Resilience Unleashed: Post-op recovery tips

When you're preparing for or recovering from surgery, understanding what to expect during the recovery process can be immensely reassuring. “I went into my first surgery not knowing what Endometriosis was, what the surgery was about, or what to expect after”, shared Theresa. “All I knew was that my surgeon was the first doctor to finally listen to me and offer a solution, so I just rolled with it… This was a terrible idea - I wasn’t ready for what came after, and this affected my healing time and mental state”.

Oftentimes, doctors and care teams play things down to keep you calm and hopeful, and because, indeed, some patients have it easier than others. But we believe coming prepared affects your healing significantly, and it’s probably worth it to prepare for beyond the “best case scenario”.

We're here to guide you through the different phases of recovery and provide insights to help you navigate this challenging yet transformative journey.

Getting Ready

The difference between good experience and a bad one often depends on how prepared you are as a patient. The less surprises you'll have on your way to recovery, the better experience and more control you'd feel over the situation.

That being said, embarking on the surgery journey means a little less control in general, and we should be prepared for that too!  Preparing for it mentally is extremely important.  To help you get your mind in the right space, we created The Surgery Guide - a short and sweet read for anyone getting ready for surgery, even if it's not your first one! We also created this detailed article about what to expect on the day of your surgery so all steps will be clear and known to you.

Check out the Recovery Essentials list we collected from the community, and Download the printable packing list to ease your recovery.

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First Few Days: Navigating Soreness and Internal Pain

In the immediate aftermath of surgery, the first few days can be tough. You'll likely experience a high level of soreness and internal pain. It's important to remember that this is entirely normal and expected and that your “usual” spots will hurt even more because everything will be raw and healing, and you should expect sudden jolts of pain that can occur with movements like sneezing, coughing, getting up, bending down (try to avoid doing all of those).

During this first week, your focus should be on rest and pain management. Stay on top of your prescribed medications, and don’t try to be a hero. Set an alarm clock to take them on time. It’s much easier to control pain while you're riding the wave with painkillers on time. Once you get off of it and the pain intensifies, it’s going to take more time / stronger stuff to get it under control again. Usually, you’ll start with a combination of a strong painkiller and a “regular” painkiller (like Oxy and Tylenol/Advil), alternating between them every few hours to create that “wave”.

It’s important to remember that this pain is different - for many, it also FEELS very different, but even if it is similar to your daily/monthly pain, this pain has a different meaning to it. It’s no longer “just another flare-up” - it’s healing pain. Also remember that healing is not a linear process, and some days may be more challenging than others. Be patient with yourself, and don’t “punish” your body for not being up to things.

A space for healing

It’s important to create a space for healing - not just in your mind but also physically in your home. It feels much better to come home and recover in a clean-smelling space with a bed that’s ready for your extra propping, additional pillows, and a dedicated basket/box for all of your additional items.
What should be in the basket? See the full list here.

Gas pain

The first few days, sometimes up to day 10-12, you’ll be working on getting gas out of you, and the gas pain might be severe. Surgeons use gas to inflate the stomach during surgery, and some of it stays in for the body to get rid of. This means, on top of your internal healing, there will be specific painful spots, usually in your chest, back, shoulders, or stomach - and if those tiny bubbles get stuck behind a nerve, a bone, or close to an internal wound, they can be very painful.

How to relieve gas pain post op?

• Walk walk walk!
  It feels counter-intuitive, especially in the beginning when everything hurts, but it does work. Walking helps your body move the gas bubbles around and towards the exit. Faster results can be achieved if you waddle like a duck and shift your weight from thigh to thigh > it helps the body “shake” those bubbles and move them around.
• Heat
  Whether it’s a heating pad for your chest/shoulders or standing in a hot shower, heat helps relieve the gas pain almost immediately. It doesn’t solve it, so as soon as you remove the heat, the pain will be back, but it’s a great way to handle shoulder and chest gas that takes longer to leave the body.
  Note the risk of using a heating pad on your incisions; direct heat like this might pose a risk of incisions re-opening, so be careful and use heat mostly around your chest and shoulders!
• Gas X or equivalents
  These chewable tabs are a tremendous help for gas pain, tho they take time to work effectively.

Internal healing

You’re about to feel very bruised on the inside. “I felt like someone took a baseball bat to my stomach and just hit me everywhere,” says Jenny. “After the first two days, I started having nerve and muscle spasms. Like a random electrocuting, I would scream or jump in pain, but it was over before I realized what exactly happened”.

The hormones rollercoaster

It's common for hormones to experience temporary fluctuations after excision. The inflammation and anesthesia used during surgery can impact hormone levels, and the stressful event for the body triggers the release of stress hormones like cortisol, leading to hormonal imbalances. This means any rhythm of bleeding or spotting, cramps, PMS symptoms, all of them are expected and might happen - so no need to freak out.(**Blood loss is a serious matter. Your care team will let you know how much is “too much” and when to go to the ER if the bleeding is concerning. But as long as you’re not bleeding this much, irregularities are expected and perfectly normal)Depending on the surgery's nature and extent, hormonal regulation may be affected for a while, and if you’ve had a hysterectomy - the effect quadruples. “I was on a rollercoaster of emotions”, shares Wendy, “I had a hysterectomy and I knew I was going for some “menopause changes,” so I was preparing to embrace the hot flashes and improve my diet - but I didn’t expect to need someone to scrape my energy off the floor. I was so depressed and didn’t expect it. I cried for days”. Wendy shakes her head, trying to clear the memory. “I just wish someone would have told me it might happen”.

Medications prescribed post-surgery can also influence hormone levels. If you’re on continuous birth control (HRT), your surgeon will likely ask you to keep taking it. If you’re not yet using any hormonal treatment, and your goal post-op is not to conceive - you might want to consider starting HRT before surgery or right after. With the reminder, of course, starting a new BC is often not a fun experience for the body, and adding it on top of recovery and healing is something you might want to keep in mind.

The TMI Corner

Every patient, regardless of their usual bowel movements, experiences slowness after general anesthesia or while taking strong painkillers. You should prepare for this based on your normal “base” - if you tend to get constipated, you might want to start taking stool softeners a day or two before surgery to get yourself prepared and make sure the first one wouldn’t be terrible.

If you have endo or adhesions removed from any of your internal organs, using those organs will result in pain. You might also experience pain before, while, or after urinating or having a bowel movement. You will most likely not be able to "push" or strain during this week, which is also why it's important to take stool softeners regularly.

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It might take 5-6 days until you have your first BM, that's normal and almost expected- depends how much you eat, what you ear, and how your stomach reacts to being shut down during surgery. When the time finally comes, here are a few tips to help you get through this:

• Use a stool to lift your feet off the ground and create a better angle with your knees
• Limit/eliminate straining or pushing, especially if there was work done on your colon.
  Let gravity do its thing - it will take a little longer but will work with your body and not against it. You can shift your weight from thigh to thigh on the toilet (a bit like waddling, but while sitting) - to help move stool faster.
• Use a bidet or soft baby wipes instead of toilet paper, if the area is sensitive to touch after a BM.

In the initial week following surgery, you'll likely require assistance with many daily tasks, from getting up and sitting down to using the bathroom and taking showers. So you might want to arrange for the right companion to assist you in those days.

Week 2-3: Transitioning and Managing Incision Pain

As you move into the second and third weeks of recovery, you may notice a shift in your pain experience. The internal healing pain should slowly decrease, and hopefully by the end of week two, most patients are able to manage their pain with OTC options only. Incision pain may become more noticeable as the muscles around your surgical site start to heal at that time, and unfortunately, in this case, the skinnier and more muscly you are, the worse it hurts. BUT it also heals faster so you got that going for you!

Your primary focus should be on avoiding infections and preventing incisions from reopening. Keep your incisions clean and avoid excessive movements or heavy lifting. If you overdo it by bending, lifting, or simply moving too much - your body will usually tell you right away. Don’t be alarmed - that’s perfectly normal and expected. If possible, try and plan an eventless recovery where you can pretty much sit and watch TV for a few weeks until you’re ready to assume responsibilities again.

You might also find yourself fighting an unfamiliar fatigue and general disorientation feeling. That’s also perfectly normal after general anesthesia and should pass within 2 weeks. “I was so “out of it” for a while”, remembers Paige, “It took almost two months for me to feel like myself again, there were awful ups and downs, but the wait was worth it”.

The first cycles post-op

Unfortunately, there are often mixed expectations when it comes to your first few cycles. Some doctors might paint a too-optimistic picture of having a painless cycle following your surgery. This is indeed the hope for long-term healing, but the first 1-2 cycles are actually expected to be horrendous… Think about it: everything inside is still raw and healing, while everything is “trying to bleed” again and, in general, more inflamed and sore = it is very likely you’ll experience an intense period and ovulation following your surgery. It’s also going to hurt in the EXACT same places it did before - because that’s where the healing is happening. So don’t be taken aback or fear that “it was for nothing” or “everything is back” - it’s more about the healing process.

Even if you’re on continuous birth control, you might feel the PMS days or ovulation days more intensely. “I never had noticeable issues with ovulation until surgery,”’ shares Sharon, “Post-op, I almost passed out when I was ovulating. The pain was similar to my period cramps, and it felt like my entire uterus was being tightly squeezed and slashed by a hot knife at the same time. I’m grateful I had a Tramadol left to help me through that day”.

Our best recommendation is to expect it, plan your life around it as needed, and prepare with some strong painkillers as much as you can - as we like to say, “If possible, there’s no reason to feel every bit of the healing” - take OTC painkillers early on, don’t wait for the pain to become unmanageable, and if needed, take a strong one following the same process as you had the first few days after surgery.

Be careful and remember that your goal is only to ride the wave, not to get to a “painless” state. If you feel like you might need help controlling your use of prescription painkillers, do not hesitate to reach out to the national helpline: USA, Canada, UK, or look up your local substance abuse help centers.

Getting Back to Life: Remember, Healing Is a Journey

While you may feel the urge to return to your normal routine as soon as possible, it's important to recognize that the first 6-12 months following surgery are still part of the healing process, depending on the scope of the work that was done.

If you overdo it, don't be too hard on yourself. Listen to your body and let it recover. This could be frustrating. a one-step forward, two steps back kind of progress - but keep your head high and remember that at the end of this journey, there’s a new you, and that healing is about adjusting the physical parts but also the mental and coping skills to better manage this condition long-term. Healing is not a race, and pushing too soon can hinder your progress.

This is a good time to remind you about pelvic floor therapy: a necessity for every endometriosis patient, and even more so post-op. Usually, you'll be asked to wait 5+ weeks before starting pelvic floor therapy, to let everything heal internally before. Learn more about pelvic floor therapy and 6 go-to movements you can try at home.

Make adjustments as needed (do you need new clothing? An adjustment to your workplace? Expectation settings with yourself about what you can/should be able to achieve in a single day?) - it’s important to create small, achievable goals, to be able to stick with the progress.

Make sure you set time to assess your abilities once every few days/weeks, to ensure you're not holding yourself back unnecessarily due to fear or habit, but please keep in mind that recovery is a long journey and that adjusting is not only necessary - it’s also the smart way to do it. Fighting with yourself or your body usually ends with both sides completely defeated :)

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To summarize, recovery from surgery can be a challenging and transformative experience. Understanding what to expect at each stage of recovery is crucial for your physical and emotional well-being.

Remember to prioritize rest, adhere to your prescribed medications, and be patient with yourself. Healing is a journey, not a destination, and it's okay to seek support from friends, family, or healthcare professionals when needed.

Ultimately, the key to a successful recovery is listening to your body, making adjustments as required, and striking a balance between giving yourself the time you need to heal and gradually returning to the activities you love. Your recovery is unique to you, and with patience and care, you'll emerge stronger on the other side.