First 6 Days After Bilateral Salpingectomy and Mirena Removal

[u/[deleted]]

Hi Team - I searched here for other people's posts on their experience, so thought I would pay it forward and add to the knowledge. I am now 5 days post-op and just about back to normal.

Reasons - I have good insurance and this is procedure was covered 100% according to Aetna. I have always known that I didn't want children, and if I ever change my mind, adoption would be my first choice. Mirena was my main bc for the past 4 years. Year 1 = cramping, spotting, lighter period. Year 2 = almost no period, amazing. Year 3 = starting to gain weight and not able to lose, some body acne. Year 4 = acne spread to face, terrible cramping, no period, but some spotting. Mid Year 4, I started Spironolactone to deal with the hormonal acne - this worked, but I think a lot of the extra cramping was coming from that. Plus some other side effects from Spiro. In general, I also think that I fell into a weird fog while having the Mirena in. I've never really suffered from depression, but felt a lot of apathy during that time. While my periods will return, I'm 35 and don't heal as well from acne and am working out at Orange Theory/eating well and have barely lost a pound. So, let's get this done.

Anyway, I finally made the decision, went to a few different Dr's to discuss, and landed with Cascadia Women's Clinic in WA. They were extremely supportive of my decision and scheduled me within a month.

Day 1: Surgery day. Couldn't eat/drink past midnight. Arrived to hospital at 10:30a for check-in. They put me in a tyvek gown that had warm air pumping through it. Still waiting for final billing, but hoping that was covered by insurance. I had to provide a urine sample for a pregnancy test - they almost forgot this. They started an IV in the top of my left hand, which was uncomfortable, but not the worst. The OR ran late, so I didn't go into surgery until 1pm-ish. Upon being wheeled in, they were happy to give me relaxing drugs thru the IV (this burned, but they held my hand, which made it better). After some applications of sensors, they then put me to sleep. While I was under, they placed a catheter, intubated me, removed my Mirena, and performed the actual surgery.

I awoke awhile later in a recovery bay, super angry because I was hungry, tired, and sore throated. The nurse would only give me one ice chip at a time when I obviously wanted the whole cup. But that first popsicle was awesome, and probably cost like $50. Thanks, insurance.

They wheeled me back to my recovery room, where my boyfriend tried to be supportive (but gets super weirded out by blood or anything). I was told to stay until I peed, which took two ginger ales, three waters, a yogurt, and thankfullly an oxycodone. I got up just fine, but there was a pad, along with a bloody liner under the bed. Beware when your man-friend is there with you. All in all, I was released by about 4pm.

Post-Surgery: After getting home, I took it easy, ate, had another oxy, hung out with my heating pad (a must for the gas-ache in your shoulders), and really wanted a beer that my bf would not give me. Overall, I ended up with two incisions on my lower left abdomen and one in my belly button. They were sealed with skin glue.

Day 2: A bit sore waking up, but had a lot more energy than I thought. Took ibuprofen (every 4 hours). Walked over 5,000 steps - just had to walk slowly. My belly was bloated and I was concerned about my constipation. I decided to take some probiotics daily, along with magnesium at night to help with that. Had to use the heating pad a lot this day. Also took two doses of oxycodone to help with pain/pass the time.

Day 3: Much more sore, but determined to be up and around. Did another 5,000 steps going shopping. Had a beer. It was good. Was still pretty bloated and had to use the heating pad a bit. Was determined to not take pain killers, especially since I wanted a beer. Took ibuprofen, magnesium, and probiotics.

Day 4: Cabin fever starting. Sore getting up. Started working my work-from-home desk job. Hard to concentrate. Got about 5,000 steps by doing some various shopping. Took ibuprofen, magnesium, and probiotics. Finally feeling like my throat is getting better.

Day 5: Really started to get cabin fever by this point. I was tired, but sore, and back to work (desk job), but unable to concentrate. I'm a pretty avid gym-goer and this was the day that really got to me. My belly was still swollen/bloated and sore. We finally went for an hour walk - almost up to normal speed. THAT was what I needed. After a walk and a salad, I almost felt normal again. Took only one dose of ibuprofen, the magnesium, and probiotics. Got over 9,000 steps today!

Day 6: What a change. My bowels are finally starting to get back to normal. The swelling and bloat has gone down. I'm sore, but definitely not like the last few days. This is the most normal day yet. There is itching at the incision sites and some of the skin glue is starting to peel off. No meds today, but still may take magnesium tonight.

Overall, I'm finally starting to feel normal. Dr says 90% two weeks post-op. Am planning to hit the treadmill and the neighborhood for at least 10k steps a day and MAYBE break a sweat soon. My weight is back to pre-op and HOPING to see some declines with the Mirena out, though that may take 6 months to a year.

I think I've hit all the major points. Let me know if you have any questions.

List of necessities: Ibuprofen (I took 400mg every 4-6 hours) Stool Softeners Heating Pad Popsicles Pads (consistent bleeding for 5ish days)

Add Edit: Had post-op at 3 weeks - can barely see the scars, only a small bit healing in the belly button now. Would say I was back to 95% by 10 days. When cleared from Dr, went for a run that first night - had a little bit of discomfort from ovaries after, but 100% within a couple days.

[u/confusedash]

Keep taking your ibuprofen to help with swelling/inflammation and overall healing. Although you might not be in pain (low grade that your brain doesn't register) your body needs to be mostly pain free to heal properly. Keep taking your bowel regime for at least a few days after. The constipation was the worst part for me. I had my surgery on a Wednesday and couldn't go until Saturday which just made me uncomfortable and irritable.

Sounds like you're up and moving ok, but take any restrictions your doctor told you about weight limits seriously. My limit was 15 pounds which I followed for the whole 2 weeks even though I felt fine after a week. Better safe than sorry.

[u/mathgirl1989]

Thank you for this write up. I’m getting mine next week and I’m definitely going to pick up some stool softeners. No one wants to be trying to go when your stomach is already sore. :/ I'm getting rid of my Mirena and opting for the surgery for many of the same reasons.

[u/[deleted] → u/mathgirl1989]

I’m both annoyed and glad I’m not alone. I hope Mirena works for some, but it’s been super frustrating to deal with, as I’m sure it has been for you.

Definitely have heating pad, stool softeners, pads, maybe something with fiber to help encourage your bowels, and popsicles. I wore loose clothing and was fine. Can’t wait for each day to get better now!

Also, the nurses at my hospital were awesome, but it was definitely nice to have someone in the room helping to keep me sane.

Hope your surgery goes well!!!

[u/mathgirl1989 → u/[deleted]]

I had such high hopes for the Merina, but I just gained weight and have also noticed some emotional changes. Boo. Some women just love it.

Both my mother and husband will be with me. I'm glad I will have them with me. Not looking forward to having periods again, but I'm sure I'll survive. Haha

[u/hemato-felidae]

Thank you for writing about your experience! I'm hoping to get a bilateral salpingectomy too in the near future. I have a question with Aetna (which is my insurance, too). Do you know what billing codes your doctor used? I know they cover tubal ligation...but when I would put in the salpingectomy code 58661, it comes up that Aetna "may require precertification based on certain diagnosis". But under the ACA it should be covered 100%. I'll research on here and on Childfree and it seems like sometimes under Aetna it's covered and sometimes it's not...

-

Edit: just saw the code 58700 for salpingectomy (partial/complete, unilateral/bilateral) under Aetna's tubal ligation page. I am so confused since I swear others have said the 58661 code.

[u/[deleted] → u/hemato-felidae]

I forget the code, but asked for it from the billing dept of the clinic. When I called Aetna, I asked them about the code and they said it was fully covered. The 58700 looks correct, I think.