Back in January of this year, I wrote a little post called Why Pelvic Self Exams Matter: A Personal Story. Since then, I decided to have surgery to remove the cyst and had surgery on May 23rd. Originally I planned on writing a follow-up post much sooner, but something about it just didn’t feel right. I couldn’t figure out how to make sense of it, much less turn it into an informative post. Reflecting on it now, I realize that this experience taught me not only about pelvic floor function, but also gave me a new perspective on being a patient which has helped me to grow as a therapist.
#1 I learned how hard it is to make medical decisions
As a healthcare provider, I’m usually the one offering people different treatment options. At the end of the day, I can make suggestions and offer explanations, but I respect each patient’s choice, even if it’s not the one I would make. As a physical therapist, the treatments I offer also have far less risk than a surgery, so for many patients it seems that the choices come pretty quickly. Exercise might make you sore or flare up your symptoms for a few days, as could manual treatments, but that’s really the worst case scenario. But my personal options were on a much bigger scale. I could: wait and see if the cyst became larger or more problematic; have a procedure done in the office to remove part of the cyst, although it was likely to come back again; or I could have surgery to remove the cyst. Although it would only be a 15-30min surgery, it still involved the risk of anesthesia problems, damaging my urethra, and bleeding.
To make my choice I did 2 things: research Skene’s Gland cysts and consult with my parents and close friends. Looking back, I realize that I had a few advantages here which not all patients have. First and foremost, I have a very strong social support system. My parents and friends were caring, understanding, and took the time to discuss the pros and cons of each option the doctor offered me. They were able to offer me support through the decision making process and bring up points which I didn’t consider initially. Also, as a medical professional, I was fortunate enough to have access to textbooks and research databases to turn to for information about my diagnosis. While I did “Google it”, I also could understand the medical jargon written about the cyst.
Now I have a much deeper understanding of what my patients may go through, or have gone through during their medical treatment.
#2 I learned to appreciate my urethra
On a pre-operative visit with my doctor, she informed me that after surgery I would have a Foley catheter for 5-7 days to allow my urethra to heal. I thought I had mentally prepared myself for this. Boy was I wrong!
The surgery from pre-op to post op recovery took about 45 minutes. I was awake, alert, and felt great right after surgery. That is, until I moved my hips. And then I felt it. The catheter. Yikes! I can’t say that I’d ever actually felt my urethra before, but man was I aware of it, and the catheter. Thankfully I only had to have it in for 3 days because of how well surgery went. During those three days I learned that:
- Sitting like a lady ain’t gonna happen with a catheter
- Walking with wide, big steps felt better than walking normally
- Walking is better than sitting, especially upright. I asked to walk myself out of the hospital after surgery because there was no way I was going to sit in a wheelchair, which totally caught the nurse off guard!
- The cord gets twisted and dear lord almighty do you feel it when it moves
- Emptying the catheter bag is a nusance
Removing that catheter was hands down, one of the best feelings ever! Again, this opened up my eyes to the experiences of other people. I wish I could go back to every single patient with a catheter that I saw in the hospital and do over their treatments. I was understanding, but I can think of so many ways that I would modify their transfers (getting in/out of bed, asking them to sit at the edge of the bed). I would also be able to provide much better information about how to manage a catheter to prevent infection, etc. This will be great information to have as a pelvic floor therapist going forward!
#3 Patients are not patient
One of the things I say most often about rehab is “Everyone wants to be better yesterday.” It’s easy to get impatient! As a healthcare provider I see this all the time. This is especially common after surgery when patients get to a point where they feel minimal pain but still aren't able to do everything they want to. And again, I took this for granted!
It’s been 10 years since I had surgery on my right knee, so the details of that recovery process are now glazed over and mostly positive. Sure enough, during the recovery from this surgery, I became that impatient patient! For 4 weeks after surgery I could not lift heavy (uhm… that’s literally all my workouts) or insert anything into my vagina, to avoid stretching the tissue between my vagina and urethra which was healing. This meant not even using a tampon.
The first week was spent just dealing with the catheter and trying to get back to “me.” By week 2 I was feeling normal and just wanted to get back to lifting!! Not moving much for 3 days also left me deconditioned, so I had to ease back into being “go go go” all day long. It didn’t take long, but again, it was a learning curve. For example… four days after surgery I decided to weed through all my belongings to get ready to move to Florida. I packed up 6 bags of clothes, 12 pairs of shoes, dresses, and a bunch of purses to donate. After a full day of cleaning and moving things, I got lightheaded, dizzy, and tired. I had to stop and rest! I didn’t realize my limit until I had pushed past it.
It was quite the doozy, but I'm happy that I had the surgery! While this isn’t a story which I go around telling my patients, I think this experience has helped me to grow as a therapist. I can understand where my patients are coming from a little more now and provide better education to them. I am also positive that I will never forget what it felt like to have a catheter in!