Finally home from the hospital, but....

...still having complications.

So to recap for anyone not following the story, recently in the hospital after takedown:
1) Paralytic ileus, a.k.a. intestinal blockage from bowels not waking up properly after anesthesia - AWFUL symptoms, lasting a couple weeks.
2) Infected abdominal abscess & fluid build-up requiring antibiotics and insertion of drainage tubes, lasting another week and a half.

24 days in the hospital altogether, released a week ago.

And now...

Felt abdominal bloating and pain (tender to the touch) a couple days after my release, noticed it didn't move or change for three or four days even though I was passing plenty of stool and gas, so thought it was another abscess. Called it in.

Yesterday's CT (oral, rectal, and IV contrast - checking for leaks as well) showed trapped air in my abdomen where it doesn't belong along with inflammation around my uterus and Fallopian tubes. The CT did not show any leaks or source of the air, though CT's are not necessarily complete pictures of what is going on, and leaks/bowel perforation are the most common cause of air in the abdomen.

Doc's orders: immediate antibiotics to head off any infection and a repeat CT in a week to see if there is any change, followed right after by an appointment with my surgeon. The hope is that my body might absorb the air on its own. If I experience any sign of infection, I'm to head straight to the UCSF emergency room.

I really don't think I have a perforated or leaking bowel, so I was confused on what it could be. After doing some research, I read about this phenomenon where if a patient is on high doses of steroids after surgery (which I was), then sometimes when the drainage tubes are removed from the abdomen, that tract doesn't close up right away like it's supposed to since healing is inhibited, which would provide a pathway for air to enter into the abdomen. I'm thinking that makes the most sense since this didn't happen until a few days after the drains were removed, and that incision took several days to close up. At least I'm hoping that's what it was instead of something more dangerous like a leaky bowel.

Hopefully it will resolve on it's own. In the meantime, it's uncomfortable/painful to move around very much (feels like a lot of painful gas that won't pass), so I'm spending a lot of time in bed. An additional three weeks of work has been ordered. (Otherwise I'd be going back a week from Monday, on the 21st.)

Anyway, just keeping you all posted. (A girl just can't catch a break!) Still staying positive, though, and trying to remain patient. Looking forward to the day when these post-op complications are behind me and I can just focus on my j-pouch and athletic rehabilitation. I know that this all has nothing to do with my pouch and that once I get through all of it (which all could have happened after any type of abdominal surgery) I will be a happy j-poucher.

Thanks for all of your continued support, everyone.

     Keeping you in my prayers.  Stay upbeat, although easier said than done in matters such as this.

She did have 3 step

Thank you for the support, Ladies. I actually feel great aside from the air still trapped in my abdomen, which is quite uncomfortable 24/7, so kind of a contradictory answer I guess. I will get to see at the CT in two days if the air has gone down at all. I did a little research on it and found out that although these things often resolve themselves in 6-12 days, it can sometimes take several weeks for all the air to absorb, so as long as the air pocket is getting smaller, I'll be happy. I have an additional month off of work now (paid), so I'm not too concerned.

But anyway, I think if it weren't for that one remaining complication, I would be quite active and ready to resume normal life. (This weekend would be about the six-week mark, which is when diet and activity restrictions are usually lifted.) So I'm just being patient and staying positive while I wait it out.

ddd45 is right; I had a two-step. But I was not on steroids before surgery, at least not for several months prior. My surgeon did consider that but decided a two-step was still appropriate. They did, however, put me on steroids after surgery (standard procedure, right?)... And it was over three weeks post-op that the drain was removed from my side, which had been enough time for the steroids to really build up in my system by then and play a role in the drainage tube tract not closing up and healing very quickly. But everything about my j-pouch itself appears to have healed up just fine between the two surgeries, which would have been the only reason to consider a 3-step. It was just the post-op complications after the second surgery that just turned into a mess, kind of like a domino effect.

But my j-pouch is doing well. The antibiotics and Christmas chocolate I've been eating up daily have caused a bit of a "pushing through" effect (almost like a mild diarrhea), but even then number of times per day has remained under ten since I left the hospital. I ran out of chocolate a couple days ago (thank god), and yesterday I only had three bowel movements in a twenty-four hour period. Very promising!

I can't wait until this final issue is resolved and I can get back to my life! Again, thanks for the support!

Bootstrap!

Ugh! Sorry to hear about what's been going on....jeez, and I thought I was having a bad month! I've heard about gas getting trapped before, but not in that area....I guess it's got to go somewhere in everyone.

Take it slow and easy...don't worry about rehab 'til way after this gets cleared up....

God Bless!

It is my understanding that 3step procedures are done when patients are on high dose steroids as steroids inhibit the healing. This is cleveland clinics method. Also UC patients on high dose steroids are much sicker overall, so the surgeons want to inflict as little trauma as possible in that first step. That is why they just take out the colon in step one and then allow the body to gain strength and heal for six months before removing the rectum and creating the jpouch. Also they use that timeframe after step 1 to wean people off the steroids... before they do step2 and step3.

I have never heard of anyone being given steroids after surgery if they weren't already on them before surgery. That seems strange. I had been weaned off steroids before my step 2 and for sure they didn't start me back up on them for that or for step 3. thank goodness!

Post Edited (ddd45) : 1/23/2013 7:34:36 AM (GMT-7)

Hm, that is interesting ddd. I've never had surgery before this, so I just assumed it was standard practice to put patients on steroids after major surgery since they just automatically did it both times with me. They told me that the body has a greater need for steroids post-op to help the body deal with the trauma and reduce swelling and inflammation. I wonder if there are any statistics that show it's affect on chances of post-op complications.

Thanks again everyone for the support. I am definitely starting to feel better. The pain/bloat has been way down the past few days, so it seems to be resolving on it's own. Now I'm just tapering off the prednisone and pain meds (withdrawals of which cause weakness, shakiness, headaches, etc.) while I learn to deal with all the standard j-pouch issues. Been testing out foods and discovering which ones sit better than others... Waiting to be done with antibiotics so I can rule that out as a cause for any GI stimulation or diarrhea.

Again, you guys are all great. Thanks for caring.

I certainly hope things improve quickly...glad to see you are getting a bit of relief but it has been too long so hope it's gone like today!

how are you feeling today?

Bootstrap,

Glad to hear you are back on your feet!

You must have a lot of energy to be a teacher period...i just finished a science fair...all the interviews..the kids don't stop do they? lol!