Crohn’s Disease
I first knew I had an Inflammatory Bowel Disease in 2000. Then-diagnosed as Ulcerative Colitis, I was treated as such and got better. My friend Ashlee used to call it “Super-Sonic Spontaneous Colon Blow-itis” because she lived under my apartment and could hear me running to the bathroom.

In 2003 many of my symptoms returned. I just got hired at UALR, so when my benefits kicked-in I started going to the UAMS Gastroenterology Clinic. My diagnosis was switched to Crohn’s Disease after my first Small-Bowel Follow-Through, a sort-of x-ray test where you swallow Barium contrast and a radiologist follows it (and takes pictures) as it makes its way through the small bowel to the colon.

My Crohn’s is kept quiet (in remission) by two medications: an anti-inflammatory, Pentasa®, and an immunosuppressant, azathioprine. When a flair-up occurs, I usually have to take a corticosteroid, Predisone, at a high dose which gets tapered-down to near nothing over the course of several weeks.

The gastroenterologists have been telling me for a while now that surgery is only a matter of time with the kind of Crohn’s that I have—the kind that creates strictures or narrowings in my small bowel. Over the last three Small-Bowel Follow-Through’s, we had identified two significant strictures: one in my jejunum (middle) and one near the ileum (end).

Prep
Prior to the main event, I had to be empty. Anyone who has ever gone through any kind of prep (and if you haven’t yet, rest assured that one day you will) knows that this process is quite possibly the most uncomfortable part of the whole ordeal.

For me, the prep was nothing new. Most every procedure I have ever done regarding Crohn’s Disease involves one form of prep or another. This particular prep was about three times as bad as the others, however, because it essentially involved three different kinds of prep: phospho-soda, laxative, and enema. Empty doesn’t even begin to describe how you feel after you’ve performed Fleet’s magic on your body over the course of 24 hours.

Surgery
I was among the lucky first surgeries of the morning on Wednesday. My parents and I arrived at UAMS at 5:30 a.m. and I would go in sometime after 7. As soon as I got the gown on I had to finish my prep with the enema. The nurse showed me the restroom and left me to it.

After that ordeal I returned to a swarm of techs, nurses, interns, and doctors. A tech shaved my stomach and we chatted about various things including the fact that David Prior was nearby, preparing for his heart surgery. Dr. Robertson, my surgeon, came by to say hello and say a few words. I asked him to visit my concerned parents in the waiting room and he gladly obliged.

No one really wanted me to have this surgery—especially my parents and Dr. Robertson. I figured they should meet. For typical Crohn’s patients, surgery is a last resort and never the cure. The disease is very likely to return exactly where it was cut out in a few years, so the medical community (whom my mother is a member) is always hesitant to operate.

After he left I met with the anesthesiologist. She explained a lot about the order of events, when I would get which drugs, when I would go under, and when I would come back. She also organized the “pain team” and the placement of my epidural for the relief (or blocking) of pain during recovery.

At the same time the pain team were placing the epidural, the surgery attending and a large mixture of interns and residents also showed up to introduce themselves. I also met the nurse team that would be working with Dr. Robertson. I told them I felt like I was on “Grey’s Anatomy,” and they assured me that none of them were sleeping with Dr. Robertson.

By now it was getting close to time, so they gave me something to make me more relaxed. Ahhh. Off to the operating room. Once inside I was carefully positioned on the table, and they began giving me the big sleep medicine. “Here I go!” I said.

Initial Recovery
Moments later they were trying to wake me up, saying my name. Confusion doesn’t even begin to describe how I felt, mainly because “confusion” doesn’t imply a tube in your nose that goes down your throat to your stomach. That had to go—I didn’t like that at all.

Julia, the recovery nurse had a sweet, polite tone-of-voice which quickly changed to a much more stern one as she saved me from myself and explained that even though I was indeed choking on the NG tube, it had to stay for a few days.

I felt drugged and hung-over. I was both soar and numb. I was connected to a myriad of tubes in many places. Besides the NG tube which was by far the worst of them all, I had a Foley Catheter, IV access in both arms, and an epidural in my back.

It took a couple of hours before I was ready to be delivered to my room for the rest of my hospital stay, and even when I was ready, it took another while before the delivery people could get me there.

My parents were waiting for me there and they stayed a while. My pain was under control, thanks to the epidural, but my comfort was nowhere near acceptable. I had tubes everywhere; I couldn’t get comfortable in the hospital bed. Again, the NG tube was the worst. It’s placement from my stomach, through my throat and nose, to the vacuum on the wall made it both necessary (due to the increased mucous) and painful for me to swallow or even talk.

The NG tube’s job is important and shouldn’t be overlooked. It keeps my intestines free from stomach acid and bile (plus anything else that has made its way down there). The vacuum port on the wall essentially sucked it out intermittently. The settings were a bit tricky, however, because too much suction too often starts to irritate the stomach, making it bloody. Too little suction doesn’t catch enough of the stomach acid goo before it reaches the intestines which at this point needed a little break.

Next Steps
As my recovery progressed, it became clear to me that the people involved were a much bigger part than the mechanics of surgery, pre-op. and post-op. My next blog will be about those that I encountered, befriended, and even lost.