Sigmoid Colectomy 1 Week Post-Op Experiences and Lessons Learned

I am 8 days post-op from a Scheduled Laparoscopic Sigmoid Colectomy (not robotic laparoscopic). For perspective: 56yo male, runner/weight lifter, vitals and blood work good, non-smoker, no other contributing health issues, 10-12 Uncomplicated episodes in as many years usually with 10-14 day easy recoveries on antibiotics. My surgeon/hospital uses/participates in the Enhanced Recovery After Surgery (ERAS) program.

Here’s what I experienced and some lessons learned along the way in the hospital and the rest of week 1.

DAYS IN HOSPITAL: I spent 4 days/4 nights in the hospital. It would have been 3/3 but 1 day of nausea delayed advancing to soft food. Most estimates I see online say 3-5 day stays.

DAY OF SURGERY SCHEDULE: I had a 5am report time for a 7am surgery that took about 2.5 hours and I was in my room by mid-day. They had me walking by 4pm and I walked 4 times per day.

MEDS: I took 5mg oxycodone with 975mg acetaminophen(Tylenol) to start with. I think I went to 10mg oxy for a dose or 2. For days 3 and 4 in the hospital and ever since it has just been the acetaminophen. I did not want to be pain-free because if I over-medicated I wouldn’t know when I’m doing damage. I wanted to feel when my body was telling me to back-off and slow down. My goal was to be almost to completely pain free when I was sitting or lying comfortably. Light pain once up and out of bed/recliner was fine. It was always going to hurt getting in/out of bed and on/off toilet. If I medicated that pain away I’d have probably been doing all of that way too aggressively. They had me on a blood thinner for clots in the hospital (standard practice I think), a nausea medicine for a day, and a light stimulating laxative. I stopped nausea meds as soon as I could to make sure I was good without them before discharge.

NAUSEA/COUGHING/SNEEZING/CLEARING THROAT/BRACING PILLOW: I always had my bracing pillow within arms length. Initially I could not even clear my throat because I could tell it was going to hurt a lot, and then started needing to cough. I realized I hadn’t been taking my claritin or flonase and it was allergy drainage. So if you have allergy meds make sure to stay on them to stop drainage and coughing and bring some pseudoephederine 12-hour just in case. Thankfully I never threw up when I was nauseous. I can’t imagine what that would have felt like with the stomach spasms. So get some meds for it ASAP if you start feeling it coming on. If you feel a sneeze coming and you’d usually lightly sniff to encourage it and get it over with, don’t. Do whatever you can to avoid it. I found a lumbar seat cushion that wraps around the belly nicely as a bracing pillow. Plus it has straps on the back that I used to hang it on things, like my walker for walks in the hallway: https://www.amazon.com/dp/B0D54VPL17

PAIN and GETTING IN/OUT OF BED: The most challenging and painful part was getting in/out of bed or the recliner. I learned the recliner was way easier so I only moved to the bed at night to sleep on days 2-3 in the hospital, and by the last night I just slept in the recliner so it was easier to go to the bathroom when I woke up throughout the night. I was getting myself in/out of the recliner for days 3-4. I could get myself into bed on day 3 and probably could have gotten out of it but I wanted help to avoid damaging internal sutures and/or incision staples.

DRINK/CATHETER/URINATION: I had a catheter put in once I was under anesthesia that was removed the next AM. I was drinking ~160 oz. per day. I dialed back liquids once the catheter came out since I didn’t really need that much and didn’t want to have to get in/out of bed for useless bathroom trips. The blood in my urine from the catheter use and removal stopped on day 3. It is interesting that I am still have limited urination sensation. Once I stand up or get to the toilet I realize I have to go but I don’t get the sensation when resting unless it’s really full and then I get a dull ache. An AI search shows this is normal and is called Postoperative Urinary Retention (POUR). It’s supposed to go away. I just try every time I get up or every 2 hours to retrain my body.

FOOD/BM’s: 1 day on clear liquid, 2.5 days on full liquid, and soft food for my last Dinner and breakfast. For BM’s I had none on day 1, 3 each on days 2 and 3, and 1 on day 4. It was loose/diarrhea of course.

SEATING/BED AT HOME: Our adjustable bed is nice, but like at the hospital, I realized it is easier to get on/off our sectional than in/out of bed so I’m starting to be on the sectional until night time. I did buy/install a nylon strap-bed-ladder-assist to help pull myself up with 1 arm while pushing off the elevated bed-back with the other arm. It helps a bit, but it is just tough either way and pulling on something still requires you to brace your core as you go up. But it has gotten easier fairly quickly. Bottom line is that even adjustable beds, at the hospital and at home, seem like they’d be the best place, but not necessarily all of the time.

MISCELLANEOUS: Walkers and canes are cheap at thrift stores. Get 1 of each just to have around in case you need them for the first day or 2. At this point they’re on either side of the toilet and help me get on/off of that until I can pass them along to someone else who needs them. I ordered the bed liner pads like the hospital has on the beds just in case. I always have one on the bed. I haven’t needed it to “save” the bed yet but it’s just nice to have and know I can change it daily instead of washing the sheets daily. I already had one of the pincher-grabber arms and it’s been very handy to get stuff off of the floor. The add-on bidet I got for under $40 was the best investment. We had a small folding table that I set up next to the bed at the same height as the bed and it’s nice to have my drinks, meds, etc right there. I started putting salonpas pain pads (icy hot pads, essentially) on either side of my main incision over a couple spots that started hurting and it helps, especially to bridge the last and first hours of the 6-hour tylenol periods. I have a robe and I bought 2 full length button up night shirts and those are my go-to’s. They’re best left open so nothing is rubbing on the staples, but not bad when someone is around and you need to button it at least partially. The night shirts are better than the robe because the robe has to be cinched up against the body and tied off. I bought fennel tea and peppermint tea and never got them out at the hospital or since. I bought rash cream on a recommendation from a friend for any wiping rawness but the bidet makes that a non-issue. Same with adult wipes/flushable wipes. Protein is key for both prep for and recovery from surgery so I scramble 2 XL eggs with 4 tbsp of plain greek yogurt for a 31g start each day. Protein2o brand protein infused water is a relatively cheap and easily digested way to add 20 more grams at least twice per day ($1.80ea at Target). Rotisserie chicken is the easiest way to have lean non-red meat animal protein around and ready to snack/dine on for another 21g per 3 oz serving. With at least 2 of those per day that combo nets me over 110g per day plus whatever else I eat, and that’s a pretty good amount of protein. I read that Vitamin C and Zinc are also important in recovery and we always have “Emergen-C Immune+” packets around anyway so I do 1 of those in one of my daily waters. (make sure it is the “Immune+” version of Emergen-C). Sam’s has them in bulk. Lastly, pay attention to meds/food/doctors plans and anything else at the hospital in order to advocate for yourself and collaborate on rather than just receive treatment. Did they enter your BM's, foods eaten, urination, mobility, walking so your Docs know what's up all of the time? Did they update the Doc's menu directive so the kitchen knows to bring the right kind of meal next? Mine got a little tired of me asking questions but I caught a few things in the process that we corrected.