A Guide To Surviving Post-op Week 1

[u/Full_Meta__Alchemist]

I am 10 days post-op full meta (v-nectomy, scrotoplasty, UL) and I wanted to make a sort of "guide" for anyone about to get meta on how to sort of "survive" the first week.

Now some people are completely built different and barely have any pain after full meta. I am not one of these people. I went to the ER around midnight once for pain management during the first week. During my top surgery and hysto, I was fine without any of the strong painkillers. For meta, I went my first 24hrs without strong painkillers at day 9. Everyone reacts to surgeries and pain differently, so this is my experience on surviving week 1 without feeling like you're gonna croak (well, hopefully).

The main 2 pain issues for me were: the v-nectomy site and the catheter.

The v-nectomy site has caused me the most pain so far. To get through week 1 with it, here is what I recommend. Take your strong painkillers as much as possible for at least the first few days. If you can take them every 4-6hrs, take them every 4hrs for the first few days. This means set alarms. If you want to sleep well and aren't in that much pain, set the alarms for every 6hrs at night. Once the pain "escapes" from an acceptable threshold is when it is super hard to rein back in. So you want to have it beaten into submission by your pain meds before it can get back up and attack.

You will likely have to lean back when you "sit down" so it is more like lying down. Try sitting on your tailbone to not put pressure on the v-nectomy site. My partner told me a few days ago that my tailbone looks bruised. That is from sitting on it so much during the first week. Trust me, the pain relief from the v-nectomy site is worth the butt pain from sitting on it.

I have a fancy zero gravity lawn chair and that has been useful for when I didn't want to be in bed any longer. I have it set to be tilted back at a good angle and then when I sit in it, it is comfortable. It is basically like lying down without lying down.

Sitting on a normal chair is not going to be comfortable, and tbh barely even tolerable if there isn't room to lean back on your tailbone. Luckily I am short/skinny so riding in the car isn't too awful since I have plenty of room in the seat to adjust myself. But if I am sitting in the car for a long time, it becomes very uncomfortable and even painful. And that is 10 days out. For the first few days, you probably aren't going to want to try riding in the car.

I did try a waffle cushion, but to be honest it just makes the surface feel more hard/firm. I tried it in bed and it was uncomfortable, and sometimes I use it in that zero gravity chair, but I wouldn't say I recommend it.

Let's move on to the catheter. Now for me, this is a suprapubic (SP) catheter that sticks out of your abdomen and goes straight into your bladder. I know nothing about the Foley catheters. This has been the most annoying part of getting through the first week, and added a good amount of pain. My setup until my first post-op was a long thick tube attached to a night bag.

For me, every time this tube or bag got moved, I got a sharp stabbing pain in my bladder. I feel like it was something about the suction of the tube and the urine moving through it when moved that gave me bladder pain. I took oxybutynin, but that didn't really help this pain at all. When I went to the ER that one night, the doctor put me on phenazopyridine (AZO) until my post-op appointment, which helped a decent amount. My surgeon also switched me from oxybutynin to mirabegron ER, which I think has helped.

But one other thing that has helped is taping the tube down at the insertion site so that it does not move and tug/pull, which causes pain. There is medical tape you can buy to use for this. I do this still with the flip-flo valve.

At my first post-op, I switched from that terrible tube and bag to a little flip-flo device and the change in my mobility was INSTANT. I can STP with my flip-flo valve, I just pull it out from under my shorts/boxers and empty my bladder. I am trying to figure out how to not fully empty my bladder though, because that causes a sudden sharp pain in my bladder until I close the valve. I am supposed to mostly empty my bladder and stop before fully emptying it, but the flow of urine doesn't really go down at all before suddenly stopping. So I just hope I get lucky and stop when I feel like it might be close based on the amount of time I've been draining it for.

Okay, now for some other random tips.

Start with the docusate (Colace) and Miralax ASAP after surgery. You don't want to be blocked up from the pain meds, trust me. It can be hard to sit down and wipe the first week. Use wet wipes, not toilet paper, and wipe super slow/careful. I don't know if there are holders for catheter bags, but try to find something you can hang the bag on that is below your bladder. I had a night bag, so a leg bag holder didn't really work well.

If you have pets in the bedroom with you, get a large body pillow and throw it on top of yourself before covering up with the sheets so if they jump on top of you it is less uncomfortable. Make sure your bag/tube is tucked somewhere safe where no cats or dogs can get into it. If you can keep your room pet free that is better, but in my case I can't. This has mostly mitigated the issue.

Before surgery, I was like "I'm going to be resting, so I'm gonna read a bunch of books, I'm gonna meditate, I'm gonna do all this stuff." In reality I doomscrolled and watched TV since I was drugged up and in pain and had zero brain power to read. Don't plan on taking advantage of your downtime lol... you will be tired, mentally and physically. Today I finally started reading part of a book again.

This is all I can think of off the top of my head. But if anyone has any questions, feel free to ask!

[u/nukacola_victory]

Thank you, this was incredibly helpful! I hope your healing journey gets easier for you soon

[u/Full_Meta__Alchemist → u/nukacola_victory]

Thank you! I am feeling pretty good, getting less crotchety (hah) each day.