Pain in Nick's A**: T+24

It's been 3 weeks since the pain in my a** was removed, literally. Figuratively, it will continue to be a pain in my a** for months to come. With that said I'm feeling pretty good these days. There's no doubt in my mind that my wonderful nurse(Lindsey) has pulled more than her share of the weight these last few months and that has helped with my feeling as good as I have. Basically being a single mom taking care of two small children. Luckily only one in diapers though. I'm truly blessed to have found such a wonderful woman.

I didn't realize how uncomfortable I was the two weeks prior to surgery until I was able to compare it to the last two weeks. For the two weeks prior to surgery if there were feces near the tumor it was uncomfortable. How uncomfortable? Basically it felt like I had to take the a giant poop ever nearly all the time (even gas would cause this feeling as well as tiny poops) and if I didn't I'd start to get nauseous (I almost tossed my cookies the night before surgery). No more feeling like giant poops need to happen all the time and nothing coming out and no more nausea.

Bowel function was one of the things the surgeons warned about. You see I have about half the amount of rectum as regular person now. What does that mean? Well the rectum acts as a temporary storage site for feces. As the rectum fills stretch receptors in the walls stimulate the need to defecate. If you don't act on the urge, often the rectum pushes the feces back into the bowel relieving the urge. So since I have less rectum, it fills faster, the walls stretch sooner, which creates the urge to defecate more often, with less ability to push it back into the bowel. Both surgeons we talked to said it's not uncommon for people to have the urge to defecate upwards of 15 to 20 times a day (uh...that would suck) after this type of surgery and then ask for a colostomy after the fact. Both also said that it can be trained down over time, like exercising a muscle (which the rectum is), but after about 2 years it is what it is. So I'm ahead of the curve here. I'm probably averaging about 3 poops a day, which is entirely manageable. At the two week follow-up the surgeon said it's likely that this is the worst it will ever be and could get better. So going from having an urge nearly all the time to 2-3 time a day...I'm going to call that a win.

As many know, I'm a bit of a nerd. I mean how many people build a machine to dispense margaritas, just because they can? Yeah not many, just giant nerds like me. I wanted to see how the incisions healed so I took a picture nearly everyday from 2/1 to 2/10.  Below is a little animation of the change.

Incision healing

As a medical device engineer I'm always fascinated by how different things are accomplished in surgery. Connecting two tubular structures in the body is called an anastomosis. My surgeon used a intraluminal (circular) stapler made by Ethicon (J&J). The stapler places two offset rows of titanium staples to create a seal between the two sections of bowel. Here's a video showing the process (warning: a bit graphic as it's a real surgery).

I read a study that said that after 3 days post surgery the coupling is at 60% strength of the bowel wall and after a week the coupling is a 100% strength. Pretty amazing that after a weeks it's full strength.