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After getting a K-Pouch one year ago and finding this forum, I have been impressed with all the praises being sung about the virtues of a K-Pouch.  Except for a few short weeks where my intubations have gone well, I have had one problem after another, and am considering getting a reversal.  If anyone knows of someone who has had a reversal, I would appreciate hearing about it and what their experiences and complications were.  Thanks for any and all responses.

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What sort of problems do you have? I suggest looking up Sharon’s posts as she has had every problem and, further, she explains the resolutions with excellent clarity. Another approach is to search the site for your problem.

Who did your K? Have you spoken with them? Sometimes the nurses are more helpful than the doctor.

I had a variety of problems during the first year with the K. Some were just getting used to it and others were legit problems, which this site helped me resolve.  After five years I wouldn’t say I have problems, but rather quirks that have to be treated differently on certain days or because of certain foods.

Sorry that you have problems. And I didn’t even answer your question. Jan

Thank you "jan15" for your quick response!  I will try to answer all your questions because I would really appreciate any advice!  Right after surgery I started with skin irritation and excessive moisture (possibly this was due to two hernias that came after surgery, one to the left side of the stoma and the other right above my navel).  Intubation was difficult because the "channel" from the stoma to the valve at the pouch was too long and crooked.  About 6 months after surgery I started getting leaks, intermittently at first then more regularly.  After a pouchoscopy in October my surgeon suggested that repairing the hernias might be a fix, which was done in November, along with a shifting of the pouch and shortening of the "channel."  For the first four weeks I thought we found a cure; the catheter went straight in easily and the leaking and excessive moisture stopped.  However, as the swelling went down it appeared that the peristomal hernia was not repaired.  I sent a message to my surgeon last week telling her that the problem is getting more and more unbearable and so far she has not responded.  Starting today I am trying to attach an outside pouch to see if that will at least give some protection from soiling my clothes.  My surgeon is Dr. Jean Ashburn at Wake Forest Baptist Hospital in North Carolina.  She is highly reputed and I have absolutely no complaints about the pouch or her technical ability.  It is the post-surgery complications she seems to not be able to correct.  As you said, her nurse is very helpful , but so far, even she has not responded.  If using the outside pouch is something I can live with, I am considering just having the whole thing reversed.  By the way, you mentioned Sharon's posts.  I have seem some of her postings, but obviously not the ones that describe her issues.  Do you know it there is a way to search by her name, so that I can see all she has written?  Or, how to to search the site for my problem?  Although this seems to be a great site, my "navigational" abilities are sorely lacking!  I hope I can get a resolution that will not involve more major surgery (I am getting too old for it!!)  Thank you again for opening this line of communication, Jan.  Bill

there Should be a Search function on the  left side of the  Screen. If you go to the top of the page you will see three  lines. select the three lines and there is a pull down menu. The Search function is  the third down. I don't know if that will yeild the  information you are looking for but I think that is what you are asking about. The best of luck to You.

Thanks for search suggestions.  However, I do not have the 3 lines and I don't see a search option on any of the top pages.  I did find two "Search" links, though.  One was for all 14,000 members and not in an order by which I could search for "Sharon."  I found another search that was down a level or two, and that let me search by name.  Only one "Sharon" was there who was not the Sharon who I was looking for.  A lot had added initials and last names, but none of those seemed to be a recent (last 5 or 6 years) participant, or K-Pouch folks.  So, the search for "Sharon" goes on . . .

Hi Bill,

I just read your post and I am so sorry that you are not doing well with your k pouch and intubation.

There are a lot of possible reasons why things are not going well...probably more than one.

Firstly, why did you need a K pouch? Why not a J pouch? What led up to it?

Next, are you hernia-prone? Do you get them often?

Thirdly, when you leak, are you sitting, standing, laying down or squatting down?

Leaks happen for a lot of reasons:

1. Your pouch has partially or completely slipped off of the wall or is hanging sideways...What that does is pull on the valve, stretching it and popping it open...the fuller your pouch, the heavier it gets and the more it tugs on the valve...the way to manage it is to empty more often to avoid it getting to heavy...until you can get it fixed.

The hanging pouch can also cause the valve/canal to twist making it difficult to find the trajectory...or make it feel like you are hitting a 'wall' when you intubate...you need to gently twist the tube as you push it in to follow the new direction or use a smaller or more flexible tube.

A peristomal hernia or a hernia in the muscle around your stoma weakens the hold that the muscle has on your valve...leaving it weak and possibly incontinent.

The fix is obviously to fix the hernia but if your tissue is weak or fragile you may need a mesh repair...I had 6-8 hernais over a period of a few years...they came on suddenly...I had never had one before the age 47 and then suddenly they wouldn't stop...in the end, after a lot of pouch surgery, valve fixes and moving the pouch, I found a very sympathetic and incredibly cooperative surgery who specialized in laparoscopic surgery...he went in a few times and did mesh repairs...they saved me and my pouch.

One of the tests for continence is to lay in a full tub...if there are bubbles coming out of your stoma, you are not continent...Try turning sideways to see if there is a specific position where you lose continence.

As for tests to see what is going on inside of you...the best that I have found is an opacification...dripping 'Opac' into the pouch and taking Xrays...my radiologist (a friend of the very kind laparoscopic surgeon) was kind enough to listen to me...

I told him that I was only incontinent at certain times...so we started by 'dripping' the contrast solution into the valve and taking a few shots then filling the pouch and taking more with me on my back, then on each side, sitting up, standing up and then the same thing with the pouch half empty and totally empty...it gave us a real idea of what was going on in there...I do not live on my back or intubate while laying flat so why take the picture with me on my back...that was how we figured things out.

I do not have all of the solutions but I did have a lot of the problems...and was darn lucky to find good doctors who were willing to go the mile with me.

You need a good radiologist and surgeon who listens and calls you back if possible.

Sharon...

p.s...do not hesitate to PM me if you need to

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