So far so good (part xviii)

On Thursday of last week I had another follow-up examination by my surgeon. In the grand scheme of things, I seem to be doing pretty well, but he was keen to check on how the healing was progressing, and whether the inflammation was remaining in abeyance or not. At the same time he wanted to check to see if my kidney was continuing to function normally after the removal of my stent.

And so I was scheduled for an MRI scan. Which to my surprise was arranged for Monday of this week.

The scan was without any contrast dyes (so no need for a canular!) and involved three main components – a high resolution scan of the pelvis, and lower resolution scan of my kidneys, and (a new one!) some sort of scan of my diaphragm while I was breathing normally.

I never did find out what that last one was actually used for, but it’s the first time I’ve been in an MRI scanner and actually felt the entire motorised bed assembly jumping from side to side in the magnetic field – so they must have really cranked the power up for that one.

And now I wait to see what my surgeon and his radiographer think of the pictures. I should hear from them in the next week or so.

Under power

It was Kenneth Grahame who once said that “there is nothing, absolutely nothing, half so much worth doing as simply messing about in boats”. And he was right. Especially when the weather turns out to be unexpectedly perfect – which was what happened when I did my RYA Powerboat 2 course on the first weekend of October.

Sensibly, our sailing club provides plenty of safety boat cover for all the regular sailing events that it organises, and rightly requires that anyone who drives the club RIBs be qualified to at least RYA PB2 level. To make sure that there are enough people capable of providing that safety boat cover, they run PB2 courses over the winter season.

I decided to book myself on one back in the middle of summer, and was pleased to have managed to get on the first offering in October when I assumed it wouldn’t be too cold. However, I was still planning to wear a dry suit, gloves, woolly hat, etc, and take a thermos of hot soup with me.

How wrong could I be? In the end I did the whole two day course in shorts and a T shirt, with lots of sun block. It was the hottest October day since records began.

The course itself was fun; I’d actually done it about 15 years ago as part of my BSAC Advanced Diver qualification, but I’d lost the certificate, and wanted to refresh my skills properly anyway. The one stand-out recollection was that going fast in a RIB is easy; it’s the slow-speed precision manoeuvring that takes all the skill. And so it was.

In the end we spent about 75% of the time on the water, and probably 80% of that was spent learning to handle the RIB with precision. By the time we were finished we could pirouette around buoys, balancing the tide, wind and engine to keep the RIB within a few feet of the buoy at all times.

So now I just need to get out and start helping to provide some safety cover, and then I’ll plan to add VHF and First Aid courses at some point too.

Ileostomy problems

As happened when I had my first ileostomy, I’m starting to run into some problems, and sadly they’re getting progressively more intrusive.

The first issue to raise it’s head was the classic problem of the ileostomy herniating. Because of the way a loop ileostomy is formed, there is quite a large hole made in the abdomen. This forms a real weak point, with the result that about 50% of them herniate. I managed to draw that short straw, though not as badly as it could have been.

Unfortunately, other than wearing a (very uncomfortable) corset-like arrangement, there’s nothing to be done about it until the ileostomy gets taken down. So for now I have to just live with it. The end result is I have gained a rather lop-sided pot-belly, and it gets distinctly uncomfortable from late afternoon onwards.

Next up were the chemical burns. These form because of the high levels of enzymes present in the small intestine. Normally these get neutralised by the time they’ve worked through the large intestine, but of course in my case, that’s bypassed. The result is whenever I cut the hole in the flange of the bag a little bit too big, my skin gets exposed to my bowel contents, and gets burned. There are some barrier creams to help prevent this, but they tend to stop the bags sticking too, which leads to an interesting dilemma. Given the issues I’ve had with the bags coming loose anyway, I’ve tended to avoid using the barrier creams. But my skin is now very painful. Again, there’s no magic solution to this beyond more very careful cutting, and the judicious use of barrier creams.

And finally, I’ve got some physical trauma to the actual stoma itself. This has been mostly caused by my cutting the hole in the flange of the bags too small, allowing the flange to cut into the stoma. But I’ve also bashed the stoma on furniture from time to time too. It all takes it’s toll. The result is that they stoma (which is really a protruding bit of my small intestine) is now quite battered.

And that means that occasionally it will start bleeding – a lot. The small intestine is very well supplied with blood, to help you digest food. But it also means you can let quite a lot out, quite quickly. Scariest so far was managing to fill a couple of bags with bright scarlet blood in about 30 minutes on a Sunday afternoon. Not funny.

But a good reminder to take more care of myself.