Crohn's Disease Forum » Surgery » First resection 5 hours from now

12-30-2013, 05:36 AM   #1
Join Date: Dec 2013
Location: New Jersey
First resection 5 hours from now

Hello everyone! I'm 25 years old and have had Crohns for 5 years. My disease mostly affects the terminal ileum. I've been on at least 6 rounds of Prednisone, Asacol HD, Apriso, Entocort, Pentasa, and Remicade. Most recently the Remicade was working very well for me. My primary symptom had always been abdominal cramping and pain. This was 100% gone with the remicade.

However, after about 3 months on only Remicade, I ended up in the hospital for 5 days with a small bowel obstruction. One month after that, a second hospital visit for another obstruction. After these first two obstructions I was given a short dose of steroids, but that wasn't enough, because as if on schedule, one month after my second obstruction I had a third 5-day hospital stay for a third obstruction in three months. This time I went on 40 mg of prednisone, and have managed to stay out of the hospital for two months. I chew my food very thoroughly and stick to a low residue diet.

My GI doc, and my IBD specialist at Jefferson University in Philadelphia, Dr. Lisa Kouzch, recommended small bowel resection surgery. I have a stricture in the TI of about 6-10 inches, and they believe it has a considerable fibrotic component. While the prednisone seems to have helped prevent another obstruction, I've also been most careful with food this time around, and I still feel food struggling to pass through the TI. I often feel bloated for hours after eating, and don't get hungry again for as long time, sometimes 8+ hours. I also haven't been experiencing my usual Crohns flare pain, indicating fibrosis. All of this seems to point to surgery being my next step. I don't want to put my body through a fourth bowel obstruction, and risk complications like a rupture, and/or emergency surgery. I feel relatively normal right now otherwise, solid BM once every day or two, minimal discomfort outside the bloated feeling, etc. Some of this may be due to prednisone, which I've been tapering off of for surgery. Prednisone long term will probably wreak more havoc than surgery, but I'm still apprehensive about going under the knife, and I'm due at the hospital in 4 hours!

I've read a lot of surgery posts on here, but figured I should introduce myself and post my story before I go into the hospital. I'm in good physical shape, 155 lb., 6'1", no other health conditions, and the procedure will be laparoscopic, so I'm really praying for an "easy" recovery. This is just so permanent that it has me very nervous about life long effects it my have. I feel like most people that have surgery are in much worse shape than I m now. I figure that's a good thing as it will aide in recovery, and I'm just not waiting until I get another obstruction and potentially need an emergency procedure.

Since remicade worked so well I'm hoping to go back on it, or try Humira, 6MP, or methotrexate if antibodies prevent me from restarting remicade. I'm hoping for a nice remission period without a structure post-op! Now I just need to make it through this surgery and the recovery period after.
12-30-2013, 07:15 AM   #2
Join Date: Oct 2012

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I hope the surgery goes well. Any long-term effects should be for the better! Planned surgery is always preferable to emergency surgery.

I've had six surgeries now, and can safely say I've survived them all with no negative consequences to date. There's always the possibility of complications, but, as you say, the meds for Crohn's come with their own risks too.

Come back and post when you're recovering - for a short while you'll feel the effects of the anaesthetic, pain from the incision, etc. but there are loads of tips for getting through the first part of the recovery period - if you have any problems, people here will do their best to recommend solutions. I know I've learned from experience about things like the best foods to eat after surgery, ways to help me sleep well when recovering, how to know when I'm ready to start doing some exercise again, etc. Once you're through that first part, you may well be surprised how quickly your body can recover. Life will go back to normal again!
12-30-2013, 09:26 AM   #3
Thunderstorm's Avatar
Join Date: Aug 2013
Location: UK

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Hey. I don't know if you're in surgery yet. But just wanted to say good luck and that I'll be thinking of you.
12-30-2013, 06:13 PM   #4
BayAreaChronie's Avatar
Join Date: Jul 2012
Location: California

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Hey there,

I just had surgery. Ileocecal Resection (cecum, terminal ileum, valve, appendix). These get cut and removed with this surgery. Mine was for 10cm - which is pretty small relatively speaking compared to others here.
I was terrified and visited this forum everyday.
I am now 3 weeks into recovery - will go back to work on the 5th week.
I just turned 26 before the surgery and am at 140 pounds.

Good luck and here are some take aways once you check this site.

You will not be let go until you have a bowel movement - this usually will happen on the third day after surgery.
They want you to pass gas but I had none.
They want you to get up and to walk the day after surgery - short 5 minute walks 3 times a day if possible.
Dont worry if you cant - I also wasnt able to do this the next day.
Try hitting the pain med button a few minutes before going for a walk to help with the pain.
You will have a catheter - you do not feel it all that much. They will take this out on the third day or around the time you have the first bowel movement. It oes hurt getting it out though so get that pain medicine flowing by IV.
Try to relax or you will need to have it put back in which hurts. Again, my luck, I had this done. Stupid nerves...
Your first week to 2 weeks of bowel movements will probably be liquid and blood. A lot of blood.
This is normal. Once you start eating more and more each day, the blood starts to slow down and eventually stops.
I was worried I wouldnt be able to have formed stools from all the posts here. Luckily, I am having both right now 3 weeks post surgery.
Limit your fiber and try to chew until the food is very small for the first 2 weeks.
I cant say much to the scars because my steri-strips are all still on.
When you get home, try to set something beside the bed to assist you with getting on - something to push off of or hold onto.
I am not a back sleeper but have been sleeping on it for the time being until the stitches come off.
Walking hurts still but not as bad. Dont be in direct sunlight - the stitched up area will hurt.

I was terrified but 3 weeks out, I seem to be ok. Slow recovery but you past the hard part. I stopped with the pain meds a week after the hospital and only took them at night before sleeping really.
Just think of it as a restart plan with hopes everything goes smooth from here.

beset of luck

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