Hysterectomy Recovery! A Cranky Fitness Guide

(Image credit: Resurge International)

I realize that hysterectomy recovery is a rather specialized topic. Very few Cranky Fitness readers are waking up fuzzy-headed in a hospital bed at this moment, wondering what will happen next now that the nice surgeon has yanked out a bunch of your body parts. You'd rather hear about a new super-easy exercise to firm up your flabby thighs, right? Or maybe clever hints on how to make cauliflower taste like cotton candy? Tips on how to tell if you have vaginal cuff cellulitis: probably not high on your list.

But hey, don't go away yet: hysterectomies are pretty darn popular! Even if you don't plan on having one yourself, you may well have a mother, sister, friend, or coworker who just can't wait to join this super-cool surgical sorority. Wouldn't it be handy to have a bit more info, so you can be all supportive and knowledgeable and not get your head bitten off by your loved one for making some dumbass remark?

Or, maybe you've googled here because you are facing surgery yourself. You may be worried about side effects, and curious as to how this operation will affect your physical fitness and psychological well-being. So, as a public service, I didn't just scour the web for resources to answer your urgent questions about hysterectomies and how to recover from them. I went the extra mile and had one myself! (The fact that I was four months "pregnant" with a big ol' fibroid-filled uterus had practically nothing to do with it).

So here is exactly what you can expect from your hysterectomy:

Any f*cking thing in the world.

Yep, from what I can tell there does not seem to be a "typical" hysterectomy experience. You could acquire super-human strength and x-ray vision, or you could end up with constipation, mood swings, and purple wombats crawling out of your navel. People mostly seem to have good experiences, but seriously, it's a crapshoot.

But I won't let the fact that each hysterectomy is unique stop me from sharing some information and tips. Here are a few things I learned about the whole hysterectomy deal, either from personal experience or from Dr. Google.

1. Where to go on the web: The best single resource for hysterectomy information is a site called hystersisters. They have a few general articles, some of which are helpful, and some... not so much. The real value is in the reader forums. Vast numbers of women have written about their experiences and shared helpful tips. Any obscure question or weird symptom you might be curious about? Someone has had that same question or symptom and can quell your panic until you can talk to your doctor. Which leads to the next tip:

2. Choose a kick-ass surgeon and a top-notch hospital. Yeah, so this might not always possible, given your location and insurance coverage, but to the extent you can ask around, it's worth doing some research. I had an awesome surgeon in Boston who cheerfully took on the huge mess I had in my lower abdomen and removed it all laparoscopically, and she kept on top of my follow-up despite my moving across country where even the longest speculum ever made could not reach me. And then I saw another great urogynecologist in San Diego. Do I think it was a coincidence that both these amazing, skilled, warm, professional and communicative doctors were women? I do not! Women doctors rock.

3. The recovery process may be something of a roller coaster ride. Expect a faster recovery if you get laparoscopic surgery, but don't expect miracles. There is at least one website advertising robotic laparoscopic surgeries that features a woman enthusiastically returning to the golf course a few days after surgery. For most women it feels pretty darn heroic to get out of bed, get dressed, and walk around. Yep, walking is good and helps with healing--but the expectation that one should be playing 18 holes before breakfast may lead to suicidal or homicidal thoughts.

4. You will need help. Preferable, an angelic spouse or best friend, and a generous and sympathetic social support network. I was lucky to have those, and it made a huge difference. (Not as helpful: small children, high maintenance pets, or surly teenagers. They should all be packed off to other quarters or supervised by someone other than yourself). And it's not a matter of strength, willpower, or determination: there are a bunch of things you're simply not allowed to do right after a hysterectomy. These include things like laundry, sweeping, shopping, driving, or subjecting yourself to any TV shows, movies, or radio programs that you do not personally approve of. (Okay, perhaps your doctor may forget to include that last one on the list, but don't tell your partner that. And speaking of partners, high on the list of forbidden activities is: sex. For a really, really, really long time. It kinda sucks).

But what if you feel great? Then it gets frustrating, because you still have to lay off normal activities for as long as your doctor tells you to. I felt energetic and ready to get back to "real life" within a couple days of my surgery, but had to restrain myself from overdoing it. (Not chores, of course. I hate chores. But I wanted to go back to working out.) The reason for these restrictions? Sadly, it's not just about fatigue or fragility. If you're too active or do the wrong stuff at the wrong times you can seriously mess things up inside without even realizing it. One word that strikes fear in the heart of any woman recovering from hysterectomy: Adhesions. From what I understand, adhesions are nasty bits of scar tissue that form inside you where they shouldn't, and if they're feeling particularly malevolent they can glue your internal organs together out of spite. Are those dust bunnies under the bed worth going back for more surgery to unstick things? Think carefully before you let your inner Superwoman try to put on her cape. A bathrobe and fuzzy slippers may be the better choice.

5. Common post-operative complaints/concerns: See the post-op forum at hystersisters for tons of these. But highlights include fatigue, "swelly belly," bleeding, constipation, trouble urinating, mood swings, numbness, lumps, bladder spasms, joint pain, insomnia, headaches, itchiness, and comically insensitive husbands. If you're getting your ovaries removed as part of the process, and are not going on hormone replacement, you'll also get to hop on the express train to menopause and enjoy all those fun symptoms too!

Note: and yeah, there are even worse things that can happen, like you could become incontinent or your stitches could come lose and your guts could burst out through the hole in the back of your vagina. But the scary stuff is pretty darn rare, and being a bit of a hypochondriac, I decided it was in my best interest not to spend much time researching it.

6. Exercise: So once you've been cleared to ease back into an exercise routine, how best to approach it? Good question! And I still don't have a damn answer! Helpful post-hysterectomy resources for working out are practically nonexistent--especially if you are the least bit hardcore in how you define "exercise." Most advice seems geared to women who have never exercised before in their lives. Or you get some combination of "listen to your body," "listen to your doctor," "don't lift heavy," "don't do abdominal exercises for a long time," and "be really really careful!!!"

[Nov 2012 Update: Help is Here! A panel of personal trainers stopped by to offer advice, including videos, on how to safely exercise your core and abs post-hysterectomy, check it out!]

My own experience has been a bit frustrating, especially since I've also got a stubborn case of plantar fasciitis and a broken elbow. Five months out, and I'm still not back to my old strength training routine, though I'm figuring out aerobic stuff to do. For some reason, my beloved elliptical remains problematic and generates pelvic pain, but I can do a stair stepper. (I like the wimpy kind, where you can choose your own step height and speed, not the hardcore escalator kind where you have to trudge up real stairs and can't keep up with fast-paced music. Have you ever seen someone look happy on one of those machines?) Bike riding figured heavily into the post hysterectomy rotation--until I fell off and broke my arm. Yay me!

7. What the hell is pelvic physical therapy? Well, I'm finding out first hand. Turns out the reason I've been having trouble trying to get back to my exercise routine is because my pelvic floor and core muscles spaced out and forgot how to function properly. My transverse abdominal and multifidus muscles got a bad case of attitude and went on strike, and my pelvic floor muscles said, "oh, hey, no problem! We're uptight and neurotic anyway, we'll just do all the work and go into a semi-permanent state of spasm. Aw, don't thank us, we're happy to do it!"

So I'm now trying to learning how to find all these elusive muscles, relax or strengthen them as indicated, and breathe from my belly. Oh, and get used to having a very nice physical therapist lube me up and test my clenching/relaxing ability where I'm not used to having a whole lot of company.

(BTW, pelvic physical therapy is also an excellent idea for those suffering from urinary incontinence--a huge issue for tons of women that is rarely talked about except in Depends commercials. And really, do you want diapers to be your go-to resource when there are better options? If you are in the San Diego area, check out these folks for pelvic physical therapy. Not only are they staffed with excellent and personable PT's, they have free granola bars in the waiting room.)

So will I ever get back to doing burpees and pull-ups and bulgarian split squats again? I sure as hell hope so! In the meantime, I've got plenty to do on my exercise list, even if the results aren't visible to casual acquaintances.

8. So why have a hysterectomy in the first place? Benefits are unique to each person, but for many of us, all the hassles are totally worth it. There are lots of reasons to get a hysterectomy (cancer, insane menstrual bleeding, pelvic pain, etc,) and plenty of alternatives to consider. So when you decide to opt to have a big chunk of your insides yanked out, it's usually because you are sick to death of coping with gynecological issues. Even with side-effects to deal with, my sense from both online communities and real life friends: very few women regret the surgery once they've fully recovered. And many wish they'd done it years ago.

So, anyone else out there have any gyno complaints, medical gripes, hysterectomy experiences or insights to share? Or just wanna say hi? It's all good!

Magic Weight Loss Pill, take two

[By Merry]


Get it? Take two, as in this is the second time we've blogged about weight loss pills or as in "take two pills" ... oh all right. Just checking.

We've already mentioned the possibility of an all-natural, working-with-the-body magical weight loss pill. It's not something that you can buy over the counter yet, but should be available soon.

But scientists have developed another weight loss pill that could be commercially available within a decade. Unlike the pill that works with your body's intestinal flora, this one is essentially a form of gastric bypass surgery without the knives. It shrinks your stomach chemically.

Normally, your stomach expands when you eat, to the point where you feel "full." Gastric bypass surgery involves physically restricting the amount that your stomach can expand. Gastric bypass surgery has had dramatically successful results with many patients. To quote the authors of a study on gastric bypass surgery, "...nonsurgical methods are notoriously ineffective at achieving major, long-term weight reduction."

But gastric bypass surgery is not without some nasty potential side-effects. Hell, Dr. J. would tell you that any surgery has some risks. (Bear in mind that I'm biased on this topic: my favorite uncle passed away due to a nosocomial infection.) So any method that would have the success rate of gastric bypass without the side effects would have me cheering.

All the same, I'm still resistant to the idea of any weight loss approach that works on the body rather than working with the body's own already established systems. One of the effects of stomach stapling is that "high fiber foods and foods with a more dense, natural consistency can become very difficult to eat relative to highly refined foods." I tend to distrust any man-made "solution" that goes against what has been working for the human body for countless generations.

We've all been raised on the notion that if you have a passing ailment, take a pill and it will go away. I am afraid that putting the gastric bypass solution into pill form will somehow put it on the same level as some passing problem. This is serious stuff and could have seriously long-term issues with it. It's a solution, but please, please, consider the more boring long-term solutions first.

Should I change my name to Crabby? Am I being too suspicious/old-fashioned/stuck-in-a-rut? I grant you, gastric bypass might be the way to go -- it's certainly worked for a lot of people that I've known. But shouldn't it be a last resort?

Really Random Friday

(Album cover photo: danacountryman.com)

Crabby isn't even going to try to tie this mess together with any sort of theme.

And for those of you not too distracted by the brunette's butt cleavage, here's some Dry Scientific Research. But have patience, later there will be Sex and Shopping!

Night shift workers do not, apparently, face higher cancer rates than day shift workers, or at least this study of Swedish workers failed to find any connection. Researchers analyzed nearly 20 years' worth of data. Earlier studies had suggested there might be a link. Crabby is glad because that just didn't seem fair!

And since we were very recently talking about Sunshine, Vitamin D, and breast cancer, there is another new study suggesting that increased intake of D-3 could prevent hundreds of thousands of cancer cases a year. The researchers recommended supplementation 2000 IU of D3 a day, plus moderate sun exposure (but not more than 15 minutes without the use of "clothing" and a hat). Damn, there go Crabby's Nude Sunbathing plans for the weekend! (Note: that was just Gratuitous Bold Text, something Crabby is having fun with today. There is No Actual Link to Pictures of Crabby Nude Sunbathing!) Anyway, from what Crabby has read previously, she suspects not all researchers would agree with these guy's recommendations, but she is too lazy to go find opposing points of view.

Despite all the controversy around Surgery to Reduce Stomach Size apparently bariatric surgery does save lives--at least among the severely obese. In one study, surgery to reduce stomach size cut the overall risk of death by 40%; in another, there was a reduction of 29%.

This was widely reported elsewhere, but it seems to be Big News that Many Seniors Are Still Having Sex. However, in this cheerful update on the sex lives of those in their 70's and 80's, "sexually active" was defined as having sex once a year. Crabby has decided to be contrarian about this whole thing, because, well, she's just that way.

In any event, despite the Horny Headlines, only 26% of men aged 75 to 85 were getting any, even once a year, and women were even less likely to be doing it. (And only 50% of men and 25% of women even indulged in admitted to masturbation!) Crabby has no agenda around Senior Sex--seems to her it fine to have Lots or None at All. Whatever! She just wonders why all the headlines seemed to go out of the way to make it sound like Old Folks are Doin' it like Bunny Rabbits, when that seems not actually to be the case. (And you may note that though the survey was of US seniors, the Yahoo people apparently had to go Spain to find a picture of two Elders smoochin').

Now, on to less scientific stuff!

So Crabby was not the only one who went clothes shopping recently. This post by the always amusing Vanilla at Half-Fast had Crabby laughing her brand new faux size 2's off.

Need to Nag Yourself About Something? This useful site, Hassle Me, allows you to harass yourself by email at various intervals--to bug yourself to go to the gym every few days, or call your mother, or whatever. It may have an Evil Application too: it looks like you can specify other people's email addresses and hassle them too!

And finally, here's a Really Random Observation:

So you know when you set up a Blogger profile you can specify an occupation? Crabby, when she started her blog, decided to call herself a "Professional Layabout." Well, recently the Blogger people did some updating and organized things, and suddenly Crabby's "occupation" was Highlighted in Blue--which means it was a link! Crabby excitedly clicked on the link and discovered there were 21 other Professional Layabouts! Crabby has no idea why she finds this amusing.

Update note: Crabby does not know why suddenly the line spacing has changed on her posts but she doesn't like it! It's too cramped. If any Bloggers have any ideas about how/where to fix this (she can't seem to find the right button) please advise!) Update to the update: If anyone else encounters this line-space problem after a picture or list, Med Journal Watch had a fix which hopefully won't mess anything else up. Coincidentally, it's a health site with a more careful and critical analysis of the bariatric surgery study Crabby just casually cited today. (Date stamp should be fixed too).


Oh hell, just say anything you want!

Frontiers of Cosmetic Surgery: "Designer Vaginas"

Oh dear, were you at the office when you decided to check on the latest in wholesome health news? Sitting in the same room with your kids? So sorry!

Actually, a good friend suggested this for a topic, and indeed it is a perfect one for Cranky Fitness: Weird, Slightly Off-Color, and Health Related! The triple crown, as far as Crabby is concerned. But she realizes there is a time and place for everything, including vaginas, and if this is neither for you right now you are most certainly excused.

She was going to post earlier this week. However, that very day she discovered that her friend Jennifer had just kindly linked to Crabby from the Family Resource Blog, saying nice things and including her in a list of "Great Family Blogs."

So she decided she might postpone the Vagina Post for a few days.

Anyway, so what is a "Designer Vagina" and why would a woman contemplate cosmetic surgery in order to have one?

Well, according to this article, the British Medical Journal released a report saying that "women are increasingly seeking cosmetic surgery to make their vaginas match pornographic pictures."

The article does go on to say, however, that some women were having their labias reduced for reasons that had nothing to do with their appearance. They were uncomfortable exercising or wearing tight clothing, for example. Crabby just wants to clarify that she's not making fun of these women. If a woman is experiencing physical discomfort because of the way she's built? Sounds completely reasonable to get it fixed.

But then one doctor said a lot of his patients told him they had better sex because they felt more comfortable. "It's more based on the self-esteem issue than how the labia look...they feel more self-assured."

The British Medical Journal commentary argues that appearance may not be a good enough reason to undergo this type of medical procedure, especially since risks include loss of sensitivity to the genitals. A physician who does these surgeries also warned against going to inexperienced doctors, saying that patients risked scarring, infection and bleeding.

Yikes.

So here's what Crabby thinks:

There may be some rare cases in which even just for appearance, the surgery might make sense. Say a woman is really, really, unusually proportioned. And say she's had a series of terrible experiences with insensitive sexual partners, brutes who have ridiculed her and scarred her emotionally far worse than anything a surgeon could do to her physically. Crabby says: well, okay. As long as you understand the risks and the discomfort you may have to endure for the sake of your "looks," go ahead and let them slice. (Shiver).

But short of that, it just seems insane to have expensive, painful, and dangerous surgery to make your hoo-hoo look more like the one your boyfriend admired so much the other night when you came home early and caught him screening "Eight Women...who Ate Women."

The increasing "need" for this surgery raises all kinds of confusing questions for Crabby. Do women really need yet another part of their anatomy to feel insecure about? And for women who think they look "unusual," how do they know? Do they really believe that porn actresses represent the entire range of normal female appearance? And if it's not through porn, how many "average" vaginas does a typical woman come across at close range in order to make a comparison? (Unless, of course, seekers of the surgery are disproportionately gynecologists, lesbians, and specialists in "Brazilian" waxes, but Crabby seriously doubts this is the case).

She wonders if yet again, insecure women are buying into the idea that there is some sort of "perfect" body out there, and that no amount of sacrifice is too much in order to obtain it. Crabby would like to convince these women otherwise, but she suspects that not many of them are regular readers of Cranky Fitness.

And for those women who might be contemplating this surgery in order to please a disapproving boyfriend, husband, or other sexual partner? Ladies: it's not excess labial tissue you need to cut loose.