What should I expect for a bowel resection?

I am pretty certain that I will need a bowel resection in the next couple of weeks...a test this Thursday should confirm this....and if not in a few weeks then, according to the Doctor with-in the next few months.

Like many people I do much better when I know what to expect and if I know what questions to ask....for the surgeon this will be just another day atthe office....but for me of course it is my life and several feet of my small intestine.  So what should I expect from start to finish?   Figuring that this will be a planned surgical event I will show up at the hospital, do my paper work and get assigned to a room...from there...

Do they suggest giving blood before the procedure?

Do you usually show up the night before?   Do they hook up an IV drip right away?

What will I do to prep for this thing (maybe the same as for a colonoscopy?)?

Will they have to do a catheter? (hate the thought of that)  If so for how long?  do they at least give you pain meds before inserting it or hope against hope do it while you are under.

Anything special done while under...breathing tubes?  Blood? 

I have been told this will involve the full 4 to 6 inch cut since they probably will survey all of each bowel. 

For the closing...any kind of teflon patch or anything to help hold things in place?

Will I be in bed for several days after? 

How long do they usually administer pain meds?  ( I love that dillatin (sp?) it is better than morphine)

How soon before they say get up and walk?

What kind of diet will I be on when I first wake up?   By the 3rd or 4th day?  By the time I go home?

Not really looking for an answer by answer response...but a written walk through would be greatly appreciated.  I know there there can be complications but I am just looking for the normal surigical event.  Start to finish.  I know I sound a bit anal...but then again we have crohns and doesn't mean we are all a bit anal...one way or another?

thanks for any information provided.

I had a resection a year ago, done about 2 weeks after a CT scan showed a blockage. Prep was the same as a colonoscopy, had to have blood tests done to check for electrolyte levels and other things (normally done a week or two before surgery, mine was done that morning), an IV was started right away in the prep area, I had to have potassium per the anesthesiologist ( that BURNS so try and do Gatorade to keep your levels up!) and lots of questions which would have been done over the phone if my surgery wasn't scheduled on Friday afternoon for Monday afternoon. My catheter wasn't done until I was sleeping, they didn't give me anything before taking me to the OR and next time I'll be sure to ask for something, I didn't like the mask on my face! I woke up once in recovery trying to get the NG tube out, but I fell back asleep right away (maybe they gave me something?) and it was gone by the time they took me to my room a few hours later. My surgery was supposed to be laparascopic but I was such a mess they ended up doing an open incision and it went from an estimated 1.5 hours to 4, my poor husband waiting all that time! I was walking the next day, and I made the nurses call the surgeon and let him know that the cath was coming out by them or me, his choice, that day. It really bothered me more than anything else. I was on demerol at first, then dilaudid in a pump for 2 days, then percoset for a day, then vicodin. My nurse gave me coffee on day 3 because she said that it makes things start moving and she was right! She told me to try potatos and roast pork for my first food, I listened to her, and she was right again! Just a couple of bites, but it didn't bother me at all. I think they said I could have banked my own blood if the surgery had been scheduled sooner, but I just agreed to transfusions if they were necessary (they weren't). I understand how it is, wanting to know what's going to happen, I'm the same way. Honestly, it wasn't too bad, the catheter was the worst part, my bladder was irritated for about 2 months. I would do it again, no hesitations, if I ever get a stricture like that again. Good luck!

Ladies,  thank you.  I really appreciate the information and I am still open to anyone else who would like to discuss what they went through and what to expect.  Again, I am not asking about horror stories....just the normal expectations.  I know I am like many others on here...I have tons of questions and then forget to ask half of them when I get to the doctor.  This way I may pare down the questions or fine tune them so as to not get the old brush off (although my doctor is pretty good about allowing plenty of time).

I will start now making sure that I eat a banana every day.  Maybe a kiwi or two.  This way I will boost my potassium level.  I am certain that I will be in surgery pretty soon since I have been fighting a lagging partial blockage all week.  Last night I had a fever that hit 104 F.   Then it broke and this morning I am still on edge with slight cramps and a little nausea but I am determined to tough it out until my x-ray and CT tomorrow.  Pretty much done with solids until after the test results.

OTHER QUESTIONs:  what about weight loss (other than the couple of feet of intestine)?  I really can't afford to lose to much more weight.  Is it it problem after this surgery?

if I have someone travel with me and do the heavy lifting of suitcases and such should I be able to get back on the road (actually flying) with in 2 weeks after the surgery.  I am trying to schedule the best time for the surgery and need to start changing meetings and appointments as soon as possible...so I am trying to figure out how far out from the surgery I need to cancel.

In a perfect world I will hopefully check into the hospital the night before (if they schedule the surgery for an early AM cut)

and then load up on the drugs and let them have their way with me.

Thanks again for the info....I am (and it was a surprise to me) according to my wife and doctor an A personality type so maybe that is why I have such a need to know everything ahead...God help the doctors if they don't do everything the way I am expecting it....LOL

Thanks Nanners....

I know everyone says that I need to plan more time for recovery...and many say it is major surgery...my doctor says it is routine...can it be routine and major at the same time?

I have been told that there is 98% chance that I will not have the lap surgery but will be opened up so they can inspect the entire system.  So that means possibly a week in the hospital....i can deal with that and probably after a few days i might be able to do some off-site computer work and make some calls to clients from bedside....I have resigned myself to a full weeks rest at home...maybe more if I can bracket the weekends together...then I am hoping to go into the office for a few hours a day for the third week and then not start traveling until the start of the fourth week...it would only be one or two trips and I would be gone only 3 or 4 days.  I think I can get one of my co-workers to go with me and that way I won't have to carry anything....time will tell, but while I am pretty bullheaded I also know my limits and I am not afraid to stop and rest when I need to.  My biggest concern would be lifting too much weight...like my computer/briefcase and suitcase....also the pressurization of the jet cabin.  there are times now when I can feel it in my gut if the pressure is not right.

hspenser,

You will be putting your healing and health at risk if you don't get the proper rest. A resection is not a mild thing. You will need about 6 weeks of rest and healing, especially if you are going to be opened up with a reg. resection.

After 2 weeks, I still had trouble going up and down my stairs and getting out of bed. The incision is quite large (about 8 inches or so) and they don't even take the staples out until 10-14 days. Then there are still internal stitches. You'll also have an "open" draining incision that won't close for a few weeks.

There is no way you should be going to the office in the third week for a few hours a day.

If you feel that pressured over your job, talk to a lawyer before your surgery and find out what you and your employer's legal obligations are in this matter.

I honestly don't understand why your doctor has not informed you properly and realistically about the recovery for this very serious and major abdominal surgery.

I wish you the best and please take care after your surgery.

Roni

Ronni and 78...thanks for the response ...

my doctor has told me to allow at least 4 weeks before going back to work and he is aware of how I feel.  It is not a matter of my employer not being supportive...it is my desire to keep on task with a job I love and one that is very important to many people.  A six week delay in my ability to work could result in holding back sales that could easily keep a couple dozen people employed full time for years to come.  I have worked very hard to get where I am at this time and am very proud of the success my hard work has brought to myself and my company.  We are just now cresting the top of a new nation wide project I started 5 years ago and I need about 2 more years of pampering it along before letting some of it go.

I am going to have a talk with my surgeon and let him/her know my desires and see what they can do to help.

gachrons said...
Hi I can see you are truly a devoted man to your work but give yourself the same devotion after all you been around for 52 years and if the company needs you that much then they are just going to love a healthier you. I had to go to the hos. every day for a couple of weeks to get bandages changed, as I got a infection so health first. When is your surgery planned for? lol gail

I am devoted...because they are and have always been devoted and supportive of me and my family.  It is a big small company...about 500 employees....and privately owned.  I have been there for almost 20 years and started there when we employed only 75 people.

The two owners have always been understanding of crohns and very helpful by letting me know about things they have found on-line or in the publications they read.

They will benefit from a healthier me and so will I ....I am just not someone who can sit still....maybe that is part of the reason for the crohns showing up so late in life.

Anyway...I have some tests to do...tomorrow is the first one and depending on the outcome of that test we will know more about the whens...either right away (like next week) or if possible put it off until the 2nd week of December...my hope is Dec.  Then I can relax a bit because the closer we get to Christmas the less travel I do...no one wants to see a salesman after the first week of December.  I think I will be lucky to make until then...I have had 7 severe blockage attacks ..one major that required a two day stay in the hospital and about 4 or 5 minor attacks in the past 6 weeks...so it seems things are getting worse. Even liquids are backing up these days.  The only thing to do now is take a good picture of the small intestine and figure out how severe things are.  My doctor had said last month that I would not make it through the year w/o surgery....I have had two strictures since at least 2002 and I guess they are just getting worse....thank God for my morphine tablets.

Another suggestion....since you have a preference to pain meds that work for you make it extremely clear that this is the med you want to be on after surgery. My doc ignored my request and used his "usual" and I ended up staying an extra 5 days because no one could understand why I couldn't stay upright without fainting. Other than that I didn't think it was too bad.

Good lucK!!
Elizabeth

2 resections. Scariest thing about all of it was signing the paperwork. I had different reactions to the two resections. They goaded me up and out of bed so I could move from bed to bed with my first. I recall waking up in the recovery room before I went to ICU. That was my blood pressure which wouldn't level out (and haha, had nothing to do with the surgery or the Crohn's...just plain ole bein' a 22 yr. old girl). For some reason, I slept through the day before I woke up. And then it was like being actually awake. Mostly, keep a pillow near the sore scar for coughing or anything. The surgeon was pretty descriptive and I had a hospital advocate for that one.

Surgery 2: Well, it was emergency. I didn't know I had Crohn's then. Figured I'd spent the five years between ER visits convincing myself it was just a one time infection (two hospitals told me I was CD free). Anyhow, I'd been on a high fiber diet from gallstones. I was a month out of the hospital from pancreatitis (gallstones) but I'd been planning on moving for the previous year and I was moving. So, I was fine when we drove from California to New Mexico. My sister was driving me the rest of the way to Missouri. The day before I left CA, I was in the ER; trying to control the vomiting and pain...I thought it was the gallbladder finally keeling over enough for me to get surgery. It wasn't. They just sent me on my way. So, I made the drive and when I made the last leg of it, I spent it fighting vomit so hard, I was close-eyed, shallow breathing, etc. Anyhow, I made it through two more days of no eating, no drinking, and vomiting anyway. Then I ran to the ER again, where they saw "a mess of things inside there". Doctor's words. Anyhow, no warning. Just sleepy and I don't recall the entire next week. There were flashes of card-playing from that week, but otherwise, I'd say it was great.

Just fyi on my last resection they gave me a pain pump with Dilaudid. That is something you should be sure to ask for. That way when you need medication you just push a button and the med is delivered and no need to wait for the nurse to come give you your meds.

Also, with my surgeries all the tubes were inserted while I was under except the ng tube on the first surgery. That first surgery was an emergency so the ng tube was inserted in the ER.

Good luck,
Gail *Nanners*

Ha ha hspenser. If your such a big baby I can guarantee that you won't be back to work in 2 weeks then. I was so surprised when I woke up from my first resection at how painful it was. I didn't want to breathe and not sure if they are still doing it, but I was in ICU for a day or two after both my surgeries. But don't worry they give you GOOD pain meds. I think with the ICU its just as a precaution, since they are working on the bowels and that is a pretty germy area, etc.

Oh I forgot another tip, ask about an epidural. I heard that people who got these (and they are properly placed) have a better control on their pain. Just fyi.

Nanners said...
Ha ha hspenser. If your such a big baby I can guarantee that you won't be back to work in 2 weeks then. I was so surprised when I woke up from my first resection at how painful it was. I didn't want to breathe and not sure if they are still doing it, but I was in ICU for a day or two after both my surgeries. But don't worry they give you GOOD pain meds. I think with the ICU its just as a precaution, since they are working on the bowels and that is a pretty germy area, etc.

Oh I forgot another tip, ask about an epidural. I heard that people who got these (and they are properly placed) have a better control on their pain. Just fyi.

thanks Nanners...I can take the pain pretty much but where I get all sqeamish and stuff is when they insert tubes into places tubes shouldn't be.  I can't imagine a cathetor....and several years ago I had to go through a sonic swallow test and then wear an acid measuring device for 24 hours.  During the swallow test they shove a small tube up the nose ...down thethroat and into the stomach and then for about 20 minutes they slide the tube up and down to find the perfect placement for the acid tester...they do this by having you swallow some water and based on the sound readings the move the tube...it took me 25 swallows to get it right...then they take that tube out and put the acid reading tube in....I felt like I was going to gag the entire time it was in my throat and stomach.

Another time I had a very bad infection in my foot from a catfish barb sting and the drain tube was almost more than I could take....pain I can deal with...medical procedures not so much.   I used faint dead away atthe sight of blood.

I'm coming late to this party. But I just wanted to add that I had 3 resections and I didn't recover as quickly from the last as I did from the first, maybe age? And I was a lot younger at the time than I am now. So please don't push yourself. I just wanted to suggest that maybe instead of making the work trips so quick, it might be better to make them a day longer so that you can schedule some rest time mid day. If you are determined to get back to work so soon, it might be the best way to do it so that you aren't pushing your body.

And my number one suggestion for anyone going to the hospital for a stay is to bring your own pillow and pillowcases. It so nice to have your own.