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dinsdag, 15 maart 2016 16:43

Operatie achter de rug!

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De operatie zou tegelijk maandagmorgen 7 maart om 07.30 uur zijn, en dus moest ik mij al zondagavond 20.00 uur melden in het UMCG. Alle opnameformaliteiten waren al op de vrijdag ervoor afgerond. Dus in alle vroegte op het ziekenhuisbed richting de OK. Dan wordt  het je tegelijk duidelijk dat het UMCG iets groter is dan Hengelo/Almelo: een immense gang met 25 operatiekamers achter elkaar! Uiteraard wordt je vriendelijk te woord gestaan door het team: de chirurg, de anesthesist en een stuk of 4-5 assistenten. Voor de pijnstilling wordt er eerst een heel klein buisje in je rug ingebracht (om de pijnstiller, een morfine-achtige stof, direct in het gewenste gebied en continu te kunnen injecteren). Daarna de "bekende" stekende ruggenprik en vervolgens binnen 10-15 seconden naar dromenland...... De operatie zou zo'n 4 tot 4,5 uur in beslag nemen.

Nadat de operatie is afgerond wordt je op de operatiekamer al wakker gemaakt. Dat is mogelijk omdat de anesthesist je niet al te zwaar onder narcose brengt. Met sensoren op je voorhoofd meten ze de hersenactiviteit en hoever je in slaap bent. Klaarblijkelijk heb ik zelf nog meegeholpen om weer te verplaatsen van de operatietafel naar het bed. In de uitslaapkamer ben ik dan ook niet zo lang geweest. Tussen 15 en 16 uur kwam ik terug op de kamer.

 

 

Links: Uit bed komen is er even niet meer bij. De linkerarm is verbonden met het infuus voor de vochthuishouding. In de rug zit een draad die is verbonden met het gele tankje aan de "paal"  en waardoor de pijnstiller wordt toegevoegd. In de eerste uren is er nog een buisje in je neus die verse zuurstof geeft. In de buik zit een slang om overtollig wondvocht af te voeren en dan natuurlijk nog de blaaskatheter om urine af te voeren.

Rechts: Mijn opgezwollen buik na de operatie. Links de wonddrain. In het midden de afgedekte wond (dus wederom een flinke snede) en rechts mijn nieuwe aanwinst: de stoma. Deze kent nu een maximale uitvoering omdat er nog een "brug" in zit. Deze brug zorgt ervoor dat de darm niet terug kan schieten in de buik. Hechtingen moeten ervoor zorgen dat deze brug over korte tijd weg kan en er een meer subtiele stomazak gebruikt kan worden. Verder is nog het mooie biggetjes-roze te zien van de desinfectie. Allemaal leuk genoeg om er een vrolijk gezicht bij te trekken ;-)

Een heel bijzonder idee is dat je niet meer naar het toilet hoeft vanwege de stoma en de katheter. De pijn viel door de pijnbestrijding ook wel mee en een eerste kleine hoeveelheid voedsel in de vorm van yoghurt viel ook goed. Er was nog wel een beetje angst dat de maagklep weer dicht zou slaan zoals bij de eerste operatie (vooral angst voor die vervelende maagsonde), maar die bleek ongegrond. De maag nam al het voedsel prima op. Toch begon ik me op dinsdag steeds onprettiger te voelen. De vraag was of de stoma goed op gang zou komen. Op woensdagmorgen het bed uit om te wassen bleek behoorlijk pijnlijk.  Er had zich een enorme druk ontwikkeld in de buik en dat drukte dus ook op het geopereerde gebied. Kort daarna begon de stoma echter vloeistof af te geven. Uiteindelijk bijna 3 liter! De druk en ook de pijn was volledig weg en ik voelde me weer prima.

Opnieuw duurde het bijna twee dagen voordat er door de stoma weer wat werd afgegeven, dus opnieuw een situatie met druk en pijn, maar minder heftig dan de eerste keer. Ondertussen was wel de vochthuishouding op peil, dus katheter en infuus mochten weg. En ook de pijnbestrijding kon worden vervangen door pillen. Dus een hoop draden minder en een stuk mobieler. Ik kon weer zelf douchen e.d. Op zaterdag begon de stoma weer te produceren en nu ook iets beter ingedikt (dus minder vocht). Toen op zondag bleek dat ook de wonddrain bijna geen productie meer gaf, was het voor de zaalarts voldoende om me naar huis te sturen.

Tussendoor kwam de chirurg ook nog even langs. Hij kon gelukkig vertellen dat de operatie weliswaar lastig was, maar dat hij wel tevreden was met het resultaat. Deze operatie is bij mannen lastiger dan bij vrouwen waar er in het bekkengebied meer ruimte is. Een beetje overgewicht c.q. buik maakt het allemaal ook wat lastiger. Wat is er nu precies verwijderd? In totaal zo'n 20-25 cm verdeeld over de endeldarm en het sigmoïde deel van de dikke darm. Waarom toch zo'n relatief groot stuk, terwijl de tumor maar betrekkelijk klein was? Omdat er een ruime hoeveelheid klieren moeten worden meegenomen i.v.m. uitzaaiingen. En zonder klieren kan een stuk darm niet functioneren, dus moet dat ook weg. De tumor ligt nu bij het pathologisch laboratorium. Over een kleine twee weken kunnen we daar de uitslag van verwachten.

De komende weken zullen we behalve herstellen nodig hebben om te wennen aan de stoma, maar de eerste indruk is dat er prima mee te leven valt. Zoals eerder gezegd zit ik er minstens drie maanden aan vast, afhankelijk van de genezing van de verbinding tussen de endeldarm en de dikke darm.

 

 

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