This topic is about the journey of recovering from a successful fistula repair surgery, including updates on the surgery itself and the challenges faced during the post-operative period. Here are some key points and advice that might be helpful:

- During the surgery, the surgeon found and removed a stray staple, which was likely causing the fistula. The intestine was reconnected, and a new stoma was created at the same site, avoiding new scars.

- A specimen was sent to pathology, which is a standard procedure and not necessarily a cause for concern, even though it can be anxiety-inducing, especially for someone who has survived stage IV cancer.

- The hospital initially used a bulky two-piece pouching system, but the patient plans to switch to their usual soft one-piece appliance with the help of nursing staff.

- The initial pain after surgery is present but less severe than in previous surgeries, and the hospital stay is expected to be just a few days.

- Post-operative challenges include low blood pressure, which causes dizziness and is somewhat improved with IV fluids, but still fluctuates.

- There is a very high ostomy output, leading to dehydration and further drops in blood pressure. The patient is now on a regimen of Imodium and Metamucil, along with oral fluids like juice, milk, and G2 Gatorade.

- Discharge from the hospital is delayed until the output is reduced and blood pressure stabilizes. The patient experiences intermittent confusion when blood pressure is low and continues to need IV fluids and pain medication.

Here are some helpful insights and advice:

1. Sending surgical specimens to pathology is a routine precaution and not necessarily a sign of trouble.

2. Focus on staying hydrated, moving around gradually, and giving your bowels time to settle after surgery, as output often increases for several days post-op.

3. When removing the wafer, protect the skin around the stoma by gently pulling the skin away from the wafer instead of ripping it off quickly.

4. Having a surgeon or stoma nurse assist with an early pouch change can provide reassurance and allow for direct inspection of the new stoma and sutures.

5. Extra IV fluids and electrolyte drinks like G2 Gatorade can help stabilize blood pressure during periods of high output.

6. Emotional support is important. Be patient with yourself, use online resources for distraction, and remember that slow progress is still progress.

7. Some people note that long-standing fistulas often require open surgery, as laparoscopic repair may not always be possible.