LAR with permanent colostomy?

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[Ana & Alex]
Posts: 96
Joined: Tue Feb 14, 2017 5:14 pm
Location: Austria

LAR with permanent colostomy?

Postby [Ana & Alex] » Sun Apr 16, 2017 9:35 am

So as recently updated I'm getting ready for my surgery in May and my mind as been busy with all the possible things still left to decide and ask about "the event".

It has however been present in my mind that a good solution for me personally would be to resolve this ocurrence in my life called rectal cancer just with once swift.

I don't like the idea of facing LARS or multiple operations until I have my quality of life back. I also do not like the idea of a surgery where a Surgeon has to worry both about getting cancer AND reconstructing a bowl where there is little or no rectum left.

So, after much though, I am preparing to have a conversation on my next appointment about the possibility of a permanent colostomy and a TEM as treatment plan.
I would really appreciate any opinions or experiences on the topic. I've read many topics on our forum about LARS and Reversals gone good and wrong, but I think I'm needing some personal counselling from you guys ;)

My thinking:

1)I would only have to have one surgery, instead of two or three - so I could expect having my problem solved with just one stay in the hospital (I have a daughter who needs me very much).

2) I would have a colostomy during chemo, which would be better from a nutricional point of view (than an ileostomy - I weigh 50 kg btw).

3) Maintenance of a colostomy is not difficult and is more compatible with better quality of life as that of with LARS (1 or 2 times in the Toilett instead of .... ?).

I must say I have my buttocks injured really bad during radiotherapy, I have had excruciating hemorrhoids and I'm currently 5 to ??? Times at the Toillet everyday. So I'm the perfect candidate for postoperative LARS - although no one can forsee the future.. I would almost bet on it.

That said,
I'm looking forward and thank you in advance for your comments.

A life with a flat belly spent thinking about poo and toilets constantly sounds much worse than an normal healthy life with a bag.

Am I being coward wanting to avoid the possibility of LARS and not even wanting to give it a try?

Anyways...
Stay strong! (And happy easter :) )
Love,

Ana
Dx @ 29 yo. Mum (2 y.o.) & Wife

12/2016: Rectal AdenoCa G2. CEA 4.3. RAS Wild. MSS. IIIB.
01 - 03/2017: 28 RTx + CHT 2,5 g/d Capecit.
03 - 06/2017: Suplemments and Cimetidine.
05/2017: TME/TAMIS + permanent Colostomy CEA 0.5
05/2017: ypT2N2aM0 (4/15), good cCR, limited pCR
06 - 8/2017: 4x CapOx 3,5 g/d (2x Oxi reduced to 80%)
09 -11/2017: 3x Capecit. monotherapy 4g/d
12/2017: Aspirin, Vit. D3, Curcumin, Multivitamin.

[Ana & Alex]
Posts: 96
Joined: Tue Feb 14, 2017 5:14 pm
Location: Austria

Re: LAR with permanent colostomy?

Postby [Ana & Alex] » Sun Apr 16, 2017 12:09 pm

(I've read this recent topic attentively, that was discussed with a many great deal of great information btw:

viewtopic.php?f=1&t=57676#p454442

But still I'm wondering about my one shot permanent solution thing... ).
Dx @ 29 yo. Mum (2 y.o.) & Wife

12/2016: Rectal AdenoCa G2. CEA 4.3. RAS Wild. MSS. IIIB.
01 - 03/2017: 28 RTx + CHT 2,5 g/d Capecit.
03 - 06/2017: Suplemments and Cimetidine.
05/2017: TME/TAMIS + permanent Colostomy CEA 0.5
05/2017: ypT2N2aM0 (4/15), good cCR, limited pCR
06 - 8/2017: 4x CapOx 3,5 g/d (2x Oxi reduced to 80%)
09 -11/2017: 3x Capecit. monotherapy 4g/d
12/2017: Aspirin, Vit. D3, Curcumin, Multivitamin.

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: LAR with permanent colostomy?

Postby Lee » Sun Apr 16, 2017 3:27 pm

Hi Freddie,

Great minds think alike :D . I too went with the permanent colostomy in my surgery & I have no regrets. Due to radiation destroying my rectal muscles, I was tied to the toilet anytime I ate. That permanent colostomy gave me my life back and it does not hold me back.

I remember telling my surgeon she could take all she wanted, just get all the cancer. I believe she succeeded, I was told a few years back that I am "cured" from this cancer.

How old is your daughter? After your 1st surgery day, maybe she could stay with you off and on at the hospital and be your helper. I know with my hernia repair, there was a whole family staying with dad in the next room. Sleeping on the floor and everywhere. Sometimes when kids can be a part of the process, it helps them to better understand what is going on. Butt do check with the hospital first.

So if you are asking me, I would say YES, you are making the right decision :D .

Make sure you see an Ostomy nurse prior to your surgery. Wear clothes you normally wear and the nurse can mark the spot on where your colostomy should be.

Also be sure to bring comfortable walking slippers for walking those halls. And a long bathrobe that wraps around you verse a robe you step into and zip up. Those first few days, you will have lots of IV's hooked up to you with one hospital gown that is open in the back :shock: That wrap around robe will be easy to get in and out off.

Hope this helps, all the best.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 16 years and counting!

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

Re: LAR with permanent colostomy?

Postby CRguy » Sun Apr 16, 2017 3:56 pm

Freddy87 wrote:Am I being coward wanting to avoid the possibility of LARS and not even wanting to give it a try?


Not really for us to decide or judge... only YOU need to be happy with your decision.
IMO .. I give you the same reply as I posted in the topic Re: Reversal or keep ileostomy?

I come at things logically in progressive stages, with medical background and as a survivor/patient
so .....
if the reversal is not working = make a stoma permanent
if it is working = keep it !

If you make it permanent first, then you have basically jumped ahead of other options = not what I would do = not what I did do
and IMO I might think that decision may be a bit shortsighted ... BUTT again I am not you

YOU only need to be yourself, and you are doing the right thing by weighing options and seeking advice
whichever decision you make, own it !
we will all offer support and feedback

Best wishes whatever the outcome

Cheers and Harmony on the Journey
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

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

Re: LAR with permanent colostomy?

Postby MissMolly » Mon Apr 17, 2017 9:37 am

Freddy87 wrote:t has however been present in my mind that a good solution for me personally would be to resolve this ocurrence in my life called rectal cancer just with once swift.


I think you have answered your own question.

Often we need to hear ourselves think through and vocalize a concerning issue to a trusted friend/family member. Other times we find value in writing about a concerning issues, expressing thought process in words and a narrative - much as you have done here with your recent posts.

At the end of the day, it only matters what is right for you and your body and your life's situation.

I am consistent in my personal opinion and experience that living with an ostomy is quite do-able. Pouching options for a colostomy are quite advanced, the composite materials that compose the wafer and pouch are flexible and intimately follow the contours of the body. With a colostomy, you would have the option of using single-use, disposable mini-pouches. No fuss, no mess. A colostomy is far easier to manage than a loop-ileostomy.

I barely notice that I am wearing an ostomy pouch.

Feel free to visit the United Ostomy Association of America (UOAA) and ask any questions that you may have of long-term ostomates.

http://www.uoaa.org

Your body. Your choices.
- 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.

SocalSteve
Posts: 1
Joined: Sun Jan 29, 2017 2:37 pm

Re: LAR with permanent colostomy?

Postby SocalSteve » Mon Apr 17, 2017 5:19 pm

I was also "given" these options of permanent versus reversible later. Ultimately I went with the permanent option for two reasons. The main reason was there's a few % less chance of local reoccurrence with the permanent option due to ability to get larger clean margins, and 2) I was tired of the my social life the past year being governed by how close to the nearest bathroom I was going to be. (My surgeon said he couldn't predict the number of times I'd continue to go per day after a reversal but it was usually 4 and to extreme 20).

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: LAR with permanent colostomy?

Postby Lee » Mon Apr 17, 2017 7:21 pm

SocalSteve wrote: (My surgeon said he couldn't predict the number of times I'd continue to go per day after a reversal but it was usually 4 and to extreme 20).


Same here.

Because my rectal muscles were mostly destroyed due to radiation, they would be removed. They were going to take something from some other part of my body and "train" these muscles to act like rectal muscles. This does not included how much rectum I would lose due to the cancer. Goal was to get to 3 BM daily, butt could be dealing with 10+ on a daily basis. Gee I was already there. Most days I did not eat anything until 3 or 4pm when I knew I was home for the day. Once I ate I was on toilet 3-4 hrs at a time. No way to live your life or raise your kids.

I remember listening to the Ostomy nurse about the bag. And my DH following that meeting, saying the good news, you do have options, but mostly you can get your life back with this bag. I knew I wanted that bag. Told my surgeon and she flat out told me I was making the right and best decision.

At the end of the day, follow your heart. If you have not done so already, talk to your surgeon (make sure s/he is a board certified colon rectal surgeon). And talk to an Ostomy nurse. An informed decision is the best decision.

All the best,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 16 years and counting!

Swirdfish
Posts: 290
Joined: Sun Jun 19, 2016 3:57 am

Re: LAR with permanent colostomy?

Postby Swirdfish » Tue Apr 18, 2017 6:10 am

Hi Freddy,

You read my post the other day regarding my reversal. Things have gotten easier I haven't had a bowel movement in like 24 hrs and I'm kinda thinking their maybe something wrong but I feel fine. I had my bag since the start of my diagnosis so radiation and chemo and lar surgery I always had the bag. I think this made it a lot easier. I wonder if they can give u a bag from the start to make it easier?? I'm not sure.

Your young but I'm not trying to tell you what to do. Maybe try a reversal without a bag and if it's not for you then opt for it to be permanent. At least give it a try first I would. Many people learn to manage reversals and it becomes easier.

Food for thought.. :lol:

Give anything a go to try get back to your original self.
06/2016 Went in for colonoscopy came out with a tumor. Age 35
12cm from verge at junction. Rectal cancer.
Clinical stage T3 NO MO
Temp illestomy
Completed 5FU and Radiation
LAR surgery planned 13 Oct 2016
Completed ULAR surgery 11-10-2016.
0/22 nodes
pT3 N0 M0 R1
Stage 2A

Pathology reviewed and changed
ypT3 N0 M0 R0

Started folfox 21-11-2016
5-4-17 NED
Reversal 12-4-17

peanut_8
Posts: 2340
Joined: Sun May 25, 2014 1:31 pm

Re: LAR with permanent colostomy?

Postby peanut_8 » Tue Apr 18, 2017 9:17 am

Ana,
Sorry to hear about your diagnosis and upcoming surgery. Glad to see that you are a forward thinker :idea: and are planning ahead.

You have gotten some really good advice in this thread, so I'm just going to add a couple of things, coming from my perspective of having a permanent colostomy.

It is certainly a manageable condition, butt there are a few negatives. First, peri-stomal hernias are common, according to my surgeon. Unfortunately, I have one. They are also somewhat difficult to repair. This is also my surgeon's opinion. Usually it doesn't bother me, butt there have been times when I have issues with blockages.

Second, depending on your insurance, supplies can be costly.

If I were in your shoes, I would opt for no colostomy, and see how it goes. You very well could be one of the lucky ones with no issues. If you found it unbearable then you could always opt for the colostomy at a later date.

Best Wishes with your decision,
peanut
female, diagnosed Jan 14, RC stage 2a, age 56
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

[Ana & Alex]
Posts: 96
Joined: Tue Feb 14, 2017 5:14 pm
Location: Austria

Re: LAR with permanent colostomy?

Postby [Ana & Alex] » Tue Apr 18, 2017 10:50 am

Thank you all so very much for your answers. I still haven't decided, although my inner voice ist getting clearer by the day.

As I speak with relatives and close friends about this possibility - the only one who really understands it is my husband, who has seen me during and after radiation - people will come up with various questions and arguments for a LAR with temporary ileostomy followed by a take down. Everyone is shocked that I don't want to give it a go.

It seems logical that you would go through small steps adressing the problem. But I have predictive factores and a context in my life that makes me want to think otherwise.

Radiotherapy, butt burned pretty bad, hemorrhoids, ocasional rectal pain, constant urge (couldn't sleep last night) and clustering. These all make a perfect fit for future LARS.

PLUS:

My daughter is 18 months and we are really attached. She still only sleeps with me and I am still the beginning and end of everything. We haven't got any relatives close-by, so we really are that close because there was no-one else from the beginning besides me and my husband. My husband is gaining a similar place now that she's getting older - but mommy is mommy. I don't want her to have to live through 2 or 3 of my surgeries if I can have good quality of life with one and BE PRESENT in her life (and not busy dealing with this SHIP).

I am a mother. And that is in this moment in my life stronger that any other obligation, including to myself. For me, worse than dying, would be leaving my daughter alone or making her suffer through this more than the absolutely necessary.

I cannot afford the "luxury" of spending 10 times a day at the toilet for 2 years, when I'm alone at home with a little toddler. What kind of quality parenting is there? I want to take her to the park, to play and enjoy the days, without spending the afternoons in the loo playing and watching television from a distance.

When she's older and independent maybe I'll regret it that this factor plays a major role in my decision - but maybe the ones of you who have kids will understand this better. I could do a temporary colostomy and take it down latter when she gets older - but in 10 years or so I don't think a takedown will make much sense as in I don't think it will be anything left by then to work with.

I also think that surgery can be more effective if the surgeon isn't thinking about strategies to save your anus or rectum. And that's what I want: effective and radical and clean cut surgery.

If I have a recurrence and I hope not, I'm sure I will wish to have a colostomy when I get to the radiation and chemo part. I think I would always think about if they were to cut more tissue would I be cancer free?

I am also sure that if I am to die in 5 to 10 years I don't want to spend the half of the time i still have dealing with complications from lars and having surgeries and convalescence and again surgery and convalescence...

With every surgery the immune system takes a beat and there is an opening for it to malfunctioning or any cancer cells that is left to gain an opportunity.

I know a colostomy isn't something to take lightly. But can it work for me better that the ups and downs of LARS?


Is it worse to regret having a stoma in 20 years thinking that I could be "normal"....

or

to waste time trying to get back to something I will never be again - the "old" me - while not knowing myself how many time I still have, instead of investing in a quick solution and more quality time with my daughter?


Is a life with a stoma really more quality time with my family?


Questions... questions...
I'm still to find my certain answer. But my belly is telling me constantly in which direction to go. Only my head wants certainties - and that, we all know, doesn't exist.

I'm scheduling a meeting with my surgeon and stoma nurse this or next week.
Next week I'm going for a full CT and Rectoscopie to see the aftermath of radiochemotherapy.

Thank you all very very very much for all of your inputs!
You've been there and have valuable experiences to make me want to go further as I can with therapy and beat this crap and get on with life.

I'm sorry for rambling...

Take care,
Ana
Dx @ 29 yo. Mum (2 y.o.) & Wife

12/2016: Rectal AdenoCa G2. CEA 4.3. RAS Wild. MSS. IIIB.
01 - 03/2017: 28 RTx + CHT 2,5 g/d Capecit.
03 - 06/2017: Suplemments and Cimetidine.
05/2017: TME/TAMIS + permanent Colostomy CEA 0.5
05/2017: ypT2N2aM0 (4/15), good cCR, limited pCR
06 - 8/2017: 4x CapOx 3,5 g/d (2x Oxi reduced to 80%)
09 -11/2017: 3x Capecit. monotherapy 4g/d
12/2017: Aspirin, Vit. D3, Curcumin, Multivitamin.

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

Re: LAR with permanent colostomy?

Postby MissMolly » Tue Apr 18, 2017 4:57 pm

Freddy:
When my friend Belle shared conversation in the weeks prior to her passing, she implored me to provide comments and advice on living with an ostomy on this forum when she would no longer be here.

Belle wanted a more open and fair appraisal of living with an ostomy/stoma, as she was advocating in her writings and blogs here. Belle wanted to see a lessening of the stigma that often precedes the physical awareness of an ostomy. Belle agonized over deciding on a permanent colostomy after she struggled with post-operative bowel dysfunction. In living with her colostomy, she wished that she had made the decision earlier.

So here I am . . . serving as one voice of a generally "pro-ostomy" perspective.

I have had an end ileosotmy for close to 6 years. My ileostomy was necessitated when the length of my large intestine dehisced, like the unzipping of a l-o-n-g zipper. I was hospitalized for 46 days due to systemic septicemia. The recovery was a long slog.

I can honestly say that living with my ileostomy is A-OK. My ileostomy is a part of me, no different than my 10 fingers and 10 toes. I am the same person that I have always been. The ileostomy has not changed me.

I have a difficult time understanding the calling of individuals who advocate going through an iffy reversal in order to "get back to your original self." I am my original self with my ileostomy.

I can appreciate that a diagnosis of rectal cancer and the year of treatment(s) is an emotionally and physically exacting endeavor. I can appreciate that restoring one's intestinal routing to its original format is a testament to not letting a diagnosis of cancer prevail. That is an admirable quest. But sometimes, the goal of "getting back to your original self" seems self-defeating if bowel incontinence and anal leakage remain as unwanted by-products of restoring the intestinal plumbing to its original self.

I do not walk around the a "bag of poop" on my abdomen. I hear this concern of individuals who are facing a possible ostomy - concern that they will constantly have a "bag of poop" on their abdomen. I empty and drain my mini-pouch 6-8 times a day. I drain my pouch when I use the restroom to urinate. Draining and emptying my mini-pouch takes 2-3 minutes. My pouch lies flat against my abdomen, for the most part empty. No one would even remotely know that I have an ileostomy and that I am wearing a pouch.

Words matter. I prefer to use the term "pouch" to describe an ostomy "bag." The word "bag" carries a more negative stereotype. With the word "bag," my mind conjures the image of a distasteful looking brown bag that wrinkles and makes noise and that is generally unbecoming.

Modern ostomy products are quite advanced from a technology and functionality standpoint. Ostomy wafers are composed of a hydrocolloid matrix that adheres to the skin owing to the material's reaction to body heat that forms an air-tight bond. There is no adhesive nor glue to an ostomy wafer. Ostomy wafers + pouches are discrete and low profile. The pouches are composed of a plastic polymer with combined elastic and collagen fibers. Ostomy pouches are quiet; they do not rustle or crinkle. Pouches come in 3 different sizes - mini, midi, and maxi. A person who is small and petite, like myself, does not need to accept a pouch that drapes the length of his/her thigh. I wear a mini-pouch. It is about 4-5 inches in circumference.

Yes, it is true that individuals with a colostomy are more prone to a paristomal hernia. This is owing to the larger diameter of a colostomy stoma and the larger diameter of the segment of intestine used to form a colostomy stoma than a comparative ileostomy stoma. The abdominal tissue deficit in creating a colostomy stoma is larger than that in creating an ileostomy stoma.

But the No. 1 precipitator of developing a hernia is increased/excessive intra-abdominal pressure. High intra-abdominal pressure influences a segment of intestine to push outward, out of the body. The stomal open gives a ready exit point.
A large number of individuals with a colostomy who go on to develop a parastomal hernia also excessive weight housed around the mid-section of the gut/waistband. Excessive abdominal weight (visceral fat) is the leading factor that causes higher intra-abdominal pressure and a resulting parastomal hernia.

Wearing a mildly compressive belly band or belly tube can go a long way to minimizing the risk of developing a hernia. These are similar to maternity belly bands that mother's-to-be use to support their growing abdomen + fetus. Other options include wearing compressive under ware/under pants composed of spandex or lycra. The goal of a belly band or spandex under ware is to provide an inward pressure that can counteract the normally present outward intra abdominal pressure from the enclosed organs and visceral fat.

ComFizz is a family-owned company based in England that makes undergarments and hernia support wraps specifically for individuals with an ostomy/stoma. I have been wearing ComFizz undergarments for 5 years and highly recommend them (I wear the women's camisole top and women's boy shorts). ComFizz has received several awards by the British NIH for their innovative designs and quality of craftsmanship. Undergarments for individuals with an ostomy is all that ComFizz does. And the company does it well.

http://www.comfizz.com

Ostomy Secrets, based in Texas, also makes undergarments for individuals with an ostomy/stoma. Their garments do not have the same attention to hernia prevention as does ComFizz, however. Ostomy Secrets under ware provide an inner pocket for the placement of an ostomy pouch. Ostomy Secrets under ware does much to "normalize" having an ostomy and provides detailed finishings that give their undergarments an uplifting feminine touch (or, in the case of men, a gentleman touch).

http://www.ostomysecrets.com

Lastly, Belle's personal narrative chronicling her decision to proceed with a permanent colostomy is archived on this forum on the "Blog Post Archive" on page 1 of this forum. Belle's writing is titled: "The Colostomy Conundrum." It is a 3 part written narrative. Her story is moving and powerful. She wrote the pieces hoping that her words could help others who might be facing a similar situation and decision. Take the time to access and read Belle's blog writings.

Freddy, whatever your decision . . your decision belongs to you and is your own.
- 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.

Swirdfish
Posts: 290
Joined: Sun Jun 19, 2016 3:57 am

Re: LAR with permanent colostomy?

Postby Swirdfish » Tue Apr 18, 2017 6:39 pm

Hi Freddy,

I'm almost a week out from reversal and the last 24 hrs have been awesome. No accidental bowel movements and it also seemed like ive got my normal life back. I actually told my body to have a bowel movement and it worked, and not the other way around it telling me. So even though everything is a struggle at first things do get better. Treatment will fly by and by the time ya finished you will think that went quick, now time to get on with my life.

I also had ULAR surgery.

Wish you all the best.. also with your decision

Sometimes I find not everything is as bad as you read.

I have a two yr old and a 12 so they keep me active too
06/2016 Went in for colonoscopy came out with a tumor. Age 35
12cm from verge at junction. Rectal cancer.
Clinical stage T3 NO MO
Temp illestomy
Completed 5FU and Radiation
LAR surgery planned 13 Oct 2016
Completed ULAR surgery 11-10-2016.
0/22 nodes
pT3 N0 M0 R1
Stage 2A

Pathology reviewed and changed
ypT3 N0 M0 R0

Started folfox 21-11-2016
5-4-17 NED
Reversal 12-4-17

[Ana & Alex]
Posts: 96
Joined: Tue Feb 14, 2017 5:14 pm
Location: Austria

Re: LAR with permanent colostomy?

Postby [Ana & Alex] » Thu Apr 20, 2017 12:19 pm

Dear Colonclubers,

I've met today with my future WOCN and had the opportunity to go through the thoughts we've shared in this post.

I must say, I was expecting a completely different reaction from her. But as she heard me, she couldn't help but smile to me and seeing my point in the conflicts that haunt me at the present situation. She said, were she in my shoes, she would opt out for the same way possibly.

She suggested something similar to an Hartmann Procedure - but without keeping the Rectum of course.

As I understand, it is possible to be doing a LAR laparoscopically until the sigmoid and be cutting out everything else above the sfincters. So basically I would have an intact bowl until my sigmoid plus my sfincters left. No rectum.

She gave me the impression that this would be a good solution for me, from the quality of life perspective, and something that my Surgeons would be probabily able to accept better, instead of performing an APR with a colostomy on a young patient aperently with no clinical need for it.

As I seen in plenty of studies, APR doesn't give you the certainty of a local cure, unfortunately I. E. APR and LAR have equivalent success rates - so I guess I can work with the option that I've imagined before.


So:
LAR: Colostomy. Keep sfincters and as little Rectum as possible. Refuse Reversal.

Bonus is, by having the sfincters still left a reversal would theoretically be possible in the next couple of years. Just in case I change my mind (I don't think I will but I cannot forsee the future).

Have anyone of you can verify this experience and has gone through with something similar? Any any input is much appreciated. (Thank you very very much Lee I've read all your post here and also I think I found you in the Ostomy Forum? :))

Sounds like a plan to me.
I'm having preoperative Rectoscopie next Wednesday and I have the opportunity to speak with my Surgeon there about it.

Wish me luck! :)

Thank you ALL very much for your input, patience and understanding. I'm hooked to the colonclub and I've spent here many hours, day and night, and can find understanding like no where else in this moment in my life.

THANK YOU!
May hugs to you all...

Keep Strong,
Ana


Ps: I saw for the first time today supplies from a company called Salts - an English company. Does anyone knows it? I was really impressed. Can't seem to find much reviews only though.


PS2: Living in Austria I'm entitled to three wafers and three pouches per day. Free. Everything else related to stoma care is 90% paid for from social insurance. I only have to pay up to 10% of it. Yeah!

PS3: I read somewhere that people who have been through radiotherapy shouldn't irrigate their colostomy? Whaaaaat?
Dx @ 29 yo. Mum (2 y.o.) & Wife

12/2016: Rectal AdenoCa G2. CEA 4.3. RAS Wild. MSS. IIIB.
01 - 03/2017: 28 RTx + CHT 2,5 g/d Capecit.
03 - 06/2017: Suplemments and Cimetidine.
05/2017: TME/TAMIS + permanent Colostomy CEA 0.5
05/2017: ypT2N2aM0 (4/15), good cCR, limited pCR
06 - 8/2017: 4x CapOx 3,5 g/d (2x Oxi reduced to 80%)
09 -11/2017: 3x Capecit. monotherapy 4g/d
12/2017: Aspirin, Vit. D3, Curcumin, Multivitamin.


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