Recovering From Laparoscopic Colectomy Surgery
Laparoscopic Incision in My Navel
Laparoscopic Surgery for Partial Colectomy
I recently had a laparoscopic surgery called a "one-step colectomy" to remove a diseased portion of my colon that was suffering from chronic diverticulitis. While there is currently plenty of information available on the procedure, I found nothing online about what to expect during the recovery process. If you're in the same boat, I hope you can benefit from my experience.
Right After Surgery
I was put under general anesthetic for the surgery and was sent to a waiting room while I recovered consciousness after. I woke up groggy. Shortly after waking up, hospital staff rolled me on a bed to my hospital room where my family was waiting for me. The nurses were totally attentive, but I was still feeling the effects of the anesthetic. At some point, they put in a catheter and an IV port into my hand, and I noticed that my stomach was shaved where they made the incisions.
My surgeon told me that I needed to prove I could handle solid food before getting released from the hospital. First, my bowels needed to wake up. I was told that the best way to get my body functioning again was by walking, so somewhere around 4 or 5pm (after having surgery in the morning), I asked the nurses to help me stand up and take a few steps. I was sore from the surgery, but feeling no pain yet. My legs were wobbly, but I took a few steps and got back into bed.
Later that night, I asked to get up again and this time I took a short walk outside my room, moving extremely slowly.
The First Night in the Hospital
I was given a PCA pump with Dilaudid for pain management. Never having gone through surgery before, I wasn't aware of any allergies to medication. After the general anesthesia wore off, I pushed the PCA button and almost immediately started feeling nauseous. The nurses gave me medication for the nausea, but then a massive migraine headache set in. The nurses kept asking me about what level of pain I was feeling on the pain scale. After surgery, I was at about a four or five level, but the headache I got from the pain medication was an eight plus. I couldn't believe my head hurt worse than the three incisions on my abdomen and all the cutting between the stomach muscles. I throw up when I get severe migraine headaches, so, each time I threw up, my stomach muscles contracted and that increased the pain. The first night in the hospital was really miserable. The surgery had gone well, but the headache and throwing up made me feel like I was set back a day in my recovery.
A noticeable pain that does not interfere with most activities.
A pain that is strong but the patient is still able to function.
A very extreme pain that makes the patient unable to function.
Day 2 off the PCA Pump
On day two I was able to get some Excedrin migraine medicine and I stopped the PCA pump completely. Instead, I switched to a Vicodin-type oral medication for pain. Someone without a Dilaudid allergy would normally be kept on longer, though. I still had the catheter in, but I went for twenty-minute walks about four or five times a day. My diet consisted of only ice chips. I was super hungry because I hadn't eaten since Monday night (and it was now Thursday). At night they put devices on my legs to keep the blood circulating. They were uncomfortable, but I was eventually able to sleep with them. I also got a nightly shot in the stomach with a drug that helped prevent blood clotting, and another oral pill that helped keep part of the Vicodin from binding to my guts and shutting them down.
Day 3 On to Clear Liquids
On Friday (day three) I was put on clear liquids. I got up every two hours around the clock and walked for 15 to 20 minutes. I was able to get my catheter out that morning. I really didn't want to have visitors with a catheter in, so having it removed was a relief. I took a shower with a plastic bag over the hand with the IV port and then was allowed to put on my own clothes under the hospital gown. Day three was a big step forward. The pain from the surgery was at a two or three at most. My headaches were mostly gone. I was drinking fluids, and was even able to drink a ginger ale. The carbonation was piling up in my stomach and not passing through, though, which was a big concern. The nurses said that if I started vomiting, that I'd have to stop drinking fluids since the fluids weren't passing through my guts. I started to get very worried. I walked as much as I could, but the bloating from the carbonation and fluids was uncomfortable. I had hoped to be moving on to a soft diet and progressing towards going home by now, but when I got bloated I had to switch back to a diet of ice chips. I expected my recovery to be linear, and I was very disappointed to learn that it wouldn't be that easy. It felt like I was taking one and a half steps forward, then a full step backwards. That night I finally passed a little gas, which was a huge relief. Passing gas is the first sign that your bowels have started working again. My recovery was back on track.
Day 4 in the Recovery
By day four I was taking walks around the clock. I moved much quicker and was feeling hardly any pain. I was almost completely off all pain meds. That morning I had a small bowel movement, but it was bloody. I flushed it, and told the nurses about what had happened. They politely asked me not to flush the next one so they could look at it. My surgeon's weekend representative was supposed to visit before 11am and advance my diet to full liquids or soft foods, but she didn't show up on time. I kept walking and asking the nurses if she was doing rounds yet. Finally, I got one of the nurses to call her and she advanced my diet to soft foods over the phone. My first food in five days was a grilled cheese sandwich and cream of asparagus soup. That was around 1pm and I was hoping to go home after eating. At 2:30pm I got the good news that I could go home and resume a full diet. I was a little tentative about eating normally, though.
Laparoscopic Incision after Staples Removed
Day 5 to Day 13
By days five to thirteen, I was slow and sore, but not in much pain. I got tired quickly. One Sunday (day 5), I made it to my neighbor's house for a bbq and ate a seared ahi salad. My stomach cramped up and I had severe diarrhea, which was quite painful.
Each day I walked about one mile and did several short walks down my block and back. Between the walks, I slept. By Thursday (day 8) I had recovered enough to return to work in the office for a few hours a day, though I still got tired quickly. When a family emergency came up, my wife left me alone for a few days with my three young daughters. I wasn't at full strength yet, but I was able to watch them and take care of them for six days with a little help from friends and family. On Thursday I had an almost regular stool. I walked more quickly and was now able to drive. At this point, it had been several days since I completely stopped pain meds.
My stomach area was still sore from the laparoscopic surgery. It felt like there was a hole in my muscle the size of a tennis ball. I had to sleep on my back and if I slipped to my side, it would start to ache pretty quickly.
On Monday (day 13) the staples were removed during my first appointment with the surgeon since the surgery. I felt better each day since I'd been home. I walked over two miles the previous day, and I was feeling about 75% at this point. The doctor told me I was recovering in the top 2% of patients who had this surgery.
The Doctor's Instructions:
- Wait three more weeks before doing any core exercises (that's just about five weeks after the surgery). He said if I tried to do them sooner, I risked getting a hernia where my stomach muscles were stitched up.
- Avoid lifting more than 30lbs.
- If I felt pain during my normal daily activities, I should rest for two or three days before resuming.
- Listen to my body and only do the activities that didn't cause pain.
Notes on Recovery
There were a few things that were very painful during the recovery process:
These three things caused my stomach muscles to contract, which was really painful. I tried holding a pillow over my abdomen and applying a little bit of pressure, which helped, but I still couldn't do a full cough.
Additionally, the three incisions needed a little care. When I showered, I patted them dry when I was done. Getting them wet wasn't a problem.
The pain from the incisions and the area that got cut between my stomach never hurt more than a five on the pain scale. That part was very manageable. The stomach muscle incision has sutures that dissolved. The incision in my belly button is the largest of the three, and it was by far the most sore part on my body.
My surgeon said that most people don't walk well, aren't as hungry, and aren't having regular bowel movements within two weeks of a colectomy, so I feel pretty lucky. I found the best colorectal surgeon that I could and had it performed laparoscopically. He says my wife has a higher chance of getting diverticulitis than I do now (unlikely).