This topic is about the experiences and challenges faced during recovery after a Hartmann’s colostomy reversal combined with a large incisional-hernia repair. Here are some key points and advice shared by the person who went through this procedure:

- The first three weeks were tough, with severe pain from the incision, constipation, and loss of bowel control.
- Bowel movements required 7 ml of lactulose twice daily, as the recommended 15 ml dose caused extreme cramping. Passing gas was still a concern.
- A 12 in × 9 in mesh was used for the hernia repair, and the abdomen will not be flat again.
- The person had leftover "Novo Mini Caps" from before the reversal, which are now unnecessary.

Unexpected postoperative issues included:

1. A rectal tube stitched at the groin, which was very painful.
2. Waking up with a nasogastric (NG) tube in place.
3. Wearing a tubigrip or elastic abdominal bandage for three months.
4. Having one large painful drain and two smaller painless ones.
5. Experiencing acute pain when the large drain was removed.
6. A surprisingly rapid overall recovery, but a slower return of bowel control than hoped.

Current feelings are mixed, with the expectation of eventually feeling glad about the reversal, but not quite there yet.

Additional advice and insights:

- Tubes and drains: The NG tube helps keep the stomach empty, and the rectal tube prevents pressure on the new join. The large drain was painful, and patient-controlled twisting before removal is recommended.
- Pain control tips: Request morphine before stopping spinal/epidural anesthesia and ask for numbing gel around rectal stitches.
- Pre-op bowel prep: A stoma-site enema failed, leading to post-op diarrhea. A two-day liquid diet and self-enema the night before is preferred. Bringing a drainable pouch to the theater is suggested in case of a messy enema.
- Abdominal support: A full-torso tubigrip was applied due to the mesh repair. Light elastic support is considered useful after any laparotomy.
- Hernia repair choices: Discuss using porcine mesh, which may avoid the need for a second surgery or tummy-tuck.
- Risk factors for incisional hernia include age over 70, obesity, diabetes, steroid use, prolonged inactivity, or previous wound infection.
- Wound care: A small scab pick led to infection and heavy drainage. Old ostomy bags were used over the wound until antibiotics were obtained.
- Psychosocial notes: The person faced work discrimination and dating rejection due to the bag, highlighting public ignorance and the need for better media portrayal.
- Instinctively checking for a pouch 18 days post-reversal.

General encouragement includes taking recovery one day at a time, as pain and setbacks are common but usually temporary. It's important to ask surgeons specific questions pre-op about routine practices and hernia repair options. Pain management should include ensuring morphine is charted before stopping spinal/epidural anesthesia and using topical anesthetic gel around rectal stitches.

For bowel function and stool consistency, keep stool softeners and lactulose but adjust the dose to reduce cramping. Post-op constipation is more common than diarrhea after colostomy reversal, while ileostomy reversal often has the opposite effect. Some people use marshmallows, loperamide, or diet changes to thicken output.

Pre-op and wound care tips include bringing antiseptic throat spray if an NG tube is likely, using elastic maternity or hernia supports early to reduce hernia risk, and keeping a spare drainable pouch in the hospital for stoma-site enemas or wound leaks.

Limit heavy housework and lifting until the abdominal wall is strong, as overactivity soon after stoma creation is linked to subsequent hernias. Psychological coping involves delaying reversal until mentally ready, seeking support networks, and maintaining a positive outlook.

Insurance and health-system notes mention that US members face coverage hurdles for reversal, while a UK poster benefited from NHS coverage for the reversal, mesh repair, and potential cosmetic "tummy-tuck."

Brands and products mentioned include Novo Mini Caps, lactulose oral solution, porcine mesh, morphine, loperamide, marshmallows, tubigrip abdominal support bandage, and drainable ostomy pouches.