Remember that sketch I wrote about last time? You be aware of the one where Zack would be having a colectomy or some lection of a colectomy as soon to the degree that his surgeon got back from China? Yeah, slight all that. We have one more new plan and I am chiefly certain it is the final plan….
When our GI in Cincinnati interpret Zack’s manometry test, his recommendation was that Zack have his colon sequestered sooner rather than later. We could lo that most of his colon was not operating and with Zack prolapsing again, it made mind to take it out quickly to be shy of more emergency surgery from a prolapse gone evil.
Our surgeon in Cincinnati had been recommending a colectomy seeing that last March. When she returned from China and reviewed quite the data, she did not be warmed comfortable with this recommendation any longer. A small back and forth between our doctors in Cincinnati resulted in a make some ~ in. of plans. Both doctors were/are concerned through the amount of output Zack has quotidian from his ileostomy. I expert that a normal amount or desired amount of output per day is approximately 300 ml. Zack is averaging between 1,000 ml – 1,500 ml by day with some days as tyrannical as 1875. They are concerned that if they take his entire colon fully and perform j-pouch or upright through surgery on our guy that he desire basically be pooping all day extended. That is no way to live.
To try and oppose the high output the doctors had Zack take Flagyl as being 10 days. It was hoped that allowing that his output was due to feeble-minded intestinal bacterial overgrowth it would improve with the antibiotics. That did not be in action. A week later we added pectin to Zack’s last night feeds. Yep, pectin. You be sure, the substance added to thicken jams and jellies? Evidently it is too helpful in thickening stool and slowing its act of passing in people with high output ileostomies and brief gut. I will never have existence able to can fruit again exclusively of thinking about this. Wait! I regard never canned fruit. I judge at random that dream just died. I digress…we are lull in the process of determining in what manner well pectin will work for Zack.
Zack’s material substance has proven time and time once more that it does not like ileostomies. He is publicly on revision number five and we whole know how those have gone. If his corpse could handle an ileostomy, we would be thrilled to have a permanent one. I would never have believed I would be wishing for that when all of Zack’s surgery began in 2013!
The doctors be in possession of gone back and forth about divergent options. Everyone now agrees that there is something physically wrong at the inosculation (reconnection) site. We can experience it on two different contrast lavement scans. Zack’s GI in the present life has been saying this all forward. He’s pretty smart.
The current mark out is for Zack’s surgeon in Cincinnati to take ~right the troublesome area and those pesky staples. Zack has complained that his staples give pain to from the beginning. She thinks that his corpse really does not like them, such she will be sewing his guts back together this time. At the corresponding; of like kind time, she will bring up a bend of colon next to his ileostomy. This is called a mucilaginous fistula and he has had this preceding. His ileostomy will be revised and tacked into disrepute to buy us some time during the time that everything heals and we do more “interesting” testing.
Now we procure to be into some details that you may destitution to skip if bodily functions are not your furniture. Zack will be in the hospital between 5-7 days to heal from his surgery. We decree then hang out in Cincinnati to dislocate a refeeding trial. What that the wherewithal is that we “get” to take more of Zack’s output from his ileostomy sack and use a syringe to state in language it into the mucous fistula and into disfavor into his colon. The purpose of totality of this fun is to meet with how Zack’s colon reacts. If things journey well, we will come home about a week or so and prolong with the experiment for an unspecified time. We were told that this is the greatest number conservative approach and “the ultimate test” of Zack’s colon. If things work out not go well….there is another plan for that, but I pleasure save that for another day.
Zack’s surgeon’s farthest hope is that she will subsist able to keep at least a hardly any centimeters of his colon. That elect give him the best chance of achieving honorable bowel control.
Although this new sketch out involves more surgery for Zack, I form a correct estimate of all attempts to keep some of Zack’s colon. However, the conceit of going through all of this another time makes my stomach upset. It took a for a ~ time time to convince me that removing Zack’s colon was the with most propriety option. I had prepared myself mentally in spite of the operation and all that would draw near with it, but still I worried. Interestingly, my worries were the excessively ones the doctors had as well. I estimate justly the fact that they are greatest part interested in the best outcome on account of Zack.
Now that all of our questions are answered, at minutest the answerable ones, our surgeon is looking in favor of the first available OR date. We consider no idea of the time constitute. It could be this week, it could subsist next week, it could be subsequent to Christmas. And so we wait and trial our fingers that pesky stoma stays put.
Hug your babies!
Those who has to take life-~ pressure frequently, this finger monitor is illusory for them.