Bowels rebooting post surgery? Never trust a fart!

Posted by fritzo @fritzo, Apr 25 11:07am

Just sharing a few thoughts on my post surgery experience and the re-firing of your digestive system, which is more polite way of saying that robotic laparoscopic surgery does a full knock-out to your bowels.

Waking it back up and getting it back to normal is a slow process during recovery. First thing, I’m not sure I’m the norm because it seems like symptoms are incredibly variable for us all. Just sharing my experiences. Recovery veterans, please share advice you have for folks.

Big deal phases of surgical recovery;

• You pass gas and people cheer! Hey, your digestive system is waking up. Let everyone know – Party Time!

• You poop! An aura sweeps across the horizon as the heavens open up to the news of your little, semi-solid gift to the world. You have offered the number one of all number twos of all time. It is fully celebrated for all its glory.

Let’s face it, we’re back to being praised like newborn babies who go through similar stages of digestive awakening. But, hey. I’ll take it. Yes, let’s celebrate these victories. It's a good thing.

But, there are practical matters after that. You don’t go straight from gas to poop. And, early on in digestive rebooting, never trust the fart!

My first gas was likely 10 hours after surgery (bit of a blur). The second gas was an hour later. However, the second release also had liquid and I got soiled through my gown. The nursing staff is prepped for this and not a big deal to clean things up. I think the nurse didn't expect this quite so fast.

In the next couple of days, here are the early warning signs that things are afoot; you hear your digestive system rumbling in sections of your body never heard since perhaps your college days mixing alcohol drink types that should never have be drunk in quick succession. Or, that trip to Tijuana and you bought the street tacos. Then, it settles and goes away. Gurgle. Rumble. Quiet in the valley. This is the precursor.

The nature of its full arrival is like you are standing atop a beautiful mountain range appreciating the beauty of nature and than a distant earthquake starts rumbling off on the horizon on another range. It then reverberates closer, now moving across your belly down to your lower backside. It rests for a bit. Then it gains power again and re-energizes. You resist, not knowing whether to clamp up or let it loose. After all of that, you emit a small, slow and less-than-impressive extended toot. A sigh of relief.

Then, a second wave comes and then the next toot includes a bit of soft liquid. Not a lot, but enough to warrant a change. You then realize….”Never trust a fart.”

When I it was time to go home (just four days ago),, I decided to up my insurance policy by wearing a pull-up brief even though it sounds like most people don’t do this.

What I knew was that people recommended wearing a continence shield up front because you do get some leakage around the catheter. But, I hadn’t heard a lot about the digestive system process. The car ride home went without incident in that regard, so yea for that.

But, I think my pull-up brief was a good call for me. It’s the nights that are tricky. You wake up with the rumbling. A low thunder. Is it a fart? Do I need to get up and get to the toilet? Trick question! You eventually find out....It’s probably both!

It’s getting better. I’m passing small, super-soft stools now. I now know when to get up and go. It gets old. But, hey, this shall pass and it’s getting better every day. Also, I’m early in this process and they say it takes at least a week to get close to normal on bowel function again.

For me, I was glad to have a brief (or shield) protection up front around the penis just from a hint of blood here and there early on (which is normal-sigh), nothing dramatic. Also, since my docs have me put on Bacitracin four times a day around the tip of penis and just up the catheter tube a bit, a shield up front helps keep that from staining underwear or shorts.

So, short version:

• Don’t trust a fart. If you are up to getting to a toilet, give it a go. If you can’t, it’s nice to have a brief to catch the initial watery mix. Having a protective pad on your sleeping spot is good insurance – though we haven’t had to change it yet.

• Candidly, a brief with tabs (diaper) would have made more sense for me during this phase because getting the catheter bag through the brief leg hole to pull it up over your hips is an annoyance I could do without. Also, getting a brief off with a catheter on is tricky too. Supposedly, you just tear the sides. But, instead, I keep a pair of scissors by the toilet and that works great.

• Take your stool softener. Remember, constipation is the enemy during the post-surgery recovery process. Let those urethral stitches heal and don’t put pressure on all the work they did inside.

• Follow your doctor’s suggestions. If you haven’t pooped, do the meds they suggest to get your system rolling. (in my case, two-ish days post surgery, a capful of MiraLax mixed with water taken earlier in the day did the trick).

Finally, I am so appreciative of my amazing wife, who has been such a strong support through this process. Early on, she told me to stop saying sorry and just is just there to help me through. Incredibly grateful.

That’s all I got so far. And again, I’m likely not the norm. But, this has been my experience on this segment. I’m too early on in this process to have more advice. What say the rest of you??

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Hey everyone-my catheter comes out Wednesday morning-so excited about that. I'm not freaking out about the actual quick inflate and whoop removal (suspect it will feel weird), but since we're talking about tender skin care.....since I'm gonna be incontinent after thatt, planning on bringing pull-ups and pads to insert in the front to swap out.

Question: Do you use an occasional wipe to clean around your penis for the urine smell
and....do you use anything to dry yourself.

Obviously, I have no clue

REPLY
Profile picture for fritzo @fritzo

Hey everyone-my catheter comes out Wednesday morning-so excited about that. I'm not freaking out about the actual quick inflate and whoop removal (suspect it will feel weird), but since we're talking about tender skin care.....since I'm gonna be incontinent after thatt, planning on bringing pull-ups and pads to insert in the front to swap out.

Question: Do you use an occasional wipe to clean around your penis for the urine smell
and....do you use anything to dry yourself.

Obviously, I have no clue

Jump to this post

@fritzo - my catheter remove was nothing at all, no real sensation one way or another. I didn’t feel a thing. If I’d had my eyes closed, I wouldn’t even had known anything was happening, it was that simple and that quick.

First, the nurse used a little syringe thingy to extract some sort of balloon that was in there. Pardon me for not getting more technical than that, but I don’t know how a Foley catheter works and I don’t need to know. All I do know is, she said, “I’m gonna get that balloon out of you now,” and before I could even look down, it was out.

Then she clamped the tube off a few inches past the end of my penis and snipped the tube just past that to disconnect me from the bag. After that, she used a large syringe to load my bladder with water.

She explained that she was going to then extract the bit of tubing still inside me by simply pulling it out, while I stood by with a little handheld urinal to catch the water-urine mixture that would rush out… “1…2…3…”, and the tubing slipped out in less than a second, no pain, no tickling, no anything, and then the fluid came pouring out.

She looked at the urinal, confirmed that more came out than she put in and pronounced me good to go, so to speak.

That was it for the catheter. I was expecting much worse.

I’ll post about briefs and guards and wipes and all that in a separate post.

REPLY

@fritzo - with the briefs and guards…definitely take a pull-up brief and a few guards with you, and some fragrance-free baby wipes, and some little trash bags. Either little office trash can liners work, or those plastic grocery store bags, if those are still available in your area.

My care team had a little package put together for me, and she went over how to wear them and all that. While the fine makers at Depends don’t recommend it, the nurse suggested I wear a guard inside the pull-up brief. The guard is heavier than a thin shield, so make sure you buy the guards.

Wearing them that way, you can just swap the much less expensive guard every time you soak it, instead of the more expensive brief, and if you’re like I was, that first day, you’re going to pee and pee and pee some more, so you’ll be changing out a lot.

Also, the brief can act as a safety net of sorts to catch any overspill, until you get used to how your body is working. The only downside is the guard inside the brief makes the whole thing bulkier. I’ll say, though, I’ve yet to have a single leak get through to my pants, and I’ve had some whopper bladder emptyings.

Normal procedure for me was/is, step into the men’s room, either the single-use family restroom or just in a stall, then drop your pants, sit down, pull out the soaked pad, into the little trash bag, in with a dry pad, wipe yourself down, tie everything up in the little trash bag, toss it, and you’re done. After the first couple, you’ll get that whole routine down to 60 seconds, and that’s another benefit of the guard inside the brief…you don’t have to remove your shoes and trousers to change out a guard like you have to do with a brief.

Do the wipes help with cleanliness? They help, but they’re not 100%. You’ll still get a whiff of yourself when you’re changing out, if when you’re home and just wearing shorts and one of the leg openings lets a little air out, but it helps.

At first, at home, I was showering three and four times a day, because I just felt…icky. A washcloth at the sink would help, but without soap, it wasn’t much better than a wipe, and with soap, it can be hard to rinse completely, so for me, wipes were/are the best all-around solution. And yes, keep yourself as dry as possible, as moisture in a cooped-up area like that just breeds irritation with the skin.

At home, I just use a hand towel to dry off after a wipe or wet washcloth, and out and about, I just grab a few paper towels on the way into the stall.

I don’t know if your experience will be the same, but for me, I peed constantly the first few weeks. I was going through literally 15 pads a day. I was also hydrating a lot, which they recommend to help the bladder heal and the bowels to get working again, so that didn’t help things.

As my nurse told me, “You’re going to be more frustrated than you have ever been in your life, but trust me, it’ll get better. Do your kegels. Don’t skip them and you’ll get there. It’ll take several weeks before you see any improvement, but trust me, it’ll happen. You just have to stay with it no matter how frustrated you feel.”

And she was right, so hang in there. For me, the first two months after my catheter came out were the worst, and I’m terminally cheerful. You just have to stick with it and know that it will get better.

REPLY

@fritzo - one last remark regarding products.

I shop at Kroger (Ralph’s, Fry’s, etc), and they carry Depends and then their shop brand. I’ve found I prefer the Kroger brand hands-down for both guards and pull-up briefs. They hold more and they’re more durable, and they’re considerably cheaper.

The only advantage with the Depends briefs I’ve found is when I want to wear a brief with no guard, the Depends have a slimmer fit, they fit more like tighty-whities, whereas the Kroger brand are just bulkier and a little less comfortable, guard or no guard…but they perform better.

I keep a mix and wear the Kroger ones more around the house, and the Depends ones when I’m going out on short trips (like to Kroger to get more briefs!).

One last thing…you’ll want some kind of little tote bag to cart your supplies around - a few briefs, several guards, a pack of wipes, and several trash bags. Whenever I get to a store or restaurant, I just grab one of whatever I need (usually a guard, a wipe, and a trash bag), cram it in my pockets, and my first stop is the bathroom for a quick change. Once you get into a routine, it won’t even seem that inconvenient.

Good luck!

If you go with Depends, both Sam’s Club and Amazon have better pricing than buying them locally.

REPLY
Profile picture for TurtBean @turtbean

@fritzo - my catheter remove was nothing at all, no real sensation one way or another. I didn’t feel a thing. If I’d had my eyes closed, I wouldn’t even had known anything was happening, it was that simple and that quick.

First, the nurse used a little syringe thingy to extract some sort of balloon that was in there. Pardon me for not getting more technical than that, but I don’t know how a Foley catheter works and I don’t need to know. All I do know is, she said, “I’m gonna get that balloon out of you now,” and before I could even look down, it was out.

Then she clamped the tube off a few inches past the end of my penis and snipped the tube just past that to disconnect me from the bag. After that, she used a large syringe to load my bladder with water.

She explained that she was going to then extract the bit of tubing still inside me by simply pulling it out, while I stood by with a little handheld urinal to catch the water-urine mixture that would rush out… “1…2…3…”, and the tubing slipped out in less than a second, no pain, no tickling, no anything, and then the fluid came pouring out.

She looked at the urinal, confirmed that more came out than she put in and pronounced me good to go, so to speak.

That was it for the catheter. I was expecting much worse.

I’ll post about briefs and guards and wipes and all that in a separate post.

Jump to this post

@turtbean Ok-that account that really helps! I was really wondering what the "test" part of it all was. I saw hints of them injecting dyes and stuff....that sounded a bit freaky-but whatever it takes.

My wife is driving me up there Wednesday early and we'll likely just get there shortly before. Wonder if I should drink liquids in the car so I have something to offer??

Love that this feels so non-dramatic!

REPLY
Profile picture for TurtBean @turtbean

@fritzo - with the briefs and guards…definitely take a pull-up brief and a few guards with you, and some fragrance-free baby wipes, and some little trash bags. Either little office trash can liners work, or those plastic grocery store bags, if those are still available in your area.

My care team had a little package put together for me, and she went over how to wear them and all that. While the fine makers at Depends don’t recommend it, the nurse suggested I wear a guard inside the pull-up brief. The guard is heavier than a thin shield, so make sure you buy the guards.

Wearing them that way, you can just swap the much less expensive guard every time you soak it, instead of the more expensive brief, and if you’re like I was, that first day, you’re going to pee and pee and pee some more, so you’ll be changing out a lot.

Also, the brief can act as a safety net of sorts to catch any overspill, until you get used to how your body is working. The only downside is the guard inside the brief makes the whole thing bulkier. I’ll say, though, I’ve yet to have a single leak get through to my pants, and I’ve had some whopper bladder emptyings.

Normal procedure for me was/is, step into the men’s room, either the single-use family restroom or just in a stall, then drop your pants, sit down, pull out the soaked pad, into the little trash bag, in with a dry pad, wipe yourself down, tie everything up in the little trash bag, toss it, and you’re done. After the first couple, you’ll get that whole routine down to 60 seconds, and that’s another benefit of the guard inside the brief…you don’t have to remove your shoes and trousers to change out a guard like you have to do with a brief.

Do the wipes help with cleanliness? They help, but they’re not 100%. You’ll still get a whiff of yourself when you’re changing out, if when you’re home and just wearing shorts and one of the leg openings lets a little air out, but it helps.

At first, at home, I was showering three and four times a day, because I just felt…icky. A washcloth at the sink would help, but without soap, it wasn’t much better than a wipe, and with soap, it can be hard to rinse completely, so for me, wipes were/are the best all-around solution. And yes, keep yourself as dry as possible, as moisture in a cooped-up area like that just breeds irritation with the skin.

At home, I just use a hand towel to dry off after a wipe or wet washcloth, and out and about, I just grab a few paper towels on the way into the stall.

I don’t know if your experience will be the same, but for me, I peed constantly the first few weeks. I was going through literally 15 pads a day. I was also hydrating a lot, which they recommend to help the bladder heal and the bowels to get working again, so that didn’t help things.

As my nurse told me, “You’re going to be more frustrated than you have ever been in your life, but trust me, it’ll get better. Do your kegels. Don’t skip them and you’ll get there. It’ll take several weeks before you see any improvement, but trust me, it’ll happen. You just have to stay with it no matter how frustrated you feel.”

And she was right, so hang in there. For me, the first two months after my catheter came out were the worst, and I’m terminally cheerful. You just have to stick with it and know that it will get better.

Jump to this post

@turtbean Oh my goodness, this is the reality check I needed. Holy moly-this sounds like a worse process than dealing with the catheter.

• 15 pads a day....guess I better order more

I saw once someone said getting your catheter out will be the lowest point....and now it makes sense. At least I know what I'm headed into. Thanks SO MUCH for all of this tips.

• I wonder if little doggie poop bags would work??? All I've got right now are your standard big grocery store bags.

• Yeah, I was wondering about the ick factor and how do you possible ever get dry.

REPLY
Profile picture for TurtBean @turtbean

@fritzo - one last remark regarding products.

I shop at Kroger (Ralph’s, Fry’s, etc), and they carry Depends and then their shop brand. I’ve found I prefer the Kroger brand hands-down for both guards and pull-up briefs. They hold more and they’re more durable, and they’re considerably cheaper.

The only advantage with the Depends briefs I’ve found is when I want to wear a brief with no guard, the Depends have a slimmer fit, they fit more like tighty-whities, whereas the Kroger brand are just bulkier and a little less comfortable, guard or no guard…but they perform better.

I keep a mix and wear the Kroger ones more around the house, and the Depends ones when I’m going out on short trips (like to Kroger to get more briefs!).

One last thing…you’ll want some kind of little tote bag to cart your supplies around - a few briefs, several guards, a pack of wipes, and several trash bags. Whenever I get to a store or restaurant, I just grab one of whatever I need (usually a guard, a wipe, and a trash bag), cram it in my pockets, and my first stop is the bathroom for a quick change. Once you get into a routine, it won’t even seem that inconvenient.

Good luck!

If you go with Depends, both Sam’s Club and Amazon have better pricing than buying them locally.

Jump to this post

@turtbean I started putting together a backpack to keep in the car for going out. But, once out, guess I'll need pants with some big-ass pockets. Suppose I could put a wipe into a small plastic baggie.

I guess the good news as I won't be tethered by a leg bag leash and a bucket as I walk the house. That got pretty old.

REPLY

Just wanted to agree with team bidet! During the pandemic toilet paper shortage, we added bidets to our toilets and were instantly sold. You can get the add-on bidets for well under $100. They are easy to install. Try one. Once you get past the surprise of the water shooting up at your butt, you realize you have never been as clean getting up from the toilet.

REPLY

I also want to back up the guys that say use all the tools offered to keep stools soft and easy to move. I can’t remember if I followed all this to the letter, but I do remember the first few times I was on the toilet, it was painful. I wish I had been a lot looser…

REPLY
Profile picture for guyrm @guyrm

Just wanted to agree with team bidet! During the pandemic toilet paper shortage, we added bidets to our toilets and were instantly sold. You can get the add-on bidets for well under $100. They are easy to install. Try one. Once you get past the surprise of the water shooting up at your butt, you realize you have never been as clean getting up from the toilet.

Jump to this post

@guyrm I guess you could think of it like a waterpark....ummm, just different. 🙂

REPLY
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