My Vestibulectomy: Part 2 - The First Five Weeks
Surgery recovery is another very popular topic in the Vestibulectomy Facebook group. The recovery from a vestibulectomy is long, so there are always a lot of people at various stages of recovery wanting to know if what they are experiencing is normal. Usually it is, and we can find comfort in sharing stories and knowing we’re not alone. It’s nice to have a place to ask questions if you don’t want to feel like you’re bombarding your doctor with a million questions all the time.
Everyone’s recovery from vestibulectomy is unique, and I think there are a number of reasons why it is so variable. The most important one, I think, is the surgeon themself. There are various techniques for performing a vestibulectomy, and each surgeon has their chosen version, unique background, and degree of skill/experience. Personally, I’ve heard too many stories of poorly performed surgeries to ever choose a less experienced surgeon. I always recommend getting the best, most knowledgeable, and most experienced doctor you possibly can. It will have a positive impact on both the recovery and the long term results.
Overall, I think my recovery was a little better than average. I was out of work for about 2 weeks and worked from home for another 2.5 weeks. I wish I had waited a full 5 weeks before going back to work, but I had an experiment that needed to be done at a certain time. I’m getting my PhD and I work in a lab that studies how bacteria cause infections and new ways to stop them. My job is physical, but not highly demanding physically. As in, I need to have nimble hands, be able to carry big things, and climb down on the floor or up to high shelves. So, not a construction worker, but not a desk job either. When I went back to work at 4.5 weeks post-op, I was still walking slowly and carefully. I was able to get the few things done that I needed to do to prep for my experiment. By the next week, I was able to move around pretty normally and didn’t have issues with long hours of standing at my bench. Sitting was more difficult than standing, and I relied on my doughnut cushion to be able to sit at all. (It took me 9 weeks to not need to sit on my cushion anymore.)
The first few days were definitely the most difficult and they really weren’t very painful, mostly frustrating. For the first week after surgery, I spent all of my time laying in bed or on the couch, bottomless, on a doggy pee pad, with an ice pack wrapped in a paper towel on my vulva. I wore a nightgown or a big t-shirt and pulled it down when I could, but I definitely wasn’t decent a lot of the time. Keep that in mind when you choose who is going to take care of you; I don’t think my mom was fully ready for that week. ;) I only got up to go the bathroom or take a sitz bath. Four times a day, I sat in a bowl of warm water over the toilet for 10 - 15 minutes. It came with a bag similar to an IV fluid bag that kept fresh, warm water flowing into the basin. The baths helped keep everything clean and I didn’t get an infection (and never took any antibiotics, not even during surgery). I was not in a lot of pain, even in the beginning, because I got injections of a long-acting numbing medication called Exparel. It wasn’t covered by my insurance, but that was the best $400 I ever spent! I didn’t take any pain medication for the first 3 days. On days 4-8, I took ibuprofen at night, and the next week I took it throughout the day. I didn’t have any sharp pain that seemed like the incision sites were hurting; I think the Exparel covered that. I took the ibuprofen for general soreness; I felt like I had been kicked really hard in the vulva and was quite swollen for the first two weeks. I haven’t watched the video of the surgery, but I’ve seen photos, and I think what I was feeling was from all the other pulling, stretching, and general trauma to the vulvar area.
I struggled to sleep the first few days, and I think I was cranky because of that. I normally sleep fine on my back, but I’m much more comfortable on my side or stomach. Those first few days, I was forcing myself to sleep still, on my back, centered on my pad, with an ice pack. Not being able to move around and adjust was difficult. I did better after the first few nights when I no longer needed new ice packs throughout the night, and I started laying on my side more and more.
My mom stayed with me for a week and helped me get up and down, continuously brought me ice packs, and made all my food. She also made another weeks worth of food and put it in the freezer. My house is one story, so I wasn’t trapped in my room, which was nice, and I spent more and more time out on the couch as time went on. I wasn’t able to lay as flat on the couch, so it was less comfortable than the bed, but I was able to tolerate it more and more. I really only got up to go to the bathroom for the first week. I might have made my own easy mac once or twice. At the end of the first week though, I was able to get up and down okay and get my own food and ice.
A friend came and stayed with me for a few days at the start of week two. She was more for entertainment than help, though she came prepared to take care of me as much as she needed to. She even brought a bathing suit to help me shower if I needed - how cute is that? We mostly played games (in bed) and watched TV. It was nice to have company while being stuck inside. She enjoys cooking and made most of the food, and made things I never would have made for myself. I got my period on day 10, so I got to start wearing underwear and pants again. Nine days bottomless is a bizarre personal record I now hold. It honestly felt weird to wear bottoms again, but the light pressure wasn’t painful. I used natural, 100% cotton pads and panty liners that I bought online (my grocery store didn’t have any). I cut down on my sitz baths a little because it got messy. My doctor (Dr. Rachel Rubin) suggested a shorter bath and then a shower, which worked well.
In the second half of week two, I was home alone and I started working from home a few hours a day. I was able to schedule my surgery at a time that I had a lot of writing to do, so I had plenty of remote work to keep me busy and motivated. I was able to work for about 4 hours a day at first. I was still taking 3 or 4 sitz baths a day, and shuffling around to get my own ice and food, so I was slow moving on work. I also got tired easily, probably from doing nothing for so long before that.
The second weekend, I had another friend come visit me. I know I’m lucky to have supportive friends and family! She also came mostly to keep me company and to refill my freezer with food. She got to take me on my first trip out of the house - the grocery store! There is a long staircase up my front yard, and I got down by awkwardly going sideways and only moving my legs from the knee down. The 5 minute drive was the worst part, even with my cushion. Once we got there, I did okay walking around with the cart. I went with her because I was picking up a prescription from the pharmacy - fluconazole. I was getting a little itchy and thought I might have a yeast infection. Since taking fluconazole is such low risk, my doctor told me to go ahead and take the two pills just in case. In hindsight, I don’t think I had an infection, but no harm done and better safe than sorry. What was actually happening, was that my skin was getting irritated from all the baths as I was not doing a good enough job drying off with the cool hair dryer after each bath. A little Vaseline helped with the external itching, and I went down to 2 baths a day in week 3.
In week three, I was home alone and working full days without problem. I still took a few sitz baths each day, but otherwise was relatively low maintenance. I spent time sitting on my cushion and was able to gradually extend the amount of time I could sit. I thought I would get stir crazy being at home all the time, but I really didn’t. I’m an introvert and a homebody, and I felt like I could have happily stayed home another month. I went out a couple of times with my husband and tried driving again. Oddly, my issue with driving was actually my eyesight. At home for 3 weeks, I’d been only wearing my glasses and had hardly gone outside, so my eyes had only focused on things within 20 feet of me. Once I got outside, it gave me a headache to look at things far away and that made driving difficult. It felt like I had gotten a new glasses prescription and everything was distorted. I tried wearing contacts again, and my eyes adjusted to those more quickly and I was okay within a few hours with contacts. I’m sure all of that makes sense to someone who wears glasses/contacts and sounds ridiculous to those of you lucky enough to never need them. In general, I was able to go out for a few hours at a time, still walking slowly, but not in pain.
At the 4 week mark, I made my first attempt to leave the house for a whole day. I went to an event for women’s health, so if anyone would understand my struggle with sitting, walking, or being there too long, it was that group. I did better than I expected and was able to attend the entire event! At the end of the day, I even (sort of) participated in a yoga class, though I had to heavily modify the movements.
I had another friend come visit for a few days at the start of week 4 too. Again, I know I’m very lucky! She cooked a ton a food and filled the fridge and freezer. She went with me to find baggy pants that weren’t too ugly for work. I had made an attempt to wear tight leggings rather than baggy pajama/sweatpants, and found them very uncomfortable. Fortunately, as a graduate student/microbiology researcher, I do not have to dress up for work and typically wear jeans or leggings. So, jogger style sweatpants and a t-shirt was okay too.
I had my first follow up appointment with Dr. Rubin at 4 weeks. I was excited to hear that everything was healing beautifully! My patience and commitment to taking it easy was paying off. I was still walking slowly and needed to sit on my doughnut cushion, but I could drive and had the stamina to be out all day, so I was ready to go back to work.
I went back to work after 4.5 weeks. I wish I had waited 5, but I did okay those first few days. I was still walking really slow and the bathroom felt like it was a mile down the hall. But, I had things I needed to do that week and I was able to accomplish that. The next week, I felt almost normal and did just fine at work.
I’ve written a part 3 about the long term recovery process as well, so check out the next part of my story. As always, feel free to contact me if you have any questions or want to know more.
*Updated in May 2019, with permission, to include Dr. Rubin’s name.