Surgical Preparation and Recovery

Gynecological surgery is common during the menopausal transition. Looking over my patient files about 3/4 of them have had some form of surgery. Most start seeing me after their surgery but I get especially excited when they start working with me beforehand. I think surgical preparation is something everyone should consider regardless of the type of surgery they are having. The earlier you can start preparing the better you cope with the procedure and the faster you recover.

I like to start surgical preparation as soon as possible ideally at least 4 weeks beforehand, but this isn’t always possible. Even a week out will be better than nothing. 

If I have 4 or more weeks I start by considering blood work. Do we need to optimise iron levels, blood glucose, potassium or other electrolytes, Vitamin D or B12, Zinc, and liver function to name a few?

It’s also enough time to consider your weight. You may not reach your optimal weight in this time frame but its’ enough time to start working towards it. Either being underweight or overweight makes recovery that bit harder than it needs to be.

As you may be spending more time at home recovering afterward, we want to make sure your home is as healthy as possible. It's time to locate and remove all the hormone disruptive chemicals. 

Now is the time to start withdrawing from any habit-forming foods such as coffee or lifestyle habits such as smoking. Consider how you could cope 1, 2, or even more days without your crutch. Would the caffeine withdrawal or the low blood sugar headache be worse than the incision pain? The earlier you start withdrawing the better chance you will be off these substances and free of any withdrawal signs before your big day.

In regards to food, it's time to start removing these: coffee, alcohol, sugar, chocolate, gluten, dairy, soy, and any individual food intolerances. Focus on unprocessed meals full of organic fruits and vegetables, lots of beneficial fats, and plenty of high-quality protein. I often recommend slow-cooked meats on the bone or bone broth to help increase collagen at the same time. Collagen smoothies are another way to do this. Adequate fibre is also important to encourage good bowel health, as it water consumption and optimal hydration. 

Now is the time to cook up a storm and freeze meals for after the surgery. Homecooked meals are more nutritious so don’t be tempted to order takeaway and you may or may not have the energy to stand for long enough to cook your favourite nutritious meal afterwards.

This leads me to another option - delegation. It's worth considering your post-surgery limitations and creating an action plan. Maybe you can arrange for family or friends to drop freshly cooked homemade meals to you?  Will you need help with children, are you caring for parents that will need alternate care while you recover, can you drive, can you work, will you need household help. It's certainly better to consider this now when you have time to look into options and ask for assistance.

This next task depends on your anticipated recovery time. If you have an extended period of time to fill I highly recommend you start considering your own entertainment. Keep in mind if you are having anesthesia you may be a little dazed and confused with a limited attention span afterward. Maybe magazines might be a better option than books. Tv shows over movies?  Card games, board games, jigsaw puzzles, coloring in are other options to keep you busy.

If you are anxious about your upcoming surgery, it’s time to learn a few mindfulness techniques such as meditation, breathwork or hypnosis.  I’ve seen some very good Youtube guided exercises to help ease your mind and help mentally prepare you.

A week prior to surgery you need to stop all supplements unless your surgeon has encouraged you to continue them.

After surgery, it's important to follow your directives from your medical team. And not be shy to call upon family and friends who offered support. 

As a general rule, you should get up and start walking around as soon as possible as this reduces the risk of blood clots. Walking will most probably be your sole exercise until you are given clearance to include other forms of movement. It's important to avoid swimming, baths, or hot tubs for at least 4 weeks afterward. You may bleed or experience vaginal discharge after your surgery, don’t use tampons or other insertable, make sure you have plenty of pads, preferably organic pads ready to use.

One of the most common complaints after gynecological surgery is bloating and gas. Many women have found relief by chewing gum. Peppermint oil pills like de-gas may also be helpful but I prefer herbal teas. You may like to try fennel, peppermint, chamomile, or dandelion.

It's so important to get rest and good quality sleep to assist in the recovery process. Deep self-care is needed.

Continue with the preop dietary suggestion.

I often add supplements for my patients at this time. It varies from person to person and their individual needs but I love an Australian scripted product called Tissue Regenex. It’s specific for wound recovery and minimising scar tissue formation.  It really does work well and I’ve had many surgeons comment on how fast women recover on this supplement. I also add in a broad-spectrum probiotic. Some women will need stool softeners others will do well on dietary fibre, either way, it's crucial to keep your bowel moving especially now. I often also add Vitamin C and collagen. Plus an anti-inflammatory like omega 3 and or turmeric. Some forms of choline like glycerophosphocholine (GPC) can help improve recovery from anesthesia.

Please don’t apply anything topical to your wound, if you have one. Once it's fully closed you can consider topicals like Rosa’s Scarless healer cream.

Once you have your final post-op checkup by your surgeon it's time to start seeing a good women’s health pelvic physiotherapist. This step is missed by most but it's such a crucial step if you want long-term pelvic health. The other appointment I highly recommend you book around now is an acupuncture appointment. This is more important if your surgery involved an abdominal incision. 

If you are having a complete hysterectomy you may like to consider additional mental health support as it's a big deal to remove an entire body system and you may need help unpacking what that means for you. Many women feel down after this, just like a postpartum woman can have the baby blues when their hormone levels drop dramatically with childbirth so can a woman who is experiencing a medical menopause. It's worth being aware of this and informing those close to you that you may need cheering up afterward. Depending on your circumstances you may require hormonal support to get you through.  

If you are personally preparing for surgery I want to wish you all the best and hope you have a speedy recovery. If you would like a hand preparing I'd love to assist you.