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Jpouch recovery please help

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Posted 9/12/2010 9:29 PM (GMT 0)
I've had jpouch surgery last week and need help. Here in Ontario you can't speak to doctor to save your life.

I'm 1 week post op and am currently dealing with a low grade fever that floats around 99. I also have no appetite and have vomitted a few times. Things are certainly moving out the "back door" although still very watery.

I just really want know if this is kind of normal or what other peoples experiences are.
Posted 9/12/2010 9:34 PM (GMT 0)
Go to www.j-pouch.org

A low grade fever is normal. It sounds as if you are dehydrated. Are you drinking liquids other than water? Water is not enough. Drink boullion, eat salty crackers, and drink fluids with electrolytes. Recovery is difficult but will be made easier when you start eating. And yes, it's normal to pass mucus or blood when you have a temp ostomy.

Sue
Posted 9/12/2010 11:56 PM (GMT 0)
What about the appetite? Everyone is telling me to eat but I just can't do it. So far all I can stomach is saltine crackers.

When does a normal appetite start to return?
Posted 9/13/2010 12:10 AM (GMT 0)
Appetite will come back but it may take a few weeks.
Posted 9/13/2010 1:21 AM (GMT 0)
Where in Ontario are you? My son had his J pouch built at Mount Sinai in Toronto and we could reach the surgeon, or one of the residents on her team, 24 hours/day, 7 days a week. You should let your surgeon know what is going on. Hunt him/her down. You need to be thoughtful of bowel obstructions (or partial obstructions) , especially while the intestine is still so swollen from surgery. Vomiting and watery output can be signs of these. Also, keep a close eye on the fever.
Posted 9/15/2010 2:30 AM (GMT 0)
Numb78
Hello, guess I don't know you or anything about what is going on with you.  So what type of surgery did you have.???  I had a Total Colecotmy with a internal J-Pouch, is that what your referring to?  So please enlighten me and see if I can assist you in any way..

Leslie

Posted 9/19/2010 10:05 PM (GMT 0)
Hi,

Read your post with interest - my father-in-law has recently had this very same operation and two weeks later is still in hospital, has not eaten any solid foods, is losing a lot of weight, is becomming weaker by the day and is in a lot of pain from indigestion type burps / hiccups. Most recently (in the last couple of days) he has started vomitting as well when trying to force himself to eat foods (he currently has no appetite). The bowel does appear to be working as he is passing - albeit liquid.

We are all very concerned as the hospital keep saying they are amending the drugs and it's a question of finding the right level of medicine, they haven't yet conducted a CT scan as they 'feel' that there isn't a kink or leak. As each day passes concern grows given how weak he is getting and if it does turn out to be a leak or kink he would need to go back under for surgery which by the time the surgery happens would be very (life/death) risky. Two weeks since the op 'seems' a long time to us to just allow things to carry on and take their course.

We'd all be very interested to understand how things are for you now. If you aren't in a position to answer this - is anyone else able to advise on ...

- When his appetite is likely to return
- Any suggestions for anything pro-active we can be doing for him (whether that be diet or anything else)
- Should we be asking any specific questions of the doctors whom we feel are letting him get too weak
- Has anyone had similar experiences post op - any similar timescales and issues faced following surgery ?

Any help or advice from either Numb78 or anyone else would be greatly appreciated - even if it's just to put our minds at rest.

Thanks,

Mike
Posted 9/20/2010 12:46 AM (GMT 0)
It sounds as if your dad has an ileus. He should be getting out of bed and walking as much as possible to wake up the intestine. Also, cut back on any pain medications as much as possible to get his system moving.

Sue
Posted 9/20/2010 2:23 AM (GMT 0)
Hitchens....two weeks post surgery is not very long (although it seems forever). After surgery the intestine is very swollen which makes getting food through sometimes very difficult. Another common complication is, as Suebear wrote, an ileus. This is when the intestine, after being manipulated, decides to take it's merry time in "waking up". This usually happens about 4-5 days post surgery and can last for a good few days. My son had this, after having his colon removed, and was in the hospital for almost 3 weeks.

Your father-in-law should be pushed to get up and walk (even though it is the last thing he wants to do) and then walk some more. It truly is the best thing for him. As he gets more active, his intestines with start working more and his appetite will return.

Hang in there....time and activity are the best medicines right now.
Posted 9/20/2010 2:29 AM (GMT 0)
As to diet...if he is vomiting that is a sign that things are not moving through very well...either due to a partial blockage or an ileus. In that case he should not be having anything but clear fluids and as I said before WALKING. I would be questioning the docs on letting him eat while he is vomiting. The fact that "liquid" is passing does not really mean too much. If the intestine is "unhappy" it secretes a lot of liquid which comes out the bottom end.
Posted 9/20/2010 3:13 AM (GMT 0)
Collicat
  I get ileus all the time...gets to the point where nothing will stay down and nausiated extremely bad, and noting will come out till ya get the darn ole NG Tube..then after a day or so on that things look up and everything goes the way it should.

I have enjoyed too many of them to count.  So make sure that when he eats that he gets up and moves and dont drink with your meals wait for a hr after to have something to drink.  Try not to eat gassy foods or drink soda.  I stick with water and gatorade..hope he feels better.

Leslie

Posted 9/20/2010 11:22 AM (GMT 0)
Hi,

Thanks for all the replies - much appreciated.

At the moment he is just too weak to walk - however it sounds as though there are a number of things to explore further with the doctors and it seems based on what you are all saying that a reversal back to the bag should not be necessary at the moment. I probably should have added on the original submission that he had his colon removed - which I understand can also lead to more liquid being released when passing.

It seems that he has been on and off the NG tube (had it in for 4 days straight - but has been off it for around 4 days now and it's all building back up again) - I think that previously had been sucking away a lot of the bile that was building up and was giving him quite a lot of discomfort.

In terms of diet - given he is not eating anything - it seems that Gatorade could be a good drink to give other than water (?) - he is currently on a drip to make sure he is hydrated - any other suggestions around liquids that are good in this situation ?

Any other pointers or signs we should look for greatly appreciated.

Thanks again for your help so far.

Mike
Posted 9/20/2010 1:08 PM (GMT 0)
Gatorade is fine; so would be bouillon, broth, V-8, etc. Beverages with salt will help him to retain water and lessen dehydration. An ileus can last a long time so even though he's weak, he needs to walk! The sooner the ileus passes the sooner he can go home.

Sue
Posted 9/20/2010 8:01 PM (GMT 0)
Mike,

    Yes, becareful when having the NG Tube  I have had them in for 4 days went home for 2 days went back in for 4 days ...all of the 4 day each time I was in I had the Ng..tube..  Mine got to where all that was coming out was blood,  so they had left it in for so long.  The purpose of the NG tube is to get the ilius gone so that you can pass stool.  With your colon gone just like me your going to have the more watery type of stool,  then graduadly you get little wafes of poop , never a formed stool like you use to having when you have a colon.  So now your new plumbing has no way to form the stool because the purpose of the colon is to take the water out and form the stool.

Monitor the output, noting the color, quantity, pH, and presence or absence of blood. Report problems, such as the inability to irrigate the tube, which may indicate clogging; a sudden increase or decrease in output; the presence of "coffee ground" or frank blood; or an abnormal pH. And calculate intake and output. Large volume losses can lead to electrolyte imbalances and hypovolemia, both of which may require IV fluid replacement.

 

Mike when did you have this surgery?  Like I think I have said before that my Total Colectomy was Feb 19,10 and had watery stools for months.  Then it slowed down, still have explosive bm's and they do not smell very good.  And for some odd reason and I am going to blame it on you all...is LOL  I have had Diahrea sat night, like 10 times and last night was horrible over 20 times, it was a bad evening.  So have not had that in quite sometime.

 

Stay away from pre-packaged foods, things with sorbitol, keep to the natural foods, grease will increase bowl movements.  I stay with chicken and turkey most every day, then I try to add foods a little at a time, but most do not agree with me.  So I never eat anything fatty or fried or deep fried, no tomato sauces, or merinades, they really screw with me.

I drink the gatorade every day about a half of a bottle and it keeps my electrolites in balance, and seems to help with the iliuses that I have gotten.  Plus the gatorade helps keep my bms moving also...could be just me but worth a try.

 

I know its hard but try to be positive and just know that this is a marathon and not a sprint.  We are all here for you too.

 

Leslie

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