The Colon Club

Hello everyone,

I am really hoping for some insight on what is going on with my Dad (76) post surgery (TEM). He had a low anterior resection due to a stage 1 tumor with no lymph node involvement, and an ileostomy. He was pretty good on the first day- ate a meal the next morning, no pain (epidural). However, he has eaten nothing for almost two days (tiny bites, just a few). He says his reflux will not allow him to eat. They are giving him medication but nothing is helping. He won't even drink the nutritional shakes (don't know why hospitals give these as they are full of corn syrup). They provide food that I have read might not be appropriate to his surgery (grapefruit, juice with pulp, peppery soups, but maybe that is beside the point as he is not eating. He is being hydrated through IV, but has no other nutrition.

Can anyone who has been thorough (or known someone who has) help me to know what to watch out for? I know how important nutrition is to recovery- and recovery is hindered for post operative malnutrition/weigh loss. I'm so worried about this. Could it be a paralytic ileus? My Dad had 5 days of pre operative radiation (5 days) and the surgery took 6 hours (was supposed to be 5, started out as laproscopic and turned into an open surgery) The doctor says he had never seen such extensive radiation damage- sticky tissues etc. I am worried the radiation techs messed up his dosage, my Dad seems very despondent. Also, his voice is very hoarse, could this be caused by tracheal damage?

I thank everyone for any thoughts..

Kirsty5 wrote:Hello everyone,
. . . They provide food that I have read might not be appropriate to his surgery (grapefruit, juice with pulp, peppery soups, but maybe that is beside the point as he is not eating. He is being hydrated through IV, but has no other nutrition.

I thank everyone for any thoughts..

Agree with above statement. grapefruit would not sound good to me either, nor peppery soups.

Try a "low fiber diet" , Look it up on the internet, he should be on this type of diet for a few weeks following his type of surgery.

Also look at the BRAT diet, Bananas, Rice, Applesauce, Toast.

Just curious, if he being treated at a local hospital?

Good luck,

Lee

Kirsty5 wrote:Hello everyone,
Can anyone who has been thorough (or known someone who has) help me to know what to watch out for? I know how important nutrition is to recovery- and recovery is hindered for post operative malnutrition/weigh loss. I'm so worried about this. Could it be a paralytic ileus? My Dad had 5 days of pre operative radiation (5 days) and the surgery took 6 hours (was supposed to be 5, started out as laproscopic and turned into an open surgery) The doctor says he had never seen such extensive radiation damage- sticky tissues etc. I am worried the radiation techs messed up his dosage, my Dad seems very despondent. Also, his voice is very hoarse, could this be caused by tracheal damage?

I thank everyone for any thoughts..

Did he have 5 days or 5 weeks of radiation? I too had a hoarsey voice following my surgery, that is because they put a tube down my throat. Should clear up in a few days. I too was cut open. One thing I am REALLY going to recommend, walk, walk, walk those hospital halls. It really does help with the healing process. FYI, I was not allow to eat or drink anything until I passed my first gas/fart. I had surgery Monday morning, passed gas on Thursday morn, liquid diet that day, Friday morning, soft food, dinner was first real food /meal in almost a week. They kicked me out Friday night after I passed my first BM.

Ask him, what foods sound good to eat? Maybe bring something that he will eat, but do let his doctor know.

I agree, hoarseness is normal when you've been intubated. It will pass in a few days. I think his small appetite is pretty normal at this stage, but the food choices you describe are seemingly not appropriate.

When I had surgery, I wasn't allowed to have anything but ice chips the first day. I overdid it on the ice chips and it made me throw up. The next day, IIRC, I was allowed to drink some broth and actual water. Sometime later, crackers and toast. By day three (I think) I was on the post-abdominal surgery diet: very low fiber, no seeds, very small helpings. A 4 oz vanilla yogurt for breakfast, for example, not strawberry. For lunch, 4 oz strained soup, or a little cup of applesauce, plus half a very small, plain turkey sandwich. At most. What they are giving him sounds bizarre. I was still eating the very small portions of limited foods when I left, and continued to do so at home for a while. I was also able to ask for antacids if necessary, because I had some heartburn.

Can't he pick out his own food from a menu that indicates acceptable choices for various diets? What kind of a hospital is he in, anyway?

Thank you for all the great replies! Sorry for the late response, juggling lots of hospital time and kid's stuff.

We are at St. Paul's hospital in Vancouver BC, which is the place to go in western Canada, apparently. All that everyone said regarding their diets post surgery was very interesting! Yes, I had read about post ileostomy diets and was aware of what a typical post surgical diet was. That was why I was surprised that the morning after surgery he was eating a peanut butter and jam sandwich..! Things like turkey cranberry meatloaf (whole cranberries) and the aforementioned grapefruit kind of shocked me too. No applesauce in sight, occasional mashed potato. I thought maybe this was a newly progressive diet based on some new research..? So strange. He is eating better now, things like hard boiled eggs, cooked carrots, enthusiastic about certain things (cheesecake!) Also, he has been leaking a lot, we've tried a couple of different bags, but every time I go in there seems to be a leak, and he doesn't even notice! He switched to a one piece bag as the tabbed closure was easier than the velcro as he has neuropathy in his hands and had trouble with the velcro.

His energy improved after he got a blood transfusion, his hemoglobin was down to 60. He has also been walking, though he is deeply opposed to a walker. Thank you everyone.

I didn’t have an appetitie for 6 weeks after surgery. I would eat very little lost 28 pounds. Was told by surgeon it happens. Now all I want to do is eat. This possibly could be your dad’s problem. I liked the ice cream and pudding. Maybe try some sweets. Good Luck

I had leaks until I was fitted right. I have luck with a one piece coloplast and small ring on top of flange. I also use the powder and prep packet plus I hold a heating pad so it seals well. Until your dad gets fitted right he will have leaks. I have an inverted stoma and use a Light convex bag by coloplast. I had several fit me wrong until I went to the clinic and found an expert.

Hello,

My surgery was in 2009 but I can still remember that I was unable to eat much post surgery. I was on clear fluids initially and then a soft diet before moving to a regular diet. I love my food but I was unable to eat more than a few mouthfuls. I don't know why but I just felt full. It was quite strange but within a few weeks I was able to eat normally again. Your dad has had a major surgery of his abdomen so just be patient and give him time to return to normal. I lost a lot of weight but gradually I put weight on and returned to normal. Nutritious soups might be good for him but if he can only tolerate a small amount (a few mouthfuls) don't be alarmed, it's normal. Small amounts often might be good for now. Best wishes.

Thanks Michelle, good to know.

I think it is odd that the surgeons adopt an 'eat anything' approach, while the stoma nurses suggest avoiding certain foods. I asked one of the assisting surgeons directly about the citrus, cranberries etc. and she explained that this was the new way and had been found to assist healing more that the old restrictive way of eating..?

Gloriamazz,

So interested in your use of the heating pad! I wonder if you use this with the spray as well as the putty?

Thank you!

Kristy:
I have a permanent ileosotmy and pop in from time to time to offer advice on ostomies.

My own opinion is that it is wise to be cautious with some particular foods with a loop or end ileostomy. The diameter of the working stoma is small, about 1”, and is anchored in place with stitches. This limits the expandability of the stoma if digested food material should form a sizeable “clump” or bolus as it tries to exit the stoma.

Foods to consume with a degree of caution:
A. Citrus fruits. It is the fibrous membrane coverings that can wreck havoc as the membrane material can bind together in the digestive tract. It is best to section away the fibrous membranes that section oranges and grapefruits, for example.
B. Foods high in insoluble fiber. Insoluble fiber is the fiber that is not easily broken down by chewing nor by the action of digestive enzymes. Foods to avoid or to eat in only a small quantity would include pineapple, celery, mushrooms, pop corn/pop corn husks, asparagus, kale, edamemte, coconut.

The wafer of an ostomy pouching system adheres/bonds to the skin through a heat-activate reaction between the composite of a wafer and the skin. Body heat is the mechanism that bonds a wafer to the skin (wafers are a composite of pectin, elastic polymers, and a hydrocolloid matrix).

Pre-heating a wafer using a hand-held hairdryer or heating pad is a good way to enhance the adhesion of a wafer to the skin. Likewise, a heating pad can be used after application of the wafer to the skin to enhance or secure the adhesion/bond.

There are oodles and oodles of ostomy products to choose from. It your father is bothered by continued leaks, it can be helpful to have a 1:1 consultation with an ostomy nurse to pursue different manufacturer products. Finding the best ostomy pouching system for any one person is an individual process of requesting samples and trial and error. It is well worth the time andeffort. Finding the optimal ostomy pouching system provides psychological peace of mind and minimizes the occurrence of leaks and distress.

Feel free to visit the United Ostomy Association of America website. The UOAA offers a wide range of informative PDFs on ostomy care and living with an ostomy, as well as contact information for each of the product manufacturers to request samples.
http://www.uoaa.org

The UOAA forum has one member who is an occupational therapist by profession (online name OTDave). He often offers advice to people who have hand dexterity issues or rheumatoid arthritis that affects the fingers/hand.

Best wishes to your father in his healing and recovery,
Karen