Sunday, 31 March 2013

Dealing with my reconnected Plumbing

I have been asked to reopen my blog in order to share my experience of the associated problems after an ileostomy reversal when part of the rectum has been removed. These things are quite personal and sometimes embarrassing however I will try to be open and honest. Everything below has been researched through the Internet and the information is there if you are resourceful enough to find it but who knows maybe my story could help by pointing someone in the right direction or by learning from my mistakes.

Email from my consultant - "You are on the waiting list and we will get you in as soon as possible for your ileostomy reversal, If that's what you want!" - Why would I not want a reversal??? Is someone not telling me something?
Yes there is! The constant urge for the toilet and the feeling that you are pushing so hard that you are going to force yourself inside out. But come on, Stay positive, It will get better, won't it?

The reasons for the problems that follow are due to the removal of the part of the bowel that stores the waste prior to going to the toilet which means that the re sectioned piece that is is now joined is not capable of storing the usual amount of waste and does not have the same type of nerves to be able to sense the same feelings as before. Having a double resection where part of the normal bowel was also removed means that bowel is shorter therefore motions are more fluid since there is less time for moisture to be absorbed into the body.
So how does one manage looser motions, less capacity and cluster urges?
It's been five weeks since the operation to reverse my ileostomy and at no time had anyone prepared me pre or post operation as to what could be expected and the challenges ahead "Eat normally and it may take a while to settle down" was what I was told as I was discharged from hospital.
The thing that you are not ready for are the Cluster motions where I was visiting the toilet several times an hour and doing very little however the straining and feeling of deification was very real. My first reaction was to visit my GP and ask for laxatives in order to completely clear me out. The GP openly admitted a lack of experience in the matter and gave me what I wanted.
The clusters did not get any better and it is only by researching on the Internet did I find that cluster motions could be reduced by increasing the amount of medicinal fibre in my diet in order to slow down the transit time through the bowel and to make the stools more solid. At the moment the answer to this could be Fybogel which when dissolved in a little water and drank twice a day after meals adds bulk, absorbs liquid and binds food waste together.
Other pieces of research mainly from USA based hospitals suggested bowel retraining so that motions could be released at a predictable time of day and reduced to twice or even once per day. One of the suggested program involves.

  • The introduction of medicinal fibre (as above)
  • Temporary use of imodium or Loperimide to slow the bowel movement down
  • Drinking prune juice
  • Eating a big meal (causes a peristaltic action in the bowel  which moves waste through)
  • Drinking a hot drink (also causes a peristaltic action in the bowel  which moves waste through)
  • Insert a glycerin suppository or if this does not work a Dulcolax suppository
  • Going to the toilet
  • Over a 14 day period reduce the imodium and suppositories
So where am I at the moment?
Well after a few weeks of messing around with no real plan I'm starting to get it together. My feeling is that if I can get myself empty in a morning then it will leave me virtually trouble free for the main part of the day when I'm out and later on this week back at work.
Therefore at the moment I get out of bed then have the following
  • Prune juice
  • Fybogel with a little water
  • Porridge
  • Hot drink
  • Toilet
  • Shower
  • Toilet
  • Brush teeth
  • Toilet - yes and wash my hands each time!
I'm finding that moving around in a morning encourages bowel movements so for me it is important to shower so that the bending and stretching promotes a reaction whilst I'm near the toilet.
I'm managing without suppositories - I just don't want to use them as I'm not one for having things pushed up my arse, however if I'm out for the day away from toilets I take two Loperamide (imodium) tablets with my breakfast and have found that this really works and keeps urges well away for several hours.
Later in the evening I'm going to the toilet again, not very often though, and this is fine for me since reducing toilet times from all day to twice a day is really acceptable.
I'm having a fair amount of wind at the moment which I cannot or don't want to hold in but this could be down to getting used to the Fybogel.
So although I'm having some good days I also have a few bad days especially when my motions are loose and / or when I'm close to the toilet. Being close to a toilet encourages me to go at the slightest urge rather that wait and hold myself. It may also be psychological.
I'll keep posting to keep anyone who is going through this informed.

Wednesday, 6 March 2013

2 Weeks Post Bob

Well it has been 2 weeks since Bob (my stoma) and I parted after exactly 11 months together.
Removal of staples
Back at home my bowel movements are taking some settling down and I have been having the urge very frequently however with not much to show for them. It's OK in bed and whilst I'm sat but once I'm up and moving it is wicked. I'm doing loads of pelvic floor exercises but it isn't making much difference.
Day 10 was supposed to be the day that the District nurse was supposed to come and remove my wound staples however she did not materialise so I set about removing them myself after a quick recap on You Tube.
It was pretty easy and don't know what all the fuss is about.
I have been out most days for walks including a trip into the Peak District yesterday. Whilst I'm out walking and talking the urge is mostly at bay, so is it a mental thing?
Where has Bob gone?
Anyway I'm going to start to eat lots of fiber to see if that improves things or makes things worse however I am aware that it could take several months to get anywhere near back to normal.
So since the news of a clear scan, has my outlook on life changed? No I don't think it has really. I always had a positive "Can Do" attitude and I think that this has helped a lot. Have I learnt anything about myself - No not really! probably just confirmed what I already knew.
What Now? Well I have another 2 weeks off work and I'm intending making full use of it in the outdoors plus I'm at risk of a hernia around my wound area so I'm going to have to go steady with the exercise for a couple more months. Meanwhile hopefully my toilet habits will settle.