Friday, June 5, 2015

Day 1 Post Ileostomy Reversal

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Day 1 Post Ileostomy Reversal

Well technically it was still the surgery day, but it felt like Day 1 for all intents and purposes.  So here was our experience right out of the OR...

He went in to surgery at 1:56 p.m. and was out at 4:04 p.m.  Two hours seems to be a pretty typical length of an uncomplicated ostomy reversal according to our surgeon.

Ryan had an end ilesotomy.  To reconnect his small and large bowel the doctor made an incision off the previous ostomy site like a "T" to reach into his abdominal cavity and grab the large intestine.  This left Ryan with an inch or so long incision that is packed with Telfa packing, stapled/sutured and covered with gauze, then clear tegaderm, then a large ABD dressing and tape.  He has weight lifting restrictions but overall no other issues.

He had a urinary catheter placed in the OR so he came out with that uncomfortable tingling in his downstairs.  No drains whatsoever for the incision.  He was on IV pain meds right out of surgery and of course lots of IV fluids.  He actually tolerated oral pain meds (norco) in the PACU which was surprising to us but a positive step.

Immediately out of the PACU and in his room.  He was groggy and confused with quite a bit of pain in this picture.

The blunt truth of this surgery immediately post op: he hurt.  Plain and simple.  An 8/10 for 3-4 hours post-op despite IV fentanyl, dilaudid, and oral norco.  The nurses seemed surprised that it took so long and so many meds to get him to a place of comfort  Their surprise should reassure you if you are doing a reversal that his pain experience not necessarily the norm. 

But keep reading for a wonderful, really inspiring surprise with his pain!).

The PACU nurses managed to get his pain tolerable to about a 5/10 and transferred him upstairs to his room.  We are in such a nice private hospital room-huge bathroom, wonderful view, big couch that turns into a guest bed and all the amenities we would need.

So once he was up to his room he just needed to rest.  His catheter was draining, his IV was running and he was on his pain pills every four hours.  He was also on a PCA pump that gave him dilaudid at requested and programed intervals.  He came out of surgery around 4:00 p.m. and by 7:00 p.m. he was sipping fruit punch gatorade and taking tiny bites of red jello.

With one eye open he sipped that gatorade.  They sent up a whole "clear liquids" tray for him but he ate about 5% of what was on it.  Selections were juice, ginger ale, broths, gatorade, jello and sorbet.

I was SO proud of Ryan because he got out of bed at 8:00 p.m. to take the tiniest of walks down the hall.  They yanked his oxygen a little too quickly and he got light headed so we didn't make it far but it was a walk nonetheless.  Then we got up at 11:00 p.m. for one last walk before bed and he made it all the way to the end of the hall!

Our advice post-reversal: sip liquids in tiny amounts and walk as soon as humanly possible.

Walking helps get the gut moving, the pain decreased, and the blood flowing.

We expected sleep for him that night because he was so tired but he was miserably itchy, an expected side effect from the IV narcotics.  Ugh he was miserable.  He probably slept just 2 hours from 11:30 p.m. to 5:00 a.m.  At 5:00 a.m. he was exhausted and so worn out from the itching so we asked our nurse if we could switch from narcotics to just tylenol.

He looked at us like we had six heads and I'm pretty sure in his brain thought,  "Y'all have lost yo damn minds" (in that accent, obviously).

The nurse really fought us on this.  "His surgery was too intense, he must not understand the pain scale, his pain won't be controlled, the itching is worth no pain..."


We held strong and Ryan took 650 mg of tylenol orally at 5:30 a.m.

His itching was gone within the hour and he slept for about 3.5 solid hours.  PRAISE THE LORD!!!!  His pain has been a 1/10 ever since.  After 4 hours he was definitely ready for more tylenol but wow did he do well. 

To have major abdominal surgery and be on tylenol alone about 12 hours post-op is as our surgeon put it, "favorably surprising".

Anyway that was our first night's experience.  Better than we could have hoped.  He was walking, drinking clear liquids, pain controlled, and even slept before the night was over.  What more can you ask for?

Ed and Joyce (two of our favorite people) came to visit Ryan for about 20 minutes.  They prayed over him and that really brightened his mood

Our final piece of advice about a reversal (or any hospital stay?):  PUT ON NORMAL CLOTHES ASAP!

Yes this probably annoyed our nurse a little because we had to cap his IV for a minute and maneuver the catheter through his shorts and undies.  But Ryan being in his favorite shirt, comfy gym shorts and a pair of underwear just gave him motivation and dignity.  Wearing normal clothes gets you out of the patient mentality and also your butt isn't hanging out for the whole floor to see.

Post-walk, post-drinking, and post-clothes change this guy was EXHAUSTED!

He continues to persevere through what pain he has and is doing so well!  Better than we could have ever hoped.  Your prayers and noticed and making all the difference.

Consider it pure joy, my brothers and sisters, whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance. Let perseverance finish its work so that you may be mature and complete, not lacking anything.

James 1:2-4


  1. AWESOME update!!!!! Keep rocking this recovery, prayers are flowing from CT!

  2. Wow! So proud of this brave dude. As much as he loves having easy access to flash us his man thighs in those gowns, i love that he wore his normal clothes. He is very lucky to have you there with him! Prayers for continued easy management of pain, recovery, and a quick discharge! Boo yah!

    1. He loves showing off his large, white, hairy man thighs.

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