Pre-Op Tips

~ Questions to Ask Your Physician ~

1. How many endometrial ablations have you performed?

2. Which endometrial ablation method are you most comfortable performing and why?

3. How far out are your patients you performed endometrial ablations on? 1 year? 3 years? 5 years?

4. What is the basic age range of your patients you performed endometrial ablations on? What was the diagnosed cause of their bleeding?

5. Am I a good ablation candidate, if so, why? If not, why not? What are you basing this on?

6. How many endometrial ablations do you do in an average month?

7. What sort of complications or problems have you encountered yourself? Heard of from colleagues?

8. What is your rate of patients with no more bleeding?

9. Do you recommend hormones or a D&C to thin the lining first? Why/why not?

10. If I still have more bleeding/cramping than I'd like afterward, can we try another method?

11. I understand things take a while to "settle". How long until the "final" results are apparent?

12. How long will the endometrial ablation "hold"? Until menopause? Do women (your patients in particular) sometimes have to have another one at some point? Why? Does the lining "grow back"?

13. Can I have my tubes tied at the same time? Is there any reason that it would be better to do them as separate procedures? Do you recommend that I have my tubes tied at the same time?

14. If applicable: Should I stop taking my BCPs? When?

15. Will I need a device to dilate my cervix (laminaria)?

16. What needs to be done beforehand (blood donation, not eating for some time)?

17. What tests will be done beforehand? What might we learn from them? How long does it take to get results back?

18. How long will the procedure take? How many people are involved?

19. Will this procedure affect the bladder, if so, how? Do you need to have a catheter during the procedure, why or why not?

20. How long will I be in hospital?

21. What if polyps are found during the pre-procedure exploration?

22. What if fibroids are found during the pre-procedure exploration?

23. What if my uterus is too big? Too small? Too odd-shaped?

24. Is a fluid used to expand the uterus? How is its volume monitored? What might cause it to "leak"? What happens in that case?

25. If there is a problem (perforation, drop in balloon pressure, leakage) what options are there?

26. What can I expect afterward (pain, cramping, sloughing-off, mood swings, discharge, fever)?

27. Will I need to be on hormones afterward? Why, or why not?

28. How long until I can return to light activities (walking, driving, sitting at desk)?

29. How long until I can return to heavy activities (exercise, lifting)?

30. About how long until I can have sex again? How about tub baths, tampons?

31. How much is all of this going to cost?

32. {Pregnancy after endometrial ablation is very dangerous, yet it does occur. A reliable method of birth control IS needed post-endometrial ablation to avoid getting pregnant. If applicable, you may want to run this question/discussion by your physician: If a younger person has an endometrial ablation and the endometrium grows back in 5 or so years, is there a reason a woman couldn't become pregnant and carry a baby to full term without a lot of complications? The main reason you can't have a child is there is not any or enough endometrium {uterine lining} to support a growing fetus. Is there another reason besides the endometrium that a woman should never have another child after an endometrial ablation? If a woman changes her mind 5 years after an endometrial ablation, and she doesn't have another endometrial ablation, what would be the chance of a safe pregnancy?

33. It would be a good idea to mention what supplements you are taking, esp. Vitamin E. Vitamin E can have a blood thinning effect and can interfere with the absorption of Vitamin K (a vitamin not usually necessary to supplement with) which helps with blood clotting. A garlic supplement has blood thinning properties as well. Ask if it is best to go off of these or any supplements two weeks prior to surgery and if you should stay off of them for two weeks after surgery. (Thanks to Jeanie for this tip.)

~ Pre-Op Comfort Tips ~

• Get a manicure, get a pedicure, get a massage ~ You deserve it! :)

• Listen to peaceful music.

• Keep busy with activities you enjoy.

• Take a warm bath with scented candles in the background and deeply R-E-L-A-X.

• Buy yourself a new and comfortable pair of pajamas for your recovery time.

• Make sure you have a bunch of nice refreshing liquids to drink afterwards, maybe stock up before hand - something to look forward to - flavored teas, sparkling water, etc.

• If you don't own a heating pad, now is the time to buy one. Be sure to ask your doctor if you can use this during post-op. ;) It helps SO much with post-endometrial ablation cramping. {You may not even get any cramping post-endometrial ablation, some women do, some women don't}

• Pick out a book or movie you have wanted to read/see and save it for the day after, when you are tired and need rest but are not so sleepy.

• Plan out the meals you will have for the couple of days following your surgery - make them "good for you" but "good to eat" too!

• Wear very easy to put on clothes to the surgery that you can wear home after surgery because you might have a hard time getting dressed after the anesthesia. The less complicated the better - avoid buttons, hooks, tight fitting clothes, and tie up shoes.

• Stock up ahead of time on whatever you'll need for a few days afterward.

• Clean your house and pay bills so you won't have to worry about that when you should be resting after surgery.

• Be sure to drink plenty of fluids so you are well hydrated before surgery to help in ease of IV and overall well being.

• Ask the doctor to call in your pain meds to your pharmacy, and pick them up ahead of time. Some doctors hand you a prescription after the surgey, and you might not feel like dropping by the drug store then.

• Unless you like hospital pads, be prepared to pack some of your own pads. I still cannot figure out those hospital pads! ;)

• Buy some "Always" disposable wipes or just plain "baby wipes" to have on hand for post-op as they can be very refreshing during post-op "drainage" days.

• You might think about taking a small overnight bag, just so you can be prepared in the unlikely event that you have to spend the night. It's pretty unlikely, but it certainly won't hurt having one prepared.

• Bring a book, crosswords, headphones - something - for the pre-surgery wait.

• Be sure to wash your hair before going in, so you can be hair fuss free for a couple of days. If you have long hair, consider getting it put up in a french braid so it will stay out of your way.

• If applicable, follow your pre-op diet and always follow your pre-op directions to the letter.