Hysterectomy 101

According to the Centers for Disease Control and Prevention (CDC), hysterectomy is the second most common major surgery for women prior to menopause. Each year about 600,000 women have a hysterectomy in the United States. More than half of those women are less than 45 years old, and the highest rate of hysterectomy is for women 40-44 years old.

Hysterectomy is the surgical removal of the uterus and sometimes other structures as well. A hysterectomy is not typically the first treatment option and will only be recommended by your OB-GYN if the benefits of the surgery outweigh the risks. Many women will have tried other options that were not successful at controlling their symptoms before undergoing surgery. The most common reason for hysterectomy is uterine fibroids, which are benign tumors of the muscle wall of the uterus that can cause bleeding and pain. The other major indications for hysterectomy include endometriosis, uterine prolapse, abnormal bleeding and cancer.

Depending on your individual circumstances, the procedure may be performed through the vagina, through an incision in the lower abdomen or laparoscopically. Regardless of the type of procedure, you will receive general anesthesia and will not be awake during the surgery. The length of your hospital stay after hysterectomy will vary and may require one or more nights at the hospital for continued monitoring. You may also get medicine to prevent blood clots while at the hospital. As with most surgeries, a major key to recovery will be getting up and walking as soon as you are able. This will greatly benefit you in maintaining your mobility and strength, as well as in preventing a blood clot.

When you return home to recover from surgery, you will be given specific instructions from your OB-GYN regarding pain management, as well as activity and lifting restrictions. Be sure to follow your specific post-op instructions for your individual procedure.

You will be sent home with a prescription for a strong pain medication and likely will need to take this initially before transitioning to using only over-the-counter pain medications like acetaminophen and ibuprofen. Pads will be needed as light vaginal bleeding is expected for several days and up to several weeks. It is not uncommon for bleeding to stop and then start up for a brief time as you heal. Many women also experience constipation after hysterectomy. This can be prevented with a daily overthe-counter stool softener, fiber supplement and drinking plenty of fluids. Contact your physician if these measures are not effective in preventing or managing constipation.

To effectively support your recovery, balance rest and physical activity. Allow yourself plenty of time to heal, but be sure to make an effort to get up and walk around throughout the day as well. Light walking that you can tolerate is encouraged and should be increased a little every day.

Although a hysterectomy may provide relief from symptoms and worries, it may also bring feelings of sadness and loss. This can be normal. Be sure to discuss your emotions with someone you trust, and be honest with your health care providers about your feelings. You may also find comfort in one of the many online hysterectomy support groups as you interact with others who share similar experiences with you.

Hailey Saunders, APRN, MSN, FNP-C, is a family nurse practitioner and Kansas City native who is passionate about evidencebased health education. When she has free time, you can find her at home with her husband and three sons tending to their garden, goats, sheep and chickens.

As always, please consult your health care provider with any questions or concerns.

About a year ago, I adopted a beautiful German Shepherd mix named Ariana. She is a very sweet dog, with a mild temperament and has taken well to training. The only issue she has is she really enjoys licking skin, especially hands. She does this until you move or ask her to stop. Is this because of the salt in our skin? Thanks for everything you do!

- Chris Kennedy

Ariana’s licking is a natural and instinctive way to communicate with you. She may be licking you for a variety of reasons such as expressing herself, trying to bond with you, showing empathy, letting you know that she is stressed, or just because you taste good to her. I would not be concerned with this behavior unless it becomes excessive. Then you can train her to stop as you have been doing.

- Ashley Flores, CPDT-KA

I have two young Australian Shepherds who eat feces. I have tried prescription meds and over-the-counter deterrents, but they have not worked. Any other tips to stop this behavior? -

Laurie

Coprophagia (eating feces) can be a tough habit to break for many dogs. Trying to find out why they eat poop is key in understanding how to curb it. Dogs may eat poop because of stress, parasites, boredom, poor diet, issues with their pancreas, and sometimes they just do it because they enjoy it, which is one of the tougher ones to break. Try to find out why, then you can work on it. I also recommend hanging out with your pooches outside so you can pick their stool up immediately and redirect them from eating it. Do this for a few months and work on the commands “leave it” and “come” so you can direct them without being close by.

- Ashley Flores, CPDT-KA

My 10-year-old very good girl, Lola, has always loved her walks. Within the last six months to a year, she has started to hide when the Amazon truck is in our neighborhood. Unfortunately, as time has passed, she is now afraid to leave the house on walks. We have been patient with her and at times can coax her into walking down the street. Ultimately at some point she becomes startled and wants to immediately return home. Do you have any recommendations for us to try? Lola always enjoyed her walks, and it is breaking our hearts to see her like this.

- Brandon

Sounds like something scary may have happened in the past and now walking is causing her anxiety. I recommend practicing walking in the back yard or in places that are not frightening for her and going out a little further into the street every day. This can even mean only an extra couple of feet at a time. You may want to practice walking when your street is less busy with low stimuli or triggers to build a positive association. You can also start by putting a blanket in the front yard and having little picnics and getting her used to hanging out in the front yard, then walking a little bit afterwards around the house and venturing further out if she chooses. Anything to create a positive interaction with her being outside is crucial. Stick close to home in case she gets nervous and constantly praise any confidence she is displaying. Take it slow and don’t expect quick changes. If she is enjoying her time outside, whether that’s walking or not, that is still enrichment for her.

- Ashley Flores, CPDT-KA

She’s tried being nice. Tried being cute. Tried begging and pleading and hoping that her forever family would walk in the door and take her home. But now? She’s just tired and starting to lose hope. Shelters across the Kansas City area and beyond are in a crisis, and it’s dogs like Bug that are suffering in these unprecedented times. Bug needs a hero. All of our shelter dogs do, but we want to get Bug OUT of the shelter before her 2-year shelter anniversary hits. We know that Bug’s forever family is out there somewhere.

READ her profile. SHARE her story. ADOPT Bug. We have no chance without the help of our community. If you would like to meet Bug, please email adoptions@greatplainsspca.org for more information!

Email askashley@greatplainsspca.org for a chance to have your pet question answered in KC Parent magazine. Animal expert, Ashley Flores, CPDT-KA, is the Senior Director of Animal Behavior and Training at Great Plains SPCA. Ashley has more than 16 years of experience in animal training and behavior.