If you’re having stoma surgery soon, the chances are you will have a few questions you’d like answering. Whilst you can always speak to your surgeon or stoma care nurse to ask for professional advice regarding anything related to your stoma surgery, we thought it might be useful to write this article to answer two of the most commonly asked questions.
So, read on to find out more about how long your recovery is likely to take and whether or not it will hurt…
Pre-operative care – before you go into hospital:
Prior to any operation, your surgeon will explain to you exactly what they intend to do and why. They will advise you on the expected length of the surgery, how long you are likely to be in hospital for and how long it will take you to recover fully once home. If your surgery is planned in advance, it is likely you will have been given the opportunity to meet with a stoma care nurse. These are experienced nurses who have additional specialist qualifications. As well as allowing you the opportunity to discuss any concerns with them, the stoma care nurse will also work with you to decide where it is best to place your stoma and will explain what to expect before and after your surgery.
Depending on the hospital where you have your surgery, you may be invited for a ‘pre-assessment’. This appointment is usually with a nurse, who will take your medical history and check you are fully fit for surgery. This may mean having some blood tests and a heart tracing called an ECG and you will have your blood pressure and other vital signs (such as your pulse) recorded. This is all perfectly normal! The nurse will also discuss what to expect from your surgery and your recovery afterwards. You may be given special energy drinks to have before surgery and any instructions on bowel cleansing or preparation will be given (not all surgery requires this).
The day of surgery:
When you go into hospital for your operation, your surgeon is likely to visit you on the ward or admissions unit to run through what will happen next. If you have not already done so, your surgeon will ask you to sign a consent form – this is your opportunity to ask any last-minute questions you may have. You may also see the anaesthetist who will talk you through the general anaesthetic and the effects after surgery. You are likely to have a general anaesthetic, which ‘puts you to sleep’ during the operation so that you are not aware of the surgery and won’t feel any pain.
When your operation is completed, you will be transferred to the recovery unit until you are awake enough to go back to the ward. Your doctors and nurses will make sure that your pain is fully controlled following your surgery and you will be monitored closely and given further pain relief as required. When you wake up, it is usual for you to have some tubes placed in and around your body, to help it as it heals. These may include:
- A ‘drip’ for intravenous fluids, until you are awake and well enough to eat and drink yourself
- A dressing over your wound(s)
- A catheter to drain your bladder
- A wound drain
- A tube up your nose to drain your stomach and stop you from being sick
- A pain-relieving epidural or self-administered drip (patient-controlled analgesia) – the nurses will explain to you how to use this
- A clear, drainable stoma appliance (to allow the nurses to monitor your stoma without having to remove the appliance).
After your operation, it is normal to feel some discomfort around the incision sites (wounds) and across your abdomen (tummy). It is important that you tell your doctor or nurse if you have pain, as different types of pain killers are available and some may suit you better than others. The stoma itself may feel a little swollen and you will feel tender from the sutures (stitches) used. As your recovery progresses, this discomfort will reduce and improve.
Your hospital stay:
The length of time that you will be in hospital varies from person to person and also depends on the type of procedure you have had – your stoma care nurse will be able to give you information specific to you.
As a general rule, you will be ready to go home when:
- You are able to walk short distances independently – eg to the bathroom/toilet
- You can wash and dress yourself
- You are eating and drinking
- Your wound is healing well
- Your stoma is active and you are able to change your appliance independently
- You are passing urine independently
- Your pain is controlled
There will always be some exceptions to these and it will also depend on how fit and active you were before your operation.
When you are discharged from hospital you will be given pain killers to take home with you and guidance as to how and when to take these. If for any reason your pain worsens, it is advisable to speak with your GP as soon as you can or to follow the instructions given to you by the hospital, as follow up after discharge can differ from one area to another.
Your stoma may feel tight until the internal and external (skin) stitches dissolve, which can take up to 6 weeks. The stoma itself does not have any nerve endings, so there may not be much sensation there when you touch or wipe it. The stoma is very vascular and can bleed readily. If you notice any specks of blood on the tissue or when you clean your stoma, try not to worry as this is to be expected. However, blood in your stools or coming from the stoma opening is not quite right and must be checked out by your GP or surgeon.
It is normal to feel very tired when you first get home. Try and take things easy for the first two weeks, although you should try not to remain in bed. It is important that you walk around gently and often, to help prevent any complications. As a general rule, most people find that they can then start to slowly increase their activity as time goes on. Walking is a safe and gentle exercise and you can aim to gradually increase the time and distance you walk for, as your recovery progresses. It is common to have good and bad days – this is your body’s way of telling you to slow down! Remember it is good to take some time to let your body rest and recover too.
After about six weeks, you should be starting to feel much more comfortable and your energy levels should be starting to improve. By three months you should be starting to feel relatively back to normal. During this time, it is important to not do any heaving lifting or strenuous exercise -your stoma care nurse will discuss this with you.
Please remember that these are guidelines only and do not replace the information and advice given by your stoma care nurse and surgeon.