This post originally appeared on ColOriginal.blog.
The timing of this surgery was awful, two weeks before starting a new job. But then is there ever a good time for a colostomy?
Normally I would have said no, but with the pain I was in two weeks ago I would have taken a pickaxe to the stomach to relieve it. Add in that the alternative could have been a ruptured bowel taking the pain and complications to a whole new level—so yes, there is a good time.
The final factor is: as a 55-year bloke who is admitted to hospital with an obstructed bowel then lurking at the back of your mind is the “C” word. So, a twisted colon and a “colostomy” with a better than evens chance of being reversed within a year is actually a pretty good deal.
But it is still a bit of a headf**k when the surgeon says he has no alternative but to remove a section of your bowel, today. In fact, this afternoon. Then by the end of the day you have a stoma (Latin for opening) and bag attached just below your stomach.
In the end I had a proctosigmoidectomy or the slightly snappier title Hartmann’s procedure. Essentially a section of my colon was removed, the end attached to my small intestine was bought to the exterior of my abdominal cavity via a stoma and tacked in place with stitches. The other part of my colon that is attached to my rectum was left in the abdominal cavity, hopefully waiting to be reunited sometime late in 2018.
So now it is about acceptance. There are essentially two parts as I see it:
1 – Physical: the day to day physical handling, cleaning, bag changing mechanics of life with a stoma.
2 – Mental: the sense of loss of part of you, shame at having an uncontrolled bodily function and the blow to your confidence that comes with a recently acquired stoma.
I’ll talk about where I am, 11 days in, with the physical acceptance.
I am competent in the mechanics of cleaning and bag handling in ideal conditions, e.g. at home, at my time of choosing. But then if I wasn’t they wouldn’t have let me out of the hospital!
Working in Adult Social Care for the last 15 months has got me used to handling poo, although it is a bit different when it’s your own.
Day 1 – I didn’t engage, I just did what I do whenever I am in hospital, I closed my eyes and let them get on with it. Then having overheard a conversation at a neighbouring bed, where the stoma nurse told the individual that they needed to engage and be involved otherwise they wouldn’t go home until they had, gave me the nudge that I needed.
Day 2 & 3 – I observed the nurses as they removed the bag, cleaned the stoma and fitted a new bag.
Day 4 – I cleaned the stoma but left the bag handling to the nurses. One good point, is that although the stoma is an active part of your bowel, your bowl has no nerve endings. So even though it looks raw you feel nothing during the cleaning, which makes it a bit easier.
Day 5 – The stoma nurse walked me through the procedure, with simple tips, a guide how to cut a ‘my size hole’ in the bags. I find the hole cutting strangely therapeutic. But, basically you need to be a boy scout, be prepared, get the stuff laid out so that you do not need to move and work calmly through the process.
That evening I changed my first bag. It was daunting, I had put some incontinence sheets on the chair and floor, just in case. Then with a deep breath and nervous hands I changed the bag and tidied up.
Day 7 – I was medically assessed as fit for discharge, I just needed a session with the Stoma Nurse and I could go. I had changed 3 bags on my own, changed a 4th with the nurse and that was it—competent to go out in to the big wide world!
Day 11 – It’s about confidence, 12 bags in, my step forward was to change the bag without stripping naked, treat it as if I was going to the toilet, trousers and underwear round your ankles and off you go. I still have a nasal gag reflex, just as you peel the top of the bag off and the smell wafts up. Luckily there is a spray that eases the adhesive off your skin which has a peppermint smell to ease that part but I guess it will soon be second nature. I would place myself at the border of conscious incompetence and conscious competence.
Useless factoid; when you type Colin on a virtual keyboard one of the predictive options that appears is Colon!