Colon resection this friday...questions

[KimT]

Hello again! I have some more questions. I appreciate all the help I've gotten in my previous posts. Just a quick update. I did go to OSU and meet with a Dr Martin and I am pleased with him. I am enrolled in a study using some sort of ultrasound probe during surgery.

I am scheduled for my right hemicolectomy on friday. Thankfully they will be able to do it laparascopically which is a much shorter recovery as I understand. What I want to know is what to expect after surgery and just hear how some other people did. I am told I will be in the hospital 5 days. I will have an ng tube for two days and I will be up and walking the day after surgery. Was it very painful? Will my bowel habits change? How long will it take to be fully up and running? I intend to fly back to thailand and do chemo there if needed. It's a 24 hour journey to my house in thailand and I wonder how soon I will be up to the trip home.

The other question is related to my fears. I have amazing support from my friends and family but none of them can truly walk this walk with me and understand what I am going through. My PET scan on thursday revealed a second larger tumor. I asked why my GI doc wouldn't have seen it during the colonoscopy. The surgeon said most likely she stopped advancing the scope after the first tumor and just biopsied it. He said once they find cancer, they don't keep looking for more. It is below the first one in the ascending colon so it doesn't change my surgery anyway as it is in the part that was going to be removed anyway. The surgeon has told me it doesn't necessarily mean it is spreading, that it is quite possibly a second site of the primary cancer. Liver and lungs were clean. But I feel that the chances that this isn't in the nodes is slipping away and I am discouraged. 85% of the time I am confidant and I know I will beat this but there are times when I think we've heard the worst of it and then this comes up that I feel I've been kicked in the gut.


y words of wisdom would be appreciaed.

[SkiFletch]

Hey there Kim, I too had a lap assisted right hemi colectomy. It's not a walk in the park for sure, but it is much easier than a full abdominal incision recovery wise. 5 days is about right on the timeframe for the average patient. I was only in 3, but I'm told I was pretty rare. As for pain, it hurts, A LOT. If I had to do it all again, I would have asked for a PCA pump or an epidural to deal with the pain. They just gave me IV dilauded sparingly and it was not enough. So if you're in pain, demand more pain meds. Tell the nursing staff and their worrying about drugs causing constipation to go pee up a tree and get the pain under control . Not everyone gets an NG tube, it depends on how conservative your surgeon/hospital is. They'll leave it in until they're confident you're having good bowel sounds, then give you clear liquids, then regular liquids, then soft foods, and then send you home provided you tolerate each step well. And yes, you will be able to walk after the surgery. Fun it will not be, but it's necessary .

As for involvement, lots of folks do just fine with lymph node involvement. Surgery is extremely effective, and coupled with adjuvant chemotherapy, more folks live reccurence free lives than dont even with lymph node involvement. What's important is that it isn't in your liver/lungs. You should be really excited about that .

If I may offer a couple other pieces of advice for the hosptial stay. Bring an ipod/cd player/laptop/etc with headphones in case you have a nutjob of a roommate . And bring some gum and chew it a lot after surgery. It helps get peristalsis going, which gets bowel sounds going, which gets the ng tube out faster and gets you eating real food faster

Good luck and le us know how the surgery goes. You're gonna do just fine and we're here to support you.

[Bev G]

Hello Kim: I had my lap colon resection in mid-December. It could be that I just don't remember things too well, but I don't think it was too bad. I was in ICU for the first 2 days (ICU nursing screw-up: they unilaterally decided I had type II, not type I diabetes and turned my insulin drip off, when they got around to checking my glucose about 12 hours later it was over 600- without insulin I had some ketoacidosis and it cost me some time in ICU---this is why I like to stay out of the hospital ) Anyhoo, I have absolutely no recollection of the first 2 days post-op, so I might have missed something else noteworthy, like a lot of pain, but I don't thin it was uncontrollable. When I "came to" in the regular room I remember having pain that was well-controlled with the PCA pump, although apparently I didn't "get it" all that well. They would say "how's your pain", I would say 10, they'd asked if I'd pushed my button, and I'd say what button? Over and over--so I don't know how bad it could have been???? My son said I would sit in the chair nodding out from the morphine, but whenever an ad came on TV with music, I would dance in my chair, ad over, I'd immediately de-animate. I do love to entertain I came home at 5 days and although I took lots of naps I felt pretty well. Took pain meds a couple of times a day. Tried really hard to eat and drink. I did wind up getting really de-hydrated and had to go back to the hospital after about 10 days. Don't forget to splint your abdomen when you cough or sneeze. I can't imagine that it would be a great idea to go on a really long flight soon after your surgery--how soon were you thinking of going? Best of luck on your surgery and recovery. I bet it will go better than you're imagining. All the best, Bev

[wwroam]

I had open chest surgery (37cm incision)on 25th June 2007 ( a Monday). I was up walking on the Tuesday and lost the morphine drip, drains etc on the Thursday morning. I was discharged the following Monday after removal of half the staples. Slept most of the Monday and Tuesday but on the Wednesday felt really well. I got bored and went into the office abou 10 am , stayed until 2.30pm. The next day the rest of the staples were removed. I continued this pattern for a week and gradually lengthened my day. I had an appointment with the surgeon 4 weeks from the surgery. At this point he did a sigmoidoscopy , general examination, discussed the path report and gave me a referral to an oncologist. Prior to chemo my centre ran a chemo awareness group. It was my first opportunity to discuss things with other patients. Lap patients seemed to be discharged at 3-5 days. Most colon patients seem to start chemo up to 6 weeks from surgery. Provided there are no complications, I feel that a flight is possible at the 5 week mark.

[KimT]

Thanks for the personal experiences. It helps to hear that others have made it through okay. I hope to fly home a month after surgery. My husband's company is paying for first class tickets so hopefully it will be tolerable for me. The seats turn into beds so to speak so I can lay down and rest. I can and will stay here if necessary but after a month we will have to make some decisions about what to do with my son if I do not go back. My husband will have to go back to work and my son needs to get back in school. I don't want to send him to school here because what he is doing in thailand is two grades ahead of the american system. I do have a full time maid/nanny that loves him like her own but it will kill me to be seperated from him.

I will be very vocal about my pain control. It is part of the reason I decided to come home for the surgery. In thailand there are few narcotics. Tylenol with codeine and IV morphine. That's it. I had a minor surgery done there and it was terrible. When I came out of recovery, I was crying in pain and they brought me two tylenol. I freaked and demanded morphine.

I'm just ready to get it done and over with. I am so exhausted all the time and I know I can't even start to get better until we get the ball rolling with treatment.

[beatcc4ever]

Hi Kim,

My mom had right hemicolectomy surgery. It was done laproscopically and things went very well. It took about four hours as her tumor was larger than the surgeon had expected; it was 4 cm. Her surgery was on Monday afternoon and she was up walking with assistance by Tuesday. Her biggest problem was that she was starving and was dizzy and faint from hunger so she really couldn't walk as much as the doctor would have liked. She started on a liquid diet Tuesday and by the evening was feeling fine. She asked that they stop her morphine drip. By Wednesday morning she was given some solid foods and was discharged on Thursday as she had had several bowel movements. I know that the biggest thing was making sure she walked as much as she could, so we had her up and about for five to 10 minutes every hour. Good luck with the surgery.

[SkiFletch]

Oh yeah, forgot to mention, flying at 4 weeks should be fine . Heck, I was going to hockey games at 2 weeks and back to work at 3. By 4, I felt almost normal

[wwroam]

First class puts a slightly different spin on it.
Personally, I would be uneasy about chemo in Thailand. Singapore sounds a much better option to me. They have a developing medical industry and are actively pursuing this market.

[dianetavegia]

Kim, I had lap surgery at age 58. I ate a regular meal 18 hours after surgery and walked many times that day. My IV was removed about 15 hours after surgery and I took NO pain meds after that. I was discharged from the hospital after 42 hours and went to Walmart that night.

We're all very different. I wish you well and hope you are back home soon.

Diane

[KimT]

I have not researched fully the chemo options in thailand. Bangkok has a certain first class hospital that is well renowned throughout south east asia. Flying to singapore is a possibility though as airfare is very cheap and it's a short flight. I just had really hoped it wouldn't come down to chemo. My aunt had colon cancer as well as my grandfather and both were cured with just surgery. I'm bracing myself for that reality though.

[DianaR]

Hi Kim,

My husband had lap surgery for a tumor at the sigmoid/rectum curve, in December. The only 'pain', other than aches, was right after waking in the recovery room. He only took half doses of pain meds the rest of the time. His surgery was late Thursday, and he was eating soft foods Saturday morning, with normal foods for lunch, and there after. He was discharged that Sunday at noon, and we also stopped at the store on the way home. He was back at work (desk work only) 11 days after surgery, and has been going strong ever since!

The surgeon got all of the visible cancer, and his CEA is low again, but he's having chemo & radiation for 'added insurance', just in case there's any stray cells floating around anywhere. He'll be having his 4th chemo on Tuesday, and so far hasn't had any real issues with it other than the cold sensitivity, a touch of nausea, and fatigue. The fatigue hasn't been great enough to stop any of his activities, he's still working every day, attends all of our church functions, etc. We're praying the radiation, which he starts in a couple of weeks, goes as smoothly.

It's very true that everyone is different, and I'll be hoping your's goes as smoothly as my husband's has.
Diana

[garbovatwin]

Best of luck with your surgery.

Bring lots of chewing gum as it does indeed the the bowels woke up quicker and will get that NG tube out faster, something you will want to get out faster for sure.

Don't overdo it but walk early and often.

Bring a comfy pair of walking slippers and robe.

Good luck!

[Ivona]

Hi Kim,

Interesting point about the colonoscopy. The doc who did mine went the entire colon length PLUS a few cm's into the small intestine...I was told this is pretty much standard.

I had lap surgery also. I had an epidural which worked great, and a morphine pump. The morphine made me very neauseous and I didn't like it at all. I also had a wingnut roommate

I did NOT have an ng tube..so I'm not sure how common that is. I didn't start eating solids until the day before I was scheduled to go home. I went home one day early due to good behaviour..... About 6 weeks later I was sittin' on a beach, wearing a bikini, drinking rum punches! You'll do just fine!

[Terry]

Ask your nurses about the gum. I was an RN on a floor where I had these types of patients and would have said a big NO to gum until the tube comes out. First of all what if you swallow it and it sticks to your tube. The tube comes out through the nose. What a mess. Second of all if we wanted your peristalsis to return that quick, we'd feed you sooner. We want it to be a gradual thing. I did however (all of did it was in the standing orders) allow our patients to have ice chips for the first 8 hours I believe. Just do what they tell you, there's a reason for it all. You certainly don't want any complications.

My patients that were in really good shape and tough as nails were out in 4 days, others that had more pain and it took longer to get them to regular food it might be 6 days or even longer depending on the problem. That's why I say do what they tell you. The best advice I can give you as a nurse caring for patients that had these surgeries is walk as often as you feel up to it. That's the fastest way to wake everything up.

Good luck and God Bless!
Terry

[KimT]

Thanks Terry. I have braces so I wouldn't be chewing gum anyway. And I am a nurse too so I do understand the importance of walking in recovery. I am going to try my best to be a good patient. Although I am a nurse, abdominal surgery is not my specialty. I spoke with the surgeon's nurse today so I have a better idea of what to expect. I am going to be a later case in the day so they won't get me out of the bed until the next morning. She said the NG would stay in until the second day post op and the foley would come out that day too. I'm not sure exactly how fast they will feed me but I will do whatever they tell me. I want to get better so I will defer to those that know more than me on the matter.