Wednesday, October 29, 2014

Ileus and I (English)

Some time ago I had written, 'Gusti, panjangaken usus kawula.' Lord, extend my intestines. In the Java language, 'long intestines' means patient. People who have long intestines are patient. And that's all I asked, to be patient. I forgot why I asked for additional patience then.

A week later the God grant my plea. I was trained to be patient. And in the true meaning, my intestines were really stretched, straightened from abnormal conditions: twisted.

Various comments came from friends about my situation. Some say I've worked out too much. Others said I did too much twisting and folding in yoga. Hm ... make sense ... NOT!

Mysterious ileus.

"Ileus (Paralytic ileus, adynamic ileus) is a condition where the normal movement of contraction of the intestinal wall temporarily stopped. As a mechanical blockage, ileus intestinal contents also in its way, but rarely ileus caused perforation."

The result of browsing here and there, ileus may be caused by an infection, tumor, severe diarrhea, outside the intestinal abnormalities (eg, renal failure or abnormal electrolyte levels), an underactive thyroid gland. In my case, the intestinal twisted because there are parts of the intestine that should be down, permanently attached to the gut above it and formed a connective tissue. At the point where it occurs, it clogged.

How my intestines acted so weird, according to Doctor Ardiyan who did the surgery on me, it may occur as an effect of appendectomy I had over 15 years ago. The inflammation of the appendix was awful it was almost explode. There may be bacteria that spread to the small intestine and causes the strange happenings. Hello, 15 years ago you know. It has nothing to do with yoga I have been doing less than a year...

Another amazing thing is, my intestines above of the blockage enlarged. Up to 2 inches in diameter. While that is below the blockage shrank, smaller than normal size. Again according to the doctor, the blockage has occurred in years, the flow of food in the intestines has been not normal for a long time. Intestines above the blockage have worked too hard so it expanded, the food did not pass smoothly, flowing just a little through the blockage (which have) not stick tight. The intestines below with a little flow became smaller.

It is still a mystery to me. If it has been happening slowly for years, why my stomach become big like in a sudden? Seriously, my abdomen is usually small and flat like Gwen Stefani’s, and many people envy ...

(Mis) Diagnosis.

If the blockage has occurred slowly over the years, why did not I feel anything? Well I did. I've felt everything. I have felt all the symptoms of ileus: bloating, vomiting, abdominal cramps. Quite frequently, like every several months in recent years. The pain was horrible. And each time I went to the doctor, the diagnosis is always: ulcer. In fact, several times I had to be hospitalized as well, still the same diagnosis. The doctors always gave ulcer drug. I got memorized. Inpepsa, buscopan, omeprazole. It is so oddly, why all the pain disappeared after being given the drug.

I had wondered why after I discipline I did, never late to eat, no longer drink coffee, do not eat spicy; the ulcer still came and made me roll-tumble?

Because it was not an ulcer. Perhaps before this, with the some rest, the blockage of the intestines open again slightly, then it flowed again. It failed to be an ileus. And the doctors concluded it was an ulcer relapse. But this time, the twist was really bad, the blockage is completely tight. Not negotiable.


Actually, not all cases of ileus should be operated. There can be overcome by simply sucking the liquid and gas that continuously be produced but could not flow. A hose (NGT) put from the nose to the stomach. From the anus also installed a hose. But there are also cases of ileus that needed to have a cut. Usually because it is damaged. So the broken part was discarded, and the intestines connected again.

They’ve tried to put NGT hose on me, but it did not reduce the pressure. And after a look at x-rays that showed how the small intestines have appeared as big as my arm, the doctors decided it needed a surgery.

The surgery was supposed to be simple anyway. Abdominal Surgery with approximately 10 cm width, for the doctor’s hand should be able to enter. Find the location of the blockage, repair. Return intestine to the starting position. Sew again. Done.

Well it wasn’t that simple. The doctor said the release of connective tissue was quite difficult. Freeing the blockage also has been a dilemma. He wanted to cut it, but it would be difficult to reconnect. The big difference of the caliber has become a difficulty. Beside that, if the enlarged upper intestine was experiencing great pressure, there would be a possibility of burst.

So the twisted position was corrected. Then the doctor cleaned intestines by slowly pushing the fill of the intestine out.
I want to put an image of the enlarged intestines, the doctor took a picture during surgery. But I know not everyone could see pictures bear viscera. So I just plug dramatic pictures while I was still in a state of infused, fitted with NGT and oxygen hose. Luckily there was no catheter hose, how would I expose it? 


Is it for any surgery, or simply surgery relating to the bowel that makes doctors and patients look forward to fart after surgery? When I had appendectomy, doctors also warn me to promptly notify if I fart. This time also.

Anxiously, nearly 20 hours after the operation, there finally came what I was waiting for. It was weak. Doctors Indra the internist who took care of me said, it was reasonable because intestinal peristalsis was still weak, still under the influence of anesthesia. After fart I could take a sip.

Day two post-surgery my fart was still rare and weak. Yes, the movement of my intestines was still weak. I've been given a ration of milk (liquid food is actually), but every time I drank  my stomach bloating and pain maximum. I broke down the drink. I could not bear the pain every time the fluid runs conceded.

Day three there was almost no development. Doctor Ardiyan asked me move a lot. Leaning to the right, to the left, and sit. The goal is to prevent bowel adhesions removed from sticky back in the wrong place. It should not be given the opportunity to stay still long enough. In addition, much motion also stimulates intestinal peristalsis.

"I know, it hurts, it hurts but you have to keep moving," he said, "and you have to drink. Definitely you will feel bloated. But the gut must be trained slowly."

Yes Doc. Painful. The pain is here (pointing at my stomach). Looks like my intestines were still swollen, my stomach was like seven months pregnant. A full bloating, and painful.

But I do not want my intestines sticky again. Finally I forced myself to vary the position. Leaning to the right. Leaning to the left. Every hour. Even at night when the eyes should be closed. Though the pain when changing position as trodden ... (uh, how the hell does it feel to be trodden anyway?).

I tried to sit up. I started by putting some supports on my back. Then off to sit freely. Get off. Stand up. Pacing in the room. While continuing to force myself to drink milk provided.

Morning of the fifth day I could poop. This is the second big thing awaited after a fart. It means my intestines movement was better. After that though the volume and shape are still not consistent I could poop every day.

I was more enthusiasts to move a lot. I spent 5 glasses of milk they gave. But the supply of nutrients for my body was still depending on intravenous fluids. The NGT hose was still left open. Most of the milk I drank flow out again from the stomach through a tube, housed in the bag at the end of the hose, and then discarded. Mubadzir huh? Yes. Then the hose was clamped so that all the milk I drank could get into the stomach and flow to the intestines to. The clamp may be opened if it is not able to continue the milk and feels bloated painfully.

The first night I the opened the clamp once because I bloated much and painful. But the next day I closed it again and up to day eight it was tightly closed. Bloating, but still I could stand the pain. And I said to my intestines, "Hold ya. Be good to me. Keep moving. Move. Keep moving until the estuary ...."

Now and the Future.

Day seven my infusion was removed. Day eight my NGT was detached. I could start eating solid food. Starting with biscuits dipped milk until it is destroyed. Then pudding. Then the porridge marrow. Then porridge plus vegetable blend. Day thirteen, the last day being hospitalized, I was able to eat treated rice porridge and vegetables that was not blended.

I'm home. Although the intestines motion is good but it is not normal yet. Also the size. Who knows how many months it takes time to adjust the difference size to be normal. My stomach is still fat even though not as big as the day after surgery. I still bloated every after meal. I still have to keep moving as usual. In order to keep my intestines moving as it should. I do not want to have the possibility of having a blockage again. It is going to be horrible. I do not want to talk about it. I choose to stay optimists, everything is going to be fine. It takes time. It takes patience. It took longer to lengthen my intestine.

Lord, give me strength....

1 comment:

Anggie...mamAthar said...

Get well soon my twins...
Miss u .. here..