Friday, August 17, 2012

Another surgery - July 2012

Whoops!! I just realised how long it has been since my last blog update...
The last one was 6 months after my "last" surgery for adhesions. I was doing well at that stage and have to say that for a whole year after that surgery I was able to eat well (carefully chosen foods of course) and had very few serious problems with obstructions. Of course I am referring to what we in the PMP community call our "new normal" ... some pain and/or discomfort is expected on a daily basis .. it is only when it increases passed that 'new normal' that alarm bells ring.

Unfortunately the old familiar 'twisting' of the small bowel began again in ernest  after that and was causing problems with partial obstructions once again and the odd total obstruction (that luckily I was able to deal with at home). Eating was becoming an issue once again because it was causing a lot of discomfort ranging to severe pain for anything from hours to a couple of days after eating something my body decided it didn't like (it was obviously getting caught in little sections again like before the previous surgery)

It was time to make an appointment for a review with Prof Hewett. 

He asked lots of questions and decided to order an barium follow through. 
Surprise surprise - that showed no problems.

Just to revamp - in 2010 it took a year of various tests to show anything up prior to surgery - and then there was only a small area of banding showing up which he thought he could 'fix' via keyhole - WRONG - that surgery was the full open incision, very extensive and required three bowel resections where it has burst during surgery. A long recovery time.

This time he said he was ignoring the fact the X-rays didn't pick anything up & wanted me to think about having surgery sooner rather than later while it was still relatively minor - hopefully a keyhole procedure. He gave me 4 weeks to think about it. In his words "I don't want it to get as bad as it was before"

After a lot of angst & thought and lots of discussion with hubby I decided to go ahead with surgery hoping it would be an easy fix.

Surgery was scheduled 2 days after I saw him for my follow-up appointment - striking while the iron was hot as they say!
So on July 5th I was scheduled for a keyhole procedure (with an understanding he would revert to the open incision if needed - he said if he found anything more extensive it would be remiss of him not to deal with it at the time - I agreed)

I woke in HDU to find the surgery had required a large open incision. 

When Prof Hewett visited the next morning he explained that the adhesions were so bad that he was unable to see anything with the camera and had to open the abdomen ... he worked hard on clearing the adhesions in the area I was having problems - bursting & resecting the small bowel in two places and then 'bailed out' because it was too dangerous to proceed any further.
He said the Adept Gel he used before finishing the surgery last time in 2010 (to help inhibit further adhesions) clearly did not work at all.
He also said any future surgery is NOT possible!!

I was moving along nicely with my recovery - moved onto free fluids and a day before discharge I had a total obstruction; extreme pain, vomiting, NG tube inserted, emergency CT scan (he thought one of the resections may have burst or be leaking) and I was bounced back to HDU.
In HDU it was decided that a PICC line needed to be inserted because even the ICU doc who specialises in neonatal canular insertions was unable to insert a line. I was put on TPN (fed via the blood) and it then turned into a waiting game to see when & if I would be able to tolerate food.
I was in hospital close to three weeks and kept on TPN until the night before discharge. I was back on ice chips & VERY gradually moved to clear liquids & then free fluids. My surgeon was very reluctant to 'push' the foods as he knows further surgery is not an option.  
I finally 'negotiated' my way home on free fluids after almost three weeks in hospital (I had another partial obstruction when they tried to put me on a low residue diet but I believed that I could monitor my food choices better at home) 
I have been home a little over three weeks now ... still on mainly free fluids with some tiny amounts of soft steamed fish, eggs, and soft chicken being tolerated and some dry biscuits and toasted white bread (all in small amounts)
I am also supplementing my diet with fortisip ...
I saw my surgeon for a post op check a week ago and he seems to think this may be 'as good as it gets' - I see him again in a couple of weeks & I want to be able to say "you were wrong!" ...(The power of positive thinking!!)

I am slowly regaining some strength and although the pain level from the wound/internal abdomen is still high at times it is improving. There was a section of wound that was not healing properly - that seems to be almost fully healed now too.

So baby steps toward recovery ... at least they are in the right direction at the moment!!!

It is SO good to be home getting the most precious daily "cuddies" from my beautiful granddaughter!!!
 I am now looking forward to being given the 'all clear' to get back in the heated pool to exercise with my friends once again!!

Life is good and each day is a blessing - never take it for granted!!
Hugs, Kay :)

Saturday, April 16, 2011

An Update

It has now been a little over 6 months since my surgery for adhesions.
I have had my post op check since posting last (I just realised it has been a while). The pathology was good ... no recurrence of PMP in there! WOO HOOOOOO

My surgeon said he "realised why I was in trouble when he got in there" ... the entire small bowel was twisted and looped on itself and 'glued' together. He had to pull out and scrape every centimetre to free it up ... a huge surgery and it has been a long recovery time... longer than I expected. As I said in my prior post - the small bowel burst in 3 places during surgery & was able to be repaired without losing anymore ... great news because I lost my colon & part of my small bowel in my "cut'n'dice" for PMP in 2001. .... (if you want you can check the story at the bottom of the blog for more info on that)

The surgery has been successful in the fact that I am now able to manage to eat solid foods (chosen carefully) without the intense pain that followed because the food could not travel through the digestive tract.

I am still having problems with partial obstructions & pain after eating some foods or some activities and have recently started to feel the familiar 'twisting' of the bowel on sneezing, coughing or twisting while bending ... it is not anywhere near as bad as it was before surgery & I hope & pray that it doesn't ever get that way again.

There is a certain amount of pain etc that is a part of 'the new normal' after these types of surgeries & as long as I can eat a reasonable diet I am happy. I will always have to choose wisely because of my ileostomy (Harriett) ... and at the moment I only eat one "solid" meal a day ... choosing something light or liquid for the other two & I am very happy with that! (especially since I was basically living on liquids or slush for the better part of a year prior to this last surgery)

As I have shared on this blog, I have other health problems and at the moment am in a very major flare-up with my auto-immune arthritis so am in intense pain in every joint & muscle - literally. I am hoping this flare-up runs it's course sooner rather than later and goes into remission where the pain is more tolerable with the use of my pain relief patch (because it has been 'over the top' for weeks now where even getting out of bed is an effort) .

BUT the absolute best form of pain relief for me? My darling 7 month old granddaughter ... a beautiful smile and hug from her and I melt and forget about any pain for the time I am holding her &/or interacting with her. ... wish we could bottle that feeling!! LOL

To all those struggling with their own health ,
JKG!! (Just Keep Going ... derived from a quote by Winston Churchill; "When going through Hell, just keep going!")

Aussie hugs, Kay :)