Read untitled text version

This booklet is for women recovering

from a hysterectomy, a bladder or rectal repair, or a surgery to treat endometriosis. It tells you how to take care of yourself in the days--and years--following your surgery. As you read, keep in mind that no booklet can replace the advice and care of your doctor and other health care providers. If you have any questions or concerns about your health, always call your health care provider.

©2 0 0 5 I N T E R M O U N TA I N H E A LT H C A R E . A l l r i g h t s r e s e r v e d .


Terms used in this booklet


4 5

recovery from surgery

Bleeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Fatigue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Incisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Physical activity and exercise . . . . . . . . . . . . . . . . . . . . 8 Sexual activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Urination and self-catheterization. . . . . . . . . . . . . . . . . 10 Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Menopause and hormone replacement therapy (HRT) . . . 13


total health and well-being


Hear t disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 Cancer screenings . . . . . . . . . . . . . . . . . . . . . . . . . . .15 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Osteoporosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18


When to call

your doctor




used in this booklet

Types of surgeries

The list below includes some of the most common surgeries among women.

Bladder and urethral repair. This surger y lifts up the bladder and urethra, moving them away from the vaginal wall and into a more normal position. Repairs can be done through the vagina or through a cut in the abdomen (laparotomy). Endometriosis ablation. This is a surger y to destroy (ablate) abnormal growths of uterine tissue with intense heat or cold. This can be done through a cut in the abdomen (laparotomy) or with laparoscopy. Endometriosis excision. This is a surger y to cut away (excise) abnormal growths of uterine tissue. This can be done through a cut in the abdomen (laparotomy) or with laparoscopy. Hysterectomy. A hysterectomy is a surger y to remove the uterus. Sometimes during a hysterectomy, the surgeon will also remove other reproductive organs. For example, the surgeon can remove your ovaries, fallopian tubes, cer vix, or all of these. A hysterectomy can be done through the vagina or through a cut in the abdomen (laparotomy). Sometimes a laparoscope is used to help the doctor see inside the abdomen. Rectal repair. Rectal repair is a general name for surgeries to help repair muscle and ner ve damage of the bowel or rectum. Rectal repairs can restore correct bowel position, improve bowel control, and ease discomfort and constipation. Depending on the type of repair, your surgeon may use abdominal, laparoscopic, or vaginal surger y. Repairs are also done through the anus and through the perineum (the tissue between the anus and vagina).



Gynecologic surgery is approached in different ways, and affects where the initial incision (cut) will be on your body. Here are some common approaches.

Abdominal surger y (laparotomy). Abdominal surger y is an "open" surger y done through an incision in the abdomen. (A cesarean section deliver y--a c-section--is the most common example of this type of surger y.) The incision leaves a scar of 5 inches or so. But if the surgeon uses a "bikini-cut" incision just above the pubic hairline, the scar will be smaller. Laparoscopic surger y (laparoscopy). In laparoscopic surger y, the surgeon moves, cuts, and sews tissue through small tubes put into several small incisions in the abdomen. A laparoscope (a tiny lighted camera) is also passed through one of the tubes, and helps guide the surgeon during the surger y. Since the incisions are only ¼ to ½ inch long, the scars they leave are small. Vaginal surger y (transvaginal surger y). This refers to operations done through the vagina. They involve making an incision in the vagina. The surgeon must pass instruments through the incision to perform the procedure. If tissue needs to be removed, the surgeon pulls it back through the incision and out the vagina.



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from surgery

Recovery is different for every woman,

and has a lot to do with the type of surgery you've had and how it was done. It can last anywhere from 3 to 8 weeks. This section gives information to help you know what to expect--and what to do--as you recover at home. Of course, you should always follow the specific instructions of your own doctors and nurses if they're different from what you see in this guide.


bleeding and discharge

It takes

After a hysterectomy, it's normal to have light vaginal bleeding for up to 6 weeks. The blood tends to be bright red or pink at first. Gradually, it changes to a brownish color. Here's what to do to take care of yourself:

time to heal

Slow down, pay attention to your body, and be patient. It will probably take about 3 to 8 weeks before you feel well.

Use pads to absorb bleeding or discharge. Change them

every time you go to the bathroom.

Do NOT douche or use tampons. Ask your doctor when you

can start douching again.

In general, recover y from

Wipe front to back after going to the bathroom. This helps

abdominal surger y takes longer than recover y from vaginal or laparoscopic

prevent infection.

CALL YOUR DOCTOR if you have unusually foul-smelling vaginal discharge. GET EMERGENCY CARE if your bleeding is heavier than a normal menstrual period, or if you pass bright red clots.

surger y. The incision usually takes about 6 weeks to heal completely. It will leave a pink scar that will fade to white over time.




Pain and soreness are common after surgery, but they should gradually go away as the days pass. If you've had laparoscopy or a vaginal surgery, you may have less discomfort than a woman who's had abdominal surgery. Cramps and low back pain are two common complaints. Also, your incisions may be sore at first, and itchy as they heal. A bloated abdomen is also common. To help ease and monitor your pain, do these things:

Take any medication as prescribed. Often

your doctor will prescribe medication to treat pain. Follow your doctor's instructions carefully.

CALL YOUR DOCTOR if you have:


It's normal to feel tired after surgery. Your body is healing! Try these tips to help speed the process:


Any increase in your pain, or if pain medication isn't working


A lot of bloating or swelling in your abdomen

Tr y to get at least 8 hours of sleep each


Take rest periods throughout the day. You


Pain, redness, or swelling in one leg, or in your groin

can take naps, too, if you feel like it.

Tell your family what they can do to help

GET EMERGENCY CARE if you have chest pain, a cough (not caused by a cold), or trouble breathing.

you get the rest you need. See the section on physical activity for ideas.

CALL YOUR DOCTOR if you are:

· ·

Increasingly tired or fatigued Dizzy for more than a few seconds at a time




from an abdominal or laparoscopic procedure

If you've had an abdominal surgery, your incision will take longer to heal than the smaller incisions from a laparoscopic surgery. But basic care for the incisions is the same. Here's what to do:

If you have steri strips, leave them alone for the first week. Steri strips are strips of

Do NOT soak in a bath, hot tub, or swimming pool. Wait until your steri strips

tape placed over your incision. They help keep the wound closed as it heals. Most doctors and nurses tell you to leave the strips on until they fall off by themselves. (You can trim the edges if they start to curl up.) But if the strips don't fall off on their own in 10 days, you can gently remove them.

are off and your incision is well healed. (It's all right to sit in about 6 inches of warm water, however. Just don't let the water reach your incision--and don't put soap or shampoo in the water.)

CALL YOUR DOCTOR if you have any of these signs of infection:

If you have stitches (sutures), leave them alone. They'll dissolve on their own. Wear loose clothing. You don't want to


Ongoing red bleeding from your incision. (It's normal to have a small amount of bloody discharge--but not red bleeding.)

rub or irritate the incision.

Wash your hands before and after you touch your incisions. Also wash them often


Redness, swelling, separation, odor, or yellowish drainage from your incision.

throughout the day. This will help prevent infection.

· ·

Fever of 100.4°F (38.0°C) or greater. Flu-like symptoms (for example, chills, body ache, fatigue, or headache).

Take a shower ever y day. You can use soap

and shampoo. After showering, gently pat your incision dry with a clean towel. Or, you can use a blow dryer on a low setting to dry the area. Do NOT rub the incision.


Increase in pain, or pain medication that isn't working.

If you've had a vaginal procedure, you won't need to take care of the incision. The internal stitches will dissolve on their own.


reason to quit


For the best healing of your incisions, you need plenty of oxygen in your blood. So stop smoking before and after your surger y. Better yet, stop smoking for good! Call this phone number today for help with quitting: 1-800-784-8669.



Physical activity

and exercise

Although it might feel strange or uncomfortable at first, light activity is good for you right now. It can help prevent many problems after surgery--such as gas, stiffness, weakness, pneumonia, and blood clots. The trick is being active at the right level. Here are a few guidelines:

Take it easy for the first two weeks. See

the list at right.

Take pain medication as needed to stay active. The more you're up and moving, the

For the first



Don't stay sitting or standing for longer than half an hour. Don't push, pull, or strain. Don't lift anything heavier than 5 pounds. This includes pets and kids! And

easier movement will become!

Take shor t walks several times a day.

Walking inside the house is fine at first. Ask someone for support if you feel shaky or dizzy. Start with short distances, and work up to longer walks.

when you're picking up small things, bend carefully at the knees and lift slowly.

Avoid climbing stairs if it hur ts. You can

Don't do housework or yard work. This

climb them as soon as you can do so without pain.

ASK YOUR DOCTOR when it's okay to return to work or do more strenuous exercise.

might be happy news! Get your family to pitch in, or hire help.

Don't drive for at least 2 weeks following your surger y. Braking suddenly

or using a clutch can strain your abdomen.

Gauging your


Are you doing too much? Not enough? Common sense is a good gauge. Listen to your body. Rest when you feel tired or uncomfor table. But don't be afraid to move. Being active--gently--can help you feel better and recover faster.



Sexual activity

Most of the time, it's fine to have sex again once your incision has healed and vaginal bleeding has stopped. But it's still a good idea to check with your doctor beforehand.

Ask your doctor when you can have sex again after your surgery.


Many women have gas after surgery. It can be uncomfortable! Here are some things to do to prevent or treat gas:

Ever y hour until your gas pains improve, gently press on your abdomen as follows:

Walk more often, or a little further, every

1 2 3 4

Take a few deep breaths--called cleansing breaths. Blow out slowly. Place your hands below your navel with the fingertips touching. Take a deep breath and hold it for 5 slow counts. Breathe out slowly and completely through your mouth while pressing in and down on your abdomen.


Drink warm drinks. Stay away from carbonated drinks-- and

don't use a straw.

Tr y the steps at right when you have gas.

Pressing gently can help you feel better.

Rock in a rocking chair. Lay on your left side, with your knees

drawn up to your chest.

Get on your knees and lean forward,


Move your hands a half-inch closer to your incision, and repeat steps 2 to 4.

placing your weight on your folded arms with your buttocks in the air.

CALL YOUR DOCTOR if you have continuing or severe abdominal swelling or bloating.



Urination and self-catheterization

After surgery, you might have trouble urinating. The problem might be due to your surgery. But it can also come from pain medication, discomfort, or anxiety. Here's what to do:

Don't strain or bear down while going to the bathroom. This can damage the area of


your recent surgery.

Urinate while sitting in a few inches of warm water. Remember to avoid getting

· · · ·

Can't urinate, or have ongoing difficulty urinating Have problems with your catheter, or with self-catheterizing Have bloody, cloudy, or foul-smelling urine Have burning, painful, or frequent urination

your incision wet if it hasn't healed yet.

Don't let your bladder get too full. Believe

it or not, it's easier to go if you urinate more frequently.

Do your Kegels! See the box at right. If you can't urinate on your own before you leave the hospital, you may need to go

home with a catheter (a small tube) in place. Or, you may need to put a catheter in yourself several times a day. Don't be concerned. At first, many women need to use a catheter to drain urine from the bladder. So, until you can urinate on your own, follow these instructions: ·

If you have a catheter in place, follow



Kegels work the muscles around your vagina, bowel, and bladder. They're great for women of all ages, and they're easy to learn and do. Here's what to do:

the nurse's instructions for caring for the catheter and drainage bag. Do any exercises you've been taught. And make sure you know when and how the catheter will be removed. ·

If you need to self-catheterize, a nurse


Tighten the muscles around your vagina and rectum. (These are the muscles you use when you're trying to stop the flow of urine.)

2 3 4

Hold for a count of 10, retightening as needed. Relax the muscles very slowly. Repeat several times a day. Work up to 100 a day.

will teach you how before you leave the hospital. Use the instructions on the next page as a reference at home. Be sure to self-catheterize as often as your nurse has told you to--usually every 3 to 4 hours during the day.


fàxÑá yÉÜ self-catheterization

If you need to self-catheterize at home, follow the steps below. Self-catheterize as often and for as long as your health care providers have told you to. 1. First, gather the equipment: catheter, water-soluble lubricant, drainage container for urine, plastic bag for used catheter, mirror, clean washcloth, clean towel, soap, and water. 2. Tr y to urinate (void) on your own. The first few times you tr y to urinate on your own, you may get little or no urine. But later, you may get more urine on your own than with self-catheterization. 3. Wash your hands well with soap and water, and put soap and water on the washcloth. 4. Get in a comfor table position: · Sitting: Sit on the toilet, or on the edge of a straight-backed chair. Lean back. If it's easier, put your feet up on another chair (or the toilet) in front of you. Bend your knees, and spread your legs. Standing: Stand with one foot up on the toilet or chair. Spread your legs. In bed: Put a pillow behind your back so that you're sitting up at a 45º angle. Bend your knees, put your feet flat on the bed, and spread your legs. 7. Lubricate the tip of the catheter. 8. Keeping the vaginal folds open, find the urethral opening. The opening is below the clitoris and above the vagina. Use the mirror if you need to. 9. Holding the catheter with your fingers, gently slide the catheter into the opening--guiding it upward as if toward your belly button. When the catheter is about 3 inches past the opening, urine will star t to flow. (Make sure the other end of the catheter is in the drainage container.) 10. Gently press down with your abdominal muscles to help empty the bladder, 11. When the urine stops draining, slowly take out the catheter a half-inch at a time. 12. Wash the catheter with warm, soapy water. 13. Rinse the catheter inside and out. 14. Dr y the catheter with a clean towel, and put it in the plastic storage bag. 15. Write down any information you've been asked to, such as: · · · · Time of voiding attempts Amount voided Residual amount (from catheter) Amount of fluids taken in



5. Separate your vaginal folds with one hand. Wash the area well with the washcloth, using downward, front to back strokes. 6. Pick up the catheter about 4 inches from the tip.




Constipation after surgery can add to your discomfort. The problem might be due to your surgery. But it can also come from pain medication, discomfort, or anxiety. Here's what to do:

After a rectal repair...

It's normal to feel some pressure after a rectal repair. But be sure to follow the tips at right to prevent constipation. Constipation only adds to the discomfor t.

Drink at least 6 to 8 glasses of water each day. Eat high-fiber foods. Fresh fruit, vegetables, and whole grain

bread are good options.

Don't strain with bowel movements. Don't use an enema, especially not after a rectal repair. Take a stool softener or laxative if your doctor

recommends it.

CALL YOUR DOCTOR if you can't relieve constipation with the measures listed above.

Drinking 6 to 8 glasses of water each day can help prevent constipation.




and hormone replacement therapy (HRT)

Menopause happens when your body stops releasing eggs and


of menopause

Women experience menopause in different ways. Symptoms differ, and can be mild or severe. All of these common symptoms are caused by hormonal changes: · · · · Hot flashes Sudden sweating Increased facial hair Changes in menstruation: irregular periods, or more or less bleeding than usual · · Trouble sleeping Tender skin, or a "crawling" feeling on your skin · · Vaginal dr yness Urinar y changes, including leaking

hormone levels drop. Once menopause is complete, you won't have monthly periods anymore and you can't get pregnant. Menopause can come on suddenly after the surgical removal of your ovaries. More often, it comes on gradually, as a normal part of aging. In this case, you'll probably start to enter menopause between ages 45 and 55. You might have symptoms for 3 to 5 years as your hormone levels gradually drop as you age. The box at right lists common symptoms. Should you do anything about the symptoms of menopause? It depends. Menopause doesn't require treatment, but some women do choose treatment if their symptoms are severe. The main treatment for menopause symptoms has been taking hormones (hormone replacement therapy, or HRT ). HRT has many health benefits--but it also has health risks. That's why you should discuss HRT thoroughly with your doctor to decide if it's right for you. Here are a few tips to help manage hormone changes:


Pounding hear t Mood swings or depression

Be aware of the symptoms that hormone changes can bring. (See the box at right.) It's easy to confuse these


symptoms with other problems.

Call your doctor if your symptoms interfere with your life.

Your doctor can give you ideas for coping with bothersome symptoms--and offer treatments for more severe symptoms.



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and well-being

As you heal,

you'll think less and less about your aches and pains. You'll start doing more of your usual activities. Soon, you won't give much thought at all to your surgery. That's how it should be. But as your recovery period comes to an end, don't completely forget about your health! Continue to take care of yourself--body, mind, and spirit.

Warning signs of a

Heart disease

You might think that heart disease is a man's problem. In fact, heart disease is the number one killer among women. Even breast cancer claims fewer lives. That's why you need to take action to keep your heart healthy--and lower your risk of having a heart attack or stroke. Here are your key steps to better heart health:

heart attack:

· Chest discomfort. It can feel like

pressure, squeezing, fullness, or pain. It lasts more than a few minutes, or goes away and comes back.

· Discomfort in other areas of the

upper body, for example in one or both arms, the back, neck, jaw, or stomach.

· Shortness of breath, with or without

chest discomfort.

· Other signs, such as a cold sweat,

nausea, or lightheadedness.

Get regular medical checkups. Your doctor can check for factors that raise your risk of heart disease, such as high blood pressure, high cholesterol, diabetes, and others. If you have any of these factors, your doctor can advise and treat you to reduce your risk. Make healthy lifestyle choices. For example:

Warning signs of a


· Sudden numbness or weakness of

the face, arm, or leg, especially on one side of the body.


If you smoke at all--quit now. Women who smoke are

2 to 6 times more likely to suffer a heart attack than nonsmoking women. · · · ·

Exercise regularly --at least half an hour every day.

· Sudden confusion, trouble speaking

or understanding.

Physical inactivity raises your risk of heart disease.

Make good food choices, like those described on pages

· Sudden trouble seeing in one or

both eyes.

16 and 17.

Reach a healthy weight --and stay there. Take your medications just as your doctor tells you to.

· Sudden trouble walking, dizziness,

loss of balance or coordination.

· Sudden, severe headache with no

known cause.

GET EMERGENCY CARE. Call 911 right away if you have

any of the heart attack or stroke warning signs listed at left.



Cancer screenings

The earlier you detect any cancer, the better your chance of surviving it. This page explains what you can do to help detect three of the most common cancers faced by women.

Breast cancer

how to

do a breast self-exam:

Using the fat pads of the three middle fingers, feel each breast in an up-and-down pattern, pressing down with small, circular motions. Do this with each breast--both in the shower, and when you're lying down. Feel for any lumps or changes in your breasts. Also, look in the mirror for any changes in your breasts.

Breast cancer kills nearly 40,000 American women each year. To help protect yourself, follow the schedule at the bottom of this page for these breast cancer screenings:

Breast self-exam. Do this at home ever y month--see the instructions at left. If you notice anything unusual, have your doctor check it out. Mammogram. This is an x-ray of breast tissue.

Colon cancer

Colon cancer is the second leading cause of cancer death for women--and your risk increases with age. That's why doctors now recommend regular screening for colon cancer beginning at age 50. Here are the tests they use:

Stool test. The stool test is done at home. You put a small stool sample on a test card and return it to the doctor or lab. Sigmoidoscopy or colonoscopy. With both of these procedures, a doctor puts a thin tube with a light and a camera into your rectum, up into your colon. This allows the doctor to check for--and in some cases, remove--any cancers growing inside.

Cervical cancer and other gynecologic cancers

All women should be regularly screened with a pelvic exam and a Pap test (Pap smear) according to the schedule below. (If you've had a hysterectomy--and never had cer vical cancer--you don't need to have Pap tests anymore. But you still need regular pelvic exams.)

Recommended schedule for cancer screenings

Note that your doctor may recommend earlier, more frequent, or less frequent screenings based on your histor y and health. for women... to check for breast cancer

to check for colon cancer

to check for cervical cancer and other gynecologic cancers




Breast self­exam: monthly Mammogram: as your doctor recommends Breast self­exam: monthly Mammogram: every year Breast self­exam: monthly Mammogram: every year

Stool test, colonoscopy or sigmoidoscopy: as your doctor recommends Stool test, colonoscopy or sigmoidoscopy: as your doctor recommends Stool test: every year, OR Sigmoidoscopy: every 5 years, OR Colonoscopy: every 10 years

Pelvic exam: every 1 to 3 years Pap test: every 1 to 3 years Pelvic exam: every 1 to 3 years Pap test: every 1 to 3 years Pelvic exam: every 1 to 3 years Pap test: every 1 to 3 years



50 and up




With so many fad diets in the news, it's easy to lose sight of what healthy eating looks like. But there's really no mystery. Good nutrition means a long-term commitment to these daily habits:

Taking reasonably sized por tions. Super-sized servings often lead to super-sized people. To maintain a

healthy weight, you need to control the amount of food you put on your plate.

Making food choices based on sound nutrition principles. Use the 6 basic building blocks (outlined

below) to help you get the most good from the food you eat.

Build a

better diet with these




Include more fruits and


whole grains and other

Eat unrefined starches.

Choose whole grains, which contain more dietary fiber, vitamins, and minerals. Limit your intake of refined starches like white bread, white pasta, and instant white rice. Try whole grain wheat bread, brown rice, oatmeal, barley, and cornmeal.

unsaturated fats and oils.

You need fat in your diet--but some types are healthier than others. Look for foods that are higher in unsaturated fats and lower in saturated fat or hydrogenated fat (called trans fat). Try olive, canola, corn, and safflower oils. Salmon and tuna also contain healthy fats.


Fruits and vegetable are great sources of vitamins, minerals, and fiber. They're also rich in antioxidants. Antioxidants are substances that protect your cells from damage--like "rust-proofing" for your body. Enjoy a variety: spinach, carrots, broccoli, tomatoes, apples, berries, melons, and citrus fruits.




"hand-eye coordination"

You can use your hand to estimate por tion sizes. Here's how:

Once you get a good idea of how big various portions are, you won't need to keep checking.

Handful = 1 to 2 ounces (snack food)

Fist = 1 cup (rice, pasta, or raw vegetables)

Palm = 3 ounces (fish, poultry, meat)

Thumb tip = 1 teaspoon (oil, butter)

Thumb = 1 ounce (½ cheese serving)


basic nutritional building blocks:


Choose heart-healthy




Limit your


low-fat dairy products.



Dairy products are a good source of calcium, protein, and vitamins A and D. However, some are high in fat and cholesterol. Sticking to low-fat dairy products will give you the same nutritional benefits without the drawbacks. Select 1% milk, low-fat cheeses and yogurts, and low-fat powdered milk.

Most Americans take in almost 3 to 4 times the amount of sodium (salt) they need. Since nearly every food we eat contains some sodium, you'll need to read food labels closely to get salt intake under control. Choose unprocessed foods, and use spices to season meals without adding salt. And take the saltshaker off the table!

Unfortunately, many sources of protein--such as red meat and pork--are high in saturated fat and cholesterol. Limit your intake of these, and learn to choose the leanest cuts. Also, choose other hearthealthy plant or animal proteins. Good examples are beans, soy products, nuts, and seeds--plus fish, shellfish, and lean poultry.



Symptoms of


Depression is an illness caused by problems with the chemicals in your brain. It's not a character flaw, and it's more than just the "blues." It's a disease that affects how you feel, think, act--even sleep. The good news? Depression can be treated. Most people CAN recover, and lead full, productive lives. People experience depression in different ways. But despite its various patterns, you should always take depression seriously. Here's how:


Depression affects nearly 20 million Americans--both women and men. But women experience depression at roughly twice the rate of men. So talk to your doctor if you have any of the following symptoms:

· Feeling down, depressed, or


Be aware of the symptoms of depression. (See the box at

· Taking little interest or

pleasure in things you used to enjoy

left.) It's easy to confuse these symptoms with other problems.

CALL YOUR DOCTOR if your symptoms interfere with your life. Your doctor can diagnose your symptoms--and offer

· Trouble falling or staying

asleep--or sleeping too much

treatments to help you recover.

· Feeling tired or having little



Osteoporosis is thin, weak bones. When you have this illness, your bones can break easily and heal slowly. Anyone can have this problem, but it happens more often in older people--especially women. Osteoporosis happens slowly over time. At first, you might not have any signs. Later on, you might have back or neck pain, or broken bones. You also might lose some height. This happens as your back becomes curved and you begin to stoop. Here's what you can do to have healthier, stronger bones:

· A poor appetite--or


· Trouble concentrating · Feeling like you're moving or

speaking so slowly that other people may notice--or feeling so restless that you move around a lot more than usual

· Feeling bad about yourself--

thinking you're a failure or that you've let yourself or others down

Talk to your doctor about your bone health. Your doctor can

take a picture of your bones to see if you have osteoporosis. If you find you have osteoporosis, you may get medication to treat this condition.


Get enough vitamin D and calcium. Have some low-fat milk,

cheese, or yogurt every day. Eat more spinach and other leafy vegetables. Take a vitamin pill with vitamin D and calcium.

Exercise ever y day. This will protect your bones as you age. Don't smoke. Smoking thins your bones faster. Don't drink too much alcohol. More than 1 or 2 drinks a day

is bad for your bones.



of when to call the doctor

During your recovery from surgery...


Call your doctor if you have any of the following:

· · Unusually foul-smelling vaginal discharge. Ongoing red bleeding from your incision. (It's normal to have a small amount of bloody discharge--but not red bleeding.) Redness, swelling, separation, odor, or yellowish drainage from your incision. Continuing or severe abdominal swelling or bloating. Pain, redness, or swelling in one leg, or in your groin. Fever of 100.4°F (38.0°C) or greater. Flu-like symptoms (for example, chills, body ache, fatigue, or headache). Increase in pain, or pain medication that isn't working.

domestic violence...

If you, or someone you know, is a victim of domestic violence--get help. Domestic violence can be physical, sexual, or psychological. It's often aimed at women and children. It's against the law, and should always be repor ted. So if you or someone you know


· · · ·

is in an abusive relationship, call one of the hotline numbers

· · · · ·

listed below. Help is available! Increasing tiredness or fatigue. Dizziness lasting for more than a few seconds at a time. Problems with your catheter, or with self-catheterizing. Ongoing difficulty urinating: you can't urinate or have pain or other problems. Bloody, cloudy, or foul-smelling urine. Burning, painful, or frequent urination. Ongoing constipation, even though you've tried the things listed on page 12. Symptoms of menopause (see page 13) or depression (see page 18) that interfere with your life. Anywhere in the U.S.: 1-800-799-7233 or 1-800-787-3224 (TTY) Hotline staff can refer you to free help, including counseling, shelter, and other ser vices.

· · ·

Domestic violence hotline numbers


If it's an emergency,

Get emergency care right away if you have:

· · Chest pain, a cough (not caused by a cold), or trouble breathing. Bleeding that is heavier than a normal menstrual period, or if you pass bright red clots.

call 911 .


©2005 INTERMOUNTAIN HEALTHCARE. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your health care provider if you have any questions or concerns. More health information is available at Clinical Education Services (801) 442-2963 IHCEDWN010 ­ 10/05



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