My husband is scheduled for J pouch surgery on Tues 1/29/08. He had ulcerated colotis and 19 years ago had the colon removed and an ileastomy done. He has been extremely healthy since - takes no medication, etc. He has now decided to have the J pouch done. He thought he wanted the one step procedure done and found a surgeon with a lot of experience. This week he met with his surgeon who told him about a patient in similar excellent health who went through one step and had a pretty miserable time with it over the last 6 weeks. He advised my husband think it over, that the 2 step option was also available. So now we are filled with many worries about the 1 step procedure and looking for feedback and others' experiences. Thank you!

Have seen this question before, and I believe you are going to get mixed responses. I have read people who had a really tough time recovering and others who recovered quickly and adjusted well. Not much of an answer.

I do hope that your husband has been doing a ton of kegels in preparation for this. He probably has some output from his bottom anyway that he has to hold sometimes (mucous)? Anyway - 19 years is a long time for those muscles to be basically unused.

Wonder if they have a boot camp for butts to get them in shape

He is leaning towards 2 step right now. Yes I am trying to encourage him to do kegels!!! Thanks for the insight - you are right there are no easy answers and everyone is different!

I am one who was quite grateful to never have to deal with an ostomy. That said, your husband already is accustomed to an ostomy, so a 2-step would not be too much of a big deal. However, the diverting loop ileostomy that he will have is much more problematic than an end ileostomy.

Life is all about risk and you just have to decide what risks you think are for you.

Even if he did decide with the 1-step, they would not know until surgery was underway if the surgery could be done that way.

Jan

Thanks Jan - I see some of your other postings and you add a lot of value! Yes - this too will pass and we will keep taking deep breaths!

I was one of those that had the two steps (creation of pouch and takedown) done as one surgery (in Oct 07). I did pretty well when I was in the hospital, which happened to be for 2 weeks (due to ileus), but found things a bit difficult when I got home. I had a lot of pain in my tailbone area, particularly when I was sitting or standing. I chalked it up to the healing process as that is where the join was. In my case, it was probably made worse by the fact that I had very bad rectal inflammation which really hadn't calmed down too much in the six months that I had my ostomy. I believe this pain was likely exacerbated by doing the two steps at once because I was using an area that was trying to heal. It slowly got better and after about two months it seemed to have resolved itself.

Getting used to the pouch I think would have been the same for me whether I had it done in one or two steps - that just takes time.

The big advantage in my mind is that I don't have to have another surgery. But I was prepared for either option, because the surgeon said he wouldn't know until he opened me up.

Good luck with your decision - as with all things, there are pros and cons to both options.....

Louise

My daughter had her end ileostomy for a year. Then she had the next surgery done in one step. Of course it is not promised until the surgeon gets inside. She had it done laproscopically and was very happy to wake up without a bag again. She has done very well with it and has never had a blockage due to the fact that her small intestine is all intact. It is always better to have one surgery than two and two times having ansthesia. She has done well right from the beginning. Just make sure to use barrier cream of some sort when starting to use the bathroom. The jpouch heals within days and it takes that long for the bowels to start working anyway. Good luck with whatever decision you make.

I had a total abdominal colectomy in July 2004 because I had been (and was still on) high doses of Prednisone for 4 1/2 years straight.

In December 2005, I went in for Step 2 (of 3), and woke up to find that they performed both Steps 2 and 3 at the same time. I knew it was a remote possibility, but did not really expect it to happen. They also repaired a very large hernia at my stoma site at the same time.

I spent 8 days in the hospital after the second surgery, and was back at work full time five weeks after surgery. The healing was rough (it was an abdominal surgery again, and not laproscopic, so I had 50-some staples in me), but I am glad it was done that way to save me another surgery and more time off of work and away from my child.

Frankly, I trusted my surgeon and would have made either outcome work. His judgment was very important because I hope to have a healthy, fully functional pouch for the rest of my life and I felt no need to rush it.

That said, I have had the pouch for over two years, and have been happy with the outcome.

-Nicole