Now the questions and fear( Colostomy)

[Stormin]

An update after speaking to my SCI doctor on the phone today.

Based on my bowel and other medical issues he agrees that a Colostomy is possibly the best solution.

I am a veteran so I would have the surgery at the VA SCI Center. My doctor says that the surgery is performed by General Surgeon at he VA( not colorectal surgeon).

My doctor says the surgeons do about 6 to 10 a year on SCI patients. He is not aware of any serious complications. Should I worry about a General surgeon doing procedure?

My doctor said that 90 percent of their procedures they recommend and are done on the upper left quadrant.

Now my fears!
Am I making the right choice?

Will it give me independence to live free of my home and to travel(something I haven't been able to do)?

For those that have gone before me, would you still have the surgery or not?

Any comments are appreciated, my mind is racing....thank you!

[sjean423]

I think you are making the right choice. If you are currently limited as to leaving your house by your bp (sounds like it in your post) this will make a big difference.

Mine was emergency surgery, so I didn;t have to make the choice. It is reversible, but I decided early on no to have it reversed. The first thing my surgeon said when I told him that at mt 4 month checkup, was "oh I am so glad, I thought I might have to talk you out of it!".

Knowing what I know now, I would certainly make that choice if it came to it.

[SCI-Nurse]

Is this at a VA SCI Center? These procedures are only supposed to be done at these centers in the VA System, not at a non-SCI Center VA hospital.

Will it be done laprascopically?

Have you met with the CWOCN (ostomy nurse) yet?

On what basis will they decide that you should have a left upper quadrant (ascending) colostomy vs. transverse or descending? What has been happening with you bowel program lately? Do you have a megacolon? With an ascending colostomy, the stool will be pretty loose all the time, and you will need to empty the bag more often. Are you able to do this yourself? When you travel, do you travel by yourself or with a caregiver?

(KLD)

[arndog]

I would definitely want an ostomy nurse to draw or point exactly where the colostomy is coming out to the skin. I thought that most people when having an elective colostomy would choose to have it below the belly button on the left side (lower left quadrant). I am surprised they said 90 % of them are in the upper left. Just make sure that they are preserving every precious inch of colon they can and are doing a descending colostomy assuming you don't have anything wrong with your colon. That way, your stool will be more formed and the water will be absorbed by the colon as it normally does.
Yeah, make sure you have a face to face talk with the ostomy nurse. I figure that any general surgeon worth his salt should be able to do a colostomy so I would be okay with the general surgeon.
In my case, my emergency descending colostomy was put as high up in the upper left quadrant as they could to separate it from the open pelvic fracture that I had repaired. I mean , it is REALLY high up in the upper left quadrant. The appliances go over my rib cage a bit. So I won't win any swim suit contests but it turns out I like the high ostomy position in that when I sitski, the waist strap doesn't conflict with the ostomy. I guess there is a silver lining there.
Anyways, good luck to you and may it all go smoothly for you...
jon

[Steph73]

Here are a few things I would address based upon experience. I would get an 'end stoma' rather than a temporary stoma (end stoma's are just much more easier to maintain and put a flange/wafer on). Have a stoma nurse mark the spot where your colostomy should go; they can look at your abdomen and pick out a spot that is the flattest, meaning that the system will stay on longer. Lastly ask the surgeon to make the stoma stick out at least an inch. I have heard horror stories about people that have colostomies that are level with the abdomen and they have to change appliances all the time and deal with skin issues; a good stoma length will make life much easier.

[RAFS]

Originally Posted by Stormin

An update after speaking to my SCI doctor on the phone today.

Based on my bowel and other medical issues he agrees that a Colostomy is possibly the best solution.

I am a veteran so I would have the surgery at the VA SCI Center. My doctor says that the surgery is performed by General Surgeon at he VA( not colorectal surgeon).

My doctor says the surgeons do about 6 to 10 a year on SCI patients. He is not aware of any serious complications. Should I worry about a General surgeon doing procedure?

My doctor said that 90 percent of their procedures they recommend and are done on the upper left quadrant.

Now my fears!
Am I making the right choice?

Will it give me independence to live free of my home and to travel(something I haven't been able to do)?

For those that have gone before me, would you still have the surgery or not?

Any comments are appreciated, my mind is racing....thank you!

Hey Stormin,
I'm sending you a private message so please be on the lookout for it.
I post as RAFS. I'm a fellow Veteran also. I'm considering having the surgery myself also.

Regards,
Bob
Fellow CC Member, Veteran & Wheelchair user

[jryprt]

Originally Posted by sjean423

I think you are making the right choice. If you are currently limited as to leaving your house by your bp (sounds like it in your post) this will make a big difference.

Mine was emergency surgery, so I didn;t have to make the choice. It is reversible, but I decided early on no to have it reversed. The first thing my surgeon said when I told him that at mt 4 month checkup, was "oh I am so glad, I thought I might have to talk you out of it!".

Knowing what I know now, I would certainly make that choice if it came to it.

Me 2 would not go back 2 old BP.

[Obieone]

Bill has an ileostomy .... same circumstances as sjean so there was no prior discussion .... he could have had it reversed but with the ongoing pressure sore issues he's had it has actually worked out for the best. One of the big things that probably wouldn't have been a consideration in deciding whether to have it done at all is that if we go anywhere now the bathroom not being totally wheelchair access is no longer a major consideration .... and of course the time saved doing a bp. Bill used to spend almost 2 hours daily in the bathroom takig care of business. I think I can speak for him saying it has been a good outcome in his case.

Wishing you all the best .....

Obieone