg, magnesium hydroxide [milk of magnesia]) or Miralax. 

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If the initial treatment does not produce a bowel movement within 24 to 48 hours, the next step is to take a stimulant laxative that contains senna (Black Draught is best if you can find it) or bisacodyl (eg, Correctol, Doxidan, Dulcolax).

 

If the stimulant laxative does not result in a bowel movement within 24 hours, try an enema (eg, Fleet). Read the directions and precautions on the package before using these treatments.

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Once the bowels begin to move, you may want to continue using a stool softener on a daily basis to keep the stools soft.  

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Chew gum. 

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Bladder function:

• You received extra fluid through your I.V. while you were in the hospital, so it is normal to urinate (pee) more than usual when you first get home.

• Drinking more water than usual will not help the bladder recover faster.

• Go to the bathroom at least once every 4 hours while you are awake.

• Take Nature's Lab Cranberry tab every day for 5 weeks after surgery. 

 

Activity after surgery:

It is normal to feel tired for a day or two after surgery, especially if general anesthesia was used. If you have a major surgery, you may feel tired for longer. Taking long naps during the day or resting when you are tired may help.

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While rest is important, it is also important to walk around several times per day, starting on the day of surgery. This helps to prevent complications, such as blood clots, pneumonia, and gas pains. You can resume your normal daily activities as soon as you are comfortable doing them. Walking and stair climbing are fine. Gradually increase your activity level as you are able.

Other activities (exercise, housework, sports) can be resumed gradually as you are able and depending upon the type of surgery.

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Showers and baths: You may shower starting 24 hours after your surgery. You may also take a bath. Consider a sitz bath.

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Are there limits on what I can lift? 

Lifting heavy objects can increase stress on the healing tissues. Avoid lifting heavy objects (13 pounds) from the floor; if the object cannot be lifted with one hand, you should ask for help. Restrictions on lifting are generally recommended for six weeks after surgery. 

 

Can I drive or travel?

You should not drive a car until you can move easily and no longer require narcotic pain medications. You may ride in a car; as always, wear a seat belt when riding in or driving a car.

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Can I have sex? Can I use tampons? 

After most types of gynecologic surgery, you should not put anything in your vagina until the tissues are completely healed. Otherwise, you may develop an infection or interfere with healing. This includes tampons, douches, fingers, and all types of sexual activity that involve the vagina. These activities should be avoided for four weeks after surgery. 

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When can I return to work? 

You may return to work when pain is minimal and you are able to perform your job. Major procedures like the one you had may require four to six weeks to recover.