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[B]Captain's Log:[/B] Thursday, April 22, 2004

[B]Weight:[/B] 165.5 lbs. That is a drop of 2.5 lbs overnight.

[B]Mood:[/B] Kind of tired. It is only 8:40 AM. ????

[B]Food:[/B] I had planned on a special Jell-O treat made with ginger ale, but I am going to skip it and stick to the plain fluids. I don’t feel as well as I did in my belly.

[B]Brain:[/B] Still cool, but I am tired. Maybe there is a hint of jumpy nerves, but I may be mistaking both my tiredness and mood when the real issue is in my belly. Or maybe, the real problem is stress on the brain, and it is making me tired and my belly knot up. Either way, I “think” I am cool, just tired and uncomfortable.

[B]Pain:[/B] My gut is flaring up this morning. Could be stress or the antibiotics I took early this morning. I started feeling good after my last antibiotic earlier in the week. Maybe there is a connection between my mood and the pain and the antibiotics. Maybe I only “feel” tired because of the discomfort.

[B]Work:[/B] No work. Just killing time and getting the bowel prep out of the way. Need to get my haircut today. I think I am going to pray, stretch and breath. Regardless of the source of my discomfort, tiredness, and slight edginess, that would be good medicine for all three.

[B]Hours to Surgery Remaining:[/B] 23.

[B]Errata:[/B] Wife is on a couple of sales calls and then going to spend the day here. Maid coming in one hour. I had two last Saturday for major spring cleaning. Windows, baseboards, all of the ironing. Today will be another major workup. That way, I can give my wifey a head start on the anticipated decay in normal routine. They will be coming back next week too, and maybe the week after just to make sure. If I can, I am going over to the school for my daughter’s lunch. She loves when I come by. Poor darling is a little stressed. But she does not show it very much. My little guy is OK. He asked me if I was going to the hospital and for how long this AM. So, I know he is aware, but he moved on to something his sister did to him before I could answer. :)

[B]Tomorrow:[/B] Tomorrow is the big day. I am not too anxious and I am not to edgy. Need to take care of the brain, and make sure I stay that way. In just a couple of more hours, the dice will be in the air, and my months of waiting for the surgery will be over. Then, I can start the waiting game to figure out when the pain stops. Then, I can wait until I get out the hospital. Then, I can wait to figure out when the diarrhea stops. Then, I can wait to figure out what I can eat.

Unfortunately, my personality does not lend itself very well to just being content with the situation I am in. I will try to enjoy each stage instead of “waiting” for the next, but that might more difficult than anything else I have going on.
Dear Ms. Shoes,

You will be fine. It is a hospital, not a torture chamber. Don’t worry too much about the pain. Just expect it too be bad. The doctor told me I would have been better off if I expected the worse. I thought lap would be easy, and it took me by surprise. Like jumping into a pool expecting it to be cool and getting freezing water instead. Takes your breath away and leaves you scrambling for a little while until the hypothermia sets in. Pretty much that is what happened to me.

Dumping syndrome is a never ending case of diarrhea, sometimes immediately after you eat food. That is living life the hard way in my opinion. A colostomy solves the social problems, but a constant health concern can be poor absorption. The large is used to balance water and salt and hold the waste until you can get to your favorite pot. Most of the nutritional absorption really occurs in the small intestine.

So, most large intestine resections that result in dumping syndrome usually just “D” all of the time, and not are in the same group as the truly malnourished.

Full blown dumping syndrome is rare (partly because those cases generally end up with the bag anyway). A more common afterlife is some degree of bowel sensitivity. Your guess as what you might be sensitive to is as good as anyone’s. For some people it is wheat or gluten, meat, cheese, pumpernickel, who knows.

If I develop a sensitivity issue, I hope it is to Brussels sprouts. Don’t like them in the first place. Say, what a great rap. I can tell Santa I am “sensitive” to all of things I don’t like.

What a great idea !!!! Note to self: Associate food allergies with things you do not like. Corollary: Attach medicinal response to things you do like. “Honey, beer and Monday Night football soothes my large intestine”.

Anyway, the truth is that most people do not develop any serious sensitivity issues at all. Even then, moderation can mitigate the resultant in many cases. It does not appear that way when you visit boards. As I mentioned on the other thread, there is a bias in the population. We have a larger number of voices from individuals that did not completely resolve, and/or are complicated by co-factors including other degenerative issues. Think about it, if you come back 100%, you are probably not going to hang out on a board and talk about your poop. I do hope you diary though. I would like to get another perspective.

I have not had any “accidents”, but I spent a lot of time on the pot because I was not sure what was going on down there. I am past that now thank goodness.

Prudent action differs between moving some gas and moving some poop. It sure as hell helps to know the difference before you get a movement. And, it is helpful to know there is a movement coming down the turnpike before it hits the tollbooth. That was a good part of my frustration the first week. I took longer to get potty trained than some of the other board members, but I got out it without training pants. The first couple of times where loose and fast. So, I was a little nervous. Once things firmed, then I was not as concerned. Fast and loose D without notice will chain you to the pot.

I have yet to wear any drawers. My business is living in a liberated way because I got the bikini cut. Restrictive waistbands are just not in the cards for me right now. Siempre Johnny Libre !!!! Yeeeeee Haw!!!!! I am a liberated man. Besides, I saw how Santa trained the Golden Retriever puppy. I am not good with that exercise. No drawers raises the stakes. My advice, stay close to a favorite pot until you feel comfortable venturing off. Example: The doctor told me to walk around the neighborhood. Good intentions, Bad idea. Resection Man says, “Walk around, but do it real close to the house. So if you explode, Mama can hose you off in your own yard.”

Goody, why do you keep challenging my manhood in the pain department? “You went lap and you’re crying about the pain?” Damn Girl, I did the best that I could. I live a comfortable life, and I guess I have just turned into a poodle.

I hope you do not have any pain. I hope the drugs work well for you. If you do get some, I hope it is less than mine. If you wake up, and it hurts real badly, I hope the hints I have given you help you navigate your way out of there. I pushed pretty hard. I was moving and walking and all of that stuff except for coughing from the get-go.

If you had two kids natural with nothing for the pain, then it might very well be a stroll in the park for you, but I doubt it. So the short answer to your question is to hit the button as often as you can until you are comfortable, then keep doing so, until you are very comfortable, try to get all of your exercises out of the way including coughing while at the peak of comfort, hit it some more, and have someone hit it for you while you are asleep so you don’t run dry while you are sleeping. The problem with the manual pump is you run dry while sleeping.

So, let me describe the pump program.

There was a handy laminated instruction book attached to the side of the pump. I read it when I was bored on Sunday. “Get Up, Cough, Walk, BP, Temp, O2, Blood Draw, Are you passing gas yet, Have you had a BM, Get Up, Cough, Walk, BP, Temp, O2, Are you passing Gas!”. Those nurses talked to me for days and not once did they say, “By the way, the pump instructions are right there”.

When you go in for pre-op, ask for an explanation of the pump-a-roony while you can still think. Better yet read the book. It will only take about 3 minutes.

There were three options on mine:

Automatic drip with no bump capabilities.

Automatic drip with bump capabilities

Manual operation.

They might put you on option one at first because you are going open. Probably the auto-drip with the manual bump is the best. I had manual.

The thing is under lock and key. One, so no one can rip off your sauce, and two, so no one can change the drip rate settings.

I can’t tell you how to operate it without knowing your settings. Read the book first. Once you know the options, then it is just a matter of hitting the button the maximum number of times.

Have you ever seen films of the little mice that will sit there and just keep hitting the sauce forsaking food and everything just for the sake of the buzz?

The docs don’t want you to build up a tolerance or a dependence upon the morphine. So, they keep you in just a little pain.

You will be fine. It is a hospital, not a torture chamber. Don’t worry too much about the pain.

If you come back with a story that goes something like this, “The pain was barely noticeable,” do me a favor and start your own thread. I don’t want people thinking I am really a poodle. Or lie for me. Think of the disservice you would be doing for the community of normal people that will get stung by the pain dragon. But mostly, I am trying to become the Supreme Colon on our board, and I can’t have people thinking I am weak.

Wait, I messed up on the pump instructions. Don’t hit the button as often as possible. You will build up a tolerance. Wait as long as you can and then hit the button. Yeah. That is better. Just kidding. But you knew that.

I read all of the same stuff as you, and I did not take any pills going in. No Xanax or Valium. So, it is what it is. You will do fine. It is going to hurt, but you are not going to scream in agony. You will moan, groan, and occasionally yelp. The nurses like it quiet on the floor.

Actually, I have been on the labor and deliver floor twice. There is a lot of screaming going on in LDR. The recovery room was a raucous. By comparison, the floor I was on was pretty quiet among 26 digestives.

Does that help?
Diverticulosis is a sneaky thing; most of the people who have diverticuli don't know that they have them. My first inkling was when I ended up in the hospital with a perforated colon. In my case, though, there had been warning signs which I didn't put together: bouts of diarrhea and what I thought were "female problems" in the form of bad cramps in the pelvis. I ended up having an elective resection later, to prevent possible perforation down the road.

While some diverticuli can get very large, most are tiny and can be tucked into the folds of the colon in such ways as to go unnoticed during colonoscopy. It's hard to say why some people can have diverticuli their whole adult lives and never have a problem and then others, like us, end up with infections, perforations and the like. Diet is only part of that equation, though an important part. One of the quirks of diverticulitis is that while high fiber/roughage diets are known to help prevent diverticuli from forming, and also to prevent infection...once you have an infected diverticula, you want to avoid all that fiber because it irritates the inflammed tissue. Of course, if you don't know you have it... that's what happened to me. I went on a health crusade, upped the fiber in my diet, launched into more exercise. Next thing I know, my bowels are in a tizzie and the inflammation got worse, perforated and you know the rest of the story. In trying to do the right thing, I made a condition I did not know I had worse. It sounds like you have a longer history of eating lots of fiber, so it's unlikely you shocked your system that way.

Did your pathology report say your perforation was due to diverticulitis? Just wondering, as other things can cause perforation.

It's good to hear you are doing well and that you didn't need a bag! Surgery is one case where two is not better than one. Did you have laparoscopic surgery or an open resection? Either way, it sounds like you are recovering just fine. I agree with goody that it's too soon for ointment. After about eight weeks, when my incision got flaky, my doc said it was all right to put a cream on them. She recommended Eucerin, which I still use to keep it nice and soft. (I had an open resection, so it is a nice long scar.)
I am 25 years post colon resection. I was 28 when I had my first occurance of colon CA. Found during emergency surgery, tumor the size of doctors fist, had colostomy for 6 wks and then it was taken down. Had a second CA occurance 2 years later, found during followup colonoscopy. I've been followed up with either flex-sig or colonoscopy every year (or 2) since. No problems until last 2 years with some raw tissue, bleeding as site of original surgery. Ended up with anemia, but it's improving with cauterization of the area and iron suppliments. As for life after resection (I have 30 cm of colon left) I am prone to diarrhea, some dumping syndrome, but for the most part it's VERY manageable. Fresh veggies, alcohol, stress/travel and overeating are triggers for problems (if there are going to be any). I've started to have some motility problems and have some gastritis that I'm on meds for. It's sometimes hard to remember to take meds before meals. Anyway, for the most part, it's all been very manageable and I feel very fortunate to have had one of the first radical surgeries of this type and that it seems to have removed the predisposition to colon ca. I wish you (and all resecties) the best with your health and healing.





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