Nervous about a reversal

I had my reversal on June 20th. I am getting better every day but I still have bad days. I had major complications with my temp ileostomy so I was in more pain than I woulld have been if it just was the reversal. I had an abscess they had to remove and all of my abdominall wall had to be scraped due to the infection. They took a little more of both intestines out as well. In addition I had quite a few adhesions. I advise you that if they offer you an epidural for pain take it. I have a very high tolerance for pain and I was asking to be killed in the recovery room since the other pain meds weren't doing anything. They tried dilauded, toradol, ketamine, morphine, iv fentanyl (even with my fentanyl patch), and I think theu tried others as well and eventually placed the epidural.

The 1 bad thing about the epidural for me was that on mu right side from the mid torso to my knee was numb. The first time they had me get up and sit in a chair I walked with the help of 1 nurse. I sat for about 2 hours and was pressing the nurse button for about 30 minutes. when my nurse came in since in my chart it said minimal help needed she came alone. Needless to say I was unable to walk I was looking down at my right foot trying to get it flat on the ground and move it but it wasnt happening. Luckily my husband and mother were there to catch me since the nurse couldnt handle me alone (I weigh about 105 lbs). After this my surgeon made it clear that I was not to get up except if I needed to use the commode and I felt as though I was ok to get there. Once the epidural was pulled within a couple hours all of the feeling came back. At this time they were using dilauded in the pca to help with pain towards the end of the epi prior to the dilauded I had continuous drip of the epi and the button also was for the epi.

On 2-11 I was admitted to the hospital, I have had Crohn's disease for 20 yrs. This was going to be my 1st CD related surgery. 2-12 I had a resection, they took my appendix, they removed a fistula that I didn't know I had and was doing well for a cpl days then I was not passing stool and my dr knew there was a lot in there. Even with aid of enemas there was nothing. On 2-19 I went back under the knife. The drained 500cc of abscess fluid, and found the the first 1/3 of my colon didnt wake up and was causing toxic megacolon this is when I got my temp ostomy. When residents would come if I was concerned over things it just made a bigger mess. One resident got feces in my incision andafter asking her about flushing it she said no it will be fine. The following day same residednt, I was getting the feeling that my wafer was going to fall off she said no it looks fine, I went for my CT scan and when I returned I had to urinate so as I sat on my comode the wafer totally let go. In addition I had abscesses and when I was on the wound vac that helped to suck it out a little but they had a tough time placing a drain due to that.

I still feel crummy but like I said I had more procedures done than most. To this day I am still having diarrhea from the surgery. I am told it can take at least 6 weeks to get back to normal bowel habits.

Good Luck
Stef

The first time I had a BM post op was in my sleep at the hospital. When I had the urge I had to run. about a week ago I had the urge to go but my husband was in the bathroom, needless to say all the clenching of my butt didnt hold all of it in. That part is getting better. I have had a more recent issue with gas, I have lots but when I pass it more than air comes out. Also 2 days ago I was waking every hour after my husband left for work. I had the feeling that I had to go but even with the pushing nothing came out. (Even though I have to push it is mostly liquid) I awoke a bit later to find that nothing besides depends would have helped that mess. It went all the way through my underwear, my pj pants, my sheet and onto my mattress. The spray "shout" for laundry luckily got it out as for the odor (I work for a veterinarian) I used "Anti-Icky-Poo". This is great for animal stains and more ...on the bottle it says that it even rids dead body smells, I would have hated to test that out.

The PCA that I spoke of is a pain pump like you mentioned with the button to push every so often (minutes depend on the drug). Prior to my surgeries in February I was 119 pounds (and was still on prednisone) I went up to 140 due to an increase of pred IV and all the fluids they gave me. Prior to my resection I was back down to 108 (On average I weigh between 103 and 108). Again in the hospital due to pred and fluids my weight went up but not nearly as severe before I was using a walker (after the ostomy Sx) to help me get around and both of my feet had to stay outside of thebars on the walker due to the swelling.

I have horrible veins and they usually end up placing a central line or a picc line in me. The central line I usually have is one placed in the chest not far from the collar bone, however I asked them to place it while I was under anesthesia and awoke with the central line in my jugular vein in my neck. I was told after the fact that they cannot place it in the chest while under due to it possibly puncturing the lungs. The great thing about these lines is that they have 3 ports so it was like 3 iv lines hooked up. My blood was drawn from them instead of having to get punctured daily by the nurses. One of the lines can be used for TPN (liquid nutrition that I had 20 yrs ago and again back in February) This time they used one for blood, one for pain meds/iv fluids and the other for iv AB's. These ports are also great since they can last a lot longer than the common ones that are placed in the arms. There is no need to change the IV every 3 days I went 9 days with that one in they make more permanent ones as well but those are more for severe cases of nutritional need etc I had that type 20 yrs ago as well.

I have had so many blood transfusions in my day it is nothing to me. I had 2 pints 20 yrs ago, then 5 bags of plasma in 99, I also had 2 pints back in Feb. They thought this time around that I may need some but my bloodwork was borderline so I went without it.

If you do need nutrition definitly ask about a "triple lumen central line" Definitly better than a hose down your nose which can be done as well, I remeber 20 yrs ago when i was having my 1st CD flare the Dr told me I had to have 2 ensure plus drinks a day and 3 meals or I would be inserting a tube in my nose and down to my stomach every night to get nutrients. I am glad during my ostomy Sx that the NG tube went in while I was under kinda was uncomfortable when pulled though. For a central line if placed when you are awake is done with a local I am unsure what "caine" drug they used but that injection was the worst part of it sort of like novacaine at the dentist.

As for pain meds I am resistant to many of them due to having Crohn's Disease for 20 yrs. The dilauded that you can get IV or oral is about 7 times stronger than morphine, some research says 5 times others say 10 times stronger. The otherone I am on is the Fentanyl patch this is even stronger than dilauded. They use it to induce before Sx by means of IV they make the transdermal patches as well which range from 25mcg/h to 100mcg/h there are also 50 and 75. I am on the 75. You change the patch every 3 days. They tried me on Oxycontin both after my ostomy and after my resection. I was finding whole pills of it (print on the pills still legible) in my bag. This time they were coming out in the toilet and you cannot crush them or split them that can cause bad things so the 12 hour releaes thing wasnt working for me.

My surgeon obviosly stopped the imodum after the reversal. I currently take 1 metamucil capsule at bedtime but it may increase since I am still having D. Like I said though my reversal was not the "typical" surgery. The Dr did go back in the same areas as before just made the incision longer. I had 16 staples and 7 nylon sutures at the incision site and 5 staples where the stoma was.

Sorry for the novel feel free to e-mail me as well if you have any more questions and I will do my best to answer them.

Stef