The young lady in the picture above is my daughter, who's known online as "Sundance 94", "Sunny" to her friends. (The little monster perched on Sunny's leg is the Infamous Meggie-Dog.) Sunny's 25th birthday was on November 5, 1998. She's recently been fighting a fierce battle; I want to share that story with you.
In November, 1997, Sunny went to see a new doctor for a routine examination. During the course of taking her family medical history for their records, the doctor learned that Sunny's father, two of her father's brothers, her paternal grandfather, and her paternal great-grandmother had all had colon cancer. We had always known that she was at some risk for familial adenomatous polyposis, but she had never suffered any unusual symptoms, so she'd never had a colonoscopy. The doctor referred her to a gastroenterologist as a precautionary measure.
The gastroenterologist insisted that she have a colonoscopy just to be sure there were no problems. When he performed her colonoscopy in December, he removed between 50 and 60 polyps from her colon, but assured us that they'd been removed before they'd become cancerous. He felt that she should have regular colonoscopies to remove any more polyps which may develop and told her she should have her next colonoscopy in 6 months.
Last June, she called to schedule the next procedure, which was performed on July 1. This time, the gastroenterologist removed over 100 polyps from her colon and told us that she probably still had that many more polyps remaining. They were so numerous, he removed only the ones that were large enough at that time to pose an immediate threat. He referred us to a surgeon.
Upon reviewing her records, the surgeon told us that she would require surgery to remove most of her colon. The polyps could not be controlled by removing them during colonoscopies; they simply multiply too quickly in her particular case. She had several options as to which type of surgery to have performed. She chose a laproscopic collectomy, which required four small incisions and had a relatively short recovery period (3 to 4 weeks). Her gastroenterologist wanted to do another upper g.i. prior to surgery (to be sure she had no polyps in her stomach), so her surgery was scheduled for September 10, two weeks afer her upper g.i.
Her upper g.i. (on August 27) showed no polyps in her stomach; she did have some in her small intestine, but they were a different type of polyp than those in her colon. We were assured that they're nothing to worry about.
On September 10, her collectomy was performed. The surgery took an unusually long time (7 hours), but everything seemed to go well. In addition to the removal of most of her colon, the surgeon found a golf-ball-sized cyst on her right ovary that he drained while he was operating.
She was well enough to come home from the hospital on September 15; she had some aches and pains and a few bouts with fever, but everything seemed to be going normally.
Three days later she began suffering violent nausea and terrible stomach cramps. We adjusted her diet to more easily digested foods, which seemed to help. By the time she went back to visit her surgeon on September 23, the nausea seemed to be occurring only in the evenings. Her doctor said he felt that the reconnected intestine was working, but working slowly. Therefore, by evening, some food was "backing up" and causing her to feel ill. He felt sure that this problem would correct itself as the intestine became more active.
Unfortunately, the nausea continued to worsen, and the cramping was becoming even more severe. We went back to the surgeon on October 7. After he had x-rays done, he immediately admitted her back into the hospital. The x-rays indicated a partial blockage, which he felt may have been caused by the intestine dilating (possibly because of an intestinal virus) or by adhesions causing a blockage.
An NG tube was put down her nose into her stomach to keep it empty. If her problem was caused by dilation of the intestine, this would give it a chance to empty and "rest" to heal itself, avoiding surgery.
By Tuesday, October 13, she was feeling unusually well. So well in fact, that we felt she'd be able to come home the following day. The doctor had a tray of liquids sent to her for dinner that evening (cream of mushroom soup, jello, ice cream) and said that if she tolerated that well, she'd be able to go home. Unfortunately, she became violently ill just hours after consuming the liquids.
On October 14, the surgeon performed an endoscopy which confirmed our fears; the connection between her small intestine and remaining colon had scarred so badly the opening was nearly closed. She would require further surgery; now we had to wait for her system to empty again.
On Sunday, October 18, the surgeon attempted to perform a "balloon" procedure to widen the scarred opening to help her system empty out more completely before surgery. The procedure was not possible; the opening had narrowed even further and was, in fact, about half the size it had been only 4 days earlier. The doctor put her on heavy antibiotics and scheduled surgery for Tuesday, October 20.
Her surgery went well, but we were horrified to learn that in addition to the scarring of the connection nearly closing her intestine, an adhesion had formed well above the connection which closed another area of the small intestine (about 90% closed). The small intestine between these two extreme narrowings would have ruptured very soon.
The epidural (Dilaudid) they gave her for pain control didn't work as it should. She was in a great deal of pain until Wednesday night, when they capped off the epidural catheter and put her on a morphine pump instead. Though she had the expected amount of pain and general discomfort that normally follows surgery, she seemed to be getting along very well. Various tubes and catheters were removed at appropriate times, and she seemed to be getting close to finally getting to come home. Her doctor assured her that she should be ready to come home by the middle of the week following surgery.
Unfortunately, she began running a fever on Sunday, October 25. They ran bloodwork and urinalysis, but couldn't seem to pinpoint the problem. On Tuesday morning (October 27), the doctor examined her incision, which had suddenly begun to appear red and puffy. He removed some of her staples, and sure enough, about 1-1/2 inches of the incision opened and began to drain.
The doctor changed her antibiotics, and had the open part of the incision packed, leaving it open to drain properly. The change of medication, fighting the fever, and the experience of having her incision open up left her tired and discouraged. I continued to encourage her to get up and move around and try to eat as much as possible from her hospital tray.
Her white count stayed up even when her fever came down; the doctors worried that there might be a leak in her anastomosis. A CT scan revealed that there was a pocket of fluid in her abdomen, but they couldn't be sure of what kind of fluid without reopening her abdomen.
Needless to say, she was not happy about the prospect of facing a third surgical procedure. By this time, she'd not been off the fourth floor of the hospital in nearly four weeks. I asked permission from the head nurse to borrow a wheelchair and take her outside for a "field trip". The day was unusually sunny and warm, and we both enjoyed our brief escape!
Though her incision was still draining, her condition continued to improve. Her white count and fever came down and stayed down....finally! By Tuesday, the doctor said that she certainly didn't look like someone who had an abcess in their abdomen and decided that surgery to drain the pocket of fluid wouldn't be necessary. He also said that if she appeared as well on Wednesday, he'd release her to go home. (!!!!!!)
This was especially important to Sunny since that Wednesday was November 4. Her birthday was November 5, and she really, really didn't want to be in the hospital on her birthday! The doctor was in surgery all day on Wednesday, and didn't get into her room to check on her until nearly 7:00 that evening. Fortunately, he found her condition to be perfectly suitable to release her. Sunny said that her homecoming was the best birthday present she'd ever received!
Her condition continues to improve, thankfully. On November 24, her surgeon released her to return to work. Regular examinations will be required to remove any small polyps which will develop in the small remaining portion of her colon. However, since the remaining portion is so small, the examinations will be simple outpatient procedures.
This harrowing experience has been an eye-opener for both of us. Certainly, many occurances in day-to-day life can be irritating...sometimes downright annoying! But when a "good" day is when a nurse is able to disconnect one of your four IV pumps, you learn to put minor irritants in their proper perspective!
| Home Page |