[Warning: graphic tumor image ahead]
Before my open abdominal myomectomy, I went on a mad Googling spree. I wanted to know every little thing I would feel or think or need before and after my body was dissected for the very first time. And despite the bad rep of search engine k-holes, my frantic research helped. A lot in fact. I knew to request anti-nausea medication in case the anesthesia made me sick. I knew to expect an enema. I knew to buy granny panties that wouldn’t rub the incision area. So to the beautiful cesspool that is the internet I’d like to add my own testimony, in case some other poor soul needs a grapefruit-sized tumor cut out of their uterus in a foreign country. Here goes!
I was admitted to the hospital 2 days before my surgery. That turned out to be a blessing in disguise; orienting myself in my room put me at ease. Dr. Furukawa went over my procedure with me and my husband John and had us sign various consent forms. Then a sweet nurse named Michiko took us to the visitor’s lounge to give me an admittance interview. She had questions prepared in English, and whenever she encountered a question on her list that she felt was intrusive, she prefaced it with “Excuse me.” “Excuse me, but do you have any children?” “Excuse me, but when was your last menstrual cycle?” She took us to my room to have a rest, and John and I exchanged our goodbyes. Later, Michiko returned to give me a grand tour of the ward, visitor’s lounge, telephone booth, and bathrooms.
The next day I got permission to leave for a couple of hours. I met John at Hard-Off, the nearby secondhand store. Thrifting is how I usually blow off steam, but I couldn’t focus with the upcoming events. John drove me home to relax (impossible) and pick up a few forgotten items.
That afternoon, Michiko came in to shave my pubes so that the surgical bandage wouldn’t get caught in the hair. We made polite conversation while she gave me a cut akin to a vulva goatee. She even told me I had a beautiful abdomen.
It was almost time, but I felt surprisingly calm. I read a little and ate dinner.* I was told not to eat anything after my meal and not to drink anything after 9 pm. Another nurse came to give me a laxative. To make sure I understood, she mimed taking a pill and then stuff shooting out of her butt. I watched Moana on my laptop, and tried unsuccessfully to go to sleep.
The laxative kicked in really early in the morning. At about 7 or 8, a nurse came in to do an enema (expected but still uncomfortable). I was also given my IV. John came about a half hour before the surgery. The doctor walked us to the operating theater. They prompted me to say my name and confirm the part I was getting operated on. The doctor even wrote “子宮” (Shikyū, or uterus) on my hand to be super sure. Everyone in the room was in a shower cap. When they put one on me, I started crying, because knowing you’re about to get cut open is terrifying. I hugged John goodbye and went with them to the operating room.
It’s a blur, but I recall the operating theater being vast and full of shiny metal and bright lights, like a clean, futuristic warehouse. I’d been asked in advance if I had any musical requests. I didn’t want to associate any of my favorite songs with this moment, so I drew a blank and just told them, “Anything is ok. Happy music.” When I arrived, the room was echoing with aggressive, autotuned pop. I guess happiness means something different to everyone.
I found some comfort in the sheer number of people in the room. Surely I’m not gonna die with this many people working to keep me alive, I thought. I was prompted to lie down on the table, and then to curl up in fetal position on my side so that they could administer my epidural. It’s crucial not to move during the insertion, so a nurse bent over me and held me in place. It hurt, but the thought of having a needle in my spine was probably worse than the actual pain.
When I flipped onto my back, one of the nurses looked at me and said “Shot Bar 35?” Our favorite bar in Nakatsu. “Have we met?” I asked. She smiled and confirmed that not only had we met at Shot Bar, but she had also assisted with the bartender Masato’s surgery last year. This conversation occurred while they were strapping down my arms, so it was a welcome distraction. Lastly, one of the doctors put an oxygen mask on me. The anesthesia started flowing, so I told everyone, “Goodbye!” and then awkwardly remained conscious for a minute or so before actually drifting off to sleep.
When I was coming out of the anesthesia, I remember having thoughts—planning a trip to Kyoto that had already happened—similar to the half-dreams you have as you doze off to sleep. I awoke to the doctor saying my surgery was finished. I replied, “Uso!” (“Lie!” in Japanese). But within a couple minutes the pain hit and I believed it. Not scream-worthy pain, but enough to make me writhe around and complain. (Think really bad period cramps + really bad gas pain).
I was told—I think by John—that the surgery had gone better than expected. We had not been able to tell from the MRI, but my fibroid turned out to be pendunculated. This means it was on a stalk rather than fully attached to the wall of my uterus, so it was easy to remove. John had taken a picture of the mass sitting in a plastic tray, but I wasn’t ready to see it yet.
I was wheeled back to my room and lifted back into my bed, and John took an unflattering picture for Facebook to prove to our friends that I was alive.
My mom had jokingly warned that you’re naked for surgery, and you wake up in different clothes than you went in with. Sure enough, later that afternoon, I realized I was now in a weird snap-on scrub thing, and my own pajamas were in a plastic bag beside me.
I still had the epidural in my back, with medicine (Anapein) that I controlled with the push of the button. I could request supplementary pain injections (Atarax-P, or hydroxyzine—THAT was the good stuff) or suppositories (Diclofenac Sodium suppository—I resorted to this after my shoulders were too sore for needles). I was also hooked up to an IV, a machine that tracked my pulse, a catheter, and Velcro moon-boots that periodically pumped my feet to prevent clotting. Nurses came every now and then to check my vitals and pain level.
I lie there, kind of miserable, honestly, but not as miserable as I expected. It hurt when I moved, but then I ached from lying still. I’m a side-sleeper, but I was unsure if I could flip on my side. So I lie on my back for hours with the mattress pressing up against my epidural needle.
At some point I developed a fever, and a nurse brought me an ice pillow. It was heavenly. Later, I called a nurse in for a change of ice pillow, and also—thanks to Google translate—I was able to ask her if it was ok to flip on my side. She said it was, and even helped gently nudge me over and propped up some pillows to support me. Another game changer! It was a huge relief to be in an actual sleeping position and to give my spine some rest.
The next morning, Michiko came in to get me out of bed to walk me to the bathroom. If I could walk, she said, my catheter could come out. At that point the thought of walking was pretty daunting. I was so sensitive, I felt like my guts might fall out! But she helped me figure out how to stand, and sure enough, I was on my feet, slowly shuffling to the toilet. My incision felt tight so I had to walk hunched over, and I used my IV cart as a walker.
Around the time I started walking, I also started bleeding. Once I even called a nurse in to show her how much I’d bled into the toilet, but she reassured me that it was totally normal.
At some point, a nurse came to clean me up and change my clothes. I didn’t want to be touched, but I was pretty gross at that point. The warm cleansing jelly she squirted on my stomach made me flinch, a reflex that I normally wouldn’t even notice, but that in this case caused me to yell out in pain. Later, Michiko’s cool stethoscope triggered the same reaction. I learned the hard way how often I engage my abdominal muscles.
I brought a ton of books and activities, but all I really felt like doing was playing on my phone and listening to podcasts. I poked around Facebook and watched makeup reviews on Youtube. While listening to an episode of My Brother, My Brother and Me, I realized how painful it was to laugh. I somehow managed not to sneeze once for the next two weeks. John came every afternoon to hang out and watch Buffy.
Slowly but surely, equipment was shed from my body. The moon boots came off after I was walking regularly. My IV and cart were removed too. Then 2 days after surgery, I lost the epidural, along with the net necklace that carried the medication. My first trip to the bathroom completely tube-free, I felt so light and unencumbered.
Speaking of bathrooms—there’s something quite bonding about a bunch of women gathered together in a space taking the most painful shits of their lives. Before my surgery, some of the hardships I heard behind those stall doors were intimidating. But I’m pleased to report that while getting on and off the toilet took some doing, my first post-surgery poops went—er—smoothly. I never experienced constipation, and thanks to a liquid diet and very gradual reintroduction to solid foods, my poo texture was never more than I could handle.
Every now and then, when lying in my bed, I’d get a sharp internal pain that would make me jump. But it didn’t take long to realize that it was just gas, common to any open abdominal surgery. I felt it bubble through me, though weirdly, I didn’t feel any farts, so I dunno where it went.
Slowly but surely, my pain lessened and my bleeding lightened. I had a bad morning around day 3. As I lamented in my Gyno Adventures video, Japanese gyno setups feature a robotic chair and a large curtain petition between doctor and patient. On this particular morning, I had to have a vaginal ultrasound. I wasn’t properly seated in the robot chair when it started its recline. I slid backwards and cried out in pain. I couldn’t handle having my abdomen exposed and touched without being able to see it, so I politely insisted that Dr. Furukawa keep the curtain open. Partially because I was shaken, partially because I felt guilty for causing a ruckus, I went to the little phone booth and called John crying. But this day also marked a turning point. After the ultrasound, I requested my last pain injection, and then I took my first shower. I felt reborn.
After I was able to shower, I felt ok about receiving visitors. I was touched by the number of people who turned up the next few days—friends, coworkers, and even my hairstylist came with hand-drawn cards, coloring books, and every fruit and sweet imaginable.
By day 4 I was only on a low-dose NSAID pill. Sleep eluded me later in the week. I had a new snoring roommate, and I’d begun experiencing muscle spasms in my abdomen. Just as I would get comfortable, I’d get a localized twinge, almost like an electric shock.
Japan is very gift-centric, so the day of my release, when I was saying my goodbyes, I handed out sweets to Dr. Furukawa, Michiko, and the other nurses. A hospital administrator helped us carry our luggage down to reception, and she wrangled an English-speaking employee to help us through the paperwork. About a month before, the hospital had given me a quote of ¥100,000 (around $1000) for the cost of the surgery and hospitalization. The final cost ended up being even less, around ¥91,000.** We set up a payment plan for the heck of it, but we ended up paying it off early.
I returned home on April 20. Thanks to my lengthy stay in the hospital, the ride home—bumps and all—was no big deal. I was even able to sleep just fine on our floor futon, and quickly mastered a roll-crouch-and-stand maneuver to get up from it.
Even my second day home, I was able to take the 10-minute walk with John to the bakery. Soon we were walking all over the place. We even took some low-key day trips! The weather was beautiful, and I was happy not to be cooped up in the house. It’s hard to believe I’m now two months out from my surgery and totally back to normal life.
In my last post, I included a list of symptoms, fears and blessings. I’d like to do it again to track my progress:
My Current Symptoms
- Swelling, numbness, and occasional soreness at incision site
- Dull backaches (If I stand or lie in one position too long)
- Peeing feels a little weird sometimes. Hard to describe. But I already have to pee way less frequently than before the surgery!
My fears (This list has really shrunk.)
- Someday if we have kids, I have to get a C-section. Which means I have to do this all over again in America, with only 3-4 days in the hospital, and a baby to nurse afterwards! Seriously how do you do it??
Things I’m grateful for (This list has really grown.)
- My amazing doctor.
- Michiko and all the other kind nurses who brought me things and put things in my butt.
- All the kind and thoughtful friends and coworkers who visited me and brought me things. (They did not put things in my butt.)
- My tumor was easy to remove.
- My paid leave. Taking a month off unpaid would have been devastating.
- The Japanese National Health Care System
- Other than the first few days, I experienced very little pain during my recovery. I had to take it easy, but I was able to relax and enjoy my sick leave.
*A little on Japanese hospital food
The food in the hospital was great overall. For those of you familiar with kyushoku (Japanese school lunch), this was similar. Entrees included things like meat and vegetable stir fry, rice, fish, and udon. Japanese breakfast, however, is a force to be reckoned with. I can’t think of anything less appetizing at 8am sharp than fish with the heads still on and miso soup. Luckily friends brought me sweets, fruit and yogurt, and soon I was stocked enough put together breakfasts of my own. Another small quirk: green tea is king in Japan. Every single meal came with it—not water—even once Michiko advised me to avoid caffeine. Fortunately there was a water dispenser in the visitor’s lounge, and I think the frequent walks to refill my water bottle played a part in my speedy recovery.
**Once, in the states while under student insurance, I went to an in-network hospital for a general physical. I had some light bloodwork and about 15 minutes with the doctor. I was billed over $800.