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Welcome to MeetAnOstoMate
The best place to meet and talk to other OstoMates with 17,427 Members.

Hartmanns Reversal

Posted: Thu Oct 05, 2017 6:21 pm

I had a Hartmanns procedure done after a tumour was removed with an abcess behind it. The chemo and radio obliterated the tumour but as there was so much scarring and previous sepsis I had to have a Hartmanns procedure instead of a resection. No more chemo was needed as nothing had spread to the lymph. that was 18 months ago. I was told to wait 18 months before a reversal of the Hartmanns and resection could be considered. Now they said my function would be too poor to do the reversal after having a sigmoidoscopy. A scan done via my stoma a month ago showed my bowel was perfectly normal otherwise.

The reversal is possible but is it worth it? I have no other health probs and am on no medication. The stoma is ok and I do not suffer from sore skin as I look after it well. I am still waiting to see my consultant for the reasoning about poor funtion. From the sigmoidoscopy I had reversal proctitis (inflammation of the rectal stump). The picture did not look pretty. I presume the scarring from previous sepsis, radio and the proctitis may be the reasons. Has anyone else been in this position and actually gone through with the reversal? I know the bowel function will be poor the first 3 to 6 months but does this improve or is it not worth it?

Posted: Fri Oct 06, 2017 2:01 am

Hello Cassie. These sorts of decisions about reversal always come down to what people feel is right for them and I cannot give you advice on the matter one way or the other. My last blog tries to summarise my own thoughts on just this subject and you will see that I decided to stick with the stoma rather than go for a reversal. Part of the reasoning behind this decision was that all was not perfect in the anal area and a reversal would not have changed that but probably made it worse. I manage the stoma pretty well so I figured that I would not chance something else going wrong when I can get by without having a reversal. 

I hope this helps you in your own decision making

Best wishes

Bill

Posted: Fri Oct 06, 2017 11:10 am

We have not even got to the point of discussing possible reversal, although the surgeon originally told me we would possibly be able to do a reversal in 6 months to a year. It's now coming up on 2 years, and still no go. I have had lots of complications since the original surgery, including 2 bouts of peritonitis (the first was the cause of the ostomy to begin with) from a perforated colon due to radiation damage from the original cancer treatment. Different side effects from the chemo, but that's a different story! The perforation just won't heal, and there can be no question of re-connection of the colon as long as that is still there - a quick passage to peritonitis round #3 if that were done! I know the perforation is still there as long as I continue to pass bloody mucous from the rectal stump, and that is ongoing. I had a full colonoscopy through the stoma (all normal) and sigmoidoscopy through the stump (pesky hole), and no sign of disease or any other issues than the perforation, so if that ever heals, we could talk about reconnection. However ...

In the meantime, I have learned to manage my ostomy quite well. It really doesn't give me any undue grief or aggravation. After dealing with the chemo bulb and other things, I figure I have it pretty good with just a wafer and pouch! Seriously, I have adjusted my life to accomodate it, and it's no big deal. I have come to accept that I may never have a reversal - both from adverse circumstances and from choice, because I see SO MANY pitfalls from what could go wrong if I do. And at 61, I'm not sure how many major surgeries I have left in me - potentially 2 if things go wrong with reconnection; one to reconnect and one to give me back the ostomy if it goes wrong.

You might wonder why I assume it would go wrong if the perforation finally healed. Actually, the surgeon said that the whole colon stump that is left is pretty friable from the radiation treatment, and a good chance of another perforation down the line, or even problems with the connection site tearing or perforating, or just not healing if they reconnect.

So, my story is NOT quite like yours, so my decision would be different from yours, but I figured you might take away from it some additional questions to ask your surgeon as you discuss your possibilities. Also remember, talk to at least 2 doctors (including your original oncologist and radiologist), because each specialist has a default position from which they are approaching your case, so it would be helpful to see if they all come to the same or different conclusions and (more important) WHY they come to the conclusion they do. The train of reasoning is at least as important as the conclusion, so you can come to your own conclusion from the facts involved.

Because, ultimately, this is YOUR body, not theirs, and YOU will have to live in it, not them. Look at all factors, Prioritize them as to which you can live with, and which you can't, and make your own decision, dispassionately, from there.

 

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