What to Expect in a D&C Outpatient Surgery
I Was Afraid of This Common Operation
I arrived at the women's outpatient surgery center at 7 a.m., afraid that everything that would happen there would hurt.
I was scheduled for a D&C, a procedure in the uterus. My mother, as well as other friends, had been awake during their D&Cs 20-plus years ago, and they had told me it was agony. But another friend, who'd had this procedure much more recently, said it took only a half hour or less and that patients today are almost always given general anesthesia. I did not want to experience any pain, nor did I want to be awake in the operating room—with my feet in stirrups and my personal parts starring in the show.
While I waited in a bed in my hospital gown, a friend at my side, each operating-room staff member came by to say hello: the nurse-anesthetist; the anesthetist supervisor who was a M.D., and my gynecologist, who was also the surgeon. The nurse-anesthetist gave me a morphine-like painkiller intravenously, which she said would last for six hours. It made me sleepy. The nurse sent my friend to the waiting room and set the bed so I lay flat, and then she rolled it through double doors and down a short hall into the operating room. Its walls were blue. I tried to see more, but just as they lifted me onto the table, the anesthesia put me out.
What's Done and Why They Do It
"D&C" stands for "dilation and curettage," meaning that the cervix or opening to the uterus is opened to pencil width, and the contents of the uterus scraped with a tool called a "curette." This is not fun but it is a common and minor operation, an outpatient procedure, and most patients go directly home. My surgeon had a special scope to see inside the uterus. He also wanted a biopsy because I had post-menopausal bleeding. It might be nothing. It might also be a sign of cancer. He wanted to be sure.
An in-office biopsy had been tried but did not work. This is when the gynecologist ordered a D&C and I tried to talk him out of it. He ordered an ultrasound view of the uterus, which showed a thickened uterine lining, or endometrium. In some places the buildup measured 5 millimeters, in others a "prominent" 10 millimeters. It might be hiding a tumor, benign or otherwise. I had taken medicine known in rare cases to cause endometrial cancer. And truthfully I had twinges down there although I didn't tell anyone. So I had to give in. A D&C might also find fibroids or be done to scrape out clots or other sources of heavy menstrual cramping or bleeding.
Preparation, Risks, and Recovery Time
I had received at home a booklet on how to prepare. No food or drink, even water or medicine, after midnight on the day of surgery. No aspirin for a week before; no alcohol or smoking the day before. I had to list all the medications I was taking. I did not have to shave the area. I was told to remove all jewelry and leave it at home, wear no makeup, wear casual clothes such as sweats, and a pair of warm socks. General anesthesia meant a friend or family member had to drive me there and back home (no cab riding allowed), and I had to take the day off from work. It was much like the colonoscopy experience I'd had four years before.
The risks of the D&C surgery: infection, or perforation of the uterus (described as "a tiny hole" accidentally cut by the curette). If your clinic and surgeon are careful these are unlikely. The normal aftereffects: Spotty bleeding might last for up to 10 days, so wear a pad, but not tampons. I could return to work the next day, but must take "pelvic rest" (no sex!) for seven days. Showering was okay but no tub baths for seven days, because baths might invite post-op infection.
When I woke I asked, "Is it over?" Twenty minutes had passed, and the gynecologist was right there saying he found nothing wrong and would phone Friday or Monday with the biopsy results, expected to be negative. I asked when I could exercise and he said, "tomorrow." He said to take ibuprofen if I had post-op cramping, as about half of patients do.
After the Surgery
My friend was allowed to sit with me while the nurse served me three halves of graham crackers and a glass of water, and then my friend went to get her car. I was taken to the clinic door in a wheelchair, feeling sleepy and as if I were drunk. At 10 a.m. I was in my own bed and slept until 1:30.There was minor cramping, hardly anything, so I took one ibuprofen but could have done without it, and I wore pads for spotting, which was light and watery. The first day afterward you are supposed to eat lightly, so I had a light lunch but ate a normal dinner, except I also ate chocolate to celebrate.
The clinic phoned the next day to ask me how I was, and I said, "Just fine." And I'm fine.
© 2011 Rula Lenski