HELP!!!!!!!!! PRE SURGERY QUESTIONS

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Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby Eleda » Wed Apr 18, 2018 5:06 am

Hi there, ivd been reading through as,many posts as I can but still confused, (and very stressed out this week)-
Surgery in 15 days,, and ive loads of unanswered questions!!!!!! I see my surgeons on fri to go over the procedure (taTME),,,,

Some silly questions answered would put my mind at ease, if u fine people can help

First regarding the Transanal part of surgery????
Do they cut around ur anus, or if the loanstar was used,,, what condition was ur bum in after it????? ( did you have external stitches?????
With a TME did ur complete lymphnode removal cause lymphedema???

Ive no clear margin between the rectal wall and sphincter, bur also apparently it hasn't invaded it either, the line is blured, on every scan mri and ultrasound

Did anyone take a chance at sphincter saving with such close margins????? ( prob won't know till in actually in surgery to know 100%......

Must ask him about a j pouch???? Has,anyone had sucess with straight anastomosis???

Im conflicted because of articles on morphine related metastasis , ie (not showing much in stage 3)
Anyone not take opiates after surgery???? If I refuse opiates, will the pain b horrendous?????

Thanks ADELE
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby NHMike » Wed Apr 18, 2018 12:11 pm

I can't answer regarding your surgery because mine was different but I can answer on the pain medications as to what happened with me.

They give you pain meds during the operation which last for a while after surgery. I was in a clinical trial and don't know whether or not they gave me the painkiller during surgery or the regular stuff. After surgery I had back pain and this was with some painkiller in me still. I solved that with a rolled-up towel - I have an old back injury which can show up if I lie down on a hard, flat surface for a long time, like a surgery table. They offered two OTC painkillers like Tylenol and Ibuprofin and Oxy. I could take one, two or three. I took the Oxy once, didn't like how I felt afterwards and did a bit of the other two. They didn't really help with pain which was caused by the ureter stents and the catheter bag design. Usually the nurse emptying the bag greatly reduced the pain.

I didn't take anything after leaving the hospital. But it varies all over the place. I've read about people that do need the Oxy after surgery when they go home.

Basically, be prepared as you might need it but hope that you don't.

I did a lot of logistics preparation for the surgery including planning out what to take with me, what your companion is going to bring to you after surgery, and getting a lot of cases on how long the hospital stay would be and when I'd be able to work and drive and so on. There's a lot of wisdom on surgery and hospitals around here.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby Eleda » Wed Apr 18, 2018 3:57 pm

Thanks mike, im similar, I don't like ke the stoned feeling of opiates, but dont want to play the mayrter either im just anxious about, the studies ive read, so hoping to stick to (NSAID) if I can
If not ill have to change,,,, morphine makes me nauseous so deffo not going for that,,, ( last thing I need is that after surgery), they have suggested, pethadine ( im not keen) its still an opiate ( synthetic)
THANKS Adele
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby rp1954 » Wed Apr 18, 2018 8:34 pm

The Life Extension surgery article recommends tramadol for cancer surgery. The first surgery at the sigmoid, morphine was used anyway (grrrr). The next day, my wife dumped this huge morphine bag right after her first small IV vitamin C infusion (15 grams C), and they used celebrex post-op. The second surgery we requested tramadol per the Life Extension article for cancer surgery, and whatever they used, they did not use morphine. They used celecoxib (Celebrex) post-op again, and we had privately arranged for IV vitamin C again (e.g. 1+ gram ascorbate/kg per infusion or day, 60 to 75 grams C, each day). Even lower dose IV vitamin C reduces pain and speeds cartilege formation. High dose IV vit C inhibits opiates, toxins, bacteria, viruses and Kras/Braf mutant cells. Celecoxib inhibits some CRC stem cells. Ireland is one of the principal manufacturing sites for injectable vitamin C.

We've had distinct comments from both the radiologist and the colonoscopy about how perfectly fused her anastomosis is, "no line" etc. We partly attribute that to some of the supplements and IV vitamin C, for tissue repair.
Last edited by rp1954 on Thu May 03, 2018 7:59 am, edited 2 times in total.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

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CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby CRguy » Wed Apr 18, 2018 9:05 pm

Eleda wrote: .....so hoping to stick to (NSAID) if I can ....
THANKS Adele

Ask your docs to get a pain specialist on board if needed
make sure they check your kidney function ( which is normally assessed for any / all pre-op patients anyway )
and ask about Toradol which is the " King Kong of all NSAIDs !!! "
few docs use it routinely ... BUTT it is there as an alternate for you if you ask up front and your kidney function is good.

FYI :
I had an open resection TME via LAR and they pulled the morphine drip PCA after 1 day, because I was not using it / needing it.
I had the Toradol after an abscess and draining post operatively.

a note about Tramadol : it is rarely effective by itself for serious pain, so they would add something to it anyway if you are having a rough time.
Often it is used to allow lower doses of opioids to be used, or as a chronic low level pain therapy once the severe pain has ameliorated.
I mention this because while we throw all these names around, sometimes non medical folks get them mixed up so ...
Toradol is one drug and Tramadol is an entirely different ... other one !!!

I've had Toradol as a patient (= I LOVE IT !!! )
I've prescribed Tramadol lots and find it works well for some patients and not so well for others ... JMO.

Cheers and best wishes
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

Caat55
Posts: 694
Joined: Sat Dec 23, 2017 6:01 pm

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby Caat55 » Fri Apr 20, 2018 12:24 am

Elena,
They took button meds away after first day because I didn't use it. I had one oxi but found neurontin to be best and regular Tylenol. Pain isn't awful but there are struggles, getting into and out of bed because of incision. My body felt like I had done extreme yoga, muscles so sore and Burky. Walking is the best thing and sleep. Didn't use anything but Tylenol after I came home except when traveling to see surgeon three hours away,used a neuron tin again.
Do at 55 y.o. Female
Dx 9/26/17 RC Stage 3
Completed 33 rad. tx, xeolda 12/8/17
MRI and PET 1/18 sign. regression
Surgery 1/31/18 Ileostomy, clean margins, no lymph node involved
Port 3/1/2018
Oxaliplatin and Xeloda start 3/22/18
Last Oxaliplatin 7/5/18, 5 rounds
CT NED 9/2018
PET NED 12/18
Clear Colonoscopy 2/19, 5/20

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby Eleda » Sun Apr 22, 2018 1:51 am

Sorry for such a late reply, so busy this,week with pre surgery ( which has now been changed to MAY 10th) clearance and scans etc, plus this is my 3rd attempt on a,reply, as I backspaced twice to use an emoji and lost the whole novel I wrote,,, hence not a,smily face insight for this memo lol

Fristly thanks Rp, im doing weekly infusions of 75g Vit C since my radiation finished in feb
And daily oral 4.5g Curcumin 3g calcium ascorbate and CBD with hight THC
Ive started to try introduce the MCP (with great difficulty) yesterday added it to natural yougart fresh lime and honey (not the worst so far)
And will b adding the Tagamet next week
As for drugs,,, ( isint tramadol an opiate???) Im up for correction, I wish my hospital would allow me bring vit c but the phrase hell would freeze over first comes to mind, so im going to bring my (livon labs) liposomal vitiman c and try take 3/5g a day while in hospital

CRguy im gona ask for that,,, it sounds,like some handsome spanish matador lol so I should remember it prety easy lol

As for surgery, I met my surgeon yesterday, and have decided against the taTME so now ultra low AR some via anal as it will b literally cut to a 1/2cm stump and complete TME, AND HANDSEWN anastomosis

Catt, I read all ur posts and threads as im only trotting behind u and find great comfort in ur recivery and positivity,
Mike in relation to the catheter???? My urethera still stings and a slight pulling sensations constantly, im wondering is it damage from the radiation and is that also why u had discomfort with the bag pre surgery, because I also prety much escaped radiation lightly with little long term side affects

Thanks Adele
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

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O Stoma Mia
Posts: 1709
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby O Stoma Mia » Thu May 03, 2018 3:59 am

Eleda wrote:...
Surgery,, same thing as im due surgery next week....


rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby rp1954 » Thu May 03, 2018 8:25 am

Eleda wrote: As for drugs,,, ( isint tramadol an opiate???) Im up for correction,

You're right. I corrected that, tramadol simply isn't morphine. It promotes Natural Killer cells rather than suppressing them. CR guy's note is interesting too, thanks.

I wish my hospital would allow me bring vit c but the phrase hell would freeze over first comes to mind, so im going to bring my (livon labs) liposomal vitiman c and try take 3/5g a day while in hospital

We brought in 2 liters of low sugar protein shake formulated to replace Ensure with very high strength nutrients including vitamin C, since they allowed home prepared foods. Looked just like a junky chocolate milk shake and the staff felt fine. Our choices were guided by articles on wound healing, cancer and surgical recovery. Careful about taste though, some supplements taste aaaaawful and have to be encapsulated or skipped.

Yes, IV vitamin C is a great pain to arrange in 98+% of the worlds' hospitals, requiring special tactics, considerations, or negotiations. ~11 hr after surgery was the soonest we got in two surgeries. Some surgeons have even used IV vitamin C to quickly abort prolonged post-surgical recovery times and sedation. It also helped us restart the mild immunochemo sooner, 24 hr after the second surgery was quite successful with no complications.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby Eleda » Fri May 04, 2018 3:02 pm

Thanks o stoma,mia,,, I think I pretty much have everything ready now,,, last question,,(,well..... lol for now lol ) ive packed both but nightdress or pyjamas??? After the catheter comes out are,they still checking ur neather regions or not again,,,,

Rp,,, can u tell me did u take yr meds,night before surgery and morning of??? I imagine therir bloodstream absorbed so should b ok????
And can u drink water morning of surgery??? To take meds,and electrolytes???

Ill ask for tramadol and toradol for pain hopefully that will get me by

Do I need panty liners??? Will u b leeking after washout or blededing during/after surgery???
Thanks for ur replies, I know my questions are a bit random lol
Adele x
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby NHMike » Fri May 04, 2018 3:39 pm

Eleda wrote:Thanks o stoma,mia,,, I think I pretty much have everything ready now,,, last question,,(,well..... lol for now lol ) ive packed both but nightdress or pyjamas??? After the catheter comes out are,they still checking ur neather regions or not again,,,,

Rp,,, can u tell me did u take yr meds,night before surgery and morning of??? I imagine therir bloodstream absorbed so should b ok????
And can u drink water morning of surgery??? To take meds,and electrolytes???

Ill ask for tramadol and toradol for pain hopefully that will get me by

Do I need panty liners??? Will u b leeking after washout or blededing during/after surgery???
Thanks for ur replies, I know my questions are a bit random lol
Adele x


They gave me this mesh underwear and something that was not quite a diaper that stuck inside. I wore one of them on the drive home. Hospitals vary of course but it did help. If you do leak, though, it will likely be mucous. Still, it's nice to have something absorb it.

I was at a teaching hospital and they did rounds early in the morning and they checked stuff, at least to the scar and staples.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby Eleda » Fri May 04, 2018 3:45 pm

Thanks mike,, its the ittle things that we don't think of lol, my brain is on overdrive atm!!!! , ill b stitched 2 cm inside anal canal, so thats why im wondering if "everyone and his mother" will have to look there aswell
Thanks x
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

heiders33
Posts: 363
Joined: Sat Nov 04, 2017 11:08 am

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby heiders33 » Fri May 04, 2018 4:07 pm

I was not allowed to eat or drink anything the morning of the surgery, including water.
40 year-old female
May 2017: Dx rectal cancer T3N2M0
MSS, KRAS G12D
6/17: 28 days chemorad
9/17: LAR/loop ileostomy, CAPOX six rounds
3/18: reversal
9/18: liver met, resection/HAI pump, 11 rounds 5FU, 1 round FUDR
11/19 - local recurrence, brachytherapy, 3 weeks targeted radiation
12/21 - end colostomy

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby NHMike » Fri May 04, 2018 4:13 pm

Eleda wrote:Thanks mike,, its the ittle things that we don't think of lol, my brain is on overdrive atm!!!! , ill b stitched 2 cm inside anal canal, so thats why im wondering if "everyone and his mother" will have to look there aswell
Thanks x


If it's a teaching hospital, then you'll have a bunch of interns and a resident checking you daily. I was 5 cm and they didn't check down there.

What you can and cannot eat should be provided you in paper, pamphlets or a booklet. I put everything into Google Calender to remind me of when to do what.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

Eleda
Posts: 328
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: HELP!!!!!!!!! PRE SURGERY QUESTIONS

Postby Eleda » Fri May 04, 2018 4:50 pm

I though as much hidders and mike but was trying to figure out how to take my tabs on the morning,,
Looks like ive to kip them surgery day I suppose :(
Thanks x
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th


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