I’m going to draw together several threads here; this one, “Kicking the chemicals”, and “First checkup”, as they’re all inter-related, and trying to run them separately will result in a lot of duplication.
So, the current state of play is that my reversal has gone less well than we might like, with a small leak developing in the lower join in my colon. This is forming an abscess in my pelvis, which is causing me a lot of pain, and preventing me from making good progress with my reversal (ie, it’s exacerbating the issues around frequency and urgency that I experience). Overall, this is now probably the primary issue that is preventing me from readily returning to work.
When I last saw my surgeon he prescribed me a course of broad spectrum antibiotics to try to help me with the healing of the leak, and also took a biopsy from the area of the colon that was leaking, as although he felt sure that this was unrelated to the cancer, he wanted to be absolutely sure. He also took the action to go away, consult with his colleagues, and come back to me with a new treatment plan.
He called me up to talk to me last night. As expected, the biopsy result came back negative for cancer, which is great. He is now in the process of getting a second opinion from a different radiographer on the original results from my gastrografin enema test, to better understand how bad the leak in my colon was then. He is also going to arrange another gastrografin enema test (sigh) in the next week to see how bad it is now, and the extent of the abscess that has subsequently formed.
From his perspective, this stage of my treatment is going to be completely dependent on me, and how I respond to each thing that we try. He does not want to do anything more than absolutely necessary. I suspect (though forgot to ask) that this is probably because each step we take now cannot be reversed; so we only abandon one treatment option when it’s proved beyond doubt that it’s not working.
With that in mind, we discussed how I’m getting on with taking the antibiotics. From my perspective, things are different, and potentially could be very positive indeed. After an initial issue with diarrhoea (normal with these antibiotics) I seem to have become constipated, despite not changing my eating habits nor medication – which is unusual. I also felt that my pelvic pain had lessened; so much so that I had stopped my Cocodomol tablets yesterday lunchtime, to see (a) what my level of pain was, and (b) to help counter my constipation. I didn’t have much to report at that stage, but our suspicion was that the antibiotics were having a beneficial effect, and that the leak may well be healing.
As of the time of writing this, I’ve now had no Cocodomol for 24 hours, and although there is some pelvic discomfort, it’s definitely not painful in the way it has been in the past. At the moment, I feel no need for pain relief at all. Which I am finding extremely positive.
The issue of course, will be how well this continues when the course of antibiotics ends. If I immediately slip back then we may need to do something else. But with a little luck, this may be all that I needed to help me over the bar and into full recovery. A bit more time will probably tell. I have another 4 days of antibiotics left, including today. Let’s hope it’s enough.
Update: One thing I forgot to mention; apparently in low resections such as mine, the incidence of leaks in the join of the colon is as high as 15%. Usually the doctors will keep those patients on bypass (an ileostomy) until the leak heals. In some cases however, time on bypass doesn’t seem to help. Provided the leak is minor, the doctors sometimes reverse the ileostomy anyway, and the majority of patients apparently recover OK; so I’m not in unexplored territory here.
Additionally, for higher resections, many patients are never put on bypass, and my surgeon is convinced that many of them have minor leaks too, which also heal perfectly normally with time.
So all in all, my positive vibe has been restored. It’s just one last push to get me over the bar, and back to my normal life, albeit perhaps with a few changes here and there to accommodate my new plumbing!