My week in Omaha: surgery at the Pope Paul VI Institute
If you deal with infertility, you live in the US and you use the Creighton method of NFP, there is a chance you may eventually pass through the doors of the Pope Paul VI Institute in Omaha, NE, where Dr. Hilgers and his team of surgeons, researchers and nurses offer FertilityCare and NaProTechnology. In fact, according to their website, people from all 50 states and many countries have gone to the Institute for care. Your first time can be overwhelming if you are going into the experience not knowing what to expect. This day-by-day, step-by-step log by Chelsea (our theological editor) of a recent trip for her 3rd surgery with the Institute - a laparoscopy, hysteroscopy and hysterosalpingogram - will not only help you prepare for treatment and manage expectations of the schedule, but will also give you ideas of where to eat, visit and worship while in Omaha.
DAY 1: Friday, June 24
7am: Today I left Kansas City surrounded by stormy weather to drive to Omaha. For both my previous surgeries my husband was able to accompany me. Due to extenuating circumstances, this time I am doing it solo and my mom will join me in Omaha to take care of me after surgery. The route from Kansas City to Omaha is pretty uneventful on the highway, with fields and rolling hills as scenery.
10:30am: I have arrived in Omaha. My first stop today is for pre-operative appointments since surgery is on a Monday; usually the pre-operative appointments are scheduled for the day before surgery. If you are traveling to Omaha for surgery, you will have a couple of different pre-operative appointments. One will be at the hospital (Creighton University Medical Center Bergan-Mercy) where surgery actually takes place. It is a convenient couple of minutes away from the Institute itself. That appointment is to go over medications and which to avoid pre-surgery, anesthesia questions, instructions on eating and cleanliness pre-surgery, and a blood draw to ensure you are not pregnant and a blood count. The nurses are so friendly and are familiar with the Institute.
1pm: After a couple of errands, my next stop was the Institute! Located in a brick building on the west side of Aksarben Village, you will find yourself going to one of a couple places within the building. My first stop was the ultrasound department for my pre-operative ultrasound (if you are doing a series you will come back to this set of offices several times during your stay). You will be asked to have a full bladder for the pre-operative abdominal ultrasound. If you are doing a series, you will continue on with the vaginal ultrasound. For me today, this showed two follicles, one on each ovary, though one was a tad larger on my left ovary. This is the follicle we would continue to watch for my ultrasound series as the dominant follicle most likely to ovulate.
2pm: My last appointment of the day was my second pre-operative appointment, also at the Institute. For these appointments you will take the elevator across from the ultrasound offices to the second floor and walk into the medical offices. This next pre-operative appointment helps update your surgeon on your chart, any charting or fertility health issues you need to address with them, and goes over what surgery goals are. For me, it was to address some abnormal bleeding and also because it had been 18 months since my last surgery (to remove endometriosis) without a successful pregnancy.
3:30pm: After my appointment, I headed to where I was staying for my time in Omaha. When you receive your surgery packet through the Institute, you are given a list of local hotels which provide discounts for patients to stay for several days as needed, or there is a woman who is a friend of the Institute who graciously opens up her home, with enough advance notice, to families needing to stay in Omaha for surgery. She is a close 5-minute drive from the Institute and I have been able to stay at her house for each of my three surgeries. She has a basement with a couple of beds, a bunk bed and a crib in case it’s needed. The basement has a TV with a couple of couches, a nice bathroom with shower, and a little kitchenette and laundry area. It’s worth noting that you may need to avoid this accommodation if you have cat allergies. The host is wonderfully friendly; I highly recommend visiting with her if you get the chance! This evening we watched Up! - because who doesn’t need a good Pixar opening to cry to?
Day 1 photos: Pope Paul VI Institute
DAY 2: Saturday, June 25
Today I needed to get some work done, so after a 9:15am ultrasound (that dominant follicle on the left was growing nicely!) I spent some time at Lithuanian Café. It’s a must-stop place to which my husband’s family introduced me. If you aren’t avoiding gluten, you need to take one of their Original Vanilla Apricot Napoleon Tortes with you to freeze and enjoy - they are absolutely delightful. The café itself has Lithuanian-style pastries, good coffee and a lunch/dinner menu.
After a couple of hours, I needed better internet so I drove over to the Willa Cather branch of the public library to do some more work. Finally I wrapped up and made it to Mass and confession at St. Frances Cabrini, which is not too far away from downtown Omaha attractions if you are interested in any of those!
Note: It’s okay to be nervous before surgery! You may want to go to confession, which cleans your soul of mortal sins. Some opt to have the anointing of the sick; this may be at the discretion of your pastor and how serious your surgery is (you can read more about this here in our blog post about this sacrament). If you desire anointing, speak to your priest, but also don’t forget the healing power of the Eucharist and confession; they are all powerful sacraments.
Day 2 photos: Lithuanian café, public library, St. Frances Cabrini Church
DAY 3: Sunday, June 26
Last day before surgery! After a relaxing morning and another ultrasound (go, dominant follicle, go!), my hostess and I watched most of Roman Holiday and waited for my mom’s arrival (plus I was meeting with a notary to sign on my husband’s and my first house!). This afternoon my mom and I went to get some Jimmy John sandwiches (lettuce-wrap style for me) and walked around the Westroads Mall. One of your instructions pre-surgery is to keep your lung-space open by taking two deep breaths in the morning and evening in the days leading up to surgery. Well, what better way to open up lung space than some good window shopping!
9-10pm: Time to begin surgery preparations. Depending on your surgery, instructions may vary. I was allowed to have a light supper (Jimmy John’s) and then fast after midnight except for clear liquids. If you’re worried, they do count a lot of pop as clear liquid, just not cloudy drinks like coffee or tea with added milk. You are expected to shower with antibacterial soap: a bar of Dove does the trick! Next was the not-so-pleasant part… the enema. Fleet brand enemas are available at most pharmacies and even grocery stores. My last step before hopping into bed for the night was to use pre-operative chlorhexidine gluconate cloths for cleansing on the body. You will be given three packages of these at your hospital pre-operative appointment, and each package contains two cloths. You are told to use one cloth on each leg, one cloth on each arm, one cloth on your front torso and chest and one on your back; thus the six cloths provided. After this, get into clean pajamas and bed sheets and rest well for your surgery!
Day 3 photos: surgery preparation essentials
DAY 4: Monday, June 27 - Surgery day
Most of my surgeries have been very early in the day; this time around my surgery was scheduled for noon. This morning I had another ultrasound (same story, still watching that follicle, they will try to be gentle around that ovary to avoid encouraging ovulation/rupture too soon).
10am: Arrive at hospital. I gave my check-in information and was taken back to get my height and weight checked. In my pre-surgery room I was given a gown, socks, hair net and more of those chlorhexidine gluconate cloths with the same instructions for cleaning the body. After a while, my mom was allowed to join me while we waited. In the meantime a nurse asked me all kinds of screening questions (what have you had to eat, drink, medications, etc.), and we had visits from my anesthesia team, surgeon team (Dr. Keefe, my doctor through the Institute, came and said a prayer with us, which was very meaningful), and a few others doing whatever checks they needed to do. Though surgery was scheduled for noon, it was closer to 12:45/1pm by the time I was finally wheeled into the hallway, which is when you say your goodbyes to your spouse or whoever is with you.
1pm: Here my memory starts to get a little fuzzy. Anesthesia actually messed with my memory pre-surgery, so I do not remember anything after saying goodbye to my mom until after I woke up from surgery, but what I remember from past surgeries is that they wheel you back to the operating room which will be busy with aides getting their stations ready. The room is usually pretty spacious, especially if you are having robotic surgery. It can also be bright and somewhat cold. You will be assisted from your hospital bed to the operating table. It can take a few minutes before they’re ready to put the mask on for anesthesia gasses to put you to sleep. Since I don’t remember this time I don’t know what my thoughts were, but before past surgeries I used this time to repeat a simple internal prayer, something like “Jesus, I trust in you,” or “Jesus, I love you.”
4.30pm: I woke up in the large recovery room where they bring all the out-of-surgery patients around 4/4:30pm. Here they let you gradually wake up, check your vital signs, and make sure your pain is under control. My memory is fuzzy on how long this took, but I would put it at around 30 minutes to an hour. After that you are taken back to your private room where you continue to be monitored and must be able to use the restroom before you are released from the hospital.
After successfully using the restroom, you can begin to gather your items and get wheeled out to your car. You must have someone to drive you after surgery, you will not be released by yourself. There may be some surgeries which require an overnight hospital stay, but I have always been released on the day of surgery. You will be encouraged to be up and walking short distances after surgery, you do not want to atrophy. Walking and gentle movement will greatly help your healing process. However, after surgery you may find you are dealing with abdominal or even upper shoulder pain. The shoulder pain stems from the pain nerve in your abdomen being irritated by the built up gas during surgery, and the pain defers to your shoulder, which can certainly be a strange sensation. Peppermint tea, GasX and moving around will help with the gas pain; a nice heating pad can help sooth the shoulder pain. I believe we were back at the house by 7pm. While I did walk a bit, my pain was irritating so I fell asleep fairly early that evening.
Day 4 photos: morning ultrasound, afternoon surgery
DAY 5: Tuesday, June 28
This morning I woke up with continued pain, with an added touch of nausea. It took a while, but it did calm down. For pain relief, you may be able to alternate between ibuprofen and acetaminophen; but given that ibuprofen could affect ovulation, they had me stick to Tylenol for pain management this time around. This morning I had another ultrasound (dominant follicle still present, starting to edge toward a size where we needed me to ovulate soon). Between this and a later appointment, my mom and I tried out Jones Bros. Café, located in Aksarben Village. This place has it all: cupcakes, boba tea, coffee, and a fuller menu besides that. We also went on some more walks and watched a movie or two.
In the afternoon I had my post-operative appointment at the Institute. Here my surgeon and another of her care team showed me a DVD of what occurred in surgery (yes, you get to see your own organs on video! That is always a bit surreal). If they have any treatment recommendations for when you return home, they will go over that as well. That afternoon we tried out VooDoo Tacos, also in Aksarben Village: creepy name, but fantastic street tacos, with over-rice or salad options for the gluten-free crowd!. And of course in the evening we continued with walks and movies!
Day 5 photos: Jones Bros. Café, VooDoo Tacos
DAY 6: Wednesday, June 29
This morning at the ultrasound we were hoping I’d have ovulated, but alas, it was just on the edge of being considered a luteinized unruptured follicle (LUF). That meant one more day in Omaha for me, while my mom needed to head for home. Today I opted to try to encourage the follicle to pop by getting a decent amount of walking in at the Henry Doorly Zoo and Aquarium in Omaha. This renowned zoo is known for its wonderful aquarium and vastness. My personal favorite was the butterfly garden exhibit. Being surrounded by all those butterflies was so cool! In the afternoon I headed back to the house for some rest. My hostess also offers board to interns and visiting doctors; this evening I watched an episode of Downton Abbey with my hostess and the intern staying for the summer.
Day 6 photos: Henry Doorly Zoo
DAY 7: Thursday, June 30
Today’s ultrasound was not until later in the afternoon, so I had a chance to do a little bit more Omaha exploration. I visited Union Station/the Durham Museum. On the bottom floor of the station you can explore old trains, learn more about the history of Omaha, and peruse any visiting exhibits. While I was there, I walked through a visiting exhibit of Nelson Mandela. Up on the main floor you can order from their old-fashioned soda fountain restaurant and browse the gift shop. The art deco style of Union Station is wonderful! After spending time there, I wanted to fit in some adoration time (to beg the Lord to make me ovulate!) so my hostess recommended St. Joan of Arc Church, which is close to the Institute. During the day the doors are open to the main church and the monstrance is set up on one of the side altars. I stopped in for nearly an hour to pray there before heading off to my last ultrasound at 2pm. Unfortunately, it was finally determined that it was indeed an LUF; basically, the follicle never released the egg and I never ovulated. They can treat it from a distance using progesterone shots and will confirm that the LUF has been managed using an ultrasound closer to where I live, rather than at the Institute. So around 3pm I was packed up and back on the road to Kansas City!
Day 7 photos: Union Station, St. Joan of Arc Church
Watch out for our resource coming later this year about preparing for surgery, not just at the Institute!