Back home as of Friday afternoon. Thought I'd fill in the results just in case anyone else comes up against this. Ok, so after 19 years with stoma 2.0, I had my first stoma area infection.
Nothing conclusive here but some interesting details.
About a week before all of this happened, I was having severe gas pain from what I thought was another gallbladder attack. I had stones in the past, and this situation presented the same way. I had severe gas pain that showed up as a bloated area right above the stoma and appliance area.
As in the past, I had simplified my diet to eliminate as much fat as possible. I noticed a lot of gas with burping and gas in the bag. But the hardness above the stoma wouldn't diminish. By the end of the week, I noticed how hard the swelling had become and the redness and heat led me to believe that it was something more. By Sunday when I changed appliances, it was obvious that the hard red hot lump that had developed was something other than what I thought. It was an infection. The affected area was about the size of a section of a large navel orange (same shape too) about 1/2 inch directly above the stoma and right on the edge of the appliance.
Now apparently, these are common with Crohn's/ileostomy patients. After years of meticulous care and no infections, I finally had one. That's what caused all the serious pain and inflammation.
I did also have significant gallstone at the same time.
The treatment was painful but simple. They inserted a drainage tube directly above the stoma on the edge of the appliance in the direct center of the infection by way of CT scan. While under the scan, they lined up the drainage tube, marked a spot, and gave me a local and inserted the tube. It drained the area over the next 6 days and after 3 days and 2 10 cc saline flushes (damn they hurt) it was completely drained. During this time, I was on an IV drip for morphine and antibiotics.
On the second to last day, they removed the drainage tube (damn did that ever hurt after 2 days off of morphine and no other pain meds - too much is too much) and did blood work. The blood work and a quick physical check of the area made it obvious the infection had subsided.
The GB pain died down but I'll have to go back sometime soon to have the GB removed (laser laparoscopically).
I should also note that the antibiotics gave me severe diarrhea and I lost 6 kilos (roughly 14 lbs) in a 4-day span. Not good for a dialysis patient (just to make it a little more challenging). Thankfully, I had been in the best shape I had been in a long time so I could handle it all a little better.
In the last 2 days, I've worked hard eating and drinking my way to the point where the flow has slowed down considerably and I'm not running to the toilet every 1/2 hr. I can actually feel the flow slow right down and my digestive system doesn't feel like a funnel connected directly to my ileostomy.
I should also note that the most annoying thing of all (annoying not painful relatively speaking) was the fact that I had to change my appliance 5 times during this stay because of the placement of the tube. It made it very difficult to manage the appliance, especially skin care, the whole time. I've been lucky all these years to have a great combo of skin barrier/paste and one-piece convex ostomy bag that lasts a minimum of 7 days. The problem was changing them every two days took its toll on my skin. It'll take a while but once the rawness of the skin subsides it should settle down back to normal again. The actual stoma is still a little swollen but seems to be getting back to normal.
Dehydrated, exhausted, and relieved it's all over...life goes on.
Hopefully, in a week I'll be able to say it and mean it, really mean it again. Life is Good!
Michael
