# Surgery Preparation Questions



## DougUte

I am scheduled for surgery on October 12th. This is my first surgery for Crohns. In fact, it is my first surgery of any kind since a tonsillectomy in 1968 and oral surgery in 1981. 

How do I prepare for this? I will be having multiple resections and a mass removed. I have been told I will be in the hospital for 5-7 days but I just don't know what to expect. 

Thanks.


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## DustyKat

Hey Doug, 

Well Roo's surgery was an emergency so no lead up preparation there. Do you want to know what to expect post op in hospital?? I guess I don't have to tell you that everyone would probably be a little different. I will tell you happened with Roo but she is probably a little different to scheduled surgery. She had open surgery.

Surgery day - She was in theatre for approx 4 hours. When she returned to recovery she had oxygen, two IV's, two drains, an NG tube and an IDC (urinary catheter). She was in ICU overnight. She asked to go back to the ward the next morning. I think the surgeon wanted her to stay another day but she couldn't get out fast enough! Oxygen therapy ceased. 

Day 1 post op - Moved to the ward and spent the day on bedrest. IDC removed. NG tube on free drainage and morphine IV remained on PCA (patient controlled analgesia).

Day 2 post op - No change with drains and tubes. Physiotherapy commenced. Up out of bed and gentle ambulation commenced twice a day. Although Roo refused to use a pan so started walking to the toilet that day.
Started eating ice chips. 

Day 3 post op - One IV removed and condensed IV morphine and fluids into one. NG tube removed. Increasing mobilisation. Ice chips.

Day 4 - Bowels open. Commenced on clear fluids. Mobilising.

Day 5 - Tolerated fluids from previous day and throughout this day so commenced on light diet at tea time. Both drains removed and IV removed. Oral analgesia and antibiotics commenced.

Day 6 - Discharged home.

I don't know if being paediatric made a difference but each day she was visted by the surgical team twice, the physiotherapist twice, the pain management team once and the dietician once. 

I hope that helps! 
Dusty


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## jazmac

I had a stircturoplasty then a resection of 60cm jejinum 4 years ago,  3 months apart. Pre op prep was just low residue diet for the week before and fluids I think from night before.
When I woke up I had catheter, which was removed next morning but no tubes down the throat. I remember my first op I sweated all night and need to have a shower and wash my hair morning after op. Thank god my mum was able to blow dry hair as all I wanted to do was get back into bed. They put these things on my legs that blow up and down every 10 secs to avoid blood clots. All I wanted to do was sleep but with these things going and nurses always in checking obs it wasnt happening. Pain wise I had self administered meth and took oral digesic. Moving in and out of bed was hard but the sooner you get up and moving the better. I went in with a plan of what foods I wanted to eat for max nutrition and healing and min irritation, glad I did cause the first meal they bought me was sandwiches. I had no intention of eating wheat for at least 2 months. 

I am going back in on 1st Oct for TPN for 7 days then another op on 8Th, so I will be feeling sore and sorry by the time you go in. I am planning on intro food slowly and keeping a food reintroduction diary. 

I'm feeling positive about this surgery (my last wasn't real successful)  and think it's really important to ask as many questions as you want to your medical pros but most important stay calm and relaxed. Hopefully you have someone to help you when you get home, I was pretty slow moving and had difficulty bending or lifting my leg to put on pants for a few weeks. 
Good luck I will send some of the positive energy your way.:goodluck:


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## DougUte

jazmac

I will be having strictureoplasty, of which I am very greatful. The surgeon wants to save every inch of bowel he can. A portion of the colon will also be removed because as my small bowel series found, there is a fistula that is bypassing the majority of my small intestine. In fact, it may be from my stomach to the colon. The fistula is not showing up in any scans, but the barium hit my colon within 15 minutes of drinking it. There may be multiple fistulas, for all we know.  There will be resections as well. 

I am sorry for you having to go back in to surgery. I hope things go well for you. :goodluck:


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## DougUte

Dusty, Thanks for the information. It helps to talk to people that have been through it, or had a child that has been through it.


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## CDDad

That is coming right up, so good luck.  I would say bring things to keep you occupied and pass the time.  Laptop computer, ipod, books, and most important - cell phone.

Also, a hospital can be kinda noisy at night with nurses talking outside the room, the infusion pumps going on and off, so I like to bring noise canceling headphones (I like the bose).  They really work for me with a white noise audio on the ipod.

Your own slippers might nice.  Or just use the socks they provide.  Once you're feeling a bit better, you might want some underware and shorts to wear under your hospital gown for the endless laps around the nurse station.


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## CDDad

I also meant to include the part where they wake you up all night to check your vitals and take blood at 5am so it's ready for the residents / docs at 8am.  It's hard to rest in the hospital sometimes.  Ask for an ambien to help you sleep if needed.

Another thing to think about is pain control.  I had an epidural for my last surgery in April which was effective at post surgery pain relief.  For my previous surgery I did not have the epidural and woke up in bad pain right after surgery, so it's worth discussing with your  surgeon.


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## Nyx

I had an emergency colostomy done this past December, so I can't comment on prep for surgery as I didn't have any...lol

I wound up being in the hospital for 24 days due to complications after surgery.  Definitely talk to your surgeon about precautions in regards to blood clots.  I developed 2 of them in my lungs during my surgery.  They can be prevented; but like I said, since mine was an emergency surgery, I couldn't take precautions.  I also developed an infection from my PICC line - also avoidable in most cases.  Besides those two things, I didn't have any problems.  I was on IV administered Demerol and Gravol for the pain, and asked them to take me off of it after about 5 - 6 days.  I should mention that I had open surgery.  They were also administering TPN through the IV, as well as antibiotics.  Yes, I was a pin cushion...lol

And Joe's right...try and get something to cut out the noise as it's very noisy at night in the hospital.  And yes, they do come and wake you up to take blood very early in the morning (mine was at 6am sharp every day for 24 days...sigh).  I was also given Ativan to help me sleep at night.

The best advice I have for you is to get up and walk as soon as you possibly can.  I waited for about 4 days before I finally attempted it and it was really hard.  (having a bag and a catheter really makes getting out of bed seem unappealing...lol)  

Definitely bring your own slippers...they have better traction than the little slip-ons they give you there.  I also recommend underwear, especially if you're doing laps around the building..lol

Good luck!


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## acg101

altough two weeks away, try to be in as good shape as you can - walk, excercise and move around. as Cindy advised, after the surgery get up out of bed as soon as possible. despite the pain I got up the day of the surgery which helped with my speedy recovery. i found that managing WITH your surgeon, your pain management will speed your recovery. I was on Diludid which is a great drug but VERY addictive, even after short duration. The combo of Fentanyl with Torodol (non narcotic) was the best.
Good luck and keep us posted


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## Zalanicht

Dusty pretty much stated it as best as I could. Just make sure when they take you off of the IV onto pill form pain meds make sure they work well.


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## 5 iron

Had my surgery in July,20' in small intestine cut out,prep was like a colonoscopy with the addition of taking a antibiotic the day before the op,my surgery was on a Thur,roast beef for lunch on Fri,came home on Sat,make sure you have a good cutter,like everthing else there not created equal,find one that does two a week of these things,GOOD LUCK


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## DougUte

Man, I feel like this is just creeping up on me. I hate this waiting for the surgery. I wish the surgery was tomorrow so I could get it over with!

My wife reminded me the other night that I could have a temporary ostomy bag for a while. I had totally blocked that out of my mind. FUN!


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## Nyx

Having a bag isn't bad at all...it saved my life and I now live a completely normal life with it!  I'm doing things I never would have been able to do prior to getting it.  Turned out to be the best thing that's happened to me in a very long time    If you wind up getting one, you can always join our club...new members are always welcome!  lol


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## Crohn's 35

Hi Doug,waiting for surgery is nerve racking.  I hope your surgery gives you a long and healthy life!


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## DougUte

Cindy.  If I end up with a bag, even if only temporary, I would be glad to join your group.  I needed the attitude adjustment.  This has just been a whirlwind for us.


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## Entchen

Hi Doug: Want to wish you all the best as you prepare for your first surgery.


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## DougUte

I had my pre-operative visit with my surgeon's Nurse today. I am much more relieved! Surgeron had left both my wife and I  under the distinct impression that this was going to be a old fashioned cut the gut open surgery. Today I was told that, unless they get in there and find a whole lot of stuff the CT scan did not find, it will be a laproscopic surgery. They will remove about 12 inches of small bowel. 6 inches at the illeum, 6 inches in the duedenum, and the lowest six inches of the colon. I guess that means I'll lose my appendix as well. They do have to remove the mass, but apparently it can be done with a scope! YEAH!


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## rottengut91

That's good to hear...hope all goes well.


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## DustyKat

Great news Doug. I wish you all the very best.................

:goodluck::goodluck::goodluck:

Keeping my fingers and toes crossed, 
Dusty


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## jazmac

Not long now, stay calm, and ask as many questions of the docs and nurses. Don't get too hung up on knowing exactly what will happen during the surgery prior as it could change once your under. Thats what happened to me in my first op and I felt really bummed that they decided to do it differently once  they got in there. I'm currently in hospital been here for 5 days having TPN to build up nutrition before op on fri. Good luck with it all.:ysmile:


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## DustyKat

Hey jazmac, :bigwave:

Goodluck with the op!!!! Will be thinking about you!!!

:goodluck::goodluck::goodluck:

Keeping my fingers and toes crossed,  
Dusty


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## QuickSilver

Yeah I had open surgery.  To be honest, I didn't think it was that bad.  Obviously I was sore, but I took very little pain medicine while in the hospital and none after I got out and went home.  The worst part was getting the JP drains taken out about three weeks post op.  It hurt like hell.  After about three weeks though I was able to start getting back in the swing of things and was getting my strength and energy back.  I had really low self esteem about having a temporary ostomy bag but I wound up getting really used to it.  The only problem I had was wearing regular clothes and trying to hide, which I never could do to my liking.  I wear bib overalls pretty much 24/7 so that made having the ostomy extremely easy.  All in all, I thought it was the worst experience of my life at first, but now that its all said and done, it was just a minor bump in the road and nothing that you can't handle.


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## DougUte

Jazmac 

:goodluck::goodluck::goodluck:

Hope your surgery goes well on Friday!


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## DougUte

Quicksilver - 

Thanks.   I think the surgery could go either way, so I will not be surprised if I wake up after and find they did the full open surgery. I have a crohn's mass that needs to be removed and I have difficulty imagining how they would do that with a scope. I guess they could cut it  up and suck it out like they would the pecies of  bowel.


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## acg101

Doug I had my surgery Laparoscopic and it helped with the speedy recovery. I was out of bed that night and walked the next day. There is substantial discomfort (pain ...) for the first few days and don’t be afraid to ask for pain meds.
I researched my surgery for a long time, spoke with the kind people here and listened to their advice and of course once under the knife things happened differently.
The 'bag' not only saved my life but gave me a new life. I am the happiest men alive.
Nyx, CDDAD, Jeff and others here where instrumental with setting my expectations pre surgery.


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## DougUte

Well, here I am, bowel prep day!. The surgery is scheduled for tomorrow. I have to call the hospital and find out what time I have to show up. Wish me well!


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## Crohn's 35

Yay!!!! Please don't worry, I know everything will go just fine!  I will be thinking of you and sending healing thoughts!  If you can keep us posted in the hospital.  Best of luck and speedy recovery!!!!!!!!


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## DustyKat

Wishing you all the luck in the world Doug! I will be thinking about you and hoping and praying you have a speedy and uneventful recovery.................................

:goodluck::goodluck::goodluck:

Keeping my fingers and toes crossed, 
Dusty


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## acg101

Hey Doug - Wishing you best of luck with the surgery and speedy recovery. 
Please keep us posted


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## Lisa

Good luck with the surgery!


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## DougUte

Hi guys.  I made it throught the surgery. Today I was allowed to eat regular food and I was sent home. The surgery only lasted 2 hours. The mass was a large area of inlamed intestine. They removed 24 inches of small bowel and 6 inches of large bowel, incuding the illieum. The surgery was not as complicated as feared an I am home 2 days ahead of schedule.  So far so good.  I really hurt though.


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## 5 iron

Way to go doug knew you would be fine,did they do open surgery?if they did kinda hard to sit up huh,my surgery was July 29 and hardly know i had surgery now,good luck with your recovery.


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## Entchen

Well done, Doug! So sad to hear about the pain; you'll get through it just fine, though. Take good care.


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## DustyKat

Woohoo.........so good to hear from you Doug! 

Early days as far as the pain goes Doug and if you had open surgery you will have a lot of internal trauma but it will slowly resolve as each day passes. Wishing you all the very best for your continued recovery. Keep us posted!

Take care, :hug:
Dusty


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## CDDad

Hey Doug,
That is great news.  Rest up and don't over do it.  Have a speedy recovery..


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## archie

hope the surgery went well, keep us posted, i'm due to go in for sb resection (reluctantly) very soon.


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## DougUte

Yes, they had to do an open surgery.  Every time I get up I have a new experience in pain. I am currently on Loratab and Loperamide. I am having diarreah and will be starting again on Benefiber. I am scheduled to start Humira on November 11th.  I am so glad the surgery is done with! I have the next 5 weeks away from work.


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## DustyKat

Hey Doug,

Roo had a similar amount of bowel removed as you. I normally site 60cms as the amount she had removed but it was actually 59cm of small bowel and 9cm of large bowel. Another thing to try for your diarrhoea is Questran Lite if the Benefiber is not successful. I'm not sure what Benefiber is but it looks the same as Metamucil. Roo found it gave her too much pain/cramping, of course you may have no issues with it but just keep it in mind so you can separate the timing of those symptoms from others you may be experiencing.

Dusty. 



Dusty.


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## Dexky

Hey Doug!!  Glad you updated!!  That's great news and I hope you have a quick recovery so you can enjoy some of that time off work!!


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## rottengut91

Hey Doug.  Glad everything went well.  Take it easy and try to enjoy some of your time off.  You should be feeling alot better in a couple of weeks.


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## DougUte

I am getting the staples removed tomorrow. I have come down with the stupid cold. Figures that would happen now.  During my hospital stay I was given my annual flu shot and a pneumonia shot. So a few days later I get this dang cold!  Anyway, I am having trouble getting back on my regular sleep schedule. I have been messed up ever since the surgery. 

I have pain from the incision, but I have not had excess drainage. Hopefully in a few weeks I will get started on Humira. My wife was told that a section of the small bowel just below the stomach was about 8 inches in diameter and the passageway was narrowed enought that a kernal of corn could have blocked me entirely. I hate this feeling of have my innards all cut apart and sewn back together, but I already feel like I have more energy than I have had in years. Since getting home I have been on pain medications, so I am not driving yet. But I am getting around by walking through the neighborhood. You get a different perspective of your neighborhood when you hoof it. I have to admit that has been nice.


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## DustyKat

Hey Doug, 

Sorry to hear about the cold,  but so pleased to hear that all else is going well, YAY! 

If they haven't mentioned it to you already just make sure you start on some supplementation for B12 and perhaps Folic Acid or whatever is recommended in a few weeks time.

Dusty.


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## acg101

Hey Doug,
So happy to hear that you are doing well!  Make sure you rest up and take it easy. I I wish you a speedy recovery.


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## DougUte

Hey Dusty.  

My neurologist has had me on B12 and Folic Acid for quite some time. It was one of the first clues about CD - "For some reason you are not absorbing your vitamin B's." Low Vitamin B (including Folic Acid) can lead to tremors in hands, which is why I have been going to a neurologist. She put me on a Vitamin B complex that dissolves in the mouth. It is the Vitamin B Trio and can be found online at ourhealthcoop.com .


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## DustyKat

So will you have been getting B12 injections?

Dusty.


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## DougUte

Probably not. The lasts tests showed B12 was in the normal range.


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## DustyKat

Without sounding like I'm nagging you! :lol: 

I'm not sure how effective oral B12 is when you have the extensive surgery you have Doug. I'm not suggesting you won't keep an I eye on it but track it and keep tabs on how far into normal range you are. 

Dusty.


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## DougUte

DustyKat said:


> Without sounding like I'm nagging you! :lol:
> 
> I'm not sure how effective oral B12 is when you have the extensive surgery you have Doug. I'm not suggesting you won't keep an I eye on it but track it and keep tabs on how far into normal range you are.
> 
> Dusty.


Dusty, you're OK.  

The B complex I am taking was recommended by my neurologist. It is a chewable and dissolves in the mouth. It is absorbed in the mouth, not in the gut. I take 2 a day, which amounts to 33,332% of the FDA's daily recommended value for B12.  My B6, B12, and Folic Acid levels are fine. She really wanted to make sure my levels were good. This was also the first indication that I really did not have IBS. Interesting that it was my Neurologist who first got on this track!

No worries. (about that anyway). I am somewhat nervous about my tremoring hands giving myself shots. I start Humira when I have my next G.I. visit.


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## DustyKat

Good luck with the shots! Let us now how you go.............

:goodluck:

Thinking of you, 
Dusty


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## DougUte

I get to start Humira on thursday this week. Does anyone know of any possible side effects I should look out for?


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## jazmac

I had my surgery a few days before you and started on Humira last week. Was really worried about side effects but it was alll good. It does hurt heaps going in. I assume they have the same dosage there which is 4 injections to start then 2 in 2 more weeks, its what they call the loading dose. I had 2 injection thurs then 2 on friday, 4 on one day was too much. I used ice pack to ice the top of my leg til it was numb. I have hesitated for years to use this med but it is my last resort and I'm just keeping positive. I tell anyone who asks that I am on a medication that will help to put it out in the universe that it must work. Don't read too much beside the basics, every medication side effects can sound pretty scary. They told me just to make sure if I feel any signs of infection, cold etc to go to doc.


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## acg101

dont worry too much about the side effects. you might get tired the day you get the treatment but no big deal. make sure to have a cbc blood test every few months and watch for not getting close to sick people. the benefits outweigh the potential side effects otherswise your doc would not have subcribed the med.
good luck


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