Bowel Resection Q&A

If you are reading this then you are probably are about to, or, have recently  undergone resection on your bowel.

Two years on from my resection I have grown to love my new ‘re-plumbed’’ bowel, and in hindsight it is actually better than before.

You will have many question for your surgeon and your CNS nurse, and it goes without saying that this should be your first source of information and guidance

Sometimes though you have to go through something  to know the right questions to ask, that may seems a bit abstract but you known what Im getting at.

As Donald Rumsfeld once famously said “There are known knowns. these are things we know that we know. There are known unknowns . That is to say , there are things that we know we don’t know. But there are also unknown unknowns, these are things we don’t know  we don’t know!”

Thankfully having gone through a successful resection I do have a compendium of my experiences which may prove helpful to you in the form of a question and answers.

It should be noted that my views and thoughts are based around my experiences that are particular to me, my surgery will be different to yours, both in terms off location, size of tumour, type of surgery etc etc. Therefore because this was my experience does not necessarily mean that it will be the same for you. Just saying…..

For context my surgery was performed laparoscopically with 12” (sorry old school measurement ) of bowel removed quite near to the rectum. Some surrounding tissue removal where a focus of peritoneal disease was found, in total my surgery took around 5 hours. I did not have a stoma.

So….

Q. How long did it take you to get over the anaesthetic?

A. I felt ‘odd’ (more than usual) for about 4 days afterwards, obviously you come around after the Op but the residual affects of the anaesthetics took longer to dissipate. I understand the residual affects depend on the length of the operation.

Q. How much pain were you in post Op?

A. I wasn’t in any pain at all, thats not to say its ‘pain free’ but the pain relief regime is very good .You may well have something called PCA (Patient Controlled Analgesia) which is admitted through the venflon you will have in the back of your hand or arm. A measured and controlled amount of pain relief is available on pressing of a button, it is controlled tightly so there is no way you can overdose, but it does mean that there is an element of self control which is good. To be honest the PCA combined with the anaesthetic meant that during the early stages of recovery I didn’t know whether it was Christmas or Easter.

Q. How soon afterwards were you moving?

A. As soon as is reasonably practical after surgery the nurses /physios will get you up on your feet. Trust me the thought of this the day after surgery fills you with a sense of foreboding, but you are safe and they know what they are doing. You have to do it, as it is important to ensure that everything starts to work again,  so the sooner you are up the better. I was dreading this but it was ok –  just a few steps and then back in the comfy chair.

Q. What about going for a wee?

A. I had a catheter fitted (don’t worry they will do this in theatre!). It stayed in for me up until the day I was discharged (3 days). It’s one of the better parts of the surgery and recovery. You simply wee on autopilot without knowing that it is happening. Particularly for the men it can be a bit uncomfortable having a tube coming out of your old chap. But it is well taped to your leg (the tube as opposed to your old chap) and lets face it you are not exactly going to run the London marathon, so the little amount of walking around you are going to do will not cause you any grief.

I was getting anxious about having the catheter removed….. I needn’t have been, again the removal is swift and pain free (slightly uncomfortable at most). Just make sure they deflate the balloon first!.  I would say that after removal of the catheter it was a good day or so before the process of going for a wee  felt ‘normal’ again.

Q. How soon were you eating and drinking afterwards?

A. The nurses will get you to drink as soon as you are able, you may well still be connected to various drips but your mouth will be oh so dry after the anaesthetic. In terms of food I was pretty hungry the next day and again the nurses will gradually introduce you to solid food, day one I had some toast followed by soup, this was gradually ramped up over the next few days. ‘little and often’ was the advice I was given, and this proved to be sage advice.

Q. What about going for a poo?

A. This may well be your biggest worry, I know it was for me. Don’t try and run before you can walk and please don’t get hung up on this one. Your bowel has been through some heavy manipulation and re-plumbing, and lets face it it doesn’t  like it. It will take a while to kick start back into  life, and don’t forget you will have had bowel prep so there is not a lot in there for it to work on. Firstly they will want to know that your system is working and that will be determined when you do your first fart.  Boy was I pleased when this historic event occurred , for me this was the next day, and that meant I was 50% happy… but still concerned that I would ‘tear’ or ‘rip apart’ the first time I went for a poo. Of course neither of these events came to fruition and on day 5 I proudly gave birth to a bouncing poo (literally) deep joy and relief.

*Don’t be alarmed if on the first one there is some residual ‘old blood’ this is to be expected. Clearly if you keep bleeding then take advice.

Q. Could you eat the same things after you resection?

A. I had a period of adjustment, during which time  spicy  foods, brussel sprouts, and several other food types went straight through me. This didn’t last though, and eventually my body adjusted to all the food types I was previously able to eat without problem.

Remember though ‘little and often’ to begin with, don’t expect to eat the same amounts initially as you did before.

Q. What was it like emotionally?

A. I struggled emotionally, for me this was the physical manifestation of the fact I had cancer, it all became very real. I also think that the GA affects your mood as well and I was advised that this could be the case. I cried ( a lot) but the post operative blues didn’t last too long and once discharged and on my home turf I soon pecked up.

Q. How soon were you physically active?

A. I had laparoscopic surgery so for me the recovery time was less than having a ‘full open’ operation. That said I was still taking things very gradually for the first few weeks. NO LIFTING , nothing heavier than a kettle was the advice. Every day I had some light exercise (walking around the house) this was increased by a few more ‘circuits’ each day until  3 weeks in I was out on my bike for a short spin on the moors. I was a good boy and didn’t drive for 6 weeks (allegedly….) seriously though, be sensible if you can safely operate the brake and all other functions then you should be ok. Your body will tell you if you are doing too much , you will get a vague ‘drawing pain’ in your abdomen. This is your warning to back off and take things easy.

Q. How soon did you resume ‘marital relations’?

A. My advice is to wait until the anaesthetic has worn off.. no seriously, you do not want to jeopardise anything so think of other ways to amuse yourself until every thing has healed sufficiently.