Surgery and beyond

 Its now a week since I had surgery to remove part of my colon containing a “mass” which looked cancer on a CT scan, together with a stricture which had narrowed the bowel to the point where the opening was so small not even a paediatric colonoscopy camera could push through.  

Surgery 19 July

Alarm set for 4.30am to give me enough time to shower and drink two bottles of “PreOp” high carb drink and some water before going nil by mouth from 5am, two hours before I had been asked to attend hospital.  Daughter Katie picked me up at 6.30am and drove me to the hospital. At that time in the morning Oxford’s notorious traffic is relatively light, and we arrived at the hospital’s Direct Theatre Admissions around 6.50am, to find at least a dozen people waiting for the doors to open at 7am. My heart sank…but we were ushered in on time, details checked, observations carried out (weight, heart rate, blood pressure, blood oxygen levels) and questions regarding medical history, when I’d last eaten and drink and such like, answered.  I was told that I was first up, so not long to wait. 

Katie was allowed to stay while I changed into a hospital gown, had wrist tags applied and met one of the surgery team to discuss what was going to happen (and make sure I understood!).  He said they wanted to add an extra procedure to the consent form - something called a flexible sigmoidoscopy, which would enable them to pinpoint exactly the location of the stricture before operating.  I was happy to oblige.  Much rather they knew where to cut, rather than go on a mining expedition to look for it…

Then I said goodbye to Katie and walked to the the anaesthetic room to meet the anaesthetist and his assistant. Cannula inserted on back of hand, epidural injection in my back, then lying down with a mask over my face.  The next thing I remember was someone calling my name.  I was in the recovery ward.  It was all over. I vaguely remember someone saying it went as well as could be expected (which didn’t sound very reassuring) before being wheeled along to the ward where I would be staying for the next few days.  I think it must have been about 5pm, so a longish session on the operating table, followed by a wait for a bed to become available on the ward.  

In all honesty, I don’t remember much about that first evening/night, other than being woken up several times for “obs” to be taken, pain relief given via an IV tube, being hooked up to another tube giving me fluids and a catheter to take them away.  

Post Op Day 1 20 July

Early start with obs at 5am and pain relief at 6am.  I think I must have dozed off again until around 8am, when I was offered a hot drink, then followed a steam of people…a visit from the Early Recovery After Surgery Team (ERAS) to explain how that operated; physios to see if I could sit in a chair, get up and walk (I could - they had to tell me to slow down as I did a tour of the ward corridor!) 

Later, one of the doctors on the surgery team appeared with others in tow, to tell me it had gone well (I’d already felt for a stoma, and found nothing).  He said I seemed “chipper”, as I sat propped up in bed, happy and relieved that there was no bag.  He also said that many people feel a bit down on day 2 post op as the anaesthetic and IV pain relief drugs used in surgery pass through the system, so not to worry if that happened - it was normal.  I was told I could eat as well as drink, which seemed amazing so soon after surgery. 

The IV pain relief and catheter tubes were removed, along with the cannula in my hand, which promptly swelled up rather alarmingly.  Without giving you too much information, I did a lot of peeing on and off after that, but found it difficult to empty my bladder completely, as confirmed by a bladder scan.  There was also some blood loss from my rear end, but the doctor said not to worry - it should stop soon (which it did).  

I did start eating, but carefully - soup, jelly and ice cream for lunch, and a morsel of chicken and some mashed potato around tea time.  Funny how you remember details like that, but it was a BIG thing to have solid food again!

Katie visited and it was lovely to have company again. 

Post Op Day 2 21 July

Hallelujah!  My bowel has woken up (nurse’s term!) and that seems to have cleared the bladder blockage too.  My digestive system is fully operational.  What a relief!  My appetite returned a bit more too.

I went for 2 walks (four times the length of the ward), spent 2-3 hours sitting out of bed reading and watching TV on the laptop, and ate three meals as per the ERAS advice.  But the surgery drugs have definitely gone through the system, and it’s really painful to move between lying down, sitting and standing i.e.movements which put a strain on core muscles.  I need the pain relief when it’s delivered.  

The consultant in charge of the surgery called in, with a posse of doctors.  He confirmed that all had gone well.  There was plenty of colon left to join up the two cut ends without the need for a stoma/bag, which was something they’d been worried about.  I was medically fit to be discharged, the only box yet to be ticked was learning how to self inject blood thinning meds, which I have to do for 28 days after the operation.  My first lesson is self injection was that evening…

We all agreed I could go home on Sunday, post op day 4, when family would be at home to keep an eye on me. 

Post Op Day 3 22 July

I continued with the ERAS advice, going for three walks today covering 6 lengths of the ward corridor.  When Katie visited she bought a big fluffy bath towel so I could dry myself in comfort after showering.  When she left, I accompanied her down three flights of stairs and climbed back up again on my own without a problem.  That was reassuring.  The wounds are still very tender, bruising is spectacular and pain is bad when I change position…but it’s still early days, and it will get better.  

Very tired after a broken sleep the night before, but ready to go home tomorrow. 

Post Op Day 4 23 July

Home today!  The usual morning and lunchtime routine in hospital, wounds checked and all obs OK.  I had a farewell visit from the main consultant to wish me luck.  Apparently I’m a model patient!  

Katie arrived early afternoon and I said goodbye to everyone. Actually felt a bit emotional at some of the nice things the nursing staff said…

Afternoon and early evening at Katie’s house, then back home to wait for son Jack and his fiancé to arrive.  They will be staying here and acting as my immediate support system, until I’m ready to live completely independently.  Self injected blood thing meds without a problem, and then to sleep in my own bed. Bliss! 

Post Op Day 5 24 July

First full day at home, taking it very easy.  Jack and I walked a circuit round the park at the end of the street at lunchtime (about half a mile), so I can keep up the ERAS advice. Afternoon nap, a bit of very light housework (folding/hanging clean laundry) and an evening in front of the TV.  

Post Op Day 6 25 July

Woke up early but rested after a good night’s uninterrupted sleep.  Made myself a cup of coffee and went back to bed to catch up on emails and news.  One of my friends offered to join me on my daily walk - twice round the park this time, just over a mile.  Onwards and upwards!

A member of the ERAS team phoned to see how I’m doing: all OK, although I need to make sure I’m drinking enough to stay hydrated.  She suggested I take a Tramadol (opiate based pain relief) if the pain gets too much.  I’ll try not to as it’s addictive, but it’s good to know it’s there if I need it.  

I took a nap after my walk - and realised that I’d curled up on my side for the first time, without thinking about it or being bothered by excruciating pain.  That’s good!

However, my abdomen looks like I’ve been a victim of knife crime - four puncture wounds above and below the navel and at the belly button itself, and a longer slit along the bikini line (where the bowel was pulled out) which has given me a sort of muffin top around the hips.  More bruising has appeared, not just around the wounds but in other areas too.  Black, blue, green, yellow…quite colourful…an indication of the punishment my body has taken.  One of the doctors advised that the bruising would eventually fade from the top down, aided by gravity.  The last thing to disappear will be what appears at first glance to be a dark blue bikini bottom. It’s not, it’s just a bloody great area of bruising!  

Ironically, the area that hurts the most when I change position is close to, but not part of, the main wound and is not particularly bruised.  At least, not yet.  It’s a fierce stinging/burning pain deep inside.  I wonder if it’s muscle damage?  Must keep an eye on it, and take action if it’s still hurts as much when the bruising has faded.