Bowel Appreciation
You know things are dire when the only thing you really want is flatulence; preferably big, reverberating, trombone-like flatulence. A veritable brass ensemble of flatus. This was at the top of my wish-list about five days after surgery to remove 25% of my bowel.
There isn't a shred of dignity left to you after bowel surgery but the recovery is so slow and painful that dignity is the least of your concerns. Any embarrassment you might normally feel about not being able to wipe your own arse or the need to wear incontinence pads, however short-lived, is swept away by the constant discomfort of nausea, cramps, bloating and the side effects of morphine and oxygen.
I was on a hard operating table for four hours, legs elevated, which left me with back pain worse than the pain of surgery. Nevertheless, the first three days, during which I was in intensive care, were relatively free of pain, thanks to an epidural anaesthetic dripping through a catheter in my spine, which kept my lower torso frozen for days, supplemented by morphine. I probably looked worse than I felt at the time, with two intravenous lines in each hand and a catheter to empty my bladder and monitor kidney function. By day 3 post-op, I felt good enough to think I might be able to go home in a couple of days. After all, the estimate of 7 to 10 days in hospital didn't apply to me. I'm super-duper woman, strong and healthy. I'd be out after five days.
That turned out to be blind optimism. I ended up being there for 11 days.
Your bowel doesn't like to be tampered with and will show its disapproval by shutting down and staying paralyzed in a petulant sulk for several days, which is why I was lulled into thinking I could go home. During its sulking phase, though, it entertains itself by stealthily forming lots of gas and, with all the retained fluid from being inactive, I soon bore a resemblance to a whisky barrel. Sliced from hip to hip, my wound seemed to be stretched to bursting and it felt as if all the staples holding it together would start flying in all directions. Surgical ward shrapnel.
The long, coiling piece of tubing that controls the digestion and elimination process is always working, clenching and contracting throughout its length to move everything through your system. If everything's working as it should, you're not aware of any of this action. If, however, your bowel's been in a paralyzed sulk for a few days, it'll remind you of it its pique by sneakily working only bits at a time over several days. So while part of it is flexing and massaging and processing waste the way it was designed to do, other parts are still inactive and when the waste reaches a still-dormant section, that's when the pain reaches epic proportions.
In my case, the section that wasn't working stretched from just below the ribs to my groin on the right. I knew this because of the intensity of the pain and that part of my body still feels like a big bruise. The working part of the bowel is pushing at the immoveable part to get it to open up and start clenching and the stubborn part's telling it to piss off, that it'll wake up when it's good and ready. So you've got this big vacuum of gas and waste that can't move in the right direction and, in addition to the unspeakable pain this is causing (worse than having a baby), nausea and vomiting start because everything's now backed up. And when you haven't been able to eat more than a couple of spoonfuls of jello for a few days, the vomiting is violent and painful and it felt like the edges of my wound were separating. This is all happening at two in the morning, of course.
When the bowel does decide to get back to work, things become evil. In a 16-hour period, I was back and forth to the toilet about 30 times. Sharing one toilet with five other bowel patients and not having full control is awful. During morning rounds, my surgical team would comment on how ill I was looking but, by the time they were back for evening rounds, they'd be saying how much better I was looking. I'd have a bad night of pain and nausea and not enough sleep, get up at 6 a.m. looking and feeling grey, force down a mouthful or two of cornflakes at 8:30, replenish my fluids, wear the hated oxygen mask (it was drying the membranes in my mouth and nose and causing nosebleeds), manage a couple of ounces of soup for lunch and have a couple of naps. By 5 o'clock rounds, the team would praise me for eating enough to get some colour back to my face and tentative guesses would be made for a discharge date. By the next morning, I'd be back to feeling grey and lifeless.
Before long though, the nausea was receding and my appetite began to come back. I was still only managing a couple of mouthfuls of food every few hours but what a difference that little bit of nourishment made to my recovery. To give my bowel a chance to recover gradually, I'd have to avoid eating any fibre for two or three weeks and the prescribed diet isn't the healthy one I'm used to - white bread, no raw fruit or vegetables other than bananas, lots of protein, no nuts or legumes. Any fruit and veg has to be cooked to mush before eating.
I'm now almost three weeks post-op and feeling better each day. I'm slowly reintroducing fibre into my diet and am now concentrating on getting well enough to start chemotherapy in another two or three weeks, depending on my recovery progress. I've now realized, after being reminded by the surgeon and my assigned colorectal cancer nurse, that this wasn't a minor operation, as I'd been treating it. It's one of the biggest operations you can have and is on the same scale as open heart surgery, but with a longer recovery period. Being the impatient little sod that I am, I fully expected to be feeling back to normal by now (despite what the doctors told me) and am feeling frustrated and disappointed that I'm still moving like an old woman and can't get comfortable no matter what. My slowness drives me mental and I yearn for the marching abilities of my sergeant-major days. Yesterday, I put make up on for the first time in three weeks and had to rest for half an hour afterwards. I needed a two-hour nap to recover from a two-hour shopping expedition yesterday too and feel quite lifeless today as a result. I'll have to rest today anyway, to prepare for a visit to an oncologist tomorrow (a two-bus journey).
Although I'm not my usual cheerful self at the moment, I do feel very lucky and grateful for all the emotional and physical support I'm getting. Having Meredith and Evan here for the surgery went a long way in helping my recovery, and Evan's been making sure I don't have to worry about household chores since I've been home. I've received scores of emails wishing me well and reminding me how much people care about me, which is quite humbling and very encouraging. And then there are all the cards and gifts and phone calls too, and prayers to many different deities, as well as spells being cast for my recovery. As I've only just begun to realize during the past few days that I've had cancer - the Big Feckin C - getting cards and emails telling me that I'm adored and missed is going a long way toward helping me cope with the shock of that.
It's less than six weeks since this was diagnosed and already I'm on my way to recovery, instead of still sitting waiting for surgery, as I'm afraid might have been the case if I hadn't been in the UK. I have the utmost praise for Britain's National Health Service and for the treatment I've received throughout. Their mandate is that cancer patients shouldn't wait longer than 56 days from diagnosis to treatment and the fact that I was on the operating table three weeks after the date of my diagnosis has lessened the emotional impact for me, I think.
The silver lining to this - the promise of weight loss - isn't yet apparent. I still have a lot of swelling and fluid retention so there isn't much difference to my waistline so far. I am delighted to report, however, that my eyelids look leaner and one of my sixteen chins seems to have disappeared. My rings and watch are a bit loose too, so maybe when the swelling around my middle goes down, I'll metamorphose into the sylph-like being I was expecting to see after surgery.
Yeah right.
There isn't a shred of dignity left to you after bowel surgery but the recovery is so slow and painful that dignity is the least of your concerns. Any embarrassment you might normally feel about not being able to wipe your own arse or the need to wear incontinence pads, however short-lived, is swept away by the constant discomfort of nausea, cramps, bloating and the side effects of morphine and oxygen.
I was on a hard operating table for four hours, legs elevated, which left me with back pain worse than the pain of surgery. Nevertheless, the first three days, during which I was in intensive care, were relatively free of pain, thanks to an epidural anaesthetic dripping through a catheter in my spine, which kept my lower torso frozen for days, supplemented by morphine. I probably looked worse than I felt at the time, with two intravenous lines in each hand and a catheter to empty my bladder and monitor kidney function. By day 3 post-op, I felt good enough to think I might be able to go home in a couple of days. After all, the estimate of 7 to 10 days in hospital didn't apply to me. I'm super-duper woman, strong and healthy. I'd be out after five days.
That turned out to be blind optimism. I ended up being there for 11 days.
Your bowel doesn't like to be tampered with and will show its disapproval by shutting down and staying paralyzed in a petulant sulk for several days, which is why I was lulled into thinking I could go home. During its sulking phase, though, it entertains itself by stealthily forming lots of gas and, with all the retained fluid from being inactive, I soon bore a resemblance to a whisky barrel. Sliced from hip to hip, my wound seemed to be stretched to bursting and it felt as if all the staples holding it together would start flying in all directions. Surgical ward shrapnel.
The long, coiling piece of tubing that controls the digestion and elimination process is always working, clenching and contracting throughout its length to move everything through your system. If everything's working as it should, you're not aware of any of this action. If, however, your bowel's been in a paralyzed sulk for a few days, it'll remind you of it its pique by sneakily working only bits at a time over several days. So while part of it is flexing and massaging and processing waste the way it was designed to do, other parts are still inactive and when the waste reaches a still-dormant section, that's when the pain reaches epic proportions.
In my case, the section that wasn't working stretched from just below the ribs to my groin on the right. I knew this because of the intensity of the pain and that part of my body still feels like a big bruise. The working part of the bowel is pushing at the immoveable part to get it to open up and start clenching and the stubborn part's telling it to piss off, that it'll wake up when it's good and ready. So you've got this big vacuum of gas and waste that can't move in the right direction and, in addition to the unspeakable pain this is causing (worse than having a baby), nausea and vomiting start because everything's now backed up. And when you haven't been able to eat more than a couple of spoonfuls of jello for a few days, the vomiting is violent and painful and it felt like the edges of my wound were separating. This is all happening at two in the morning, of course.
When the bowel does decide to get back to work, things become evil. In a 16-hour period, I was back and forth to the toilet about 30 times. Sharing one toilet with five other bowel patients and not having full control is awful. During morning rounds, my surgical team would comment on how ill I was looking but, by the time they were back for evening rounds, they'd be saying how much better I was looking. I'd have a bad night of pain and nausea and not enough sleep, get up at 6 a.m. looking and feeling grey, force down a mouthful or two of cornflakes at 8:30, replenish my fluids, wear the hated oxygen mask (it was drying the membranes in my mouth and nose and causing nosebleeds), manage a couple of ounces of soup for lunch and have a couple of naps. By 5 o'clock rounds, the team would praise me for eating enough to get some colour back to my face and tentative guesses would be made for a discharge date. By the next morning, I'd be back to feeling grey and lifeless.
Before long though, the nausea was receding and my appetite began to come back. I was still only managing a couple of mouthfuls of food every few hours but what a difference that little bit of nourishment made to my recovery. To give my bowel a chance to recover gradually, I'd have to avoid eating any fibre for two or three weeks and the prescribed diet isn't the healthy one I'm used to - white bread, no raw fruit or vegetables other than bananas, lots of protein, no nuts or legumes. Any fruit and veg has to be cooked to mush before eating.
I'm now almost three weeks post-op and feeling better each day. I'm slowly reintroducing fibre into my diet and am now concentrating on getting well enough to start chemotherapy in another two or three weeks, depending on my recovery progress. I've now realized, after being reminded by the surgeon and my assigned colorectal cancer nurse, that this wasn't a minor operation, as I'd been treating it. It's one of the biggest operations you can have and is on the same scale as open heart surgery, but with a longer recovery period. Being the impatient little sod that I am, I fully expected to be feeling back to normal by now (despite what the doctors told me) and am feeling frustrated and disappointed that I'm still moving like an old woman and can't get comfortable no matter what. My slowness drives me mental and I yearn for the marching abilities of my sergeant-major days. Yesterday, I put make up on for the first time in three weeks and had to rest for half an hour afterwards. I needed a two-hour nap to recover from a two-hour shopping expedition yesterday too and feel quite lifeless today as a result. I'll have to rest today anyway, to prepare for a visit to an oncologist tomorrow (a two-bus journey).
Although I'm not my usual cheerful self at the moment, I do feel very lucky and grateful for all the emotional and physical support I'm getting. Having Meredith and Evan here for the surgery went a long way in helping my recovery, and Evan's been making sure I don't have to worry about household chores since I've been home. I've received scores of emails wishing me well and reminding me how much people care about me, which is quite humbling and very encouraging. And then there are all the cards and gifts and phone calls too, and prayers to many different deities, as well as spells being cast for my recovery. As I've only just begun to realize during the past few days that I've had cancer - the Big Feckin C - getting cards and emails telling me that I'm adored and missed is going a long way toward helping me cope with the shock of that.
It's less than six weeks since this was diagnosed and already I'm on my way to recovery, instead of still sitting waiting for surgery, as I'm afraid might have been the case if I hadn't been in the UK. I have the utmost praise for Britain's National Health Service and for the treatment I've received throughout. Their mandate is that cancer patients shouldn't wait longer than 56 days from diagnosis to treatment and the fact that I was on the operating table three weeks after the date of my diagnosis has lessened the emotional impact for me, I think.
The silver lining to this - the promise of weight loss - isn't yet apparent. I still have a lot of swelling and fluid retention so there isn't much difference to my waistline so far. I am delighted to report, however, that my eyelids look leaner and one of my sixteen chins seems to have disappeared. My rings and watch are a bit loose too, so maybe when the swelling around my middle goes down, I'll metamorphose into the sylph-like being I was expecting to see after surgery.
Yeah right.
posted by Jacki | 8:39 AM
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