Colostomy after three emergency surgeries in Costa Rica

Hi all,

I'm writing to get your support and advice. My husband and I were vacationing in Costa Rica when 4 days ago he came down with a fever and severe abdominal pain. We were an hour drive from the nearest hospital, which was the scariest hour I've ever had, with my husband crying and screaming and vomiting. We arrived to the hospital, which was horrible (stray dogs, no toilet paper, wheel chairs made of plastic lawn chairs, etc). While the surgeon there certainly saved my husband's life (he would have certainly died had we not made it to the hospital), he also didn't follow standard of care, didn't remove the damaged part of the sigmoid colon, and didn't do a temporary colostomy. We had to air ambulance him to San Jose where he has since had 2 more surgeries, the first to clean out the pockets of infection that remained in his open abdomen and the third surgery of the trip to close him up and do the colostomy. The diagnosis is a perforated sigmoid colon from diverticulitis. I'm hoping to get him out of here ASAP and back to the States on another air ambulance, maybe even for the rest of his post-operative care, because I'm worried he won't recover here as he's so scared.

He was in the ICU for three days, intubated for 2 days. Today he woke up and has been incredibly depressed and scared, crying frequently and getting angry, neither of which is like him, but certainly very understandable. Tonight his abdomen blew up with gas (I heard some farting noises this morning through the colostomy, but not since then). It's like a balloon, causing tremendous pain and making his stitches very taught.

Any words of wisdom? Advice from the trenches? I'm exhausted and also 4 months pregnant with a high risk pregnancy, so I'm also feeling a toll. It is so hard to see him struggle so much.

Thanks for writing back. We live in Virginia. I've been in touch with the head of Georgetown University's GI unit, and he is taking my husband's case and was the one who told me to get him out of the first hospital and over to San Jose. Now, the lead surgeon here, who is very good, prefers that my husband stay here for 6 more days to complete antibiotics, as the sepsis was so bad from the first botched surgery. But I think his emotional stability is also important at this point. I am hoping to speak with both surgeons (here and in Washington) to say that as soon as he is physically stable enough for an air ambulance, I want to go home.

No advice unfortunately, but did want to send healing hugs and prayers your way. Hopefully, someone else will have some suggestions for you.

Hugs!

My gosh! What a terrible ordeal! I just want to give you a few virtual (((Hugs))).

It sounds like the worst is over, now you need to get him back to the states and into a hospital to oversee his recovery and any possible complications. I think you definitely need to talk to your health insurance company to see if they will cover any part of an air ambulance. There are several private air ambulance companies out there (never used one, so I can't give any advice there). But I would also try contacting a few of them to figure out what the cost is - also these companies probably have legal departments that can work with your insurance to figure out how to lower costs for you. Perhaps if insurance won't cover it, but you have enough money in the kitty to cover it (or even go into a little debt), just pay it. I belong to the philosophy of thought that you can't take it with you - and this is a pretty dire situation. If money will buy you access to better care and peace of mind, I'd just take it, even if it means paying for it for years to come.

You and your hubby have taken quite a shock, and it will take some time for him to bounce back emotionally. That's ok, and it will help to get him feeling better physically. Feeling better physically will help with emotional recovery. I hope you are doing enough to take care of yourself, eating regularly and getting rest. I hope you two will make it back safely, and get the care you both need.

Hope you'll be back in the US and well on the road to recovery soon.

((Hugs))
PV

Thank you ALL for your support. My husband is doing a bit better. The colostomy is finally functioning and expelling liquid and gas, and he vomited up an unimaginable amount of bile, which made him feel better. He has an NG tube in place now which should help as well. We have the air ambulance team ready to go as soon as he feels strong enough, and a great team of doctors waiting at Georgetown hospital. He’ll get through this. I will be sure to keep turning to you guys for advice. virtual hugs back at you. M

Regarding the ng tube and your husband's comfort, I can share my 2 cents from my many ng tube experiences. NG tubes come in various diameters. The last time that I was hospitalized, I requested a smaller diameter tube so that it wouldn't hurt my nose and throat so much, and they did give me a smaller diameter tube, I'm not sure of the size, maybe 12 or 14 French. I think 16 is probably about the biggest they ever use. "French" is the unit of measurement for the diameter NG tubes and the scopes that gi's insert into the gi tract. So if your husband ends up having to undergo another surgery or remain on the ng tube, it might be worth asking about for comfort sake. They can change the ng tube when he gets knocked out for surgery is usually the easiest.

The other thing I would mention about ng tubes is that, at least in my experience, the pump should be set on "intermittent" suction rather than "continuous" suction. That way it does not irritate the stomach lining so badly, at least that's what I was told the last time I was in the hospital for 10 straight days with the ng tube during that time.

Also, last time around I had dilaudid for pain and Zofran to combat the nausea that accompanies the dilaudid medicine and it worked very well.

Just tossing out these little tips I've learned myself over the years in case they might help. Best wishes to you both.

Wenesday, this post is from 2010....I'll be surprised if you get a response from the original poster