Total Colectomy Part 7

Amira-It's great to hear from you. I was wondering if things were still looking good for you. I'm home now with a surgery date of Dec 27th. When I met with the surgeon yesterday, he was very nice and compassionate, and he said that after much consideration, he thought that I was a good candidate for the surgery. He offered to do it next Tues, before Christmas, but he said that I would likely still be inpt for Christmas and I didn't want to do that to my kids.

We discussed more specific about my surgery. He said that he will do an open procedure...I thought that would happen due to the number of previous abd surgeries I've had. Looking at the research, I'm OK with that decision since there aren't significant diffs between open and lap (if you don't want to call a couple days less pain significant!) Makes me feel a little better knowing he will be able to visualize everything in there. He also said I will wake up with an ng tube, a rectal tube (sounds horrible!), a catheter, and a lot of pain Emma-I took your advice about the IV situation...I, too, have horrible veins that they can't ever get to begin with, but that infiltrate or get phlebitis within 48 hrs so he'll put in a central line during surgery. Thanks a lot for that idea...IV's are always a source of problems for me!

Also, he said that he likes to use a nonopiate pain med that he begins during surgery and continues in recovery that blocks pain receptors. When he said the name of the med, I had never heard of it before. I know it started with a "pr...", so when I got home last nite I did some checking. I think it might be prialt (ziconotide)...I'll ask his nurse to make sure. It's an intrathecal med, so that would explain why he said he sometimes keeps pts in recovery overnt to administer the med initially in addition to the morphine, etc. I looked it up (for those of you in the med field) and it's a new calcium channel blocker protein that's derived from some venomous marine snail (no...I'm not making this up!) Anyway, it's used primarily for treatment of chronic severe pain, but it's shown a lot of promise for adjunct treatment of post-op acute pain. If it works, you all will be the first to know! (after my husband who will be the one sitting there listening to whether I scream or not anyway...)

And Emma, I did talk to the surgeon about admitting me pre-op for the prep. Obviously Baylor has done a better job strong-arming md's than we have at our hospitals...he actually said that he would always like to do that, but that insurance companies don't like it, often won't pay, and the hospital doesn't want him to do it. I used to be a clinical social worker in an acute med-surg hospital here (before private practice) and I was in case management, so I'm definitely impressed that Baylor has gotten that point across to him! But, as I told him, that "rule" isn't to prevent pre-op admission for someone who really needs it...just to prevent "convenience" admissions. Of course once I got into specifics, he laughed and said I was over his head and for me to talk to his staff, so I'll call and talk with them ahead of time to see if I can just be admitted on the 26th. I will undoubtedly start puking and hurting, and I'd much prefer a little "medication support"...I'll let y'all know if I win that battle or not.

Again, thanks to everybody for the support. Now that I've heard from you all and the surgery is scheduled, I think I'm ready. At least there won't be (m)any surprises! And Cathy, I hope your daughter is doing ok...

We're home!  It didn't take quite as long to break Jen's asthma attack this time.  We got lucky.  We did get a private room though.  We were roomed in with a girl, and her dad came to visit.  Respiratory was doing a treatment on Jen.  She said she'd be right back.  In she came with a nurse, they grabbed our stuff and whisked her out of the room.  They said that the dad of the little girl reaked of cigarette smoke and that Jen couldn't be in the room with them.  So they put us in the chemo room- alone. Yeah!!!!

Lesa- congratulations on the surgery date.  The new year will bring good things for you.  I only woke up with a catheter also.  I ended up with an NG tube after I got an ileus, but no rectal tube.  I guess it's to prevent gas pains.  When I go back in for connection surgery, I'll be asking for a central line in surgery too.

Amira-  I'm glad you had a good conference.  Sometimes those things can be pretty boring.  I usually end up seeing people that I haven't seen in a long time, that can be nice (most of the time- haha)

By the way, my other daughter Tiffany says hello to everyone.  She has her last final on Friday and then she'll be home for about a month.  I'm glad that we'll get to spend some time together.  She's so grown up.  I'm not sure when that happened!?! 

I've been doing well.  No pain, gaining strength, working some, eating everything.  No real complaints except for the added appendage on my body (ostomy).  Anxiously awaiting Feb.  Work is going well.  We're seeing alot of infections- strept, flu, sinusitis, gastritis, pharyngitis, etc.  We'll get busier starting in Jan with a peak in March or April.  My husband will have to do Feb. on his own- again.  I think that he appreciates better everything that I was doing running the practice, not just seeing patients.  Men sometimes take us women for granted, you know.

I'm going to call it a night, I'm tired after not sleeping well in the hospital with Jen.

Good night and I hope everyone is feeling good.

CAthy

 

Amira-  I have a feeling that given everything that happened last time, that my surgeon will be on her toes anyway.  I was the first patient that she ever had to put into intensive care.  Great!

For the first time, I woke up today and my wafer had creased and sprung a leak.  How embarrasing.  I had to wake up my husband and have him help me to clean up and change my ostomy bag.  I felt so bad.  Oh well, crap happens.  I was very embarrased though.

I am working today until I get too tired or my daughter calls, she went back to school today but still doesn't feel 100%.  They get so far behind in their homework that it seems impossible to get it all done.  The stress alone makes her feel worse.

Hope everyone is feeling well today.

Have a good one.

Cathy

Cathy-Thanks for your positive words. That "no pain" thing sure sounds good. Of course I think I'm like you as far as luck goes...hope I'm not my surgeon's first anything! I can't even imagine what it must be like for you being sick for so long and having an ostomy to deal with. But I tell ya, you certainly sound like you're handling things 100 times better than I would. You must be getting all kinds of gems in your heavenly crown...

I got stir crazy today and decided to go up to the office. Stupid idea. So I guess I'll be paying for that for a couple days. Maybe this is God's way to make sure I go through with the surgery...making it so bad that I think heck, anything's gotta be better than this!

When I did the transit test, the instruction sheet I was given said to stop all laxatives, but to begin taking fiber daily for one week prior to beginning the test, and to continue taking the fiber while the test was underway. I hated that, because the Miralax I was taking 3 x day was the only thing keeping it all moving, so after the whole thing was over with, I was impacted.

My original instructions said to go for a KUB (abd xray) on day 3 and day 5. When I went in on day 3, the markers had barely made it into my ascending colon; some were still at the end of my small intestine. On day 5, the markers were all in the transverse and descending colon. I had the xrays done in my hometown, and the local radiologist wanted me to return the next Mon (day 8) to see if they had passed, but I already had the appt with the surgeon for that day in Dallas. So I just took the films with me to the appt. The surgeon said he didn't need to see anything else...that it was obvious that I had severe colonic inertia. Apparently "normal" people have the markers at least in the descending colon by day 3, and have them completely gone by day 5. I can't imagine that...

Hope this helps...

I didn't take any laxatives during the time I had my sitz marker.  If I remember correctly (my last marker study was nearly a year ago), I had 17 markers (out of 24, I believe) just beginning to go into my descending colon on day 5.  Also in the middle of that week, I had a horrible "blowout" of diarrhea.  My surgeon said the same thing to me, there is no question that I had colonic inertia. You would think after a huge blowout, there would be nothing left in there! 

Everything has continued to go well with me, no problems with my gut (or what's left of it!).  I can't believe that it has already been 10 months since my surgery.  Amazing!

Welcome all of the newcomers!

Cathy, I'm glad you continue to be well.

~Somer

Somer-Even though I read all the previous posts, including yours, I can't remember if you had an open or a lap procedure. I'm trying to get some general idea when I can be back at work some with the open, assuming I don't have any complications.

Can everybody give me a summary of whether they had lap vs. open, how many days inpt, and then how many days at home before returning to work??

Isn't it funny how people have such a need to feel in control of life, even though we never are??

Thanks guys.

Cathy-Thanks, that does help. Glad to hear that the incision from the open wasn't a lot worse...that just seems like an awfully long cut to have! And it's also nice to hear that even with all your complications, you still felt ok at 6 wks. Did you wear the fashionable hospital gowns the whole time (when you weren't in ICU), or did you wear some of your own stuff while you were there? I'm trying to figure out if I'll need some loose fitting pj's, etc. Also, can you take showers with the incision? Or should I prepare for lots of sponge baths? I'm making sure I've got everything I'll need, and you all are definitely my best source of info. Anything you didn't have that you wish you did?

Thanks.

Amira-Thanks for the info! But between you and me, let's keep the "not needing pj's" thing quiet...as far as my husband knows, I'll be needing new cutsie pj's every day of my recovery!

Oh, and do you consider yourself a "tough gal" that just grits her teeth and moves on in spite of the pain? Because I'm fairly certain I'm a "wimpy gal"...

Lesa- I wore the hospital gowns that were straight from the fashion district in New York. I'd bring your own slippers, tooth brush/paste, soap and shampoo (I didn't like the cheap crap from the hosp.), Charmin and cottonelle wipes (for comfort sake). I brought a pillow too. You can take showers, your doctor will determine when. Plan on 5-6 days barring any complications. Save the new PJ's for when you get home. You'll want loose fitting clothes (I went with the elastic waist pants so that they fit over my pouch), after you get home. Anything that you forget to bring to the hosp., they can get for you. They even got me nail clippers. I have to say that the most important thing that you can bring to the hosp. is a positive attitude, it helps more than anything else.

Hope this helps.
Cathy

Lesa,

I had an open surgery done.  My surgeon told me he wasn't much sold on the laproscopic but if I really wanted it, he would do it.  He said you are under anesthesia for longer with the lap, and would add OR time of 2-3 hours.  My surgery was 3.5 hours long w/ the open.  I was in the hospital for 6 days, I had an ileus (bowels weren't waking up).  I was supposed to have an NG tube (b/c I was vomiting) but the nurses tried 2-3 times to get it in but I couldn't handle it.  I'm a wimp! Even though I knew that was what would make me feel better, I just couldn't keep it in.  I stayed at home for 2 weeks and was back at work the third week and felt just fine, just would get tired easily.  I didn't have staples on the outside, just steri-strips. Just like Emma, I swore that I would not wear a hospital gown while I was there.  I went out and bought lots of cute new pj's to wear and ended up only wearing them the night before I went home.  It was just soooo much easier to manuever around the IV, the pole, the foley with the gown on.  And you know what, no one really pays any attention to you anyway!

As far as pain goes, I'm pretty tough.  I had an epidural for 2-3 days, then I had morphine PCA and IV toradol.  I think I used my PCA about 2 times when I got it.  I mainly used it those times to try and go to sleep. 

~Somer

Post Edited (Somer) : 12/19/2005 11:39:35 AM (GMT-7)

Lesa,

At the begining, they were giving me Astromorph and Fentanyl via epidural.  I remember waking up in recovery itching to high heaven.  I remember crying and yelling (which I NEVER do).  Then they gave me Nubain after the pain meds, which helped with the itching AFTER I had already scratched myself crazy for 1/2 an hour.  I told them why not give them to me at the same time so that I don't have to go through the immense itching before they decide to give me the Nubain.  Gosh! What a good idea?! Turns out that those meds weren't controlling my pain as best they could, so they changed me to Dilaudid for a day or so.  Then they took out the epidural and gave the the morphine pump that I controlled myself.  Then, it was smooth sailing! Like I said before, I think I pushed my button twice only to help me sleep a couple of nights.

~Somer

Post Edited (Somer) : 12/20/2005 7:03:15 AM (GMT-7)