Ok. I've stopped using my pain button for the most part so I'm feeling a bit more clearheaded. They will be moving me onto a clear liquid diet this morning and if all goes well I will be venturing into solid, low-residue foods tonight or tomorrow morning. They said I have progressed very quickly, which is good, but because of my history they are a little hesitant to consider a Sunday discharge so it still looks like Monday will be the day. I haven't eaten since Tuesday so I am very excited to get some jello this morning! Because I haven't eaten solids yet, I am still not totally familiar with how the J-Pouch is going to be so I am a little nervous for food but, ultimately, I am too hungry to not want it! The pain is pretty manageable today (Day 2 Post-Op) without any medication, so I've asked them to switch me over to just Tylenol rather than going on the Dilaudid orally.
So, as I mentioned yesterday, I wanted to talk about my experience on Tuesday with the pouchagram (a procedure whereby they insert contrast into your J-Pouch and take a series of X-Rays to eliminate the possibility that your pouch has any leaks before surgery). I had read in another patient's blog that he had a bit of trouble with the pouchagram and so I ran this by my surgeon, asking him if I will need to tell the technicians exactly what they will be doing. He laughed at me and said, "look, there are a lot of hospitals around the country that are starting to do this surgery that have no business doing surgeries that are this technical, but I assure you the technicians at North Shore will be competent."
Well, for as often as he is right, he was wrong this time. I walked into the Registration area and told them I was there for a pouchagram. They looked at me like I was crazy. "OK, this is just registration. Of course they wouldn't know what a pouchagram is," I told myself. About a half an hour later I get into the X-Ray room and I see the technicians playing with some pretty large tools. I felt compelled to let them know at this point that I don't have a colon. "What? What do you mean you don't have a colon?' they asked. "Um, well, they took that out. And while we're on the subject I guess I should tell you that I don't have a rectum either." All three of them began to whisper and then left the room, saying they needed to conference with the attending physician.
When they came back in they were with a resident who had a large syringe in her hand. All three of them gathered around me and the resident asked if I could undo my ostomy belt (a belt I would wear around my waist to keep the appliance flatter against my abdomen). I said sure but asked why. She said, "Oh, well we would have to take it off anyway." I thought that was strange since there was no metal on it, but obeyed and took the belt off. Then she proceeded to ask if my bag snapped off. This is when I started to get freaked out. "Well, yes, it does snap off, but why would you need to snap it off?" I asked. "Well, we need to inject the dye through your stoma."I quickly wrapped the blankets around me and shot up from the metal board I was laying on. "You do know that I have a loop ileostomy, right? And, if I am correct and know my new anatomy, my stoma is not a direct port of access to my pouch and if you were to inject dye into my stoma, it would not reach that area. So, then, how would you take X-Rays with contrast of my pouch by injecting the dye into my stoma?" All three of them looked at each other and then said they needed to go speak with the attending again. They came back and said "you were right! We will have to go in through the other end."
Now, I tell this story because this is not the first time I have heard of people having trouble with the pouchagram. Even though I was at one of the leading hospitals for the ileo-anal-pouch anastamosis (the part of my first surgery that refers to the creation of the pouch), the technicians had no experience with the pouchagram. This should just be a lesson to all….know your anatomy and know what is going on with your body, because you can't count on the fact that your doctors and other health professionals will!
And I am sure you are all sick of me saying this, but please come out to support our show "Guitars for Guts: A Benefit Concert for the Crohn's and Colitis Foundation of America!" on Sunday August 14th. Tickets can be purchased by clicking the link above. And if you can't attend, please consider making a donation to the CCFA through our fundraiser "Guitars for Guts" on the CCFA website. Thank you in advance for your support!
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