Back problem prior to surgery

Women's health
1

I am due to have a vaginal hysterectomy with anterior and posterior repair on 27th July.

I am really worrying because I have two slipped discs in my back (L3/4 and L4/5) and I still have some numbness and weakness in my right leg. I have read that the position I will be in for surgery sometimes causes nerve problems afterwards and my mind has gone into overdrive thinking that I’m going to have more problems with my back. The pain when I first hurt my back was so severe, particularly in my groin and down my leg, that I don’t know how I will cope if anything happens to exacerbate the problem.    

I have told the gynaecologist about my back, and I also mentioned it to the nurse at my pre-op appointment, but I don’t really feel as if either of them took any notice. The consultant made a comment about slipped discs being really painful but said nothing else, and the nurse at the pre-op appointment said it wouldn’t matter as long as I was mobile. As far as I know neither of them wrote anything down about it. I have thought I could mention it to the anaesthetist when I go in, but I feel a bit like a moaner before I even have the operation.

I am feeling generally a bit in the dark about everything. The pre-op assessment was very rushed (I was out in 10 minutes), and I wasn’t given any information about the operation. Literally the only thing I was told was not to eat or drink after midnight and to have a shower in the morning. I asked how long I would be in hospital and was told two nights, but the nurse didn’t expand on that at all. I haven’t been given any leaflets or information about anything, even what to take into hospital (although I have worked that out). I have picked up everything I know from reading this forum (e.g. that I will have a catheter and a pack, that the consultant may use some kind of mesh). If I wasn’t so desperate to feel better I think I would cancel the operation.

Any advice or reassurance would be welcome.

2

Oh gosh you poor girl. Hopefully you are having a UROGYNAECOLOGIST operate. Not a Gynaecologist? Can you ask to be seen again before going into hospital so that you can get answers on your already damaged back? How can a Surgeon not fully explain the procedure he is planning to do to you? You have to sign a consent form which says you have had the procedure fully explained to you!! It amounts to medical misadventure surely? What Country are you & what hospital system? Are you already under a Specialist for your back and can get to discuss the forthcoming prolapse surgery & the impact it may have on your back? Mostly I imagine the fact your legs will be up in lithotomy poles for the surgery plus you are moved around while anaesthetised - legs lifted into poles & back down again and transferred from operating table to your bed once op finished. Get answers girl & be clear about it all before you go into hospital.

3

Florin if you are under the care of a specialist for your back problem I would advise him you are having this surgery and he can advise your Urogynaecologist of the best and safest position for surgery. I have seen it performed without lithotomy poles whereby 2 people (nurses or doctors) gently lift the legs just high enough for the consultant to operate.

4

It's a sad fact that in UK very little is explained prior to operation. I'm a nursing student so witnessed a few of these style of operations prior to having my own ( anterior and posterior repair plus bladder sling on 13th June hysterectomy 8 years ago) unfortunately there is only really one position you can be in during the operation, however your notes will contain your previous history so during your hospital recovery ask to have morphine for the pain and ask for the strongest combination once your meds are getting done for discharge. Keeping on top of the pain will allow you to move better so hopefully once home you can minimise the time spent in one position so minimise the chances of your back problems getting worse. Don't forget everyone is individual in their recovery. Personally I've been absolutely fine, uncomfortable at times yes, especially while still with the catheter and had an infection in outside stitches which cleared with antibiotics but am doing all my usual stuff but NOT lifting anything over 1kg. Sweeping and not hovering, getting stuff carried and then sorting it out, just general adjustments. I like you considered not going a head as was terrified I would be so unwell afterwards I could not return to my nursing course but while tired more than I expected I have recovered really well. Please don't be put off by horror stories, it's not always like that. This site in invaluable in answering what at the time will seems like the oddest questions! Ask to speak to the surgeon or one of the team and get them to explain exactly what is going to be done ( I did this on morning of op) the pack will only be in for 24 hours and is just a very long piece of gauze, doesn't hurt on removal. Good luck, try to relax, as you know being tense doesn't help your back. Take care and Hope this helps Xx

5

I have back pain problems and had them prior to surgery (L4/L5, L5/S1) The position of surgery did irritate things but it was OK.  Definitely manageable and not enough to make me second guess my decision.

When  I came to, post-op, the back pain was worse than the surgery pain but I told them how much it hurt and where and they added more meds to my IV.     It took a little time to settle down after the op, but I was on opiates and it helped my back feel ok.  By a week later it was back to a more normal level instead of a flare up level.  For me, laying down helps my back so that helped the flare up.   Ice helps too.   I have some nice big gel packs and I definitely used those, both on my back and between my legs.

right now I am 9 weeks post op and working on increasing my walking and starting some of my gentle PT exercises (just abdominal bracing and some stretches, so far).  I am trying to work towards where I was pre-op so I can go to physio for my back and get my pain under control.

for preparation, I found the book about recovering from gynecological surgery by Sue Croft to be very helpful.  It has a lot of information.  It should be available on kindle.

it is weird that you weren't told what they were doing and maybe you can get more information over the phone.  My visits were really rushed too and it was disconcerting.  the book I recommended and these forums helped me a lot.

6

If you read my post elaine you'll see that the Urogynaecologist doesn't have to put a patient in lithotomy poles and the legs can be gently held in position. It just means the surgeon has to take his time 

7

Hello robyn and thank you for your reply. It is a gynaeoclogist I have been seeing, but when I was sent the date for the operation and phoned to say I could attend, the woman told me that there is another consultant, who is a urogynaecologist, assisting with my operation.

I have not yet signed a consent form, so  I did wonder if someone is going to explain things to me when I get to the hospital. It just feels a bit last minute to me. I do have an orthopaedic consultant re my back, and he told me to tell the gynaecologist about my back but didn't make any other suggestions. He has said that it might take a long time for the weakness and numbness to go, if ever, because one disc in particular is bulging right out and although the inflammation will gradully settle down it will always be a weak point.

It doesn't feel as if there is any communicaton between people.  

8

Consultants don't off advice to other consultants unless they are approached. It's up to your Urogynaecologist to ask the orthopaedic specialist for advice. I personally wouldn't have surgery without that happening if I had your problem Florin. 

9

Sorry Matron, didn't see the post! I did only witness a few of the operations, makes sense that is can be done with assistance rather than poles. Nice to see you back 😄 X

10

Hi Florin,

I do not know what to say to you, apart from please google lithotomy images for posterior prolapse repair.

Can you put your body into this position.

I wish I had had this knowledge before my surgery.

I have spinal neuropathy in both legs, and disc degeneration at three levels, so know the type of pain this causes, both in legs and back.

I don't know if it would make your pain worse. My gynaecologist said he would be mindful of my back condition, but you obviously have to be in a position where they can see what they are doing.

They can do the hysterectomy abdominaly, I don't know if there is another way of doing an a and p, even separately.

You definitely need more information, I'm not just going to sympathise and wish you well, I'm being totally honest, knowing the impact spinal disc problems can have, I've been disabled for thirty years.

If your surgery is essential and you are young and will recover quickly, maybe it's right for you.

I am hoping to get back to "my normal" I just wish I had known more about the positioning, but I didn't ask, because I didn't know to ask. Maybe I was naive.

I'm really sorry to give such a non positive answer, I wish I could do.x.

Please PM me if you would like to ask anything at all, click the envelope under my name.x.

11

That's ok elaine. I've seen it performed differently on a few occasions and interestingly enough 2 out of the 3 were nurses however they were my age and we worked without health and safety rules and just had to get on with lifting no matter how heavy the patient was. So look after your back elaine.....it's precious.

12

I was typing as matron answered so have just seen the post, about having your legs held instead.x.

13

I will, had occupational health assessment yesterday and returning on light duties on 18 th July, am just too old to defer but if I didn't feel up to it I wouldn't return. I felt it was important that someone going in for the operation is not completely put off, some people recover quick, some slower. When I first came on the site prior to the operation the first reply I had was completely doom and gloom, while we need to give realistic comments and experiences I think it's important for the ladies waiting for the operation to know it isn't always bad. The lack of info does seem to be the one thing we all have in common which without this forum would be a nightmare X

14

Thank you so much everyone for your replies. I will definately phone for more information and buy the book by Sue Croft. I feel much better reading that although things might flare up slightly they will settle down.

This forum is wonderful.

15

Before you are taken to theatre, you should get a visit from the anesthetist, who will explain what they will do and one from either the surgeon or his assistant who will check you know what procedure you are having and if you have any questions before you sign a consent form. Explain your concerns to both of them and make sure it is noted down. You should check with the nurse when they are booking you in about who is coming and when and also raise  the matter with them- they need to know.

You are not being a moaner at all - you are only trying to ensure a good outcome,which is what they should want as well. If you do not make it clear, they can't  guess about concerns  that you have . I was nodding politely before my first procedure but before my second I was still very polite but double checked the what if's and also checked who was actually doing the operation because that was important to me in that case. 

16

Not Medical Misadventure - duh - I was tired! Something like that anyway. I know - malpractice!!

17

Well said elaine x

18

Hi, Florin:  I am in just about the same situation as you.  I live in the USA, but my surgery is the 19th. I am already had my hysterectomy in 2001, but I have a huge prolapse, both anterior and posterior.  I was in pre-op yesterday for about eight hours, counting my doctor appt.  He went all over my meds, and when I mentioned my back, he said..you will be really sore in the back after three hours of lying on that table...I have degenerative discs, scolosis, and spinal stenosis...I am really dreading how my back is going to feel when I get home. I can hardly stand the pain now, and I nearly scream every time I get out of my bed.  It is my lower back and two bad knees.  I pray that we both do well and are better off for having done this.  The prolapse is driving me insane...HUGS.

19

Hi Carole. I'm in the UK but have almost the same problems as you. I have a rectocele and vaginal vault prolapse plus spinal osteo arthritis, scoliosis and hip OA. I've been doing some reading up about prolapse surgery with all these problems and still can't decide whether to go ahead. I'm 73 so I'm not too keen on having any surgery really because of "possibilities" during and after. My GP and the gynae surgeon said that all the problems will deteriorate as time goes on so I have to make a decision before next appointment with gynae at the end of August. It's the thought of all the pain and lack of mobility after I'm concerned about. I'm still recovering from a salpingo oophrectomy and cyst removal in April. Can't seem to get my energy back and going upstairs is a no go still at the moment. I live in a bungalow so thats ok at home but can't visit my kids as they all have upstairs bathrooms! Not much fun getting older!  I've always been very active and quite fit until lately. Pollyanna