Total Laparascopic Colectomy for Colonic Inertia

I had shared this info on the IBS support site forum & wanted to post here also since some of you were following me here as well :

Hi all !

I just wanted to post to let everyone know I made it through the total colectomy last Thursday, 9/16 which was done laparascopically for treatment of CI (colonic interia) as a result of chronic laxative usgae from years of suffering from IBS.

Two surgeons did the procedure which took only about 1 1/2 hours. I am thin so they said that made it a bit easier and quicker. No keyhole incision for the MD to insert his hand into my abdomen was needed.

I have 4 puncture wounds from the scope - right upper and lower and left upper and lower abdominal with one central incision in my naval through which they removed the 5 feet of colon/large intestines.

I was on bedrest with a Dilaudid pain pump the day after (last Friday) and got myself up without help that night to stand at the bedside. My foley catheter was removed last Saturday and as it was the weekend and the nurses were short-staffed, I got myself up and back and forth to the bathrooom.

I have to admit the pain and nausea were pretty intense at first - mainly from where they blew my abdomen up with gas to seperate out the organs to reduce the risk of nicking a nearby organ with the scapel.

After the foley catheter came out the IV fluids were going though me pretty quickly which was causing me to have to get up and down a lot to trip back and forth to urinate. So I had them pull the IV Saturday and started on clear liquids then advanced to full liquids Sunday. I started a soft diet Monday which I will stay on for 2 weeks.

The downside about having the Iv pulled is I had to go to pain meds by mouth and since they were short staffed it took awhile before the nurses could get the meds to me. I ended up being released to home Sunday after I was able to get myself up to the shower and get dressed and even did my own hair and make up on only day # 3 !

Monday day # 4 is when it really hit me. I put in a call to the doc as my intestines stopped moving once I started the soft diet and I was terrified I was getting an ileus. They called me in some Reglan and it started my bowels to start slowly moving l - thank God ! as I was afraid I was going to have to get re-admitted for an ileostomy.

I see the doc for my first post-op check up next week (on Monday) and I will be off work this week and next and hopefully will be able to return to work then.

Again, the main problem has been the gas from the surgery and then my bowels slowing down on me - despite me being up and active right away. The pain was intense at times but I think that is because I was unable to stay on top of it before it got too bad.

All in all I am extremely pleased with the surgery - esp the fact I did not have the big scar and that I was able to go home so soon. I have tolerated soft foods this week well and have been able to eat everything except meats and raw fruits & vegetables.  The nausea was a problem at first while I was in the hospital but was controlled by meds. I have my appretiate back & I am actually starting to feel hungry now

The doc said it would take about 2 weeks for the swelling to go down in my abdomen and I hope he is right because I need to fit into my work clothes as I plan to be back on the job by then.

Anyway - all said and done I am glad I did not wait any longer and went ahead on with the surgery. I welcome any questions anyone has and will keep you posted as my recovery progresses.

I hope everyone is as well as can be expected in dealing with each of his/her GI problems. Unless you have been there, it is difficult to relate to. I am very blessed to have found this webiste and want to thank each and every one of you for your support, concern, and prayers for me.

God bless and will be in touch re the results of my MD appt on Monday. Take good care. Love & hugs !~ Pamela ~

Hi Hodaya ! YES - a successful surgery - YAY !!! I was amazed at how quick the surgery went as well, & was really scared that I was going to get an ileus too, so thank God for the Reglan ! The gas pains were the absolute worst part of the surgery for sure :-( I am on week 2 and the swelling is starting to go down - although not all the way yet. Glad to lnow that after about another week the swelling shoul be resolved. I will contine to keep walking for sure, I am sooo glad the surgery is over & it couldn't have gone better Thanks for all of your support, advise & prayers through all of this ... & will let you know how my doc appt goes tomorrow. Nice hearing from you & I hope all is well with you !!!

Great to hear you are doing well and thanks for the luck re my MD appt tomorrow. I am expecting a good report - so will post as soon as I can & let you know. Have a blessed day & will ttyl then ! Love & hugs   ~ Pamela ~

Wow ! It sounds like you got off even better than I did as I have the four portals (one in each quadrant) where they inserted the scope to cut the colon & cauterize the vessels - then removed all 4 pieces through a similar incision in my naval. The scars on my tummy are small though and I am using Mederma to help them heal/fade.

I had a similar problem with nausea but it was expected as I always get deathly sick from anesthesia and pain meds. I started on soft foods as soon as I got home (day # 3) which was abut the same time I started the oral pain meds (Lortab 5 mg).

The Lortab was slowing down my system too so the doc ordered me a Reglan Rx to take (which also helped with the nausea) and it cleared right up. I only had to take the Reglan a couple of days and have been going each time after I eat now and sometimes in between, depending on what I have eaten. I am trying to eat about 4-6 small meals a day.

I am keeping myself on soft foods for awhile - oatmeal, egg whites, rice, mashed potatoes, pasta (without the spicy sauce), mac & cheese, Tofu, bananas, cottage cheese, yogurt, peas and carrots and beans (the canned kind - cooked and mashed).

Bread always used to stop me up because it swells in your abdomen so I have not even tried it and have actually lost my taste for it anyway. I have not tried any meats or raw fruits or veggies. I think I could tolerate them but they would probably pass through quicker than I would like so a going to give my small intestines some more time before introducing too much roughage.

I am just sooo blessed I did not develop an ileus, blockage, hernia or any adhesions so far - praise the Lord, & have minimal scarring and pain. I was only on the Lortab one a day for a few days - so all in all I think I have done pretty darn good ! Sounds like you have as well, thank God !

I appreciate you writing and hearing about your surgery. Please do keep in touch and let me know how the rest of your recovery progresses. I go back to work Monday and see the doc again for a re-check on 10/25. If anything comes up in the meantime I will let you know and you please feel free to do the same.

I will be praying for you to have a complete healing and recovery with no complications and look forward to hearing back from you with a good progress report !

Take good care & God bless !!!

~ Pamela ~

Hi Leslie !

Thanks for writing about your experience with your surgery. I know I was blessed to have the totally colectomy via laparascope, but would have taken the big scar any day compared to how things were before ... so kudos to you and welcome to the club ! lol ;-)

So you still aren't able to eat fruit & veggies but can you eat cooked veggies ? - as I am tolerating those well if chewed really well or mashed up lol. I have not had fruit yet but any dying to eat some - hold off though until my body gives me the go ahead.

How long has it been since your surgery and any other foods you suggest to avoid or things to do or not do as far as activities ???

I will add you to my prayer list along with several others who are experiencing similar circumstances & situations. I appreciate your prayers as well & look forward to hearing about anything else you have to share !

Take care and many blessings you way

~ Pamela ~

Hey Leslie !

Thanks for your reply & the additional information re your surgery & recommendations. Sounds like you have really been through a lot and come a long way this past year !

Any idea what caused the repeat ileuses to happen so I can hopefully prevent them from happening to me ?!? And yes, I got hooked up so was able to avoid the ileostomy & additional surgery for reversal.

I do keep a journal of what when & how much I eat. I plan to just stick with cooked veggies & not raw. Canned fruits are softer so I may try those at some time. I am introducing one new food at a time to see how my body responds.

I am eating small amounts of foods frequently but still feel hungry all the time as I never feel really full - but better that than to eat too much and have transit problems. I don't understand why the lettuce would slow you down ? I would think with it being raw roughage it would do the opposite & pass thru quickly ?

I am lactose intolerant as well but found I can now eat low fat cottage cheese & yogurt. I do not drink milk (even the soy kind) as it makes me bloat, or eat cheese as it tends to be constipating, along with chocolate.

Again, I don't eat breads - even crackers - because they swell & also slow things down. I do plan to try meats soon as I need to get some weight back on me. I love seafood, chicken & turkey so have plenty of choices there as long as I make sure they are cooked well & are small portions.

I don't have much of a sweet tooth but get my sugar fix from hard candy or the yogurt & fruits which are like dessert to me. Sweet potatoes also are, well sweet lol as well as soft. Pasta & rice seem to do ok too & I even tolerated cooked brussell sprouts well.

The main foods I haven't eaten yet are meats, except for tofu, & foods with a lot of roughage like broccoli, cauliflower, cucumbers, radishes, celery, carrots, & lettuce - things like you would munch on or have in a salad - which I REALLY miss - but I am following my gut instincts (literally ! ;-) & not eating them yet.

I may try to steam the broccoli & cauliflower & see how that works ...

Anyway - I will eventually get it figured out - just any advise on how NOT to have to be re-admitted for an ileus would be greatly appreciated !

Thank you sooo very much for you help as well as the support I have also received from everyone else. This is an amazing site as until you have been thu this it is difficult to relate - & even at that each case is different.

I appreciate you sharing and look forward to any other information you have that I may need to know about - esp on how to avoid the ileus !!!

Have a great day and God bless ! -)

~ Pamela ~

Hey Jana & thanks so much for sharing !

I did not know that carbonated beverages could cause a blockage just from gas so I really appreciate you sharing that with me ! I guess gassy foods could tend to do the same thing so I will have to avoid those as well. I drink flavored water, poweraids, as well as Lipton Green Tea (which is really good

You are so blessed to have had that new procedure. I wish my doc was trained in it but I was lucky to just get the 4 puncture wounds from the scope. The first doc wanted to cut me open about 6 inches straight down my abdomen & around my naval !

I did not know they had a barrier protection they could use to prevent adhesions ! I will have to ask my doc about that. I have had a vaginal hysterectomy but still have my ovaries and other major organs.

I am only 2 weeks out and have been using the Mederma about a week now since my puncture wounds only had a slight scab over them with dissolvable stitches on the inside. It has softened the scabs and like you, I am hoping the scars will fade so I can wear a bikini next summer. I would go ahead & get some if I were you & start using it as soon as your incision is healed.

I was already underweight before my surgery & with eating small amounts & no breads, sweets, or meats right now I am doing good just to maintain my weight. I need to put on about 10 pounds as my jeans are baggy on me & I have lost my figure, but I don't want to just pig out and eat a bunch of fattening food & have it turn to cellulite !

Once I am cleared to work out I am going to start trying to eat a lot more protein & hopefully I will be able to handle it by then & may add protein powder if I can't handle the bulk from the meat. Hopefully then when I start increasing my calories & protein & start working out it will go to building my shape back & not just settle on my things since I have a sedentary job & have not been really active yet.

The doc said this is the prime time to develop an umbilical hernia as when you start feeling better then you start lifting & doing things you don't need to do yet. He has 2 patients now that he has to go back in and do hernia repair operations on. Sooo - I am taking it easy until he gives me the ok to do more !

Oh - & re my colon and large intestine they removed (about 5 feet total) - the doc did say it appeared very "torturous", inflamed, thick & swollen - like yours said, from the 20 plus years of pressure straining & stress from the IBS-C & CI.

I am sooo very glad I had the surgery and wish I had done it 10 years ago - but they weren't using the scope procedure then so I am glad I waited after all. Now if I can just avoid an ileus, blockage, & adhesions & can handle some proteins fruits & veggies I will be estatic !!!

Guess that is all for now so will be in touch to post of any new developments & please do the same. I wish you & every one else a smooth & speedy recovery & hopefully I will experience the same !

Blessings to all !

~ Pamela ~

Hey Leslie -

Thanks for explaining about the lettuce - I may try it at some point further in my recovery. Not sure why you have ileus problems either, but if the gatorade helps - then I will keep that in mind just in case I get in trouble - God forbid ! - down the road.

I am sooo glad to have only been on meds for less than a week. They made me groggy and nauseous as well. I have an extremely high pain tolerance so I am very thankful for that.

Well get some rest and hope things keep going well for you. Stay in touch & will ttyl then God bless,

~ Pamela ~

Thanks again Leslie - I have a desk job and a short commute to work - I am just hoping I can tolerate the stress. No one else is trained to do my job and my boss has had other people trying to cover for me. I need to get back but just dread it as I know it is going to be a nightmare trying to sort everything out and go back and fix things as well as try to catch up on 2 weeks of work.

The doc said he would keep me out another week or two is needed - so I am going to try it and if the stress affects my gut or eating then I will get a MD excuse to stay off longer. I was told it would take several months before expecting to return to a hard work out - so I am not going to push it and just relax over the holidays & look forward to the New Year until I hit the gym and will be trying to get some protein in me in the meantime.

I did eat a small can of Starkist tuna in water last night - ate slow & chewed well & ended up having to take a Reglan to help it digest - so not sure my body is ready for even chopped meats yet. Will try it again in a few days or maybe some chicken and see how that works as I am really craving protein and you can only eat so much beans & tofu (of course you have to watch the gas factor with too many beans).

I am dying for something crunchy ! and a salad keeps calling my name ;-) but I know I am not ready for one of those yet. Better to be safe than sorry ! OK - well thanks again for all your advise & for helping me with all my ?s. Will let you know if anything else comes up & hope you get your dentures fitted properly as I am sure that will help your chewing ! Take good care & be blessed ~ Pamela ~

OMG - I was afraid of that ! I always thought stress is what caused my IBS & CI in the first place ! I could type for hours & not even touch the surface on what I have been through ...

I could always feel my colon and large intestines tighten up so hard like a charlie horse before (guess that is where the saying "my stomach is in a knot" came from ! lol) - I just didn't think about my small intestines doing that ! Ohhh nooo !!!

Between my job, my son who is recovering alcoholic but still smokes pot, is out of work & has shopping & card gambling addictions, my 18 yo niece who was molested by my bipolar brother after my dad died last year who is now in my custody with both her parents facing jail sentencing in the next couple of months, taking care of a house, yard, cars that are always in need of repair, medical bills on top of financial struggles already - I stay stressed out.

Lord help me not get an ileus or blockage due to STRESS !!! Thanks for the warning - I am begin so careful about my food and not taking pain meds that might slow things down - I did not even think about the stress ! I really need to go back to work as I want to save some vacation time for over the holidays. I will talk to my boss and just have to take it a day at a time and if it gets too bad I will just have to take more time off. I really appreciate you letting me know about that

I have taken Depakot before but was unable to tolerate it (among most everything else) as I am very sensitive to meds and can't function - drive, work, or anything else for that matter - if I take anything stronger than headache medicine ! Hope you will eventually adjust to it - just be careful driving !

Have a nice evening and a good day tomorrow - I need to try to do a light house cleaning after church before I hit the job on Monday - so I have a busy day ahead of me tomorrow and am just trying to take it easy today and enjoy the football games. Hope you are having a good weekend and will check in later !

Blessings, ~ Pamela ~

Pamela,
I forgot to tell you. The adhesion barrier they use is called Seprafilm. We use it frequently in all kinds of surgery. It literally just looks like a sheet of Saran wrap. You can use it as a full sheet the way it comes or some doctors prefer to use it as a slush, where you just crumple up the sheet and mix about 30 cc's of saline with it. He used 2 full sheets on each of my ovaries. Its expensive stuff, about 500 bucks a sheet, but it works very well. I've assisted surgeries on patients who had Seprafilm placed and while the adhesions still form they literally melt off of your organs. Its super cool. Do you live in a smaller community? I'm amazed at the number of people on here who's physician's aren't trained in laparoscopy. You and I seem to be the only people who were able to have ours done that way!!

Hey Leslie - I had Swanson canned chicken last night - fat free and it is cooked where it melts in your mouth - and already chopped so requires minimal chewing. I tolerated it well with some beans and applesauce and also had yogurt and some canned green peas and carrots mashed potatoes, oatmeal, and a banana yesterday.

I am now able to eat a lot - just have to space it out during the day in 6-8 small meals & I am STILL hungry ! lol My stools are starting to be more formed and I pretty much only have to go after I eat so I feel very blessed that all has been so good so far.

I was already underweight when I had my surgery & was able to advance my diet quickly so am trying to gain some weight and get my figure back. I am 5'5" and had gotten down to anywhere from 95 to 105, depending on how bd my symptoms were. I am fluxuating between 95 & 100 right now with a goal of slowly adding 5 pounds at a time until I get back up to a healthy weight for me which is about 115 pounds as I am small framed & have always been slender.

You sounded happy with your weight loss so perhaps that was a good thing for you ? Funny - have clothes ranging from size 0 to 6/8 due to the weight fluxuations and had to leave room for the severe bloating from the CI - my fat or "maternity clothes" I used to call them ;-) I look forward to getting my weight back to where it needs to be, maintaining it, and being ONE size again so I can redo my wardrobe !

FYI - the Vicodan will slow you down so you may want to try to reduce it (not sure how much you are taking) or ask your doc for some Reglan which will help your gastric emptying and small bowel motility so you can start adding more foods in your diet. A can of peaches and mashed potatoes is not near enough to sustain you & you need your vitamins and calories for your body to heal itself.

I also drink green tea which seems to keep my bowels moving - so you might want to try that as well as applesauces and maybe drink juices instead f so much water to give you some nourishment and calories. Just suggestions ! - you do what works for you.

I hope you have a good day today and am glad you are feeling better ! Enjoy the rest of your weekend and I am going to get started cleaning so I will be able to finish in time to get to church tonight. I start work back tomorrow so wish me luck & will ttyl then !

Blessings your way, ~ Pamela ~

P.S. - I have a cat & a ferret - and yes, animals ARE very theraputic ! One of God's many precious gifts to us

Hey Leslie !

That is amazing that you can eat all of that food and not get stopped up or gain weight ! It sounds like you are at a good weight now - that is if you are not too tall (was not sure about your height). I assume you were overweight before your surgery then ?

That is so good that you have no problems with elemination - esp on the Vicodan ... but from a health standpoint it doen't sound like all that food you ate was very healthy ! I am handling processed meats ok now and added canned fruits (peaches, pears, & fruit cocktail) this week so, so far so good as far as the food & elimination goes ... for now anyway.

If I had known what I was facing at work yesterday I would have asked the doc for a permanent off work excuse ;-) I worked a 10 1/2 hour day with no lunch break ... my work was a mess and I got chewed out by my boss to the point of tears because I said something to someone about it in confidence and they went behind my back and told her. I have learned my lesson and will NEVER open my mouth or express my opinions or feelings there again !

 

The doc would have given me 2 more weeks off and I knew no one was there that knew how to do my job and so I went back as soon as I could. If I get a complication because of this I am going to be veryyy upset. I would look for another job that is how upset I am but the market is not good right now in my field because of the outrageous health care reform act !

I had to have a good cry and take it to the Lord last night and am much better today. I have decided to limit my hours at work to 8 a day or a 40 hour week since I am salaried and don't get paid overtime anyways. I am going to also start taking my breaks so I can eat regularly.

 

I had a talk with my boss this morning and hopefully got things striaghtened out re my work. Still trying to catch up from being off for two weeks - but that is just going to take time - and I am going to try to just take one day at a time and do the best I can each day. I also know I need to get a full night's sleep so I need to adjust my bedtime since I am having to get up early now.

 

Well I am glad you are doing good and are able to eat ok. Sounds like you are well on your way to recovery after all those surgeries ! Well, I better get back to work now. I have enjoyed your messages and all of the information you have shared with me. I will write back as time allows as now that I am back to work my time is going to be really limited.

 

Take good care & love, hugs, & many blessings back to you ! ~ Pammie ~