Today is exactly two weeks post-op, and I am honestly feeling pretty good. I'm certainly not back to 100%, but I'm much closer than the first day I came home from the hospital. I was very discouraged when I first got home. I was having to empty my pouch VERY often (especially at night), had almost no appetite, was not sleeping well, and felt pretty miserable in general. However, after a full week at home and a little more rest, I'm happy to report that things are starting to look a lot better. My appetite is back in full swing, I am mostly sleeping through the night, and the pouch emptying has become less of a hassle. It is still no picnic, but I think about it much less every day and am less paranoid about it at night.
I had two appointments on Monday of this week. The first was with the ostomy nurses at the hospital. I really needed my pouch changed since the home health nurse didn't do the best job of changing the last one. I never got a great seal and was a little paranoid about having a leak. Luckily, it lasted until I could get to the appointment Monday morning. At this appointment, she removed the old bag and then removed the rod that inserted in order to hold the ileostomy in place above the skin. Because I have a loop ileostomy, the surgeon placed this rod to ensure the loop didn't fall back into my abdomen before the skin and muscle had a chance to heal around the stoma. The rod was bothersome for two reasons: First, because it was held in place with a few sutures, it was painful. Second, it made it very difficult to get the pouch to seal as well as it should. Luckily, with this rod removed, both of these hindrances have been removed as well! The nurse cleaned around my skin and shaved a little bit of hair to ensure a good seal. I asked her to try a different brand of pouch (Hollister instead of Coloplast) and I am very happy with the change. The Coloplast "wafers" are very large and fairly rigid, making it really hard for me to get a good seal. My stoma is close enough to my incision that the Coloplast wafer overlaps the incision, which almost guarantees there will not be a good seal. The Hollister wafer, on the other hand, is a little smaller and much more flexible. It has given me a really good seal so far, and seems to be much more flexible than the Coloplast wafer. Also, the new pouch is opaque instead of transparent. At first, it was weird since I was used to looking at how things were working. Now, I just have to rely on feeling the pouch and there is a nice little surprise every time I empty the pouch (sorry, that may be a little gross...). I'm a little anxious about my first solo bag change which will probably happen on Friday or Saturday of this week. I feel much more comfortable with the thought of changing after watching the nurses do it several times, so we'll just see how things go!
The other appointment I had on Monday was with the surgeon. My hope was that he wanted to remove the staples, and I was right! The staples had become annoying and almost more painful than anything I felt at the hospital. Every time I moved, I could feel them tugging and, on occasion, they would actually bleed a little bit. At first, his nurse came in and removed every other staple and said that I would probably have to come back in a week to get the rest out. When the surgeon finally came in, he looked at my incision and was happy enough with the way I was healing, so he took out the rest of them! He then put some tape across the incision for added protection and said they would probably fall off in a few days. He was very pleased with the way surgery went and how I am recovering, so he doesn't need to see me until January (of course barring any complications in the meantime). At that point, he mentioned that he'll do an exam to make sure everything is healing well and we will discuss the second surgery.
The timing of the second surgery could prove to be very tricky. He originally said he wanted to do the surgeries three months apart. This would put surgery 2 in the middle of February. Unfortunately, February happens to be the time of the school year where we are rigorously preparing for the annual LGPE (Large Group Performance Evaluation - essentially concert band exams). This is a very important event for us and is also very stressful. I can't imagine going through surgery during this time since it would knock me out of school again. Plus, I don't want to leave my coworker alone for this stressful time.
I would prefer to wait until May (at the earliest) to have the second surgery. We have our final band concert of the year at the end of April since the month of May turns into a mess where we hardly see our students (at least not on a consistent basis) because of EOCTs, AP Exams, and crazy final exam schedules. This has always been my least favorite time of the year because the kids don't want to do anything, but they have to be there. I feel like a glorified babysitter for the last few weeks of school and it is pretty miserable. This would be the perfect time for surgery #2 since it is low stress and minimal work. My absence would be felt much less during this time than during February.
My fear, however, is that my Doctor is not going to let me wait until May to complete the ileostomy "takedown". I asked him before surgery how long was too long to wait for the takedown and he said he usually likes to do it within 4 or 5 months (at the latest). This would put surgery #2 at the beginning of April unless he is willing to wait any longer. I know my coworker and principal will tell me to do whatever I need to do, but it still makes for a tough decision when I am potentially going to be about 3-4 weeks... again. The second surgery is much less intense than the first, so the likelihood that I'll be out for 6 whole weeks is very slight. If all goes well, it may only take 2 or 3 weeks to rebound. It really is a guessing game and I may not have much of a choice depending on what Dr. Liberman wants to do!
I am slowly increasing my activity and exposure to the real world. Monday, after my two appointments, I was exhausted and slept very well! Tuesday, my coworker and some students and a band parent came by to drop off some gifts and cards from the band. I knew they were doing something (I got a group email from one of the moms who forgot to remove me from the list :) ), but was totally surprised and blown away at what they got me... an iPad Mini! Definitely a nice little get well gift/early Christmas present and much more than I was expecting! After their visit, I actually DROVE to the bank and the grocery store to pick up a few things, and then quickly came back home to take a percocet. I was completely wiped from running just a few errands! Another reminder that I just had MAJOR surgery only 2 weeks ago. Hopefully, time will continue to make me stronger and stronger.
Today, I am headed to the other side of town for Thanksgiving. I'm a little nervous about the drive (an hour across town on the busiest travel day of the year), but I will just take things very easy to make sure I arrive safely! I can't wait for Thanksgiving, especially now that my appetite is back in full force. All the "carby" and starchy foods that I'm allowed to eat are always my favorites during holiday meals! Until next time, Happy Thanksgiving!
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