How long in hospital after surgery?

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mpbser
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Joined: Wed Apr 19, 2017 11:52 am

Re: How long in hospital after surgery?

Postby mpbser » Sun May 21, 2017 9:40 am

CV here again. The creatinine level has dropped and is near to the normal range. Urine looks good. His belly is extremely swollen and his ankles are no longer visible due to the edema. They are talking about discharging him tomorrow. He is concerned that might be too soon. We'll see....
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

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dianetavegia
Posts: 2731
Joined: Sat May 16, 2009 8:47 pm
Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia

Re: How long in hospital after surgery?

Postby dianetavegia » Sun May 21, 2017 12:45 pm

42 hours
Stage III cc surgery 1/7/09. 12 tx FOLFOX
Stage IV PET = 1.5cm liver met. HR 4/11/12

14 years since dx and 11 years post liver resection.
Pronounced CURED and discharged by onc

“O Lord my God, I cried out to You, And You healed me.” Psalms 30:2

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: How long in hospital after surgery?

Postby mpbser » Sun May 21, 2017 1:43 pm

CV again. Is it normal to have so much edema 48 hours after surgery? Husband is bloating up like a balloon, head to toe. I'm starting to get very concerned.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

Beckster
Posts: 438
Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: How long in hospital after surgery?

Postby Beckster » Sun May 21, 2017 1:55 pm

As I stated in an earlier post, I was discharged within 48 hours. He must be doing well for them to consider this. I had the same problem with urine....you are so dehydrated with the preoperative regime and surgery, but after drinking alot of liquid, my levels became normal. Also, they would not let me go home until I had a bowel movement, which I did 30 hours after surgery. My stomach was very swollen from the surgery because they blow you up with gas. It took 2 weeks to start going down to normal.

Hope this helps
Beckster
57/F
DX:(CC) 10/19/16
11/4/16- Lap right hemi(cecum)
CEA- Pre Op (1.9), Pre Chemo (2.5)
Type: Adenocarcinoma
Tumor size:3.5 cm x 2.5 x 0.7 cm
Grade: G3
TNM: T3N0M0/IIA
LN: 0/24
LVI present
Surgical margins: clear
MSS
12/27/2016 - Capeox, anaphylactic
1/2/17 to 6/9/17- Xeloda
6/17,12/17,6/18,12/18,6/19,12/19,12/20,12/21 CT Scan NED :D
CEA- 6/17- 3.6, 9/17- 2.8 12/17-2.8, 3/18-3.1, 6/18-3.0, 9/18 2.8, 12/18 2.5 3/19 3.1 6/19 3.1 9/19 2.6 12/19 2.8 6/20 3.0 12/20 2.7 6/21 2.9,[color=#000000]12/21 2.7[/color]
Clear Colonoscopy 10/17, 11/19,11/21 :D

MissMolly
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Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: How long in hospital after surgery?

Postby MissMolly » Sun May 21, 2017 1:56 pm

CV: With your husband's rocky cardiac findings and invasive testing as an added stress prior t surgery, it certainly is possible that he is suffering from fluid overload from the IV fluid replacements.

Also, has he been receiving any corticosteroids IV? Steroids can compound fluid retention problems.
- Karen -
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: How long in hospital after surgery?

Postby mpbser » Sun May 21, 2017 2:27 pm

MissMolly/Karen "CV: With your husband's rocky cardiac findings and invasive testing as an added stress prior t surgery, it certainly is possible that he is suffering from fluid overload from the IV fluid replacements.
Also, has he been receiving any corticosteroids IV? Steroids can compound fluid retention problems.
- Karen -"

Well, he has not had his Lasix since the night before surgery, per anesthesiologist instruction and the IV fluid drip was only set to 40. Apparently, when he was previously hospitalized it was set to triple that #. I don't believe he has been receiving any corticosteroids IV. When I left the hospital earlier today they were doing a bladder scan. I don't think he has urinated at all since they removed the catheter this morning at around 8am.

I am going to be bringing our home scale back there in a couple of hours. Husband has blown it off, saying he was told it was normal to be filled with gas. However, as in a previous comment, this is systemic edema and I am sure he has gained at least 10 pounds of fluids in the past 36 hours or so.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

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LPL
Posts: 651
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: How long in hospital after surgery?

Postby LPL » Sun May 21, 2017 2:50 pm

Hi CV,
Since it sounded as your husband's surgery was not without some added worries... I find it very odd that they want to send him home so soon!?! Why? Do they need the bed? Or do they think he will feel better at home?
Since you will be the one caring for him at home, it is not without worries (also for you!) if they release him too soon. If I was in your place I would say: NO to sending him home until you felt he 'was back to himself'. My hubby was not bloated when he was discharged 7 days after his surgery.
I hope these worrying symptoms goes away and he will feel better soon! All the best to you and your DH.
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: How long in hospital after surgery?

Postby MissMolly » Sun May 21, 2017 4:45 pm

CV: You are undoubtly knowledgeable in your own right, so it is good that you are being attentive to your husband''s edema and its rowing presence.

As we all know, the nurse to patient staffing ratio is generally higher during the weekend - meaning less direct nursing availability. Dealing with issues that crop up during the weekend is more difficult as nursing resources are less.

It is true that laparoscopic abdominal surgery does lend to a swollen belly post op due to the carbon dioxide used to inflate the abdomen. But what you are describing is systemic edema. That is not a typical consequence.

Possible underlying causes of systemic edema would included:
1. Fluid overload from routine IV infusions. Excess fluids leaking from the vascular system into the soft tissue, fluid gradient causing fluids to seep into extraneous tissue spaces
2. Decreased cardiac output, ventricular inadequacy and/or inadequate ventricular ejection factor
3. Decreased kidney output, varying degree of kidney failure.

Is the character of the edema a pitting edema? Pitting edema is particular in that pressure applied leaves an indwelling pit. The tissue deficit does not bounce back to normal when the pressure is relieved. The edemetous tissue is overly soft and spongy to touch.

You mention that your husband has been off Lasix since the surgery on the advice of the anesthiologist. He made have ordered the Lasix to be held so not to overwhelm the kidneys in the initial post operative period. A call into the anesthesiologist may be in order.

Perphaps it would be prudent to D/C your husband's IV fluids? A temporary hold?

Go over all of the medications that your husband is receiving. Systemic edema can be due to too many medications that the kidneys are not able to filter/detox. Corticosteroids can cause body-wide edema at high dosing.

I hope you can get the attention of a hospitalist on staff today to troubleshoot the growing edema.
- K -
- K -
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: How long in hospital after surgery?

Postby mpbser » Sun May 21, 2017 7:28 pm

Molly/K,

I copied and pasted your comment and emailed it to my husband. He still hasn't been able to pee. I told him that he needs to speak up for himself and not count on the staff to be taking care of this. Thank you and I will keep you all posted.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

tarheelmom
Posts: 168
Joined: Mon Mar 07, 2016 5:55 pm

Re: How long in hospital after surgery?

Postby tarheelmom » Sun May 21, 2017 9:18 pm

I had a hard time peeing after the catheter was removed. I think there was so much swelling that things were squished. I had to contort into different angles just to get a dribble. It may be very different for a man ...
52 y at dx, mom to 4
DX: RC on 2/22/2016
Stage I, T2N0M0, 0/32 LN
23 mm x 7 mm moderately differentiated invasive adenocarcinoma
3 cm from anal verge
4/12/16: ULAR, TME, & temp ileostomy
6/14/16: ileo reversal

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Jacques
Posts: 678
Joined: Sun Dec 28, 2014 10:38 am
Location: Occitanie

Re: How long in hospital after surgery?

Postby Jacques » Sun May 21, 2017 11:31 pm

tarheelmom wrote:I had a hard time peeing after the catheter was removed. I think there was so much swelling that things were squished. I had to contort into different angles just to get a dribble. It may be very different for a man ...

In one of my hospitalizations I think this difficulty was due, in part, to the way the catheter had been removed. I think that the balloon hadn't been entirely deflated before the catheter was pulled out, and this may have caused some sort of bruise that made urinating very difficult and painful for a few days. My doctor prescribed some kind of urinary antibiotic for one week, then after a week I had to go in for a urine test to see if a urinary tract infection had developed. In the mean time I got some relief from bladder-sphincter pain by using paracetamol.

Reference:
http://calder.med.miami.edu/pointis/indwelling.html

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: How long in hospital after surgery?

Postby mpbser » Mon May 22, 2017 5:59 am

Thanks, everyone. He was able to pee last night at around 9pm. I have no idea how much but that's a good sign.

The reason the surgeon said possibly today for discharge is that he had a bowel movement yesterday and the creatinine level had dropped. That was before the urination issue.

I just looked at his labs online and see that his hemoglobin has dropped (it dropped after surgery, went up yesterday, but has dropped again interestingly). They have not yet retested creatinine. I hope they test it today.

Heading back to the hospital.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

TXLiz
Posts: 249
Joined: Thu Sep 22, 2016 3:31 pm

Re: How long in hospital after surgery?

Postby TXLiz » Mon May 22, 2017 11:27 am

I am not extremely knowledgeable but I know my hemoglobin wasn't WNL after surgery; it still isn't after chemo.

It takes time for things to be normal, it's a rotten disease that messes your body up and makes things wonky. Surgery and other health issues add their flavor to the mix.

Hope for the best for your husband. It's scary and day by day is the best way to go. Sometimes docs make their best guess and it's good; or it's not and back to the hospital you must go. Not comforting, sorry.
Vomiting and blockage 9/19/16 46 y F
R hemi colectomy 9/20/16
Stage 3 B CRC, located in cecum
3 out of 16 lymph nodes positive
perineural invasion/lymphovascular invasion
infiltrating, mod differentiated adenocarcinoma with a mucinous component
separate tumor nodules present in pericolonic adipose tissue
MSI-high
Baseline PET scan clear 9/16 CEA 0.5
FOLFOX 10/16- 3/17
April 16th, CT scan clear. CEA 1.1
Lynch "inconclusive"
Colonoscopy 10/5/2017 clear

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: How long in hospital after surgery?

Postby mpbser » Mon May 22, 2017 12:46 pm

CV again. Thanks, TXLiz.

He's back on Lasix and urinating without problems, thankfully. However, still no good bowel movement yet. Mother in law had hiatal hernia surgery a few months ago and they would not let her leave until she had a "good bowel movement." Hubs only had a squirt of diarhhea yesterday morning and the same again this morning. Because of this, he feels that leaving today would be too soon and has communicated that. Since surgeon said it's his (hubby's) call, it looks like discharge will be tomorrow. That is unless he still hasn't had a bowel movement.

We'll see....
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: How long in hospital after surgery?

Postby MissMolly » Mon May 22, 2017 3:47 pm

CV:
That's GREAT news that the Lasix was instrumental in nudging your husband' kidney function and effectively diuresing the fluid overload. He should feel better without the added fluid in his system.

I would not be overly concerned that a "proper" bowel movement is in the waiting. The intestinal tract does not like to be manhandled during surgery and typically is slow to return to normal function.

In addition, as I recall, your husband was instructed to drink protein drinks in the 2-3 days leading up to surgery - replacing solid food. There may not be a lot of fecal mater stored in the upper intestinal tract based on the low residual diet that he was on in the days prior to surgery.

Your husband will feel more confident and stronger with an added day in the hospital. There is nothing wrong with an added day.

It reminds me of days gone by in health care. When I was a newly minted physical therapist, hip replacement patients with Medicare routinely stayed in the hospital for 3 weeks. Lumbar laminextomy patients stayed in the hospital for 2-3 weeks. With daily physical therapy 2 x a day.

But I digress . .

I hope that your husband is feeling more like himself with each passing day, on his way to a gentle recovery.
- Karen -
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.


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