Shoulder surgery with Continent Ileostomy

[abs0728]

I have a Koch's pouch, which I have had for over 30 years. I am having major shoulder surgery tomorrow and live in an area where there is little knowledge about continent ileostomies among the medical profession. I have to keep my arm immobilized for 3 months and when I told the doctor I need two hands to intubate and irrigate, he said "that's going to be tough - it will make the pain worse and could affect your healing!" I have spent two months trying to figure out what to do. Home health care is a waste, as they will only come once a day and won't guarantee a time. Besides, they don't have any experience with CI anyway. So I am wondering if anyone has been through this, has any suggestions, experience, thoughts...anything! I have a good friend who is a PA and will stay with me for two days - after that, I am on my own. My husband can't deal with it and honestly, I would prefer to take care of myself. I am a very active person, am a yoga and Pilates teacher, and it is going to be difficult for me to be still for such a long time. I have been told repeatedly how painful this surgery is, but I have been so focused on my ostomy care that I haven't thought much about the pain. The doctor said it will be worse if I have to move my arm alot. I feel frustrated and would appreciate any input. Thanks...

[BillV]

I have a BCIR (similar to a Koch pouch) and had an experience that might shed some light on your situation. My return home from Florida to northern Wisconsin involved a flight with one plane change plus a 5 hour drive. Just prior to discharge from the hospital, the nurses inserted a Foley catheter into my pouch, secured it outside with gauze and tape, and connected it to a leg bag. During the following 12 hours, I emptied the bag twice and had no leaks. Perhaps this setup would be helpful for your situation and hopefully your husband could be more supportive of your needs during your recovery. I suggest that you be seen in the hospital by a WOCN (nurse specializing in ostomy care and related matters) for instruction on this kind of setup. Also, ask for sufficient supplies that you can take home with you. Some additional thoughts: (1) Eat foods that will not clog the catheter (use a blender on fruits and vegetables as needed) (2) Drink plenty of fluids so that that your output flows freely through the catheter. I have found that many medical professionals need to be enlightened by us on how our "plumbing" works. Perhaps others on this board can furnish additional information. I wish you the best on your surgery and recovery.

Bill

[BillV]

One very important caution regarding use of a Foley catheter: Under NO CONDITION should the balloon at the tip of the catheter be inflated since doing so could result in damage to the valve. The presence of the catheter for a period of time will not damage the valve. The surgeon who made your pouch (if you still have contact with him/her) could also provide advice on this.