HELP! Some questions for the recently resected...

[SarahAnne]

I am having a resection very soon, my last one was 15 years ago and kind of an emergency situation. So this time around I realize things will be a little different, and I know there are lots of you who have recently had surgery. I'm freaking out a little! :ywow:

1. What kind of bowel prep is done beforehand? I have serious issues w/GoLytely and other drinks. It is physically impossible for me to keep them down. I vomit them up immediately and violently, even with anti-nausea meds. Will I be allowed to use laxatives to completely void? Should I start laxatives on my own a few days before, just to be on the safe side?

2. I've heard that some resections are being done laparoscopically now, is this very common? Do adhesions and scar tissue have any effect on this, as I have quite a bit of both.

3. How long did you have to stay in the hospital after the surgery? How soon did they make you eat, get up and walk, etc.? I don't want to move too fast too soon, but I will have a 5 hour car ride home after surgery. Will that be possible right away, or will I have to find a place to stay there for a time until I can travel? I can put the seats down in back and lie flat, with quilts and pillows, but I don't want to be tearing stuff open either. :blush:

I feel like I'm being such a spaz, but I like to know the goods and bads before I go...I'm on prednisone right now and bad news is better than surprises.

 

[Grant]

Sarah Anne, I had my last one 13mths ago & a lot of what your asking I can cover but obviously different people in a different part of the world = different experiences.
1. Bowel prep-I'm exactly the same as you & vomit it up. The only one I can tolerate is Picolax. So when I had mine I told my surgeon & he had two enemas given too me. All done in 40mins. Thats what I'd ask for.
2. I had my Ileocolic Resection done laproscopically. He tidyed up some of the adhesions but I've still got lots. Scar wise he still had to cut me from naval down, about half the size of my previous two surgeries.
3. I was up & walking the next day & eating about 3 days after surgery. I was in for 5 days total.
That journey though, it was bad enough my wife having to drive over speed bumps very slowly. 5 hrs-I'd be asking the surgeon about that tbh & lying down tends to stretch the wound unless your curled up in a ball.
I hope things go well for you, we forget here in UK just how large the US is. Most of us here are reasonably close to a large town or city with Hospitals.
Best Wishes
Grant

 

[DustyKat]

Matt had surgery in April. He had no bowel prep prior to surgery.

The surgeon said from the outset that he didn't think he would be able to do the op laparoscopically because of the complications he had with with a fistula and abscess but would try. They did try but it turned out there was another abscess adhered to his abdominal wall so they had to go to open surgery.

Surgery day - He was in theatre for about 4 hours and recovery for 2 hours. When he arrived back on the ward he had one IV that consisted of the PCA (patient controlled analgaesia) and other IV fluids for hydration and IV medication. He also had one wound drain, a urinary catheter and oxygen.

Day 1 post op - No change with IV's or tubes and drains. Started mobilising and about an hour sitting in the chair.

Day 2 post op - Still no change with the tubes and lines. Commenced on clear fluids and continued with gentle mobilisation.

Day 3 post op - Urinary catheter removed, still on clear fluids, mobilising well.

Day 4 post op - PCA removed and started on oral analgaesia, remains on clear fluids, started farting, only one IV now left.

Day 5 post op - Last IV removed, commenced on free fluids, bowels open.

Day 6 post op - Commenced of light diet.

Day 7 post op - Commenced on full diet, drain out.

Day 8 post op - Discharged!

I think they were more conservative at this hospital than the one Sarah was in for her op. She had an emergency resection and was discharged on Day 6 post op.

Matt had no issues post op and I feel that the start of week 4 post op was the real turn around in his recovery. It was at this point that he really started to move freely and shades of his old self started to appear. His recovery has been much quicker than Sarah's. He returned to school 3 weeks after surgery, was allowed to drive short distances after 3 weeks and long distances after 6 weeks but he was driving longer distances at 5 weeks. Started soccer training at about 5 weeks as well.

We chose to fly home, we are 600kms away from the hospital, but we could have driven home had we decided to do it that way.

HTH,
Dusty. xxx

 

[darkmuse]

Sarah, talk to your doc and see if they can give you miralax and gatorade. That's he prep I have to use, as I can't tolerate Golytely or Halflytely. Average hospital visit is around six to seven days, barring complications (which I pray you won't encounter). As soon as they deem it ok to get up, try to move around a little, but don't overdo it. They should give you an incentive spirometer to exercise your lungs and help prevent post-op pneumonia. They'll more than likely administer a DVT prophylaxis, seeing as you won't be as mobile as usual, and they'll probably have you wear lower leg devices called SCD (Sequential Compression Devices) to gently massage your calves one leg at a time to help prevent DVT.

They usually won't give you food until you pass gas or stool, and with whatever pain med they give you.....Pain meds are notorious for causing constipation, fyi.

I will keep you in my thoughts and prayers, SarahAnne! Please keep us posted on how everything goes.

 

[archie]

Hi I had a hand assisted laproscopic iliocecal resection in nov and they removed about 1 ft. I didn't have to take bowel prep which is quite stNdard now in the uk. Surgery was approx 3 1/2 hrs and in recovery a couple of hrs. I had an epidural in which in hindsite I wouldn't have again, it gave me more trouble than the surgery!! I was up walking very short distance the next day and started on a light low res diet. Thankfully got rid of the epidural and catheter.

Following day up as normal increasing the walking, eating normally. Day 4 got really bad gas pain in shoulders which took 2 days to subside. Day 6 finally had a bowel movement as they seemed very sluggish after surgery and was allowed home.

Have a 5 cm scar through belly button which took a good month to heal properly 2 weeks post surgery started to feel a big Improvemt and 5 weeks after I was feeling better than ever had tapered of pred and all other meds. 10 months done the line I'm still good. Post surgery I got very stron cramps prior to needing the loo I still occasionally get this but less often Im also able to eat most things. Recent scopes have shown mild inflammation / ulcers at surgery site but nothing that requires treatment. All in all I had a very positive outcome with the surgery and wishing the same for you. A lot has changed in 15 years so try not too worry too much x

 

[SarahAnne]

Thanks so much guys, I'm not freaking out about the surgery so much anymore.....

I had seen C-diff all over the forum, and never having had it, I had no idea what it was. Actually thought it was one of those "extra" diseases CD'ers tend to get like AS and Graves, etc. I looked it up the other day and started freaking out!! I had been in the hospital with vomiting, weight loss, violent diarrhea, and horrible pain in my abdomen several times over the summer (literally for a week in each month of June, July and August). I was given fluids as I was severely dehydrated; also tons of Flagyl, which was making me feel even worse, wasn't eating anything but having bright green diarrhea. I finally asked the nurse what the flagyl was for and all she could say was it was something they gave Crohn's patients. Duh, but WHY? I let it go.

I read that Flagyl is one of the antibiotics they use to treat C-Diff. They never once took a stool sample, I wonder were they just giving it to me in case? Why couldn't anyone tell me why?

So now I'm having surgery (at a different, much better hospital, with better surgeons), but I'm still kind of freaking out about the possibility of an infection afterwards. I know I shouldn't worry but I just really need this all to go well and smoothly.

 

[DustyKat]

Flagyl is normally used to treat the bowel infection often associated with a Crohns flare, it also assists in reducing inflammation.

Dusty. xxx

 

[Carrie]

I didn't have a resection this time round, but I wanted to add that I was put on a seven-day course of Flagyl after my strictureplasty this summer. In my case, I'm guessing it was to help prevent any infection after the surgery and help reduce the inflammation since it was only cut into and not actually removed during the surgery.

Four weeks later, and I have to say, I'm so glad I jumped at the opportunity to have my surgery when I did. I really hope that your surgery and recovery goes well too!

 

[SarahAnne]

Thanks everyone. I was on so much flagyl, and so many times, but no one could tell me what for. It is one of those antibiotics that work great, but makes me sicker than a dog. I was miserable the entire time I was on it. If there is a reason, and it helps, then I totally understand. I just felt like I was getting sicker and no one could even explain why my GI had me on it. And he wasn't one to explain things either. Good to know it's usually just precautionary.

 

[DustyKat]

I should have mentioned that Matt has been on Flagyl for two very different reasons:

Pre op he was on it for three months to help keep inflammation and infection under control, he had a fistula and abscess.

Post op he was on it for three months because the Crohns specialist said research indicated that Flagyl prescribed for this length of time post op greatly increases your chances of gaining and maintaining remission for a longer period of time.

Matt had his surgery at the beginning of April and is in remission.

Sarah had her surgery 5 years ago. She didn't have post op Flagyl but has maintained remission since her op.

Dusty. xxx

 

[Feather]

I had a laparoscopic resection to remove an ileal stricture (~10 cm) a little over two weeks ago.

1. I had no bowel prep. I was allowed to eat/drink anything until midnight the night before, and then I could drink clears until 3 hours before the surgery was scheduled. I was really surprised by this, actually--less prep than a colonoscopy! I was also on a low-res diet for the few weeks before to prevent another obstruction, but it probably helped with the prep, too (I was also on prednisone and tramadol for pain, and I was allowed to take those with clears until I got to the hospital).

2. Mine was done laparoscopically; my surgeon specialized in minimally invasive surgery, so he always opted for that. However, it was my first surgery, so I didn't have any problems with scar tissue from previous resections. I had two small incisions (~1cm each) where the tools went in, then a larger one from the top of my belly button down about 7-8cm, where the camera went in and the intestine came out. They were closed with dissolvable stitches on the inside and dermabond on the outside.

3. I was in the hospital for 7 days. I could only have ice chips/sponge water for 2-3 days, then I was allowed to have clears when I started passing gas. I took a short walk the day after surgery, then gradually walked more and more each day. Definitely be careful on the way home--I only had a 10 minute ride home from the hospital, and it was definitely painful going over bumps and turning corners. You might want to break the drive up over a couple of days, because it can definitely be exhausting to ride in the car so soon after surgery.

Regarding infection, I was given a few days of antibiotics post-surgery (and I think I received some while in the OR) and had no problems. My doctor said the same thing about Flagyl, that it helps maintain remission post-surgery.

I hope everything goes well for you!

 

[archie]

Bring plenty of pillows for the car on to sit on and a couple to hug, dose up on painkillers Nd get a hot water bottle stop every hour to get out and walk around and do a few simple stretchs every so often otherwise it will be very painful at the other end if you've seized up. My journey was only 30 mins but it wasn't as bad as I thought, we've heated seats which helped!!