Today’s EUA went fine. We arrived on-time (at an ungodly 6am), checked in quickly, and were promptly placed in a pre-op room where we waited for 2 hours until the actual procedure. My first nurse mangled the initial attempt to start my IV, which was unpleasant, but the second try went fine. Other than that, no issues. They started the sedative as soon as they started to wheel me to the OR, and I only remember bits and pieces of getting positioned on the table before waking up in the post-op recovery area an hour later. Because I was so heavily sedated, my surgeon didn’t even try to debrief me in person, but discussed the exam and results with my wife (see below). After about another hour in the post-op, we were on our way home.
The ride home was pretty unpleasant. It felt like there were stitches or glue or something in and around my anus, which hurt going over every bump or when I twisted or turned. I assumed it was just an after-effect of the procedure and my J-Pouch being dilated during the procedure, but when I got home, I learned different. I went to the bathroom to see if I could discover the cause of the pain and make sure I wasn’t bleeding, etc. Low and behold, my J-Pouch and anus were packed with gauze. You’d think someone might have mentioned that before I was discharged, but no. My wife called the hospital to see if we could take it out and were advised we could. Pulling it out was painful and unpleasant (they really packed it in there), but I felt much better after it was out. I took some pain pills and relaxed on the couch the rest of the afternoon. Just another day (not) at the office.
As for the results, there’s not much to report. My surgeon did a thorough exam with the scope, probing and prodding the entire surface of my J-Pouch. There were no visible signs of a leak. Typically, if someone has a significant leak caused by surgical failure or some other complication, she is able to easily locate it (and correct it). In my case, she’s confident no such leak exists. In all likelihood, she thinks that the “leak” identified in the CT Scans (see here, here, here, and here) was just the contrast fluid finding a way out through tiny openings in the pouch that simply had not fully closed yet (as opposed to a tear or a an actual hole). Because they use a fair amount of force to inject the contrast fluid, it’s not uncommon for the force to allow the liquid “to find a way out” of a normal, but still healing, pouch.
My surgeon did identify a couple staples which were sticking out from the wall of the J-Pouch. The tissue had healed around (but not over) the staples, and the integrity of the Pouch in that area was not compromised. However, sometimes the body will attack exposed staples as foreign bodies, causing mucus production, pain, pressure, and even infection, so it’s possible the staples were the source of some of my recent issues. She removed the staples, which should clear up any related issues.
Overall, the results of the exam were good, but a bit frustrating. Although I’m happy there does not appear to be any major issues with the J-Pouch, which would have delayed my takedown for a significant period of time, it’s frustrating to not have any real answers for what is causing my persistent back pain and abdominal pain/pressure. Or, for that matter, the cause of my recent infection(s). Hopefully, removing the stray staples will help, but I’m not overly optimistic. Perhaps the best news is that, for now, she’s sticking by the original estimate of a one-month delay for the takedown surgery. I can deal with one month. I have an appointment scheduled for September 16 for a clinical exam, which if all looks good, will be followed by the battery of pre-takedown tests and scans to verify pouch integrity. If all goes well, I’ll then be cleared for my takedown—hopefully by the end of September. But that is a long way away, so I’ll just take it as it comes in the meantime.