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Too Sweet 74 09-06-2006 09:00 PM

Hubby has question about pain treatment post surgery....
Hi everyone,
My husband is scheduled for his surgery on the 22nd . As it gets closer he is asking more about what will happen. He asked me to ask everyone about the pain treatment after surgery. His surgeon said something about an epidural pump. Not sure if I heard him right. Not sure he's crazy about anything in his spine. He was giving alot of info at the time. Alot to absorb. Anyway. what kinds of things do they do for the post operative pain? He is having half the colon removed and is not happy about it and dooes not understand why so much is being taken when the cancer area itself is small. The surgeon trie dto explain but my husband didn't understand it all I think. He was still in a shock state I think about all of this. We both would appreciate any help about what he can expect. I'm going to print it out so he can read the replies. Thank you all so much for all the help you have been and the kindness and caring that you've extended. :angel: Thank you again. Sherri

bmccrea 09-06-2006 09:25 PM

Re: Hubby has question about pain treatment post surgery....
Hi Sherri,

I can understand your husband's concern. I was scared to death too, going through my things and telling my son who was to get certain things. Awaiting surgery is a nightmare, so my heart goes out to your husband. I got along wonderfully well. Was in the hospital only 3 nights. I had about 18inches of colon removed and it was done laprascopically. Small incision about 3 inches long and with 3 more half-inch incisions for looking around in my abdomin. My doc explained that the colon does not have many nerves so I would not feel pain deep down inside where the resectioning took place, and he was right. I had a morphine pump which I only hit one time and that was because the nurse told me to do it when they moved me from the stretcher to the bed. I had some kind of medicine in a round ball with very thin tube that went into my incision. They called it a "Q-ball". I was given a non-narcotic drug called Torodal (not sure of the spelling).

Personally I believe alot will depend on your husband's incision as to how much pain he has. My cousin had colon surgery with an incision in her abdomin from her belly button downward. She experienced more pain with that than I did.

I hope this helps some. Blessings to you both.:angel:


Anders 09-06-2006 09:47 PM

Re: Hubby has question about pain treatment post surgery....
too sweet,

The most important piece of advice I can give is WALK WALK WALK. They will have him up walking the same day as surgery. This more than anything else will help speed the recovery (ie- wake the bowels from surgery and passing gas). I believe I was walking to the nurse station that first day (it may have only been a few feet, but it's walking)

He will be on limited liquid diet until he can pass gas, after that they will put him on soft solid foods. Once he is able to pass regular solid food and there are not problems or complication, he should be able to go home (About 5 days following surgery). It will take about 2-3 days for the bowel to wake up to the point he is passing gas.

He will probably be on some type of pain pump. I can't remember where it was hooked up, but know it wasn't the spine. He will be in pain those first few days, the pain pump will help there, but again I stress waliking up front reduces pain in a few days, speeds healing and helps wake up the bowels.

Good luck, he will make it, if I can help more let me know.


larbo's wife 09-06-2006 10:04 PM

Re: Hubby has question about pain treatment post surgery....
Hi Sherri, My husband had his first surgery last October. He had a tumor high up in the rectum, near the sigmoid colon. He had 5 1/2 weeks of chemo/ radiation prior the his operation to shrink the tumor. His operation consisted of first having the tumor and surrounding lymph nodes removed, then having the colon connected to what remained of his rectum. Once that was the surgeons gave him a loop ileostomy that was reversed after his post surgical chemotherapy regimen was finished. He had quite a bit of pain with his surgery but the epidural did a good job at keeping it at a tolerable level. He had a button to push to administer the morphine when he needed it. He was also getting other pain meds through his IV lines and with pills. If I remember correctly He only had the morphine pump for the first 4 days and for the most part only used it before taking his walks in the hallways
My heart goes out to you and your hubby. Please keep us posted.
This board helped me keep my sanity at times. :jester: Kathy

CancerDad 09-06-2006 11:25 PM

Re: Hubby has question about pain treatment post surgery....
Hi Sherri:
You can look through and find my old posts regarding pain treatment...but I will type the gist of it here.
They will try to talk your husband into an epidural saying that it does such a great job numbing him up since it's major surgery and all. They talked me into it...worst mistake I made. First of all, they put the needle in your back, and then run tubing that they tape in place and remove the needle. This is to deliver a "lidocaine" type medicine into his back and numb him from around his ribs down. Like him, I was not fond of having anything in my back, but they said it was best.

Well I woke up from surgery and felt intense pain on my right side, but my left side was numb. So they made me "roll" so the anesthesiologist could readjust. They did this about four times in the Post Anesthesia Care Unit. It seemed to get better, so I was brought up to my room. Then, I was in and out of sleep, and it must have been about 4 or so hours later when the pain was SO intense again (it had been slowly building, but I wasn't that aware) on the right side of my body, I had the nurse call anes. again. He can up and when he suggest that he just "readjust it a little again," I demanded that he take it out and put me on a PCA (Patient Controlled Analgesia). The machine attaches to your IV line and delivers a narcotic at a constant level. FINALLY, RELIEF!! You also have a button with the machine that you can push to get an extra dose each period the machine you will never overdose. Make certain IF he decides to go the PCA route (my recommendation is don't even try the epidural, and I didn't for future surgeries,) that he push that button whenever he is going to move, or try to get up, or WHENEVER he feels pain. They will look at how many times he pushed the button on the log when it's time to change the narc bag in the unit, and will program his standing dose lower than before if he doesn't push that button. I say this because the second day is when the pain REALLY peaks, and if they lower his dose before that happens, he won't be as comfortable.

Also, as stated... WALK as soon as possible (which depending on when you get up to the floor might not be until the next day). But walk with Sherri holding onto the IV pole (and you CAN unplug the machine and nothing will turn off, it just switches to battery power). Walk up and down the hall, letting the nurses see you (they do write it down!) And if you are like me, you heal better being in your own bed at home. Seriously, walking helps move gas in your colon, speed of functioning, prevent blood possible blood clots in your legs, and DOES impact how well you are doing and when you can get out--to an extent!

It's REALLY important that you let them leave your cath in for 5-6 days so you won't have problems peeing. It's uncomfortable and a pain in the butt, but if they take it out too soon, you won't be able to pee, could cause more damage and they will just have to put it back in... not pleasant at all!!! Mine was in for 4 1/2 days and when they took it out, I couldn't pee for the life of me (my tumor was so low in my rectum, some nerves got permanently damaged). I still can't pee to this day-- two years from initial surgery due to nerve damage, so I cath myself 6plus times a day since surgery...I am sure you won't go through this, but don't be in too big a hurry, and let things heal... It does take longer to heal if you had radiation which honestly I can't recall if you did. Expect to be in the hospital about 6-7 days. I was in for 5 days or 4 days AFTER surgery.

BTW they will get you over to oral pain meds as soon as possible. Most patients keep a PCA for about 2-4 days. For rectal surgery, you can expect an incision from just above your navel to just above your pubic hair-- a little less for colon cancer.

I wish you luck. I'm sure everything will go great. My advice between now and surgery is to enjoy your time with you kids, and definitely enjoy spending quality time with Sherri ;). For me, when I had surgery at 31, I took things like this for granted, expecting ALL to be well after rectal surgery. There is a small chance of problems-- like the peeing, you can also have problems below the belt with rectal surgery (again, I can't recall if you are getting treated for rectal or colon cancer). In any event, just ENJOY things, don't take anything for granted, and EXPECT that everything will be fine because the likelihood is it will!:)

My Best to you,

fifistoosh 09-06-2006 11:37 PM

Re: Hubby has question about pain treatment post surgery....
My FIL has recently had 1/2 his large bowel removed (his tumor was fairly small - it hadn't spread), I think this is done as a precaution, just to be on the safe side rather than risk it spreading. We don't need the amount of bowel we have, so tell him not to worry, his stoma will most likely be reversible and he will lead a normal life once he recovers.

FIL had an incision down his tummy and also has a morphine pump which he pressed when the pain got too bad. The pain he felt was around the skin wound rather than deep inide him. 6 weeks on and the pain from his scar is almost subsided now.

Try to keep him as active as possible, get plenty of rest (you too), freeze some meals so you can relax a little afterwards. It will take it out of you too, the stress and additional time out visiting.

Wishing you luck.

Annie57 09-07-2006 06:35 AM

Re: Hubby has question about pain treatment post surgery....

I had surgery for rectal cancer March 2004, a mastectomy in August 2004 and a complete hysterectomy done in September 2005. Results were cancer each time. I also had a reversal surgery due to a temporary ileostomy in June 2004.

Due to so many different sugeries I read up on and learnt as much as I could on pain management , depending on the type of surgery you have. I opted for the epidural for pain. The needle was inserted in the OR after I had already received medication. I felt nothing when it was inserted. It was great. I had no complications and was pain free for the first 4 days. On the fourth day they began to ween me off the epidural and I was started on pain pills. By this point the worst of the pain had passed and the pills worked.

I have had surgeries with both the pump and the epidural. From my experience and from other people I have spoken to the epidural, when inserted and monitored correctly, is the best medication to keep you pain free.

I realize there can be complications with any type of medication, talk to your doctor and ask a few others who have used both types of pain medication. I used the pump when I had the reversal done, for that the pump was great. I was not even offered the epidural for that surgery.

You must get up and walk around as soon as you are able after surgery. The epidural allows for this and you are pain free and able to walk with no problem.

Good luck.

Jeni61 09-07-2006 10:15 AM

Re: Hubby has question about pain treatment post surgery....
Just to chime in here about epidurals - I had a c section for my 11 year old's birth -- the child's head seemed to be about the size of a basketball - and was given fentanyl, which I cannot tolerate.

So I had some ugly hours in recovery. Its like an old episode of Dragnet, you know, the one where the college students get the bad batch of LSD and hallucinate and see snakes, etc.

The drs realized for the rest of my recovery they should play it safe and so just left my epidural in for post-c-section pain management. I did very well with it, and I am a big weenie. I didn't even realize when they were installing the thing, and that was true for the birth of my 2nd child, too.

I like the idea of the epidural because you can be concious enough to do things like walk a bit in the hallway of the hospital but also not feel pain.

Annie, your story intrigues me - was the breast cancer related to the rectal cancer, or just a whole different thing ? Was the hysterectomy also related, or again, just a different thing ? Indeed, you are a survivor.

You also seem to have a pretty good grip on the pain management thing - as I will have my surgery at the beginning of November, I will be paying close attention to this.


Too Sweet 74 09-07-2006 01:38 PM

Re: Hubby has question about pain treatment post surgery....
Wow, Thanks everyone !!!! :)
All of this is helping him understand his options and what to expect. He doesn't have alot of pain tolerance so this issue worries him. He is not crazy about the epidural at all if he is awake for it. He wants it all done, including the catheter, while he is asleep. He had a cath for his kidney stone years ago and you could hear him yell throughout the floor. The nurse was a big guy too, muscle builder. Husband said he looked like he benched Buicks.LOL .He swore to never have it done like that again. I guess I can understand. It is an uncomfortable experience to say the least even for a female to go thru. Do you think they will give him any choice in any of it?
I had two c-sections and a third surgery for a large dermoid cyst on my right ovary and I had the self administered pain management for all of them afterwards and it helped me alot. I don't know how much he'll handle. I have been relaying everything that everyone has told me and he has more understanding now than he did and was happy about learning more. He keeps talking about the kidney mass and has really got himself convinced it is cancer as well. His family is prone to these masses come to find out. His sister has one too.Hers is benign. I told him about the walking too. I suggested maybe walking with our youngest around the block maybe would be nice for both of them.
CD, his cancer is on his right side of his colon. Doc said no ostomy because of where the resection is being done. It's not big, a little more than the size of making the circle part of the "OK" sign with your hand. I do have a question about the type of cancer though. He has the adenocarcinoma, you said it is what most get. What is the difference between that and lymphoma? He retested the biopsy three times to make sure of what it was. It looks like lymphoma. I looked up pics of them both. If anything it looks like my husbands mass is in the beginning stage of the disease. It isn't very far out from the wall at all. No "grape-like" lumps at all like the pics I saw either.
He has been having more trouble with being tired and his bowels habits too and is worried that the cancer is spreading quickly. The one nurse I talked to said that these things can happen partly because he is so worried and stressed over this. It will mess with him in a big way. He isn't sleeping too well either most of the time.Some days just a half hour at a time. I have him on vitamins and reduced his caffiene intake at home too.
Annie you really are an amazing survival story . I was wondering the same as Jeni about what has been your story . You must be an extraordinarly strong person.
I am so thankful for all of you. I don't know what I'd do without these boards for both hubby as well as my own health issues. I was mostly on the Pain management and nueropathy and RSD parts of the boards. What wonderful people thru all of them. A real Godsend. :angel:
I had better go get things done around here. Hope everyone has a great day.By all means keep the responses coming. :)

Love and hugs, Sherri

Annie57 09-07-2006 02:59 PM

Re: Hubby has question about pain treatment post surgery....
Hi Jeni & Sherri;

I will try and be as brief as possible in giving you my history.

I am 49 years old and began this saga of my life in December 2003. I was dx with DCIS in my left breast. I had a lumpectomy done in December but unfortuantely the doctor could not get clear margins. I had to have another surgery in Jan 04 to try for clear margins.

During this waiting period I had some rectal bleeding that my family doctor told me not to worry about. I told the breast surgeon and he ordered a colonoscopy that week. I was dx that day with rectal cancer, staging etc had to wait until surgery. My cancer was very low in the rectum ( 4 inches into the rectum).

The second breast surgery was also unsuccessful, no clear margins. March 5 I had rectal surgery, a resection and a temporary ileostomy. I had the bag for 12 weeks. I was staged 1 with no lymph node involvment.

June 4th I had the reversal and was told I had to have my left breast removed as the DCIS was found throughout the breast and could not be removed any other way.

August I had the breast surgery and was put on Tamoxifen. This was not an invasive cancer.

June 05 I had a biopsy done on my uterus, due to the Tamoxifen and after genetic testing proved I had inherited a gene HNCPP which probably caused the rectal cancer and could possibly cause uterine cancer. The biopsy showed no cancer but the Gyn/Oncologist decided on the hysterectomy anyway. A frozen section was done the day of surgery and that also showed no cancer. Unfortunately I received a call from my surprised oncologist who told me I had uterine and fallopian, both primary cancers staged 1A. I had to have 6 chemo treatments, Taxol/Carboplatin. The cancer in the tube was very aggressive and very rare.

I am now one year from surgery and 8 months post chemo. I had a cat scan done on Monday with blood tests and will find out the results September 12. This was my second 3 month follow up.

It has been a long 3 years. I am hoping to return to work this month and praying my results remain good. I still have the tingling hands and feet but my hair has grown in. Short but I have hair.

I have been very lucky, all cancers were found early. I live one day at a time and try to enjoy each day. I still have alot of bathroom issues, but am slowly learning to live with it. I have to try and watch what I eat and always know where the bathroom is. I have been told I will never be normal again due to the amount of rectum and colon that was removed.

If I can answer any questions for you just let me know. There is always hope and with all the new medical treatments today everyone does have a fighting chance to overcome this horrible disease.

CancerDad 09-09-2006 01:34 AM

Re: Hubby has question about pain treatment post surgery....
:angel: [QUOTE=impactzone]I just had colon surgery for Dukes C. They took out 18 inches. I had surgery on Friday the 1st and was released from the hospital on Thursday the 7th. Surgery went well. They did find 1 node with cancer out of 21 and there is a met on my liver. That freaked me out but I kept saying it could have been worse. I reordered my days so that mentally a good day was not the same as before but just better.I did have the PET scan done and will get results soon about the spread. I had an epidural for 2 days. I felt no pain but did get low blood pressure and when they asked me to walk I felt dizzy and threw up. They took out the epidural and put me on a morphine IV drip. That was fine for pain. I then went to a pump, again, no pain. I walked alot as my goal was to pass gas. It took 5 1/2 days. Looking back now it seemed like I was in for hours not 1 week. I am still scared and sleep intermittentantly but I know I am better today than 1 week ago. For me, the mental pain is the hardest. Nights in the bed were horrible with my mind running and not being able to sleep. I did find comedy DVD's brought in helped. Physical pain was not any large problem.

I am 47 male coach with a 10 and 12 year old and wonderful wife, who was not an emotional type and now I cry for no reason when kindness is shown. I really want to believe in prayer but I am also eating well, reading, sleeping when I can. I try to live by a motto I read on one post here befor I went in. "Be stronger than not angry at." Start the steps necessary. I am only relating my hospital experinces but the nurses were overworked angels, the way I view each moment is much more intense and I come here to refuel.

God bless you and I want to help go through this together.

It sounds like overall it went pretty well. I'm sorry for the discovey of the met, but most times the follow up chemo can knock it out. Worst case... you have the small spot removed. At least you only had 1 node positive. That is GREAT news and reduces your chances of the cancer escaping to other parts of the body.

Be Strong,:)

Jeni61 09-09-2006 08:54 AM

Re: Hubby has question about pain treatment post surgery....
To Impactzone - let me echo Cancer Dad, one node and one spot is not a bad thing. There is a lot of good in that. Yep, we'd all like to have nothing on the liver, like we'd all like not to have this disease, but like you say, it could be worse and there is a lot they can do.

To Annie - thanks so much for sharing your story, I love to hear them. And I am sure your ct scan will be fine, your cancers, despite battling them over and over, sound like they were caught very early. I am sure I will have more questions as I am very early into all of this.

Annie, did you have chemo/radiation before surgery ?


CancerDad 09-09-2006 02:31 PM

Re: Hubby has question about pain treatment post surgery....
[QUOTE=Too Sweet 74]CD, his cancer is on his right side of his colon. Doc said no ostomy because of where the resection is being done. It's not big, a little more than the size of making the circle part of the "OK" sign with your hand. I do have a question about the type of cancer though. He has the adenocarcinoma, you said it is what most get. What is the difference between that and lymphoma? He retested the biopsy three times to make sure of what it was. It looks like lymphoma. I looked up pics of them both. If anything it looks like my husbands mass is in the beginning stage of the disease. It isn't very far out from the wall at all. No "grape-like" lumps at all like the pics I saw either.[/QUOTE]

I'm SORRY I missed this one! To clarify then, your husband DOES have ADENOCARCINOMA...RIGHT??? I ask this because Extranodal Lymphoma or Malignant Lymphoma presenting in the colon is MUCH different and pretty rare. This condition is usually present in immunodeficient patients such as AIDS patients in advanced disease. Epstein-Barr virus and a human herpesvirus-8 DNA sequence have been implicated as well. Again though, it's really pretty rare without other disease present. And the two histologies are treated very differently with a dx of Lymphoma leaving surgery for bleeding or perforation or obstruction.

None of what you have described sounds like Lymphoma, but it ALL has to do with histology. If you are confident with the GI who biopsied the lesion/tumor, and they tested the specimen FOUR times/ three of which were positive for Adenocarcinoma... if I hear you right... then I would trust their assessment.

Tell your husband that it's PERFECTLY NORMAL for him to be fatigued. The stress of it alone is enough to drive you over the breaking point! Yes, the mass on his kidney COULD a met. OR it could be perfectly benign. Is he still losing a lot of blood rectally? If so, then then his blood levels are probably off--he could be anemic-- which would make him tired on top of the WHOLE process.

Hang in there and keep me posted.
I wish you guys the best.:)


Too Sweet 74 09-09-2006 03:57 PM

Re: Hubby has question about pain treatment post surgery....
Hi CD :),
You understood correctly. He has adenocarcinoma in his right side of his colon. They made absolutly sure of it. We know more on monday. He has more bloodwork and his CT and MRI of the kidney. The doc who did his scope is pretty well respected and so is the surgeon. His bleeding has lessened lately. His blood tests came back that he is not anemic as of a few weeks back. Liver function and all of that was normal too. His sister has a similar mass on her kidney . Hers is from a hormone problem she has she told me. She is lacking growth hormone.Has to give herself shots.She told me that their uncle informed her that the family gets these "weird masses" for no reason that can be anywhere. No urinaliysis was done on him though that I am aware of. He went to his bloodtest by himself. I'll ask him when he gets up in a while.Would a urine test tell anything at all about the mass? Monday they are doing all the preop stuff. EKG ,MRI and CT as well as bloodwork.We'll know by the end of the week what the mass is the surgeon said. Hoping it won't take that long.My husband is obviously very worried and the sooner he knows something the better it will be. His surgeon said that mets to the liver is rare for most people, the liver is what shows them first alot he said.Hope he's right. If he has it on his adrenal I wonder what else it has spread to ? Less than two weeks to go now.
My husband decided that today would be his last day at work. He is just getting too wore out and hurting more when he goes. His friend said if he shows up tomorrow night he'll end up in the hospital "cause he's going to kick his backside" (cleaned up version LOL) . His friend just told him there is no reason to put himself thru staying at work with what he is going thru with the cancer. I know my husband will lose his mind from boredom very soon though. His sick pay is kicking in first day he misses. Only 50% of it his regular pay though. It will be a really tough time around here for sure. He can get unemployment along with it once he can be considered "light duty" .I am off work cause of all my comp BS and I don't know what to do. I was going to write my comp judge to get my pay reinstated but I don't know if that will hurt my case or not. I need to make some money somehow though. All the money worries are certainly adding to how hubby is feeling as well it adding to what I am dealing with. Like I said this is going to be a rough time for alot of reasons. I appreciate all the help with all of this. I know I, we would have been in a bad way if I hadn't found you all.
I've been trying to get things done around here, partly because I need to occupy myself. There is stress added to all of this by my mother too. She has become just mean this past month. Too much to go into right now. She seems to resent me having my pain problems and not doing all her driving and everything else she wants done. Now hubby is sick she is actually behaving worse. There is an explaination in another post of mine . I just don't know how she can just walk away from her daughter and grandsons when this stuff is going on. It's like if I can't do things for her then to hell with me kind of thing. So I decided to just not talk to her right now. We don't need the drama or stress or her negativity either. Amazing what really comes out in people during times like these. It sadden me that my boys' grandma is doing this to them. My husband's mom passed from cancer 11 years ago so she is all they have too. My husband said he's pretty happy I'm not like her. Me too . LOL
Well anyway I am telling my husband about all of the info from everyone . He's understanding more now. I told him about the cath you have to do yourself and he was very much freaked by the idea. Is there anything they can do to help you with that? Anything that will decrease the damage somehow?
I had better go. More to get done here. Take care of yourself. Thanks and a huge hug !!!! Sherri

CancerDad 09-09-2006 06:13 PM

Re: Hubby has question about pain treatment post surgery....
It REALLY is incredible when a loved one becomes sick... on top of it with all that you are going through. You DO find out who your TRUE friends are.

When your husband goes out of work, his insurance is going to cut out at some point... they will offer him COBRA for a period of time, but he may need to apply for additional benefits. Actually, his pride might get the best of him and YOU might have to contact the social worker in the town where you live. There IS state aid available for insurance, and some aid if you qualify for food assistance. We got/get help with health insurance. If you husband complains about you looking into this, tell him that he put enough into it... now it's his turn to LEGITIMATELY claim from it. There are also social workers at the cancer centers who can file for donations, essentially grants that foundations give to families in need going through what you are. PLEASE inquire about them.

Also, tell your husband that they most likely will NOT put in an epidural when he's out... they need to make sure they hit the right area, that it's working and he's numb. I told you my experience with an epidural, and personally would NOT go that route. As far as the catheter, they DEFINITELY can put it in when he's out, and do any prep work they need to-- shaving a little down his pubis or abdomen if necessary (if their nice!!). Also, PLEASE tell him when it is time for the catheter to come out, once they remove ALL the solution holding the foley catheter in place, he should be forceful in telling the nurse that HE WILL PULL IT OUT. All he has to do is slowly pull down and outward. It is MUCH less painful when you do it yourself.

As for telling anything from his urine... Yes, they can see if there is microscopic bleeding, sometimes there are cancerous cells that can come down and into the urine. The surgeon is right... the first spot for a met from a tumor in the colon is typically to the liver and then the lungs. This is not to say that it CAN'T go elsewhere though. HAS HE HAD A PET SCAN? PETS show where there is cancer in your body. THEN you follow up with CT or MRI's for a closer view of where it "showed cancer present."

As for me, tell him when you cath 6 or more times a day, it just becomes something you do. Like getting adjusted to the colostomy bag, learning to live with not being able to "perform" sexually, living in constant pain... these are all things that were due to WHERE the tumor was, and the damage that was done to the nerves and tissue from radiation and surgery. So, no, I have been to top specialists in the field and this is it. I can get more surgery to get a penile implant... at 33 and married, it's looking better and better to have something rather than nothing. Thanks for the hug, we ALL need one sometimes.:)


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