Cecostomy

Cecostomy

Life before and after

By:

Amy Cox Tate

Nursing 101 project

Hi, I am Joshua's mom and this is what our life was like before a cecostomy. When we started potty training we didn't think much about Joshua having bowel movements in his pants, as this is a normal part of training.. Joshua has been in school since he was three years old. I have always and still have to provide the school with an extra pair of clothes just in case Josh has an accident. School was a nightmare because Josh was tormented due to the accidents he couldn't control. This unfortunately still happens if he doesn't flush right or on schedule.

I don't remember the exact age we started Josh on medicine etcÐ'... for the bowels. I will do my best to educate you till he is nine years old. Our family doctor has had Josh on Propulsid (cisapride), mineral oil, soap suds enemas, diet modification, suppositories, timed toileting, Metamucil. Propulsid seemed to help some, as the accidents were fewer, but this medicine was removed from the market. I went back to our doctor and asked about Hirschsprung's disease, as Josh had a lot of the symptoms. We were referred to a wonderful doctor employed by the children's hospital in Peoria, IL. This doctor would soon find Josh's problem and give both my son and me a life.

Dr. Taufiq, who is a wonderful man, had Josh tested for Hirschsprung's disease. The test concluded he didn't have that. My son has endured so many exams in his rectum that it isn't even funny any more. Dr. Taufiq finally decided to test his ability to push while having a bowel movement. For this next test the doctor was going to see if we could train Josh's muscles in his rectum to work properly.

To perform this test Josh had to have numerous enemas and had to clean. On the day of our test, Josh had a probe inserted in his rectum. This probe measured how much pressure is inside his rectum. We all have a baseline of 60, when we push it doubles, but not Josh's. When Josh pushes he measures at 80. Dr. Taufiq and I observed Josh during this and noticed he was really pushing as hard as he could. Joshua's face was red from the effort and exertion that he was putting forth. I was then informed that Josh may never have complete control over his bowels.

While Josh got dressed Dr. Taufiq pulled me to the side and informed me about a procedure called a Cecostomy. An appointment was made for Josh to have a cecostomy, as he was a prime candidate to possibly benefit from the procedure... We reported to the hospital were shown to our room. Josh had to be taken to x-ray. We had to find out if Joshua's bowels were completely cleaned out. Just our luck they are not, so we now endure a nasogastric tube. If you don't know what that is, well, they insert this tube in your nose and you swallow it into your stomach. I had to leave the room. I am normally a very strong person, but this I just could not handle watching them do this and finally get it right the 3rd time. Josh started having so many accidents after this that they put a depend on him.

Day of surgery Josh still isn't completely cleaned out. He had to endure more enemas and x-rays till finally he was clean enough for this surgery. When Josh came out he had in many ways a colostomy bag though this was in his cecum. We had tubing on the outside and a bag for his bowels to empty into. Lord, how those things smell. When we went home we no longer had the bag but the tubing hanging outside of Josh. I was shown how to flush his tubing and had a date to return in 6 weeks to get a permanent chait trapdoor. To flush the tubing before the chait door we had to use a syringe and fill it with 10ml of distilled water two times a day for a week. Once Josh got his chait trapdoor (c-tube) we had difficulty opening it, so had to use a popsicle stick to open for awhile.

To flush Josh he has to open his chait door and connect a tube. Now this tube connects to a kangaroo bag. We start out flushing with 100cc of adult's fleet enema. Wait 15 minutes and now we add1tsp of salt and 500 cc of warm water and wait. This whole process takes about 30- 45 minutes to complete. Once flushed you have to wash out the connecting tube and the kangaroo bag with warm soapy water, rinse, and let air dry. Unfortunate for us Josh played with his c-tube and pulled it out enough a Foley catheter should have been inserted. I took Josh to the ER. The doctor didn't have a clue what a cecostomy was or what to do. I handed them my book and told them of the web site. All we got was an appointment with Dr. Mitchell in the a.m. for Josh's