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Countdown: Only 4 days till my SURGERY for Rectal Cancer Removal!

maryjane
Posts: 71
Joined: Dec 2009

I was diagnosed Nov 23, 09 with Adenacarcinoma and have spent this past Holiday month interviewing docs. FINALLY...I put myself in the PASSENGER SEAT and have allowed the Doc to do the Driving! My final decision..SURGERY..no chemo or radiation...YET! I want to see what's happening inside first and also get this life-threatening growth out NOW! It's a different approach than what I've heard as I gathered other opinions. I'm happy with my decision to finally QUIT RESEARCHING and get the surgery. But...my fear factor is OFF THE CHARTS! I keep trying PRAYER, IMAGING, DEEP BREATHING, WORKING THRU MY FEELINGS WITH ART, but..fact remains..I'm PETRIFIED! Have been very healthy all my life with just 1 other minor surgery for a broken elbow. Any thoughts on coping with PANIC ATTACKS???
MARYJANE

dorookie
Posts: 1736
Joined: Jul 2007

I didnt handle the panic attacks well, I had to use some meds, which my Doc gave to me. Its hard, you go through so many thoughts and feelings, its hard to understand them much less control them. However, please know this, you will get through this even if you dont feel like you will right now. I pray you wont need any chemo/radiation, but remember if you do, you will make it through that too. Nothing wrong with being scared, we have all been there, its perfectly natural in my book, you are going through alot right now.

I will be praying for you, and please try to take a deep breath and relax best you can. Like you said the DOC is in the driving seat and GOD is his navigator so you dont need to worry yourself, let them do the worrying for you...again I know easier said then done but give it a try..

God Bless
Beth

lizzydavis's picture
lizzydavis
Posts: 893
Joined: May 2009

I had a colon resection on May 15, 2009 (Rectal Stage III – No tumor). Approx. 6" was removed. Your surgery will be different but reading what I went through might help you.

I was in the hospital for 3 nights. I slept in a recliner when I got home since I was not comfortable in the bed. It was easy for me to get up and down by myself that way and I used a comforter and was cozy.
Things went better than I expected. If you have more questions, please feel free to ask. That's why we are here - to support each other.

I was prescribed a Low Residue Diet after my surgery.
A low residue diet eliminates coarse fiber and other indigestible material that may cause distress to the gastrointestinal tract and designed to reduce the volume and frequency of bowel movements. It is similar to a low fiber diet, but also restricts milk and milk products and prunes. Stock up on soup, pudding, jello, saltines, bananas, rice, applesauce.

This is some info I found which may help.
Colon Resection Surgery
Details of the procedure
What do I need to do before surgery?
Please contact your insurance company to verify the coverage and determine whether a referral is required. You will be asked to pre-register with the appropriate hospital and provide demographic and insurance information. This must be completed at least five to ten days before the surgery date. Your surgeon will give you specific instructions on how to prepare for the procedure.
Before surgery, your colon will need to be emptied. Your physician will give you directions on how to do this. You may be put on a liquid diet and instructed to drink a solution that will induce diarrhea. You may also be instructed to give yourself an enema.

What happens on the day of surgery?
You will report to a pre-operative nursing unit, where you will change into a hospital gown. A nurse will review your chart and confirm that all paperwork is in order. You will be taken to a pre-operative nursing unit where an anesthesiologist will start an IV. Before any medications are administered, your surgeon will verify your name and the type of procedure you are having. You will then be taken to the operating room. After the appropriate form of anesthesia is administered, surgery will be performed.

What type of anesthesia will be used?
You will have a pre-operative interview with an anesthesiologist who will ask you questions regarding your medical history. Colon resections are performed under general anesthesia, which will keep you asleep during your surgery.

What happens during the surgery, and how is it performed?
If your surgery is performed laproscopically, your surgeon will make three to four small incisions, and insert tube-like instruments through them. The abdomen will be filled with gas to help the surgeon view the abdominal cavity. A camera will be inserted through one of the tubes that will display images on a monitor in the operating room. In this manner, your surgeon will be able to work inside your abdomen without making a larger incision.

Your surgeon will perform the colon resection with the laparoscopic method unless other factors require open surgery. If the procedure will be performed with the open method, your surgeon will make one larger incision to enable him or her to view and repair the colon.
Once inside, the surgeon will clamp off the diseased section of colon and then cut it free. The diseased colon will be removed, and the healthy colon stitched back together. In some cases, a colostomy (link to colostomy procedure) may be performed.

What happens after the surgery?
Once the surgery is completed, you will be taken to a post-operative or recovery unit, where a nurse will monitor your progress. It is important that your bandages be kept clean and dry. Mild discomfort may occur at the incision site, so your surgeon may prescribe pain medication. You will be scheduled for a follow-up appointment within two weeks after your surgery.

How long will I be in the hospital?
Most patients are in the hospital from five to seven days with an open colon resection and three to five days with a laparoscopic colon resection. You may need a ride home when discharged from the hospital.
What are the risks associated with a colon resection?
As with any surgery, there are risks such as bleeding, infection, or an adverse reaction to anesthesia. Other risks include injury to the ureter, bowel, or spleen, and anastomotic dehiscence, which is the separation or leaking of the sutured colon. Your physician will inform you of the risks prior to surgery.

What should I watch out for?
Be sure to call your doctor if any of the following symptoms appear:
• Fever
• Worsening pain
• Redness or swelling around the incision
• The incision is warm to the touch
• Drainage from the incision

Will there be scar(s)?
If the procedure is performed laparoscopically the incisions should heal well, leaving small discrete scars. If the open method is used, a larger scar will be present.
When can I expect to return to work and/or resume normal activities?
This can vary from patient to patient. There are no restrictions after laparoscopic colon resection. You will be encouraged to return to normal activities such as showering, driving, walking up stairs, light lifting, and work as soon as you feel comfortable. Some patients can return to work in a few weeks while others prefer to wait longer. You should not perform heavy lifting or straining for six to eight weeks after open surgery. If you are taking narcotic medications for pain, you should not drive.
While you are in the hospital for recovery, stay ahead of the pain curve and if you have discomfort, don't be afraid to ask the nurse for the pain killers. Even when you start feeling better, and you will, stay on the pain meds. They make the stay more bearable.
Also, get up for a walk as soon as you can. They won't let you out until your system kicks back in and the signal for this is passing gas. Walk as much as you can while in the hospital.
Holding a smaller pillow over the incision area. The pillow is comforting. Don't be afraid to ask for an escort while you walk, you wouldn't want to trip or fall.
You will also be very, very thirsty in the beginning and they'll just give you crushed ice, but if you can tolerate it, you can have more.
It takes approx. 3 months to be back to yourself. So, don't push going back to work or your normal routine too quickly, it will be tempting. Try to stay busy with books, light housework, TV, Internet while you are home. Get outside and walk as much as possible.

Also, if they use staples on your incisions, when they take them out, it's no big deal, most of them I didn't even feel. A couple were only a tickle while being removed. None was painful.

maryjane
Posts: 71
Joined: Dec 2009

Hi Lizzie...
I am so impressed with your detailed, straight forward account of what to expect on the 30th! I feel my anxiety level shrinking. I didn't understand how you could have cancer with no tumor. Please explain. My cancer growth is 7.5 centimeters from the base of the rectum. I understand this makes it more difficult for the surgeon. Also..they will have to remove some lymph glands but supposedly it has not gone beyond the wall. Growth is 2 cm--less than an inch. My hospital stay is from 5-7 days. Then I'm planning to go to rehab. Sounds like you had a pretty easy recoup. Do you have any LEAKAGE? How bad was the pain --could you feel it when you had pain meds? That scares me! I'm very PAIN SENSITIVE! Thanks for being there. You have been extremely helpful. hOW DID THEY CATCH YOUR CANCER? Mine began with taking 3 Advil for a pain on my side. I've been told Advil is a blood thinner and that's what initiated my bleeding which got me into the emergency room for another colonoscopy and the rest is history. Had a colonoscopy 3 years prior with only benign polyps. Now..I'll need one every year.
maryjane

maryjane
Posts: 71
Joined: Dec 2009

Hi Lizzie...
I am so impressed with your detailed, straight forward account of what to expect on the 30th! I feel my anxiety level shrinking. I didn't understand how you could have cancer with no tumor. Please explain. My cancer growth is 7.5 centimeters from the base of the rectum. I understand this makes it more difficult for the surgeon. Also..they will have to remove some lymph glands but supposedly it has not gone beyond the wall. Growth is 2 cm--less than an inch. My hospital stay is from 5-7 days. Then I'm planning to go to rehab. Sounds like you had a pretty easy recoup. Do you have any LEAKAGE? How bad was the pain --could you feel it when you had pain meds? That scares me! I'm very PAIN SENSITIVE! Thanks for being there. You have been extremely helpful. hOW DID THEY CATCH YOUR CANCER? Mine began with taking 3 Advil for a pain on my side. I've been told Advil is a blood thinner and that's what initiated my bleeding which got me into the emergency room for another colonoscopy and the rest is history. Had a colonoscopy 3 years prior with only benign polyps. Now..I'll need one every year.
maryjane

maryjane
Posts: 71
Joined: Dec 2009

Hi Beth..
Thanks for your response and inspiration. I believe in your approach--GETTING YOUR FEELINGS OUT! I've been doing lots and lots of crying. Had a few real blessings over Xmas--re-connecting with family which has meant sooo much to me. I'm learning so much from all of you friends in this discussion group. A true blessing! Let's both be passengers in this vehicle and know that our Driver is doing all the right things.
Bless You...
maryjane

khl8
Posts: 810
Joined: Nov 2009

whch type of surgery will you be having?
I was not a candidate for laprosopic.
Kathy

Fight for my love
Posts: 1530
Joined: Jun 2009

Best luck and best wishes to you with the coming up surgery.Hope everything goes well and you will have a speedy recovery.

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

all I need to add is all my best wishes for you...and be patient, it will serve you well in your journey and your 100% recovery......Love and Hope, Buzzard

HollyID's picture
HollyID
Posts: 951
Joined: Dec 2009

Just want to tell you good luck as well. I was diagnosed on the same day as you!

I had my open abdominal surgery just three short weeks ago. My very talented surgeon took out the lower part of my sigmoid colon and part of my rectum for clear margins. He then reconnected the healthy parts of my colon back together. I'm also one of these people who've never been in the hospital except for the birth of my kids, and two very "simple" surgeries for my appendix and my gallbladder.

I'm a nurse and for years took care of these kinds of patients. It's been years since I have taken care of them, but it's amazing how it all comes back to you. :o) You're however, facing the unknown. I totally can empathize with your panic. Sometimes the best way to alleviate would be through knowledge. Ask tons of questions of what you can expect and what they expect of you.

The best advice I can offer to you, after surgery and for quicker recovery, is to get up and walk. I was up and out of bed the morning after surgery. I'm not a back sleeper, so it was more a matter of my comfort, plus, as much as it hurt, I knew my lungs, veins, and kidneys would love me for it. :o) I also started using my incentive spirometer, which is a device that helps you breathe deeper to keep pneumonia at bay. By that evening, I was up and out of bed again and walking as far as I could go. I think I might have only gone 20 feet, one way. Remember though, you have to walk that far back to bed as well, so don't go too far. By the second day post-op, I was walking the halls around the nurses station. I had to use a pillow to brace my abdomen, but it helps with the pain. My daughter or husband usually pushed my IV pole. Everyday, I made up my mind that I would get up two more time than I did the day before -- even if it was to sit in a chair. Also, a flat harder type of pillow is great to brace your abdomen for when you need to cough. I had my husband push down on it to help with the pain. It did help.

Don't be afraid to ask for pain medication. It's there for a reason. I had a walking epidural that automatically gave me medication and I could push a button if I needed more. By the fourth day, I was passing gas, eating a regular diet and passing stool. The epidural was out as was my urinary catheter. My pain level was nil by that time and it was very easy to walk. I was in my own clothes from home, but wasn't cleared to go home until the next day. I believe I took two pain pills before I went home for a pain level of 3/10. They will ask you to rate your pain all the time. On a level of 0-10. Zero being no pain whatsoever and 10 being the worst pain you can imagine. Since I had all my kids naturally, I used that as my "10". This surgery didn't even come close to that number.

I can't say I was scared of surgery, mostly because I knew what to expect, and what was expected of me. I did everything that I would have told my patients and It really does help to know what you're in for.

Again, maryjane, good luck. My prayers, thoughts and good vibes will be with you!

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maryjane
Posts: 71
Joined: Dec 2009

Hi Holly,
Happy for you that you've gotten thru it. Thanks for your detailed account. You being a nurse is even more helpful. Do they provide the INCENTIVE SPIROMETER? You didn't mention chemo or radiation? Did you have either? Have you ever heard of a pouch being made with staples? My cancer is 2cm and is 7.5 cm from the base of the rectum. I understand that it's much more difficult to get at. Also..one doc I saw wanted to do a colostomy and iloscopy (sp). I'd be wearing a temporary bag etc. This one doesn't think that will be necessary. I went for the least invasive surgery and wanted them to see what they were dealing with before trying chemo/rad. Hope that was a good decision--I've taken good care of my body and didn't want to be burnt up--especially if it wasn't necessary. I appreciate your input--it's an anxiety reducer! I'll plan to lots of walking. Do they provide the right kind of pillow in the hospital? MaryJane

HollyID's picture
HollyID
Posts: 951
Joined: Dec 2009

Respiratory therapy will come in the day after your surgery and give you an incentive spirometer. They will also teach you how to use it. I can't even think of anything to compare it to. But basically, just keep the bottom level and suck in. Normally, a person can breathe in about 3000-3500cc of air. I could only get mine up to 2800cc before I left. They check on you once or twice a day to make sure you're doing OK with it. Your nurse should also be keeping track of how well you're doing. It's yours to take home to use after you go home as well. :) It really helps to use that. Your lungs will LOVE you for it!

No chemo or radiation was recommended before my surgery. In fact, I haven't even seen my oncologist yet. I see him in January. I do plan on doing chemo for as long as it takes. My cancer was detected by an early colonoscopy screening because my dad passed away from colon cancer. (His was a stage IV over 21 years ago. You can imagine how treatment has improved since then.) I had no signs or symptoms that anything was wrong. My tumor was 3cm by 2 cm and it passed on into one lymph node. That makes me a stage IIIb (so far). I've had no CT scans yet. While he was in my abdomen, he visually and manually checked each of my organs for anything amiss. Also, my surgeon didn't realize how low my tumor was. During the colonoscopy, he thought it was more up in the sigmoid part of the colon than it really was. (due to the insufflation from the scope, it distorted his view.) When in reality after he got in there, he found he had to take part of my rectum as well so he could be sure that he had clear margins on both sides. He took a total of 15cm of bowel. He said he had a pretty hard time getting to it as well because it's so far down in the pelvis. I wouldn't have minded if he took my uterus out, but since he couldn't see a medical reason for it, he didn't. The day after surgery, it also felt interesting because I could feel my uterus bouncing around in there. They had to retract it up so far and move it around so much, there wasn't much holding it in place anymore. :) Feels normal now. :)

I missed having a colostomy by the skin of my teeth. If I would have ended up with one, so be it. I really wouldn't have minded. I'm much happier just being alive. I've taken care of them on my patients and have taught them how to maintain their own appliances, so I'd need reminded on how to do things, but I would have caught on pretty soon. :) I can't say I've ever heard of a pouch being made out of staples. That might be something new since I've done med-surg nursing. I bet someone else here would.

Glad you're planning on doing a lot of walking. The hospital should provide you with an adequate pillow for bracing yourself. I got the firmest one they could find. Even a firm mattress pad would suffice. No fluff. I did bring my own pillow from home for behind my head, though. I wanted to be as comfortable as possible. I see you have a great boyfriend. That really helps. My husband stayed with me (more for his comfort than for mine) the first night right after surgery. I didn't see any reason for him to stay with me after that. I had EXCELLENT nursing care and he (and I) could sleep much better at home. My daughter would help me with my walking as well as my husband during the day. Poor girl having to see her mothers backside so early in life! *laughing* I have a very supportive family circle as well as friends. I see you do too. You're going to do just fine, maryjane. Our prayers are with you!

maryjane
Posts: 71
Joined: Dec 2009

Hi Holly,
Happy for you that you've gotten thru it. Thanks for your detailed account. You being a nurse is even more helpful. Do they provide the INCENTIVE SPIROMETER? You didn't mention chemo or radiation? Did you have either? Have you ever heard of a pouch being made with staples? My cancer is 2cm and is 7.5 cm from the base of the rectum. I understand that it's much more difficult to get at. Also..one doc I saw wanted to do a colostomy and iloscopy (sp). I'd be wearing a temporary bag etc. This one doesn't think that will be necessary. I went for the least invasive surgery and wanted them to see what they were dealing with before trying chemo/rad. Hope that was a good decision--I've taken good care of my body and didn't want to be burnt up--especially if it wasn't necessary. I appreciate your input--it's an anxiety reducer! I'll plan to lots of walking. Do they provide the right kind of pillow in the hospital? MaryJane

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

I had rectal surgery, as well. Removed my entire rectum, and sigmoid colon, and fashioned a new rectum out of my descending colon. 5 years later, I'm doing well.

I made plans for after to visit a local spa in Palm Springs...just me....for 3 days. It got me thru some narly moments, making my plans!!! And I did it, too! (after the treatment for the breast cancer that followed the rectal..lol).

Trust in your surgeon. I did, mine. We called him 'Dr. Wonderful'. He specializes in low bowel resections...

Hugs, Kathi

Aud's picture
Aud
Posts: 480
Joined: Oct 2009

I read your story and it's inspiring. I had a transanal resection; my rectal tumor was 1 1/2 to 2 cm, Stage I, T2, in the wall but not through it. Margins were not clear in one small area, lateral to the tumor, so my surgeon re-excised to gain clear margins. The tumor was so low that he could only re-excise only so far or he would go into the anal sphincter. 6 weeks of radiation and chemo (oral Xeloda) followed. I tolerated it fairly well, went to work; main problem was very severe vaginal soreness/swelling and rectal too (which didn't feel nearly as bad as the vaginal).
Initially, my surgeon talked about shrinking the tumor with radiation/chemo, followed by removing the rectum with colostomy. After staging (they weren't sure if it was T1 or T2, though the surgeon thought it was probably T2), the team thought transanal was the way to go. After seeing T2, treatment plan included radiation/chemo, though I've also heard that is sometimes done with T1 also, since recurrence rate is higher for these low tumors.
What you had done was not offered, although my surgeon talked a little about that in case of recurrence, although I heard that treatment is often not as successful once there's a recurrence.
I went to Pennsylvania Hospital, which has a good reputation.
thanks for listening.
Audrey

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

You ARE a trooper!!!

After the rads to my pelvic region, I, too, have discomfort in the vaginal area....and, with me taking Tamoxifen for the breast cancer, that makes dryness a way of life (lol!). I am still amazed that my 'new' rectum works so darn well!!!!! I have the occasional 'everyone into the pool' toilet experience, when my descending colon forgets it's now supposed to hold, but, for the most part, I lead a VERY normal life!!!

I have and HMO, and had to fight to go to my surgeon...thankfully, although not a provider in my group, he WAS part of the HealthNet umbrella. So I just had to be a bit pushy...he quoted a 3% chance of a colostomy, my first surgeon told me 45% chance...I ended up not having one at all, not even a temp! I understand he no longer takes that chance, he's still doing the procedure, but now with a temp to let the sutures heal a bit. He is known around the world for this work, his name is Dr. Stamos at UC Irvine medical center.

Hopefully, you will never need this knowledge...

Hugs, Kathi

victory10's picture
victory10
Posts: 75
Joined: Dec 2009

I want to invite you to 'join the fear not club'. That's what I did...Its not a real club but I read in the Bible where the angels told Mary and others to FEAR NOT and before I had surgery I went into a Family Dollar Store and saw a pen at the cash register that read FEAR NOT. I bought 5 and gave them away but kept the message in my mind and heart.

I hope my story about surgery will be helpful: I had my surgery on November 4.2009
I was diagnosed with Adenacorcinoma as well in my ceacum. Dr. Olt (my first female surgeon who is so awesome). She did a colon resection to remove my ceacum, 1/2 ft of colon (we have like 8-12 ft she said). While in there she remove the apendex b/c we dont need it and she also removed my rt ovary to test b/c it was sitting under the ceacum and had fibroid cyst. I didn't mind b/c i'm not having anymore children.

Well the victory report that I also speak over you is that I experienced 0 level pain. The first day and a half is due to the morphine but on the second day I was forgetting to push the button because I felt no pain. God supernaturally took away the pain!!!!! I was walking on the 2nd day and when it was time for the tube to come out that drained the fluid off my stomach my throat started to feel like when I got my tonsils out.(never had that either so like you i was a little aprehensive which caused me to pray as you are doing!!!!) For that I requested throat lozengers which was a great relief and I pressed the morphine button 1 more time for my throat :) before they took it away due to my lack of use...

When it was time for the cathetor to come out the bag just kept spilling so I would have to call the nurse to get the castodian. She said that the bag was telling us it wanted to be removed. They said if i didn't urinate they would have to put it back in so I ask God to let my body do what it needed to do. And He did!

Couldn't leave the hospital until I passed gas or my bowels moved. Day 4 in the hospital I requested prune juice and within 3 hours the gas passed. (It takes about that long for the digestive system to wake up so they check your stomach with the stethescope to hear movement like they do to hear a heartbeat.

My surgical experience and hospital stay was so miraculous and I still thank God for taking the sting of pain out of my surgery. If He did it for me, He will do it for you.

Blessings, peace, successful surgery and speedy recovery!

Victory 10

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