Sunday, May 08, 2022

Life Three Weeks After my Ileostomy Reversal

by Derek Benoit May 7th, 2022

Oscar the Ileostomy departed this world over three weeks ago. Photo by Derek Benoit

Expectations Going into the Ileostomy Reversal Procedure

Most of the research I did prior to my ileostomy reversal suggested a hospital stay of 3-5 days. Shockingly, I was asked if I would like to be discharged the day after. I asked for one more night (I usually try to weasel my way home earlier than staff recommends) and the care team obliged my request.

Immediate Results Following the Ileostomy Reversal Procedure

Within 24 hours of the procedure, my bowel started to turn “on.” As expected, the early movements were loose and watery. However, things quickly started tightening up and within the week, more solid movements were the general rule rather than the exception.

Thankfully, no blood was observed in any output whatsoever. I did experience cramping and some mild abdominal discomfort as things began to wake up once again. This was easily tolerated and did not present any major issues.

Dietary Strategy Following Ileostomy Reversal Procedure

Of course, with newly reconnected bowels, my diet was very, very light. The return to actual food consisted of things like Cream of Wheat, yogurt, and the like. This continued at home for several days before slightly heavier foods were introduced later in the week, including solid proteins like fish, chicken, and steak. At present, three weeks post op, I’m still gradually introducing more fibrous (but well cooked) vegetables. Without question, the lost art of chewing my food has been rediscovered… and then some. I’m almost obsessed with chewing my food to a fine mush before swallowing. It’s working.

Overall Results of the Ileostomy Reversal Procedure

All in all, the ileostomy reversal could not have gone better. Zero issues post-op left me pleasantly surprised and feeling very, very blessed. I attribute the success of this procedure to both tight blood sugar control as well as consistent exercise going in. I feel that my theory of “better shape going in, better shape coming out” was validated. Thus I’ll be applying such to any planned procedures moving forward as I’m able.

One Major (But Underestimated) Complication of Ileostomy Reversal with Dialysis

One major issue that has emerged revolves around my status as a dialysis patient. I feel that I grossly underestimated how much of a safety valve the ileostomy was regarding excess fluid.

While having the ileostomy, dehydration was a major concern. Specifically, bypassing the colon meant that the body was not able to reabsorb water as it normally would. Of course, with poor renal function, this was, if carefully observed, a relative benefit. Once the colon began to do its job following the ileostomy reversal, the excess fluids that were previously shed gradually began to build up.

To be fair, this was detectable as both weight and blood pressure gradually increased. This was despite tighter fluid intake. I simply whiffed on the extent of fluid reduction required. Frankly, I should have been more vocal about the situation as it continued to develop. Ultimately, I ended up in the local emergency room with serious breathing issues because of fluid buildup in the lungs. Moreover, in the several days leading up to this visit, breathing was difficult enough to preclude any attempt at sleep. As soon as I would become somewhat comfortable enough to attempt to fall asleep, my body would literally jerk itself awake and I found myself struggling for air. Within a few days, I became a walking zombie, often nodding off while sitting straight up.

Dialysis Adjustments Post Ileostomy Reversal

Moving forward, my dry weight is being adjusted downward and my treatments will be much more aggressive. I’ll be removing significantly more fluid weight per treatment than was previously attempted. Along with this I’ll be returning to as close to previous cardio activity as possible. This will in of itself be a major adjustment but is necessary. Assuming that this major adjustment to dialysis works, there will be only one other issue to address: my left shoulder.

Comorbid Recovery to Ileostomy Reversal

Back in November I sprained my shoulder significantly. The result was ultimately a tear in the deltoid and a partial separation from the bone. Of course, I neglected to rest it for long enough, giving it only a month or so of rest. As a result, each shooting session with my bow required a good 4 day plus layoff to allow for another shooting session. I was stubborn and hoped beyond reality that this would allow gradual healing. Of course, it didn’t. I should have gotten the MRI and the orthopedic consult months ago. What prompted me to get an MRI was a rather disturbing tear that I both felt and heard while exercising the week prior to my ileostomy reversal.

Fortunately, surgery does not appear to be required per my orthopedist. Still, out of an abundance of caution, I have a consult scheduled with an orthopedic surgeon shortly. October’s bow season opener here is still achievable. I have scheduled PT for June, following a total of six weeks of shoulder rest. I look forward to hitting PT hard and then working very hard on regaining strength-and shooting form! On to October!

While published by a UK based system, this pdf gives a good rundown of ielostomy reversals for anyone considering having the procedure performed:

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