Hi Eugene,
You ask about the operation - wow, there is a lot to tell. Well actually, the "lot to tell" is more about he stay in hospital than the operation itself. The highlight during my stay in hospital was talking another patient through an episode of delusions from 1 am through to 6 am on Day 7. Now remember that “everyone is different” and just because this is what I experienced, it could be completely different for you.
Here is the short version; the long version (Communique #8 out of a total of 18) goes for about eight A4 pages…
The operation itself was a bit of a non-event for me - I was out for the duration thanks to the anaesthesia. Apparently, the surgery (ie, adaptation of the Ivor Lewis procedure) took about 4 or so hours. Apparently there were no complications. During the surgery I was fitted with all sorts of extraneous plumbing including a central line to my jugular vein, 2 nasojejunal tubes (not “nasogastric” because I no longer have a stomach), an epidural line, arterial line to my right radial artery, 2 cannulas, abdominal drain and a jejunal feeding tube.
I was in intensive care for the remainder through to the evening of day 2. During that time and even the next few days, I developed a bit of a bad relationship with the opiates that they gave me for pain management – I was having rather nasty dreams where I was witnessing and then rationalising mass murders. So my options were to go without sleep and endure the pain or take the pain medication and have rather disturbing sleep.
The epidural line was to assist with pain management, but I had to be lying flat on my back for it to be working. It was removed on Day 5. “Next time”, I will go without.
The jejunal feeding tube is fitted so that you can get your fill without any disturbance to the work site. They will push you to get as much nutrient in as possible. I started at 30 ml/hr with the plan of getting me to 85 ml/hr asap. I was sufficiently strong willed to negotiate my rate including lowering it during the night so that I might be able to have some restful nightmares.
The important point in regard to the feeding tube is to take control of the cleaning (flushing) of the line for yourself. One nurse in particular was exceptionally efficient, managing to push the 70 ml flush through in about 6.3 micro-seconds. Remember that my feeding rate was set to 30-50 ml/hr This sudden squirt of cold water caused significant pain – my problem not hers. Later, I learned that she could have caused a rupture at the lower anastomosis. No, you need to do it for yourself at whatever speed you can manage – take 5 minutes if that is what it takes to avoid significant pain. And also ask for the water to be warmed to just above room temperature so that you don't end up with cramps from the cool water hitting your warm core.
I started on clear fluids on Day 5 and softs (or semi-solids) on Day 7. The temptation with the food is to “show ‘em what ya can do” – this is a mistake. Take it slow. Eat small amounts, chew it up really well and take your time. Too fast and serious abdominal cramping may help to teach you a lesson, but by that time it is too late. After learning the error of my ways, I tried to pace myself so that I finished breakfast just in time for lunch and finished lunch in time for dinner. Once I could demonstrate that I had my dietary intake under control, the stopped the jejunal feeding, but kept the line in just in case and this required 6 hourly flushing until it was finally removed about 4 weeks after surgery.
I was discharged at 5:30 pm on day 8.
I hope that this is more of a help than a hinderance. Let me know if there is anything in particular that concerns you.
Best wishes,
Rick
PS Avoid the patient toilets like the plague. Actually, the plague is probably less of a risk to your health.
