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Ileo-Pouch Anal Anastomosis Guide
After your operation, you will spend two to three hours in the
recovery room. You will start your cough and deep breathing exercises
there. You will find that a catheter has been inserted into your
bladder. This catheter drains your urine and will usually be removed
within three to four days. In addition, you will have two wound
drains called Jackson-Pratts inserted in your abdomen to remove
excess fluid from the surgical area. These will be removed once
the drainage decreases, usually in about five days. After you are
in your room you will begin using your incentive spirometer about
ten times per hour. This is important because it will help inflate
your lungs and decrease your risk of pneumonia.
Post-Operative Pain Control
There are various methods for controlling pain. One very effective
method is called an epidural. This is the pain control that is commonly
used during childbirth. Although not every patient is a candidate
for an epidural, it seems to be the best way to control pain when
it can be used.
To administer the epidural, an anesthesiologist will insert a small
needle into your lower back along your spine. A tiny tube is then
threaded through the needle and left in place next to the spinal
nerves. These nerves are then bathed with pain medication. Because
a small amount can be used to obtain good pain control, generally
less medication is necessary and there are fewer side effects. Occasionally,
there is weakness or numbness in one leg. This is temporary and
can be corrected by reducing the medication dosage.
The next most common method of pain control is a PCA pump, or patient
controlled analgesia pump. This allows you to give yourself an intravenous
dose of morphine or Demerol on demand. You will have a button to
push that delivers the medication. Controls exist in the machine
so that you cannot give yourself too much. You must caution relatives
that they are not to push this button-only you should push it.
There are various types of injectable medications that can be used
if you are allergic to morphine or Demerol, or find their side effects
unacceptable. As soon as possible, we will switch you to oral medications.
These will be given for the first week or two when you are home.
After that, it is unlikely that you will need to continue taking
narcotic pain medications.
Diet
The first few days after your operation, you will get your nourishment
intraveneously. When your intestines begin to work again, and gas
and stool are able to pass through, you will be started on clear
liquids. You will advance to a normal diet by the time of your discharge.
Activity
Activity is very important for your recovery. It helps speed up
the return of normal body functions and helps you avoid complications
like pneumonia and blood clots. The day after your surgery, your
nurse will help you to walk. At first, you will walk only a few
steps, gradually increasing daily.
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