Adhesion surgery for intestinal blockage: UPDATE at one year

Hi ladies! Nearly 5 years postop from an LSH. This past Wednesday I went to urgent care with searing bowel pain, I would say 9 on the scale (throwing up, nearly incoherent). CT scan with contrast revealed what appeared to be a partial blockage of the small intestine. Initially it was hoped it would clear itself but I ended up back at urgent care which coordinated with the ER at their affiliated hospital. I went into surgery Friday night to address it, and it turned out to be a singular adhesion causing all the issues Where the small intestine meets the large intestine. I’ve got a nice 4 inch vertical vertical incision below my belly button. Fortunately no other adhesions were spotted.

The surgeon gave some good guidelines on the timeline, a lot of what’s echoed here after a hysterectomy. Still, it’s always good to hear the experiences of other women. For those of you who had complications from adhesions and had to have follow-up surgery, do you recall what your timeline was in recovery? How long it took before you could get back to normal activities? Any further issues for you since?

so sorry you had to have surgery...i hope you feel better really soon

So sorry you had to have surgery! I had a blockage about 5 years ago. They said adhesions were strangling small intestine. But an NG tube for 3 days and no food or water for 3 days allowed things to release I was very close to surgery.

	Quote:
Originally Posted by Kim M So sorry you had to have surgery! I had a blockage about 5 years ago. They said adhesions were strangling small intestine. But an NG tube for 3 days and no food or water for 3 days allowed things to release I was very close to surgery.

So you've not had any issues since that time 5 years ago?

Tried for two days to let it clear itself since the hospital thought it was only partial. I was still throwing up, and not able to eat anything. It was that, dehydration and I was starting to worry about urinary retention which had me back at urgent care. If there are blessings to be found, one of them was that the same doctor was on duty. He promised to make a sales pitch to the hospital and his insistence got me admitted. The surgeon on call must have agreed and wanted to get me in surgery that night.

Talking with the surgeon afterwards he said the adhesion broke away as soon as he "lifted things a bit". As I mentioned, he didn't see any more. What are the chances, right?!

I've thought it might be good to post general updates on my progress. It may help someone else in the future.

1 week update:

Released for home on Day #2. Incision is 4" vertical, secured by 3-week stitches in the skin, 90-day stitches in the abdominal muscles. Given Norco (hydrocodone) and something for nausea if needed. Advised that the 2-day course of antibiotics I was on in the hospital would be all that I needed for the UTI detected during my urgent care visit. I'm on lifting restrictions and will be at home at least through March 31st which is when my follow up appointment is in about 3 weeks

First notes:
Bruising is terrible, black and purple, about the size of my palm, just off off the vertical incision and going across the bikini line. Strangely, it's nearly all on the left side, even though the obstruction and adhesion were in the lower right quadrant of my abdomen.

Ah, my old friend Swelly Belly is back! At least I know what to expect this time. I noticed that the swelling is uneven, as some Sisters have noted after their hysterectomies, and have also noticed a "shelf" type swelling noted by other Sisters - like I'm wearing a fanny pack up front .

I'm definitely more sore with the vertical incision than I was with my lap incisions from the hysterectomy, and it's difficult to get in and out of bed even using the log-roll method. I feel the internal bruising with every movement and a burning-pulling on the incision.

Biggest concern is bowel movements. Since I had a bowel obstruction and I'm sore, I don't want to strain. Surgeon recommended liquid - soft - low residue foods AND taking Miralax, starting with two doses daily, backing off if that's too much.

A few specifics:
I slept 15 hours overnight the first night home. Had to use the bathroom a few times (staying hydrated!), noticed a lot of intestinal rumblings. Congestion really bad, trying to clear my sinuses, but breathing is fine - no shortness of breath.

Day #3, all the plumbing works, thanks to the Miralax. Between breakfast and getting on my laptop in the morning, it was apparent that I sat upright too much. I then stayed put in the recliner and I kept a small pillow against my tummy the rest of the day whenever I got up. Slept for 10 hours overnight. Couldn't quite sleep on my side, but was able to stuff pillows around me so that I wasn't on my back. Congestion and intestinal rumblings still very noticeable.

By Day #5, hydrocodone no longer needed during the day and I opted for Tylenol PM before bed. Congestion no longer an issue, intestinal rumblings seem to be better - I cut out the morning Miralax and the night time dose is sufficing.

General notes:
I'm sticking with the liquid - soft - low residue diet and 1x daily Miralax to give the bowels a chance to rest.

Incision is healing well, no oozing or redness. Bruising closer to my belly button has turned the yellowish green of a fading bruise. I thought I saw some "crusting" in the incision after my shower today, but upon closer inspection, it's stitches.

After a week, I'm easily sleeping on my side, and getting in and out of bed via log-roll is now second nature, no discomfort. Still afraid to cough (I try to clear my throat instead) and have only sneezed once (big time OW).

I've been able to work from home with our cloud-based software and data, and quite a few things happen digitally anyway (like payroll). A coworker can bring what I need. I'm doing the basics and not taking on any projects, perhaps a couple of hours for 2-3 days a week max. As long as I'm reclining, there's no tummy strain, no back ache.

This go 'round, no organs were removed and I think that's the difference in how I'm feeling a week after this surgery vs. one week post-hysterectomy. At the same time, I'm more aware than ever of the importance of taking it easy. Can't rush recovery.

	Quote:
Originally Posted by Cussette So you've not had any issues since that time 5 years ago?

It has not happened again, nothing even close. All systems are normal.

	Quote:
Originally Posted by Kim M It has not happened again, nothing even close. All systems are normal.

Once you go through something like this... I truly get that! (I'm saying "All the plumbing works"....)

I'd had something similar at the end of December / early January, but not nearly as bad. It seemed to correct itself after a few days, but for the rest of January, things weren't quite right. The clinic didn't detect blockage through x-rays, and I got a "clean out" prescription. Should've worked quickly like a colonoscopy prep, but took overnight. February was totally fine. Little did I know it'd come back for the body slam in March! Hopefully this will be my last experience with it.

What is interesting about my experience is that I had surgery years prior to look for adhesions due to ongoing issues, but not a one adhesion was found. I did have bowel issues for quite a few years after my hysterectomy, but acupuncture resolved most of my problems.

Sounds like you are the road to recovery!

2 week update:

I'm definitely feeling human again much faster this time than after the hysterectomy. Head is clear, no hormone imbalance. Working from home at reduced hours in a reclining position is no problem.

Incision itches on occasion! There's still dark bruising on the left-hand side, but the edges are fading.

I've introduced lean meats and pastas to the diet, along with white bread (low residue). Sticking with 1 dose of Miralax at night. It has not affected the urge to empty my bowels, so I'm not concerned about dependency at this point.

First outings Days #9 and 10 - rode with hubs to visit dealerships (we like looking at cars!), some walking around. Kept a travel pillow tucked between abdomen & seatbelt. Monday walked about 3/4 of a mile around two blocks in our n'hood. Felt fine after both outings.

Day #11, Tuesday, had hubs take me into work (he stayed with me) to drop off filing and pick up stuff I can work on at home. Although I was only there for 45-60 minutes tops, the sitting up, walking and standing made my back sore! Gee, just like the old post-hysterectomy days. Fortunately, no abdominal swelling, but it's an indicator that I'm indeed post-op.

During one walk in the neighborhood, about a mile, started feeling the telltale tugging of a going a little too far.

3 week update:

Bruising continues to fade, noticed skin contracting as wound steps up the binding process. Still see a "shelf" of swelling and experience swelly belly.

Day #18, drove for the first time after checking my ability to depress the clutch, turn to look over each shoulder and slam on the brakes. No issues, so I made a quick drop-off and pick-up run to my office. Got to chat with more of my coworkers - really sweet to feel the love of being missed!

Day #19, Wednesday, first follow up appointment with the nurse practitioner at my surgeon's office. I was weighed at Urgent Care prior to heading to the hospital for surgery, and after being weighed in for the follow up, I noted that I've lost 7 pounds during this health episode - I'd wanted to drop a few but not this way!

• Incision is healing very well.
• Asked about the bruising, swelling and pain (when coughing or sneezing) being more on the left side when all the work was done on the right side. She explained that the one side is retracted and clamped to keep from interfering since skin and muscles get stretched.
• Diet and digestive system: She suggested to cut back Miralax use to every other day. I'm allowed to gradually include more bulk - adding one food item at a time, and of course... stay hydrated. (I confess to being nervous!)
• Given the go-ahead to return to work the following Monday, part time at first to see how that goes.
• Activity restrictions: walking-only for exercise through 6 weeks post-op, weight restrictions increased from 10# to 15#.
• Encouraged to get my first Covid vaccine as soon as I left - in the same building.
• I'll have to call the medical records department for my surgery report. There is no pathology since nothing was removed.
• My final follow-up appointment will be with my surgeon at 6 weeks post-op, and if all is well, I should be released.

I'm able to sleep on my side without stuffing pillows under my tummy.

4 week update:

Requested and received my surgery report - 23 pages (!) including some pre-admission info and all the results of the blood tests during my hospital stay. The report revealed that a "single band adhesion" was causing the bowel obstruction. My doctor had said the adhesion broke away upon lifting the area; surgery report notes that the adhesion was then cauterized, movement through the bowels noted, and the blockage completely resolved with no injuries, abnormalities or other adhesions noted in the examined area.

(One surprising pre-op note in the report was "anorexia". Normally I eat as much as my husband to fuel my gym workouts, but from the time I got so sick Wednesday morning until surgery Friday night, I'd been unable to eat anything. It turns out anorexia is indeed the medical term for "loss of appetite", and not just the well-known eating disorder.)

Had been a little concerned about the sometimes-pain I've felt in the lower right quadrant (where the blockage was) as my bowels regain normal function. The cauterization of the adhesion in the same fully explains it, much to my relief - soft tissue trauma.

Reduced and cut out Miralax by Sunday night, added prune juice and have been having near- normal bowel movements. Still signs of some constipation but I'm going regularly and... drinking enough water-water-water to swamp a canoe.

Resumed work Monday, part days. I stay seated most of the day and have my seatback more reclined for comfort. While I can think clearly, by 4-5 hours I'm mentally exhausted. That's when I go home.

Mild intermittent pains (no more than a 1 or 2 on our Hysterectomy Pain Scale) on the left side under where all the bruising was from the retractors. I'm thinking nerve damage, and I feel it a bit more at the end of the day. I have noticed that some nights I do have to stuff a travel-pillow under my tummy when I feel this more. Three steps forward, a step back.

There's also an area of my colon on the left side where I've felt pain off and on through the last few years whenever I've had bowel issues, including my intestinal bleed 2-1/2 years ago. It seems be the area where I had nerve damage after my hysterectomy. Perhaps I still have a nerve issue after all? It's less than a 1 on the pain scale when I feel it at all (seldom), and not worth pursuing - muscle cramps are worse!

Really pleased with how the vertical scar is looking! It's flattening out and I can definitely see the incision filling in. It's a little "tucked" at the lower end, but yanno, that's well covered even by low-cut underwear. With the variety of bathing suit options including some higher cut bottoms, I fully intend to continue my sass and wear bikinis!