APR Surgery

Hi, I am sorry for this newest challenge you face and hope we can be of some help. It does sound like you are confident in your medical team and that is important.

I have had an ostomy as part of my treatment for Stage 3b anal cancer for 5 1/2 years now. There are several different ways to perform this surgery, and as I'm sure you know, what is right for one is not the best for another. My surgery was done at the onset of my treatment due to size and location of my tumor. It was not intended to be permanent and to be reversed within the year. Unfortunately severe radiation damage limited the success of reversal, and so it remains. I have what is called a loop ostomy, and more commonly done when there is the potential for reversal. Basically it means I still have my rectum and anus yet they are "out of commision" so to speak. The colon is pulled through an opening in my lower abdomen and a small cuff is made to create a stoma. (It looks similar to puckered lips, lol)

In my case healing was not difficult and I was beginning treatment of chemo/radiation as well as being in extreme pain and fatiqued due to what I now consider a late diagnosis. The ostomy surgery offered some relief from pain, so I was thankful. It is my understanding that the typical permanent ostomy surgery (APR) which involves closing off that end of the colon and removing the anus/rectum as well as sewing this area shut (sometimes referred to as a "Barbie Butt") involves about 7-10 days of healing. I do not know that that is all hospital time or based on assistance at home. I imagine there are packing and dressing changes involved.

I was very sick at the time of my diagnosis and was never referred to a stoma nurse (someone trained in this area) to assist with picking proper placement and appliance management afterwards, and would have much welcomed the advice. I am now in a support group and have made all those connections, but would have liked some say in the location of my stoma......if it was discussed I do not remember it. Think about the type of clothes you wear most and discuss this with a stoma, or wound care nurse as there is often some flexibility as to up a little or over a little, making pants, jeans, etc. fit more comfortably. There are also a LOT of products out there to use (bags) made by several different manufacturers. The hospital where you have the surgery will send you home with their most preferred, but a stoma nurse can help you with getting samples of different brands that may work better for you. Picture paper towels, they all do the same job, but some are softer, different texture, more absorbant, etc.........there will be one that works just right for you.

I kept a food journal once done with chemo to try to better manage certain foods that may trigger concerns. I am now able to avoid certain foods that I know will cause "the runs" and the need to empty the bag more often, or others that may have an opposite effect and a serious issue as well. I am active with my family (8 grandkids), swim, travel, and even went back to college. With a little patience, trial and error, and allowing yourself time to adjust, this is a very doable thing.

While it is a major surgery, I do not remember being too anxious over the need, although as I said, at the time I was sick and in pain, so not as focused or in the place you are now in. My surgery was performed in central Wisconsin by a general surgeon at Marshfield Clinic. He came highly recommended and I have since seen him for other health concerns.

It sounds like you are in good hands and my only suggestion right now would be to contact a stoma (sometimes called wound care) nurse to help PRIOR to this surgery.

You will be in my thoughts and prayers that all goes well as you move forward.

katheryn