My LAR experience

[CatherineG inAF]

I had one cancerous polyp in the rectum removed and when biopsied, the margins weren't clean.
Fast forward two months later, and I was a patient at Univ of Wa Med center having a Lower Anterior Resection (LAR).

I hadn't been in the hospital before except to give birth. I didn't have an epidural then. The doctors told that I would have the epidural placed before I had surgery to make sure everything was okay and it would be delivering the pain meds while I was in recovery. I was really nervous about it.

The surgery took nine hours. Two of those hours had something to do with getting the anesthesia tube placed or working. I'm still not sure what the problem was and I have forgot to ask the surgeon what the problem was. I had the surgery done laparoscopic but have a 6 inch incision near my pubic hair line.

I woke up in recovery and the pain meds were already working. I told the nursing staff two jokes. (I like puns and I have two favorites- so this doesn't surprise me.)

After I got up into my room, my pain was very limited. They asked me the typical pain question. "Rate your pain on the scale of 1 to 10." The most was a two. I rarely pushed the button for more medicine because I thought if was something that I wouldn't take an aspirin for, why push the hand held button for more medicine. I credit my lack of pain to the epidural delivering the right amount of medicine. The pain management folks were spectacular at knowing the right dose and the timing for the epidural.

They say to start walking. They wanted me to walk 16 laps the first day. Within 24 hours, I walked 43 laps. If I couldn't sleep, my IV pole and I went for a walk. This usually tired me out and i could sleep afterwards.

The 2nd day in the surgery ward they lowered the rate of the epidural drip and gave me a different narcotic to take for pain. It caused me to be dizzy, blood pressure shot up and pulse rate increased. I felt worse on the 3rd day than any other day. I started refusing the narcotic and I asked for Tylenol instead. Pain management was fine using Tylenol and I didn't have the dizziness that I felt with the narcotic.

I was released on the fourth day. As everyone says, each day gets better. I'm not back to work yet and I don't plan on going back for a couple more weeks. My energy level is increasing each day. The only downside is that I am still learning the new bathroom routine. I take a stool softener twice a day need a stronger laxative every two to three days. I am still making many trips to the restroom. I am looking forward to my bowels learning how to function without the 8 inches of rectum/colon removed.

I hope my story helps someone else know that this surgery can be managed very successfully with pain meds.

My lab results were very good. I won't be needing chemo or radiation. I'll be back in a year for another colonoscopy.

I appreciate this board so much because I went here when first diagnosed and learned so much from all of you. You encouraged me and calmed me down when I had no idea what I was facing.

[nkoske]

Sounds like everything is going well congrats

I had the surgery done laparoscopic but have a 6 inch incision near my pubic hair line.

I pretty sure this is standard. Laparoscopic ports are between 1/2" -1", so there's no way they'd be able to pass the resection through them. So they need to make a bigger incision to get it out. The also have some stapler bits they need to pass into the abdomen for the anastomosis (coupling) of the colon, that would not fit through a laparoscopic port.

[tarheelmom]

So happy you had as good a surgical experience as possible.

My ULAR was all laparoscopic. My surgeon talked to me about the possibility of having to make a bikini incision or do the surgery open. It all depended on his real time assessment of the situation. However, he was confident that he could get everything out through the lap ports, and he did. Of course he wasn't able to make a J-pouch or use staples for the anastomosis, but post surgery he explained all the issues (with lots of drawings) and why he had to change direction midway through the surgery. I'm glad he had some backup plans to his main plan.

Also, good luck with your bowels. That's been the most challenging thing for me.

[DarknessEmbraced]

I'm glad that your surgery went so well and that your recovery is going well too! Thanks for sharing your story!

[Pita]

Glad your surgery went well.
I had mine on the 19th, lasted 4 hours, all was successful and no ostomy bag needed, 2 nites in hospital. As far as pain goes, I'm still on pain meds, pain comes and goes at a 6-8, mostly my arthritis in hips acting up but getting better everyday.

[Jacques]

Sounds like everything is going well congrats

I had the surgery done laparoscopic but have a 6 inch incision near my pubic hair line.

I pretty sure this is standard. Laparoscopic ports are between 1/2" -1", so there's no way they'd be able to pass the resection through them. So they need to make a bigger incision to get it out. The also have some stapler bits they need to pass into the abdomen for the anastomosis (coupling) of the colon, that would not fit through a laparoscopic port.

Nick: Thanks for the clarification. For the past couple of years I have always been wondering how they ever managed to get your big tumor out through those tiny laparoscopic ports!

[Rob in PA]

Very informative post, thank you. Best to you during recovery.
Rob