Ulcerative Colitis J-Pouch Surgery

Mayo Clinic Surgery for Ulcerative Colitis

2009-03-08T15:17:00.001-05:00

Surgery
If diet and lifestyle changes, drug therapy or other treatments don't relieve your signs and symptoms, your doctor may recommend surgery.

Surgery can often eliminate ulcerative colitis. But that usually means removing your entire colon and rectum (proctocolectomy). In the past, after this surgery you would wear a small bag over an opening in your abdomen (ileostomy) to collect stool. But a procedure called ileoanal anastomosis eliminates the need to wear a bag. Instead, your surgeon constructs a pouch from the end of your small intestine. The pouch is then attached directly to your anus. This allows you to expel waste more normally, although you may have as many as five to seven soft or watery bowel movements a day because you no longer have your colon to absorb water.

If you have surgery, your doctor may discuss whether an ileostomy or an ileoanal pouch is right for you. Between 25 percent and 40 percent of people with ulcerative colitis eventually need surgery.

Winter Update

2009-02-20T13:05:00.003-06:00

Chad is adapting well to his new digestive configuration. My sister Jaimee and her family were down from Oklahoma last weekend and Chad was able to go out for family dinners several times with no problems. The meals were multiply hour sit down meals that before the surgery Chad would not have been able to endure. He is gaining more confidence every day and I hope and pray by summer he will be almost 100%.

Day 10-11

2008-12-05T15:46:00.006-06:00

It finally happened! Yesterday Chad had another day of eating slight amounts throughout the day and keeping it down, so today he was released from the hospital. He does tire easily, but we have made the transition from a hospital room to a hotel room. Tomorrow we will leave the snow covered ground in Minnesota and head south. Chad is eager to get back to his own possessions and his own space. It was a challenging time, but thanks to all of the thoughts and prayers, we are finally headed home.

Day 9

2008-12-03T20:09:00.002-06:00

Things seem to be headed in the right direction today. Chad ate a small amount for three meals and one of those meals included pizza. He was able to take a few long walks and spent most of the day sitting up in a chair to make himself stay awake. He's trying to build up his stamina so that he can make the long trip back to Texas hopefully soon.

Day 8

2008-12-02T19:17:00.007-06:00

Same song, different verse ....... Chad did not get the TPN IV today. He did eat a few mouthfuls of food, but is still bothered by consistent nausea. It is pretty debilitating. It's nearly impossible for him to do anything except sleep or lay in bed with his eyes closed. The nurses tell him he needs to get up and walk but he says that he will vomit if he does. Since surgery day, he has not looked at his computer, iPod or cell phone. These are items that a teenager cannot live without, so we know he is miserable. Too bad there's no cure for nausea. He seems to make it through the day without vomiting but the evenings are the time when we start worrying. He began vomiting this evening at 9:30 pm. He was so close to making it through the whole day. So, we have high hopes for tomorrow.

Day 7

2008-12-01T17:09:00.002-06:00

We thought that this was the day that Chad would really make good progress, but.....not so much. He started off the day with a bowl of cereal and also took a few walks, but as the day went on the nausea got worse. He was vomiting by late afternoon. So, he is back on a liquid diet. Tomorrow will mark 7 days after surgery and that is when the doctors seriously consider putting in a TPN IV for nutritional supplementation. Chad has lost a considerable amount of weight since he has not eaten much for 7 days.

Day 6

2008-11-30T11:33:00.002-06:00

Chad has been told by the doctors that he can now eat soft foods. He is starting his 6th day without solid food, so unfortunately he is not hungry. We know that his digestive system works with liquids, but need to get regular food into him. Minnesota has been a cool change for us, but after being here for a week and with light snow today, we need Chad to step up to the plate and do some serious eating so that we can get back to Texas. We thought some tutoring in eating would help, but showing him how well his parents can eat, hasn't seriously impressed him.

Day 5

2008-11-29T11:43:00.002-06:00

Good News! Chad had the NG tube removed this morning. He was up every hour last night using the restroom, so his bowels are now fully awake. He has started a liquid diet and is tolerating it very well.

Day 3-4

2008-11-28T12:22:00.002-06:00

It was not a very good Thanksgiving yesterday. Chad became nauseated around 3:30 am Thanksgiving morning. The anti-nausea medicines weren't working and after Chad was vomiting for 12 hours, the Dr.'s decided to put in an NG tube (a tube that went in Chad's nose, down his throat and into his stomach). The reason Chad was vomiting was because his bowels were not ready to start working yet and were not allowing anything to pass through them. So, anything that could not go down came up. The Dr. said that this happens in about 20% of patients. The tube gave him some relief through the night last night, but he was uncomfortable with the tube down his throat and still vomiting, although not as frequently. A little before noon today, Chad finally had the urge to use the restroom, a good sign that his bowels were waking up. The Dr. has said that this little setback will put Chad behind 1-2 days in his hospital stay. Hopefully Chad will begin a liquid diet soon.

Surgery Day 2

2008-11-26T10:00:00.003-06:00

Wednesday morning Chad is on a full liquid diet. He is getting various tubes removed today and hopes to be more mobile by this afternoon. This surgery was a breeze compared to the first according to Chad. We just saw Dr. Cima and he says Chad is doing great. So far so good.

Surgery Day

2008-11-25T07:30:00.004-06:00

Chad finally went into surgery at 1:15 pm. and his estimated time to get to recovery is 1-2 hours. We should see him maybe around 4-5 pm. He was very calm and confident going into todays surgery. We had to wait this morning because several of Dr. Cima's surgeries scheduled before Chad's procedure took longer that expected.
Loving Father, I entrust myself to your care this day; guide with wisdom and skill the minds and hands of Dr. Cima and the medical professionals who minister in your Name, and grant that every cause of illness be removed, I may be restored to soundness of health and learn to live in more perfect harmony with you and with those around me. Through Jesus Christ. Amen.

Mayo Clinic Second Surgery

2008-11-24T07:23:00.009-06:00

We arrived yesterday at Rochester without a hitch. Chad has an appointment this morning at Radiology to have a Hypaque Enema X-Ray. This test will insure the lower portion of the small intestine is all healed up and ready for digestive function. Chad met with Dr. Cima this afternoon to go over the X-Ray results and it appears Chad's small intestine is healed up and looks good. For those of you reading this that are in the Oil Field, the Dr. pressured up on the casing and the production liner tested good. We do not have to squeeze the liner. The surgery is scheduled for tomorrow at 10.00 am. So far so good. Please keep Chad in your thoughts and payers tonight and tomorrow.

Week 10

2008-11-03T10:27:00.007-06:00

Less than two weeks to go until the take down surgery. Chad knows that the adjustment period after his next surgery will take time. However he has done so well after the first surgery I think he is very optimistic on his recovery time after the final take down surgery. Chad and I were out yesterday and he seems to be more energetic and I can tell his overall health is much improved. The next blog post will be from the Mayo Clinic in Rochester Mn. November 24th.

Week 6

2008-10-13T16:00:00.014-05:00

Chad has been eating and exercising more this last week. He has more overall energy and wants to

go out more with friends and family. At this point I believe Chad is now completely healed from the first surgery. At least outwardly he appears healed but I know he is still healing internally. Last week Chad bought a new guitar and is determined to really become proficient at playing. I hear him practicing every day. Chad knows he is over the half way point for his next surgery in November and he can see the light at the end of the tunnel. Please keep Chad in your thoughts and prayers.

Week 4

2008-09-25T18:36:00.007-05:00

Chad is now off his pain medication. I think this is a minor miracle considering he has been on these medications for over two years with only little if any withdrawal symptoms. Today is Chad's 4 week anniversary for his surgery. We made an appointment at Mayo Clinic to have his take down surgery on the Tuesday before Thanksgiving.

Week 2

2008-09-13T10:59:00.006-05:00

Chad's pain from his surgery is now going away. Chad is starting to cut down on his pain medication and hopes to be off the pain medications in a week. He is more confident with his pouching system and is going out more. Last Saturday Chad went to a movie and out to eat with his girl friend. Today Chad had a Cat Scan appointment to make sure everything is healing up OK. Day by day improvement is his goal.

Day 8

2008-09-04T08:25:00.009-05:00

This morning Chad's fever was gone. We suspect that Chad has had a flu bug since Sunday that started with a sore throat. He is up and moving this morning and looking and acting more like his old self. Chad had more blood tests done this morning, but as far as we know they have not diagnosed this five day illness.

Hooray! Chad was discharged out of the Mayo Clinic Hospital at 5:30 p.m. this afternoon. We are flying back to San Antonio tomorrow afternoon. We all are looking forward to getting back to South Texas.

Day 7

2008-09-03T08:49:00.004-05:00

Chad isn't doing too well since early this morning with a fever of 103 and vomiting. He is back on IV's for hydration and a stronger IV antibiotic. He's not talking to us much this morning because of a sore throat, fever, nausea and pain. The blood work done the day before yesterday showed that his white blood cell count is good , so it doesn't look like an infection. The doctors have more tests ordered for today. Maybe his fever will break today, God willing. Please keep Chad in your thoughts and prayers today.

Day 6

2008-09-02T12:54:00.007-05:00

Chad's fever was gone this morning and he looks much better than yesterday. Chad is off the IV that he was put on for hydration due to the fever last night, and is being given antibiotics for his sore throat and fever. He is still having trouble eating today because of his sore throat, but has managed to take a few walks. We do not know when he will be released from the hospital. Hopefully tomorrow will be the day we can make arrangements to go home. We're waiting to see if the fever returns tonight.

Day 5

2008-09-01T08:15:00.020-05:00

Two steps forward one step back. Yesterday afternoon Chad was having abdominal cramping possibly caused by dehydration or maybe food blockage which is not uncommon after his type of surgery. He had his IV in only for pain medications and not for hydration. He needs to drink 8-10 glasses of liquid each day and learn to eat his food slowly and chew it thoroughly which will aid in digestion. This a learning process for him and he will get it eventually. Chad did get up and moving this morning. He took a shower and went for a walk. He did not eat breakfast, but he did have a hot dog for lunch, yummy.

Unfortunately Chad will not be released from the hospital tomorrow. At 7:30 p.m., Chad said he was hot. His temperature was running 102.8 degrees. The doctor has ordered blood cultures and other tests to see what is causing the fever. Please keep Chad in your thoughts and prayers tonight and tomorrow.

Day 4

2008-08-31T13:43:00.007-05:00

Chad is eating well today and getting used to changing his temporary pouching system. He got to go outside this afternoon to the sun deck at Rochester Methodist and enjoyed the 79 degree sunny Minnesota summer. He is on oral medications starting today in hope of getting his IV out tomorrow.

Day 3

2008-08-30T08:33:00.003-05:00

Chad called us in the hotel this morning saying, "Bring me some food", but of course we couldn't. It's a good sign that he is hungry. He had the catheter and abdominal drainage tubes removed this morning and took a shower on his own. He is on a soft food diet, but needs to eat small amounts slowly so that his digestive system starts functioning again. He ate a small amount for breakfast but was not feeling great in the middle of the day. By dinner however, he ate an entire cheeseburger, some banana cream pie, and was then messing around on his laptop. It's great to see him acting like a teenager.

Chad's Day 2

2008-08-29T14:01:00.007-05:00

Chad did not sleep much last night because of the pain, but he is having a good day. He has sat up in a chair and has taken three walks so far. The Dr. wants him to walk 6 times today, so he is trying to meet his goal. When he walks he has to drag lots of plastic tubes and machines behind him, IVs , drug pump, abdominal drains, etc., but some of that stuff should be removed over the next few days. He has eaten jello, sherbet and drank some Gatorade and water. He can drink 800 cc of liquids today or about 27 ounces.

Chad is out of Surgery and doing well

2008-08-28T12:25:00.008-05:00

Praise God! Chad is out of surgery and Dr. Cima said that everything went as planned. It must have been because of all the prayers from family and friends. We are so blessed to have so many people praying for Chad.
Chad is in his room now and is still a little groggy from his long surgery. He has been sleeping a little then the nurse will come in and wake him to check his vitals then he will fall back to sleep. The doctor came earlier and told Chad he needs to get out of bed and walk a little tonight. I don't think its going to happen until tomorrow.

Surgery Day

2008-08-28T07:57:00.003-05:00

Chad was admitted at 5:45 am this morning. Surgery will start at 9:00 and will last 3 1/2 hours. Recovery time will be 1-3 hours. So, we won't be seeing him again until between 2:00 and 3:00. The nurses said that they will be giving us updates from time to time.

Report to Surgery at 5:45 a.m.

2008-08-27T20:25:00.007-05:00

We are to report to Rochester Methodist Hospital at 5:45 a.m. and prep. for surgery. We are ready for Chad to start a new chapter in his young life.

Loving Father, I entrust myself to your care this day; guide with wisdom and skill the minds and hands of the medical people who minister in your Name, and grant that every cause of illness be removed, I may be restored to soundness of health and learn to live in more perfect harmony with you and with those around me. Through Jesus Christ. Amen.

The day before surgery

2008-08-27T16:47:00.007-05:00

Chad met with the Surgeon and the GI doctor today. Both doctors said that Chad's decision to go ahead with the surgery is the right option, however the Surgeon Robert Cima said that since Chad is tall that there is a slight chance that his small intestine will not be long enough to make the final connection. This was the first time either of us had heard this possibility. I guess you can't know everything before a surgery. Chad is still optimistic today after hearing the surgeons full disclosure as to possible surgical outcomes. I have to call the Mayo Clinic tonight after 8:15 p.m. to learn when to report to the hospital the following day. All I know right now is that the surgery is tomorrow. Please keep Chad in your prayers tonight and tomorrow that he may have a quick recovery and successful surgery.

First day of tests at Mayo Clinic

2008-08-26T18:00:00.008-05:00

Today Chad had tests all day. He was not allowed to eat until after his last test at 5:30 pm. We just got back from eating a large Greek meal across the street from the Marriott. Tomorrow we meet with the Doctors to go over the previous day of tests. Chad is still very positive about the surgery on Thursday. One of the main tests today was the Flexible Sigmoidoscopy which would check Chad's colon for the present severity of his UC. The GI doctor told Chad after the test that his colon was moderately ulcerated and appears the Remicade infusions were not controlling the Ulcerative Colitis. We will see what the Doctors say tomorrow about all of todays tests.

Mayo Clinc Marriott arrival

2008-08-25T19:48:00.006-05:00

Chad is in good spirits today. The flight was on time with clear skies all the way to Rochester. Chad has appointments tomorrow starting at 7:00 am: blood, urine, stool tests and a Flexible Sigmoidoscopy all before 1:30 pm.

Surgery for Ulcerative Colitis Is a Difficult Choice

2008-08-25T09:20:00.001-05:00

Chad's surgeon Dr. Robert Cima discuses in the second half of the NY Times article below the decision to go through with the J-Pouch surgery is very personal.

http://health.nytimes.com/ref/health/healthguide/esn-ulcerativecolitis-ess.html?ref=health

UC to J-Pouch Story

2008-08-24T18:13:00.000-05:00

This link below shows a young man that wanted to share his experience with his J-Pouch surgery.

http://ucstory.wordpress.com/surgery-1/

Mayo Clinic Surgery

2008-08-24T10:14:00.001-05:00

Surgery
If diet and lifestyle changes, drug therapy or other treatments don't relieve your signs and symptoms, your doctor may recommend surgery.

Surgery can often eliminate ulcerative colitis. But that usually means removing your entire colon and rectum (proctocolectomy). In the past, after this surgery you would wear a small bag over an opening in your abdomen (ileostomy) to collect stool. But a procedure called ileoanal anastomosis eliminates the need to wear a bag. Instead, your surgeon constructs a pouch from the end of your small intestine. The pouch is then attached directly to your anus. This allows you to expel waste more normally, although you may have as many as five to seven soft or watery bowel movements a day because you no longer have your colon to absorb water.

If you have surgery, your doctor may discuss whether an ileostomy or an ileoanal pouch is right for you. Between 25 percent and 40 percent of people with ulcerative colitis eventually need surgery.

Going to Mayo Clinic

2008-08-23T22:17:00.003-05:00

Chad and I are heading to Rochester MN on Monday August 25th. Chad told me last week that he wants the UC J-Pouch surgery at Mayo Clinic ASAP. I called last week and to my surprise they scheduled surgery for August 28th. Chad will have the UC surgery at Rochester Methodist Hospital which is the main Mayo Clinic hospital. The hospital directly attaches to Mayo Clinic. Chad has suffered with Ulcerative Colitis now for almost three years and he has tried every medical treatment without success.