Dr. Conways Post-Op Guidelines

Dr Quesada - Nerve Blocks and Diagnostics including Pain Management = New Hampshire

Dr. Conways Post-Op Guidelines

Postby Karyn » Sat May 14, 2011 3:15 pm

1 - 3 Weeks Postop
Modified bed rest
No lifting, squatting, or bending
Able to sit for toileting only
Limit stairs to 1 -2 times per day
Household ambulation limit to 5 - 10 minutes at a time (3 - 4 times per day maximum)
Able to stand 5 - 10 minutes for meal prep, brush teeth, bathe, etc ...
Exercise: diaphragmatic breathing, ankle pumps, heel slides, gentle trunk rotation

3 - 6 Weeks Postop
Same as above
May sit with cushion 5 - 10 minutes (2 - 3 times per day) for meals if it does not cause pain
May gradually increase walking/standing to 10 - 20 minutes (3 - 4 times per day)

4 - 8 Weeks Postop
Begin gentle postop PT - myofacial release and gentle connective tissue release
Vaginal or rectal manual therapy may begin when cleared by MD

6 - 12 Weeks Postop
Avoid bending, squatting, or lifting
Gradually increase walking/standing (limit to 30 minutes at a time)
Limit stairs to 2 - 3 times per day
NO high impact activities (no biking, running, weightlifting, or aerobics)
May begin aquatic exercises, gentle stretching or basic yoga exercises (when cleared by MD or PT)

12 Weeks to 1 Year Postop
Avoid frequent squatting
Avoid heavy lifting
Avoid prolonged sitting
Avoid high impact activities (i.e. running, jumping)
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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Re: Dr. Conways Post-Op Guidelines

Postby helenlegs 11 » Sat May 14, 2011 3:52 pm

I hope you are being a model patient :)
Take care,
Helen
Fall 2008. Misdiagnosed with lumber spine problem. MRN June 2010 indicated pudendal entrapment at Alcocks canal. Diagnosed with complex variant piriformis syndrome with sciatic, pudendal and gluteal entrapment's by Dr Filler 2010.Guided piriformis botox injection 2011 Bristol. 2013, Nerve conduction test positive; new spinal MRI scan negative, so diagnosed for the 4th time with pelvic nerve entrapment, now recognised as Sciatic, pudendal, PFCN and cluneal nerves at piriformis level.
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Re: Dr. Conways Post-Op Guidelines

Postby Faith » Sat May 14, 2011 4:50 pm

Interesting. Thanks for posting Karyn. What do you think he defines as "prolonged" sitting (12 weeks-1 year)? Are you going to do PT? I know you didn't have a great experience with it pre-op. I hope you are getting a little better everyday. I think of you often and what a great positive attitude you seem to have. That always helps!

Blessings,
Faith
-11/08 vulvodynia began spontaneously around conception of first & only pregnancy
-3/10 sacral/sitting pain began after SIJD manip
-Progressive widespread pain- central sensitization ?
-PT, meds, injections, botox, ESWT = debilitated.
-5/12 Potter MRI - scarring of left ST, coccygeous & posterior alcock, but pain is bilateral
-10/12 -bilat ischiofemoral impingement & labral hip tears/FAI
-12/12 - left FAI/labral hip tear surgery - no help so far
www.thepurposeofpain.blogspot.com
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Re: Dr. Conways Post-Op Guidelines

Postby nyt » Sat May 14, 2011 10:37 pm

Thanks for posting. He's a little more restrictive than Dr. Hibner's post-op guidelines.
2/07 LAVH and TOT 7/07 TOT right side removed 9/07 IL, IH and GN neuropathy 11/07 PN - Dr. Howard
6/08 Obturator neuralgia - Dr. Conway 11/08 Disability, piriformis syndrome - Dr. Howard
4/09 Bilateral obturator decompression surgery, BLL RSD - Dr. Howard
9/10 Removed left side TOT, botox, re-evaluate obturator nerve - Dr. Hibner
2/11 LFCN and saphenous neuralgia - Dr. Dellon 2/11 MRI with Dr. Potter - confirmed entrapment
5/11 Right side TG - Dr. Hibner 2012 Left side TG - Dr. Hibner
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Re: Dr. Conways Post-Op Guidelines

Postby Griff522 » Sun May 15, 2011 3:07 am

Take it easy Karyn. I hope you're feeling better Hon. :D
Burning vulva pain began 10/09
Treated for SIJD 9/10 and burning stopped and pain localized to rt side
Surgery w/ Dr Dellon 5/11 - didn't help my pain
2012 - PT, massage therapy, and ART therapy from chiropractor
MRI showed labral tear and US of groin found hernias
2/13 - surgery for sports hernia
5/13 - still have obturator internus spasms
5/13 - appt with ortho spine dr
8/16/13 - Arthroscopic surgery to rt hip for FAI and torn labrum
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Re: Dr. Conways Post-Op Guidelines

Postby Karyn » Sun May 15, 2011 2:14 pm

helenlegs 11 wrote:I hope you are being a model patient

Well, no - not really. I didn't get these postop guidelines until my 6 week check up. :( Dr. Conway and his assistant are not happy or impressed with me. We were supposed to talk about beginning to walk at this appointment, but I've been doing it since week 3. I increased the distance and walking time during week 5. They also feel I'm on my feet for much too long
(4 - 6 hours/day for the first 3 weeks, 8 - 10 hours after that) and they're right, so I'll be trying to cut that back. Explains the burning at night. Duh! :shock: In my pitiful defense, I was never one of those that felt "reduced pain levels" in the morning or during the day. I rolled at a 8 or 9 - 24/7, and have always had an extra hard time at night. I'm USED to being in extra pain at night. Even my current "end of the day pain" is less than before surgery. So, I really didn't think much about it. My pain levels since surgery are a 2 or 3 (mornings/daytime), which I haven't experienced for years. This is HUGE for me! But yes, I do have to be more aware of all the internal healing that needs to happen and keep the weight off my pelvis by staying off my feet.
Faith wrote:What do you think he defines as "prolonged" sitting (12 weeks-1 year)?

I really don't know, Faith. I would imagine he doesn't want anyone sitting for 8 hours at a time. I'm sure if I asked him, he would say that it depended on the persons tolerance and if the sitting hurts or gets uncomfortable, then it's too much sitting.
Faith wrote:Are you going to do PT?

I have no immediate plans for PT. I'd like to try massage first. I will never sign up for the internal PT ever again. I still have some low level pain in my hip & sacral area but that could be from being on my feet all day and from the scootching I've been doing. I'm not supposed to be bending at all, which I haven't, but I've been informed that I can't even scootch! :cry:
Faith wrote:I hope you are getting a little better everyday

Thank you! I really do feel like I am!!! For me, the hardest part is NOT the pain - it's the restrictions!!!!!
Griff522 wrote:Take it easy Karyn. I hope you're feeling better Hon.

Thanks, Linda! I'm feeling so much better than before surgery! :D I'm looking forward to recovering with you! Maybe we can have long telephone conversations while lying down on the couch?!? ;)
Warm regards,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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Re: Dr. Conways Post-Op Guidelines

Postby Celeste » Sun May 15, 2011 4:03 pm

Karyn wrote:
helenlegs 11 wrote:I hope you are being a model patient

Well, no - not really. I didn't get these postop guidelines until my 6 week check up. :( Dr. Conway and his assistant are not happy or impressed with me.


They need to get unhappy and unimpressed with THEMSELVES for not giving you the guidelines they wanted you to follow until it was too late for you to comply. What do they think you are, a mind reader? :roll: :roll: :roll:

I'm glad you're feeling as well as you are, and I don't think you've done any damage. Please don't accept this criticism from them. You don't deserve it.
Last edited by Celeste on Sun May 15, 2011 6:54 pm, edited 1 time in total.
PNE as a result of childbirth, 2002. Treatment by the Houston team, with neurosurgery by Dr. Ansell in 2004. My left side ST and SS ligaments were found to be grown together, encasing the pudendal nerve.

I am cured. I hope you will be, too.

There are no medical answers on the forum. Your only hope is to go to a doctor. I was very happy with the Houston team, which has treated the most PNE patients (well over 400), more than any other US provider.

http://www.tipna.org
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Re: Dr. Conways Post-Op Guidelines

Postby Karyn » Sun May 15, 2011 5:49 pm

Celeste,
Thank you so very much for what you wrote. I must admit, I was a bit upset when I left the Dr.s office. I do understand his need to be very cautious, but I was expecting a little more praise and optimism. After all, I'm way pleased and proud of myself! :D I honestly wasn't expecting to do so well, so soon after surgery and this has been the most pleasant surprise! The majority of my discomfort, even right after surgery, is coming from the surgery itself. All that soft tissue cutting and stuff trying to heal and reknit. The bottom of my butt and perineal area still feel a little sore and pretty tight but I would think this is normal and it's NOTHING compared to the nerve pain. Stabbing, pinching, shooting pains, electric shocks are no longer my constant companions. I now understand the end of the day burning, which wasn't one of my symptoms pre-surgery, and will try harder not to irritate the nerve so much by standing and/or scootching! ;)
Thanks again, Celeste - for your kind words and support!
Warmest of regards,
Karyn
Ultra Sound in 03/08 showed severely retroverted, detaching uterus with mulitple fibroids and ovarian cysts.
Pressure and pain in lower abdomen and groin area was unspeakable and devastating.
Total lap hysterectomy in 06/08, but damage was already done.
EMG testing in NH in 04/10 - bilateral PN and Ilioinguals
3T MRI at HSS, NY in 09/10
Bilateral TG surgery with Dr. Conway on 03/29/11. Bilat ilioinguinal & iliohypogastric neurectomy 03/12. TCD surgery 04/14.
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Re: Dr. Conways Post-Op Guidelines

Postby Lernica » Mon May 16, 2011 12:45 am

What's "scooching"?? :? I hope I haven't been doing it either (whatever it is)!

Keep up the good recovery, Karyn! I'm so glad you're feeling better after your surgery. I hope it continues apace.
Athlete until pain started in 2001. Diagnosed with PN in Nov. 2010. Probable cause: 3 difficult labors, 5 pelvic surgeries for endometriosis, and undiagnosed hip injuries. 60% better after 3 rounds of shockwave therapy in Cornwall, Ontario (Dec - Feb/12). 99% better after bilateral hip scopes for FAI and labral tears (April and July/12). Pelvic pain life coach Lorraine Faendrich helped me overcome the mind/body connection to chronic pain: http://www.radiantlifedesign.com
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Re: Dr. Conways Post-Op Guidelines

Postby Celeste » Mon May 16, 2011 1:18 am

Lernica wrote:What's "scooching"?? :? I hope I haven't been doing it either (whatever it is).


Just a term for when you're seated and you slide down...for example, how you move to the end of a booth in a restaurant.
PNE as a result of childbirth, 2002. Treatment by the Houston team, with neurosurgery by Dr. Ansell in 2004. My left side ST and SS ligaments were found to be grown together, encasing the pudendal nerve.

I am cured. I hope you will be, too.

There are no medical answers on the forum. Your only hope is to go to a doctor. I was very happy with the Houston team, which has treated the most PNE patients (well over 400), more than any other US provider.

http://www.tipna.org
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