This topic is about preparing for and living through an ileostomy reversal after dealing with a severe C. difficile infection. The person sharing their story had a challenging journey, including emergency surgery, recovery, and the eventual reversal of their ileostomy. Here are some insights and advice based on their experience:

- After emergency surgery for C. difficile, the person woke up with an ileostomy. Initially, there was confusion about how much of their colon remained, but a test later confirmed about 18 cm was still present.

- Born with a disability and using a wheelchair, they faced severe post-operative depression, kidney failure requiring temporary dialysis, and significant weight loss, dropping from 142 to 89 pounds.

- The rehabilitation stay was tough due to staff unfamiliarity with their congenital disability, reluctance to allow their power chair, poor nutrition, and incorrect ostomy supplies, which led to a severe peristomal acid burn.

- They regained strength using a NuStep seated cross-trainer, bringing in outside food, and participating in online ostomy forums. This led to the decision to attempt an ileostomy reversal.

- They expressed gratitude to forum members for their support and aimed to educate others about proper ostomy care.

Post-surgical updates and concerns included:

1. Immediate Post-Op:
- The surgery involved small laparoscopic punctures and a small ileostomy-closure wound. A drainage tube was in place, and they experienced severe shoulder-tip gas pain, nausea, and vomiting. Gradually, gas and stool returned within 24 hours.

2. Bowel Function & "Butt-Burn":
- They experienced liquid output every 1–3 hours, causing intense perianal "bile burn." Various creams and products were tried to manage this. Loperamide was used to control frequency, but it risked constipation. Dietary triggers like milk, cheese, sugar, fat, and spices were identified, and Benefiber was used to thicken output without causing excess gas.

3. Pain / IV Access / Advocacy:
- Fragile veins led to repeated IV failures, and there was reluctance to use opioids due to their effect on gut motility. They advocated for earlier mobilization to avoid discharge to an unsuitable rehab center, and a psychiatric consult improved staff response.

4. Wound Care Change:
- Iodine packing was discontinued, and the wound was left open to heal from the inside out with daily simple gauze. Home-care nursing was arranged, and a friend was trained to help with wound care.

5. Long-Term Status (6 months & New-Year follow-ups):
- Bowel movement frequency reduced to 4–5 times a day, with occasional bile burn managed with barrier cream. They could take long bus trips by pre-dosing loperamide and regularly attended the gym. Weight was regained, and occasional bloating was controlled by staying hydrated and avoiding lactose and spicy foods. They offered surplus ostomy supplies to others in need.

Advice and insights shared include:

- General Support & Mental Strategy:
- Stay strong and take one day at a time. It's okay to return to an ostomy if necessary. Be patient with the adjustment period, as good and bad days are normal after reversal.

- Skin Protection for Bile/Acid Burn:
- Use barrier products like 3M Cavilon, diaper-rash creams, hydrocortisone ointment, or zinc-oxide paste. Cooling options like ice packs and a bidet with soft paper can help reduce burning.

- Medication & Bowel Management:
- Loperamide (Imodium) can be used to control frequency, but watch for rectal pressure or constipation. Soluble fiber supplements like Benefiber may be better tolerated than Metamucil.

- Dietary Tips:
- Follow a low-residue/low-fiber diet immediately post-op and avoid certain foods until tolerance improves. Stay hydrated with electrolytes to prevent dehydration headaches and bloating.

- Pain Control & Advocacy:
- Request appropriate pain relief and sleep aids if needed. If staff are dismissive, ask for Patient Relations or a nurse manager and document interactions.

- Peri-Wound & Stoma-Site Care:
- Verify with the surgeon about wound care, as leaving the closure wound open to heal inside-out with saline-moistened gauze is common.

- Rehabilitation / Mobility:
- Early upright positioning and mobility devices like the NuStep can aid recovery and help avoid unwanted rehab placement.