Archive for May 29, 2012

Release Day…

On Saturday I was told that even though initially I was to be in for a week, that I had progressed well enough to go home on Sunday.  Though still in pain, I was glad to be out of the hospital!

Dr. Burleson checked me over mid-morning & confirmed that I could go home, so I called Dawnette & gave her the news.  She came up within about an hour or so & I filled out the paperwork & they wheeled me down to the waiting Caddy.

We had a friend in the hospital (Centennial Medical Center in Frisco), and even though I was supposed to go straight home, we went & saw her for about 20 minutes or so to see how she was doing.

That 20 minute detour was pretty rough on me believe it or not.  I got home & got settled into the downstairs guest bedroom & fell asleep…and I don’t remember much after that!

STILL no bowel movement through the stoma though, which was beginning to concern me as that meant that starting with the liquids on Thursday & solids on Friday, Saturday & Sunday, I STILL hadn’t had anything come out of the stoma (other than air or “gas”)…

A Stoma Tells Its Story!

I AM A STOMA!

Mary Lou Thomas, RN, ET, North Arundel Hospital via OAB Bulletin, Boston

Hi, I’m a stoma! I am great when you think about it. I must admit I have upset many people. Some people even consider me crude, rude and socially unacceptable. Well, excuse me!!

Just about everyone gets bent out of shape when their doctor says, “It may be necessary to create a stoma”. Me!! They make it sound like a dirty word. Listen, it isn’t the greatest for me either. I’m usually created from a piece of your intestines. I guess you know all about that. And then, just maybe you don’t. So I will tell you Becoming a stoma wasn’t my original function. No sirreee!! I used to just lie there in your abdomen, minding my own business. Then boom!! Some surgeon decided – let’s make a stoma. He had a nerve! Why?? How could he consider such a thing? Well, I guess it was because you hurt so much, because you were very sick from a disease like Ulcerative Colitis or cancer, from a trauma like that automobile accident or from a birth defect. Your surgeon knew that by putting me to work, you could be free of discomfort and problems. In truth, so you could get on with living.

If that is why I was created, then why do so many people complain about me? Did you know that I am not given to just anyone? You see, there is a lot of planning and evaluation of each human being before I am created. So I know you can say only a “chosen” million or so are lucky enough to have me. You see – my people are special. My people are not like the normal run-of-the-mill people. I must say it takes them a while to recognize that fact. And, sad to say, there are a few who never do.

It isn’t easy being a stoma! Some of you just don’t understand what a miracle I am! Listen, before creation, I just lay quiet and usually content in your abdomen.

Now I work! It’s rather easy when fecal waste comes through because that’s what I’m used to. But some character decided, why not water waste as well? We then found out that character was very wise because that works also.
You think YOU have problems adjusting! Phooey. Did you realize that I am a delicate mucus membrane? Yet I am durable but some people think I am asphalt tile. Thank God, I don’t have feelings. But my friend skin does. You want complaints? Give a listen to her sometime. She really gets upset because of ulcers, fungus, irritants, barriers, etc. We are a team! And a darn good one. I’m moist, she is dry. I’m pink red, she is natural. I’m smooth, she is a little bumpy.
One of my biggest problems is my size. I am not always the same size from one human to the next. I am not always round. I don’t always protrude nicely. Then why do some of you insist that my pouch opening is always the same? You need to check my size once in a while and fit me appropriately. Your shoes fit, don’t they?

Some of you complain because I’m not pretty. Well, your anus wasn’t Miss America! I think I am attractive. I am red like a rose. I am always moist if I am healthy. And, I don’t smell. My discharge can’t help what you put in your mouth. If you care for me with thought and keep my equipment clean, that just about takes care of that.

In closing, let me say you can live a good life, a productive life. It’s up to you. Believe me, I do not deserve a pedestal life. I am just part of you trying to do my job. All I ask is that you be honest about me. The doctors, special nurses, other professionals and your Ostomy Association are always ready, willing and able to help you.

Recovery…

Thursday was a bit better…I felt a bit more “mobile” & actually left the room & walked the hall ways a bit…I’m pretty sure I was the youngest one there on the entire floor.  For the most part the nursing staff & techs were good, though the night shift for some reason was significantly better than the day shift.

There are a hand full of staff that stood out…Robin, Gordon, and a few others I’ll have to get their names…they were great.  It still baffles me why the day shift wasn’t as “attentive”, etc.  I just felt more like a burden to them than when the night shift was on (7:30 p.m. – 7:30 a.m.).

Thursday was also when i started being allowed to have liquids (instead of just water/ice)…basically soup broths, etc.  Apparently that was faster than “normal”, so that was good I guess.

Each day I started to “feel” a bit better.  I was more mobile each day, walking further & further.  At first, just to the nurses’ station on the one side, then around the one side of the floor & eventually within a couple of days, around the entire floor.  I usually walked at least twice, if not three times per day.

Friday was yet another milestone…I was allowed to have “soft” foods.  Now, what THEY consider soft foods and what I consider soft food are 2 completely different things.  Regardless, there were no complications, though there was also no bowel movements either.

Friday was also nice because I got the catheter removed…it didn’t “hurt”, but lets just say that the last 12″ or so is a feeling that I NEVER want to feel again…seriously!

On Saturday I was allowed to have the next level of foods, which they classify as “low fiber”, so the food progression apparently I was doing really well with & I was considered ahead of scheduled.  I also got the drip bag removed on Saturday as well, which was nice as it meant I wasn’t “tethered” or tied down to anything at all.  I had MUCH more freedom to roam around, etc.  I hadn’t been using the morphine that much as the pain had started to diminish (a little bit each day).

Saturday was also nice as I got the “JP” or drip pouch, whatever it’s called, removed.  It was basically a tube…how shall I say this…up what “was” my rear-end that was connected to a collection ball at the end.  It “collected” any additional fluids my body couldn’t absorb naturally.  Given it’s location (my rear end), to sit or lay was very uncomfortable, as that’s pretty much about ALL you do while you’re in the hospital!   Anyhow, apparently, the amount of fluids in the pouch had gotten low enough that they felt it could be removed.  Yet another nice feeling as it too had restricted my movements and was of course, uncomfortable.  Again though, no “bowel” movement(s) through the stoma.

My Colostomy

So, as part of my cancer “treatment” or removal, I have to live with a colonostomy.  Sometimes these are temporary, until the initial cancer-infected area heals after the cancer has been removed.  However, in my case, due to the sheer size of the cancer (at the time of removal on Tuesday, May 22, 2012 it was the size of a squash ball), the location (only 1 1/2 into my rectum) and the shape (semi-circular), my colostomy will be permanent.

According to Wikipedia, a Colostomy is:

colostomy is a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body. It may be reversible or irreversible depending on the circumstances.

Surgery Day…

My surgery was scheduled at Baylor Medical Center in Plano on May 22, 2012.  We arrived at 10 am & they got us into the prep room by 10:30, which I thought was a bit early given the surgery wasn’t scheduled for noon.  While they got me prepped quickly, surgery never happened at noon…they gave me my anesthesia around 11:30 a.m. & that’s the last thing I remember till they woke me up around 5 pm or so…I was in and out from there until they moved me to my room around 8 pm.

Dawnette stayed with me the first night, which was nice as I was in and out all that night in pain…I kept pushing that morphine button every 5 minutes or so…at least when I was awake!  ;o)

Believe it or not, they had me get out of bed the next morning & walk over to the chair where I stayed the entire day until it was time to go to bed.  The surgery supposedly went well, the doctor said he got everything…the cancer was about the size of a squash ball, or just a bit smaller than a tennis ball.  I guess it was one of the largest rectal cancers he’d had to remove.

That first day, Wednesday, was tough…I had a catheter where I NEVER want one again…it was incredibly uncomfortable.  They had me drinking water & chunking on ice all night Tuesday night & I guess my body adapted pretty well because around 11 am or so I heard this gurgling sound & liquid came out of the stoma.

Oh yes, I’m pretty sure I’d mentioned it already, but in most cases of rectal, colon, etc. cancer, the patient has to have a stoma (basically redirecting their bowel movements through a hole in their stomach) until the cancer area that was removed has healed completely (usually 4-6 months) and then they reverse the stoma & re-route things “back to normal”.

My situation, unfortunately, is permanent.  In the first place, was the size of the cancer…as mentioned, it was the size of a squash ball, which is quite large.  Secondly, the location of my cancer was only an inch and a half inside my rectum, so it was *extremely* low.  Lastly, the “shape” of my cancer was such that it was semi-circular.  If you think of your rectum in the shape of a cylinder, the cancer was not on the “side” of the cylinder, but it was semi-circular around the cylinder.  All of that means that my stoma/colostomy is permanent…which I’m not all that happy with to be honest…I had hoped it was only temporary.