Yesterday I had my surgery pre admission appointment. I am scheduled for the first stage of J-pouch surgery on Oct 20th. I arrived at the hospital 10 minutes early for my 9:00 am appointment. Shortly after 9:00 I was taken to a small room and was told that several different people will come to see me in this room and it will take a few hours.
The first person that came in was doing a sleep apnea study on patients heading for surgery. This is at a teaching Hospital and quite often I am approached with new studies and students accompanying doctors. This study is not necessary for surgery but it may provide useful information beforehand. I was given a questioner about
my sleep habits and I was asked if I would like to participate in the study. They would send someone to my home to connect a monitor and probes to me overnight and then again in the morning to remove it. It would collect data as I sleep for one night. I agreed to it and they will have someone call me to make the arrangements.
The next person to come in was the ostomy nurse. The first thing she asked me was to explain the surgery to her in my own words. After doing so she said I have a good understanding of what is going to be done. She gave me a pamphlet about
the surgery and dealing with an ostomy. She had an ostomy bag and flange with her and explained how to install, empty and change it. She gave it to me to take home. She marked the
location of the stoma on my stomach with a permanent marker. She told me to re-mark it if it starts to fade. She will check the spot just before I go for surgery.
She told me that for a colostomy, the stoma would be on the left side and for an ileostomy, like I am having, it will be on the right side. It can’t be too far on the right because it must be located within muscle. She then located a spot on my stomach that was flat and could easily hold the flange. She could not locate it too low because I have a belly that rolls under towards my belt. Because of this I wear my belt fairly low, under my belly. The stoma should not be located at the belt line. I do not have enough flat and smooth area below my belt line to locate it there. Most people with a flat stomach would have it located below the belt line. She then pealed off the back of the flange and stuck it on my stomach. She then had me bend forward and back while I was sitting to make sure there was no interference with it. She marked the spot with a permanent marker.
The flange didn’t hold very well because of all the hair I have on my belly. They will shave it off for surgery and I may have to shave it periodically when I change the bag. Because it will be located above my belt she recommends I don’t tuck it under my pants. I should leave it out and cover it with my shirt and not tuck it in. This is fine for a temporary ileostomy but I wouldn’t want to do that for a permanent one. Once I’m released from the hospital a nurse will periodically visit me at home to make sure I can handle the ostomy properly.
The next person to enter the room was a pharmacist with a student. She asked me questions about
all the medications, vitamins, minerals and other supplements I have recently been taking. Currently I am on no UC meds. I am taking Celebrex for my arthritis but it isn’t helping. I was told to stop it after 3 weeks if it doesn’t work. That will be at the end of this week. The Pharmacist told me that if I continue to use Celebrex that I should temporarily stop it one week before surgery. She then asked if I have used Prednisone in the last 3 months. I did use it but completely tapered off it 3 weeks ago. Because of that they may give me a prednisone injection just before surgery.
The next person to enter the room was a nurse with several questionnaires about
my health. Shortly after completing them the nurse came back and we were just starting to talk when a doctor that is part of the surgical teem came in with a student. He wasn’t my surgeon but he works with her. He went over one of the questionnaires about
my medical history, medications and answered questions about
the surgery. He had me sign a release form. I asked him about
filling out a form for my work. It would allow me to be paid for my time off work. He told me to take it to the surgeon’s secretary. He gave me a prescript
ion for Cipro and Flagyl. I am to take both the day before surgery. After he left I had to wait about
30 minuets for the nurse to come back.
The nurse also discussed my medical history. One of the forms I filled out asked the type of room I want, ward, semi private or private. I wasn’t sure if my insurance would cover anything better than a ward so I left it blank. She told me I could call in later to change it. Today I found out my insurance will pay 100% for a semi private room. The form also asked if I want a telephone for a flat rat of $15. I asked if I could use my cell phone but was told no. I then signed up for a telephone. I asked about
a TV and was told that someone would come around to my room offering TV’s.
The nurse gave me information on what to bring on the day of surgery. She gave me information on bowel preparation the day before surgery. I am to take 2 bottles of Fleet phosphasoda, one at 9:00am and the other at 5:00pm. Earlier I was told my surgery would be at 8:00am. I thought that meant I had to be at the hospital at that time. The nurse told me I had to be there 2 hours earlier. That is going to be tough. I will have to wake up at 4:00am in order to get there by 6:00am. The nurse then gave me a pamphlet about
using a morphine pump for pain relief. She then took my blood pressure and pulse followed by blood samples for testing. I was finally finished at 12:00 noon. That was 3 hours in that room and I managed it without going to the washroom at all. I went immediately before and after.
I then went to the surgeon’s secretary to give her the form from work to have the surgeon fill out. She said it wouldn’t be until next week and she will fax it to my employer. She told me they normally request 6 months absence from work to cover both surgeries and if I feel better sooner I can go back between surgeries. I don’t mind and I won’t be in any hurry going back to work. Over the last 18 years I have accumulated over 6 months of 100% sick leave and another year of 75%. I then went for lunch and returned to work at about
Thanks for listening
Diagnosed in 2000 at age 43 with UC extending half way across transverse colon.
Bad reaction to Asacol, Pentasa and Dipentum - can’t take any more 5ASAs.
Prednisone - worked well for 1 month, then side effects became unbearable.
6-MP - blood tests showed not metabolizing properly.
Corticosteroid enema, Flagyl, Ciprofloxin, VSL#3, Adacolumn Apheresis – no effect
Methotrexate with Remicade - 7 infusions with no improvement
Folic Acid and B12 injections.
Abatacept trial - no effect