Yesterday was my first scheduled meeting with my surgeon after my ileostomy take-down operation, and the good news is that in general he was very happy with my progress. From his perspective there is nothing more that he can do surgically; it’s now all down to my body to adapt to what he’s done to it, and for me to make the best recovery on top of that adaptation that I possibly can. That can be helped a little pharmacologically, but much of it is purely down to my own recuperative powers, and me then adapting my life to cope with any limitations that I’m left with. As always, it sounds like a positive mental attitude is going to be a help with this!
I then had another physical examination, after which he declared me to be fine; there’s no sign of any restrictions or blockages, and my lower GI tract seems to be starting to settle down (at last!) with little sign of any more bleeding. In general it seems that I’m starting to show the sort of progress that he’d expect at this stage.
He also had a careful examination of the old stoma wound site, and again he’s really pleased with the healing there. He wants me to stop getting the dressing changed & packed by my GP practice nurses, and instead to switch to a simple dry dressing (a large “elastoplast” to the likes of you and me) which I can change myself every day or two as required. His view is that there is a tendency to continue wet-packing wounds like mine for too long, which results in the wound failing to scab over early enough. That then results in a very small wound, which is still weeping, which can then be very difficult to finally heal. I’m quite pleased about this, as I’ve been concerned that I’ve been wasting the nurses time for at least the last week now, and would rather have been changing my own dressings anyway.
We also had a good chat about how I’m now actually coping with all the changes to my bowel that he was forced to make when he did my original tumour removal operation. He spent some time drawing me some pictures of what he actually did, compared to other approaches, and why he’d selected the one he did. You might say that that’s rather academic at this stage, but it was interesting, and helped to explain to me at a physical level why I’m struggling with some of the issues that I am (urgency and frequency, to put it delicately!) and why those ought to slowly improve with time.
We also went through my current drugs regime, and he’s now taken me off all my anti-inflammatory and pain-killing medicines: “Are you in real pain? No? Ok, stop taking them all then.” The up-side to this is that the diclofenac and cocodomol that I’ve been taking are both known to disturb the GI tract in various ways, so stopping them may well help me. The draw-back is that for the next couple of weeks or so, I’m likely feel as though I’ve regressed somewhat, while my body gets used to operating without all those extra chemicals. However, I clearly need to do this sometime, so it may as well be now, while I’m still signed off work.
For the time being he wants me to maintain my existing loperamide dose, and possibly even increase it slightly over the next few weeks to help compensate while I get used to not taking the cocodomol and diclofenac. Longer term however, he’s hoping that I’ll be able to reduce or even stop taking that too, which would be a real result from my perspective. Here’s hoping that he’s right.
I also mentioned that I was concerned that my peripheral neuropathy seemed to have got slightly worse, rather than better, since I stopped taking the chemotherapy. He happily admitted that he knew very little about that side of my treatment, but as a consequence he’s going to arrange another meeting for me with my oncologist, which will give me a chance to see if we can start to get some improvement, or at least understand the limitations (in either time or degree) of the recovery I can expect to make in that area. The reading I’ve been able to do wasn’t very conclusive, but tended to indicate that the damage may be irreversible, which is slightly depressing.
And finally, we booked my first post-treatment test; on January the 25th I’ll have my first (annual?) full-body CT scan to see if there is any sign of the cancer, either in-situ, or having spread elsewhere. Sadly that means drinking another litre of gloop, and having a big cannula put in for the IV contrast agent, but as long as the results come back negative, I’ll be a happy, happy man!