I’m about to have my takedown surgery. So what exactly does that mean? During my first surgery in June, three things happened:
- They removed my colon and rectum;
- They stretched my small intestine to create a J-shaped reservoir attached to my anus (aka the J-Pouch);
- They created a diverting loop ileostomy, which means they pulled a loop of my small intestine through my abdomen and created an open to allow waste to go into an external bag. By diverting waste to a bag, the J-Pouch can heal quicker and with less risk of infection, etc.
The takedown is essentially a reversal of step 3. They close up the hole in the small intestine, which had been feeding into my external bag. Because the waste is no longer diverted, it continues to the J-Pouch reservoir, where it is stored (sort of like a makeshift colon) until I have a bowel movement. They then “drop” the small intestine loop back into my abdomen. In most cases all of this can be done from the ileostomy site, so there should be no need to reopen my larger incision sites (or create new ones). Generally, the former stoma site is left open (packed with gauze) and allowed to heal from the inside-out. I’ve seen and handled some pretty unpleasant things during this process, but packing (and unpacking) my wound may take the cake for the most difficult to stomach (so to speak). Maybe I’ll post my own stoma wound video. We’ll see.
With all of my plumbing reconnected, I will function like a “normal” person. Food will go in my mouth and out my butt. Who would have guessed that’d ever be something I’d cheer for? Initially, I will have frequent bowel movements (likely 20+ a day), as the J-Pouch adjusts to its new duties. But over time, its capacity will increase, it will “learn” to better absorb water (thereby firming up the stool), and my body will learn to “hold” it longer. It will never be like having a healthy colon. But, if all goes well, I should be down to 8 or so bowel movements a day. It sounds like a lot, but it’s nothing like what it was like when I was sick with ulcerative colitis—both in frequency and unpleasantness. My J-Pouch bowel movements are likely to be loose and may be accompanied by skin irritation, but they should not be the crampy, painful, bloody diarrhea of the UC days. And, most importantly, there should not be the intense urgency of UC—I should be in control. Again, we’ll see.
As I’ve written before, I’m just now getting used to my ileostomy (and it’s not that bad), so the thought of starting over again is daunting. But this is my journey, and I’m only halfway there. Time to finish things and get my life back.
See you on the other side.