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Need Help For My Mother ... Emergency Ileostomy And Reversal

 
Posted by WorriedDaughter, on Wed Oct 22, 2014 1:26 pm

Hi all. My mother was recently in a head on car accident (oct 03 '14) in Spain - visiting from the UK for a friends birthday - and it resulted in her having some of small bowel removed under emergency conditions due to heamoraging, I am here to find some advice for her.

She now has an ileostomy from this surgery (05 oct). After about a week in ICU she is now in a *normal* room with her husband staying there.

She has been told she can have a reversal with in the next week, this seems VERY soon to me, she broke her right arm in the accident and she suffers with fibromyalgia and is 56 years old. She has been told to walk about as much as she can but she also injured her leg which is now out of restraint.

They put her onto mushy foods about 2 days after she came out of ICU. And now she is persuaded to go onto more solid (she has been eating toast and alot of orange juices and soups and bananas etc). Altho she has been steadily improving daily she is very weak after minimal movement (possibly the fibromyalgia influence ontop?).

Unfortunately she has not got an infection (i think where they cut possibly at the stoma wound) and a contrast dye scan showed a leak (and some came thru her stoma i believe) and the surgeon says that though she is on antibiotics for it they will need to open her up and clean the infection out, but he says they will repair her at the same time ... the scan also showed her gall bladder is full of stones and possibly this can cause pancreatitis so he wants to also remove her gallbladder aswell. I think all at the same time.

Then he says she will be able to travel back to the UK in about 3-4 weeks time.

We are beyond worried about her, but she is strong and very brave. She is also a nurse (30 years) and was a secondary carer to me (wheelchair bound) and she is more concerned with me than herself Sad I just want to try and help her by getting some info as they have no internet or wifi and there is a huge language barrier (although there is a nurse who helps them translate back and forth)

Kari

 
Reply by Primeboy, on Wed Oct 22, 2014 10:36 pm

Hi Kari. Is there any chance your mother could be safely returned to the UK before further surgery? I am concerned because I understand reversals normally take 4 to 6 months allowing for proper healing and that your mother is not in the best situation to make an informed decision. No internet access in a modern hospital? Hard to believe. Can she get a second opinion there? Could you speak with her primary care doctor in the UK and seek his/her opinion? Perhaps this UK doctor can access her medical records and then get a colorectal specialist to offer an opinion. Also, maybe your mother could give you her questions and some of us here at this website could respond. Your mother must be a wonderful person to have raised such a caring daughter, and I can only wish you the best in this difficult time.

   PB

 
Reply by WorriedDaughter, on Thu Oct 23, 2014 4:49 am

Hi Primeboy thanks for replying Smile

Yes she is absolutely wonderful, selfless and devotes herself to helping others in and out of her work. I am very proud to be her daughter!!

Last week we (myself. my partner and my brothers) flew out to see her. She is in a semi-private hospital in Cadiz (they moved her after 4 days in a different hospital where she recieved the initial surgery near Seville - she has no recollection of this though) ... It is a very clean and tidy hospital with very nice staff who work very hard to overcome the language barrier but its mainly via bodylanguage and basic words/gestures. The surgeon who performed the initial surgery and saved her life is to be doing the reversal. Initially he told her it would b around 8 months til reversal but has decided it is able to be done very soon.

My mother is in good spirits, and trusts him implicitly (she has a very good instinct on these things usually) and before she knew he was to do the reversal she wanted to return home and wait for the NHS to reverse her at a later date. They speak through an interpreter who works on ICU as a nurse but as she has no research at her disposal (they dont allow internet/wifi as far as they are told) then I am trying to get a grasp of the complications and problems that could incur so she has an informed opinion. If she was home she would be consulting her medical books 24/7 to educate herself!

Im sure in her 30 years she will have some knowledge of this this from a nursing perspective but on the other side of the bed it is all new to her.

My aunt has been in touch with her general practioner here in Wales, but we need to follow up on that.

I am just worried as she has underlying conditions, use of only one arm etc that it is too much too soon (and now with the GB removal also)

I think the surgeons logic is that if she is reversed earlier then she can repair quicker (not so much loss of muscle tone etc) ...  she had no bowel conditions before the crash, it was damage from the seatbelt/airbag that caused the injuries. And every doctor any of us speak with assures us a reversal is a much less involved surgery with a quicker recovery time. But as you said, she has not yet recovered from the inital ileostomy yet, so I am a bit paniced!

She is on pain meds etc so I am worried she hasnt got 100% of her mental awareness to decide but we now have no financial means to get back over ... as I saiid I am a wheelchair user and could not stay without my support (brothers and boyfriend) staying with me otherwise I would not have come home without her Sad

 

 
Reply by cagabolsa, on Thu Oct 23, 2014 9:41 pm

Hello WorriedDaughter,

After having suffered a serious traffic accident (which is quite a traumatising event), and a life changing intervention, I think it would be wise to wait.

Of course you can operate someone within a short period, taking all the risks into consideration. But that is going to be quite hard on your mother. She would be so much better off if she could wait till she is back in Wales with her family and friends and choose the right moment for a reversal.  I am sure the Spanish surgeon is very good, but the language barrier and being so far away from home take its toll.

If it wouldn´t be so far from my house in Spain I would drive over immediately to help a language hand. I don´t speak Welsh though, hahaha.  I live 120 kms East from Madrid and my house is partially adapted for wheelchair users (I have not had any visitors yet)

If you want your mother to be operated in Wales, you can tell the surgeon the following:

"Mi madre prefiere esperar con otra cirujía hasta que ha vuelto a casa, donde puede disfrutar del apoyo de su familia y amigos, durante su recuperación".

If he doesn´t agree with this, then he just likes to operate for the money Smile

There must be plenty of Welsh and English in the South of Spain that can help translating. Should you all be desperate, contact me. Although the administrator does not permit the exchange of personal information, we may do it before he discovers that he himself has written AdminiSTARTOR since a long time, so there you go, hahaha Smile

Wish your mum a speedy recovery. Hugs, Richard

 
Reply by nikkib, on Fri Oct 24, 2014 12:35 am

Hello Kari.....First I would like to say,  that both you and your mother sound

very strong,  and  wonderful people.  My  opinion  only,   I to had an emergency

Ileostomy,  my body hemmoraged, 9 oints of blood back into my body, and they had to 

Reseitate me before 9 hours if surgery.  12 weeks later  we tried to reverse,  everything

In my pelvic area was inflammed and foynd a cyst on my ovary...they thought it was cancer

They aborted the surgery.  I still have my ileostomy almost  5 years later and I'm now 50.

My point,  I told my new gastro doctor about how soon the second surgery (12 wks.)

He said that was to early.  I  think mom should have some time to heal,  being back home

With family close by, rather than traveling shortly after, might be to much.  Second opinions 

Are always a goid idea,  AGAIN  JUST MY OPINION.  Wishing you abd your family

PEACE AND BLESSINGS.., MOM A SPEEDY RECOVERY...It does take time to heal. Smile

 
Reply by nikkib, on Fri Oct 24, 2014 12:39 am

Hi again..excuse all of my mis-spelled words,  tired.  I hope that

I made some sence and/or  little help.  Again, wishing you and your family

All the best.  Smile

 
Past Member
Reply by Past Member, on Fri Oct 24, 2014 2:41 am

Hi there,

from your initial post it sounds like they found a leak, which means they have to go in and clean her out. If there is an internal leak, they do have to go in and fix it (urgently!) - maybe this is why they figured they would do the reversal at the same time since they have to operate to fix the leak anyway? This might explain the short timeframe. 

I had an emergency ileostomy as well (due to perforated colon during a c-section, yikes). Due to the perforation I had a really bad infection which took a month of antibiotics, drains etc to beat. If your mom has an internal leak somewhere, I think fixing it asap, and "washing her out" is a priority so the infection doesn't get worse. Maybe they figure might as well reverse it while they're in there. I would ask your doctor about whether a reversal so soon is a good idea but also mention the leak/infection.

FYI my surgeon wanted me to wait 6 months for a reversal due to the bad infection I had etc. I think usually it's 3-6 months. (My reversal is in 9 days!)

My thoughts are with your mom and family, I really hope things go well and she is able to come home soon!!

 
Reply by WorriedDaughter, on Tue Oct 28, 2014 7:17 am

Thanks everyone for your kind messages and information, I have been unable to get back until now.

My mother's infection was a staph infection and the leak they think is not coming from the input side ... as they tested her by ingesting some dye ... she is going to go ahead with the reversal tomorrow morning (I have explained my concerns but she feels like it will help her to have it done before heading home) She works in hospitals and knows what the ones here are like, so I respect her decision (she would be the first to say if she was unconfident!)

They have now said they may not remove her gallbladder, depends what state it is in.

I am going to be sending all my love and support to her for tomorrow and hope they can reverse her successfully. She is very strong and feels ready, and ultimately its her decision.

I think she mostly just wants to come home!

Kari

 
Reply by Primeboy, on Tue Oct 28, 2014 10:32 pm

Hi Kari. Good luck to your mom. Please keep us posted on her condition.

   PB

 
Reply by B.red, on Wed Oct 29, 2014 10:33 am

Hi Kari,

You have my details, if you need me let me know, ok?

B.red

 
Reply by WorriedDaughter, on Tue Nov 04, 2014 7:59 am

Hi everyone!

My mother had a very succesful reversal according to the surgeons! She is now out of ICU (after a day and a half) and back in the room she had previously. She explained they had to attach to her transverse colon as the other end was not long enough? Im not quite sure what that means? But that it was more complex than the other method.

One of the surgeons says that she may be able to come home within a few days but no plans for a medical team back home have been put in place, but she has been told to get a surgeon in the UK ASAP incase of any problems (apparantly they are a bit concerned that the stomach wound will reopen (they had to cut away alot of damaged tissue apparantly and then sew her closed, and are a bit worried if it would reopen that they need someone on the case ASAP) or that is how it was explained to me by my mother.

I am pretty sure the insurance will help them sort this all out as she will need a nurse also, to change her dressings etc. Anyone have any experience with being injured abroad and returning home? I do doubt the "2 days" tho as it is quite a trip. But she has passed stools and is now back on mushy food (though they say she can have solids tomorrow???? I said she has to chew it into mush and NOT have anything too adventurous and I told her I have read that it will take weeks and sometimes months for her to get back to a more normal eating/toilet routine? Is that correct in yoru experiences?

Thought I would come back and let you all know it went well Smile Now it is the case of waiting until she is ready to travel and getting her home where she belongs!! Smile

Kari

 
Reply by Primeboy, on Tue Nov 04, 2014 11:20 pm

That's great news, Kari. Be sure your mother has plenty of pain meds for the trip. It takes a while for one to recover from abdominal surgery, and almost any movement will put some stress on those very sore muscles. Good luck!

   PB

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