January 7, 2016 was my surgery date. The 2 days prior I prepared for surgery by drinking only clear liquids, completing a colon cleanse, and taking the required antibiotics. Being that my intake was already extremely limited due to my pain, the colon cleanse was rather easy. Unfortunately, the antibiotics were extremely harsh on my stomach and created severe pain, nausea, and vomiting during the night.
The morning of surgery, I was ready to go! All my fears were at rest and I was ready to receive some relief. When I was called back to the pre-op, I was introduced and questioned by numerous nurses and doctors. All were very calm, pleasant, and positive helping me to remain optimistic.
A few hours later, I awoke from the surgery with an IV morphine pump for pain. This was the first time ever, that I've had a pain pump. Having a pain pump allowed me to push a button to receive more pain medicine whenever I needed it for the first 24 hours after surgery. (It was programmed so that there was no way that I could overdose.) After the first 24 hours I began receiving the morphine (through an IV needle), and oxycodone which was later switched to tramadol were crushed and administered via my feeding tube.
The day after surgery, I was thoroughly surprised about how I felt. The concern over what my stoma would look like or how difficult the management of having an ileostomy bag were eliminated. The stoma looked much better than I had prepared myself for and knowing that it would continue to shrink only made it better. The surgical related pain was bad, not going to hide it, but it was not any worse than I had expected. I felt as if I was on my way to recovery and much desired relief.
That was until they began my formula feedings the following night. Since my tube feeds and nutrition had been almost non-existent for the previous months, we began the feeds slowly at 20 ml/hr. Before I knew it, they began increasing my feeds by 10 ml/hr every couple of hours. I began having so much nausea and cramping pain, that I tried telling them that it was more than I could handle, but they kept increasing until I began vomiting, heaving, and in painful distress. The next day they finally listened to me. We dropped the rate back to 20 ml/hr until Monday, as we decided to try a different more elemental formula Peptamin AF. Once again, they quickly began increasing the rate of my tube feeds and my body kept rejecting it. I struggled all day Tuesday and then Tuesday night into Wed I began vomiting my stool and having extreme continuous off the scale pain. My pain and nausea were so severe that I was unable to move, kept my eyes closed all day with moaning, too weak to stand and finding absolutely no medicine that would even begin to touch my pain or nausea. (I was blessed to have still be inpatient when this horrendous pain began. If I had been at home I would not have survived.) After having painful x-rays taken we finally had an answer to my struggles, I had an ileus. This meant that my small intestines were not moving, not awake yet, as a result of a complication from surgery. I was aware that this was a risk, not uncommon yet not a high incidence either. Basically what this meant was that my formula was not moving anywhere (hence why I was having so much pain, nausea, and vomiting). Instead it was backing up into my stomach. To help improve my symptoms, I went back on IV fluids only for a couple of days and set up a continuous stomach drain via the G portion of my GJ tube to allow my small intestines a chance to "wake up". After that, we were able to slowly begin reintroducing my tube feeds. Thankfully, this time was more successful and I was able to be discharged home with a PICC line for home IV hydration to prevent dehydration.
Since being home, I have been able to increase my feeds to 45 ml/hr for a total of 2 cans of formula a day. I am able to wear my previous clothes without the bag being noticeable. The physical healing and recovery from the surgery has gone well, the acceptance and ability to deal with the ileostomy has been fairly easy, but emotionally I am still a work in progress. I strongly believe that the surgery was a success and I have no regrets at all. I just wish some of my other GI issues would improve along with the relief from having my colon removed. The typical hospital stay after a colectomy with ileostomy is 3 - 5 days, however, I was in the hospital for 2 weeks because of the ileus and troubles with reintroducing my tube feeds.
BUT in the end, the surgery was definitely more than worthwhile!