To not have the surgery?

[FrasierCranium]

NC for this, just in case I'm recognised.

Ok, I had a c section 18 months ago. Since then I have experienced pain on my left hand side, underneath my scar. It's quite like period pain, it gets worse during ovulation but the area is fairly tender. It's sore but it's not awful, tbh. I can live with it.

However I went to get it checked out because I wanted to check it wouldn't have an impact on trying to conceive baby #2, and just generally that everything's ok. I had a scan about six months ago. I got a very vague letter from the GP which said the scan had revealed some ovarian cysts and they were referring me to a gynaecologist. As the appointment was six months away, I wasn't worried and carried on as normal.

So the appointment finally arrived on Tuesday. The gynaecologist basically said the cysts are a red herring and that he doesn't believe they are abnormal, or that they are the cause of my pain.

He thinks the problem may be "adhesions" - things stuck together after my c section, I think is what he meant. Recommended a laroscopy (or something?) basically - a camera going into my abdomen through my navel and through my c section scar, to see what the problem is and hopefully fix it. It is done under general anaesthetic and he thinks I would need 2/3 weeks off work.

I don't want to have the operation. I understand it's minor but I don't want the general anaesthetic, I have a toddler who needs looking after (husband is fab but works long hours and we don't have much in the way of family support) and I can't risk my health. I asked the doctor what would happen if I didn't have it and he seemed to think, not very much!

Issue however might be that they don't do the operation and it's something serious and we don't know because we haven't looked (low chances of this). Also he said I may need an MRI to check my womb lining isn't out of place??

He's going to write a detailed letter and we'll have another appointment to discuss in detail once I've chattered it over with my husband. At the moment I feel quite set on not doing it, living with the pain and hoping the next c section sorts it out.

Husband and my mother think I should do it (or at the very least find out more about it).

I wondered if anyone here had any experience with this. Sorry for the book...

[Doyoufeelluckypunk]

I really would recommend you have the surgery OP.

I had significant adhesions which I didn't know about until during my second c-section which rapidly progressed from a fairly standard emcs to a stressed rushed environment due to the level of adhesions.

Had there been any complications with baby there would have been a very high risk of not getting him out in time...

[Headofthehive55]

I think a lot of people who have had c sections have this sort of pain. I know I did. Until I had pregnancy with DD2. At some point she must have stretched them because the pain went. Never had another CS and that pain touch wood never came back.

[BlackSwan]

I'm the one who comes out of the woodwork when someone is afraid of anaesthetics. By age 5 DS had something like 45 general anaesthetics. Something like, because i have actually lost count. Thank goodness they are safe. It's still not easy - but we do what needs to be done.

[FrasierCranium]

Thank you everyone. The advice here has been fab.

Ok. So while I'm still not quite saying, yes, let's do it, I'm definitely swaying towards at least pushing forward with the process and speaking to the consultant again, and the anaesthetist.

Maybe it's just something I need to be strong about.

[Libitina]

Laparoscopies are not usually done under local. You are lying steeply head down for the procedure and they fill your abdomen with carbon dioxide. You could be there as little as 20 minutes are maybe more. With the anaesthetic it will feel as though you have been asleep for only a minute or two. You would not be comfortable. They will give local anaesthetic at the incision sites and you'll be written up for pain relief afterwards. Some people get shoulder pain after a laparoscopy.
If they find any adhesions or endometriosis they will use diathermy to sort it out. You will have at least two small incisions (but usually three), one in your belly button and the other two a bit further down and out to the sides (like a triangle).

You will have a pre-assessment to check that you are fit enough for an anaesthetic and the surgery. You will also be assessed by your anaesthetist on the morning of your surgery.

If your bladder is causing problems ask about the possibility of a check cystoscopy too whilst you are in theatre, no harm in asking.....

[ADishBestEatenCold]

"I'm frightened."

"What if I close my eyes and I don't wake up and I leave my baby with no mother?"

Of course you are frightened, Frasier, and with the same sort of fear (and the same sort of words) as many other mums who have had a GA.

I think YellowDinosaur has given you some excellent advice on how to weigh up whether you should have the surgery or not.

I just came on to say that, should you decide to have the operation, don't try and hide your fear from people in RL. In fact, one of the very best person to tell (about your fears) is your anaesthetist, and there is a lot he/she can do to put your mind at rest.

[Xmasbaby11]

You should do it. I've just had keyhole surgery for a prolapse repair and am off work recovering for at least 6 weeks. Dcs who are 2 and 4 are in nursery full time, my parents are helping. Dh is taking time off work. It is a massive upheaval but my health is important and I wouldn't consider not doing it.

You must put your health first.

[GrouchyKiwi]

Ask for a meeting with an anaesthetic consultant. They should be able to talk you through the options for this kind of surgery, and maybe help put your mind at rest about some of the worries.

[Imustgodowntotheseaagain]

Hi OP, as others have said, it sounds like they want to check you for endimetriosis.

I've had three laparoscopies for endo. They are uncomfortable but I don't think I was off work for more than a week. Two of them were day surgeries and the third was done at a different hospital that wanted me in the night before.

I don't want to make you anxious so if you want to know the details of what happens let me know and I can explain more but basically when you come round you'll have a small incision in your belly button where the scope went in, and another towards your bikini line.

Do check that they intend to do treatment at the same time i.e that if they find adhesions they'll be lasered in the same session - much better to only do it once! Laser treatment is very good for removing the adhesions and reducing your pain. If untreated, endo can affect your fertility so it really is worth doing. And the cysts can become quite painful as they grow.

I don't think laparoscopy can be done under local anaesthetic, unfortunately.

[YellowDinosaur]

Frasier, I'm going to be completely brutal: there won't be another c-section without this surgery, because if you have adhesions, there won't be another baby

You just can't say this at all. If they adhesions are involving both of her tubes then you're right. And they might be. But plenty of people get pregnant with adhesions or why isn't everyone infertile after abdominal surgery? I've had 2 sections, which will inevitably cause some adhesions which are simply scarring inside and as inevitable as the scar on the outside. The extent varies greatly from person to person but everyone will have some. By your logic my second son shouldn't exist and he's alive and kicking and sitting next to me on the sofa as we speak!

[BumWad]

If it is a diagnostic laporoscopy then it is usually a day case affair and although a little weak you should be fine and fit within a couple of days. If that helps you make your decision.

I have had 2 laparoscopies one for pain which they thought was possible coming from my appendix, nothing was found. Second time it was for infertility - guess what adhesions found on my right side with a blocked tube (obviously caused by laporoscopy number 1!)

[VoldysGoneMouldy]

Right, with the bladder as well, all the more important to get looked at. MRI's are wonderful, but really the clearest way to see, is to see insider. TBH, it's less stressful than an MRI, having had both!

[Gobbolino6]

If you have adhesions, I'd definitely recommend discussing with the surgeon the implications of a further pregnancy if you do not have the procedure.

[YellowDinosaur]

Yellow Dinosaur, can you tell me what kind of pain levels you would expect to see in someone with adhesions? It's just while the pain is there, it's not crippling or anything

It's totally variable because it depends where the adhesions are and how extensive they are

I mean there's a good chance they'll do the operation and won't find anything at all, surely?

It's possible, yes

The good thing about the operation would be for them to check my bladder because that can be quite painful if I let it get too full

That's not really my area but most bladder investigations as far as I can remember (which is from about 15 years ago so don't rely on me!) would be tests of function and a telescope examination of the inside of the bladder. I can't think of any bladder pathology that would be demonstrated by this apart from if there were adhesions involving your bladder.

The main reason as I can see given that your pain isn't too bad is to divide any adhesions involving your tubes if you were struggling to conceive.

[purplemeggie]

Frasier, I'm going to be completely brutal: there won't be another c-section without this surgery, because if you have adhesions, there won't be another baby. I have had the surgery and it really isn't that bad - I was working the next day (from home, but working) and able to look after my young son.

Please have this surgery. The risk of anaesthetic is tiny, really tiny, but you leave yourself infertile if you don't fix it. I have had 6 years of ttc, and 8 rounds of IVF because they left it too late to fix my adhesions.

You'll be okay.

[FrasierCranium]

Yes, since my section. Totally fine before then. I mentioned it at the appointment but he never really referred to it again.

[Turquoisetamborine]

I had a laparoscopy done after suffering secondary infertility. The lap diagnosed me with adhesions on my tube (have only one) from my previous caesarean.

I would have kept blindly trying for baby number two if the lap hadn't told me it was pointless. They did try and clear the tube but I was told it was a very difficult job and not often successful so we had IVF.

It really wasn't a big deal. I had it as a day patient and had a three year old. I had it on a Friday, H looked after me all weekend then my friend came and helped with son on the Monday. I was fine to look after him after that.

[VoldysGoneMouldy]

You'd struggle for an MRI to be confirmed in my bitter experience. I had one suggested, doctor above him refused it.

Pain levels with adhesions vary from person to person, depending on where exactly they are, if they're attached to anything else. Have the bladder issues been since the CS?

[FrasierCranium]

Thank you all.

Yellow Dinosaur, can you tell me what kind of pain levels you would expect to see in someone with adhesions? It's just while the pain is there, it's not crippling or anything.

I mean there's a good chance they'll do the operation and won't find anything at all, surely?

The good thing about the operation would be for them to check my bladder because that can be quite painful if I let it get too full.

But can they look at this, for adhesions etc your MRI?

You're right, I need another meeting with the consultant and this time I'll take my husband with me. Be good to have another pair of ears.

[Libitina]

I too would have the surgery. As said previously, it is usually day surgery and would be well worth having to rule out potential future problems.

[HaveUpsetHer]

Ask to have the surgery done under spinal anaesthetic.

[YellowDinosaur]

I'm a general surgeon. Sometimes we see patients like chickieduck's mum who have their bowel blocked because of adhesions. In addition, if you are fit and well the risks of a general anaesthetic for a procedure like they're proposing are extremely small.

However, more surgery risks more adhesions so it's not as simple as saying have it to deal with them just in case you're someone who might develop significant problems later. It's not a given that adhesions equals a serious problem later, many people have surgery with no such complications.

I think you need to go back and see your consultant to talk about alternative options and to find out exactly why they want to do the surgery. If it is primarily to rule out something more serious and there isn't another way to do that, and there is the side benefit of being able to deal with adhesions while there, then that's probably sensible.

On the other hand, if they don't think there is anything else going on, and the surgery is just to divide adhesions that are causing symptoms you'd be happy to live with, I think not having the surgery is a reasonable option.

But none of us can tell you what to do. Which is why if you're unsure you need to see your consultant again.

[mineofuselessinformation]

I totally get the fear thing.
To put it into perspective though, I've had over ten general anaesthetics (I've lost count!) and I'm still here to tell the tale. The care before, during and after an operation are now much better than they used to be.
Ultimately, the decision is yours, but knowing there's a potential problem with another pregnancy, but wanting to have another baby, would make the very small risk worth it for me.

[VoldysGoneMouldy]

I had a lapraoscopy where adhesions were burnt away. I was under for about half hour, if that. The pain was gone when I was awake, and recovering from the OP - I had a toddler at the time, it was my second lap. - was absolutely fine.

I have severe anxiety, and was sobbing when they put me under the first time, slightly (only slightly!) calmer the next time, and it was worth it completely.

[LaPharisienne]

I should say also you'll hardly know you've had anything done - laps are done by keyhole normally and I'm sure the impact is so much less than something big like a caesarean.