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Open colon resection surgery...Help


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Old 05-03-2004, 04:20 PM   #1
goody2shuz
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Open colon resection surgery...Help

I am scheduled for open colon resection on 5/10 for 4 episodes of diverticulitis. I'm 45 and don't know what to expect after surgery. How much pain,will I be able to go home with no help. I had my gallbladder removed 15 years ago & have some back problems and am concerned about what to expect after surgert. My doctor said the pain can be mannaged with morphine pump or epidural..which i never had. I did have the morphine which made me out of it & thought I may co better with epidural. How does that work & can you walk around with it? And the tube in your nose...how bad is that? Please reply ASAP...just found this board and would apprecialte any info from someone who had this done recently...thanks...Goody

 
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Old 05-03-2004, 05:41 PM   #2
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Re: Open colon resection surgery...Help

I had to have this done because of a fistula. It was an emergency for me so my situation will be different from yours. I was in the hospital for about 3 weeks after surgery. I don't remember any tubes up my nose and I was in intensive care for about 3 days after the operation. I did have the morphine pump but I only used it a couple of times because the nurses told me I'd be out a lot sooner if I didn't use it. If you get told that DON'T believe it and use the pump to handle your pain. It made no difference with me as to getting out any sooner than the doc was ready to let me go and made everything very uncomfortable for me. Hope this helps some and good luck with everything.
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Old 05-03-2004, 06:53 PM   #3
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Re: Open colon resection surgery...Help

I wish you well brother. The morphine pump was useless for me. Get someone to pump it for you if you cannot. Meet with the surgeon before and go over all of the pain mgt plans. I did not, wish I did. They can put it on automatic-drip and only give you the ability to bump it up for when you are awake. Don't go solo man where it requires you to make all of the pump decisions. The pain is significant enough to cloud your thinking. There is no need to be in pain. You can always turn it off, but it might take an hour to kick in so don't run dry. Did that, hated it. The pain hurts, but it won't kill you. So don't dwell to much on it. You start to get used to it in an odd way too after the first 24 hours or so. So, remember this about pain mgt if you remember nothing else from this post: The pump has controls on them so you cannot accidently overdose. Know how to operate the damn thing before you are buggered up and in pain. Or tell a freind to figure it out. Once you run dry, it takes (depending on the drip rate) an hour or more to get ahead of the pain. So, you have to hit the pump based on where you think your pain is going to be in say thirty minutes, not where it is at right now. Check out a steroidal anti-inflamitory called Turbidol or something very close. It is very good. One more thing, there is an alternative to morphine that some hospitals use for resections which I assumed I would get and did not. I will look that up for you too. It has the benefit of not causing the ab swelling from gas, a major source of pain in the first place.

Epidural is quite effective method. Wife got one with each child. Forget about walking. Epidural carries its own risk, plus clot risk increases with longterm bedrest. No walking on an epidural. But no pain. If you go on the epidural, try to come off in a day or two max so you can start walking.

The tubes in are not worth sweating either. I had a bladder cath for a couple of days including a couple on the jogging track (the walker trail around the center of the floor), and the one down the nose is just an annoyance. Both were just a little itchy. And by comparison, you won't even think about them.

If you can go lap, that is the best, but I am sure you already know that. I will repost some lap links in just a second in case you are not aware of the bennies.

I do wish you well. Can't really say more about going open, because I went lap. But I am about the same age, and once you catch up healing-wise, the good news is that the long term prognosis for the resected to quite good. The boards have a higher percentage of cases that did not resolve completely.

Don't let all of the posts scare you too badly. It is biased by the population. Overall, you have GREAT resolution prospects.

Peace,

Resection Man

 
Old 05-03-2004, 07:37 PM   #4
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Re: Open colon resection surgery...Help

Ditto on what resection man says. I completely agree with him. He could not be more ON TARGET. I have had approximately 8-10 bowel surgeries, including five ostomy resection surgeries, and the rest were resections. I dont say this to scare you. I do NOT have diverticulitis, I have Crohns disease, and I have had it for 30+ years.

Please take heed in what resection man says. I just dont think I have much to add. Just stay calm, dont let anyone scare or rattle you. These surgeries are done by the hundreds every day.

The only thing I will add is, that personally, I did not have good luck with an epidural. An epidural is placed into the spine, and the medication is delivered through an IV type tubing directly into your bloodstream. However, I have had them "dislodge". If you are on your back in bed for a long period of time, and you DO have an epidural, just make SURE that either yourself or a relative/friend stay "on" the nursing staff to keep checking the placement of the epidural. Mine dislodged both times, and they just thought I was sweating, because the bed was damp. Well, it was the pain medication that had been leaking for HOURS in TO my bed, BECAUSE it was dislodged. Meanwhile they had been ignoring my repeated requests for pain medication, and my repeatedly telling them in how much pain I was in, and them not believing me, because of the epidural. THERE, that is the end of my story. I know scads of people who SWEAR by the epidurals. I would imagine they work very well, according to these people who have had such success. Just make SURE it stays in, because as "resection" said, it takes a good hour to catch up if you are without pain medication, especially after surgery.

Also, I think Resection Man was talking about the drug "Toradol". It is not a narcotic, but it works VERY well on pain.

Take care and much good luck to you. God bless.

Suzi

Last edited by suzi47cmt; 05-03-2004 at 07:39 PM.

 
Old 05-03-2004, 07:51 PM   #5
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Re: Open colon resection surgery...Help

You did not say in your original post why you were going open, but if you can go lap, here is some good starter read. I had five bouts before the surgery, and the seven inches I lost were glued to everything like I giant barnacle. Much can be done. If you are healthy enough to get plugged into a lap center, I would think hard about doing so.

Pure Morphine Only Alternatives:Better pain management, faster removal from pain killers, faster gas movement

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11535845&itool=iconabs tr

http://archsurg.ama-assn.org/cgi/content/abstract/131/4/417
I could not find the name of the med that was of most interest to me. It was something like met……


Minimal Access Surgery Info:

From Columbia University, here is a link that is much more succinct, and it shows the cartoon picture of the incisions (I had the button and the two lower incisions). The procedure itself is only 13 years old:

http://www.columbiasurgery.org/divisions/colorectal/laparoscopy.html

Here is a webcast from Harvard Medical Teaching School (Mass General Hospital) on the procedure:

http://www.or-live.com/massgeneral/1161/

University of Pennsylvania Health System
Illustrated Man:
http://www.pennhealth.com/health_info/bloodless/blood_lap1.html
http://www.pennhealth.com/health_info/bloodless/blood_step5.html
http://www.pennhealth.com/health_info/bloodless/


In my own studies, I came across at least ten centers like these around the US before I drilled down in my home town area. University of Texas Medical Branch, Baylor College of Medicine and St. Luke’s here in the Houston area all had set up minimal access / bloodless centers. Many procedures are now available.

Western Europe is toe to toe with the US in terms of skills and facilities.

Within 15 years, virtually all procedures will start lap in my opinion.

Again, every major teaching facility probably has a MASC already setup.

Extra reading:
http://archsurg.ama-assn.org/cgi/content/abstract/131/4/417

Hey Suzie, we have not met. You are the real vetern. Most of my knowledge came off of the internet. I give big first hand snaps on the Tordol. It also carries risk. If you can hold off for a day or two do it. The pain is bad enough on day one that you are in shock anyway. Don't waste something like the Tordol. They will only give it to you for a max of four days because of a risk of kidney damage. Choose your days wisely, and use sparingly. I only used for 1 1/2 days.

Resection Man

 
Old 05-03-2004, 09:08 PM   #6
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Re: Open colon resection surgery...Help

Resection & Suzi...thanks for the info. I really don't know why I'm thanking you for so realistically preparing me for what lies ahead. I am going open because that's what the surgeon does...he begins lap assisted but does it open 75% of the time. He's a great surgeon & has done thousands of resections in his 18 years. It's close to home and my insurance doesn't cover anyone local that does lap....I feel confident in this surgeon & guess don't want to take chances of going lap & getting a so-so surgeon. From what this surgeon shared with me...there are more chances of not seeing all going lap and of snipping other organs that lie so close to the problem area. I've had 2 kids with no meds & gallbladder surgery(open) with the PCA(morphine pump)...surviving both. I guess I have a pretty high pain threshhold & hope I do with this as well. I'm really scared...I know this is more than the gallbladder surgery!!! I've had to tolerate the pain of a kidney stone & can't really imagine anything more painful than that!!! And they gave me the toradol for that & I recall it worked even better than the morphine injections. So, I know I'll get through this one too...but for some reason I'm really scared this time around. Wishing someone would say that the pain would be less than things I've experienced already. And it scares me to think that resection had that much pain with the lap...what am I in for?....Goody

 
Old 05-03-2004, 10:02 PM   #7
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Re: Open colon resection surgery...Help

Edit: I just re-read your post. The reason it hurt so much, is because I did not know how to use the pump. I think I am a bright guy, but the pain got away from me and I did not use the pump. I would hit it a couple of times, then wait as long as possible to hit again on day one. I did not realize it locked me out and the multiple hits did nothing. Then, I was afraid of taking too much, so I would lay off. Just keep hitting it as often as you can until you are comfortable. That is what I did not know. Seems pretty reasonable, but I was unreasonable at the time.

Original post follows:

Sorry we spun you up. If you had kidney stones and already have had the Toradol then you know what the pain is all about. Guy-Stones are right up with childbirth (from what I understand), but it does not drop off so quickly afterwards (birth vs surgery). You can and will get passed it. Your brain will eventually just turn down the noise anyway.

I have a high pain tolerance as well. I had a hernia repair with about a 6 inch incision in my groin 20 years ago, and thought I understood the pain that I would encounter. The expectation gap took me by surprise at first. The resident told me to start all over. Come to terms with the increase in pain, and go from there. I got into a chair my first night, and walked with a walker in 18 hours. By the middle of the second day, I was walking on my own without the walker. By the third day, I was cruising solo on the jogging track.

I did the imagery thing. Breathing etc.. until I had the 1 1/2 hours on the pump to take the real edge off. Once, you get ahead of the pain, you can manage it. My pump was manual. So, the first time I went to sleep, I woke up to another hour and 1/2 of agony waiting through another pump routine.

I don't tell you that to scare you. Just get an auto-drip, or make sure you stay ahead of the pain. If someone would have told me in advance, I would have kissed them on the lips ... man, woman, animal, makes no difference.

If my tolerance is as high as yours, my advice would be to go PCA morphine day one. If it is too hot, go epidural day one and convert to morphine day two. Start taking the Toradol mid day two or three for the first day and wean off as much as possible. The Toradol was quick acting for me. So, you can ask for it on the fly. Find out how many you can have ... if it is 16 doses or whatever. Then decide how to ration them out.

I was never able to cough early on. There is a technique called "splinting" that I found out about afterwards. Press a pillow into your gut to support the incisions. The coughing is to clear your lungs, not cause more pain. It is super important, but I just did not have the balls on day one or two to pull it off. It is to get the junk out of your lungs. Hell, I sneezed today and it hurt good ten days after surgery. Also, plan your coughing, and walking to coincide with your peak medication.

My floor was just for post operative digestives. Only about 10% or less of us were really walking the floors. The balance were bed ridden. That is not good. I had it in my mind that by God, I would be walking within the first 24 hours. That determination really helped. Your recovery is gated by how soon you ambulate (start walking). The sooner you get going, the sooner you get going, and the faster you get out. A more important discussion than how much it is going to hurt is how soon your doc would like to see you walking. Whatever he says, day one, day two, day "x", make yourself a promise to do it. You will be so much better off. Even if it is only a few steps. The pain is going to be there whether you lay around or walk. At first it is most definitely worse, but once you erect, it is about the same. That is huge. Go for it. Get out of bed and walk. It is THE best pain medicine. The walking gets the gas going, and the gas is the source of the majority of the nasty pain. Get rid of the gas, get rid of the pain. Walking is better for pain then morphine ... just ask the nurses. They know. Being erect and walking is the important part, not the getting erect. If you can't handle it, get one or two people to help you get on your feet. It will start to abate once you are in position. Most people give up too soon before the are standing. Push through it.

There is a newer anti-nausea, Zofram, that they started before I left the O.R. You do not want heaves after the surgery. It is not quite as good as Phenergan, but it is not harsh on the veins. Zofram, also takes the edge off too. Not like Phenergan, but it helps. If they let you take oral meds, take the Phenergan. If not, then take the Zofram.

Don't be scared? Suzie is right. They perform 100's everyday. Knowlege is power. Don't let the pain surprise you or keep you in bed. You have kids and stones and didn't die. Promise to walk, and stick to it. What part of the country are you located in? Also, don't think about it in terms of days. Just think about one to two hours. I have talked to a handful of people that have a similar story. 1 1/2 hours on the manual pump will get the edge off. That is 9 ten-minute hurdles. Count them down. Keep pumping for two hours, then do the walking thing. Just don't think longterm when you are in pain. That is just not helpful. Think, 1 ten-minutes, 2 ten-minutes, 3 ten-minutes, there is a big difference between 2, and 6 and 9 and 12. Each one gets better.

Aaaaaaagh!!!! Finally relief. I probably slept 6 to 10 hours a day for the first couple of days. That should be a indicator too. It is ugly, but tolerable.

Resection Man

Last edited by resection; 05-03-2004 at 10:09 PM.

 
Old 05-04-2004, 01:29 AM   #8
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Re: Open colon resection surgery...Help

i had the full incision colon resection on sept 11th and then a colostomy for 3 months and then had the resection surgery dec 18th, the pain and healing time will depend on which type of surgery you have, the lap is much easier and less painful and recovery times are so much quicker than the full incisin, after the first emergency surgery i was put on some pain meds and apparently worked so well i to this day cant remember what it was,lol however after the 2nd op i had the morphine pump and it seemed to not help much, so i also tried the turadol and it helped alittle, seems like 1 med would knock me out but didnt do much for the pain and the other helped the pain but i couldnt sleep, also i wasnt allowed to get out of bed for a few days and had these "boots" on my legs which feel like someone masaging your legs and keeping the blood circulating so you dont get any clots,the whole ordeal can be scary but it is managable, you will have to eventually get up and walk, that is what i found the hardest but the sooner and more often you walk the better off you will be, again if you have the lap surgery youll be up in a day,just hang in there and dont be afraid to ask the nurses and doctors questions, theres nothing such as a dumb question

 
Old 05-04-2004, 07:26 AM   #9
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Re: Open colon resection surgery...Help

Everyone experiences pain differently. Mine really was not that bad; but my brother-in-law had terrible pain after a similar operation. As much as possible, you want to get a balance between pain management and the fact that most pain medication has a constipating effect (not a good thing in this situation).

But about having help after you go home . . . yes, arrange it if at all possible especially if you live alone. In preparation for the surgery, get everything done in advance that you can . . . bill paying, stock up on non-perishables and heavy items, get all the laundry done, cook up (or buy) some comfort foods - soups/stews/whatever - and freeze them.

They throw you out of the hospital very quickly these days. That has advantages and disadvantages, but that's the way it is. For at least the first week, figure your major accomplishment will be getting yourself back and forth to the bathroom. Plan on the worst case scenario that you will not feel like doing much more than that. Try to arrange for someone to look in on you at least once a day, and hopefully prepare AT LEAST one meal a day, and hopefully have the makings of at least one more ready so you just have to grab it.

You will start to build up after that, so see how it goes. You will probably want help with some things for a couple of weeks at least.

Good luck! Let us know how it is going!

 
Old 05-04-2004, 11:24 PM   #10
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Lightbulb Re: Open colon resection surgery...Help

Hey again,
I dont know if this will help at all, but I just wanted to tell you that the best thing you can do for yourself right now, is to NOT think about the pain. HAHAHA,, real easy for ME to say, right? The main thing, as others here have said, is to have a set plan.
Here is mine:
#1. Make SURE your pain relief plan is in place BEFORE the surgery, and that you are VERY comfortable with it.
#2. Discuss ALL medications available via the PCA. If morphine does not provide good relief for you there are other medications, such as Demerol, Codeine, and the strongest and MOST effective one of all....Dilaudid. DO NOT be afraid to ask about these. Unless you are allergic to any of these, they are ALL possibilities. I am not saying they are okay, I am just saying they are out there and available, and only YOU can advocate for yourself. So DO IT!!! (I am not trying to be mean or anything, just want you to know that YOU have the RIGHT to ask for good, effective pain relief, and if that is the one biggest fear you have now, and I dont blame you, then STAND up to the docs and tell them that you REALLY must feel comfortable with this aspect of the surgery BEFORE you have it. ).
#3. If at ALL possible have someone in your family, or a friend available at ALL times before, during, and AFTER your surgery, to advocate FOR you. As Resection said, you will be "out of it" and that is when the pain medication tends to be forgotten about, UNTIL you wake up in a lot of pain, and are behind in the dosages. By having someone with you after surgery, in your room, etc.... THEY can ask that you be medicated as often as possible, per orders of the doctor. (and THIS is the thing you want straight with the surgeon BEFORE surgery, that you have HIS ORDERS for continued pain relief right after surgery).
#4. Lastly, you want to make sure also BEFORE your surgery, that good pain relief will be provided to you upon DISCHARGE from the hospital. Thses orders should be in writing, so that just in case another doctor has to discharge you, there will be NO misunderstandings, and you WILL receive your proper prescriptions upon discharge. This is a VERY COMMON mixup believe me.

I HOPE I have not further complicated matters for you, but having been through all this MANY MANY times , I hate to have anything go wrong, and these are just almost fool proof ways to see that you have NO WORRIES before, during OR AFTER your surgery.

Now...Good LUCK!!! My dear, and....If you have ANY questions you would like to ask me, PLEASE feel free. I check on here every night, and would love to help, even if it is just moral support.

Take care, and once more, God Bless.
AND... NEVER FORGET....What you say as the patient DOES COUNT, you just must sometimes SPEAK louder and stronger to be HEARD. LOL

 
Old 05-05-2004, 02:31 PM   #11
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Re: Open colon resection surgery...Help

Thanks Suzi, Auntjudyg & of course Supreme Colon Resection...for your support and quick responses to my questions. Have calls in to my GP, Gastro MD & Surgeon to finalize everything.

It's not easy being a mom and having to go through preparing for this surgery. I want to go in rested...but that's impossible with all that goes on here!! Trying my hardest to relax & not be too concerned....and convincing myself that it's somebody elses turn to take care of me for a change. I'm so use to being the one that takes care of everything & I'm finding it hard to switch roles and so are my 12 & 15 yr old daughters who are into the me me me stage of life!!!

Going out for my Mother's Day meal today since I will be clear liquids & cleansing out over the weekend. Youngest daughter leaves for a school trip tomorrow and returns late Saturday...so it's the only time we can all clear our schedules. Was surprised the OR schedule was open on the 10th...guess all the smart mom's are staying home!!! The good thing is that I should be the only mother in the OR unless there's an emergency of some sort. And the surgeon should be well rested...I don't think he'll be out partying with his Mom!!! So there are bright sides to everything.....

Please do keep me in your prayers...I could really use them at this time just for peace & comfort and a good dose of courage. I picked myself up an inspirational CD to get me through and we just returned from Belize & I have the most beautiful Easter sunrise pic that I'm going to print out nice & big to put in my room to look at.That should help out....and tonite over dinner I'm going to tell my family that it's time for mom to be pampered & spoiled and that I'm expecting to be treated like a queen... and I think I'd enjoy that for a change.

Well..I need to freshen up for my big night out...feels like my last supper and I'm going to enjoy it. Just praying that my tics don't act up prior to this surgery...so I'm going to take it easy so I can get this all done & over with. Thanks again...Goody

 
Old 05-05-2004, 11:29 PM   #12
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Thumbs up Re: Open colon resection surgery...Help

GOOD Luck "goody". Hope you had a wonderful dinner. Good planning . somebody cares about you alot to think ahead and treat you to dinner now.

You will definitely be in my prayers, and will be on my mind all day during your surgery. I will be sending positive thoughts all the way from here in Maine.

Sounds like you have a wonderful plan, with your CD, your beautiful Easter sunrise picture, etc..

I am a mom too, so I know where you are coming from. But, it IS your time now, so lay back, DEMAND that pain medication, etc... and go for it.

Hugs to you from a fellow mom () () ()
And "No more worrying young lady". hahaha (the mom in me got out, oops!!!)

God Bless,
Suzi

 
Old 05-06-2004, 07:05 AM   #13
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Re: Open colon resection surgery...Help

Thanks again, Suzi....my dinner was great and just what I needed. Now on Mother's Day I'll be served my clears in bed with hugs & kisses. Only a few more days to wrap things up. Feel like I have most things in order...which makes us mom's happy!!!

Trying my best not to worry...but that's what us mom's know how to do best...right?
Thanks for your support...I can feel it all the way here on good ole Long Island, N.Y.

Really appreciate those thoughts & prayers...that's what gets us through these rough times in life. Love that new song..."You Raise Me Up" by Josh Groban!!! That's what I have playing in my mind right now....Goody

 
Old 05-06-2004, 10:00 AM   #14
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Re: Open colon resection surgery...Help

You are not alone. My wife and I were thinking of you this morning. We know it is tough to move the clock along. Try and stay plenty busy. Give your family lots of love and reassurance. Also, thank you so much for posting. I have gotten deeply attached to some of the storylines.

You quipped in one of you posts that it wasn’t all that long ago that Resection Man was in Goody’s 2 shoes. You’re right. And just look at me now. Svelte, rocking, and roving about.

From my last post before I made the twenty mile drive into the city for my surgery:

“If you are following me into surgery and even if you are not, then here is a beautiful scripture that I found very helpful: Isaiah 41:13”.

It felt good. If you get a chance to read it, please do.

Probably the last thing on your mind when you get through surgery will be to make a post. When you can though, I for one would greatly appreciate it. I will be thinking of you without fail until I hear you are broadcasting live from a healthy, normal, back-to-yourself state. We will pray for you and your family and your health care providers through out.

Peace,

Resection Man

 
Old 05-06-2004, 10:03 AM   #15
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Re: Open colon resection surgery...Help

Keeping you in my prayers as well Goody, hang in there honey.
Glad you had your Mothers day dinner already. Looking forward to mine IF i feel well enough to go out that is, BUT IM A HOPING I WILL LOL. Also on clear liquids and just plain smoothies here for a while to give my tummy a rest and get it ready for surgery next week. The best that i hope for in a day is maybe cereal or oatmeal but im up to my ears in oatmeal already lol. Keep a sense of humor hon and KEEP praying. It really does help.
Love,
Jen

 
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