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Newly diagnosed Invasive..Need Support

9 years 4 months ago #32587 by mmc
Yep, that counts as bowel prep Andy.
:blink:

I got drink two bottles of magnesium citrate and the a fleets for my RC.

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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9 years 4 months ago #32586 by Andy
My input -

I had the RC and neo at University of Michigan - Dr. Khaled Hafez. My only bowel prep was liquid diet for 24 hours prior to surgery and a Fleet Enema the night before. No NG tube for me, at least not when I woke up after surgery. I was in for 5 days.

Mike - Glad your surgery went well!

Andy

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9 years 4 months ago #32585 by Patricia
Here the Italians experimented with no bowel prep and no NG tube
http://www.so-online.net/article/S0960-7404(07)00099-0/abstract
This from Pruti in Chapel Hill..also removes NG tube
http://www.mdconsult.com/das/citation/body/205866908-2/jorg=journal&source=&sp=22786629&sid=0/N/22786629/1.html?issn=1072-7515&issue_id=24304
At any rate though its up to the particular institution or doctor to decide whether NG stays in or out..as for bowel prep...i can find that different institutions do it differently..some do 4 days prior liquid diet plus that alful Go Lytely..HA.....mine was different just the day before the Go Lytely.....but i can't find anyone in the states thats skipping the prep. Let me know if you find someone?
We Italians will try anything!!..Did you already guess i was Italian? :woohoo: And heaven forbid the other half Irish ;)
pat

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9 years 4 months ago #32584 by mmc
Here's one link: http://www.urologyrounds.com/files/PDF/jan-27-10.pdf

I know I read it about three or four different places before I went in for my bowel repair. However, I can't find any of the articles that I read. The link above is a presentation. When I went in for that repair, I didn't have bowel prep. I did have bowel prep prior to my neo. If Pat says the jury is still out then I believe her. I don't do as much research and I trust her her research.

I did have NG tube at the NCI hospital after the RC and I had it again at a non-NCI hospital after my bowel repair.

In both cases, they turned off vaccuum to see if things would work. When they didn't the vaccuum would get turned back on. For my RC, the NG tube was removed too soon and had to be put back in two different times. First, they got it down my lung and needed to pull back to get it into my stomach. Then, after having delusions from phergan a few days later, I ripped out all my tubes, including the NG tube. That time it went back in easier but it is still not fun.

I don't really care about what articles may say for the NG tube issue. If people don't mind having a tube shoved up their nose and having to swallow and swallow and swallow to try to get into their stomach, then more power to them. If I EVER wake up with an NG tube still in, I'm not getting it out until I am DAMN SURE it doesn't need to go back in again. On this, I speak only for myself. As always, everyone should discuss the details with their doctors and do their own research.

Arthur: Always ask the doctor yourself. My experiences are my own and your mileage may vary.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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9 years 4 months ago #32583 by Patricia
Jury still out on no bowel prep before surgery. The studies that have been done..in Ireland??...show a propensity for post op ileus with ones that do not have bowel prep...plus the study was only with those who were getting an ileal conduit.
The NG tube is not used at all after surgery in some NCL designated centers.....Indiana U. does not use them.
Please use links when you give medical advise.
Pat

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9 years 4 months ago #32579 by mmc
Arthur,

Did you ever get the results back from the re-TURBT that your new doctor did? You mentioned a few weeks back or so that you were waiting and that you were starting the chemo.

Had it spread to urethra? Is it confirmed T2? Since they wanted to do chemo it must have been T2 for a while.

A while back I gave you some things to ask and things to do in preparation for the surgery. I can certainly understand with everything going on if you haven't had the chance to do the kegel exercises. If not, you may want to start now. It's what will strengthen your pelvic floor muscles and that is what is needed to get continence more quickly after the surgery.

Since your other update was kind of in the middle of someone else's thread, I came back here to your thread. Feel free to open a new one as well whenever you move into a new chapter of this book called Life with Bladder Cancer. Of course after the surgery, it will be a whole new book called Life after Bladder Cancer! :)

One of the keys to getting out of the hospital sooner (and being ready to get out) is that your intestines have to wake back up. I mentioned this previously but now that you are getting close to the surgery date, you may want to follow up with your surgeon.

Here are some questions:
1. Do I have to do bowel prep prior to the surgery?
If no, then good. If he says yes, then ask why since studies have shown reduced post op ileus complications when not doing bowel prep. The prep involves mag nitrate and pooping your insides out prior to the surgery. Try to get out of this!

2. Can this be done with an epidural to reduce post op ileus chances? Depending on your situation, he may have good reason not to. People who have epidural seem to have quicker recovery so it is worth checking into.

3. Are you going to put in a suprapubic tube?
Not all do. Mine didn't but it sure sounds like it was a good thing for people who did get it. He can explain what it is if you don't know or you can google it.

After the surgery, as soon as possible, walk. You want to walk starting the next day at the latest. Morning, noon, and evening. You will not want to. Get someone to make you. If you wait until you feel like walking you will be inviting problems and it will interfere with your recovery. Even if you start off just walking in place or in the room. Have someone with you in case you aren't steady on your feet but they can get a nurse to walk with you if someone is not around at all the times you need to walk.

If all goes just wonderfully, you can expect to get out of the hospital anywhere from 5-8 days. If you get a post-op ileus that lasts a long time, it can take longer. I was in for 12 days. I can tell you the ileus issues can be really bad so that's why I give so much info about trying to avoid them.

Also, same day as surgery, chew gum. You will have a nasal gastric (NG) tube in. The chewing helps trigger responses in the body that have been shown to help wake the intestines.
Regarding the NG tube, even though it's a nuisance, DO NOT get it removed until you are ready. You DO NOT want them putting that sucker back in while you are awake!!! Just trust me on that one. You are ready when your intestines are working and you are able to take liquids without throwing up. They usually wait until you have bowel sounds before letting you have liquid.

I hope all goes well with your surgery and you are out of the hospital and on the road to recovery in a very short amount of time.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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