I am new here but read many of the posts prior my recent total colectomy. I found most of the posts to be very informative and helpful. Thanks to your posts, I was much more aware of what was about to happen and what I would feel like afterward. I thought I would share my experience as kind of a payback for the comfort and assistance I received.
about 5 months ago I went in for my first colonoscopy and found I had hundreds of polyps in my colon. They thought it might be FAP although I am 50 years old and that usually manifests earlier. Anyway the good news was my polyps were not cancerous. The bad news was they were the type that were likely to become cancerous at some point in time. I was told that the only way to deal with this issue was by having the colon (and possibly the rectum) removed. I was in shock. I had absolutely no symptoms and was otherwise in pretty good health.
I am an American but I currently live in Singapore. I was planning to have the surgery in the US and hooked up by phone with the top colo-rectal surgeon at Medical College of Wisconsin. He explained the surgery and the possibilities. He was to perform a hand assisted laproscopic total colectomy. He was not sure whether he would have to remove the rectum or not (i.e. would I need a pouch or not). As an aside I asked him if he knew of any good surgeons in Singapore and he told me that yes, not only did he train at Cleveland Clinic with the new head of Colo-rectal surgery at Singapore General, but he also knew of this guy's mentor, who was one of the best in the world. That was a guy named Dr. Francis Seow-Choen. Dr. Seow-Choen is now in private practice at Mount Elizabeth Hospital (owned by Parkway Group of the US). I looked him up and was impressed. I met the doctor about a week later and was still impressed. I scheduled a follow up colonoscopy and had it a few days later. Dr. S-C confirmed the earlier findings and also removed several polyps from my rectum. The biopsy of those showed they were of the type that NEVER become cancerous so he was able to confirm that we would remove the colon and reconnect the small intestine directly to the rectum. This was quite a relief. He also did an endoscopy because with FAP there is a greater likelihood of polyps and growths in the upper GI system. Lucky he found none.
While I wasn't in any immediate danger I was told to have the operation sooner rather than later so I set a date of December 14th. Dr. S-C told me he would perform the surgery totally laproscopicaly. He said that the healing time would be a bit shorter then the hand assisted method. The Doc said I would be in for anywhere from 3-7 days but it could be longer depending on how quickly my system adjusted post surgery.
I was never really too concerned about the surgery but as the date approached I did get a little nervous. I kept thinking how great I felt and how it was going to get pretty bad for a while before I got back to normal, if I ever was going to be normal again. My swan song before the surgery was a week of binging on my favorite Singapore foods. It was a great week of eating. I knew it would be some time before I would be able to enjoy some of those tasty treats.
On the 14th I arrived at the hospital, checked in and was shown to my room. My insurance covered the cost of a double but I splurged on a single room. I got settled into the room and a nurse and a couple of orderlies came in to take me to the operating theater. I was a little nervous but still felt I was in good hands.
On a gurney in the holding area I met the anesthesiologist. Afriendly fellow named Dr. Lai. He explained exactly how they were going to put me under. Several nurses including Dr. S-C's nurses came in and gave me words of comfort and encouragement. Dr. Lai did his thing and out I went. My wife was waiting in my room and then outside the operating theater. We were told it would take about 3 hours.
The next thing I knew I was waking up back in my room. Not sure what time it was or even where I was my wife quickly assured me that the surgery was over and was a success. I was groggy and very thirsty. I was hooked up to an IV and now know a drip that included some morpheme. The first hours were a bit of a blur. I remember seeing the doctor, nurses, my wife and then trying to go to sleep (the surgery started at about 5 and ended after 8:30 PM). That first night was a little tough. I was on my back and having a few breathing problems (due to some congestion I think). The put my on oxygen and everything seemed fine.
The next morning I woke up and the doc and my wife were there. He explained that all went very well. He had made three incisions. On above the navel one in and under the navel (the one they used to remove the colon) and one below the navel. My gut felt a little sore and bloated but I was otherwise not feeling too badly. He told me to stay in bed that morning. I realized I had a catheter for urine and some kind of rectal catheter in as well. The first day was not too bad. The drugs were pretty good and I dozed in and out. That night was alright too as I slept a little better. It is still hard to get comfortable with all the aparatus and I am not good at sleeping on my back.
By day two I was felling ok. He backed off the pain drugs a bit and I wasn't in much pain. I was pretty alert and really felt ok under the circumstances. By day three they removed the catheters. It was a relief. I developed an issue where I was unable to urinate so they were going to put the catheter back in. I think the very fear of this process propelled my urinary system into action. I had yet to have any motions as of the end of day two. On night three I woke up with a painful bloated feeling and asked for an got a pain injection. The injection really helped. The next day the doc tried me on water, small sips and them later on soup. He was felling good about things and even removed the IV. Unfortunately about that time I started to feel very bloated in my stomach and my bowels pretty much shut back down. This was when I was treated to the first of three nose tubes (in the nose, down the throat to the stomach) to alleviate the bloating and drain my stomach. This was to settle things down to allow the intestine to kick back in. I would say that the nose tube insertion (and just having it in) was the most uncomfortable thing I dealt with the entire hospital stay (including any operative pain). It just sucks!
Turns our I was suffering from postoperative Ileus. Ileus is actually common and can last from a day or two to up to several weeks. This was a setback for me, but I was assured by the Doc (and my wife's research) that it happens and that the system always "reboots" eventually. The ileus went on for several days. I had the nose tube in and out a few times and the doc sent me for an x-ray trace where I had to drink some very nasty anise tasting stuff (like drinking 50 shots of Zambuca). This stuff could trace the progress of my system by x-ray and also was though to help get the small intestine moving. My gut felt terrible and I had to get wheeled down to x-ray every hour for the better part of a day and night. Good news was the system was not obstructed, just moving really slow. I actually started to have motions that night.
By this time I was able to get out of bed and go to the bathroom with no problem (except I needed to drag the IV). I also took some walks around the ward and just tried to get some physical activity in. The ileus continued for several more days. They had to put me on a more nutritious IV as I had been without food for a week. They also arranged to have an IV inserted in my neck so they could get more nutrition in. This procedure (a little painful) took place on my 8th day in hospital.
It was the 23rd and Dr. S-C told me he would have me out by Christmas...hopefully! That day the stomach calmed down a lot and the motions started to be more frequent and substantial. The night of the 23rd I was able to have some clear soup. Best thing I ever tasted! the 24th I had a little solid food and there were no ill effects. Doc said I could get out the 25th if all continued. I ate some small meals and sure enough on Christmas Day I was discharged.
Before I move on to what happened next I want to say a word about my decision to have the surgery in Singapore rather then back in the US. I am thrilled with my decision. The nurses at Mount E were amazing. A United Nations of staff from Singapore, China, Philippines, Indonesia, Malaysia, India and Burma all served me and treated me like a King. Unlike in the US, the nurses here all do everything so the same nurse who changed my IV also changed the bedsheets. Whenever I called they were there and never uttered a word that wasn't positive and encouraging. They were absolutely fantastic. The doctor was also a champ. He visited me at least twice a day (also on weekends) and he even called the nurses most nights well after midnight to see how I was. On a few occasions, when I had issues or concerns in the middle of the night they called the doctor. I said not too, but they said he didn't mind. The overnight doctors on duty were also quite good, changing my IV or checking to see how I was doing.
So I got out...finally. Since then I have slowly gotten better and better. Doctor S-C said, eat what you want and what you can but stay away from fresh fruits, vegetables and fiber for the first few weeks. I have done so and have gradually added more and more food into my mix. I've even had some spicy stuff. I have only had one night of pain, bloating and really bad gas and it came after I had a bottle of beer. The pain went away and I am laying off beer for a while. My motions started out to be very frequent and have now (at almost one month post surgery) tapered off to about 4 times or so a day and I can make it all night without using the toilet. The consistency of the stools is still pretty gloppy (for want of a better medical term). Not quite total diarrhea, but certainly not solid. I am probably going more then I need to because I am so conscious of it. The bathroom visits are constantly on my mind but I am getting past that.
The surgical stuff is almost 100% healed. the 2 small incisions are almost completely disappeared and the bigger (maybe 1 inch) incision is about 80% healed. Still a little sensitive to the touch.
I lost about 15 pounds (which put me at my High School weight) and have put about 5 back on. My stamina was really bad but it too is getting better. I have walked every day and after about a week I went swimming. I'd say I am at about 80-85%. I still get tired a little easy. I'm eating bread, tuna, beef, lamb, chicken, pasta, potatoes, rice, noodles, soups, sandwiches, pizza, dumplings, Indian food, coffee, tea, juice and more. I am going to start introducing a few veggies this week. My follow up with the Doc went well and I will see him again in February.
I am very pleased with how this worked out. It was no fun, but it wasn't as bad as I thought it might be. I still have many months to go before I will be back to normal as I understand the "new" system needs time to adapt. I go back to work on the 18th, about 1 month post surgery. Oh, yeah, and as an added bonus they also take your appendix out, since it is attached to the colon.
Finally, having the surgery in Singapore was good from an economic point of view too. While I am not sure what this entire thing would have cost in the US, I am pretty sure it would have been much, much more expensive than here. When I left the hospital I got a total bill for my 10 day hospital stay, the surgeon, the anesthesiologist and even the mini bar in my room. My insurance picked up most of the cost and my out of pocket was very, very reasonable, most of the out of pocket was the difference between the single and double room. I also got that one bill and will have no other bills to sort out and deal with, which is really nice.
Sorry this is so long, but I wanted to tell you as much as I could. Please ask me any questions and if you are going to have this surgery good luck!