Reply to "everyone list best trick to enter full/tight pouch"

Surgery for a slipped valve was on Oct 3rd and went very, very well. The situation was, as Dr Kiran had confirmed with pouchostopy and CAT scan, that the two layers of the valve had slipped apart, disabling the continence of the valve, which is not uncommon with K-pouches after 15-20 years. I had a lot of adhesions as well and Dr Kiran also moved the opening in my abdomen up by about 1.5 inches to stronger abdominal tissue. Six days in the hospital including the day of admission and surgery.  Liquid diet for  a day, and soft food starting the second day, solid food the day after — Dr Kiran says this was possible because he makes a LOT of tiny stitches to seal the pouch immediately and also because The Princess was usually quick to recover activity. Beware hospital menus: don't eat any binding stuff like bananas or peanut butter or rice; these menus are tailored for other GI patients, not us, and you should drink as much liquid as possible so your output is thin and flows easily into the collection bag because the nurses aren't allowed to flush the tender post-surgical pouch as thoroughly as you normally would. Pain was not severe at any time; oxycodone for the first few days only when needed and gabapentin (which does not slow down gut motility) every 8 hours. A flexible catheter sticks out about four inches from my abdomen and stays in place continually for 3 weeks from date of surgery. (When Dr Fazio first built The Princess, I had to stay cathetered for 6 weeks in order to ensure that the valve would heal perfectly straight.) Home on Oct 9 wearing leg bag, toting night bag and supplies: I can shower but not bathe and every day I change the absorbent pad under the plastic faceplate that holds the catheter in place, all held down by an elastic belt, as you all probably recall from when you had your pouches built. Virtually impossible to put on even very loose pants with this tubing sticking straight out of me; one should prepare in advance for that.

The catheter and incision staples come out next Thursday Oct 25. Dr Kiran treats pouch and valve revisions just as cautiously as when he first builds a pouch, so there may be surgeons who would let you remove the catheter sooner and/or who might use fewer staples but I ain't complaining. His staff of ETs and NPs are great and Dr Kiran deserves every bit of the enormous trust I placed in him. 

To get back to the topic of this page: if you are having chronic problems with intubation and/or leakage, especially if you have had your pouch for a while and these intubation and/or leakage problems just started, I would suggest that you see your surgeon to find out whether there is a problem with the valve. Especially if the problem is progressively getting worse, a pouchoscopy and maybe a CAT scan might be in order. 

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