Thursday, October 24, 2019

Hooray for Farts! J Tube Surgery

On October 16th I arrived at my local hospital at 530am. You would be surprised how many people are at the hospital at this hour. I sure was! lol I was quickly whisked away to pre-op as I was the first surgery of the day. I met with the surgeon, the anesthesiologist, and many nurses. When it was time, 740am to be exact, I was wheeled into the OR. If you have ever been in an OR you know how creepy they are. Typically located down a cold, dark, seemingly forgot hallway of the hospital. The double doors open to a fully tiled floor to ceiling room covered in surgical instruments, with the centerpiece being multiple giant round lights. They make endoscopy rooms look downright cheery! 

Next thing I know, I woke up in my hospital room around 12pm. The surgery went longer than expected, and I was in much more pain than I anticipated.

Click for Image Credit 
Let me give a brief overview od exactly what placing a Witzel Tunnel Jejunostomy entails - in Chanel terms, that is. A Witzel Tunnel is a method of Jejunostomy tube placement, there are 5 or 6 different methods to place a feeding tube into the Jejunum. They all come with their own pros and cons. Needle Catheter, Roux En Y, Straight J, etc. My surgeon prefers the Witzel as he believes it reduces the possibility of dislodgement and reduces drainage from the stoma. This can be done via an open abdominal surgery or laparoscopically, either way, it is typically only performed by skilled Thoracic surgeons. Once inside the abdomen, a portion of the jejunum is located and a tube is fed through, the tube is then stitched into the intestines by creating a sort of "tunnel" with sutures. The portion of the small intestines is then tacked to the abdominal wall with more sutures. My surgeon performed this all laparoscopically. I have about a 3 inch incision above my belly button, a crescent-shaped incision below the belly button, and two incisions to the right. Well... where my belly button used to be, I don't really have one anymore. lol The tube lays to the left of all that. I also have 5 huge sutures holding the tube externally, as there is nothing holding it in internally like the G tubes. The intestines, especially after a Witzel are just too small to inflate a balloon or bumper safely.

Back to waking up. Ouch! I don't think I mentally prepared enough or this surgery. It was much more involved and much more painful than I anticipated. It also altered my anatomy to a degree I did not apprehend prior to surgery. To put it very straight forward, it was a bigger deal than I expected. Recovery was grueling. Pain control and muscle relaxers every two hours, which is tricky since I am allergic to so many opioids. We struggled to find the right combo for the first 48 hours, during which, I was literally crying out (loudly and uncontrollably) in pain... My poor roommate. Once we found the right cocktail I began to improve. Next step, attempt feeds into the tube. Unfortunately, we began feed attempts a bit too early, my intestines had not turned back on yet, we quickly realized. I became a nauseous mess. I could not stop dry heaving and throwing up. Thick, dark green bile was pouring out of my G tube. I was assessed to still have a post-surgical ileus. Bad news. We waited another day. Finally, things began to slowly work again! Wanna know how they know it's working? Farts. I farted! Finally! After almost 3 days! We began feeds which were no longer causing pain, nausea, vomiting, or producing bile backup.


Getting my feed rate up to something the surgeons were pleased with was a slow process. Finally, after a few more days inpatient, they were satisfied sending me home on 24 hour feeds. I will continue in my attempt to up my feeding rate so I can have a few hours a day off my pump. Once recovery in the hospital was complete, recovery at home began. They say it takes about 6 weeks for everything to heal up completely, so I have a ways to go! Today is 8 days since surgery and I finally left the house. Nothing exciting, just a doctor's appointment, but it was my favorite doctor, so that's something! (Hi!) My weight is down to an all-time low, 127lbs (I am 5'10"), but hopefully, now that I have a stable source of nutrition we can get that weight back.

In other news, my podcast with Enabled Warriors I recorded back in September aired this week. Please take a listen. It is hands down my favorite interview to date. The host is such an amazing woman and it felt like talking to an old friend. I have attached a few links for different listening formats below. I suggest youtube since it is visual as well. Hugs!

Youtube: https://www.youtube.com/watch?v=OHdRXgIhfY4
Spotify: https://open.spotify.com/show/1hoKTsCTJpQYtyuhewpvzQ (Oct. 23rd)
Website: https://disabledtoenabled.podbean.com/e/there-are-two-times-i-wish-i-just-died/

For more images from surgery, check out my Instagram, @thetubefedwife Have a great week!