CAREFUL SOME OF THE INFORMATION COULD MAKE YOU A BIT SQUEAMISH
I have had numerous people asking about the surgery Ryleigh will be having and what happens afterwards. I asked Ryleigh if this was okay and she thought it was a good idea. She said that she would like people to know what is happening to her. I asked if she was embarrassed especially about the stoma, ileostomy, and pouch. She wisely said that this was not something she planned or is her fault – why should she be embarrassed. I hope that she will feel this way when she leaves the hospital setting and gets out and about.
The surgery will take about 3 hours and there is no guarantee that it can be finished laparoscopically. If there are any complications they may have to do the traditional surgery.
Ryleigh’s surgery is a little more complicated than others because she is still on prednisone and blood thinners. But the teams here have been so wonderful and they have taken this week to consult and collaborate to make sure her surgery will be as safe and successful as possible. They are wonderful.
This information was adapted fromhttp://my.clevelandclinic.org/services/total_abdominal_colectomy/childrens_overview.aspx
What is a laparoscopic total abdominal colectomy?
A laparoscopic total abdominal colectomy is an operation that removes the large intestine.
(area shaded in diagonal lines)
The term “laparoscopic” refers to a type of surgery called laparoscopy. Laparoscopy enables the surgeon to complete the surgery through very small “keyhole” incisions in the abdomen. A laparoscope, a small, telescope-like instrument, is placed through a small incision near the bellybutton.
Once under anesthesia, the surgeon will make a small cut (about 1/2 inch) near the bellybutton. A laparoscope will be inserted into the abdomen through this incision. Images taken by the laparoscope will be projected onto video monitors placed near the operating table.
Once the laparoscope is in place, the surgeon will make 4 or 5 more “keyhole” incisions in the abdomen . Surgical instruments will be placed through these incisions to complete the surgery.
After the large intestine is removed the doctors will create a stoma.
A stoma is a surgically created opening in the body that replaces a normal opening. Stomas serve as new sites for basic bodily functions.A stoma is an artificial opening to or from the intestine (which is also known as the gut or bowel) on the abdominal wall usually created by a surgeon
Stomas are carefully sited on the abdominal wall so that they can be hidden and yet still function. With an ileostomy, a special bag is attached to the site that collects the faeces. The opening on the abdominal wall must be well cared for because bowel contents can irritate the skin, which results in ulceration and infection. Unlike at the anus, no mechanisms are in place to regulate the flow of faeces. The use of appliances such as a bag-and-seal over and around the stoma can, in turn, cause damage to the skin from their frequent removal, and from allergy to the materials used.
Ryleigh is taking this all very well. This does not surprise me anymore – her wit, positive attitude, and resilience continues to inspire me. With support from the ostomy nurse she has come to terms with understanding what will be happening to her body. She goes through the wide spectrum of emotions. She is trying to find the humour in things. The nurse has said that we will most likely experience the stages of grief because of the life altering surgery. We are prepared for this and will support each other as best as we can.
Pain management, I am realizing, is the key right now. Ryleigh is in lots of pain she says it is like a wave on the pain scale from a 3 to a 6 to over a 10. She is now on a infusion pump where she controls the pain medication. It has allowed her to be pain free. It has been an eye opener for me because I have had to come to terms with the realization that Ryleigh has been in chronic pain for most of the last two years. She is less grumpy and much easier to talk with and be around. I wish I was more patient with her the last two years — she had every right to be upset and grumpy. Even Ryleigh is not familiar with the feeling of being pain free and it has been a challenge for her to think this is how she should be feeling.
Because of the pump she is needing a bigger IV stand. It is almost like a small tree! This is a picture of Ryleigh pain free! In front of her giant IV stand.