Resources

Gynecological resources in Fairbanks, AK

Hysterectomy Post-OP Instructions

You have had an abdominal hysterectomy. The incision on your abdomen is either horizontal-side to side above your pubic hair, or vertical-between the belly button and the pubic hairline. Your uterus has been removed through this incision. The ligaments that support the uterus are now sutured to the vaginal cuff-top of the vagina and the vaginal cuff is partially closed with a purse string suture. Any vaginal drainage is fluid from your abdomen coming through the cuff. This cuff will close by its self in the next 6-12 weeks. You may or may not go home with your urethral catheter in place. You may be asked to clamp, close off and open the catheter at regular intervals until it is removed; this is called bladder training.
  • If your incision is vertical, the staples will stay in and be removed in the doctor’s office.
  • If you still have a catheter to empty your bladder, wash once a day in the shower with soap and water
  • If you are changing from a leg collection bag to a regular collection bag at night, wipe the connection with alcohol before disconnecting it
  • Your urine should be lemonade in color, have no strong odor and clear with particles
  • You may return to your normal activities over the next few weeks; walk often
  • You may shower as desired
  • Drink lots of liquids
  • Take your temperature by mouth 2 times a day for 3 days
  • Avoid heavy lifting or strenuous activity; limit heavy housework
  • You may drive if you are back to doing other normal activities and have no pain when putting your foot on the brake
  • Do not drive while taking prescription pain medications
  • Talk to your doctor about resuming use of tampons, douching or sexual intercourse
  • If your ovaries were removed, you and your doctor will discuss ERT or estrogen replacement therapy
CALL YOUR DOCTOR IF
  • You have vaginal bleeding that gets worse instead of better or greater than one pad soaked in one hour
  • You have severe abdominal pain, tenderness, dizziness, persistent nausea or vomiting
  • Your temperature is 100 degrees by mouth or you have the chills
  • Your incision becomes red, swollen or starts to have drainage
  • You have burning or pain when you urinate or “pee”

C - SECTION POST - PARTUM INSTRUCTIONS

When you get home, following your cesarean section delivery:
  • You may return to your normal activities over the next few weeks; walk often
  • You may shower as desired
  • Drink lots of liquids
  • Take your temperature by mouth 2 times a day for 3 days
  • Avoid heavy lifting or strenuous activity; limit heavy housework
  • You may drive if you are back to doing other normal activities and have no pain when putting your foot on the brake
  • Do not drive while taking prescription pain medications
  • Do not douche or use tampons for 4 weeks
  • Talk to your doctor about when it is okay to have sexual intercourse
  • Foams along with condoms may be used for birth control; you can become pregnant even though your periods may be irregular or have not started again
  • Diaphragms must be refitted at your 6 week checkup
  • All new mothers should continue to take prenatal vitamins; if you are breast feeding, continue to take them for as long as you are breast feeding
  • Do not take any medicines without checking with your doctor
CALL YOUR DOCTOR IF
  • You have vaginal bleeding that gets worse instead of better or greater than one pad soaked in one hour
  • You have severe abdominal pain, tenderness, dizziness, persistent nausea or vomiting
  • Your temperature by mouth is more than 100 degrees or you have chills
  • Your incision becomes red, swollen, or starts to have drainage
  • You have bleeding from your incision
  • You have a hot, reddened area on your breast
  • You have burning or pain when you urinate or “pee”

VAGINAL BIRTH AFTER CESAREAN

The following is information regarding vaginal birth after a cesarean section (VBAC). This information is provided to mothers so they can make an informed decision on how to proceed after a previous cesarean section. This information is important and should be carefully considered while consulting with your obstetrician. Once you have weighed your options please initial and sign on the option you choose. 

All mothers who have had one previous low transverse cesarean section are offered an attempt at a vaginal delivery. Prior to your delivery we must review the operative report from your previous cesarean and any other uterine surgeries you may have had. Once the reports are reviewed and it shows medically reasonable we will offer the trial of labor for a vaginal birth. 

There are risks with both cesarean section and vaginal birth after a previous cesarean section. The lowest risk to mother and baby after a previous cesarean is an uncomplicated vaginal birth; however, there is a 1% chance of risk that the previous cesarean scar will rupture during the attempt. In the case of uterine rupture or placental separation, an immediate cesarean section may be necessary. If this were to occur some of the risks to the mother are bleeding, blood transfusion, infection or the need for a hysterectomy. There could also be risks to the infant, such as, hypoxia (lack of oxygen) and blood loss, which could result in brain damage and possible fetal death. The success rate for those attempting a vaginal birth after cesarean section is 60 to 80%. 

Risks are also associated with a repeat cesarean section and scar tissue may have formed from the previous surgery. Some of the risks include bleeding, blood transfusion, infection, and damage to other organs, such as, the bladder or bowel. There also may be a need for repair or future surgery. There could be a slight risk if a cesarean section is performed after an unsuccessful trial of labor. If you have had multiple cesarean sections trial of labor can still be an option; however, the risk of uterine rupture increases with each cesarean section. Also with multiple cesarean sections the risk of the placenta abnormally attaching to the uterus increases and the potential need for a hysterectomy during the cesarean rises. There is little data supporting vaginal or cesarean after three or more prior cesarean sections, but it is strongly suggested that another cesarean section should be considered. 

Repeat cesarean sections are generally scheduled for 39 weeks estimated according to your gestational age. If you present in labor the rupture of membranes, prior to this time frame, a cesarean section will be performed.

BLADDER TRAINING

Bladder Training Instructions

These methods are to help you regain control; think of it as "mind over bladder."
  • Start by going to the toilet and trying to pass urine every ___ hours while you are awake. You do not have to get up during the night!
  • You must try to void whether you feel the need or not. You must try to void even if you have just been incontinent.
  • If you get an urge to go to the bathroom before your scheduled time:
  1. Stop, don’t run to the bathroom!
  2. Stand still or sit down if you can.
  3. RELAX. Take a deep breath and let it out slowly.
  4. Concentrate on making the urge decrease or even go away, anyway you can (imagine the pressure becoming less and less).
  5. When you feel IN CONTROL OF YOUR BLADDER, walk slowly to the bathroom, and then go.
  • Keep this schedule until you can go two days without an accident. Then, increase the time between scheduled trips to the toilet by ___. When you can go two days without an accident, extend the time between trips again.
  • Keep this up until you can go four hours between trips to the toilet (which is normal), or until you are comfortable. This usually takes several weeks.
  • Don't get discouraged! Bladder retraining takes time and effort, but it is an effective way to get rid of incontinence without medication or surgery.

INSTRUCTIONS FOR TEMPERATURE RECORD

  1. Insert the date at the top of the column in the space provided for the date and month.
  2. Each morning, upon wakening, but before you get out of bed, place the thermometer under your tongue for at least two minutes. Do this every morning, even during menstruation. Be sure not to eat, drink or smoke before taking temperature.
  3. Accurately record the temperature reading on the proper location. Indicate days of coitus (intercourse) by a down-pointing arrow in the space provided.
  4. The first day of menstrual flow is considered to be the start of a cycle. Indicate each day of flow by blocking the square indicated on the graph, starting at the extreme left under the first day of cycle.
  5. Any obvious reasons for temperature variation such as colds, infections, insomnia, indigestion, etc., should be noted on the graph above the reading for that day.
  6. Ovulation may be accompanied, in some women, by a twinge of pain in the lower abdomen. If you notice this, indicate the day it occurred on the graph.
  7. Start a new cycle on the next graph.
Call us today to learn more about gynecological and obstetrical care resources in Fairbanks, AK.

SAFE MEDICATIONS WHILE PREGNANT

Your doctor has approved the following over-the-counter medication safe to be used throughout your pregnancy. If you have any questions regarding these medications listed, or others, please call our office at 479-7701. Refill Line: 907-479-7720.

Symptoms

Nausea
Rash/itching/or insomnia
Nasal congestion
Cough/cold
Headache/ generalized pain
Diarrhea
Heartburn
Constipation
Vaginal yeast infection
Sore throat

Medications

Vitamin B6 – 50 mg by mouth once daily
Benadryl 25 – 50 mg by mouth every 4 hours
Chlor-trimeton tabs - take as directed
Robitussin plain – take as directed
Tylenol 1gram (2-500mg tab) every 6 hours
Imodium - take as directed
Ranitidine 150mg every 12 hours
Milk of magnesia – take as directed
Miconazole vaginal cream-use as directed
Throat lozenges (e.g. Halls, Ludens and Riccola)
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