For more information on endometriosis and my story, read previous One in Ten series posts here.

We’re in the final countdown, readers. Two days to surgery!

My pre-op appointment was last week, but I thought I’d share the details today. Let’s pull back the curtain on what leads up to endometriosis surgery.

The appointment had a rocky start — my partner and I accidentally went to the wrong location. But I called the office, and they managed to still fit me in once we got to the right place. The office was large and welcoming, with big windows, and empty except for the receptionist. The one TV in the room had “soothing music” playing, like something you’d expect at a salon or massage place. The nurse I met with was very friendly, and we hit it off pretty well. Actually, our conversation got a little distracted talking about life stuff before I remembered “oh hey, I’m supposed to be asking my questions.”

So what’s involved in the actual appointment? Here’s how mine went:

The parts I expected

• The nurse drew a few vials of blood for a CBC (complete blood count) and metabolic panel. These check for red blood cell count, white blood cell count, kidney and liver function, blood sugar, and other things. They basically make sure you’re in good general health, with no current infections, and have a healthy starting point for surgery.
• She gave me a bottle of antibiotic soap and instructions. I’ll have to shower the night before surgery and the morning of, using half of the bottle each time. Absolutely no conditioner or lotion allowed, which kinda sucks, but I get it. We’re aiming for least possible chance of infection or irritation in/around the wounds.
• Q&A! I kept a list on my phone of every question I thought up in the weeks before this appointment. These included (with her answers):
  • What blood tests are you running today? (CBC and metabolic)
  • Can my person come into the hospital/room and wait with me before the surgery? (Usually a given, but not in the time of COVID. Answer was yes. Also encouraged to bring snacks and drinks, since the cafeteria may be closed due to COVID.)
  • What paperwork or advanced directives should I expect to prepare? (Probably just your driver and emergency contact’s names and phone numbers.)
  • When asked for my name for identity confirmation with paperwork, ID bracelet, medications, etc., should I use my legal name or can I use the preferred name included in my records here? (Definitely legal name.) Which lowkey sucks.
  • Can my person be present for all conversations after surgery? (Yes)
  • I am gluten and dairy free, and allergic to bananas. How do we make sure I’m not given anything I can’t eat at the hospital (such as regular crackers)? (Made a note in the allergy section of my medical file)
  • Can I still take my necessary prescription medications the morning of surgery as usual, despite the food cutoff the night before? (Yes, with a sip of water, no later than one hour before arriving at the hospital.)
  • How much walking should I do post op to handle gas pains? (As much as you can!)
  • What should I expect as far as laxatives or constipation after surgery? (Nothing ordered or prescribed by doc, but nurse recommends taking stool softeners regularly with LOTS of fluids. Probably will have low appetite and activity for at least a few days.)
  • What pain medication might be prescribed? (Probably just acetaminophen and ibuprofen – aka Tylenol and Motrin. Prescription pain meds contribute to nausea and constipation, so they’re avoided as much as possible. If needed, there may be a medication that combines oxycodone with acetaminophen, or Percocet.)
  • Should I do or avoid kegels during recovery? (Shouldn’t hurt, probably would help.)
  • Some questions she said I should keep to ask the surgeon: What happens if we discover adenomyosis (growths within uterus wall) rather than endometriosis? How much bleeding or discharge is normal after surgery, and for how long?
• We made a note to tell the surgery scheduler that I do want the Mirena IUD, recommended by my doctor, ready for insertion while still under anesthesia.
• The nurse gave me a packet of paperwork with various instructions on how to prepare for surgery, what to expect during the operation, and what to do during recovery.

The parts I didn’t expect

• No bowel prep! My online support group said to expect bowel prep, and my doctor and I had discussed the possibility of endo being on or in my bowels, so I thought this would be a given. But apparently, per the nurse, any accidental nicks/damage to the bowels during surgery is easier to fix/”clean up” if anything in the bowels is, ahem, more solid than liquid. So yay, I guess?
• There were a lot of questions the nurse asked me. I didn’t realize how much goes into preparing for anesthesia. I guess that part of surgery is a bigger deal than I realized.
• Due probably to the long list of questions we both had, the appointment took a lot longer than I expected. These days it seems medical appointments are getting more and more rushed as the shortage of doctors gets worse, so it was nice to have someone’s full attention for a whole hour.
• The nurse told me to bring my inhaler to the hospital. I don’t have asthma, and only use my inhaler for allergic reactions to tobacco and cigarette smoke, so this hadn’t even occurred to me. Again: anesthesia’s a pretty big deal, apparently.
• Since NSAIDS (anti-inflammatory meds) like ibuprofen are banned for 1-2 weeks before surgery, I thought I’d have to stop my allergy med (generic Zyrtec), too. Nurse said I can keep taking it as usual, which is awesome. Springtime and open-window season just kicked off in Indiana.
• The take-home packet was much more extensive than I anticipated. It included all the information I’d put together through internet research, and then some. Now I’m as prepared as I can possibly be!

What’s next?

If anyone’s reading this in advance of their own laparoscopic endometriosis surgery, there’s a few notes from my take-home paperwork I’d like to share.

First of all: quit smoking and no alcohol. I don’t smoke (allergic to tobacco, remember) and rarely drink, so I was already doing these. But they’re super important for the best possible recovery.

Second tip: keep up (or ramp up) the exercise. Staying physically fit and active is something I am sometimes good at and sometimes not so much. It’s a big part of being in the best possible shape for surgery outcomes and recovery. Walking is especially encouraged. After first being booked for surgery, I started walking on a treadmill while watching How I Met Your Mother episodes on Hulu. Find what works best for you, and keep it up regularly.

Finally: drink so much water. Hydrate, hydrate, hydrate! I already carry a reusable water bottle with me everywhere, but I’ve also started alternating with apple and white grape juice. I tend to drink more fluids when I have more options throughout the day. Gatorade and clear sodas, while not the healthiest options, can work too.

Tomorrow I’ll share my packing list for my hospital bag.

While my surgery is scheduled as an outpatient procedure (where you leave the same day and don’t stay the night), there’s always a chance I could be admitted as inpatient for a night or longer. Today I packed a duffel bag with enough things for a few days’ stay. I’ll share my list (and the day-of items to remember to pack) tomorrow.