It really sucks having 5 kids under 8 and feeling as though you might die.

[altarflame]

So it seems that there are two kinds of post operative blockages that occur. I've escaped the first one, which is early post operative SBO (small bowel obstruction), which is characterized as happening within 30-50 days of the surgery, depending on what you read. I'm not sure what causes that, only that it generally gets treated with decent results but sometimes reoccurs again.

I'm 3 months out from surgery at this point, for what it's worth.

The other kind of blockage can happen anytime - months or years or decades after initial surgery - and after ANY abdominal surgery, not just a small bowel resection like I just had. Basically if you form adhesions, as most people do and we all know I do, they can become fibrous loops that your intestines get caught/stuck in at some point, and get strangulated by. If you would like to see a picture of actual adhesions - and I don't know why anyone in the world would, except that I actually found it interesting after hearing so much about them - you can by clicking this link and scrolling down a bit: http://www.rcsed.ac.uk/eselect/sig12.htm There is nothing else gross or potentially traumatizing on the page that I saw.

Basically if that happens you usually know because you are really constipated, have a lot of tenderness and/or pain in the belly, and end up ultimately puking. Bloating and diahrrea are also symptoms. It gets really dangerous when there is death of tissue, which can lead to sepsis like I had before - symptoms of which generally include fever, racing heart and elevated white blood cell count.

My belly is a little tender sometimes, but only like down REALLY low right above my pubis and only in a "when kids sit on it" way - it's not just uncomfortable in "normal" situations (although the kids sitting on it IS normal for us...). There's no "just sitting there" pain whatsoever, and the tenderness comes and goes based on when I last ate, if I have to go to the bathroom, etc, so basically it's nothing to write home about, just more than I think Grant for instance deals with.

But, I have been feeling like my belly is bigger, and my waist is wider, just in the last two days - and it's very obvious since I've been losing weight and examining myself and the way my pants fit and my reflection all too often - and in those same two days I've had (way tmi.....) the same really weird narrow soft little poop that I was before I got completely constipated and out of commission before.

I'm still embarrassed talking about poop. I don't think I'll ever get over it. Sometimes I think this is all too ironic, as I've always had such a bodily function hangup.

Anyway, yeah, I have to sit around now and think about when I last had really wide poop and how loose it is at this or that time and imagine my intestines halfway through a loop of adhesions and getting squeezed and released based on random ways everything inside me falls as I bend, sit, stretch, stand and lay. It's enough to drive a person crazy.

I told Grant tonight that if the whole poop situation doesn't resolve itself by tomorrow evening I think I'm going to the ER just so they can CT scan me or whatever, because a difference of a few days in cases like this is huge and my appt on Tuesday is far away, if I do have a strangulation. It would be horrible to get readmitted and go through more of this BS, but it would be worse to deal with sepsis and ICU and far more dangerous hoohaw because of tissue death that can be avoided.

This is going to be on my mind for the rest of my life. I don't know how to let it go. I'm trying to just have faith, and when I pray about it, it does really help...for like 5 minutes. And/or I get really stupid and ridiculously sentimental trying to talk to God about death fears and worry for my kids and cut myself off so I can get it together.

For the record, if you have an adhesion related blockage they go in and cut the adhesions and sew you back up. It usually works pretty well and people move on, although then of course you're back to square 1 of waiting around to see if it happens again, as you form new adhesions from the second surgery.

There is this stuff out there - one popular brand name is seprafilm - that surgeons can use during operations...it's basically dissolving mesh that they place between organs so that by the time it dissapears, everything is healed, and nothing had a chance to adhere to anything else. I've only personally seen one study on it, but that study did prove that it at least lessens the severity of adhesions - which can do less dangerous but equally horrible things like just cause a ton of pain, like they did for my mother in law after her hysterectomy. The problem? The stuff costs money, and takes time to place. So right now only people like Britney Spears get it when they have c/s (or anything else). It's not how things have traditionally been done and requires a certain above and beyond, so it's not catching on for standard protocol as it isn't necessary for the immediate business at hand. I'm disgusted by all of that, as you may have guessed. I mean when are they going to realize the time and money that can be saved by using the crap? Unless, of course, it's about the time and money patients have to shell out later - I was reading that at this point in time, the biggest cause of intestinal blockage is adhesions from previous surgeries. But maybe I really am too jaded.

I have 4 different incision scars going in two different directions on my belly. I've realized I'm some kind of psycho in that whenever I'm holding a knife now (i.e., cooking) or a sword (my brother and Grant both have several so I'm always moving them further out of reach of children) it seems like the most natural thing in the world for me to run them along my belly or poke around my middle with them. I don't usually do it; it's just this compulsion I have, irrationally, like the compulsion I have to throw myself off cliffs or rooftops if I'm standing on them (which generally makes me step back warily). I've never had any interest in knives or swords and I've definitely never considered "Cutting" or any of that - I just have this new compulsion/fascination, since some time last year. And I found myself considering the way counselors tried to gloss over a G-Tube for Elise to me, as such a minor thing, and just...I had such a drastic internal reaction. Like an adrenaline kick-in of fight or flight hormones, at the thought of anyone cutting her skin open or getting inside her stomach with scalpels. Her perfect baby skin. That perfect rounded, fat belly that fits in my hand. I really believe in our physical bodies holding onto memories, and wonder what that means for me, underneath the anesthesia. Abdominal surgery is such a wild violation; so incredibly invasive. It's such a confusing and frightening thing to realize you can't lift your leg up the same way, or get up out of bed like you normally do, with those muscles hurt. Whether totally unnecessary (i.e., my c/s with Ananda and Aaron) or a complete butcher job like Jake or seeming to go off fine at first and being COMPLETELY necessary, like with Elise...I mean the whole idea of someone leaving a big giant sponge inside my body and it wrapping around and strangulating my organs and killing me INTERNALLY while I have no idea is just so fucking disturbing. We're used to surgery in this day and age, and that's fine because it really does do a lot of good, but I also think it would be good to realize just what a massive thing it is - how it impacts you as a living creature to be cut open and have peoples' hands under your muscles and fat, moving your insides around. I've read about patients emerging from very successful operations to be cured completely and healing quickly, but still having lasting depression they don't understand - they being the patients or the doctors. It's something described as "the reaction some peoples' bodies seem to have", like maybe they produce more or less of various hormones after the surgery until enough time passes. This is what I mean about physical memories lingering in my freaking flesh.

Every now and then I just all of a sudden want to remember pushing her out in that sunny apartment so bad that I weep. I could also remember having her - holding her and knowing she was mine and using my own judgement - in those first hours and days and weeks. And I could look down and see a totally different midsection. And I could not feel like an idiot, or a victim, or someone who might relapse and end up full of tubes again anytime.

It's 5 am again and this got a lot messier than I thought it would.

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