To be fair, I’ve not much to report at the moment. Fundamentally I’m waiting for a convenient time to finalise my treatment with either a permenant ileostomy or a permenant colostomy. Since my health is reasonably stable at the moment, and I’m generally coping well with the day to day business of life, we’re working towards a time in July for that. Since raising the issue of perhaps opting for an ileostomy rather than the more usual colostomy, I’ve done a reasonable amount of research into each and how they would fit with my lifestyle. Needless to say, they both have advantages and disadvantages.
In a lot of ways the ileostomy looks a lot more attractive at this point in time; it’s a known quantity (since I already have one) so I know I can cope with it and continue to work. However, if I’m brutally honest, I’m just hanging on in there, rather than actually enjoying life. It’s too limiting, and has too many awkward side-effects to be easy to live with, especially long term.
The colostomy on the other hand, is an unknown quantity, and as with all these things the medicial community have an infuriating tendency to give you a very rose-tinted vision of what life could be like with one. In fact, depending on how well the colostomy turns out I could end up with anything from a much improved quality of life, to (whisper it!) a complete nightmare. This seems to be largely determined by how much colon the patient has left, so the fact that my cancer was so low in my colon helps here; my surgeon feels that I’m likely to have a “good” result from a colostomy. But of course, he cannot guarantee it.
But perhaps the deciding factor for me was based on a comment from one of the nurses I was chatting with, who brought up the issue of my life much further into the future – something I’d not really considered up to that point. Ultimately a patient with a colostomy that can no longer actively manage it themselves can still live (largely) independantly in their own home with a small amount of nursing daycare. A similar patient with an ileostomy would have to be moved into fulltime care in some form of institution. I’m certainly not planning to end up unable to manage, but I’m now much more aware of the uncertainty that the future can hold, so I’d rather hope for the best, and plan for the worst.
So on balance I’m going to take the colostomy. And (as the same nurse said) if the absolute worst were to happen then I could always convert a colostomy into an ileostomy, albeit with another huge operation. But choosing the ileostomy now would leave me with no other options at all.
And I’m convinced that having a Plan B is always a good idea.