You will normally be admitted the day before your operation. On admission you will be assigned a bed on the surgical ward and asked some routine questions about your general health, the medicines you already take and any allergies you may have.
This will then be followed by visits from some or all the following People / Departments. If you have had a Pre-Op assessment some of this will have already been done.
A member of the medical team responsible for your care will explain your operation in more detail and tell you about any risks involved in the procedure. When they have explained these to you, you will then be asked to sign an operation consent form to allow them to proceed with the operation.
The stoma nurse will give you an information leaflet explaining about your Stoma and then answer any questions or concerns that you may have. She will then mark your abdomen below your normal clothing waistband; this will be where the stoma is sited so that it is not irritated by your clothing.
Your anaesthetist will explain the anaesthesia that will be used during and after your operation. Your operation will be carried out under general anaesthetic, which means you will be asleep throughout the whole operation.
They will also discuss the options of pain relief available following your operation and explain any risks involved in the anaesthesia.
It is important to remember that you never need experience severe pain and should inform your nurse in the unlikely event of this happening who can get more pain killers prescribed for you.
The (ECG) department may come and take a heart trace (ECG), this would normally be ordered by your anaesthetist and is quite a normal precaution.
The Phlebotomy department may come and take some blood samples, this is normal before any operation.
You will be asked not to eat anything, chew or smoke for at least 6 hours prior to your Operation; you should have nothing to drink for 3 hours before surgery. They will inform you of the scheduled time of your operation, and a sign will be put on your bed stating, “Nil by Mouth”.
You may also be asked to have an enema during this time just to help clear out your bowel prior to the surgery; this would be done by one of the ward nurses.
During this time, you should take the opportunity to have a shower and you will be given a theatre gown to wear.
If you are particularly hairy in the area where the surgery will take place, the nursing staff will shave you using specialised clippers (to not damage the area before your operation). Do not shave yourself.
When you first wake up after your surgery you could be in one of two possible places. The first may be a small ward where you will have your own nurse: this is called (IUC) or in some cases you may have been taken back to the surgical ward where you started.
You will have several pipes and drains connected to you. Depending upon the surgery you have had, they may differ, but the most common are listed below.
- Their intention is to decompress or drain either fluid or air from the area of surgery and will normally be attached to a measuring device on the side of your bed be left in for 3 – 4 days post-surgery.
- A urinary catheter is any tube system placed in the body to drain and collect urine from the bladder this will be attached to a measuring device on the side of your bed and will normally be removed when you are mobile or when there is no further need to measure your fluid output.
- Fluids are given during surgery to counter the loss of fluid during the operation. After surgery, you may continue to have a drip if you are dehydrated or have limited oral intake, so fluids are continued until you have stabilized.
- Is a tube that is passed through the nose and down through the nasopharynx and oesophagus into the stomach, which is used to decompress the stomach and remove air / fluids to help avoid you being sick.
- The epidural is an injection that numbs the lower half of your body. This includes your abdomen (stomach), pelvic area and legs and is your main pain control, this will normally be removed after 4 – 5 days if you still require pain control you may be given Patient Controlled Analgesia (PCA) where you will press a button if you have pain.
- Although deep vein thrombosis can develop after any major surgery, people who have had surgery on the lower parts of their body are especially vulnerable, the DVT Cuffs are similar to the blood pressure cuffs but are attached to the lower part of each leg and expand and contract on their own.
- post-surgery you will normally be given oxygen therapy via a mask this is known to aid recovery and prevent hypoxia and help with wound healing and nausea.
All of the above items will gradually be removed over 3 – 5 days post-surgery as you recover and become more stable.
You will also find attached to your abdomen a bag over the newly formed stoma. Once you have recovered, and at home, you will be able to use an opaque stoma bag but initially in the hospital this bag will be clear so that the nursing staff can see and monitor the output from your stoma.
You will also have a surgical wound from the bottom of your rib cage about 9 inches long where your abdomen was opened this will normally be stapled with a dressing over it, the staples will normally be removed after 10 -12 days.
After a short period of time the stoma will start to work, initially the output from it will be dark and very watery and seem to be continually but over time this will thicken and you will soon see a pattern as at certain times of the day it will be less active than at others.
During the first few days the nursing staff will empty and change the stoma bag for you.
For the first few days after surgery you will continue to receive pain medication through your IV or Epidural. You will not receive any food until the doctors hear the bowel sounds from your abdomen that indicates your intestines are “waking up.” At this time, you will be given some clear liquids to eat such as broth and juice. If the clear fluids are tolerated well, your doctor will let the staff know that your diet can progress to full liquids or solid food.
Your nurses or the physiotherapists may get you out of bed and standing or sitting in a chair a few days after surgery, depending on your condition. Standing and walking as soon as possible is very important to the recovery process, even though it will be uncomfortable at first.
Your Stoma nurse will visit you several times before you are discharged from the hospital to show you how to care for and change your stoma bag, cut the template and measure your stoma so that your bag fits correctly, as during the first few months your stoma will change in size and shape.