just had surgery - questions

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just had surgery - questions

Postby mct » Sat Mar 18, 2017 12:08 pm

HI all
I had surgery yesterday for RC. The surgeon had predicted an over 80% chance of having a stoma. However he said the re-attachment looked so perfect he didn't think it was warranted. So I'm super happy that I don't have an ostomy bag. But now starting to feel some anxiety creeping in about what that first bowel movement will be like and worried about a leak. I have no reason to think anything will go wrong, just hard not to worry. Also good news is that the chemo/rads shrunk the tumour to the size of a pea!

For those of you that did not need an ileostomy, what was your experience like post surgery? Thanks in advance for your insight.

Diagnosed rectal cancer Nov 2016, T3N0M0
28 days rads/Xeloda - finished Jan 19 2017
Surgery mid Mar 2017

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Re: just had surgery - questions

Postby Jacques » Sun Mar 19, 2017 5:33 am

If you just had surgery, then you must be in the one-month rest period between surgery and the beginning of adjuvant chemotherapy. You didn't mention it, but I assume that you will be continuing on with adjuvant chemotherapy in a month or so.

I had an ileostomy, so I cannot answer your main question about post-surgery experience without an ostomy bag. However, I have my own opinions, based mainly on what I would call common sense.

What I would say is that in the next few months you would need to make sure that you do not eat anything that is going to get stuck in the newly formed anastomosis junction or that would cause that part of the neo-rectum to expand too much. One of the cautions I think, would be to always eat several small meals instead of one large one. If you eat a large meal, it is likely to eventually end up transiting through your neo-rectum as a large mass of stool that may cause too much pressure on the new junction. Also, I think that you should probably avoid high residue foods with big chunks, such as trail mix snacks, muesli, pineapple chunks, etc. Whatever you eat, you should be sure to chew it very, very well so that it doesn't end up being an undigested mass. Also, I think that it would be a good idea to try to avoid foods that cause a lot of gas, since if a big volume of gas ends up in the neo-rectum area near the anastomosis junction then it might put too much pressure on the junction. Of course, you should also avoid foods that are known to cause constipation, since a large, constipating stool passing through the neo-rectum junction would probably put excessive pressure on the junction.

These are just a few suggestions off the top of my head, As I said above, these suggestions are not based on actual experience similar to yours. They are based on some of the things I went through after my ileostomy reversal, when I had to manage what went through the newly patched-up part of my rectum.

Another point: Now that you have completed the surgery, you should get a written copy of the pathology report from your surgery and discuss it with your doctor. There will be many new medical terms to learn, but most of them are very important in determining your risk level for possible future recurrences. The pathology report is what the doctors look at very closely when they are trying to determine the best regimen to use for mop-up adjuvant therapy. You should ask your oncologist what regimen they have planned for you. If it is either Folfox of Xelox, then it would contain oxaliplatin. In that case you might want to discuss methods of reducing the oxaliplatin dose or doing an oxaliplatin desensitization protocol, because the side effects of oxaliplatin can be rather bothersome.
DX(2012): RC
Stage II, T4 N0 M0 L0 PN1 H0 D0 P0 I1
MSI: not tested
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0

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Re: just had surgery - questions

Postby ColleenC » Tue Mar 21, 2017 6:39 pm

Hi Mich,

I had a Lower Anterior Resection four months ago for rectal cancer. I did short term radiation pre op as well. My surgeon thought I would need a bag but I ended up in the same situation as you. He determined that I did not need a bag. I remember being so scared about my first bowel movement. It started off slow though and I had a few little stools each day starting about 2 weeks after surgery. It is now slowly getting more and more. I can't say that it was easy. Figuring out your diet and what you can and can't eat is really important. It takes time and I am no where close to figuring it all out. It is scary and if I could give you any advise it is to stick to the diet your surgeon has suggested for at least the first month. My diet had very restricted fibre and I did not think it made sense. After a few weeks I added fibre too quickly and it caused some other issues. I learned my lesson. :) Your bowel movements will start and it probably will not be as scary as you think it will be. As my surgeon keeps telling me we have to figure out what our new normal is.

Good luck with your recovery,
Rectal Cancer Diagnosed Sept 2016
Pre op Short Term Radiation November 2016
LAR November 2016

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Re: just had surgery - questions

Postby Need2talk » Tue Mar 21, 2017 7:24 pm

I had lower resection. I did receive a list of things not to eat and I made sure I did not have a lot of fiber in the beginning as he instantly came out and was not pleasant but everything did work of. I remember random pains and it was hard to figure anything out bc there was no schedule. But it did get better

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