post sub-total colectomy

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snugglesaurus
Regular Member


Date Joined Apr 2010
Total Posts : 206
   Posted 11/14/2010 9:15 PM (GMT -6)   
My story and then questions at the bottom if you don't care about all the details.

I got my sub-total colectomy with ileorectal anastomosis last Tuesday. My surgery started at 1:30PM and I didn't enter into my room until 10PM. It seems common with us that we have extra long colons - hence the reasoning for my long surgery supposedly. I also heard a comment while drifting in and out the word 'obese.' I'm overweight but I don't think I'm that bad. Not sure what that meant or if it contributed to it.

After surgery I was in the recovery room and I woke up first feeling my abdomen to make sure I didn't have a colostomy. However, I could barely move my arm. Apparently the blood pressure cuff was partially over my elbow and caused severe pain going up and down for hours. I complained of horrible pain and they gain me more dilaudid.

I went in and out of consciousness and don't remember anything except for my arm, super dry mouth (I got lemon swabs), and going into the elevator.

Once I got into my room, my mother was all ready waiting for me even though she wasn't supposed to go there until I was settled in. It was so late that they just told her my room number. They handed me the pain pump and I hit it. I was in HORRIBLE pain to the point I was trying so bad not to scream and cry my eyes out. Then I started itching uncontrollably. After some arguing they switched me to morphine and gave me Benadryl. I still was itching and in so much pain that they were trying to do breathing exercises with me while I squeezed my mom's hand. I don't think anyone has mentioned how much pain they were in initially?

After one of the nurses told me "you're just going to have to deal with it" my mom managed to shoo them out of the room. I kept hitting the button every 8 minutes but I couldn't sleep as I kept waking up. I asked her (bless her heart) to hit it for me. I don't know how long she was there when I told her to go to bed.

I hit the pain pump non-stop on Wednesday. My pulse was around 125 (super high for me) and I had to continue wearing oxygen or else my numbers started dropping into the 80s. As for nutrition I was on clear liquids. My family fed me lemon ice and I drank some water. The nurses forced me to walk down the hall and sit in the chair for 30 minutes. I cut my chair sitting short and went back to bed. Late in the day I passed 'something' in bed and I was mortified. At least my system was awake, right? My doctor also came in for a visit and gave me a prescription for Toradol. It helped tremendously. I was almost livid they didn't just give it to me in the first place.

On Thursday, I was very nauseous and started vomiting which cleared some of my family out of the room (gee, thanks!) for the day. I only had liquid in me so thankfully it wasn't any worse. After Reglan and Zofran I was feeling slightly better. I didn't drink anything more.

On Friday I was told I could try full liquids which meant an upgrade to chocolate pudding and now my doctor approved red products. The hospital doesn't make red Jello so I had a special request put in to my sister. I barely had anything that day as nothing was appetizing. They removed the foley catheter which made it a lot easier to do my walks. However, it was extremely difficult to use the muscles. I stopped using the pain pump myself.

When Saturday rolled around I was 'upgraded' to full liquids plus. That meant I could have bread! My mom made a bread and butter sandwich for lunch and then I had the same thing for dinner. I was taken off the Toradol (and they made no mention of it to me) and took away the pain pump. When I realized it I asked for some Motrin which they had to page the doctor on call. I didn't want to take the Percocet. Big mistake.

Today I was upgraded to a low-residue diet. I had 2 mini pancakes that tasted horrible. I also ordered some grapes and that was my breakfast. The doctor on call came in and told me I could go home! smilewinkgrin I ate some noodles this afternoon and some ice cream and grapes for dinner tongue

The doctor on-call this weekend told my mom that 2% of people with constipation make up those of us with colonic inertia. 98% of those with colonic inertia are women. He said the usual 'we don't know why' but some believe it is a hormonal imbalance due to the fact mostly women are affected. I have read that there are certain probable causes such as psychological, nerve or muscle damage, sexual abuse, etc. For a long time I was in denial about any of those reasonings as my problem was exacerbated after having terminal ileitis several years ago.

Biggest annoyances: the initial pain, interruptions ALL THE TIME, Heparin shots, being stabbed with a needle 20+ times (not counting injections through my IV) mad

My BMs have gone from liquid to small somewhat formed Tic-Tac sized to larger ones. I've had a lot of gas naturally, but it isn't always easy to pass. I've been worried today as I didn't have a BM until around 6PM and I was very bloated and even had the same constipation feeling before and after. Now I'm not feeling as rough.



>>> I was kind of expecting many more BMs but I haven't been eating much real food aside from yesterday and today. Has it slowed everything down?

>>> When did people move on to more of a regular diet? I plan on eating rice, pasta, bread, etc. this week and start introducing fiber slowly. Any particular foods that may cause an ileus?
Diagnoses: Colonic Inertia, Rectocele, Anismus
Surgery: Scheduled November 9th - subtotal colectomy with anastomosis

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 11/15/2010 5:51 AM (GMT -6)   
My surgeries were for Crohn's so the BM's were always plentiful...sorry, I'm no help on that question.

As for the diet, did they say Low Residue for 6 weeks? I'd be cautious with the grapes right now, too, since they are not easily digested (skins) and with surgery your intestines are a little swollen. Canned pears and peaches would be ok right now and canned veggies but be careful with anything raw or not cooked to a mushy consistency.

Foods do not cause an ileus, it's our intestine that either don't wake up or go back to sleep.

Things will get easier...remember walking really is your friend!
Crohn’s dx 1989
some terrible years before my
temporary ileo in 2001
Proctocolectomy w/end ileo in 2008
...wish I knew then what I know NOW!

Hischildvalda
Regular Member


Date Joined Feb 2010
Total Posts : 176
   Posted 11/15/2010 7:04 AM (GMT -6)   
Snuggle - So glad that you are home.  Your time in the hospital sounds awful! 
For the first week or so after surgery I had very few bowel movements.  Perhaps because I wasn't eating much.  The first or second day home from the hospital I was so scared because I didn't have one all day but finally did about midnight.  Now, three and a half months later and depending upon what I eat, I have between three and six bms per day.  The day after eating pizza with lots of veggies on it I spent most of the time in the bathroom.  I have not been able to add fiber to my diet yet and wonder if I will ever be able to.   I can't believe you are already eating grapes! 
 
Val

2much2bear
Veteran Member


Date Joined Mar 2008
Total Posts : 624
   Posted 11/15/2010 9:42 AM (GMT -6)   
Hi snuggle
 
glad you are home now... i dont think there are foods that cause an ileus as far as i know...i was told to eat soft foods little and often for a few weeks after surgery - to give the bowel time to adjust.  i was told i dont need fibre at all.  just take it slow and eat foods that are mushy when you eat them - so carbs are ok as anything cooked well - then after a while you will know when to introduce more roughage type foods i.e. salads etc. 
 
as far as poo goes - i am having a similar experience too - last friday my surgeon told me to give it more time to adjust - up to a year apparently.. however i go back in three months for follow up..
Karen 48 years old
1997: Diagnosed IBS
2003: Pelvic Floor repair
2006: STARR surgery for mucosal prolapse/Obstruction/diagnosed slow transit constipation
2007: Sigmoid resection-partial volvulus resulting in worsening of colonic inertia (cleared obstruction though)
March 2009: Loop Ileostomy
23 Sept 2010: Ileostomy reversal

snugglesaurus
Regular Member


Date Joined Apr 2010
Total Posts : 206
   Posted 11/15/2010 10:01 AM (GMT -6)   
thanks guys.

Nothing sounded appetizing except the grapes.

I'm feeling pretty horrible this morning. I just woke up (almost 11AM!) because the phone rang a few times. I'm behind on my pain meds because I was sleeping. /end of complaining

My sweet mother set up babysitters this week for me. My first is off to the store to get me Motrin. I thought it was silly, but now I'm ever-so-thankful.

Thanks for clearing up the ileus thing. When does the pain 'get better'?
Diagnoses: Colonic Inertia, Rectocele, Anismus
Surgery: Scheduled November 9th - subtotal colectomy with anastomosis

2much2bear
Veteran Member


Date Joined Mar 2008
Total Posts : 624
   Posted 11/15/2010 10:25 AM (GMT -6)   
HIya

so you are nearly a week post-op? is it incisional pain you are talking about - or gas pains from your bowel waking up? bowel waking up pain is hte worst ever - i was ok after around 7 days i think... then ok and just nauseous. that is why you should be very careful as to what you eat cause you bowel is still adjusting and waking up.
Karen 48 years old
1997: Diagnosed IBS
2003: Pelvic Floor repair
2006: STARR surgery for mucosal prolapse/Obstruction/diagnosed slow transit constipation
2007: Sigmoid resection-partial volvulus resulting in worsening of colonic inertia (cleared obstruction though)
March 2009: Loop Ileostomy
23 Sept 2010: Ileostomy reversal

snugglesaurus
Regular Member


Date Joined Apr 2010
Total Posts : 206
   Posted 11/15/2010 10:57 AM (GMT -6)   
Karen - I am one-week post-op now. The incisions don't really hurt per se. The pain that is the worst is on my left side near an incision. I told the resident on duty about this and she said it was very strange as that is where the reconnection is (cool factoid for me!). She said it doesn't normally hurt for people. I'm not sure if they had to move so much around because I'm slightly overweight or what.

I do have separate gas pains that I can't relieve just sitting there. I have to go to the bathroom. I did have a BM this morning! Yay!! It was actually quite a bit and while skinny, they were pretty formed. I'm fortunate I haven't hit the 20x a day BM stage, but scared it didn't help enough.

I need to force myself to drink more fluids today. I feel slightly nauseous and so I don't want to push it.

What did you take for pain? I'm taking Percocet and Ibuprofin.
Diagnoses: Colonic Inertia, Rectocele, Anismus
Surgery: Scheduled November 9th - subtotal colectomy with anastomosis

2much2bear
Veteran Member


Date Joined Mar 2008
Total Posts : 624
   Posted 11/15/2010 11:27 AM (GMT -6)   
hiya

i wonder did they keep some of your large bowel intact?

glad you having comfortable bms... dont worry about frequency and such - it takes time and fluids are good. not sure about the pain you are getting - you are gonna hurt a bit after being opened up right down the middle - as long as it is not wearing you down to tears (which would be just wrong) then just keep on with the meds.

I was very fortunate regarding pain - i had the usual morphine and stuff straight after surgery with pain pump for a few days - then went onto oral meds like paracetamol and tramadol when i could take fluids. i had those for around a week then just the paracetamol. when i went home on day 10 i didnt need meds just nausea meds. that was in march 2009.
Karen 48 years old
1997: Diagnosed IBS
2003: Pelvic Floor repair
2006: STARR surgery for mucosal prolapse/Obstruction/diagnosed slow transit constipation
2007: Sigmoid resection-partial volvulus resulting in worsening of colonic inertia (cleared obstruction though)
March 2009: Loop Ileostomy
23 Sept 2010: Ileostomy reversal

snugglesaurus
Regular Member


Date Joined Apr 2010
Total Posts : 206
   Posted 11/15/2010 11:32 AM (GMT -6)   
I had it laprascopic - 5 total incisions. One is large at my bikini line. She did leave a foot of my colon. Not sure why she left so much, but I was always so drugged to press for more. I had about 6' total so clearly a lot is gone :)
Diagnoses: Colonic Inertia, Rectocele, Anismus
Surgery: Scheduled November 9th - subtotal colectomy with anastomosis

snugglesaurus
Regular Member


Date Joined Apr 2010
Total Posts : 206
   Posted 11/15/2010 11:40 AM (GMT -6)   
Oh - I updated my Caring Bridge with a photograph of my post-surgery incisions.

http://www.caringbridge.org/visit/semi-colon
Diagnoses: Colonic Inertia, Rectocele, Anismus
Surgery: Scheduled November 9th - subtotal colectomy with anastomosis

2much2bear
Veteran Member


Date Joined Mar 2008
Total Posts : 624
   Posted 11/16/2010 4:05 AM (GMT -6)   
Ah interesting photo.... never thought about putting pics of incisions on site - too late now ha. How long did you have colonic inertia for? You wont definitely be having 20+ bm a day with a foot of colon so no worries there! My surgeon wouldnt let me keep any bowel whatsoever. Have a good day with less pain. x
Karen 48 years old
1997: Diagnosed IBS
2003: Pelvic Floor repair
2006: STARR surgery for mucosal prolapse/Obstruction/diagnosed slow transit constipation
2007: Sigmoid resection-partial volvulus resulting in worsening of colonic inertia (cleared obstruction though)
March 2009: Total colectomy with ileorectal join and loop ileostomy
23 Sept 2010: Ileostomy reversal

snugglesaurus
Regular Member


Date Joined Apr 2010
Total Posts : 206
   Posted 11/16/2010 7:39 AM (GMT -6)   
I started noticing symptoms when I was around 20 and now I'm 25. The two and half years have been with non-stop treatment of some sort.
Diagnoses: Colonic Inertia, Rectocele, Anismus
Surgery: November 9, 2010 - subtotal colectomy with anastomosis
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