On the day of my surgery I went to the hospital where I changed into a gown, compression stockings (thigh high) and sat in a small waiting room. I was called in to review the surgery that was to be done, the Doctor stopped by to talk to me and before I knew it, my name was called and off I walked, right into the surgical room. It was really large and there were a lot of people but the "operating team" was all introduced. I was given an IV in my hand and an epidural block in my back. I don't remember much other than we made a few jokes, there was laughter and I felt very relaxed which surprised me as I thought I was terrified. Next think I knew, I was in recovery.
Apparently this time they removed the end of the small intestine, the valve between the two intestines and a small part of my large intestine. This means that food is slowed by the little "fingers" of the small intestine, and then when it hits the large, there's little to slow it down so it goes right through. This results in the runs, and smaller absorption of nutrients, so will require a new diet and medication (Cholestyramine - powder form*) to aid with the issue of the runs.
*Cholestyramine is used to lower high cholesterol levels in the blood. This may help prevent medical problems caused by cholesterol clogging the blood vessels. Cholestyramine is also used to remove substances called bile acids from your body. With some liver problems, there is too much bile acid in your body and this can cause severe itching.
Cholestyramine works by attaching to certain substances in the intestine. Since cholestyramine is not absorbed into the body, these substances also pass out of the body without being absorbed. - from Mayo Clinic
Cholestyramine works by attaching to certain substances in the intestine. Since cholestyramine is not absorbed into the body, these substances also pass out of the body without being absorbed. - from Mayo Clinic
Cholestyramine powder is a bile acid sequestrant. It works by increasing the removal of bile acids from the body. As the body loses bile acids, it replaces them by converting cholesterol from the blood to bile acids. This causes the blood level of cholesterol to decrease. - from Drugs.com
Other medications I know I was receiving after surgery were Morphine (for pain) and heparin* for clotting. I took my shots in the arm as the thought of a needle in my tummy was horrifying to me.
Heparin is an anticoagulant commonly used after surgery. It prevents the blood from clotting too easily. It is also used to treat blood clots when they do form, helping prevent the clot from increasing in size and preventing additional clots from occurring. Surgery increases the risk of blood clots and Heparin is an important preventative measure after your procedure.
Why Is Heparin Given After Surgery?
Heparin is often given after surgery, particularly in patients who remain hospitalized for several days after surgery, to prevent blood clots from forming. Patients who are unable to get out of bed in the days following surgery are at greater risk of forming clots, making heparin a commonly used drug in intensive care units.
Heparin is given subcutaneously, meaning it is injected into the body in an area such as the abdomen, and also given intravenously (IV).
The compression socks I wore during surgery and for several days after, are also to reduce the risk of clotting.
I don't remember much about recovery which isn't any surprise. But new this time is that I was asked to chew sugar-free gum as soon as I woke up. (You are asked to bring your own gum to surgery) This is supposed to help the gut.
The other thing is that they now put an IV Epidural into your back and it keeps the abdominal area numb for several days. This is a hug boost in recovery time as without pain, I could sit up almost right away and was up and walking in no time. As you use the muscles in that area immediately, it speeds up recovery and when it's removed a few days later, the pain is minimal as you've already been moving. I wish they had left it in one more day though.
I was up and walking laps of "3 East" the floor that I was on. First it was one lap, then two and finally I made it to three. I was standing up straight, not hunched over as one usually is after abdominal surgery. I was truly amazed at the speed of recovery.
Then they introduced food back into my diet. Unfortunately, my tummy didn't like the food. I would have terrible cramps and pain after every meal and it appeared to be getting worse with each meal I ate. Suddenly I went from doing three laps around the floor, to barely making half my hall. I spend the day in bed, feeling exhausted and in pain and the Morphine that I was on was doing little if anything to help. Apparently after surgery of this type the surgeon usually prescribes Pantoloc* and this time he'd forgotten to do so.
*Pantoloc is a Gastric acid pump inhibitor & antiulcer agent -
Pantoprazole is indicated for short-term (up to 4 weeks) treatment for symptom relief and healing in patients with active duodenal ulcer
Once I got onto the Pantoloc, the pain was a little less each day. I am now on Day 12 post-op and now seem to be able to tolerate food. Unfortunately, I have a lot of "runs", more than before.
By the way I was released from the hospital on Day 11. It was an exciting day as not only was I finally home (I'd expected to stay just 5-7 days in hospital), but our son and his wife had a baby boy that day!!! It was also July 1st, a National Holiday.
I should mention that I have lost about 6-7 pounds this past week. I met with a Dietician in the hospital, twice, and she said that as I'm not absorbing the nutrients as I should be that weight will be an issue and I must be careful to not lose too much. After the last surgery I lost 30 pounds which I certainly can't afford to lose this time. Also, as the body had such a shock last summer, with the surgery and getting C.Diff, I lost about half my hair. It was terrifying the day in the shower when it began to come out in my hand. Thankfully, I had very thick, fine hair and other than myself, my Doctor and my hairdresser, no one really noticed. This time I've not enough left to be losing more but I've noticed the past 2-3 days that a lot seems to be coming out so here's hoping this is a short temporary issue this time!
After last summer's surgery it was about 3 weeks before I could even sit up, this time I am already sitting at the table for meals. Last night I even cooked part of our dinner! I didn't do that for about 1 1/2-2 mths last summer.
One thing now that I've got "the runs" my bottom gets raw so I use Cottonelle wipes and they just soothe the skin.
I take chewable vitamins now... as they are better absorbed. I also eat Arrowroot and other children's cookies which are also more easily digested.
I am not to drink with meals as it tends to "flush" the food through my system too quickly. I've a new diet and must eat a lot of foods you might think not as healthy but are easier to digest (i.e. eat white bread not whole wheat and white rice not brown or wild) No raw vegetables allowed. No sweets, sugars etc. I remember last summer my birthday was 11 days post surgery and I was determined to eat a cupcake to celebrate my birthday. I kept it in the freezer for weeks and when I finally did eat it, I suffered with pain for 24 hrs. afterwards.
So, it is one day at a time. Some days will be better than others but no matter what, the worst is behind me and now it's time to heal and take control of my life again. I did this last year and can do it again. I am determined to be once again able to host dinner parties and go out to a restaurant to eat.
Here is the information on my diet that I must now follow, compliments of "The Ohio State University Medical Center":
https://patienteducation.osumc.edu/Documents/short-gt.pdf
No comments:
Post a Comment