Below is a timeline of events leading up to and post J Pouch surgery. It's a long read. I picked up many things by reading others experience. I feel if I pen down my experience it may help someone. Here goes...
Early April 2017: Delivered a baby girl. It was a vaginal birth. My Obstetrician "felt" a mass in the rectal area and advised me to get a colonoscopy.
Mid-June 2017: Colonoscopy done. Biopsy results indicates a large cancerous growth in my rectum. It was Stage 1 Rectal cancer.
Late June 2017: After discussions and 2nd opinions, I underwent Laparoscopic Proctocolectomy (large intestine and rectum removed) and J Pouch with temporary ileostomy.
1st week post surgery: Acute pain. Lots of distension. I was on Oxycodene on PCA. Intravenous drips. Fasting. Midway through the week, I vomited several times. The NG tube was put on. Hell.
2nd week post surgery: I started to get green liquid (bile + gastric acid) in the stoma bag. Occasionally there would be gas. Encouraging signs that some bowel activity started to occur. I went from fasting to drinking liquids. NG tube was taken out. I still had pain and was given morphine injections.
3rd week post surgery: More progress. Bowel output went from greenish liquid to thick brownish liquid. I started to eat soft solids.
A day or two later: There was a sudden decrease bowel output. Acute pain. Gastrografin did not help ease the bowel. Back to fasting again. I was soon put on Total Parenteral Nutrition. The NG tube was back. The painful morphine injections continued
End of the 3rd week: Surgeon performed an ileoscopy and found a benign appearing stricture about 10cm promixal the stoma. The J Pouch was intact and compliant.
Midway through the 4th week: The stricture was still present. My surgeon did not want me to languish in pain. The stricture will need to be taken out by a surgery. We decided the J pouch reversal will also be performed in the same surgery. The J Pouch was scanned and tested for leaks (through gastrografin injected via anus) and it was in good condition. The surgery went well. About 12cms of small bowel (stricture) was removed . The J pouch was now connected.
Immediately Post-surgery: The pain was not as intense and relentless as the first surgery. There was bearable pain where the stoma was present. Surgeon said I might take few days more than normal to resume bowel movements. We thought, a week, at most.
5th week: Lots of distension, as expected. The entire bowel area was quite dilated.
End of 5th week: Things went south. Acute crampy pain. Its been a week since J Pouch reversal surgery and there has no small bowel activity. I vomited few times. The NG tube was back. Lord! The surgeon found there were two points of bowel obstructions through the scan - the first one, an inflammation near the stoma wound; second, a kink in the bowel.
Midway 6th week: The pain remained. Back on Oxycodene via PCA. Total Parenteral Nutrition continued. Surgeon did another scan. The kink seems to have gone away. The inflammation near stoma area had reduced considerably. During the scan, surgeon observed the gastrografin goes all the way through the length of the small bowel. So no major bowel obstructions. No bowel activity too. Ileus.
Now: Ileus continues. When will the bowel start working?!