As usual when doing anything under general anaesthetic, the hospital required that I eat nothing for the previous 6 hours, then only water until 2 hours prior to the scheduled start, then nothing at all. Which is OK if everything runs to plan. But of course, “The best laid schemes o’ mice an’ men, Gang aft a-gley”.
In this case, the patient prior to me on my surgeons list was having a seriously bad day. So by the time the surgical team had sorted them out, we started a lot later than expected. C’est la vie, these things happen, and if it were me on the table when things went wrong I’d not want the surgical team worrying about when they needed to start on the next guy.
But it did mean that by the time I got down to the operating theatre it was more like 5 hours since I’d last had anything to drink, and I was quite seriously dehydrated. Which meant the poor anaesthetist had no chance of cannulating me in the back of the hand, as the veins had all gone into hiding. He tried. And tried again. And then suggested using a vein in my neck (which I veto’d!) before finally finding a vein in my arm.
By this time, feeling somewhat like a pin-cushion, it was a pleasant relief to get some fentanol, before drifting gently off on a wave of propofol. And then on what felt like my next breath I was wide awake in the recovery suite. Mightily impressive. I can heartily recommend the members of the Portsmouth Anaesthetic Group – they do a particularly fine job!
The surgeon tells me that he managed to dilate the join in my colon without any issues at all, and that from now on I simply need to maintain this until such time as we reverse my ileostomy. Without going into unnecessary detail, this requires that I carry out a rather unusual (well, to me anyway) procedure once a week or so.
The other news however, is that he also carried out a flexible sigmoidoscopy to examine the abscess in more detail. The result of that is that the abscess is now very well defined, and draining freely, with plenty of granulation tissue. However, there is still no real sign of the healing moving on to the next phase inside the abscess itself. Which is very frustrating.
The surgeon feels that because the contraction of the joint is itself a healing response, and is happening so close to the abscess, we should certainly give things more time. And since I now have a lot of time and effort invested in this treatment, he would be inclined to give me as long as necessary for us to be convinced that there really is no healing going to happen before we take the decision to move me to the colostomy.
So, the current plan is for me to have monthly reviews with the surgeon, and in 3 months time to do another full imaging work up and then take a decision on what to do next. But realistically, unless we see some real progress soon, that decision is really just going to be setting the date for the colostomy operation.
So between now and then I really need to start preparing myself for a very major operation, just in case. The expectation is that that operation will take several months for me to recover from, so my view is that I need to get myself into the best possible health now so that I have the best surgical outcome possible, and recover as quickly and as well as possible. Assuming the worst case for making the decision, and the best case to schedule the operation, I would expect that to be some 5 months away. So being practical, and discounting Christmas, maybe February or March.
And if by some (increasingly small?) chance I don’t need the colostomy then at least I’ll be in great shape for spring and summer 2013!