I Think I Can

I just had major surgery (an ileostomy), and I was in some major pain.  After examination of my bandages, it looked like I  had one larger size incision (the one I assume was used to remove my colon) and a few smaller incisions (probably for cameras and instruments?)  But regardless of how large or small or the number of incisions there were, my whole core felt like one extremely sore muscle.

Now I was thinking after this event that I've just been through that I might get to rest.  For one thing, I thought there's no way I could get up out of bed.   Like I said, I was hurting.  But there is no rest in the hospital as we know due to blood pressure checks, blood draws for lab work, and of course, all of the various medical staff checking on me (it was Vanderbilt Medical Center after all; a teaching hospital).

But I had to get up.  Doctor's orders I guess.  And I would take this challenge.  The very next day, they had me sit up in bed and swing my legs over the side of the bed.  That seems like an easy task, and it is normally, but I just had my guts removed.  Things were moved around in my abdomen to be able to get to my colon, and my small intestines were rerouted.  I was adjusting to being on Morphine to help control this pain when I hardly ever normally take Tylenol.  How was I going to be able to do this?  One painful movement at a time.

I raised myself up in bed (or so I thought), but I was not budging because all of the soreness was stopping me.  However, failure wasn't acceptable.  The staff were insistent that I had to do this.  It's important to move to get that soreness worked out.  Well, I did just that.  The moans and groans and whimpers I produced somehow helped me get into a sitting position on the side of the bed.  I had to sit there for a while just to gather myself because it hurt so bad!  Once I was ready to stand, I had issues more with sea legs than I did with all of the soreness.  But I was eventually walking the hospital hallways.

Now to learn to care for my new constant companion: my ileostomy.  This was scary for me  It was such an unnatural process.  I had to empty this bag on my side as it became full.  But what was "full" where this was concerned?  And how do I get things cleaned after emptying?  How do I even empty the bag??  Wound Care and Ostomy Nurses to the rescue!  Now there were certain things they showed me to do that didn't work for me.  But they gave me the basics to build off of.

Emptying the ostomy bag felt strange at first but quickly became the new normal.  I learned to cuff the end of the bag for easier cleaning.  The end where wastes would exit was folded back, and I could wipe that end off a couple of times and fold the cuff back down into it's original position.   (For a better idea of what I'm describing, I added a picture of a folded cuff on a shirt sleeve above and a picture of my ileostomy appliance system below.  Hopefully this helps the visual effect!)

And then there's a matter of changing the whole system.  Above, you see a wafer (the square piece), the ostomy bag (which attaches to the wafer by aligning and securing the circles on each piece) and the clip which goes at the bottom of the bag to keep it closed and to keep wastes inside until time to be emptied.  (There are closed bag systems and other variations of the above picture, but this is similar to what I use.) 

Definitely changing the appliance was more nerve wracking than emptying the bag.  There's more detail needed.  In the beginning, I had to use a wafer where the small circular opening had to be cut according to how my stoma measured at the time of changing the appliance.  This was because, after surgery, the stoma is larger than it will be after the healing process.  So for a while, I had to measure with a pre-cut guide provided by the ostomy manufacturer to see what size my stoma was and cut the opening as best as I could to make it fit securely.  Once that's cut, I would apply a product called ostomy paste which isn't a paste so much as it is a caulk used to fill in gaps and seal areas (much like the purpose of caulk used in housing and construction).  The cutting and caulking process is done before actually removing the old appliance as the stoma can become unknowingly active (as there is no feeling in the small intestine).  The activity of the small intestine can't be controlled. 

After removal of the old appliance, I had to clean and thoroughly dry around the newly surgery-induced tender area.  And then I had to get my new appliance on .  

Now this sounds like it was just me and the nurse participating in this.  But it wasn't.  My parents were learning with me.  I was glad.  Because I was very nervous about taking care of this "thing" on my own.  They were ready and willing to participate in the process when changing time came.  We were able to work through the process together.  Because not only did I have to care for the appliance, but I also had incision wounds to care for.  One was deep and needed to be packed with clean bandages. Again, not something I had ever done before.  So we would learn together, and they were right there until I was ready to go solo (much like riding a bike without training wheels).  Having support from others makes healing a lot easier.