Showing posts with label Advantages colitis operation. Show all posts
Showing posts with label Advantages colitis operation. Show all posts

Thursday, 19 September 2013

Guest Writer - Daniel - Part 2

Me (Daniel Newall) and IBD Surgery Blog – Part 2 Surgery and Post Op


Day Before – I rang the number that I was given, and 12 o’clock the time I was given, to check that there was a bed ready for me and was told that I needed to be there for 2 o’clock that afternoon (they mustn’t think other people work!). So, after declining to get the bus which was suggested by the staff member on the phone, my dad came out of work to take me and I arrived on time at five to two. I was then left sat outside the ward for two hours and was then invited to my bed which hadn’t been cleaned yet. 

I then sat there for a further two hours before I was booked in. So as you can imagine I was quite annoyed! I already knew everything that was going to happen as my uncle, who has been some what of a rock for me despite him living in south Wales, has unfortunately had colitis since before I was born and had the same operation twelve years ago. I doubt I could have coped with the disease or the operation without him.

Day 1 - I wasn't that nervous beforehand, but the doctor that put me to sleep had had the same operation as me and even showed me his scars before sending me off - so that was quite encouraging and before I knew it I was off. I awoke in complete confusion and pain, with a nurse trying to explain how to use the morphine pump for pain relief, which I already knew so began pressing and I couldn’t keep my eyes open which she wasn’t happy about. I then went back to sleep and woke in the recovery ward with tubes in almost ever hole I have! 
After a few hours I was asked 4 or 5 times to get out of bed. I refused I was feeling sick and was still in a lot of pain! But eventually I cracked and said okay, after being bribed by the nurse by putting my surgical sock back on, so at least we had a laugh. This was short lived as as I began to attempt to move - I just couldn’t move properly and it took me about 15 minutes to get from lying down to sat in the chair. I was so dizzy and felt so terrible I just asked to get straight back into bed after it had been changed.


In all this confusion I had completely forgot that I now had the bag which needed to be emptied and changed for the first time. I felt so bad that I didn’t pay any attention to it and I didn’t really want to acknowledge the fact that it was there I guess. During the night I woke to find the bag was blown up like a beach ball so that kind of got my attention. During the day I was on the extremely powerful morphine pain killers but the wounds were unbelievably painful and I was on oxygen for most of the day. However a rather attractive nurse removed the catheter I had, so it wasn’t all bad news.

Day 2 – Day 2 just consisted of sleeping. Towards the end of the day all tubes and drains that were in me were taken out; the main drain in my left side hurt the most. I imagine that’s how getting stabbed feels as it was so deep, and left a huge, deep perfectly round hole right in me. After this I knew things were getting better, as I was sat out at the side of the bed and unbelievably even began to walk around, albeit just 5 yards and in immense pain, as I was now only on tablet pain killers. I was also eating and drinking, but just soup and water
Day 3 – I was now walking more - even going to the toilet, as now I had to empty my own bag. Also, after only 3 days, I was moved back on the ward from the recovery room.

Day 4 – Here I was changing my own bag for the first time with the help of the specialist stoma nurse. Also I had 3 other men with me on the ward one fresh out of a different operation (he had had his gallbladder removed). As I had previously had gall stones, and been told I needed the operation he'd had, we exchanged stories. He was on the morphine pump and was acting rather odd as a result - as everyone does. He later told me that I pictured a mad professor tying him a noose in the main doorway and heard a nurse calling him saying it was time. So this cheered me up a lot, along with a meeting with one of the surgical team who had to check the operation was only 4 days ago as he couldn’t believe how fast I was recovering and told me I could go home tomorrow.

Day 5 – Home!

The next week I had the IVC filter removed with a small procedure which involved a doctor going into the jugular vein in my neck and retrieving the filter designed to stop blood clots travelling to my lungs or heart. It worked as he showed me the filter about five minutes later, it contained around nine small clots. I continued blood thinning injections for a week then recommenced the anticoagulation tablets.

Five weeks later as I write this having just re-enrolled at university for the coming year I feel fantastic within my self - I know the colitis has gone. I have spent my time reacquainting myself with a old friend known as the PlayStation 3. The bag is at times really annoying and I don’t yet know the extent of the impact it will have on my life and whether I will have the reversal next year. I just plan to enjoy life again and try to do as much as possible. The operation was a total success; I recovered in a remarkable amount of time and who knows in a year I could be writing another one of these after the reversal.



Tuesday, 11 June 2013

Colitis and Surgery Part 3 - Risks, Advantages, Stomas and Laparoscopy

An ileostomy showing stoma opening
This information is about the types of surgery that may be needed in the treatment of Ulcerative Colitis (UC). You may also find other Crohn’s and Colitis UK information useful, especially our booklets Ulcerative Colitis and Living with IBD. Most of our publications are available from our website: www.crohnsandcolitis.org.uk.

Stomas

As described above, sometimes in surgery for Ulcerative Colitis the intestine is brought to the surface of the abdomen and an opening is made so that digestive waste products (liquid or faeces) drain into a bag, rather than through the anus. If the part of the intestine brought to the surface is the ileum (the lower end of the small intestine), this procedure, and the end of the intestine connected to the opening, is known as an ileostomy. If the large intestine or colon is brought to the surface and connected in a similar way, it is a colostomy. Both types of opening are also called stomas.

2 piece stoma bag
1 piece bags are available
Most stomas are about the size of a 50p piece and pinkish red in colour. Because the contents of the small bowel are liquid and might irritate the skin, an ileostomy usually has a short spout of tissue, about 2-3cm in length. Depending on the type of stoma bag used, ileostomy bags usually have to be emptied four to six times a day and changed about twice a week. Colostomies pass firmer stools, so colostomy bags are usually emptied slightly less frequently (about one to three times a day), and usually need to be changed each time.

Laparoscopy

Some of the operations outlined above, including pouch surgery, may now be carried out using laparoscopy (minimally invasive surgery). This is also known as ‘keyhole surgery’. Instead of making one large opening in the wall of the abdomen, the surgeon makes four or five small incisions (cuts) each only about 1cm (half an inch) long. Small tubes are passed through these incisions and a harmless gas is pumped in to inflate the abdomen slightly and give the surgeon more space. A laparoscope, a thin tube containing a light and a camera, is used to relay images of the inside of the abdomen to a television monitor in the operating theatre. Small surgical instruments can also be passed through the incisions and guided to the right place using the view from the laparoscope. If a section of the intestine needs to be removed, this can be done through a separate larger incision.

Laparoscopic operations tend to take longer than ‘open’ surgery, but can have a number of advantages, such as:

  • less pain after the operation
  • smaller scars
  • faster recovery for example, being able to eat and drink more quickly after the operation
  • reduced risk of a wound infection
  • a shorter stay in hospital.


However, laparoscopic surgery may not be available in all centres and may not be appropriate for some procedures, particularly if you have already had abdominal surgery.

Are there risks to surgery?

Ulcerative Colitis is a very individual condition and the risks and benefits of different types of treatment will vary from person to person. Your IBD team should be able to help you weigh up what will be best for you.
Surgery for UC, like all surgery, will carry some general risks, including those linked to having a general anaesthetic. There is also a small risk that some operations may lead to complications such as infections.

Particular operations may have other risks: for example, occasionally an anastomosis (join) or an ileo-anal pouch can develops a leak and will need further surgery. Adhesions (sticky bands of material that form as part of the healing process) can twist the intestine. These usually settle down by themselves, but sometimes need dietary treatment. If you have a pouch there is also a risk that you may develop pouchitis (inflammation of the pouch), which may need treatment with antibiotics. Your surgical team will be able to tell you more about any possible complications, how likely they are for the operation planned for you, and how they are usually treated.

What are the advantages of surgery?

Unlike Crohn’s Disease, which can recur after surgery, Ulcerative Colitis cannot recur once the colon has been removed, and so is ‘cured’ by surgery. This should mean:


  • relief from pain
  • relief from symptoms such as urgency and diarrhoea
  • being able to stop taking drugs which may be causing side effects
  • feeling able to lead a fuller life, for example being able to leave the house in a more relaxed frame of mind.


However, as above, complications do sometimes develop, and it will take time to get used to having a pouch or an ileostomy.

Coming up in Part 4 - What to expect - Before and After Surgery