Managing Ileostomy After Surgery: Pain Meds and Bag Changes

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484
kclay1230
Jul 18, 2023 1:17 pm

I've had an ileostomy since 1988. I'm facing rotator/bicep surgery soon. Will I be able to empty and change my bag on my own? I use a 1 pc. bag. Wondering if I should use a 2 pc system temporarily so it might be easier for my husband to assist me.

Also, will opiate pain meds cause constipation even without my colon?

AlexT
Jul 18, 2023 3:14 pm

Were you told that you'd have to take such strong pain meds? If you have a husband, he should be more than willing to help you out, that's what partners do. I wouldn't change anything if what you're using works.

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Ben38
Jul 18, 2023 3:26 pm

When I had surgery on my hand, the ostomy nurse gave me two-piece bags to use. She said they would be easier for me as I could just remove the bag and put a new one on instead of emptying it. I can't remember which brand it was, but instead of having the usual locking ring, it was a wafer on the back of the bag that just stuck on to the base. I never had leaks from them, just found it annoying having to keep changing it. I thought it was a waste of bags, so I tried my usual one-piece drainable bags. I found them much easier to use. I didn't have any problems rolling the bottom up with one hand to close with the Velcro closure system. The only problem was I couldn't clean the end of the bag very well. I found changing the bag with one hand quite easy after a few times. You have time to practice changing and emptying one-handed before surgery, so by the time you have it, you will be an expert changing one-handed.

Good luck with surgery.

Mysterious Mose
Jul 18, 2023 7:19 pm

I was on opiates for the first 3 months following my colectomy and no constipation. Only withdrawal when it came time to ditch the drugs. :-)

Daniel

TerryLT
Jul 18, 2023 9:09 pm

I don't know how much pain you might expect with that type of surgery, but in my experience, hospitals are always quick to push the opiate pain meds and you may well find that you don't need them. Try going without opiate meds first. With all four of my surgeries, I used opiates very rarely, and only for a day or two even then. Not sure whether they would give you constipation without a colon. My last two surgeries were after having my colon removed and I didn't use opiates at all.

Terry

 
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kclay1230
Jul 18, 2023 10:37 pm
Reply to TerryLT

Rotator cuff surgery is supposed to be extremely painful. I know of at least 6 people who've had the surgery and hydrocodone was needed. Of course, they stopped it as soon as they could. These people didn't have ileostomy and talked about how bad the constipation was. I've had a blockage with ileostomy and it's no fun. I'm just hoping not having a colon will prevent the constipation. I plan to consult a pharmacist. Thanks for all comments.

CrappyColon
Jul 18, 2023 11:10 pm

Hi, so this is my personal experience, I'm not giving medical advice, etc.. Are they repairing the rotator cuff using anchors and working with your body's own tissues? My surgeon told me a replacement would be less painful, but not an option for me. I have 6 anchors to stabilize the 'ball' in the socket then he made a little cuff all the way around out of whatever tissue is there. I was on pain meds for 3 months. The goal was to taper down from Percocet to Vicodin to Ultram. We found out I hallucinate on Vicodin. So had to go back up then transition down to the Ultram. Can't remember if I said to you or someone else...Get the nerve block. You won't think it's helping but after 48 hrs when it wears off you'll be able to tell how much it helped. I realize I am very fortunate that for me it's like this little signal goes off in my brain and I can tell I'm done with the pain meds. Some withdrawal (itching) going from Percocet to Ultram. But no withdrawal going off the Ultram. We know by now what opiates can do but unless someone has had shoulder surgery I don't think they understand how painful the recovery is- there is much connected there and so many movements we make a 100xs/day that we take for granted. I still have pain every day and it's been over a year (from that surgery). I did the same step down after both abdominal surgeries last year and that has worked really well for me, no constipation/no colon. Some ortho surgeons will pair a pain med with something like Phenergan to help with nausea. I know we also tried things like Toradol and steroid packs to get me off the opiates sooner. Every time I would call my surgeon's MA they would tell me how typical it was to be in so much pain and with the type of surgery I had it was 'completely normal to still need the prescription pain meds. They have this thing you can fill with ice and it's constantly putting cold into a pack for you- some insurances cover it. A friend got me those homemade Ice/warm packs that are filled with the corn kernels that don't pop. I ordered on Amazon, more of the ice bags like they use on you in the hospital so when 2 melted I'd have 2 more ready to go (you tie 2 together so one goes down the back of your shoulder and one over the front. Oh buy the best recliner you can if you don't have one and are able to do that. I spent a month sleeping in a recliner and now hate that recliner '

You should be able to move your fingers on the surgery arm to help hold light things. Start working now on trying to do it with one hand. Grab a scarf or something to use as a sling. Then figure out what you can/can't do by yourself and know the gaps that need to be filled in with help. I think a 2 piece would be more difficult esp one handed. I tried and that was a no go.
Oh! Oh! Chick-fil-A ice is the best size to fit in the bags like they use in the hospital AND you can get it through the drive-thru. The ice machine in our freezer could not keep up with needing ice packs 24/7 pretty much the first 4-6 weeks. Sometimes I'd use a bag of frozen peas and write on them 'don't eat this'

imsafanwa
Jul 19, 2023 12:54 am

Hi K

I was able to muddle through the one-handed bag changes after an inverted shoulder replacement. There is some trial and error, and we all know what the errors entail, but we've been through it before. Have a look at the post "Oh no, I fell!", more info there. You CAN do this.

jeanneskindle
Jul 19, 2023 3:49 am

Hello, OK. I wrote that post. Oh no, I fell. It turned out that I had a broken arm and displacement. Thankfully, they shared rotator cuff ligaments was a mistake. I have been on oxycodone 5 mg. The first few days I took probably three in a day but now I just take one at night. Even just a broken arm and displacement is very painful. I have been able to move my wrist and hand enough to empty my two-piece bag and even change it. You are very lucky that your husband is there. I do have a fair amount of water retention and some constipation although not bad. I think the water retention is from the cortisol resulting from breaking my arm stress, etc. You will be OK. I feel so grateful that I don't have to have rotator cuff surgery. Take what you need for the pain. It's way too painful like Jodie says to go without something. I had a small tear in my rotator cuff on my other shoulder and that pain was pretty nasty. Good luck! Definitely read that column. Oh no, I fell. There was great advice in it. Keep talking to us. We totally understand what you're going through, hugs. Jeanne.