Ovarian Cyst Surgery; Laparotomy: Part II

After a cut and open abdominal surgery for removing a cyst or tumour on your ovary, you will be kept in the hospital for 6-8 days. This post is about the period after that and till the eighth week post op. For the period of the first week post-op, please refer my previous post, OvarianCyst Surgery; Laparotomy: Part I.

 

On my discharge from the hospital on the eighth day after surgery, I was given some instructions:

1. Eat normal, regular food.
2. Wear the abdominal belt for three months. Loosen it, if required, while eating.
3. Do not sit on the floor.
4. Do not sit/ sleep on furniture below a height of 13-14 inches.
5. Keep the sutures dry. If sweat accumulates, pat-dry it.
6. Walk. Do not lie on bed all the time.
7. No bending forward for three months.
8. No lifting heavy weights for three months.
9. No climbing stairs for three months. Climbing 6-7 stairs was ok.
10. Do not do any activity that may strain the abdominal muscles.

 

On discharge from the hospital, I was asked to come back for dressing change after 5 days.

 

At home, I took rest most of the time. But I walked whenever I could. Walking is the best exercise you can give your body at this time. It also aids in your healing. I would walk around our building in the morning and at night after dinner. During the day I would walk in the house whenever I felt like it and for the time that I was comfortable with.

 

I continued to take sponge baths.

 

Laughter is best medicine but laughing hurt a lot at this time! If at all you laugh, snugly put your arm around the abdominal belt to further support your tummy. I did this but the insides still hurt.

 

On the fifth day after coming home ie. thirteenth day post-op, I went to the hospital for the scheduled dressing change. After checking me the doctor said that I did not need dressing now. I could also take shower without any plastic tapes on the sutures but then I was to pat-dry the sutures and continue to keep them dry during the day. I was told to apply Neosporin or Betadine powder on the sutures. And to keep wearing the abdominal belt.

 

I took my first proper shower the next day and it was such a feeling of luxury! It felt good and fresh. When I took bath from a bucket, I sat on a chair in the bathroom. Within the next few days, the sutures started to dry up and their bits and pieces started falling off. Around the end of sixth week, all the sutures had dissolved/ dried and fallen.

 

Sitting and standing for long durations were difficult for me. My abdomen would swell if I did. My back would hurt. The abdominal swelling would then reduce gradually after lying down. Also, the sutures felt sore most of the time and more so after prolonged sitting or standing. Even if my clothes brushed against the sutures, they would feel bruised. This got better after the sixth week.

 

My abdomen looked completely out of shape after surgery. The cyst was on the right ovary and was big; 11cm X 9.5cm. The right side of the lower abdomen, just to the side of the incision, looked like a pouch bulging down. I had spoken to my doctor about it on the day of last dressing check and was told that the shape would come back with time once the muscles were exercised fully. Today I am eight weeks post-op and so far the bulge is the same.

 

I must mention something important here. I felt very weak in this period. I would be out of breath and exhausted with something as small as talking. I spoke to my General Physician about it and he said that I had just had a major surgery. Weakness was understandable and it would go with time. Today after two months post-op, I still feel breathless and weak most of the time.

 

I ate my normal food in this period but focussed on getting protein and iron. I also ensured to drink lot of water and juices to avoid getting constipated.

 

My first period also came during this period. It lasted for fifteen days! And I am still spotting. After the surgery, my surgeon had advised me to see a gynaecologist for taking treatment for Endometriosis as my tumour had turned out to be an endometriotic cyst. I was advised the hormonal injection Depo-Provera by the gynaecologist. The surgeon and the gynaecologist had both told me that my first few periods may be unpredictable. So I am waiting for things to settle down in this reference.

 

From my experience I would say that you will need assistance for the following once you are at home. So please make arrangements accordingly:

 

1. Washing your hair for the first three weeks post-surgery. This is because you cannot bend forward and bending your neck backwards and washing your hair yourself is a strain on the abdomen.
2. Cutting your toe nails.
3. Getting up from the bed. Getting up from the chairs should be no problem.
4. Pushing heavy doors.
5. Shopping. I avoided going to the market completely for the first six weeks as it is a risk to go in the crowd and also because it causes exertion.
6. Lifting anything heavy. For the first three weeks, even a water bottle was ‘heavy’ for me so I used to lift it with both hands to avoid too much pull on the abdomen. With time, you should be able to lift a few things at a time but listen to your body; it will tell you when something is too heavy.
7. Picking up something that has fallen on the floor. I learnt to use my toes for this! But then bottles and pillows are too big for your tiny toes to catch hold of, so ask for help.

 

I wish speedy recovery to everyone who has undergone any surgery. The first few weeks will be tough but keep your spirits up. Decide that you want to live. Decide that you want to get well fast. And you will!

Ovarian Cyst Surgery; Laparotomy: Part I

In this post I will share my experiences of an open cut Endometriotic Ovarian Cyst surgery. Information shared by many other women has helped me during my recuperation and I hope this post can be of help to others.

 

Laparoscopy is a minimally invasive surgery whereas Laparotomy is a cut & open surgery. I had a cut & open surgery to remove a cyst over my right ovary because prior to the surgery, my tests had come positive for malignancy. Also my cyst was partly solid and quite big; 11cm X 9.5cm. In case of cancer, the surgery is not Laparoscopy but Laparotomy because the surgeon needs to inspect all the surrounding organs to check the damage and remove whatever is affected. Thus, Laparotomy gives them a better view and ease of movement. My surgery was done by Dr Hemant Tongaonkar, a Gynaecologist-Oncologist & Urologist, at Hinduja Hospital, Mumbai.

 

Post-surgery, my ovarian lump turned out to be an Endometriotic cyst and it was not cancer but the surgery that I went through was the same that someone with ovarian cancer would have gone through.

 

When I woke up after the surgery, I had severe discomfort & pain in my abdomen. I was given an instrument where I could press a button to release an immediate shot of pain killers in case the pain became unbearable. I have to admit that I pressed it many times. I was given a vertical, mid-line incision. Single thread running stitches were used to stitch me up. The sutures were dissolvable. The discomfort caused by the big incision and the surgery was very troublesome for around 2-3 days.

 

I had a nasogastric tube in my right nostril, a catheter in my urinary tract and a drain pipe on the left side of my abdomen. Medicines and food was given to me intravenously. The anaesthesia and strong antibiotics caused vomiting even though I was not taking anything from my mouth.

 

The doctor kept asking if I had passed gas. I finally passed it on the third day. When you are given general anaesthesia for a major surgery, your intestines also go to sleep. Passing gas means they are waking up and now you can be given something through your mouth. On the third day, the nasogastric tube was removed and I was given some water to drink but I kept vomiting. You may experience nausea and vomiting till the effect of the anaesthesia starts to wear out.

 

I was also given an abdominal belt to wear on the third day. This belt protects your sutures and incision from any sudden impact and injury. It also supports the internal sutures and organs. I was told that I will have to wear this belt for three months.

 

On the same day, I was also made to rise from the bed and walk a little. For support, I was given a walker. And it was still a nightmare! A nurse and my brother helped me get up but I felt so giddy that I was not even able to balance my neck. They made me sit on a high-seat sofa with back rest for some minutes and then helped me get up for the walk. When you get up on your feet for the first time after this surgery, you will feel that you are never going to walk again but hang on; it will get better each day.

 

I was unable to stand erect because of the pull and tug I felt in my abdomen. I would suggest to you that don’t force yourself to keep an erect back. It is ok. Your abdomen is wounded and weak and wants to stay curled. Let it be. With time, the posture will correct gradually. The walk that I took was exhausting even though it was a small walk. I was given thin lentil-water to drink that day. So I was started on liquid food from today.

 

By the fourth day, my vomiting had stopped but I developed diarrhoea. This was again due to the strong intravenous antiobiotics and painkillers.

 

I was given a spirometer for exercising my lungs. I was too weak to do it so the doctor said that I could start it after a few days. I then made the mistake of completely forgetting about it for a long time. If you are given a spirometer, please use it. It helps your lungs come back to their normal capacity.

 

On the fifth day, my catheter was removed. That was a relief. And removing the catheter was a moment’s job and painless. I had started taking semi-solid foods now. The diarrhoea was still on. Every time I would eat or drink anything, I would have to ‘go’. I was so scared of eating that even though I felt hungry, I would eat only a little. The doctor told me that I should not worry about the diarrhoea; it was harmless. But staying hungry was harmful.

 

There was a big crepe-bandage kind of bandage pasted across my abdomen after the surgery. This bandage helps to keep your sutures (stitches) and the abdominal muscles together. On the fifth day, this bandage was removed. My sutures were cleaned and I was given a dressing of gauge bandage and tape. Up till now, I was being given sponge baths. Today I was given a big plastic tape to cover my abdomen and was asked to take a shower. I poured water on my lower body but sponged my upper body as I was scared that some water might seep into the tape somehow. The sutures have to be kept dry so you have to be careful. I continued to have loose motions. On the fifth day, I was also given solid food.

 

By now, I was walking around without the walker. I was advised to increase my walking time and frequency which I did but did not force myself too much.

 

On the eighth day, my drain pipe was removed. After the surgery, a drain pipe is inserted in your abdomen to drain out the fluid that collects near the surgery site. This fluid keeps seeping out from the drain pipe and collects in a plastic pouch. This drain is not removed till the daily fluid collection comes down to less than 5ml. My daily fluid collection was 200ml – 180ml and reduced slowly. On the seventh day it came down to 5ml. While removing it, the doctor asked me to take a deep breath and hold it in. Once my abdomen was inflated like this, the doctor pulled out the pipe in one swift pull. It did hurt but only for that one tiny second.

 

Once the drain pipe is removed, you will feel very relieved. It is easier to go to the toilet now, to move, to walk and also to take bath. The hole from where the pipe was pulled out was immediately covered in bandage. My suture dressing was also changed. And I was given discharge in the evening.

 

This post was about the first week after the surgery. My next post will be on the period starting from second week till eighth week, ie. the two month period after surgery. This is the period that you will be spending at home. The instructions given to me for home care are also discussed in the next post, Ovarian Cyst Surgery;Laparotomy: Part II.

A River Runs Through It

“Eventually, all things merge into one, and a river runs through it. The river was cut by the world's great flood and runs over rocks from the basement of time. On some of the rocks are timeless raindrops. Under the rocks are the words, and some of the words are theirs.

I am haunted by waters.”

― Norman Maclean, A River Runs Through It

These are the haunting words from where the title of this blog, Everything Merges, is derived. Ever since the book was published, readers have mulled over these words trying to decipher their depth. I loved them from the first time I heard them. And this post is a tribute to these words and the book.

To me the river represents Time; the constant; the eternity. Eventually, we all realise that everything is the same. It is the same Earth that runs from the mountain tops to the river beds, across all continents and oceans. All things merge into one. It is the same Universe that fills our cores. Everyone's. It is all a flow.

Sunrise.. It’s a New Day.



I woke up today morning and stood at my window, feeling not particularly cheerful. The Sun was just beginning to rise beyond a high rise building and I decided to capture the colours in my camera.

I kept looking at the colours. I noticed that gradually my mood started to improve. Sunrise is often used as a symbol of hope, new beginnings and motivation. So perhaps it was the mind’s conditioning that made me feel better. Or perhaps my muscles and cells slowly came out of their sleepy grogginess and started to feel alive. Or perhaps it was just the Vitamin D I had started absorbing from the light! Whatever it was… I felt good looking at the Sunrise.

I stood there motionless but the Sun kept moving. Millimetre by millimetre. Time kept advancing. Millisecond by millisecond. The Earth’s rhythm was being manifested right in front of my eyes. Within some minutes, the Sun was almost up. Time really does not wait for anyone!

The birds went about their chores; their biological clocks in sync with the nature. The morning walkers became visible. The number of vehicles on the nearby road started to increase. I remembered a few things that I had been postponing for last few days and decided to attend to them today itself. I closed my eyes, still facing the Sun, and the bright pink & orange hues of the sky filled my closed eyelids! The Sun was up now.

The whole of my previous day had passed and now I pondered whether my health had been better yesterday compared to the day before? Whether my abdominal surgical stitches had pained less yesterday? Whether I had done yesterday whatever I had meant to do? What was it that I intended to do today? I felt that sunrises are benchmarks of our life and another milestone of a new day was just beginning.

Surviving Cancer: How to Prepare for Treatment

Recently I was diagnosed with a lump on my right ovary and the medical tests pointed at malignancy. As you can imagine, the news brought with it a lot of concern, worry and anxiety. I expected it to be a tough ride from there on; tough physically, mentally and financially.

 

I have had the surgery now and the biopsy report said that it was not a cancer tumour; it was a big endometriotic cyst. But I have not stopped wondering about cancer.

 

Cancer is a disease that hits at your morale with its first footsteps itself. Our life changes the moment we see the first test reports.


For Cancer, we use terms like fighting cancer, surviving cancer, etc. Terms we do not use for other diseases. It is because cancer is an aggressive illness. It often strikes without warning and it strikes hard.

 

When my family and I were searching for a good cancer doctor for myself, I came across a blog by a survivor of a fourth stage cancer. This blog post very efficiently and objectively tells us about the blogger’s personal experience and how to prepare for the cancer treatment. I would like to share the link here because I personally got lot of strength from reading it:

 

http://satish-botheyeswideopen.blogspot.in/2011/07/fighting-stage-iv-cancer.html

 

I hope this can be of use to others too.

My Doctors' Review

I recently had a major surgery. When we were trying to find a doctor for me, we also looked up on the Internet to find information on doctors. There was perfect information on the qualifications of the doctors but very little information was available on their approach, their integrity and their knowledge. There were a few reviews on different platforms but often they were negatively inclined reviews. They were outbursts of anger and frustration with the doctors who had not been good. So I decided to write down this blog and give out information about the helpful and good doctors who have treated me at various points in my life.

 

I am deliberately leaving out the doctors with whom I have had negative and unhappy experiences because I want this page to be a page of positive information for anyone who may need it. Also because, eventually, we all have our own experiences.

 

Before I begin to write about the doctors review individually, I would like to mention a few things that are actually common to all these doctors and are the main reasons why I like them:

1. They are all knowledgeable in their fields.
2. They are all good human beings. For me this has always been the most important thing I look for in a doctor. I believe that no matter how good your qualifications or knowledge or experience, but if you are not a good person, you are nothing.
3. They are all simple persons. There is so façade to any of them. No showing off. No airs.
4. They are all good listeners. An important trait in a good doctor, I think.

 

Dr Madhav Tembe – General Physician – Clinic at Mahim, Mumbai

Dr Madhav Tembe embodies all the good qualities that you may want in a doctor. He is our family doctor and we have gone to him for a very long time now. He is simple, knowledgeable, humble and experienced. He listens patiently and has a knack for correct diagnosis. He also guides patients to right doctors when need be. I have had two surgeries. In both the cases, my surgeons were excellent in every way. And both of them were suggested by Dr Tembe.

 

Dr Ashwini Wagh – General Surgeon – Clinic at Mahim and associated with S.L. Raheja (Fortis) hospital, Asha Parekh hospital and Sushrusha hospital

My first surgery was a haemorrhoidectomy. The physical examination for piles may leave a patient feeling that her privacy has been intruded. That is what I felt with two doctors I had seen long time back, before Dr Ashwini Wagh. That is why I preferred a lady doctor for the surgery and Dr Tembe suggested Dr Ashwini Wagh’s name. Dr Wagh’s examination was respectful and gentle. She gave me proper time and answered my questions to my satisfaction. She did the post-op examinations properly and gave me the same unbroken attention through the long recuperating period.

 

Dr Hemant Tongaonkar – Gynaecologist-Oncologist & Urologist – Associated with Hinduja hospital and Tata Memorial Hospital, Mumbai

My second surgery was done just a month and a half back, for a lump found on my right ovary that seemed to be a cancerous tumour. I went to Dr Hemant Tongaonkar when Dr Tembe asked me to see him immediately. Dr Tongaonkar is a very knowledgeable doctor and the best in his field. Our appointment was at 10:30am but on the last minute the doctor had to go for an emergency operation. So the appointment was rescheduled at 2:30pm. He finally saw me at 4:00pm. I thought that now he would be too tired and too tied up to give me proper attention. I was completely wrong. He apologised for the delay, saw my reports, reading all of them, asked me questions and heard me patiently. When he spoke after physically examining me, he did not beat around the bush. He spoke precisely, to the point and explained my situation to me. I asked him questions, all the questions that I had and he answered all of them. He was objective, as a doctor should be and yet he was considerate and fully aware of my fears and concerns. Later my biopsy stated that the lump was benign and was an endometriotic cyst. With his vast knowledge and experience, Dr Tongaonkar may have suspected that there was a slim chance that the lump was not malignant and therefore he wanted to wait for the final biopsy report. He is not a doctor who will lie to you. In case your situation is grim he will say so but he will also know what to do.

 

Dr Devyani Mahajan – Assistant Doctor to Dr Hemant Tongaonkar at Hinduja hospital

Dr Devyani Mahajan is Dr Tongaonkar’s assistant at present. I had a vertical incision for my surgery and Dr Mahajan gave me the stitches. She also changed my dressings. She has a good ‘hand’. I used to ask her all types of questions about my recovery and she used to answer all of them. She is a hardworking, sincere doctor and like Dr Tongaonkar, is attentive and nice to the patients.

 

Dr Sheetal Vedak – Homeopath – Clinic at Goregaon West, Mumbai

There are homeopaths and then there is Dr Sheetal Vedak. Homeopathy diagnosis has a different approach compared to allopathy and Dr Vedak is different still. I used to go to her despite her being on the other end of the city from my place. One visit to her place meant crossing the whole of Mumbai but every visit was worth it. Dr Vedak asks the right questions in the right direction. She has a keen sense of the underlying emotional causes for illness. Besides homeopathy, Dr Vedak has knowledge of many other forms of alternative medicine which she uses to help understand the illness and patients better.

  

That is my list of doctors. Since I belong to Mumbai, all doctors mentioned here are from the city. But I intend this page to be of use for anyone who is looking for or willing to provide information on good doctors anywhere in India. Please feel free to share such information in the comments section.