Sep 13, 2012

How to Cope with a Cesarian Section (CS)

(Image source: Jerome Ware)
Last week, I underwent my fourth cesarian section (CS), and my doctor has advised me against having a fifth because my uterine walls were already thin.

It feels a little sad to say goodbye to child-bearing. This article is my way of saying farewell to this part of my life.

How to Survive a C-Section (I dare say not many people can say they have survived four!)

1. Pain killers are your friend. On my first CS, I was gung-ho about avoiding pain killers. They were bad for your liver, right?

But on my latter C-sections, I realized that pain killers help you walk sooner rather than later. The sooner you start walking, the faster you will heal.

On my last C-section ten days ago, I had pain killers as often as the nurse would let me take them. On the first week, it was once every eight hours. The pain killers let me walk around less than 24 hours after my operation.

By the fifth day after my CS, I only needed my mefenamic acid twice a day. By day 7, it was down to once a day.

It is now 10 days after my CS. I still have one tablet of mefenamic acid left. I don't think I will need it anymore today.

2. Accept the sedatives they offer you after childbirth. CS is a comfortable way to give birth, but the oxytocin they put in your system via IV for about 24 after childbirth can be terrible. It caused my uterus to contract like crazy every five or ten minutes or so, and it's no walk in the park, I tell you.

I noticed, though, that when I receive sedatives (for my first and fourth CS), I hardly felt the contractions at all. I don't know the medical explanation for this, but that's my experience.

I am not sure if it will work the same way with everyone, but considering how terrible those contractions feel, I'd say it's worth trying this method to avoid them. After all, if they give you the sedatives after your baby has been born, it won't affect the baby anymore.

Will you still be able to nurse your baby? Yup. Despite the sedatives, I was awake the whole time that my baby was allowed to stay me after delivery for Unang Yakap. It was only after they took her away to clean her up that I fell asleep.

3. If you can't pee in the bed pan, try it on the toilet. Urinary retention -- the inability to release pee from the bladder (a.k.a. balisawsaw) -- is a common post-CS problem.

If you are unable to pee after the catheter is removed, your bladder may get distended so much, the doctor will need to put the catheter back in and retrain your bladder to release pee when it should.

You don't want to get the catheter reinserted, I assure you. It will not be a pleasant experience.

So before your doctor takes this last resort because you can't pee in your bed pan, try forcing yourself to walk to the toilet instead.

The mind is a slave of habit. The sensation of sitting on a toilet bowl can be a powerful stimulus for your bladder to finally release the urine it's been holding in for so long when you were seated on a bed pan.

4. Lay off the binder. Trust me: your wound, if properly stitched, will not burst open. (This is, of course, presuming that you are not lifting anything heavier than your baby.)

Binders may give you some peace of mind, but in my experience, they tend to irritate the wound, and when I take the binder off, the muscles feel more painful.

When you keep the binder off, blood flows around your wound area better, and I guess that helps the wound heal faster as well.

5. Breastfeed. First, when you breastfeed, you are forced to lie on different sides. In other words, you are forced to move.

We've already mentioned that movement is important for faster wound healing.

In contrast, if you bottle feed your baby, it's far too easy to just lie still and let somebody else do the feeding for you. This slows your healing. It also deprives you of an important opportunity to bond with your baby. And it deprives your baby of the immunity she can get from your body to protect her until her own immune system is more developed.

Second, breastfeeding helps your uterus contract to its original size more quickly. The sooner your uterus shrinks, the more comfortable your wound will be (and the sooner you can wear your old clothes too).

6. Drink a lot of water. First, this helps flush your body of all the chemicals they loaded into it during your operation.

Second, proper hydration helps your wound more quickly.

Third, as counter-intuitive as it may sound, drinking more water actually helps reduce the swelling in your body caused by water retention (when your body is fully hydrated, it tends to excrete water more freely rather than try to hoard it in).

Fourth, drinking a lot of water can prevent UTI, which can be caused by that catheter they inserted into your urethra before the operation. Urine helps wash your urinary tract.

And fifth, drinking a lot of water (and avoiding sugary food) is also good for preventing yeast infection, which is caused by all those antibiotics you need to take. The antibiotics also kill the good bacteria in your vagina, which can make you prone to yeast. Urinating often can maintain a good acidic environment in your vaginal area, to help prevent yeast infection.

7. Leave off the underwear. Hush, don't tell anybody, but since my CS, I've taken to wearing long skirts and nothing else below my waist. If I bleed on the skirt, I wash the skirt and wear a fresh skirt.

Why did I nix the knickers?

First, it is so much more comfortable when there is no panty or panty garter rubbing against your wound.

Second, the absence of underwear keeps your pelvic area cool and dry, not warm and humid, so you can better avoid yeast infection.

8. Get Tegaderm for dressing your wound. This is a clear plastic adhesive bandage used for dressing surgical wounds. You can get it at the drugstore for about P100 per piece. It's very useful for keeping your wound dry when you wash your feminine area or when you take a shower.

This is how I use it: I clean the wound with alcohol then Betadine, I cover the stiches with clean gauze, then I place the Tegaderm over the gauze. This forms a nice clean waterproof seal over the stitches.

To remove the Tegaderm, it helps to have an alcohol-soaked cotton ball to loosen the adhesive. I change my dressings after every shower.

Ten days after my CS, I was allowed to wet my wound, so I've stopped using the Tegaderm.

9. Arrange for a private car (or at least, a cab) to drive you home. And get a very careful driver, one who knows how to make the car glide over street humps and road bumps.

Avoid tricycle rides, in particular. I don't think the inventor of the tricycle has ever heard of the word "shock absorber" -- and believe me, you will feel every single bump on the road.

Don't forget to take your pain killer an hour or two before the ride home, to give it time to take full effect. Remember, pain killers are your friend!

I hope this list helps you survive your own C-section. If you have any questions, feel free to ask. If you have your own CS survival tips, do share it with us!

DISCLOSURE: I've just realized this article kinda looks like an advertorial for Tegaderm. It is not -- though I wish it were!