Reconnecting surgery

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Reconnecting surgery

Postby cbownds » Thu Apr 21, 2011 6:38 pm

Hello all!! I'm meeting with my surgeon Wednesday about my reconnective surgery after a temporary ileostomy and I was wondering some good questions to ask. Any help would be nice and greatly appreciated!! Thanks!
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Re: Reconnecting surgery

Postby nicola smith » Thu Apr 21, 2011 7:18 pm

How soon can the reversal be, following the original ileostomy surgery? What are the pros and cons of waiting?
Should I be doing Kegel exercises?
How long will the surgery be? How long will I likely be in the hospital?
Will it be laparoscopic?
What tests are being done before hand e.g. leak test, flex sig, blood work?
How much post op pain to expect, and what will be available for it (especially important if some pain meds make you nauseated...example, me and dilaudid)?
What time of wound - open or closed? What are the pros and cons of each?
What diet to follow and for how long (e.g low residue)?
What about following the MD Anderson program for ileo reversal (involves taking psyllium up to 4 times a day)?
Will home care be available to dress the wound?
What do do about butt burn?
How many BM's to expect and what will they be like?
What are the odds of having a complication like pouchitis (much higher if you have a history of ulcerative colitis)? Should I be taking probiotics as a preventive?

You will get answers to these questions, as well as more questions to ask, both here and on the UOAA temporary ostomies board as well as the jpouch page on the IBD sucks forum.

I had my reversal about 5 weeks ago and it's gone really well.

Hope this helps
UC history
11/09: Dx
02/10: colectomy, temp ileo; pT3N1Mx
10/10: 12 Folfox6
03/11: jpouch
03/10,11,12&13; 06/14: CT NED
04/12: PET/CT NED
03/13: port out
CEA ~3 mnths: 2.9@dx,.9,1.7,1.5,1.1,1.3,.8,.9,.9,1,.9,.8,.8, 1.1,1,1.1,1.3,1.2
nicola smith
 
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Re: Reconnecting surgery

Postby cbownds » Thu Apr 21, 2011 7:29 pm

Wow thanks soo much those are great questions I wouldn't have thought of asking. I'm glad you are doing well and again thanks so much.
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Re: Reconnecting surgery

Postby nicola smith » Fri Apr 22, 2011 8:12 am

a few more questions for ya

- is your surgeon a board certified colo-rectal surgeon
- how many reversal surgeries has he/she performed
- how many reversals are done annually at this hospital
- is there anything abut your body type that would make the surgery more difficult...for example, people carrying more weight around the belly area or with narrow pelvic girdles are more challenging for the surgeon

Good luck
UC history
11/09: Dx
02/10: colectomy, temp ileo; pT3N1Mx
10/10: 12 Folfox6
03/11: jpouch
03/10,11,12&13; 06/14: CT NED
04/12: PET/CT NED
03/13: port out
CEA ~3 mnths: 2.9@dx,.9,1.7,1.5,1.1,1.3,.8,.9,.9,1,.9,.8,.8, 1.1,1,1.1,1.3,1.2
nicola smith
 
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Re: Reconnecting surgery

Postby Surroundedbylove » Fri Apr 22, 2011 8:16 am

My reply is a little off topic but I wanted to make sure you were aware of my "mini-blog" I did here about my experiences after the takedown surgery. I wrote about the foods I tried and what worked and didn't for me. I've heard from many that it is a valuable resource. Here is a link.

viewtopic.php?f=1&t=10327&hilit=takedown+info
Surroundedbylove

Rectal Cancer @ 43, '08
Clinical: T3,N2a,MX (IIIB)
6 wks XELOX & radiation
LAR, colonic j-pouch, & temp ileo '09
Surgical: ypT3,ypN0,ypMX (0 of 20 nodes)
FOLFOX; XELOX
Ileo Takedown '09
SIL Dx 2014 - Rectal T3
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Location: Seattle

Re: Reconnecting surgery

Postby stexcanuck » Fri Apr 22, 2011 9:07 am

Besides the responses above, may want to discuss gas buildup in bowel. You can get this from swallowing too much air, common if you are grunting from pain alot, swallowing saliva, etc. I had a gas blockage that kept the bowels sleepy and that extended my hospital stay about 3 days....
43M
Heart Stents 1/10
dx Rectal CA Stage III B 5/10
LAR/TME 09/10, 27 cm rectum/colon removed, 1/27 nodes +
Ileo reversal w/ straight pipes 12/10
DX Kidney CA 5/11, Partial Lt removal (open surg) 08/11
They keep us patched up and rollin'
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Re: Reconnecting surgery

Postby BrownBagger » Fri Apr 22, 2011 9:20 am

I was in the hospital for 4 days and nights following my reversal, which was routine with no complications. It's all about getting your guts to wake up afterward, and then seeing how well you tolerate food. It's not a very debilitating nor painful surgery and recovery--nothing like the operation that got you there. Sitting around waiting for your guts to gurgle is bor-ing, so bring a laptop, books, movies, etc. to keep from going nuts. The pills ease the pain and cut the bore-dom, but be aware that they tend to slow down the digestive tract, so don't overdo it.

The real challenge is in the first couple of weeks after you get home. You'll want to find a nice, comfortable place within short striking distance of a toilet, because you're going to be making that trip a lot--and on short notice much of the time. It can be painful. Stock up on good toilet paper, Calmoseptine lotion (OTC, but it's what the pros use), Tucks wipes, Percocet or other strong narcotics, Immodium and lots of clean underwear. It sucks, but it gets steadily better.
Eric, 56
Dx: 3/09, Stage 4 RC
Recurrences: (3/lung)
Major Ops: 5
Chemo Rounds (career): 84
Bicycle miles post-dx 10,346
Motto: Live your life like it's going to be a long one, because it just might, and then you'll be glad you did.
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Re: Reconnecting surgery

Postby nicola smith » Fri Apr 22, 2011 10:02 am

Lots of good advice about the post-op experience. My guts took about 2 days to wake up and I was home 3 days post op. My surgery was laparoscopic and I had no pain that couldn't be managed with the odd Tylenol3. I was nauseated for about a day and half immediately post op and threatened with an NG tube - fortunately didn't need it because the guts woke up and the nausea disappeared.

Oh - and a tip about being in the hospital - they can be noisy and lights are always being turned on and off. Take an eye mask and really effective ear plugs. My kindle was a lifesaver.

There's a great vlog resource about j pouch surgery and post-op j pouch life as well - http://ucvlog.com/past-videos/. I found the one on rectal spasms very useful...nasty but as promised they went away after a few weeks though with some they last longer.

I followed all the advice here about stuff to have handy at home. My doctor also gave me a prescription for this compound which I alternated with calmoseptin as needed: Westcort 15 grams, Nystatin oral suspension 20cc, Zinc Oxide 225 grams.

I also treated myself to a thing that replaces the toilet seat with a bidet function - so soothing and worth it for me as I'd always wanted one anyway. http://www.bibidets.com. I also took their battery powered portable purse-sized bidet with me to the hospital and was glad I did. The hospital TP was rough. Take your own!

Because I have a history of ulcerative colitis and because many j pouchers with that history get pouchitis, I also take a strong probiotic - VSL#3 or VSL#3DS daily.

I followed the low residue diet religiously for the first three weeks and introduced changes slowly - I am now back to almost normal. I chew the heck out of everything and am really careful around raw veggies and leafy greens. Here's a link I found helpful. http://www.hamiltonhealthsciences.ca/.../LowResidueDietFoods-trh.pdf

I'm also following the MD Anderson bowel management programhttp://www2.mdanderson.org/app/pe/index.cfm?pageName=opendoc&docid=34

For the first few weeks post op, I tracked the timing, number and consistency of BM's I had and what I ate. Now I don't, as things have settled down to BM's at night, in the morning, and that's just about it.

Hope you have a good experience
UC history
11/09: Dx
02/10: colectomy, temp ileo; pT3N1Mx
10/10: 12 Folfox6
03/11: jpouch
03/10,11,12&13; 06/14: CT NED
04/12: PET/CT NED
03/13: port out
CEA ~3 mnths: 2.9@dx,.9,1.7,1.5,1.1,1.3,.8,.9,.9,1,.9,.8,.8, 1.1,1,1.1,1.3,1.2
nicola smith
 
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Re: Reconnecting surgery

Postby Nickmark59 » Sun Apr 24, 2011 6:45 am

Unfortunately my reversal went bad. take down was routine but i had a lot of pain. was home 3 days after take down when pain significantly increased day after i was home and bowels shut off. they had to reopen and clean incision due to an infection while I was awake in emergency room they gave me Novocaine shots to help ends up I developed air embolism and spent 8 extra days in hospital till bowels started working again . It was miserable.
CRC- IV 7-th yr Survivor -5 rectal tumors 1 bleeding with mets to liver
Rad. 36 treat.
with 6 Chemo 2-Ox.- 4 Fol.
surgery 15 hrs to resect colon and liver- Feb 08
follow up 6 chemo Folfox
www.darkinvestigations.blogspot.com
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Re: Reconnecting surgery

Postby cbownds » Sun Apr 24, 2011 6:16 pm

Wow thank you all so much for your input...it will all be very helpful and I am glad to be armed with questions since my parents are unable to go to the appointment with me and they are always the ones with the good questions. I will definitely check out yalls blogs and am very grateful for all the people here and the good advice you can always be sure to receive. I am sorry for those who have had a hard time with their reversal. I am a bit scared considering the first time they tried to put me together I ended up back in the hospital and had to go to ICU and stay opened for 2 days for cleaning. But like I said I am hoping for a different outcome, I even changed surgeons because I was having too much anxiety about the original one and I knew that that would definitely not help my healing.
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