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YOU
Stories
Gary's
Story
Here's a little story about my experience with
stomal surgery, with exaggerations and elaborations courtesy of an
overactive imagination. Note that the following, story should not be
taken as (completely) gospel, let alone fact. Everyone has a unique
story and not everyone's body reacts the same. But maybe it will allay
some fears... and introduce others.
It all began back in early 1998 <insert
tacky flashback sequence>. I had been suffering with recurring and
recalcitrant perianal abscesses and fistulae. The colorectal surgeons
had been trying to keep the cavities draining freely by inserting
"setons" (loops of surgical thread). This form of treatment
was enjoyed and celebrated by the whole team of surgeons, interns and
students, who poked and prodded with the splashing of "oohs" and
"aahs". The teams were especially entertained when after one
particular session in theatre; some sick sadist had used tape instead of a
"T-Bind" to hold the combine dressing in place. My hairy
butt did not appreciate the joke.
Despite being a new and interesting procedure
for colorectal surgeons, the seton treatment didn't do anything for
me. Things were getting worse. The surgeons admitted that they
were stumped, so I packed up my bat and ball and went off to find someone
else to talk to.
After much seeking, I found an ancient Chinese
herbalist, who pottered around asking me to snatch a pebble from his
hand. This wizened old man brewed me up the foulest smelling
concoction he could find and instructed me to drink one third and sit in the
remainder. This "tea" was made from the offal of a dragon
from the Ming dynasty and the obligatory bamboo shavings, and tasted worse
than Dilmah. I stuck at it for two weeks. It didn't work but I
would have been kicking myself if I hadn't at least given it a go.
I was in a lot of pain, particularly in the
mornings and had been off work for over six months. As anyone who has
been on long-term sick leave can testify, this is not easy, and presents a
number of issues. Depression, frustration, anxiety and anger are just
some of the problems, as well as mental dullness and memory loss (yes folks,
it's not just you, memory loss is quite common amongst the chronically
ill). It helped to try to establish some sort of routine, to keep my
mind off things. I had a daily routine of being depressed, frustrated,
anxious and angry.
One of the most difficult issues for me was an
increasing feeling of financial insecurity. This sparks off a number
of other issues, such as a feeling of failure as a provider, low self-esteem
and enormous pressure on other family members. With being off work for
so long I was anxious about whether the job will still be there when I
return. I was even questioning whether I would ever be fit enough to
return to work. Even if I did get back to work how long would it
last? When the revolution comes and it was time to assess people's
productivity, I would not be very high on their list. Luckily, my
employer was very supportive, and a large enough company to absorb the cost
and develop a "back to work" plan to ease me back into the
office. I also think it helped that I kept in regular contact with my
boss keeping him updated on my progress and asking how he was going in the
footy tipping.
After six months of being off work, eight
months of progressively worsening infections and a new litter of colorectal
surgeons, I was starting to get a little fed up. This was beginning to
become a real pain in the posterior.
The advice from the senior surgeons was that I
would require a permanent colostomy and full proctectomy. I had tried
a number of lesser treatments and various pharmaceutical cocktails, to try
to avoid "stomying" my "colo", but now it was time to
make a decision: either to continue to put up with the perianal
infections and survive on painkillers, or to have the surgery to give the
area a rest and see if that helped. I was particularly anxious about
having a proctectomy due to the very delicate apparatus down there and I had
heard that there is about a 10% risk of impotence after such an operation.
However, the new surgeon presented some other
options. He was relatively young and not so set in his ways and was
willing to take things one-step at a time. He advised first trying a
temporary colostomy and see if that helped and then to try a "rectal
advancement" and see if that helped. This sounded much
better! So I bit the bullet and booked in for surgery.
Despite having plenty of warnings of this
surgery, doing plenty of research and having plenty of time to get used to
the idea, I was still very anxious. I would find myself thinking about
it constantly. I borrowed a few "Dealing with Worry" books
from the library and while they were all very nice and have lots of good
ideas, I was still worried. I guess this was one of those situations
where no matter how much you sweat over it, the bottom line is you'll just
have to accept it. The future was a big unknown and I would just have
to trust in my own ability to adapt.
Finally, after an agonizing wait, I went in to
hospital to have the surgery. Now, I was a "veteran" of 3
bowel-resections, so I knew pretty much what to expect. But for those
that have not had surgery before, I can understand that it can be more than
a little daunting. So here's a little insight for the
uninitiated. Don't be put off by the gory details - remember that it
is only a relatively short period in your life.
Preparation:
I had a bad experience once with the Draino.
Since then I have learnt to drink some cordial (or other salt-replacement
fluid) while taking the stuff. And another tip: don't draw smiley
faces on the stoma site markings ... the rest of your body is fair game,
though. And make sure that they have one of those handles above your
hospital bed so that you can pull yourself up when your tummy muscles aren't
working.
Day 1. I was given a PCA (Patient
Controlled Analgesic) to administer morphine to control the pain. I
chose PCA mainly so that I could get mobile as quickly as possible.
That is my secret to an early recovery: Get moving as soon as
you are able (under supervision, of course - you are just "testing the
boundaries" and don't want to overdo it). There was general
soreness around the abdomen. It is pretty hard to do anything, so lay
back and enjoy the sponge baths and general pampering. Being
bedridden, I needed a catheter to empty my bladder, and warfarin injections
to prevent unwanted clotting. DON'T SNEEZE! Coughing, laughing
and sneezing hurts. At first, the cough is pitiful (like the sound of
a cockroach sneezing, magnified 50 million times), but it gets stronger over
time. Try not to laugh and ban all joke-telling visitors for a few
days. Sneezing is nasty. It can take you unaware and be very
explosive. Try violently pushing your nose into your face. It
doesn't help, but it can offer the nursing staff a few laughs. With
all of these, fold a pillow in half, and hold it against your tummy.
It might sound strange, but it does help.
Day 2. I managed to stand for a few
minutes. It was enough to convince the staff that I no longer needed
the catheter and to stop the Warfarin injections. I was glad. It
happened only once but I had a bad experience after having a catheter.
I don't know how those razor blades got in there! But this time, the
nursing staff gave me something found only in the mountains of Europe to
reduce the acidity of the urine and there were no problems.
Day 3. I was not only standing but I
walked, albeit like the Hunchback of Notre Dame. I had one hand on my
tummy and found it nice to have the other hand on my lower back. To
mess with my mind I dressed in my street clothes, trying to fool my
brain. It worked.
Day 4. Walking a bit more. My lower
back was hurting a fair bit. Applying heat packs (e.g. wheat) helped a
lot. The stoma had started to roar into action and I was disconnected
from the IV. It still hurt to cough and sneeze but I managed to
develop a sinister laugh that wasn't too painful - so I called the in
joke-telling brigade and invited them to do their worst.
Day 5. Now I was doing laps of the ward
and getting to know my fellow inmates. I don't know whether this was
normal for a colostomy but it hurt whenever the stoma started to work.
So I was still taking a regular dose of codeine.
Day 6. Things just kept on
improving. Walking, sneezing, and stoma-ing were all getting a lot
easier. There was some redness around the staples (yes, I had staples
instead of stitches) due to them tugging against my clothes.
Day 7. I proved to the Stomal Therapy
Nurse that I was a Master of the Poo Pouch and was sent home. A day
later I received a big basket of goodies from the suppliers. And this
is how I started to get my life back again.
I went back to the doctor's again about 3 days
later and got the staples removed. Two out of the twenty hurt a bit
when they were removed. But it felt so much better afterwards!
The pain had gone apart from the expected tenderness after major abdominal
surgery. Even that settled down over the next 6 weeks but until then
no lifting, and no operating heavy machinery! That includes
cars. They are extremely hard to lift. Hernias come easily to
those whose tummy muscles have been weakened. I told myself to be
patient and to take things slowly. It wasn't long before I was back
mountain climbing, parachuting and wrestling crocodiles.
Of course, with such a change to a primary
function of one's life, there was a period of adjustment. I remember
the first time I saw the stoma, it was pretty off-putting. It looked
like a mound of squashed raspberries. The Stomal Therapy Nurse
reassured me that it was still fresh and swollen but that it would settle
down. And sure enough, it has changed. It is now more like a
pink little brain. And the smell! It was stronger than I
expected. Again, the Stomal Therapy Nurse came to the rescue with
these magic drops - I was sceptical, but they actually work! However,
I still put the exhaust fan on in the bathroom.
It was an experience, too, having a shower and
watching the stoma after getting warmed up, in action. Bed was another
weird experience. Try to imagine going to bed with a beach ball!
Actually, it's not that bad. But it did take a few weeks before I
stopped cringing at the thought of being touched. A month later, my
wife told me that she doesn't even realize that it's there. It's not an
issue.
I had been warned to expect "the usual
teething problems". Nobody actually explained what problems to
expect so I imagined all sorts of catastrophes and faeces-filled moats, but
I didn't end up having any major problems. Nothing unmanageable
anyway. The colostomy output is still erratic and often very
loose. So loose it clogs up or even leaks out of the bags
filter. Bandaids didn't help. I called the supplier's hotline
(they are great and are more than willing to help with advice or to send
freebie samples). I decided to change to a non-filtered bag until
things firm up. I am still waiting for things to firm up.
While I was still tender after the operation, I
chose to use a two-piece system with a "floating flange" (one that
I could get my fingers underneath so that I wasn't pressing so hard on my
tummy). The suppliers hadn't heard of this happening before but I had
a bit of trouble with the flange splitting when it should have been
floating. So I changed to a non floating two-piece.
The only other little problem was with
noise. The stoma has a malicious mind and will always wait until the
quietest, most inconvenient moment to start trumpeting. My only advice
is to maintain a sense of humour. It may help to give your stoma a
name. Mine is called "Pete", after a good friend of mine ...
'Ave a Good One!
Reprinted from the "Thoughts of YOU"
membership folder. Most stories were written from the early to mid 1990s.
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