Surgical management…what to expect?

[Cinai]

Sadly my surgical management of a missed miscarriage is coming up this week 😞on top of the emotional turmoil, I’m starting to stress out about the procedure. Can anyone who has been through it share what the recovery is like? For how long did you bleed, and how heavy is the bleeding? How does pain management work, would you have liked to have anything stronger than paracetamol? And how many hours after the procedure did you leave the hospital?

I’m sorry you’re going through this. I had surgical evacuation at 8 weeks on Wednesday. Pain they gave me codeine but I’ve only had to take that twice. I’ve been in a bit more pain because I got a UTI afterward (I had a lot of internal scans and the doctor thought this didn’t help). My GP was able to diagnose and give antibiotics for that though.
cramps have been manageable for me, first day after I alternated paracetamol and ibuprofen and had codeine when it broke through. Key is to take them before the pain gets too bad but they were like bad period pain for me.
bleeding has been minimal but they did do ultrasound guided evac because of a potential strange shaped uterus and suspected molar pregnancy so they were less likely to miss anything
ADD: I left hospital about 5pm and went onto the ward at 7.30am. I was procedure number 3 but there was some emergencies after my procedure which meant discharge was delayed a bit as doctors were understandably busy. I would have been able to leave earlier, they wanted you to have a wee, have something to eat and walk around a bit which I did straight after returning to the ward about 1pm.
I hope this helps, sending hugs

Thank you for replying. I hope your recovery is going well ❤️‍🩹

Also good to know that you got codeine, they said to me I can manage the pain with paracetamol once I’m home, but I think I’ll ask for codeine just in case it gets too bad. I have a rather low pain tolerance and would like to be prepared.

I’ve had a couple of these - turned up to the ward for 0800, left no later than 1400 (depending on where I was in the schedule, once I was in first, the other time I think I was third) having had a cup of tea and a sandwich lunch.

Never had much more than spotting for a day or so after, and never needed painkillers. There was a little cramping but very minor.

When you arrive in the morning they’ll go through all the paperwork with you, you’ll change into your gown and chill out in your cubicle until it’s your turn. I took a book and a cosy shawl for the wait as I was on my own. There will be a locker you can leave all your things in, but they’re not huge so don’t take lots. You’ll get wheeled down to theatre by a nice porter, they’ll give you the anaesthetic, and next thing you’ll know you’ll be waking up in recovery - they will keep you comfortable and warm for a while (blankets out of a heating cupboard) before the nice porter takes you back to the ward. You’ll get a cup of tea, which somehow for me was the best cuppa I’d ever had.

I hope it goes well for you, so sorry you’re having to go through it at all 💐

Hi OP, sorry that you're going through this. I've had two surgical managements, both done under local anaesthetic. Very quick procedures. I had to wait around 30-60 mins afterwards before I could leave so not too bad. I didn't need any painkillers once back home and there was no further bleeding. I appreciate not all cases are like that but that was probably 'best case scenario'. Hope it goes ok for you xx

@Cinai Sorry for your loss and that you are going through this. I had surgical management just over three weeks ago - it was a long day but straightforward and the recovery was quick for me. I had to arrive at the hospital by 7.15am - I was on the elective surgical unit so not a lot of privacy and my husband wasn't allowed to sit with me while I waited, which I found very upsetting (I was meant to be on a ward but it was closed due to the doctors strike). I had a magazine with me to read to kill the time while I waited. I had some pre-op assessment with the anaesthetist and registrar, I was given misoprostol tablets and eventually went into theatre around 10.45. I came round from the surgery around midday but was in recovery for quite a while as there was nobody available to take me back to the surgical unit. When I got back there I was given water and some biscuits, and they wanted to make sure I could pass urine okay before I could leave. I was discharged just before 3pm.

In terms of after effects, I had some cramping when I came round from the surgery - similar to period cramps. As I had had paracetamol before the surgery and hadn't eaten yet they couldn't give me any other pain relief (other than morphine, which would have been excessive!) but I took some painkillers when I got home and just rested up with a hot water bottle. I had bleeding for about 3 days afterwards - I was told to expect it to be like a period but it was lighter than that - which then reduced to some spotting for another couple of days. I had some discomfort on the side where I had ovulated in the few days after the surgery, again manageable with painkillers/hot water bottle.

One word of warning in case you haven't been told about this - there is an enormous hormone crash about 48 hours or so after the surgery, I really felt that and was in a really poor emotional state on the second and third days after my surgery. It's not really something you can do much to prepare for and it is a really horrible feeling, but had I known how it would feel I would have taken a bit more time off work (I had surgery on a Friday so went back to work on the Monday and found it a real struggle).

I hope your surgery and recovery are straightforward - look after yourself and take it easy afterwards. 💐

Thanks all…sorry to hear that so many went through this, these last few days since finding out that my pregnancy has stopped developing were so tough, I just want it all to be over now.

I felt the same, from reading the replies I possibly think my pain was worse because I developed a UTI after and the pain was mainly in my back. I was quite crampy all the way through the 8 weeks though. I meant to add that make sure you get some of your favourite foods in (I also had wine!) for a couple of days after. I’m physically a lot better now but the emotional /hormone crash that others have mentioned happened too. I also cried when I came round from the anaesthetic… also quite common apparently

Also… don’t underestimate how much time you might need off. I was already off work due to a family emergency and have had 2 weeks off in total (and off the next two as I have a two week half term break anyway) I personally would have struggled to go back tomorrow if half term wasn’t there. I’m very lucky my work are very supportive (my team knew I was pregnant as I needed a comprehensive RA with the young people I work with)

Yes, I’m due to go on a business trip (involves flying to another country) two days after the surgery but I think I need to explain the situation to work and cancel it. Problem is that they didn’t know I was pregnant.

My sick note from the early pregnancy / gynae unit just said ‘gynaecological problem’ it might be worth seeing if their doctors will put that as I think it’s probably quite common for work not to know. They did a note for a week but would have done more

Are you having it under general or local anaesthesia? Sending hugs.

@Cinai I would definitely encourage you to tell your work - even if you just keep it to your line manager and HR lead (and of course you can share the information in confidence so nobody else finds out), miscarriage counts as pregnancy-related sickness and is legally protected so as well as ensuring you get the support and time away that you need, it also protects you against the time off being used towards any absence triggers. You might find you don't need a lot of time off, everyone is different, but it's probably sensible to assume you might not feel up to a trip abroad a couple of days later.

I didn't bleed at all afterwards and only had to take a couple of paracetamol on the first day. I took two weeks off from work as they offered me the sick note and I really did need it as emotionally I was a mess.

I had this 11 years ago. The actual procedure was quite civilised compared with my natural miscarriage 6 years previously. I was asked beforehand if I wanted it done in the day surgery unit or gynae. I chose the day surgery unit because there would be pretty much guaranteed no emergencies to cause delay. The other ladies in the bay were all gynae patients too. The waiting is the worst bit. Dh was allowed in the bay but not to the anaesthetic room. I had to walk to theatre which wasn't far but lots of people around so I was glad I had my dressing gown and slippers on. I woke up with a scratchy throat and feeling a bit dizzy but no pain as such. I was wheeled back to the bay and they phoned dh to say I was back. I got tea and toast which made me cry because you get that after having a baby. Turns out you get that after any surgery but I didn't know that. As soon as I had finished I was encouraged to go to the toilet and then I could go home. They asked me if I wanted to see the baby and I wasn't sure so I asked the nurse what he looked like and then I decided I would rather remember him as he was from the scan. I'm referring to him as he because all my dc are boys so I'm guessing this one would have been too. I asked if my milk would come in and they said no, it was too early. But on day 4 afterwards it did. Thankfully I had an 11 month old who had very recently weaned because my milk had gone so he was able to start feeding again and I breastfed him for another year. Afterwards we went out for dinner and the next day PIL brought our other 3 children back. I was pretty much back to normal physically although I did notice my bleeding got heavier when I did anything strenuous. The bleeding was mostly just spotting and a bit heavier if I was active. Much less than a period but my periods are really heavy.

Sending hugs OP.
I had surgical management 2 weeks ago, my first pregnancy/ miscarriage. I had never had an aesthetic or even been to hospital for anything other than A and E before, and was nervous! So I'll give you the full run-down!
Arrived to the ward at about 8am, it was a small, early pregnancy ward with individual rooms with en suite toilets, which was nice. I wore my joggers and comfy clothes, and brought some pads, my sliders, dressing gown, book and headphones. Also brought my toothbrush and a change of clothes, just in case I needed to be kept in.
Various nurses, anaesthesiologist, etc came in to get me to fill in forms, take my blood pressure and do a blood test. Also lovely cleaner popped in and catering staff to take my lunch order! I got changed into a surgical gown and compression socks.
Luckily I was the first surgery and there were no emergencies before me, so I was in surgery by 9.30. A porter came to collect me and wheeled me to surgery. In the surgery were nurses and anaesthesiologists, who lay me down, attached the cannula (after a lot of slapping/ squeezing my hand, as it didn't want to go in!) and put on oxygen mask on me. When the aesthetic went into my hand it stung a bit and they told me to think of a nice place, a beach or something.
Next thing I know I'm waking up in a room with nurses who are saying wakey wakey. They changed my pad and then I was wheeled back to the ward.
I was a bit sleepy and had some deep back pain, like period pain for about an hour but after a cup of tea, some lunch and chilling out, I felt almost normal. A nurse came to take my blood pressure and temperature about every half an hour.
I was discharged at about 2.30pm and walked out like nothing had happened, no pain and just a little bleeding. Carried my own bag and took the stairs. Felt a bit spaced out but some chips on the sofa with my partner helped.
I had a few days off work on the sofa but no pain and barely any bleeding, just a fair bit of crying! 2 weeks on I'm still bleeding every day but only like the last day of my period, so just a bit of brown-ish blood, not really enough to warrant a pad/ only noticeable when I go to the loo. Physically I feel completely fine, been swimming a few times, walking the dog, etc. Emotionally, still a bit sad.
I felt cared for (props to the NHS! The hospital may be a bit old and falling down and no funding, but the care was there still) and 100% made the right choice of management for me. Good luck with your surgery and recovery xx

Thank you all, I really appreciate it ❤️

@Cinai How are you doing at the moment? Did you have your surgery? Hope you are feeling okay.

Sorry for your loss.

This was a few years ago. I was in hospital for about 6 hours. The canula was put it and I was given a gown to wear and wheeled down to just outside the theatre.

The nurses and anaesthetist were so lovely and reassuring. They told me they would give me the anaesthetic and kept talking to me.

Next thing I knew I was awake again and the procedure had been done.

I was given codeine for pain but barely needed it. There wasn't much bleeding afterwards either. It was like a light period.

Physically I was ok and went back to work the week after. I had such a lovely Line Manager at the time. He tried to talk me out of coming back so quickly, saying I should give myself more time but because I was ok physically I went back.

Then my emotions hit me. It was hard to not cry when I wanted to cry. I also didnt have much of a support system so it was difficult emotionally. But it's ok after a while.

Thanks @CluelessInLondon I had my surgery yesterday and it was alright. I was in at 7am and out by 1pm, had some cramping after I woke up and they gave me codeine. I didn’t have to take anything else since I came home yesterday, I don’t have pain and only minimal bleeding. Emotionally I’m also doing well so far, I had quite a good day today, looking at it as the beginning of a new and happier chapter. If I’m still feeling well tomorrow, I’m planning to go back to work on Monday…I think returning to normality might do me good.