From: meirman@... <meirman@...>
Subject: Re: [colostomy] Colostomy Reversal
To: colostomy@yahoogroups.com
Date: Wednesday, August 19, 2009, 4:04 PM

 

At 08:15 AM 8/19/09, bbcbkb3 wrote:
>Can anyone tell me how long after a colostomy I have to wait to have
>it reversed? Or where I can fin out this information.

I'm sure it depends on individual details. So the best way to know
is to have the patient ask his doctor.

There seems to be a big range. And it probably depends a lot on the
reason for the colostomy. Was it an inguinal hernia, like for me, or
cancer? I hate to think about such things but maybe trauma could be a cause.

After I joined this list last October, I read the archives here,
including stories of people who waited a year or two or even more,
and I had fantasies that what my doctor had said might not remain
true, that mine could be in 3 to 6 months. Remember I had no cancer,
no other disease. I had trapped my colon in the hernia between my
scrotum and my lower abdomen, which kept the feces from reaching the
toilet, and that last day or the last part of it, I guess it cut off
the blood supply to part of the colon. He had to remove 7 inches and
said if I had taken longer to get to the hospital, even the pace of
colon death would have increased. But I had no disease they had to
cure. I'm guessing all that had to happen was that the two ends of
my colon had to heal enough to be sewn back together again. (Even
though one end was already sewn to the stoma, where the colostomy bag
was. and he did that within a few minutes, no more than a hour or two
of opening me. So it must have been the other piece that had to heal. )

(I feel obliged to say that I had an enlarged (twice the size on one
side) scrotum for two years before this, so I had plenty of notice,
during which time I should have done something. Although it looked
scary, everything was working fine until 11PM one night when I
suddenly had to vomit, mostly very black stuff, mostly, maybe
entirely liquid, 28 times, followed by fainting 14 times, I guess
because I was dehydrated from all the vomiting. Over the course of
about 8 hours. I still didn't get to the hospital until about 3 PM
the next day, 16 hours after it started. During the other 8 hours,
I had napped, listened to the radio, and finally I went to my desk,
called a hospital to check on something, then called a taxi, and
though I arranged for the cab driiver to walk me from my door, I was
able to walk out to the cab. I got myself dressed too, though I
couldn't find shoes. I took my cell phone which I needed, to make
calls from my gurney, but I should not have taken my wallet, which
they lost along with my key ring. . Nothing was spent on my credit
card by anyone. I should have taken only the key to my house, and if
I hadn't taken a cab, I should have give all this stuff to whoever
took me to the hospital.

My story seems strange to me, but maybe someone here can make it seem
reasonable. When I was about to leaving the hospital after getting
the colostomy, the doctor said I could have it reversed in 3 to 6
months and it was my choice. That seemed strange in itself. And
later it didn't seem to be my choice after all.

Three to 6 months would have been Dec 1, '08 to March 1, 09. And
I think at the next appointment, where he took out the staples, he
told me that the longer I waited the better. (I think he meant
within his original 3-month range.) So I read what I could find,
here and elsewhere, and thought about it. The problem was that I had
a long business trip planned for March 8, and he told me it would
take 6 weeks to recover from the second operation. So that meant I
had to have the surgery by mid January, 4 and half months from the
first operation. But when I called months in advance to get that
date, the secretary gave me a hard time.

I could only talk to the doctor through her, it seemed, and later she
told me that I would only be in the hospital for the reversal for 2
days, 3 maybe. Why she said this I have no idea, but it screwed me
up because I expected to be out soon, and I thought something must be
wrong. Finally I found a doctor who was willing to say that it is
always 5 days at least.

On one of the exams, the Friday or Monday before Thanksgiving, he
sprang on me that, since I had never had a colonoscopy (I was 61) and
hadn't had one within the last n years, he didn't say, I couldn't
have the reversal until after I had a colonoscopy. That makes
sense. He doesn't want to put me back together when if I do have
something wrong, it would be a lot easier to treat me when I already
have a stoma. But it was a new requirement, and I thought it was
going to delay the reversal. They would have done it at the
hospital, but I was told probably by the smae otherwise annoying
secretary (see below) that it was 1000 dollars cheaper if I had
someone outside do it. So I spent Monday or Tuesday calling 2 or 3
doctors to find out about this, and the one or two I asked about an
actual appointment told me they were booked for weeks. And I saw my
chance of making my scheduled trip drifting way. But that secretary
mentioned in passing, maybe like thinking to herself, that they were
busy next week because no one wanted to do it this week with
Thanksgivign coming up. Some were going out of town. I missed the
full meaning of this Monday until I was in bed when I realized that
meant they probably had time for me on Wednesday. They had told me
that I would have to have an hour or 2 hour interview before the
procedure, but when I called on Tuesday, she said Wednesday was good,
and someone would call me. Someone did, and the interview only took
10 or 15 minutes, probably because my medical history is
bland. There was no need for follow-up questions to any of the
questions they asked, like for some people.

The actual test, start to finish takes I forget, an hour or at most
two, starting with getting undressed and ending with leaving. They
don't want you to drive afterwards, but I was able to leave my car
there until the next day. It wasnt' painful at all, no discomfort,
full anesthetic, but this place used an anesthetic that is constantly
administered and you start to wake up within 5 or 10 minutes after
they stop. I was fully awake in 20 minutes, no hangover, and ready
to leave as soon as I got dressed. I was fine the next day too, no
pain, no discomfort, no indication they'd had a flexible stick up
me. And the doctor said I should eat more fiber, because there were
small little islands of feces left in me, but no disease, or polyps
or anything. Most people are healthy, but for the 2 or 5 or 10
percent who have a problem, it's good to know early. My aunt died
of colon cancer in her 50's. She was scared of doctors and didn't go
even when she had blood from her rectum. By the time she went it was too late.

They faxed him the results that day and mailed them to him by
Monday, But it turned out, that wasn't a sticking point and he still
wasn't ready to do the reversal.

I'm forgetting the order of the details, but eventually the doctor
told me I couldn't do it in December. I don't know how he knew. His
follow-up exam was limited to removing the stitches. He didn't take
a blood test, or even my blood pressure, pulse, or body temp. He
didn't even look at the stoma, which was covered by the bag. I was
vigorous, and never had any complications (except for one of the two
surgeries, my potassium was low and I think it delayed my leaving the
hospital for one day. But that surely didn't delay the surgery for a
whole month. I never understood why he said I could do it in 3
months. Since afaict, there was no medical reason, he excluded December.

Eventually it was the 17th or 18th of January.

I was probably healthy enough to go on my trip, but I hadn't made
airplane reservations and the price doubled or tripled by late
Januaary or mid-Feb. I wasn't sure if I would be vigorous enough,
and it was marginal. It's hard enough to change planes, fly 12
hours when one is perfectly healthy. So I postponed the trip, maybe
for this March.

It was hard for me to read this list's archives, because wrt some of
them, it hurt to read about people even sicker than I was. My heart
went out to them, but there was nothing I could do for them. But I
forced myself to read some more and I think I found no one who had a
reversal before four months.

If someone thinks it may be taking longer than necessary --
especially if he says there won't be a reversal at all** -- I'm not
at all precluding getting a second opinion and changing surgeons if
necessary. I seem to have had no problems with the doctor this
time, but on other issues, I've had several other problems with
doctors being wrong.

**However, if someone had anal cancer there might not be anything
left to reconnect to.

For example, I had a doctor in a small hospital tell me I needed an
appendectomy that day, when in fact all I had was a bruise. I had a
little bit of fat that had kept me from seeing it myself (though I
could have used a mirror) and I had no recollection of bruising
myself. But I still had sense enough not to depend on doctor in a
tiny hospital no one had ever heard of (but it 2 blocks from my
apartment), especially when I had no deep pain, etc.. . I found a
second doctor, at a famous hospital for what it is worth, who found a
small black and blue mark and told me to go home.