My Laparoscopy & Excision

Just about a year ago in 2022, I had an operation that diagnosed my endometriosis and interstitial cystitis. The surgery consisted of a laparoscopy, cystoscopy, hysteroscopy, appendectomy, and the excision of scar tissue, adhesions and endometriosis.

Finally, after years of increasingly difficult pain without an official diagnosis, I had answers. This was the most satisfying thing after the surgery: (at least some of) my pain WAS endometriosis all along and I was not crazy, nor was I making it all up. Leading up to the surgery, I was so worried the surgeon would find nothing, and I would be left with no clear way forward to cope with my chronic pain. I was also of course worried that the pain could be caused by something much more sinister and with a far worse prognosis than endometriosis, which thankfully was not the case.

Here's a bit about my surgical experience.

Leading up to the surgery

Appointments & Scheduling

In order to have a surgery date scheduled, I had several appointments with my gynecologist. He and my primary care physician in the US ordered lots of imaging (including ultrasounds, MRIs, X-Rays etc). No evidence of endometriosis showed up on any of the images by the way, which is common. After reviewing the images and my symptom logs and listening to my experience, he confirmed that I was a candidate for surgery. I was due to leave for England to start my Master's, so a surgical date in the US would have to wait until my program finished (although the symptoms became unbearable that year). In the interim, I relied on lots of heat packs, rest, and MyOovi, a discreet TENs machine my partner Alex got me which really helps disrupt the pain (get 10% off).

In between finishing my Master's and starting my new job in Canada, I set aside a few months to be home in the US and have the surgery. Scheduling the surgical dates and pre-op appointments was difficult from a different timezone, but luckily, it all worked out fine and the dates aligned.

I came back from Europe in August 2022, had my surgical date set for September 9, 2022, and planned to leave for Canada in early-mid October to start work in November. Since a covid test was required before going into the operating room, I isolated for three weeks prior to my surgery to make sure getting covid wasn't going to make me miss my surgery window. My family opted to isolate with me (my parents both work from home, and my sister was away at school for part of the time), which made that a lot easier.

Pre-Op

Just prior to my surgical date, my gynecologist went over what to expect, prescribed some medications to help pre and post op, and gave me a chance to ask last minute questions. When my surgical date came, I was scared, but I honestly felt so safe knowing that my gynecologist would be doing the procedure. It was my first operation as an adult (I had three orthopedic surgeries for sports injuries in my teens), so with a more adult perspective on risk I appreciated greatly having someone I trusted and respected "at the wheel."

One of the difficult (but forgettable given the overall context) things about surgeries is the fasting (usually from midnight the night prior), especially if you don't have an early morning time slot. At the hospital prior to the surgery, I remember the nurses being REALLY nice and attentive to me, my mom in the room while my gynecologist explained the procedure again, and being REALLY hungry.

Post-Op

Waking up after surgery is always disorienting. This time, I felt incredibly nauseous and the bloating, a biproduct of the surgeons pumping the abdomen with air, was simply awful. For the first few days, I felt like my abdomen was going to spill out (really gorey, I know). Pressing into my skin, I could actually feel the bubbles of air moving through my body up to my shoulders. The bloating also made it hard to breathe in fully, and the fullness in my chest extended up to my shoulders. In terms of pain, I felt endo flare-up level cramps, and my urethra was BURNING from the catheter. It was a very hard few days and I felt incredibly weak and fatigued, which is to be expected following an operation.

Persisting past the first few days, my lower right abdomen (where my appendix was pre surgery) was very sore. The bloating worked its way through and eventually subsided. The incisions were covered by surgical glue, so I could shower as normal, but they looked grisly until my gynecologist removed the glue and cleaned the area at my follow up appointment.

If you are recovering from a laparoscopy (or any operation for that matter), and you feel something doesn't look or feel right in your recovery, tell your surgeon! I worried that I might have had a blood clot from being sedentary after the operation (I have hereditary risk factors), and my surgeon ordered an ultrasound to put my mind at ease (and to confirm there was no clot).

A long road to recovery...

I've heard that some people recover from their laparoscopies and excisions really quickly and notice the reduction in endo symptoms almost immediately. This was not my experience, and my symptoms and surgical recovery dragged on for several months before I noticed a reprieve. I suspect that I may have set myself up for failure by constricting my recovery time to 4 weeks on the dot before staging a road-trip style cross country move and starting a new job (where I started as a laborer on a construction site, outdoors in -30 C in Alberta). I also lost my grandfather the night we (my partner and I) set out on our big road-trip move. The physical and emotional stress of those few months definitely set my recovery back. I would recommend not making any major life changes directly after having your laparoscopy, or any operation for that matter. Give your body a chance to heal, it deserves it.

The Results

A few days after the operation, my surgeon gave me a run down of how the procedure went and what he found. We also reviewed surgery photos (gross, but cool). He found endometriosis on the peritoneal wall and hiding under an adhesion on my appendix. The adhesion and my appendix were removed. He performed chromatuberation to demonstrate whether or not my fallopian tubes were disrupted (they're not, yay!). There was a small cyst on my ovary. Also, based on the photos, ovaries look WEIRD.

The cystoscopy showed that I had interstitial cystitis, or "painful bladder syndrome," or "IC," a condition resulting in chronic bladder inflammation and pain that resembles the symptoms of a UTI. Great. But wow, that was the biggest revelation of the whole surgery--I had given up on understanding what was going on with my bladder. I started noticing urinary symptoms when I was around 8 and was treated for UTIs many times, and eventually told that constipation was the cause of my bladder pain (my colon pushed on the urinary tract causing frequent urgency). It's another condition without a cure, like endometriosis, but boy is it relieving to have answers. Now I can approach the problem with a place to start. Like endometriosis, it can be potentially mitigated through lifestyle adjustments like an anti inflammatory diet, which I'll get into later. Although, my IC has flared up more frequently since I started taking isotretinoin (accutane) for my acne. This will also be explored later.

I was so grateful that my surgeon took so much time to explain the procedure, the photos and the diagnoses with me. This truly made a world of difference in how I approach my body and what it needs.

Pelvic Floor Physical Therapy

Pelvic Floor PT and the physical therapist I've worked with have also drastically improved my experience and recovery. My PT discovered that, likely as a result of chronic muscle spasms and pain, I have very tense pelvic floor muscles. Exercises to strengthen my core and hip muscles while releasing the smaller, internal muscles have helped so much. I'll get into this in more detail in another post.

Final Thoughts

So that's pretty much the basics of my laparoscopy experience. It's interesting to look back at it all a year on, especially knowing that after a few hard months of recovery, things have really improved drastically with the surgery and pelvic floor physical therapy treatments. I was really worried for a while that nothing would change. Phew, glad that's over.

Have you had a laparoscopy? Was your experience similar? Let me know, I'd love to find out!

Please keep in mind that these posts reflect my experiences only and not in any way medical advice.