Mikenh and Surgery

I started the colonoscopy prep eight hours earlier than expected by stopping eating Saturday night. The trip to Boston would take several hours and I didn't want an accident while driving down or taking the train to Brigham and Women's. Compounding this was the forecast of heavy wind and rain for early Monday morning. So I drove to my mother's home and took the train to a hotel next to Brigham and Women's. The weather was windy and wet Sunday evening. I forgot a lightning cable so I walked about 0.6 miles to Walgreens in the harsh weather and passed by the hospital on the way back. I decided to go in to dry off a little and ask about admitting. I found out where I should go. The lady in Admitting said that there's a huge line of people at 5:30 for 7:30 surgeries. I returned to the hotel room and did the Hibiclens for the day.

One problem with the directions is with the instruction to pour a quarter-size amount onto a washcloth. So I poured out that much as I took it to mean the US monetary coin. It meant a quarter of the bottle which I figured out on the morning of the surgery so I followed the correct directions only once. I kept doing the quarter-sized bits so I got the stuff on me but you're supposed to use a quarter of the bottle in the facecloth and squeeze it into a lather to apply.

I woke up around 3:30 to do the enema (worked very quickly), then the morning Hibiclens, and then drank the ClearFast. It was White Grape flavor and has 200 calories per bottle. Then I walked over. The rain had stopped and the wind had died down. I got there at 5 AM and was asked to sit in the waiting room after they took my name. At 5:15 AM, they opened the doors and a long line of people came in. Many with suitcases. I assume that those folks traveled, perhaps from faraway places. They then called me and I gave them my information and my workout bag. I went back to the waiting room for a few minutes and then they called me and one other person to go to the pre-op area.

They took my clothes and valuables and I was in a bed and getting stuck, poked, checked, etc. I was supposed to start at 7:30 AM but I didn't actually start until 9:45 AM and I believe that some staff didn't make it in on time. The surgeon said hello (her resident gave me most of the information and he had a very good bedside manner) and I was wheeled into the operating room and they put a mask over me and I was out in about a minute. I woke up feeling pretty sore in my back but I was otherwise not feeling any pain.

I had a back injury in my 20s from carrying a weightlifting set up to my apartment and I'm fine if I keep my core strong. The OR table was flat so I think that was the reason for the soreness. I did hit the pain pump three times but there was no improvement for the backache and I learned that some kinds of pain do not respond well to medications used today. It took me a while to figure out that the ache was from my old injury and not the surgery and when I figured it out, I just asked for a towel to place under the curve of my back and that took care of the problem.

Surgery was done at 2 PM and I left recovery around 6 PM. My sister was there with my backpack (computer, charger, and other stuff) and chatted for a while and then went up to the floor as it was ready but they were cleaning the other side of it so I was delayed. I had a ton of stuff attached to me: IV in the left arm, butterfly in the right for blood draws, Foley catheter, Uretal Stents, drainage tube under the stoma, EKG leads and Oxygen. I did not get out of bed until Tuesday morning so I was okay. No real pain as the anesthesia took time to wear off. I didn't have anything to eat on Monday but I had a Ringer's Lactate IV running through.

Hey Jim - I have two of those conditions as well. Bizarre to say that the neuropathy I experienced while I was on Oxi and 5FU actually somewhat masked them. Sounds crazy I know. As my neuropathy is going away my arthritis and Reynaud's are coming back with a vengance.  I talked to my oncologist about it and although he didn't say the research supported it he also didn't challenge me on it and included it as a side effect of my chemo in my medical file. That said, the neuropathy is unpleasant and has it's own challenges. Just thought I would share my unique experience with it. Feeling comfortable with your treatment plan and maintaining quality of life issues is such a personal decision and one we all make in deciding how to deal with the cards we are dealt. Gotta love Kenny Rogers, know when to walk away and know when to run... 

Annabelle41415 said:

See You're Posting

Glad to see you posting.  Take care of yourself first and everything else will fall into place.  When are you coming home?  It seems they don't keep you long anymore.  Hope your recovery is speedy.  Praying for a fast bounce back to living.

Kim

Many suggested today for leaving but I had planned for tomorrow so I've been pushing for tomorrow. I told me surgeon, somewhat humously, that I could take the train into Boston and then take another train to Newton, walk 1/2 mile to my mother's house and then drive 75 minutes to get home. And she said, "No.". I have a pain issue but it feels like it is related to bladder pressure. It's the dull ache type of pain which isn't sharp but really annoying because of persistence. It has come and gone and pain medication, outside the Oxy at 5 mg, doesn't feel correlated. The Oxy dulls the pain by about 50%. Sometimes I feel fine and sometimes not. When I'm in bed and not moving, there is no pain. Walking can bring about the pain. I went out to walk 8 times yesterday, in addition to filling up my pitcher from the ice and water dispenser. Sometimes there was pain and sometimes only a little pain. It also took a while for my bladder to wake up and there's a regular amount of blood in my urine. The nurse said that's normal because of the ureter stents and it takes several days for that part of the body to heal.

Perhaps Jim, Beth or Grace could comment on where they felt the pain was after surgery. I was hoping that there would be no pain by the time I left but that doesn't look like it will be the case. What's interesting is that the pain is near one of the small cuts. The big cut in the middle feels fine unless I cough. For those that will have the surgery: they encourage you to drink a lot of water but take the drinking slowly. I was gulping it down last night and some went down the wrong way causing a coughing fit and you don't want to do that after surgery.

Ruthmomto4 said:

Could it be

just irritation from the catheter and bladder stents? Maybe the start of a bladder infection? I know they are not common in men but after a catheter and stents it's very possible. Bladder pressure certainly sounds a bit like the start of an infection, or it just could be irritation. Drinking will help, go slow. I hope it resolves itself today!

I told the doctors this morning and they are aware of it and mentioned the stents. I suspect that I would be in no pain at all if this weren’t an issue. I will continue with water and going to the bathroom. Never had. UTI before so I don’t know what it feels like but it’s over to the left.

airborne72 said:

Superman

Mike:

You need to change your avatar to Superman.  Considering your mental acuteness, physical fitness and self-discipline you fully qualify for the name.  I am impressed.

However, I do want to caution you.  Even the real Superman (Marvel Comics guy) had issues with kryptonite.  Don't worry about it, but do remain very much aware of the fact that your body is being held together by stitches in several internal locations.

My sister got onto me about this a few days after I got discharged and I was looking out the window at my garden.  The temptation was too great so outside I went with a rapidly growing list of things that I NEED to do right now to prepare the garden for winter.  The sun and fresh air were invigorating, so much so that I picked up a garden rake and began to reposition dirt.  I would recommend hard raking for those who want to have a flat stomach, but do not do so 6 days after a major abdominal surgery.  I don't believe that I pulled anything in my torso too much, but I could tell that my insides were not normal.  Sixty-six year old sanity finally prevailed and I went inside to rest.  Later I told my sister in an email what I had done and she scolded and chided me for taking the chance of tearing stitches and staples.  I listened and have not since violated medical restrictions, thanks to my big sister.

My pains did not match your's.  I retained consistent incisional pain in my midsection (largest incision) and even for a few days after discharge.  The larger pain for me just seemed to be broad internal area that would increase or decrease in pain levels for apparent reasons and not for apparent reasons.  This pain could become significant in terms of duration, frequency and strength.  I rated mine at 7 two days after surgery but within a week it was minor.

Surprisingly, I did not have any issues with the catheter.  Once home and closer to normalcy, I have noticed a persistent higher level of pain during urination.  I believe this to be the result of and recovery from the tissue damage inflicted during the surgery.

Discharge dates come with mixed feelings.  You might ask yourself if you really want to leave this secure place? Or, you may say something to the effect of get me out of here NOW!  I wanted out so when my surgeon offered a date I took it. I just could not tolerate another blood thinner injection into my stomach so I politely asked my surgeon if he would give me three steps toward the door. My surgery was on a Tuesday and I left on Friday.

The recovery period for this surgery is just as important as the preparation phase was.  Therefore, it is extremely important that each of us follow instructions.

Continue to heal Mike.

Jim

Jim is so right. 

I bet many of us can attest to overdoing it after surgery.  

After my liver surgery I was starting to feel pretty good. About a week out of hospital, I asked the nurse if I could start my regualr walks. She practically shouted down the phone 'Lady, you've just had liver surgery. NO!' 

Well, I felt pretty good, and I wanted to walk my normal five miles. I ended up having to picture/visualize my liver. I had to picture the surgery and what they did INSIDE of me, before I could understad why I was being told what I couldn't do. 

As Jim said; allot went on underneath that abdominal incicion. Don't push it! Bits of you were stitched together. Don't undo it by doing too much. 

But you are definitely on the right track. Keep up the good work but be patient and be good to yourself. 

There endeth my rant. I will now climb down from my soap box and leave you be. 

Tru

Ruthmomto4 said:

Could it be

just irritation from the catheter and bladder stents? Maybe the start of a bladder infection? I know they are not common in men but after a catheter and stents it's very possible. Bladder pressure certainly sounds a bit like the start of an infection, or it just could be irritation. Drinking will help, go slow. I hope it resolves itself today!

I looked up the symptoms of UTIs and bladder infections and some of them are quite graphic or colorful. I don't have any pain from urinating so that's likely not the problem. It seems like urinating or just resting gets rid of it. I may experiment around more with meds. I took pictures of the staples. I had never seen them before. Amazing what tech they use these days.

after all you and everyone here has been through you would think we would all know better then to look things up on the internet loll

its most likely the stents or the catheter that just left you with some irritation. Mainly it would be pain and pressure that feel better when you pee, maybe pain after you pee, and a constant need to go. Although all those can be from the stent/catheter. My husband had horrible back pain from the stent, gone oncevthey took it out. I am sure it will feel better soon. You remind me of my husband who went back to work a week after colon resection and a week and half after the liver surgery. I won't tell you to take it easy because it's not in your make up, so be smart! You are pretty inspirational! 

Tuesday

It’s pretty hard to sleep in a hospital bed at night as there are folks coming in to take your vitals every few hours, check your IV, take blood, empty your catheter, drain the stoma, drain the drain tube blood along with the noise and lights of the ward. So I did get some sleep but not as much as I should have but that’s the way it goes. I think that risk is pretty high the day after surgery so they want to keep a close eye on you.

I had a lot of chest congestion from 7:00 to 7:30 AM and I attribute that to the irritation from the chest tube. One of the nurses suggested using a cough pillow and that worked out when it was within reach. When it wasn’t, I had to clutch. Coughing was big pain but for a very short time. This took a few days to resolve though my voice was still weaker than usual at discharge.

TMI bucket: You can pass gas from the anus. I thought that it was shut off but it isn’t so stuff can come out there like mucus. They provide mesh underwear and put in pads to catch stuff.

I ordered breakfast but bland stuff was recommended so I ordered white toast, broth, and cranberry juice. It took me about five hours to eat because my body didn’t feel like eating even though my mind was very hungry. It was a little painful to sit and eat.

The major pain was on the left side and I tried to figure out if it was the wound, just general pain or related to the catheter. The catheter bag filled up fast because of the amount of fluids that they were pumping through me. The stoma bag filled up fast as well.

I did get up and walk three times. One round of 1 trip around the ward, one round of 2 trips around and one round of 3 trips around. The anesthesia wore off today so pain was unmasked. The left-side pain comes and goes and maybe urinating relieves it. They want me to crank up the fluids as they removed the ureter stents and the bladder has to wake up. I think that they were worried about infection if I didn’t get more through the bladder. In normal GI operation the body reabsorbs water from the large intestine but this is bypassed with my setup. So I could get dehydrated without enough water. An indication of enough water would be urinating and less in the bag.

One of the Surgeon’s doctors said that I will have to inject Lovenex into my thigh for the next month. I am scared of needles and close my eyes when I am stuck. I asked my wife if she would do it and she volunteered to do so. But I don’t know who will do it. I kind of pushed the unpleasant idea out of my mind.

The surgeon came and told me that things went well and that I might be down-staged depending on the path reports. I don’t know if the post-surgical treatment will be any different.

I had a long training session with the Stoma Nurse and she went through the making of a pattern, cutting the piece that attaches to the skin, applying the adhesive and putting them on. She went over suppliers as well. They will leave me with 10 bags and a tube of adhesive so I need to order more when I get home. Theoretically, it should be five bags per month but they give you ten of them per month. I’d rather be safe than sorry. I will order some on my own (without insurance) if I have to.

My friend George came down to visit. I wasn’t expecting him and I was a bit surprised that he took the time and expense to come down here. He only stayed for a little while. I would guess that he was scoping out the trip. He thought that I was doing quite well.

I tried Tylenol 650 mg. I couldn’t tell whether or not it helped. Dinner was toast and chicken soup. So about 400 calories for the day. My body wasn’t hungry but my mind was. This hospital has a fantastic menu and choosing from all of the options was challenging. I sent my wife the menu and she said “you have got to be kidding” - it had so many options. My roommate was impressed with the food and he’s a retired doctor.

I managed to empty my stoma bag but I forgot to squeeze out the gas.

Thursday

The left hip pain seems independent of the pain medication but I still took a Tylenol as I was debating ramping up medication for one last try.

Urine output has improved to 250-300 per shot but it’s still blood-tinged and I asked a nurse for a scale and she went to fetch one. They had this huge electronic scale that looked like it cost $2,000 and I weighed about seven pounds less than a week ago and that seemed reasonable to me.

I went to the visitor’s lobby and tried out a number of exercises. I wanted to do a few more but didn’t have the opportunity. I did a squat, crane pose, warrior pose, Neck rolls, Arm circles, Upper Body Twists, Rotator cuff stretches and Tree pose.

The doctors came in for rounds early in the morning (6 AM) and said that I should take Imodium and I was given three or four for the day. The bag material became much less watery and urine output increased. I’m still doing about 275 ml at a time. I think that my body wants me to go at a certain pressure level. Their target is 500-1500 ml in the bag and I was at 1800.

I took a lot of walks today, many to refill my pitcher. It may be that the overall amount of pain is decreasing with whatever is getting pressed healing.

I ordered a big breakfast to experiment: oatmeal, cream of rice, whole wheat toast, scrambled tofu. It was all good and filling. Dietary recommendations are to eat a bunch of small meals. This makes sense given the limited size of the bag.

Someone came in and told me that they were thinking of discharging me today but I said that I didn’t think that I was ready and my ride was scheduled for tomorrow so I didn’t hear anything more on discharge today. I also talked to someone about the discharge time and process and then sent email to my ride to schedule pickup at 12:30 PM on Friday.

The nurse came in for another teaching session on giving myself shots of Lovenex. I applied the alcohol to my leg but I was supposed to apply it to the roll of tape. So she asked me if I wanted to just inject myself or still test on the tape. I decided to just inject myself with her coaching and did it and it burned for about ten minutes and I could still feel it 30 minutes later. But it was done.

I had a look around work and considered starting a small project but decided against it. Things were relatively quiet and I spent time resting and doing some social media.

I ordered glazed salmon, macaroni and cheese and sweet potato for dinner and a chocolate chip cookie for dessert. I had the first three and saved the cookie for Friday. I have had no problems with any of the foods that I’ve tried. Several more walks, pitchers of water and I skipped pain meds for the rest of the evening. Then I wrote up these logs.

I feel like I’m ready to go home tomorrow.

My hospital food & care was amazing.  I did not want to leave until 100% ready.  Glad you are getting the same!  

Not sure what type of ostomy you are dealing with, but I found Coloplast to be far superior to Hollister.  Interestingly, much of my pain was around and under my stoma. A burning pain.  Oxycodone made me feel mentally out of it and didn't help the pain.  I used Norco at home and still use it on occasion to help me sleep.  My incision never hurt much.  Lots of staples!!  But not really sore.  Also I was given choice of belly or thigh for heparin shots.  No pain when administered to thigh.  

I hope to be back at the gym next week.  Need to get my legs back in shape and improve endurance before going back to work on the 13th.

Mike you are a great inspiration.  And, Jim, I love the poker game analogy!  I feel the same.  Quality of life is so important.

Best wishes to all from Beth