postsurgical adhesion and bowel obstruction

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troylenderink
troylenderink Member Posts: 9
edited March 2014 in Colorectal Cancer #1
I was diagnosed of stage four colon cancer with metastasis to the liver October, 2008 after a sudden onset of excruciating pain in the abdomen which brought me to the ER. Initial surgery removed the tumor in the colon along with 26 affected lymph nodes. Three months later, I had a smalll intestine bypass surgery due to the build up of postsurgical adhesions. The adhesions not only caused bowel blockage it also brought me tremendous pain and discomfort daily. Another 3 months later, I'm back in the hospital with same complaint, small bowel obstruction! This time the blockage involved many loops of the intestine therefore surgical intervention isn't possible according to my surgeon and oncologist. Three days ago they decided to put a G-tube in my stomach to drain excess fluid and pressure and a Groshong line to deliver TPN since I'm significantly malnourished. I am only allowed clear liquid orally. Since the initial surgery, I had 12 treatments of folfox with avastin but tumors in the liver remained the same size and the cancer has spread to the belly and the cat scan showed increase fluid in the peritoneal cavity. Oncologist thought the regiment wasn't working and that I'm developing drug resistance to it. However, my CEA did drop from 52 to 14.6. Two weeks ago before I was admitted to the hospital I was being switched to folfiri. so far I've already have one folfiri chemo.
Since the first chemo regiment didn't work, I'm debating whether or not to continue the folfiri. In addition to that I'm seeking remedy for the scar tissue related bowel obstruction. It seems like if I don't get my bowel fixed, problems would persist. Hoping to hear advise from those of you who share the same experience!!!

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  • Shayenne
    Shayenne Member Posts: 2,342
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    Hi there!
    Welcome to the board Troy!

    I was diagnosed with Stage 4 Colon cancer with a tumor in the liver in January of this year. I had never been sick, no signs or symptoms, except a "hardness" above my belly area to the left, and alot of fluid that was swelling me up, I gained like alot of weight, and was uncomfortable even tying my shoes, which brought me to the ER room because of the discomfort, and that's when they ran the scans and saw I had a thick mass on my colon with a tumor in my liver, and being anemic, I was way down in the levels...they then transferred me in an ambulance to the James Cancer Research Center in Columbus, where I been going ever since.

    My doctor is a specialist in the colon, and her plan was to start me on Folfiri with Avastin, which I've been on ever since. Now, in March, I had a couple setbacks, I had an absessed wisdom tooth which caused me to be hospitalized with an infection, and then 2 weeks later, I had gotten a colon perforation, which led to emergency surgery..my bowels were going into my belly, and I had to get a colostomy, which saved my life actually, I was in ICU for a couple days, and then the hospital for 2 weeks, sent home with a wound vac for my incision, and ever since that, I been doing well, they had to stop chemo till I was able to recuperate from the surgery..

    I had my first CT scan last month, and my doctor was happy to say that the chemo has killed most of my cancer! she told me she gets good results with the folfiri treatment. I feel so much better then I did before I started chemo, no more fluid, I lost over 20 lbs, but that was good for me, since the weight gain was due to the cancer. My tumors are shrinking, and she was eager to get me back on the chemo right away, now that my incision is healed, and colostomy working as it should. I have finished 5 treatments of it, out of 12 that I have to do...

    You will experience alot of hair thinning (she told me I wouldn't lose my hair on it, but I am, alot is coming out, but I'm not bald yet), nausea is the worse, but they have great anti-nausea meds, since I been taking Emend and Dexamethasone, I have not had any nausea or vomiting...I go in every other Wednesday, and have a pump connected to me for 46 hours, till Friday, when a home health nurse will come and disconnect me, and it's such a nice relief to get the pump off, but then you will feel totally wiped out for a few days, but dont worry! you will bounce back to your old self! you will feel like a zombie, and that's ok, it's only temporary, just lay in bed, take it easy, and once your energy comes back, you'll see you'll be able to do this! if I can do it, you can do it!

    Drink lots of water! especially during the chemo, it will flush it out faster, so you can feel better, but anyway, Folfiri is working for me, and hope it shrinks my tumors to nothing, and I hope it does well for you!

    Hugssss!
    ~Donna
  • troylenderink
    troylenderink Member Posts: 9
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    Shayenne said:

    Hi there!
    Welcome to the board Troy!

    I was diagnosed with Stage 4 Colon cancer with a tumor in the liver in January of this year. I had never been sick, no signs or symptoms, except a "hardness" above my belly area to the left, and alot of fluid that was swelling me up, I gained like alot of weight, and was uncomfortable even tying my shoes, which brought me to the ER room because of the discomfort, and that's when they ran the scans and saw I had a thick mass on my colon with a tumor in my liver, and being anemic, I was way down in the levels...they then transferred me in an ambulance to the James Cancer Research Center in Columbus, where I been going ever since.

    My doctor is a specialist in the colon, and her plan was to start me on Folfiri with Avastin, which I've been on ever since. Now, in March, I had a couple setbacks, I had an absessed wisdom tooth which caused me to be hospitalized with an infection, and then 2 weeks later, I had gotten a colon perforation, which led to emergency surgery..my bowels were going into my belly, and I had to get a colostomy, which saved my life actually, I was in ICU for a couple days, and then the hospital for 2 weeks, sent home with a wound vac for my incision, and ever since that, I been doing well, they had to stop chemo till I was able to recuperate from the surgery..

    I had my first CT scan last month, and my doctor was happy to say that the chemo has killed most of my cancer! she told me she gets good results with the folfiri treatment. I feel so much better then I did before I started chemo, no more fluid, I lost over 20 lbs, but that was good for me, since the weight gain was due to the cancer. My tumors are shrinking, and she was eager to get me back on the chemo right away, now that my incision is healed, and colostomy working as it should. I have finished 5 treatments of it, out of 12 that I have to do...

    You will experience alot of hair thinning (she told me I wouldn't lose my hair on it, but I am, alot is coming out, but I'm not bald yet), nausea is the worse, but they have great anti-nausea meds, since I been taking Emend and Dexamethasone, I have not had any nausea or vomiting...I go in every other Wednesday, and have a pump connected to me for 46 hours, till Friday, when a home health nurse will come and disconnect me, and it's such a nice relief to get the pump off, but then you will feel totally wiped out for a few days, but dont worry! you will bounce back to your old self! you will feel like a zombie, and that's ok, it's only temporary, just lay in bed, take it easy, and once your energy comes back, you'll see you'll be able to do this! if I can do it, you can do it!

    Drink lots of water! especially during the chemo, it will flush it out faster, so you can feel better, but anyway, Folfiri is working for me, and hope it shrinks my tumors to nothing, and I hope it does well for you!

    Hugssss!
    ~Donna

    Thank you so much for sharing your experience!
    Hi Donna,

    Thank you so much for sharing your experience with me. I am sorry to hear about your bowel perforation but happy that the folfiri + avastin are able to shrink your tumors. It is very encouraging for me. Actually, six weeks ago I was admitted to the ER when an intense pain get to me in the midst of my twelveth folfox + avastin treatment. After cat scan, i was told that the wall of my small intestine has air in it and that was an early sign of perforation. My oncologist thought that the avastin was the caused of it. Therefore he decided to switch me to the folfiri but discontinue the avastin. My major problem at this time is not the cancer itself, It is the obstruction of the small intestine and the problems it brings. I am not able to eat normally, for instance, no solid food, no fruits nor vegetales, no cheese, nor grains, all of the above travels through my bowels with difficulty and causes tremendous pain. At this very moment, I am in the hospital bed with pca pump constantly pumping in 12mg of dilaudid into my body every hour to relieve the pain, TPN to nourish me and sodium chloride to keep me hydrated. Of course drainig of my stomach acid and pressure constantly throughout day and night. It seemed like your open surgery didn't cause any postsurgical adhesions problem I'm happy for you!
    Please keep me posted!

    troy
  • Shayenne
    Shayenne Member Posts: 2,342
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    Thank you so much for sharing your experience!
    Hi Donna,

    Thank you so much for sharing your experience with me. I am sorry to hear about your bowel perforation but happy that the folfiri + avastin are able to shrink your tumors. It is very encouraging for me. Actually, six weeks ago I was admitted to the ER when an intense pain get to me in the midst of my twelveth folfox + avastin treatment. After cat scan, i was told that the wall of my small intestine has air in it and that was an early sign of perforation. My oncologist thought that the avastin was the caused of it. Therefore he decided to switch me to the folfiri but discontinue the avastin. My major problem at this time is not the cancer itself, It is the obstruction of the small intestine and the problems it brings. I am not able to eat normally, for instance, no solid food, no fruits nor vegetales, no cheese, nor grains, all of the above travels through my bowels with difficulty and causes tremendous pain. At this very moment, I am in the hospital bed with pca pump constantly pumping in 12mg of dilaudid into my body every hour to relieve the pain, TPN to nourish me and sodium chloride to keep me hydrated. Of course drainig of my stomach acid and pressure constantly throughout day and night. It seemed like your open surgery didn't cause any postsurgical adhesions problem I'm happy for you!
    Please keep me posted!

    troy

    I thought...
    ...the Avastin caused my colon perforation, but it didn't. I was losing blood from somewhere in my body, they just couldn't find where...well, we found it, it was leaking from my sigmoid area, and that's where my coloscopy was, they took out the sigmoid part, cleaned all my intestines out, and it took 11 liters of sea water they used to clean out my belly area of the bowels.

    She was debating whether to take me off the Avastin, thinking if it was the cause, but decided no, it wasn't, because I was going into my 4th treatment at the time, when my the perforation happened, and if anything, I would have had an earlier reaction to the Avastin then. She said the avastin is something she wants to keep me on since that's what is good for the diseased liver, so we stayed with it, I finished treatments 4 and 5 since the colostomy, and knock on wood, everything has been ok! I was worried about them taking the Avastin away as well, as I wanted this drug, which showed alot of promise in killing the tumors, starving them and not letting anymore grow, so we are going on with it. If it was to give me some colon perforation, she said it would have happened in the 1st or 2nd round, sooner not later.

    NO, my surgery lasted a few hours, and I had the chief surgeon on staff do me. It was late too, and my wound was totally opened, with some wet/dry dressing, they later put the sponges in there and taped it down with a wound vac, since it's supposed to cut the time of the healing time in half, with less risk of infection. It was painful, especially when it got time to change the dressings, but you get used to it, I learned to take the pain killers before the nurses came to my house to change it, and also a xanex, to calm me down while they did it, lol....

    I'd tell your doctor to keep you on the Avastin, it is highly unlikely mine said that it wouldn't cause any colon perforations unless it was very early when used, not when it was down the road already somewhere. It's a very useful drug in the cancer field, my doctor really likes it, and it has done very well in the shrinkage of my tumors.

    Hugssss!
    ~Donna
  • troylenderink
    troylenderink Member Posts: 9
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    Shayenne said:

    I thought...
    ...the Avastin caused my colon perforation, but it didn't. I was losing blood from somewhere in my body, they just couldn't find where...well, we found it, it was leaking from my sigmoid area, and that's where my coloscopy was, they took out the sigmoid part, cleaned all my intestines out, and it took 11 liters of sea water they used to clean out my belly area of the bowels.

    She was debating whether to take me off the Avastin, thinking if it was the cause, but decided no, it wasn't, because I was going into my 4th treatment at the time, when my the perforation happened, and if anything, I would have had an earlier reaction to the Avastin then. She said the avastin is something she wants to keep me on since that's what is good for the diseased liver, so we stayed with it, I finished treatments 4 and 5 since the colostomy, and knock on wood, everything has been ok! I was worried about them taking the Avastin away as well, as I wanted this drug, which showed alot of promise in killing the tumors, starving them and not letting anymore grow, so we are going on with it. If it was to give me some colon perforation, she said it would have happened in the 1st or 2nd round, sooner not later.

    NO, my surgery lasted a few hours, and I had the chief surgeon on staff do me. It was late too, and my wound was totally opened, with some wet/dry dressing, they later put the sponges in there and taped it down with a wound vac, since it's supposed to cut the time of the healing time in half, with less risk of infection. It was painful, especially when it got time to change the dressings, but you get used to it, I learned to take the pain killers before the nurses came to my house to change it, and also a xanex, to calm me down while they did it, lol....

    I'd tell your doctor to keep you on the Avastin, it is highly unlikely mine said that it wouldn't cause any colon perforations unless it was very early when used, not when it was down the road already somewhere. It's a very useful drug in the cancer field, my doctor really likes it, and it has done very well in the shrinkage of my tumors.

    Hugssss!
    ~Donna

    Thank you for the
    Thank you for the information. I will definitely talk to my oncologist about using avastin again. Hope you have a wonderful day!

    troy
  • PhillieG
    PhillieG Member Posts: 4,866 Member
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    Similar but not as bad experience
    After my initial operation in Sept 04 for a tumor on my colon and a liver resection and a few other "un-needed parts" taken out, I did OK for about2 months. Then one day I got hit with the bowel obstruction. It hit like a ton of bricks. I was in the hospital with the NG tube down the nose and all. One of the most unpleasant things I ever had done to me. The were able to correct the blockage by removing the scar tissue and ever since then I have been OK.
    As far as what chemo to do, I think I went on FUDR and CPT11. I have been dealing with lung mets since then, 3 plus years.
    I hope this is of some help Troy
    -p

    PS: I did Avastin and had very good results with it. I think I did that with the FOLFOX.
    I am currently on Erbitux
  • troylenderink
    troylenderink Member Posts: 9
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    PhillieG said:

    Similar but not as bad experience
    After my initial operation in Sept 04 for a tumor on my colon and a liver resection and a few other "un-needed parts" taken out, I did OK for about2 months. Then one day I got hit with the bowel obstruction. It hit like a ton of bricks. I was in the hospital with the NG tube down the nose and all. One of the most unpleasant things I ever had done to me. The were able to correct the blockage by removing the scar tissue and ever since then I have been OK.
    As far as what chemo to do, I think I went on FUDR and CPT11. I have been dealing with lung mets since then, 3 plus years.
    I hope this is of some help Troy
    -p

    PS: I did Avastin and had very good results with it. I think I did that with the FOLFOX.
    I am currently on Erbitux

    Thank you very much for your
    Thank you very much for your information. Lung mets? have you heard of cyberknife for inoperable tumors? I heard it has been very promising particularly for lung tumors and it is lease invasive with minimal side effects? There are two hospitals in michigan that does cyberknife radiotherapy. I just got their phone number today wiill call tomorrow to obtain some info.

    hope your treatment goes well!

    Troy
  • PhillieG
    PhillieG Member Posts: 4,866 Member
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    Thank you very much for your
    Thank you very much for your information. Lung mets? have you heard of cyberknife for inoperable tumors? I heard it has been very promising particularly for lung tumors and it is lease invasive with minimal side effects? There are two hospitals in michigan that does cyberknife radiotherapy. I just got their phone number today wiill call tomorrow to obtain some info.

    hope your treatment goes well!

    Troy

    I think someone mentioned it here
    I did a RFA (radio frequency ablation) once and that was a walk in the park. Needle in tumor, it heats up, fries it, go home next day. The Erbitux has been keeping things in check.

    Who knows, since I am no longer able to have a regular lung op due to scar tissue, maybe a cyber-knife is in my future.
    -p
  • troylenderink
    troylenderink Member Posts: 9
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    PhillieG said:

    I think someone mentioned it here
    I did a RFA (radio frequency ablation) once and that was a walk in the park. Needle in tumor, it heats up, fries it, go home next day. The Erbitux has been keeping things in check.

    Who knows, since I am no longer able to have a regular lung op due to scar tissue, maybe a cyber-knife is in my future.
    -p

    seeking resolution for bowel obstruction!!!
    My oncologist told me yesterday I have 4-6 months to live if I go without chemo or 8-12 months with chemo. Due to my bowel obstruction, he didn't think I can safely receive the chemo without getting my small intestines perforated again. I'm at a point where i have to choose whether to live comfortably without chemo, or build up my body in the next few weeks o prepare for another round of chemo and its side effects. Today I decided I want to give it another try, but of course that is if my body's able to build up enough strength to do so. Does anyone out there know any hospitals or surgeons that would perform surgery on a partial small bowel multiple loop obstruction? or anyone who has similar experience who like to share?

    Troy
  • irene511
    irene511 Member Posts: 2
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    adhesions and bowel obstructions
    I was diagnosed with Hodgkins when i was 12 yrs. I had chemotherapy and radiotherapy around my groin. This seemed to be the start of the problems. I had also had an exploratory laparotomy for the cancer (quite a large operation). I had my first bowel obstruction at 16yrs which required surgery. I had my 2nd requiring surgey at 22 yrs. Since then i have also had 2 caesareans (24 yrs and 26 yrs). All this surgery keeps putting me at risk of further bowel obstructions. I have been admited another 2 times into hospital for bowel obstructions, but was lucky enough to avoid surgery. I am now 28 yrs and am scared that this will keep happening in the future. However, i am prepared for the surgery next time and will do anything i can to avoid the adhesions building up. I want to share this information (dont know if it will help) so that others have the knowledge to talk to their doctors. The first is an article i found on the study of a pain releif medication. If taken for 7 - 10 days after surgey, adhesion formation is limited (which is the best prevention). The mediaction is called celebrex and here is some information --->http://www.ehow.com/how_4451464_prevent-abdominal-adhesions.html
    www.adhesionprevention.com.au
    http://www.boston.com/news/globe/health_science/articles/2005/02/08/painkiller_may_prevent_adhesions_after_surgery/

    The last time i felt the familiar pains of the bowel obstruction, i started searching the net for a way to avoid surgery. I came across an article on pressure points in the back, i massaged the point and low and behold the pain subsided. I kept with the massage and within 2 hours i had passed wind and felt my stomach rumbling. This pressure point is supposed to help encourage intestinal activity. I dont know if its scientific, but all i know is that i didnt need surgery. Here is the article http://findarticles.com/p/articles/mi_m0HKP/is_1_28/ai_65014422/?tag=content;col1

    I dont know if this information will help, but at the very least it has prepared me in case of another obstruction. I now know what to ask the doctors to do, i dont just want them to operate and hope that the problem wont come back. Im too young to he in hospital on a regular basis for this.

    Good luck to everyone
  • serrana
    serrana Member Posts: 163 Member
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    seeking resolution for bowel obstruction!!!
    My oncologist told me yesterday I have 4-6 months to live if I go without chemo or 8-12 months with chemo. Due to my bowel obstruction, he didn't think I can safely receive the chemo without getting my small intestines perforated again. I'm at a point where i have to choose whether to live comfortably without chemo, or build up my body in the next few weeks o prepare for another round of chemo and its side effects. Today I decided I want to give it another try, but of course that is if my body's able to build up enough strength to do so. Does anyone out there know any hospitals or surgeons that would perform surgery on a partial small bowel multiple loop obstruction? or anyone who has similar experience who like to share?

    Troy

    seeking resolution to bowel obstruction
    Troy
    As a 2 1/2 year stage 4 survivor of 3 surgeries and almost 30 chemo infusions I would not listen to an onc who gave me the stats of survival that you were given Statistics are for horse races, they are at least 4 years old and all the folks are not like you in the group.

    I urge you to get a second and third opinion from a Board Certified Colorectal Surgeon ( FACRS) at at NCI Cancer Center or at least at a teaching hospital.
    Ask for your case to be presented at Tumor Board Review.

    I was told to go get a colostomy by the doc who found my tumor on a colonoscopy; I said no way, got an opinion from an NCI Cancer Center FACRS Surgeon and didn't have to have one at all.

    Don't take no for an answer.
    Blessings and prayers
    Serrana
  • angelsbaby
    angelsbaby Member Posts: 1,165 Member
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    irene511 said:

    adhesions and bowel obstructions
    I was diagnosed with Hodgkins when i was 12 yrs. I had chemotherapy and radiotherapy around my groin. This seemed to be the start of the problems. I had also had an exploratory laparotomy for the cancer (quite a large operation). I had my first bowel obstruction at 16yrs which required surgery. I had my 2nd requiring surgey at 22 yrs. Since then i have also had 2 caesareans (24 yrs and 26 yrs). All this surgery keeps putting me at risk of further bowel obstructions. I have been admited another 2 times into hospital for bowel obstructions, but was lucky enough to avoid surgery. I am now 28 yrs and am scared that this will keep happening in the future. However, i am prepared for the surgery next time and will do anything i can to avoid the adhesions building up. I want to share this information (dont know if it will help) so that others have the knowledge to talk to their doctors. The first is an article i found on the study of a pain releif medication. If taken for 7 - 10 days after surgey, adhesion formation is limited (which is the best prevention). The mediaction is called celebrex and here is some information --->http://www.ehow.com/how_4451464_prevent-abdominal-adhesions.html
    www.adhesionprevention.com.au
    http://www.boston.com/news/globe/health_science/articles/2005/02/08/painkiller_may_prevent_adhesions_after_surgery/

    The last time i felt the familiar pains of the bowel obstruction, i started searching the net for a way to avoid surgery. I came across an article on pressure points in the back, i massaged the point and low and behold the pain subsided. I kept with the massage and within 2 hours i had passed wind and felt my stomach rumbling. This pressure point is supposed to help encourage intestinal activity. I dont know if its scientific, but all i know is that i didnt need surgery. Here is the article http://findarticles.com/p/articles/mi_m0HKP/is_1_28/ai_65014422/?tag=content;col1

    I dont know if this information will help, but at the very least it has prepared me in case of another obstruction. I now know what to ask the doctors to do, i dont just want them to operate and hope that the problem wont come back. Im too young to he in hospital on a regular basis for this.

    Good luck to everyone

    Troy
    My husband had a blockage too they took the small intestine and gave him an ileostomy bag is that possible for you. I am so sorry that this is happening My husband at the end opted for no more chemo. And that is a personal choice. And he was good with his choice, Now me on the other hand, I was not good with that choice but it was the best for him and that was the important thing. I hope and pray that this will all work out for you.I am glad your going to try the chemo.

    michelle