This is what your abdomen looks like 18 days after they create a j-pouch using a non-laparoscopic approach (slightly graphic!). From left to right:
-Temporary loop ileostomy (as opposed to my old, end ileostomy)
-6.5” incision scar (what’s left of my navel is located between the third and fourth red dots on the right side)
-Jackson-Pratt drain scar
I was discharged from the Clinic around 1:00pm on Monday. Even as I began the ride home I started to feel a bit nauseous and picked up a headache. I figured it was probably due to the bright sun and having really pushed myself physically while packing my things up, getting ready to leave.
By the time I got home, all I could do was stagger into the house and crawl into the recliner. I took more pain meds and measured my temperature at 99.5º—high, but not by any amount to be concerned about. The nausea continued as the day passed and I continued to watch my temp rise as well. It eventually peaked at 101.1º.
My breath had grown short and I had no energy at all. After talking to Jeanine around 10:00pm, she convinced me I better go back in. The pain meds had tylenol in them and so my temperature was probably actually worse than it read. Four hours, lots of blood work, a couple chest and abdominal x-rays, and a CAT scan later, it was determined I had the early stages of pneumonia. They sent me home with an antibiotic.
After sleeping all morning, I began to feel better as soon as the next afternoon. Each day has been better than the previous and the pneumonia symptoms are all but gone. Now I only have the effects of the surgery itself to deal with.
In my entry about the surgery I forgot to explain why the surgeon decided to only complete step two. His reasons were as follows:
1) I had gained more weight than he had thought, not that that was a bad thing.
2) He needed things to be “picture perfect” to finish me up and things were only “perfect.”
It’s been a week now, but I finally found the motivation to document last Thursday’s surgery.
I spent Wednesday making sure all loose ends were tied up between work and home. I got everything organized and had my desk completely cleared before going home. I packed, did some cleaning, and made sure everything was unplugged while I was gone the next two weeks or so. Even as I went to bed that night I don’t think it had truly set in yet that surgery was tomorrow.
Thursday morning my parents picked me up at 5:00am, as we had to be at the Cleveland Clinic by 5:45. Without traffic we were able to get there around 5:25, but then had to park, walk across the skybridge, and check in. The surgery center is an amazing place that is set up with many, many miniature living rooms (think little areas composed of a coffee table surrounded by a couch and a couple chairs all lined up next to each other. The place was multiple floors and could probably seat over 200 people. At the same time, it felt very calming and intimate.
They hand you a pager with an LCD screen at check-in and tell you to wait to be buzzed. They also give you the code word for how your name will be displayed on their giant status boards (as if you are at the airport). Mine was “Dr..r.,G.” I like how clever, yet simple that is. The pager is then used to keep those waiting updated on the status of the patient’s surgery throughout the whole process.
Eventually they buzzed and we walked back to the staging area. The receptionist hands you a card with a room number and you enter a hallway similar to that of a hotel. Once you enter your room it looks similar to an ER room with a bed, IV equipment, monitors, lots of storage cabinets, and a giant sliding door leading to a common-area nurse’s station. I lucked out and was placed in the pediatric area—my curtains were giant dinosaurs. Luckily, the gown and bed were adult sized.
After getting my IV inserted and stickers attached for the monitors, I waited about 20 minutes before they wheeled me off to surgery. As with last time, I must had passed at least 20 operating rooms before reaching mine. Unlike last time, I actually made it inside and transferred onto the table before the anesthesiologist knocked me out. What struck me was how bright—and small—my room was. It was the polar opposite of what you see on Grey’s Anatomy, House, or ER.
Next thing I knew, I was waking up in recovery about 4 hours later. I guess they waited a lot longer to let my parents in this time and I was much more coherent. I remember asking if they completed all three stages or not. When they told me no, I remember not really being upset and instead being very okay with that. The more time passes, the more I find myself happy about this. The first couple days of recovery were rough enough as they were.
With half of the colorectal floor closed for renovation, there’s an obvious shortage of places to put people after surgery. I ended up spending the first night in the recovery ward, which would have really sucked had I been awake for any of it. At some point Friday morning I was moved first to one area and then onto the H50 floor where I would stay until being discharged on Monday. It was nice to have Jeanine come into town Friday night and spend the weekend by my side. Unfortunately, I have very little memory of any part of my stay.
They gave me a morphine pain pump (later switched to Diluadid) that allowed me to dose myself as often as every 6 minutes. It certainly took the edge off, but I was still in a lot of internal pain where they had created/attached my j-pouch. I also had to deal with a catheter and drain coming out of the left side of my abdomen. I think I was first offered an all-liquids meal for breakfast on Saturday, but held out until lunch to eat anything. Sunday’s breakfast brought my first solids meal.
When I arrived at the room, my roommate was a quiet, laid-back kid a couple years younger than me. His family was very friendly and respectful. I should have known he was going to go home soon based on what a good roommate he was. After he left at lunch on Saturday, I enjoyed a brief period of solitude before the next guy arrived. He was friendly as well, but snored like a freight train—good thing I brought earplugs. He stayed until lunch on Sunday and, when I hadn’t received a new roomie by 11:00pm, I thought I might get a night alone. Karma then scolded me for letting that thought cross my mind.
Around 11:45pm all of the lights come on and some dude comes stomping in the room smiling, saying “you’re getting a new roommate.” They bring this old timer in who’s cursing up a storm and his companion (daughter I think) is yelling about everything they are doing wrong. I pull the curtain closed around my bed, decide I won’t be sleeping for the next hour, and wait it out. She demands a cot be brought in so she can sleep next to him and someone how they wedge one past my bed—no apologies needed for all the banging apparently. Once things had finally calmed down, around 1:00am, she gets on the phone and starts telling everyone how they have finally made it to the right floor. They eventually go to sleep and I spend the rest of the night waking up to the guy moaning in his sleep. His faithful companion? She’s snoring louder than his moans.
After that I knew I had to get out of there the next day. When the surgeon came bright and early and asked if I felt ready to go I had no hesitation with my answer. They sent me home at lunchtime on Monday and things have been improving each day-other than the trip back to the emergency room Monday night. But I’ll write about that little bit tomorrow.
Having the bottom staple removed after it partially pulled out. This allows me to claim I have a mere 15 staples—not the original, awesome 16.
An email sent to friends, family, and others I kinda, sorta know through the Innertubes:
“Everyone-
I’m sending this mass email to everyone that’s been involved with, or asked questions about, my adventures in the land of colorectal surgery. It’s hard to believe it’s been six months already since the first surgery. I feel great, however, and am excited to continue on.
Tomorrow morning at approximately 7:00am I will go under the knife for stage two (and possibly three) of the j-pouch creation process. The first scenario is that I come out in basically the same shape I am right now. My new pouch will heal for three months and then the final surgery will allow me to begin using it. The second scenario is I’ll be done with surgery and begin the slow, but final recovery process. The surgeon will make the decision on just how much to do once he has me open.
My hospital stay will be a minimum of 3-5 days, with a possibility of being there up to three weeks (should any complications arise). Obviously the stay will be longer if stage three is also completed. If anyone wants to contact me during this time, you can call or text me at 440-570-6928. My only request is that you hold off on calls until Friday and visits until Saturday. You’re more than welcome to try sooner, but I guarantee I won’t even remember talking to you.
As for recovery, I could be back to work in three weeks. If both stages are completed it will be 4-6 weeks. To get a point where everything is functioning at full strength will take about a year.
As much as I have downplayed the surgery, it is, in fact, a rather serious operation. I ask that you please keep me in your thoughts, prayers, etc. tomorrow. Everyone’s support over the past six months has been invaluable during the healing process. I appreciate your sympathy, words of encouragement, questions about the surgeries, and all of the other many, little things everyone has done to help.
Thanks again and wish me luck!”
I just found out my surgeon was recently appointed to the position of department chair. I knew he was good, but this is awesome.
…is setting in.
Last September I went into the Cleveland Clinic for life-saving surgery. I didn’t ride to the hospital in an ambulance and I don’t mean to sound dramatic when I say that, but I also feel confident I wouldn’t be alive now if it weren’t for having my colon removed. To emphasize this point, I’ll point to the fact that I had to check myself in the day before I was actually scheduled for surgery. I had dropped thirty pounds in three months, I was going to the bathroom every thirty minutes, and even chugging bottles of Pedialyte couldn’t keep my hydrated. The pain of going number two was so intense I was literally pulling my hair out to distract myself while on the toilet. If that’s not seriously fucked up, I don’t know what is.
So, with my immune system waging a jihad on my large intestine, the surgeon removed the roughly five feet of colon and my nine-month, three-surgery adventure in colorectal land was under way. Since that time the only thought I’ve had in the back of my mind (when it comes to health) has been, “the next surgery is in March.” For the majority of the past six months I’ve been under the impression I was going to go in, have my j-pouch created, get my end ileostomy turned into a diverting-loop ileostomy, and be back on my feet in three, maybe four weeks. The real work wasn’t going to be until the end of June—when I actually had to start using my new pouch.
The recent news of possibly having surgeries two and three combined into one, final procedure was welcoming, but brought with it a whole new necessary mental approach. If things end up going this route I’ll regress to a restricted diet for probably six to eight weeks, I’ll have to learn how to deal with this new approach to waste collection and removal while also dealing with incision pain, and also won’t really be back on my feet for six weeks (or more). I’ve been reacquainted with a freedom of life that may soon be partially taken away from me again. That sucks.
I’ve fought many mental battles with myself over this whole situation and stayed extremely positive for the most part. I feel pumped, almost excited to go in and get this over with. I’m ready to kick ass and take names. Yet, the true reality of what is about to happen is beginning to set in. I know I’ll eventually gain back most of the freedoms I have now, but really and truly I am healthier now than I will ever be with a j-pouch. It’s the trade-off for gaining the convenience of no external pouch.
So how do I make sure I really get the most out of my last few days? That’s a great question. My last real meal will be breakfast on Wednesday; after that I go to a clear liquids diet. So with that in mind, I’ve decided I will be having a McGangBang for dinner on Tuesday. It just seems like the right thing to do.
I’m going out with guns blazing.
My name is James and I've found that I spend entirely too much of my free time looking at random crap on the internet. In an attempt to make myself feel better about this, I share.
