Rectocele Recovery; TVT Recovery - The Ugly and The Good

I must qualify this blog entry. Please read only if you meet the one of the following criterion: You are a woman who is considering a stress urinary incontinence or a rectocele repair surgery who would like to know about my recovery experience; a partner of someone considering the aforementioned procedures who would insight on how to be empathetic to what is happening to your partner before and after a procedure; a surgeon who performs one of the procedures (same reason as previously stated); or someone who is curious about this type of surgery. At any rate, proceeding with reading this implies that you will not make any inconsiderate or perverse comments and really, if this type of information is TMI, don't think about reading any more.

The reason I am posting this is I found little information about the recovery from these procedures online. So many women have asked me about the procedures that I'm thinking this entry would be helpful to them. I am hoping that by sharing, I can provide a little window into the days after the surgery for others, as well as my thoughts on if the experience from my perspective was worthwhile.
This past winter I had two procedures performed, a TVT sling for stress incontinence (I can't remember what initial they gave it - an O perhaps?), what I liken to propping up my bladder/urethra in a hammock and a rectocele repair. The former, at least at this stage of the game, is the best thing "I've done" in years. The latter is still in the air, but I have achieved some of the intended benefits and am still healing. Once again, please do not read or comment if you are immature, squeamish, or a pervert.

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Background
It started a long time ago, but basically, voiding has always been a problem. (That's the euphemism you get to use at the Dr.'s office...) It got worse - bothersome and embarrassing after babies. In birthing classes, they don't tell you about possible side effects of childbirth. (Although, it appears the docs don't think that birthing could be the cause, but then again, these same physicians are taught that teething isn't painful for babies...) So, for years, I thought leaking while standing and having problems pooh-ing was something I had to live with, even having one doctor tell me that aging is a process and we all have to suffer the inconveniences associated. Jerk. Then another doctor asked me point blank why I hadn't had the surgery and all I could offer was that I was ignorant, scared, unprepared, too busy, and/or hadn't put much thought into it. As well-thought out as that reasoning is, I think my actual response was, "Hmm, just haven't gotten around to it I guess..."

The first gyno told me that along with the TVT surgery, I might need to have my uterus removed. After research on the Internet (thank God for that) I learned that my uterus and rectocele and/or bladder problems didn't necessarily have anything to do with eachother; I needed another opinion. So, more researching and I self- referred to a doc who was rated highly on local sites for pelvic floor problems. He was great - very kind; very forthright about my situation; took the time needed to make me feel comfortable + his glasses were really cool, and most importantly, he agreed my uterus wouldn't need to come out. Sold.

I'm going to skip the tests (yes, stirrups were involved; yes, voiding both 1 and 2 in front of medical personnel was involved...although I can't say if every OB requires that as I know my doc does studies), the biofeedback my doc asked me to get (OMG, that was an eye opener - literally), and talk about the process and the recovery.

The process involved some testing (see above) followed by a consult with my doctor who told me my options. He gave me an anatomy lesson and told me what my problems were and what could be done to solve them.

My only challenge is that the doc thought I was a more knowledgeable than I was. I always come with a list of questions - the type "A" in me. So, I had indeed done extensive research on the net, but not on the solutions. There comes a point when the internet is counterproductive, especially when you are accessing it at work and content that could get you fired comes up onscreen. It happened for me when I saw the rectocele surgery pics which were graphic; they were more a trigger for an anxiety attack and potential violation of use of my work computer (I pity anyone who checked on my site visits...) Anyway, there are several forms of slings - my doctor asked me to think about the type I wanted. I "chose" the one he recommended, because while interested, I'm not a doctor. I digress. The point is, if you find a knowledgeable doctor and trust his/her training, then let him/her make the recommendation and stop the internet research... There comes a time to let go and trust.

Because I had 2 procedures, I'll break the surgery and recovery into two sections - the bladder section and the "rectocele" portion. If you are wanting to know how to be supportive, you can skip to the end
Bladder - TVT for Stress Incontinence
The UglyI had been told the recovery for the TVT could be as few as a couple of days. When I was able to walk shortly after the surgery, I was asked to urinate. I was told it would be normal for the urine to ebb and flow because the bladder would be acclimating to its new position. On peeing successfully and a sufficient amount, I was sent home. The flow of urine continued to be a bit erratic for 2 days and then returned to normal. For me, one thigh was fine the day of surgery and continued to feel great thereafter. My other thigh, however, felt like someone had taken a club to it. I struggled to get in and out of bed the first few days. Then, it got better. Not great, but better. It took 5 days for that pain to ease, about 10 days to walk without concentrating through it, and 4 weeks for the discomfort to ebb. I'm on week 7 and I have no achiness anymore. My guess is there are a number of variables which mean everyone's experience will be different.

The Good
In the meantime, my life has changed completely. The first time I sneezed, I felt the usual panic. I squeezed my thighs together, felt dread, and then had a liberating feeling - absolutely no urgency, no leaks. I've had repeated moments like this - dread followed by relief until I've started to trust that what had been a problem for 1/3 of my life was not a problem anymore. It's a bit like culture shock - you notice what is shocking at first, but then it gradually becomes an acceptable part of your life. I'm more relaxed. I can walk great distances without worry. I don't gauge my activities by proximity to bathrooms. I don't shower multiple times during the day. I don't avoid strenuous activities because I'm worried I'll smell bad. I'm exercising with confidence. I've tried laughter yoga and I can approach it without fear. I'm down one size and will keep up the progress now that I relish the freedom of movement again... I feel like I have a new perspective on life. Worth it? Yes, and then some.

The RectoceleThe Ugly
This is graphic, so be forewarned and skip to the "The Good" section if you are squeamish!
I was told my rectocele was small-ish. I didn't want to hear much more after seeing the pics of what they look like online, so I let it drop and didn't ask too many questions (I'm sure that's up for debate, but again I digress...) In sum, they go in through the vagina, fold the tissue and sew it up. And that's where I left it.

After the surgery, I was told that I would need to wear pads. I wasn't prepared for the first hours after the surgery. There was a LOT of blood. This lasted for the first few hours and by the next day was much better.

It took forever to get my bowels moving and 4 days into recovery, 3 stool softeners and 3 laxatives later, I had a very painful bm which felt like I opened some stitches. The doc checked and said things still looked good. Lesson? Do what you can to have soft stool after the surgery because it really did hurt and I think lengthened my recovery by at least a couple of days.

Pain? Yes. I decided to err on the side of more meds than not that first week. So, honestly, I slept the first 3 days, off and on, watching a Brazilian telenovela in fast forward when I got tired of the same adultress lying to her husband for 10 hours straight... I liken the pain (not the soap opera but the surgery) to having someone rub sandpaper on your inner cheek. It burned a lot. It felt like I was sitting on that sandpaper for about four weeks, with it getting a bit better every day. I did force myself to use the treadmill every day starting on day 3, walking slowly in a medicated stupor. I am guessing that it did me good, but can't say for sure. Sitting was a bit of a challenge the first 2 weeks- I should have returned to work using a donut, but didn't and regretted it every night until week 3.

For the first 4 weeks, there was a lot of discharge, starting with blood and turning into a yellow-ish somewhat smelly substance. I know what a relief diaper cream is for babies with sore bottoms... If you have this surgery, plan on using it for between your cheeks - it saved my sanity. I was well enough to start work 14 days after surgery, however I felt that I probably started too soon. My chair at work is hard and sitting all day on a pad was a uncomfortable/burned, while walking up and down stairs was tiring. The 3rd week was the first time I felt I could work with a clear head. Inconveniences aside, tiredness was my biggest challenge. I'm on week 7 now and while just a bit sore, am feeling good.

The GoodI draw the line at details on my new anatomy or marital life. I'm still sore. It feels a bit like I have packing towards the back. I'm told there will be scar tissue and possible loss of sensation. But, the good news is that I no longer have to suffer the "inconveniences of aging" the first doctor talked with me about. My reasoning for having this surgery was that in my old age, I really don't want to have the embarrassment of the rectocele problem if others have to take care of me. The jury is still out - it was the harder recovery of the two procedures, but overall, I think I am glad I did it.

Update - 10 weeks out. Still going well. I have some discomfort sitting on hard surfaces and have rectal pain, but the doc assured me this is normal. I have read many posts about nightmarish results after a rectocele surgery. What I am taking from this experience is that I had a doctor who is good at what he does. In this world, the bell curve reins supreme, so I recommend, as with any major influence in your life, shop around and find a surgeon with a good reputation for positive outcomes. Ask how many surgeries of this type your surgeon has performed. Ask about the recovery period for his/her patients. My doctor said it would be 1 - 2 week's recovery. That was a bit optimistic, but perhaps it would have been the case had I been able to focus entirely on my recovery, but family obligations prevented me from doing so. I have a feeling my research took me to a great doctor given my positive experience - a quick recovery compared to the 6 - 8 weeks I have seen posted, and few complaints to date. I have a friend considering the surgery and I've asked her to see my doc instead of her own. In sum, my experience has been a good one.

Update 4 years later... I think the surgery helped. I am 50/50 if I would recommend it for someone else. The doctor who offered a second opinion originally suggested that controlling what I eat so I wouldn't ever get constipated had a good suggestion. Unfortunately, that isn't my reality. That non-surgical option makes sense and I would definitely suggest trying that first. Physically, the tissues have relaxed or stretched a bit. I still occasionally have to help push out stool, but not as frequently as before. I have areas of tissue which are not exactly tender, but definitely don't feel great either.This far out it's hard to say if the surgery was worthwhile. I wouldn't do it again, but think my objectives were met. It's not a magic bullet - so keep your expectations in line.

Planning for the Surgeries
For the TVT, not much planning is needed other than to follow the instructions they give you and plan for a longer recovery than 2 - 7 days. If you have the leg pain I did, returning to work 7 days after the surgery would have been very difficult. If it goes great, then you have covered your bases.

For the rectocele repair surgery, purchase night-time pads for wearing in bed and diaper cream for reasons mentioned above. Purchase stool softener to try and prevent constipation, especially the first few days after the surgery. Purchase ibuprofen. Purchase 5 weeks of pads for daily wear, with the first week being a steadier, heavier flow. Plan on not lifting kids or heavy items for as long as the surgeon specifies. Take warm baths or use the sitz bath stuff you can get from a pharmacy. Plan to get enough sleep. Plan on walking each day. Take the pain meds if you need them; or just ibuprofen as needed.

Being Supportive of Your Partner
Stay informed - ask her what she's going through. It can be an emotional process. Ask what's going to happen. Show interest in her, the process and her recovery. Plan on at least 2 weeks before she's really able to return to normal life. She may look great, but remember, she's recovering from surgery and may tire easily. Make her healthy meals. Remind her to walk around - the exercise is good for her or take a walk with her. Make sure she has water by her bedside. Monitor her meds that first week - help her manage the pain. Take care of the day-to-day for 2 weeks - give her the time she needs to recover. Help her up and down from the bed if it is painful or put a stool by the bed. Give her privacy in the bathroom. Ask her how she's feeling and what she's feeling. Those are my ideas for a starter. When the time comes for intimacy, be gentle and understanding.

Fin
If you have stuck with me through this lengthy blog, good for you. I hope that you found it informative. It's probably more than anyone ever needs to know about me as it moves well into the TMI spectrum, but I'm hoping my willingness to share helps at least one person. Good luck!

Facebook Friends

My first foray into online blogging starts with a commentary on FB friends.

In grade school, I hated the feeling of leaving someone off my party list. My mother indulged large parties, thank goodness, or I don't know how I would have coped. I still feel the need to embrace everyone. Facebook, it seems, has capitalized on the concept of letting everyone in. While I know deep down that my circle of friends is quite small (sadly small I sometimes feel) I get a sense of comfort in keeping tabs on other peoples' lives - Vicarious living, so to speak.

So, I accept friend requests. As long as I'm careful, there's probably no harm. And, it's fun to find out about other peoples' lives.

I've only once thought of deleting a friend - the one person who moved my ranking from 2nd for Scramble down to 3rd. It was actually my son's suggestion, "Why can't you just delete him, Mommy?" "Because that would be petty even though I really want to..." I've since found myself sitting in 6th place, so I've gotten over the unhealthy competition, or maybe just have accepted my limits. Strangely enough, that same person must have deleted me - I only found out when I climbed from 3rd to 2nd and he'd dropped off the rankings and into the "Suggested Friends" list. I question his motivation.

All this goes to say that the FB friends feature has provoked quite a few thoughts on connections, filters, vicarious living, etc. At best, I feel more connected to the world. At worst, all my many friends lull me into a false sense of acceptance in the world. Cheers!