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Crohn's Disease Forum » Surgery » Surgery consult tomorrow - left hemi


01-01-2014, 01:28 PM   #1
hawkeye
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Surgery consult tomorrow - left hemi

So I am booked for a surgery consult for a left hemi colectomy tomorrow.

GI thinks they will take the descending colon and part of the transverse based on where the structuring is and blood supply to the colon.

Reading through a lot of the posts on here it seems that right hemi colectomy are more common in terms of resections.

Can I expect the same recovery / issues as a right hemicolectomy?
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Current Medications: None currently. Was on Imuran (150mg/day) and 5-ASA (3000 mg/day) as maintenance meds prior to surgery
Surgeries: Left hemicolectomy 2014.
01-01-2014, 02:15 PM   #2
DustyKat
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Wow hawkeye, I didn’t realise you had upcoming surgery.

I would imagine procedurally it would be similar, IYKWIM, and recovery time wise it would be the same.
Do you mean long term issues, like malabsorption and diarrhoea? If so then no, you would not have issues with malabsorption and I don’t think you would have diarrhoea issues either as you likely still have enough large bowel to absorb water back out of the bowel to create firm stools. Diarrhoea issues with a right hemicolectomy relate to removal of the terminal ileum.

And above all else…Good Luck!!!

Dusty. xxx
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01-01-2014, 05:16 PM   #3
2thFairy
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Best wishes, hawkeye!
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Total colectomy with ileostomy featuring Sideshow Bob since January 2012

"The colon seems an unlikely candidate for dramatic effect, but now and then it serves that purpose well." The Associated Press Guide to Punctuation
01-01-2014, 09:51 PM   #4
hawkeye
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Dusty:

Yep have 2 strictures that are causing issues. The strictures have been there since at least late-2010 (CT scan then and still there in a CT scan from this past July). My GI is of the opinion that surgery would be more effective than another drug.

Down 40 lbs. in the past year.


Hawkeye
01-02-2014, 01:38 AM   #5
DustyKat
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Given the amount time they have been present they would have progressed to scar tissue and no drug on this Earth will fix that.

Good luck with the consult!

How is your lad doing these days hawkeye?

Dusty. xxx
01-02-2014, 03:13 PM   #6
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I've had a right hemi about a year ago. Same issue with scar tissue, but so far so good
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01-02-2014, 06:45 PM   #7
hawkeye
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Surgeon is sending me for a CT colonography (virtual colonoscopy) so we'll know what things are like on the other side of the strictures as they can't get the scope through the strictures.

He also recommended a polyethylene glycol laxative daily to keep things "mobile and soft".

Little lad is doing great - learning numbers, colours and the alphabet.
01-31-2014, 08:22 PM   #8
hawkeye
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Had the CT a couple of weeks ago, and met with the surgeon again today. Based on the CT scan the right side looks good so it looks like it we will plan for a left hemi. Now just waiting for the surgery to be scheduled.
02-06-2014, 07:22 PM   #9
hawkeye
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Got the date today - February 20th
03-09-2014, 02:39 PM   #10
hawkeye
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So It is now over 2 weeks since my surgery, here is how things went -

Day 0 (Thursday) - Surgery Day. At the hospital for 6:15 AM, and was wheeled into the surgery “holding area” before 8. Met with the anestheologist, surgical resident and surgeon while I was waiting. The last thing I remember was looking at the clock in the OR, it was 8:10 AM. I don’t remember much from the recovery room, it was about 12 or 1 when I woke up. I think the surgeon was there because I was told that the left hemicolectomy was successful and that things were reconnected, but I really don ‘t remember. When I was wheeled up to recovery I told my parents and wife that they just sewed me up meaning that they took out the structured part and was reconnected. They thought they just opened me up, looked around and closed me up. After this I was wheeled up to my room on the surgical unit. I had a urinary catheter in, a PCA pump and spent the rest of the day in bed.

Day 1 (Friday) – Not much change. They got me up to do a lap around the unit in the evening – I felt nauseous and was in a cold sweat by the time I reached the halfway mark. That night although I had ear plugs I did not sleep well – come to find out I wasn’t pushing the PCA button enough. I could push it every 6 minutes for Dilaudid.

Day 2 (Saturday) – More walking and sitting up in a chair. They gave me something in the IV to combat the itchiness from the Dilaudid. I started on clear liquids at the evening meal.

Day 3 (Sunday) – The catheter was removed and I sat up in the chair in the morning to watch the last 2 periods of the men’s gold medal hockey game at the Olympics. Up and moving around more as well. . I started on full liquids at the evening meal. I still didn’t feel all that great, this was the day that I really started coughing to clear my lungs. I had a fever of 38 C in the afternoon.

Day 4 (Monday) – They removed the PCA in the morning and switched to oral pain meds Dilaudid and (Tylenol – 975 mg every 4 hours). The surgical “dressing” came off but the strip of tape and steri strips under this remained on. Apparently they use a glue / adhesive on the wound, no staples or stitches. Started a solid diet (low fibre) at lunch time (noon). Began to pass more gas.

Day 6 (Wednesday) – Released in the afternoon. Appetite was not that great.

Day 7 / 8 (Thursday / Friday) – Had heartburn when I was at home, although this started in the hospital before I left. Thursday night I also had pain right under the centre of the rib cage. I took one of the 2mg oral pain tablets that I was prescribed when I was released and two hours later I was still in pain. About midnight I call the 1-800 healthcare number and they advise me to go to the ER. We drive to the ER and I go right in after being assessed by the triage nurses, one of whom says something to the effect of "maybe you were released too early”. It was a quiet night in the ER, I got sent back to the trauma section where they have a better nurse to patient ratio. After awhile they send me for an x-ray and then give me buscopan and prevacid. They flagged me for a surgical consult. The surgical resident came around at about 5AM and then I started to get some heavier pain meds – Fentanyl (which did not work) and Dilaudid which did. About 6AM they gave me an NG and admitted me. The on-call surgeon came in as I was being wheeled upstairs and chatted about the x-ray and said that I was booked for a CT scan for a closer look. There was a pocket of air on the x-ray that they were concerned with as a possible anastomatic leak (although there was no fever and the bloods were fine).

I had the CT scam about 9:30 and the anastomosis looked fine, there was distension in the small intestine that indicated a likely obstruction. I spent the rest of the day in the plastic/surgical short stay unit getting shots of Dilaudid every few hours.

Day 9 (Saturday) – More Dilaudid. I was moved back to the surgical unit about 6 that evening to the same room and same bed that I was in before I was released. The patients that were in the room when I was released were surprised to see me back.

Day 10 (Sunday) – Started to pass gas.

Day 11 (Monday) –The NG Tube was taken off suction in the morning and I started on a clear liquid diet at noon.

Day 12 (Tuesday) – The NG tube and the IV were taken out and things started to move again. The diet was bumped up to a full liquid diet.

Day 13 (Wednesday) - Started on a solid (low fibre) diet. Had some pain at night so they gave me a tablet of Dilaudid. There was some diarrhea as well so they were watching that to make sure it wasn't C diff or some form of hospital acquired gastro bug, luckily it was just a brief episode on Wednesday evening. I was really tired Wednesday evening.

Day 14 (Thursday) – Walked around a bit more and the appetite really started to come back.

Day 15 (Friday) – Released from hospital in the morning.

I am also off the Imuran and Salofalk until I go back to the GI in a couple of months. It's different just taking a multivitamin and Vitamin D instead of a daily regimen of two prescriptions.

Last edited by hawkeye; 04-13-2014 at 06:42 PM. Reason: spelling
03-10-2014, 05:38 AM   #11
DustyKat
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Thanks for the update hawkeye. Good to have you back mate, mind you Anamae did a cracking job! , and good hear that things are looking up again! Long may it continue that way.

Sooo…you were discharged the first time without having had your bowels open?

Dusty. xxx
03-10-2014, 02:18 PM   #12
hawkeye
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Sooo…you were discharged the first time without having had your bowels open?
They opened the morning I was discharged. Looking back, I was probably discharged too early. The second time around I stayed a couple of days after things opened.
03-10-2014, 09:30 PM   #13
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LOL. what he didn't say is that he nearly gave his mother and me a heart attack when, in his drug induced haze, he said "they opened me up and then closed me up." She and I both looked at each other and thought what could they have found if they opened you up and then closed!?

What he meant they were able to get it stricture out and he didn't need a bag.

The second time he went in I stressed I wanted him to stay in until they were sure he was ok.


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