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  • 12-hour Operation for Neobladder

    Posted by bookwriter on July 24, 2008 at 10:56 am

    Will’s (sailorman) operation for taking out the bladder and building a neobladder took 12 hours. It’s the largest operation that it’s possible to do on a human body, effecting the most organs. The entire torso is involved. Think of a heart operation – it’s only one or two parts – a knee operation – complex, yes, but again, one or two parts. Doing the RC with neobladder effects the prostate, bladder, intestines, lungs, heart and blood flow. They are all interconnected as the doctors are working and they all play a role. The anesthesiologist told me this after. He didn’t last the whole operation, he had to be relieved.

    The doctor said it was going to take 7 hours, but I never believed him. The more variables you have, the more room for change. The reasons for the extra time were several: he’s overweight, he’s muscular, his pelvis is deep, there were adhesions (scars) on his intestines from years of undiagnosed gastroenteritis, he needed a blood transfusion, he didn’t respond well to the robot they used (and I guess the robot didn’t like him), etc.

    When they do this operation, your feet are in the air and your head is down. Because they had him up-ended for a long period of time, the IV fluids settled around his head and neck, so they had to leave the breathing tube in even after he came out of anesthesia for a long time. They kept him heavily sedated during this. The tube in your throat is so uncomfortable you can’t stand it unless you are heavily sedated (or out).

    The upshot of all this is that it went well. It’s hard, complicated work, but he’s OK and he already managed to use his blackberry (one of the nurses called it a crack-berry) from the ICU to send out email.

    I’m posting this here, on a thread, because Will said no one reads the blogs. I wanted all of you considering this surgery to have a heads-up on what it can be like. That’s it for now –

    MrTaste replied 16 years, 6 months ago 11 Members · 15 Replies
  • 15 Replies
  • MrTaste's avatar

    MrTaste

    Member
    July 31, 2008 at 11:16 pm

    well call me mister lucky… my rc/w neobladder lasted about six and a half hours… i was a couple of days in icu, more because my doc just felt he could keep a better eye on me in there… when i came home from the hospital i had about four tubes in me as well, but in about five weeks they were all out… i had a quadruple bypass operation two months before my rc, and i have to say, it was a walk in the park by comparison, but i’m healing well about three or four months post op, and i’m glad to hear you’re doing well… walk + walk + walk… = healing.. be well… m

  • 's avatar

    Guest
    July 31, 2008 at 3:01 am

    Glad your doin well,,see you on chat next Tuesday at 8pm….chatGene

  • sailorman's avatar

    sailorman

    Member
    July 31, 2008 at 1:06 am

    Got home this evening. Actually, it is amazing in a way, my surgeon had told me a week to 10 days and that was when he was assuming 7 hr operation with little or no Intesive Care. The operation was so long followed by a couple of days in Intensive care and he told me again that I could have gone home last night in his opinion (we wanted to be a little more healed).
    He again told me that I am coming along very quickly.

    So right now, I have four tubes. Lower site is a foley catheter (fun fun fun) and the upper site has a collection of 2 ureter stents and a tube to the neobladder. They are draining through an ostomy pouch into a larger tube. So, externally, its two tubes.
    One problem with the upper site is that it was positioned for access to the neo and ureters, NOT for optimal ostomy positioning. Therefore, keeping the wafer going is a bit of an issue and over the past few days had a lot of changes, even by the ostomy nurse. Thankfully, that is only for a few days as the doctor is planning to remove the stents next week, leaving only the tube to the neobladder. That will take away the need for the ostomy connection and just connect to the foley’s tube and only one bag.

    Actually I have not had much site pain, just the gas and pressure pains. One strange one was that I am a CPAP (air mask) user when sleeping and was told to bring it to the hosp. We tried it about four days after the operation once the nasogastric tube came out and I had it on for about three hours before the pressure it added to my system (through the stomach) had me in a lot of pain. Off it came and stayed that way for the rest of my time in the hosp. Not sure whether or not to try it again tonight or just wait a couple more nights.

  • 's avatar

    Guest
    July 29, 2008 at 6:39 pm

    Will,
    Good goin, glad your on the other side to recovery. Take it easy, have any issues we can help with we are here for ya…Ginger

  • sailorman's avatar

    sailorman

    Member
    July 29, 2008 at 6:20 pm

    Thanks everyone for the good thoughts, words and prayers.
    Things are moving along (at times, the most painfully have been the gases through my healing intestines.

    IV disconected. Down to two major tubes.

  • thewifeagain's avatar

    thewifeagain

    Member
    July 27, 2008 at 12:50 pm

    WOW! 13 hours. The human body really is amazing. I hope Will has an uneventful and fast recovery and puts that BlackBerry to good use soon.

    I would like to add that all hospitals, big or small, have Social Services department and they will always arrange a “discharge plan” which will include home visits from VNA (Visiting Nurses) for wound care, stoma care–whatever the patients needs are. Unfortunately social workers are another profession where they are over worked and have huge case loads. It is important to ask to speak with one early on so that when it comes close to discharge time there is already a plan in place.

    As far as the private room I urge everyone to ask for one. Often we have been given one without asking. Recovering can be so much easier without a roomate.

    Sending my hope for a fast and speedy recovery!


    Age 53 Currently
    Bladder Cancer Diagnosis October 2006 T1G3
    2011 Finally made it 6 month between Cystos
    8/22/2011 Cysto in the OR
    (BCG and BCG Maintenance over the years)
    Graduated to yearly Cystos
    Tumor found at first one year Cysto – TURBT 4/26/2013
    Kidney pain – CT scan 5/1/2013
  • Bookwriter's avatar

    Bookwriter

    Member
    July 26, 2008 at 1:11 pm

    Well, I was wrong, I found out yesterday, it was 13 hours. The doctor said it was 11, but that was only the part that he was working on. The anatheseologist didn’t know because he was relieved towards the end. It was the nurses who eventually got the gossip on the entire length – 13 hours.

    Will’s in a private room now, reserved for dignitaries (like doctors and nurses, when they have surgery), a corner single with big windows and lots of chairs. Every nursing shift that comes on has to have training on how to deal with his tubes because this is so complex. So there’s been crowds in there, many of them women, surrounding the bed, looking at his private parts. Fortunately he’s on morphine.

    Even though he has his blackberry, he can’t keep concentration very long because of the morphine. So he’s still pretty much out of contact (no phones allowed). He’ll be better when he can get in contact with the world again and tell them what’s happening.

    Oh, and they automatically gave us a visiting nurse service to come in once a day after he goes home. This is the benefit of using a small, local hospital where the doctor knows everyone and has a lot of pull. I thought I was going to have to fight for that, but they already arranged it.

    I’m going to copy both these BB postings onto the blog, in case others are looking there to see what people experience.

  • webs's avatar

    webs

    Member
    July 25, 2008 at 3:42 am

    My operation was 12 hours and I am 5’5″. they said my insides were very compact. I also had my wound open and it finished closing a week ago. My RC was 5/22/08. Jeff I can only say wow I would have been going crazy if it was still open. You are a trooper.

    Webs

  • jeff-f's avatar

    jeff-f

    Member
    July 24, 2008 at 11:02 pm

    My R/C was 11 hours, and I had the ileal conduit performed. I did have 2 pints of blood during surgery, and 2 more during hospitalization. I was told the length of the op was due to my size, 6’3″, 240. They said there was a lot of slicing and dicing and size affects that. I had the breathing tube until late the next day. Was really happy to spit that out! I was in the hospital 14 days. This was due to my wound dehissing. I am 3 months post op and still dealing with a couple of open wounds. They had to debride one today to reopen it since it was going to close. They can’t let them close until they are healed down below. Otherwise, I am doing pretty good. I was the same weight when I got home, but lost 20 pounds my first week at home…I have put 10 pounds back on. I would classify it as the mother of all operations.:)


    BC diagnosed 01/2007
    Cystoscopes and Miomyacin in 2007
    R/C ilial conduit 04/27/2008
  • geo's avatar

    geo

    Member
    July 24, 2008 at 10:41 pm

    Will,
    I wish you well and a speedy recovery. In a couple of days you will be up dancing!!!!
    Good Luck,
    George

  • 's avatar

    Guest
    July 24, 2008 at 9:18 pm

    As you said in your pm to me he is doing just great. 12 hours is a long time,after 8 hours it just gets a little worrisome, doesn’t it. Recovery is in site, and as I have said before, take it slow and easy,,don’t be surprised he if he looses some weight, walking and rsting is n the menu right now. Take care , Ginger

  • julie's avatar

    julie

    Member
    July 24, 2008 at 9:07 pm

    Thanks for posting about Will’s surgery. Believe it or not I was reading the blogs yesterday and the last one I read was where the Dr. had just phoned you. I’m impressed he was able to use his Blackberry so soon. Sounds like he was in good shape going into surgery. I hope he continues to do well with his healing. Julie


    Volunteer Coordinator
    ABLSC
  • 's avatar

    Guest
    July 24, 2008 at 6:27 pm

    Thank you for posting..i’m glad Will is on the Blackberry already..i couldn’t even find my nurses button!
    The surgery has many variables ..I know of a neobladder done in 3 hrs..and up to the l2hrs. My Indiana which is a little more complicated than the neo believe it or not took 4 hrs 20mins.
    I’m continually amazed at how this surgery is never the same for any two people.
    Continued recovery for Will…Pat

  • cynthia's avatar

    cynthia

    Administrator
    July 24, 2008 at 3:26 pm

    Interesting side bar the blogs get the most hits of anything on the site from what the stats in my back room tell me. We just need to get them stocked as the blog is only a mounth old and new to many users.

    Tell Will I said to get off the “crack berry” and walk, walk, walk………


    Cynthia Kinsella
    T2 g3 CIS 8/04
    Clinical Trial
    Chemotherapy & Radiation 10/04-12/04
    Chemotherapy 3/05-5/05
    BCG 9/05-1-06
    RC w/umbilical Indiana pouch 5/06
    Left Nephrectomy 1/09
    President American Bladder Cancer Society
  • momof4's avatar

    momof4

    Member
    July 24, 2008 at 3:05 pm

    Bookwriter,

    Wow…what an operation! I honestly had no idea…amazing…(and well written & explained by you I might add) I am glad that that part of the journey is over for you…

    Already using the blackberry! LOL “Crackberry”…what a trooper…

    Tell him I was asking for him….

    You are doing a wonderful job…he should feel safe in your hands….Hope to hear from both of you soon.

    Karen


    Caregiver for my Wonderful Husband Angelo, who has Metastatic Bladder Cancer.

    Life isn’t about how to survive the storm, but how to dance in the rain.

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