New ostomate and not happy

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craigk
New Member


Date Joined Dec 2010
Total Posts : 3
   Posted 12/24/2010 4:02 PM (GMT -6)   
I just had a voluntary sigmoid colostomy done on the 15th and I am far from happy.  I am a paraplegic who has full us of his arms and hands.  I did it primarily out of convenience.  It was done laprascopically and I would really like to have it reversed.  I was wondering, hoping that someone out there might know if I could get the colostomy reversed again laprascopically and if I would have to worry about anastomotic leakage the rest of my life?  My colon was and still is perfectly healthy, just in one large part and another small one.  I am concerned about hernias, skin breakdown, and now I am fearful that I will be forced to intermittent cath instead of being able to force void as I have been doing for the last 10 years.  PLEASE someone give me some help!

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 12/27/2010 12:08 PM (GMT -6)   
Hi Craig,
 
Sorry to hear of your situation.  If you do not have prior adhesions from multiple prior surgeries, you would be able to have the reversal done laporoscopically.
 
Surgeons are supposed to do a leak test after they do the rejoining of colon ends (in other words they test the anastomosis at the end of the surgery).  If a leak appears they fix it then and there.  If somehow they missed a leak that was there, you would get peritonitis and be in severe trouble within 24-72 hours....so if your anastomosis healed fine you would not have to worry about a leak for the rest of your life.
 
Do keep in mind that with a rehook, even if there is no leak, there is a chance that you can form a stricture.  That means a narrowing at the area where they rejoin the two ends of the colon.  I think, if done correctly, that would not happen, but medicine is not an exact science.  A stricture would severely impact your ability to move stool out of the colon.  If you already had this trouble due to your other issues, you could get into worse trouble.
 
My story is VERY dark and I won't bore you with all the details as this is your question and you are the focus of the answers, but I experienced a stricture from an incorrectly done anastomosis of sigmoid removal which on case review did not need to be removed in the first place.  Further scarring internally lead to need for lysis of adhesions and permanent end ileostomy, which so far so good, but I get to worry about adhesion regrowth for the rest of my life, but am healthy otherwise so am counting my blessings and going for the gusto in life as an ileostomate.  Wish I could give you some concrete advice, but this is just some info to consider.  Best of luck with your decision and I wish you well.  Rosemary

craigk
New Member


Date Joined Dec 2010
Total Posts : 3
   Posted 12/28/2010 10:50 AM (GMT -6)   
Hi Rosemary,

thank you so much for your response. I am very conflicted right now. I do enjoy the freedom that it has given me not being tied to a bowel program, however, it seems like more work than what I was expecting and having to worry about hernias my entire life scares the bejeebers out of me. Each time I look at my ostomy I say, "what the hell were you thinking?" I keep reading that ANY pressure on your abdomen can lead to herniation and being spinal cord injured, I pee by forcing the urine out. So, naturally, I have to use my abdomen muscles to do it. So, what you are saying is: be sure to get a surgeon who is experienced and skilled in reversing the colostomy?

Oh. The surgeon did say that I had a LARGE colon. I didn't have any problems passing stool through my colon. Making sure I was done just took a long time and had me tied up at home most of the day when I did my program.

Craig

Oh, I've heard about problems with diarrhea when the reversal is done, true?

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 12/28/2010 8:03 PM (GMT -6)   

Hi Craig,

Your surgeon should have told you that due to your spinal cord injury and having to push abdominally to pee that you might be at risk of stomal herniation.  It was HIS or HER job to tell you that, not your job to know that.

In the land of "What the hell was I thinking?"  I AM THE LEADER IN THAT!  Here is my issue in a nut shell:  I had a hysterectomy at 39 for heavy bleeding THOUGHT to be from fibroids.  BUT on review of that case that was not the cause, it was a hormonal upset that could have treated medically.  I was fine for 12 years.  THEN I started having incomplete rectal emptying.  I was still passing much stool every day rectally, colon fully intact and healthy, but because most moves were incomplete it took me 2-4 hour each day to feel finished.  Some moves were complete and others were incomplete.  This made me late for work and I sought help.  BIGGEST error in my life that almost cost me my life and still may, but am OK 3 years now and hoping.

I had this image test called a Defecogram.  A resident radiologist at a major hospital said my sigmoid colon blocked off the top of my rectum when I pushed to make a BM.  I went for 3 consults at top hospitals, all colorectal surgeons said I needed my sigmoid colon out.  I was tired of spending half the day in the bathroom.  SO I had it out at the place that sounded the most experienced in what I was told was all these internal prolpases from having the hysterectomy (was told that my sigmoid colon filled the space left by absence of uterus.)  Long story short, these surgeons did multiple unconsented organ prolapse surgeries for organs that were not prolapsing, they created tons of scar tissue, I got a sever stricture (narrowing) at the colon anastomosis, then the scarring also closed off my small intestine.  It took 13 months, 11 surgeons, and 7 hospitals to find someone willing to help (because the problem had been created by doctors).  The only thing that could be done was cutting adhesions off small intestine and permanent ileostomy.  So here I am an ostomate not due to any disease.  SO,  I WIN THE TITLE FOR "WHAT THE HELL WAS I THINKING".  I can sooooooo relate to how you feel.  On review of my case it was found that it was not my sigmoid colon pressing off the top of my rectum but only a loop of small intestine.  I did not need my sigmoid colon out all I needed was closure of a space in my pelvis where the loop of small intestine came down and sat on my rectum...as much simpler procedure with no bowel resection of any kind.  In surgery the two original surgeons saw that my sigmoid colon was not elongated or redundant and proceeded to remove it anyway.  Currently in litigation, but no amount of money will undo what was done.  But am lucky to so far be alive.  Prior to the lysis of adhesions and ileostomy I was unable to eat (due to ongoing small bowel adhesion obstructions) unable to get nutrition, and unable to pass waste due to the narrowing at the sigmoid anastomosis.  Was just passed from doc to doc, nobody wanting to get involved, until I found the doc who saved me, one who was in medicine for all the right reasons.

Yes, find an expert in reversals and also involve a neurologist as you have the spinal cord injury.  A friend of mine has this type of injury too and he has a long morning bowel "program" too.  I understand what you are referring to.  We all make decisions based on the info we have at the time or the info we don't have at the time.  I have not stopped kicking myself yet.  BUt, I'm  traveling a lot as I lost my teaching job as I was out of commission for 13 months until I found help for my surgical injury.  You are an inspiration.  When I read your post I just wanted to respond.  It touched me that you are dealing with bowel stuff AND your spinal cord issue.  Made me more appreciative of my mobility.  I guess we all take a lot for granted.  My friends who have no bowel issues take pooping normally every day for granted.  They don't have a clue. 

Best Regards, Rosemary


esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 12/28/2010 8:05 PM (GMT -6)   
Hi Craig,

I'm not sure about the issue of diarrhea when a colostomy reversal is done, maybe someone else can answer that for you. Rosemary

craigk
New Member


Date Joined Dec 2010
Total Posts : 3
   Posted 12/30/2010 7:08 PM (GMT -6)   
I'm really interested in knowing if someone out there knows how many guys with spinal cord injury herniate?
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