My perforated bowel - a result of undiagnosed Diverticulitis

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On the morning of 17th July 2007 I was particularly happy. Summer Term had just ended so I had 6 weeks of holiday from my Teaching Assistant job ahead, my husband was coming back from a 3 week research visit to Australia on Friday and my first grandchild was due in August. Life seemed very good – I was listening to Women’s Hour, and my 16 year old son was asleep as usual upstairs. I felt a need to rush to the downstairs toilet and whilst sitting there fell forward with agonising and unexpected pain. I recall trying to shout my son’s name but being able to do so only weakly. After what seemed like hours, he arrived sleepily at the toilet door and asked what was wrong. I replied ‘this is the worst pain since childbirth’ (already acknowledged in my family as the gold standard for pain after two 3 day labours!) and he said’ better ring an ambulance then’……I recall a paramedic trying to open the toilet door to get to me, and then…….

I awoke 8 days later in Intensive Care.

So this part of my story is what everyone told me later. I was admitted to A&E and there were several hours of uncertainty as to what was occurring. Fortunately an experienced Consultant passed by and noticed how ill I was and took over the case, sending me for an X-ray which revealed air in the abdomen which meant a perforated organ, probably a bowel. He arranged for emergency surgery as the contents of the bowel would be leaking into the body effectively poisoning my system. My son called his best friend’s mother (and my friend) who came to the hospital and spoke with the consultant who said that my husband should be called as there was an 80% and rising chance that I would die in the next few hours. She made the call to my husband in Sydney and then passed the phone to the doctor who explained that I was to go into emergency surgery for a perforated bowel, would probably not survive and he needed to return at once. My husband immediately left for the airport where Singapore Airlines got him onto the next available flight to the UK with 32+ hours of travel ahead not knowing what he would find on arrival. As my son was only 16, they also called my brother as someone could be needed to make life and death decisions and my friend was asked if my husband would trust her to make those decisions in the meantime. The operation took place in the middle of night and lasted several hours – nearly a foot of bowel was removed and a stoma created to allow the bowel to heal. There had been a lot of bowel content dispersed over the body and severe sepsis had set in and after the surgery I was taken to ICU ventilated and sedated and not expected to survive.

My elder son was also called back from Sri Lanka where he was volunteering in a children’s home – he was called by his elder brother, my husband’s oldest son, who also arranged for a car to meet my husband at Heathrow and called him in Singapore to update him on the situation. It would be his story to describe his feelings but it doesn’t take much imagination to realise what a nightmare journey that must have been.

He arrived back very early Wednesday morning and the taxi driver rushed him to Leicester from Heathrow and to see me in ICU – the usual frightening scenario with lots of tubes, machines breathing for me, feeding me through tubes and monitoring all my vital signs.

Over the next few days his life had the nightmarish quality you would expect – hours at my bedside and then going home to deal with phone calls from family and friends and feeding the children, doing the washing and trying to keep some sort of normality in the home, whilst being told that the staff were concerned that I had not come round and each day like that was increasingly worrying.

I meanwhile was in a horror movie in my head where I was being held prisoner in the desert in the Middle East and then taken to an institution where I was to have my organs harvested whilst I was still alive. (I later learned that such hallucinations are normal and a result of both the drugs given and the general sedation experience).

When I awoke I saw my husband hovering at the end of the bed like a hologram and assumed it was some new Skype phone development where he could send me his picture whilst telephoning from Australia. He was unable to convince me that he was actually in the UK or that I had had emergency surgery and a colostomy. I assumed that the staff were lying to him too (paranoia is also a key feature of a stay in ICU).

Eventually I was transferred to a general ward where I spent 5 weeks recovering, and was discharged with a colostomy and a massive 11” long open wound – my abdomen had burst open after the surgery because of the systemic infection I had. Naively my husband and I thought that the wound would close in a few months and I would regain my strength and become one of those people where others said “Isn’t she marvellous, she’s had a colostomy but you’d never know”.

In fact the wound was still open when I returned to the hospital 11 months later to have to colostomy reversed - it never healed. This second surgery resulted in an ileostomy which was also reversed 6 months later, and another 12 months later I had my fourth surgery in December 2009 to repair the large incisional hernia the other operations left me with. I adapted well to having a colostomy, being in a wheelchair for a period, and to every aspect of my life being medicalised. I found the support of organisations like the Colostomy Association invaluable but was increasingly irritated by the stories of how so-and-so had climbed Everest with a stoma, or travelled round China or the Amazon basin. I’d never wanted to do those things before I was ill and I certainly don’t now. I found the incessant cultural clamour to be a ‘brave’ patient, to bear quietly and stoically my misfortunes, and to keep quiet about them as the months went by and family and friends were ready to move on and I wasn’t, particularly difficult.

I can only thank all the NHS staff who took care of me so well in those three years.

It is now over three years later and I am writing my story down because I couldn’t find out anything about perforated bowel when it happened to me, and I want someone to read this knowing that they are not the only person it happens to, and you can return to health afterwards. I would also recommend the website ICUsteps which is very helpful to people who’ve been in Intensive Care.

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  • Posted

    I realize I am not from the UK but I have been desperately searching for information and I found this forum and it sounds like most here had circumstances like mine. On November 6, 2013, I was at my desk working in the afternoon when I began experiencing abdominal pain. I left the office at about 5:00 pm and during the hour and a half commute home the pain continued to increase. By the time I arrived home the pain was intense and I told my wife I was not going to eat the dinner she had already prepared. I decided I was just going to go to bed and sleep it off. After preparing for bed I collapsed and fell to the floor from pain while walking down the hall. My wife said she was going to call an ambulance and I said I was just going to go to bed and sleep it off and I would be fine in the morning. She insisted I go to the hospital. We went to the hospital and within a very few minutes I was examined and a doctor was running tests. X-Rays and a CT scan originally diagnosed a perforated duodenum and I needed emergency surgery to repair it. A surgical team was called in and surgery began just after midnight, the doctor told my wife it would take about an hour. As it turned out, I was misdiagnosed. When the surgeon opened me up he discovered my bowel was perforated and he had to remove ten inches in a surgery lasting about four hours. I of course knew nothing about this until the next day when I discovered myself in a hospital room with 8 tubes in me. When the doctor came in the room later that day some of his first comments to me were “you are an extremely lucky man”. I was sort of groggy about it and did not understand and he said “number one, you’re alive and number two, you don’t have a colostomy bag”. Every medical person I have talked to in the past 33 days have basically told me the same thing. I was in the hospital for ten days and the hospital staff was wonderful and I could not have asked for a more compassionate group. I had nothing to eat or drink for 7 days, not as much as an ice chip as my doctor did not want anything to pass through my system. I had an NG tube keeping everything out of my stomach for these 7 days and I must admit, this was probably the worst part of the situation. Because of the leakage from the intestine into the abdomen, I had a significant amount of antibiotics. By IV while in the hospital, then another 7 days by pill form when I was sent home. I had two drain lines installed during surgery that remained in even when I was sent home from the hospital and I had to measure the output and keep meticulous records of the output until they were removed ten days later. The surgical incision itself was open when I came home from the hospital and my wife was taught at the hospital how to pack the wound and redress it. For two weeks she changed the packing and dressing every day. The open wound closed last week. Like other stories I have read here, I had diverticulitis but was never told to watch my diet or anything and that is the only thing the surgeon can point to that may have caused this to happen. So I am now in a position where my insides just randomly exploded without warning, there was nothing (apparently) I could have done to prevent it, and I had no warning it was happening. How do I prevent this from happening again? I’m recovering well I believe but I’m still tired a lot. My stamina is not where it was but what do I expect so close to surgery. I’m reluctant to do much more than minor things and the doctor has me on some restrictions. I went back to work today and it was difficult (desk work, administrative) to make it through the full day but I am riding with a co-worker so I needed to work his schedule. I’m 56 years old and although this is not the first thing I have had repaired in my life it sure is the most serious. Right now I’m tired all the time still and I don’t really feel like doing much of anything. I still have some residual pain but not real serious, I suspect it is scar tissue. I follow up with the surgeon in two days and I will discuss it with him then. I have trouble laying comfortably on my side as it feels like everything sort of falls over when I lay on my side. I would really like to get some sort of idea of a realistic recovery time I can expect.
    • Posted

      I too felt like everything sort of falls over when I lay on my side. That feeling finally went away. It has been a little over four months since my reversal and I feel a little pressure (might be scar tissue?) but hopefully that weird falling over feeling will eventually go away for you.
  • Posted

    dmheil ,I Don't think anyone can answer the question of an expected recovery time ,I recovered well others on this forum still have issues ,But as we are still here and able to write our thoughts says it all really .The only other alternative to recovering at all fast or slow was "Not "

    I will say this expect the tiredness to continue for some time ,what everyone here had was major .

  • Posted

    "The only other alternative to recovering at all fast or slow was "Not "

    Love this! - it's really the only thing to hang on to during the long recovery process. The feeling of everything sort of 'falling over' when you lay on your side is very familiar.....I don't think I managed to lie on my side for months. (much later on I was diagnosed with an abdominal hernia which seems to be a common 'side-effect' of large abdominal incisions)

    On recovery times, one of my surgeons says it takes a month to recover for every hour you were under anaesthetic so if yours was 4 hours that is 4 months, and that's just the recovery from having had any operation!

    Also recovery isn't linear, it's very much two steps forward, one step back, so expect it to be up and down and you won't be so disaapointed on the 'bad days' . Pace yourself, especially with work, and expect to betired after any exertion, and need lots of rest time.

    You are doing fantastically well at the moment, and well done to your surgeons for avoiding the colostomy. Perforated bowel has to be seen like a burst appendix - accept that it just happens and there is probably nothing you or the doctors could have done to prevent it. My surgeon told me that having removed a good 12" of bowel where the diverticula normally are, means that there is nowhere left for it to happen again, so no need to worry about that!

    Sending you best wishes for your recovery process.

  • Posted

    Thanks. Yes, I am finally starting to realize just how lucky I really was throughout this entire ordeal. I guess what bothers me the most is the not knowing the reason why it happened in the first place (so I don't do whatever I did again). This really bothers me a lot.

    As I read what some of you went through I realize my situation could have been so very much worse. Barbs....you are amazing. No other way to phrase it. My complaints are minor compared to what you experienced. Last night for whatever reason I just couldn't sleep in any position so I came downstairs to the chair where I managed a few hours. that entire feeling of "everything falling over" was keeping me awake so I just slept a few hours in the chair. I am pleased to know this is not an unusual feeling. Just knowing others have experienced this is a comfort to me and it lets me know on top of everything else I'm not loosing my mind as well. I have already discovered that the recovery process is going to be slow. For everything I try to do, even small things, I need to rest afterwards. But, I'm here and that could very easily have been a different result.

  • Posted

    Not knowing 'why' it happened to you is hard to accept (someone said to me "why not you?" which is an interesting way to think about the arbitrary nature of this sort of event). We were just very unlucky.....As I posted earlier in this discussion, I think having some diverticular disease is quite common as you get older and isn't necessarily a big medical problem, but very rarely something gets trapped in one of the diverticula setting up an infection which can become an abcess and it is when that abcess bursts that you get bowel perforation. There's some information on the website linked earlier in this thread which is very clearly written and I found helpful.
  • Posted

    Everything I have read here has been helpful. Just hearing from others who have experienced the same exact thing is helpful. You're right though, why not me....it's an interesting perspective. I follow up with the surgeon today and I have some questions for him so maybe i'l have some additional answers later today. Thanks for your support as well.
  • Posted

    hi barb i can tell.ya i knw how strong u must of been..and thank god ur here to talk about it. my story is somewhatsimilar to yours. but i do have a ? what is life like after the reversal such as bm, recovery, so on. here's my story. nov 2 went to hospital caise i was in labor. im 31 years old first baby very strong and healthy. anyways i ended up having a csection on the 3rd cause i wouldn't dialate past 5 cm.my baby boy tylet was born a healthy boy, so while i was in the baby ward x day my stomach was bothering me and nurses told me oh its cause of the csection so they gave me ocycodone, well.the x day i notice mybelly was a little disended. and im still in pain. i couldn't even breast feed normaly cause my stomach hurt i had to more or less hold my son tylet like a football just to feed him. day 3 my.stomach is in more pain and it is bigger. doctors come in and say oh u have a elius and i wss told that sometimes happens after a surgery cause of the Anastasia. for those who don't knw elius is air in ur intestine. doc says walk thats tje best way to help rid of it, so day 4 im walkn up and down the hallway in the baby ward im so much pain and im bigger, by now i look 5 months pregnant, doc ask of i had a bowel movement i said no so he had nurses do subpositories, it didn't help i just couldn't poop. so then they procede to put a tube down my nose into my stomach and it was supposed to release any type of air. day 5 they are still doing subpositories and now a enama, meanwhile im trying to bond and feed my son, it was so hard i was in so much pain, i now look 9 months pregnant. day 6 in baby ward my auntie comes and visot me and starts raising hell, i wish i could show a pic cause it look liked if u stucl a needle to my stomach it would literly would pop like a balloon. so my auntie noticed i was modelling meaning blotches all over my skin and i just looked horrible. meanwhile after all the ruckus the nurses finally called in some doc and he had me go for cat scan. soon after that scan i was being rushed into emergency surgery for a perforated bowel. doctors i guess wasnt sure i was gonna make cause i was sooooo septic. but i had my health and youth and stubborness behind me according to him. me i think it was the will to live and take care of my son...i was in the hospital in icu for 52 days, i too was hullcinating also i swore the nurses were demons trying to kill me and i couldn't escape cause my legs and arms were tied down. but after the surgery i was on a venalator and had four iv stands
  • Posted

    sorry phone died.. so to continue... four iv stands w all types of meds had a blood transfusion of two pints and a wound vac on my stomach, my scar is about 15 inches long, i had a feedingtube and a tube sticking out of me for a infection drain. but what really got to me and made me so depress was having a ileostomy. for being in the hospital so long i lost most my muscle mass i couldn't walk i could barely lift my arms. its now almost 3 in a half months later and im still recovering from it. Good news is i get acess this april gor the ileostomy reversal surgery. it was so crazy i went to have a baby and all this happen. doctorsare never gonna say bit i believe when i was in my c section and the cut me open i believe they nicked my intestine, but im alive and able to be w my son and his father and thats what matters the most, bit can anyone tell me about the reversal surgery what to expect im so scared ive been reading stories like people after this surgery have anywhere from 5to 20 bm a day and your bowels are mostly very soft. idk please help
  • Posted

    What a terrible experience at what should have been such a joyful time, and I am so impressed you were strong and brave enought to survive for your son.

    I can only tell you about my experience. I recognise the muscle weakness after ICU. I was only in ICU 8 days and it took me months to get over, it is a 'one day at a time' situation but you do get better very slowly. Each surgery (like the reversal) tends to knock you back a bit but generally it is all slow progress in the right direction. I can say that my reversal was completely successful, I have one fully formed Bowel Movement every morning (although I don't get much warning it's coming so I need to be around a toilet!) but apart from that after some initial soreness and being all over the place it DID settle down with a week or so. I'm aware that not everyone is so lucky but the reversal is still easier to manage than the stoma was for most people. The operation is very simple compared with the previous one and you're more prepared as it's not an emergency.

    Wishing you all the best with it, and enjoy your baby as much as you can.

  • Posted

    Well, I have to say I'm glad I am doing so well compared to all the terrible experiences in the above posts. I had my emergency surgery on Dec 18, 2013 after 2 weeks of abdominal pain (with no BM's but no feeling I had to go) and 2 ER visits, a CT scan and X-ray with the diagnosis of "constipation". They sent me home the first time with 2 different prescriptions for bowel cleansers (the kind you take before a colonoscopy), the second time had the x-ray and they told me to take Miralax and Fleet enema's. NOTHING resulted from all these treatments - I was totally blocked. I had been diagnosed with diverticular disease years ago after a routine colonoscopy but didn't follow the Dr's orders on foods to eat and avoid! Four days after the 2nd ER visit I still had pain and no BM so my Primary Dr. referred me to a Gastroenterologist who discussed my CT and x-ray with the hospital radiologist - they could see NO sign of diverticulitis (it was apparently hiding) so I was sent back to the ER where they decided to inject a dye - this is what caused my dime size perforation. I had to wait 4 hours for an OR and the surgery lasted 3 hours with me having a temporary ileostomy. I also had hallucinations a day or two after my surgery which they blamed on the morphine. After 8 days in the hospital, I'm home and have adjusted to having "the bag" and am looking forward to it being reversed in April. I had originally considered consulting a lawyer for malpractice on the part of the hospital's Radiologist when he read the CT and x-ray, but then decided it's my fault for not standing up for myself on the 2nd ER visit and should have refused to leave until they corrected my problem. Even if I still ended up with the perforation at that time, it would have saved me 4 days of pain.

    I can only say if someone is diagnosed with diverticular disease - listen to your Dr. and eat correctly!!!

  • Posted

    My consultant did say that perforation is very difficult to diagnose, as your experience proves.....don't blame yourself either - he said that you only need one diverticula to get an abscess and it is just out of the blue often with no warning (very like appendix bursting he said, and people don't blame themselves for that!)
  • Posted

    Thanks barbs55, I didn't know of the difficulty to diagnose. I once heard that the reason Dr's tend to be "difficult" patients is because they know how much Dr's don't know! I had a ruptured appendix 7 years ago, the Urgent Care Dr thought it was kidney stones until the 2nd CT scan showed appendicitis. He said older people (I was 60 at the time) sometimes present with unusual symptoms - that pain is suppose to start behind the navel then move to the lower right side - mine only moved straight up and down.

    I wonder if these two incidents of rupture mean I have very thin intestinal walls? I'll have to ask my surgeon at my next appointment.

  • Posted

    Barbs 55...Wonder if you could advise me about stress levels ,I Went in for my Hartmann's reversal yesterday ,Had to be there (Heartlands Birmingham ) at 8 am ,Having had bowel prep ,eaten nothing in 24 hours and no drink for 12 hours sat in operation gown surgical socks in a hot and stuffy waiting "area" ....My operation was cancelled at 3.30 pm due to emergencies and patients needing theatre and beds ...(which I accept was the correct thing for them to do ) .I had hardly slept in 48 hours due to the stress of thinking about what was about to happen , now I have to do it all again ,how did you relax ?
  • Posted

    That is horrid. One of my ops got postponed 10 days before I was due to go in and that devastated me, but to go through bowel prep etc and then not get int otheatre must be devastating, even if you do understand about the

    emergencies. Have you got a new date for the operation? And the stress is so exhausting itself with all the missing sleep too. They will be careful to ensure it doesn't happen again to you - the staff don't like doing it to patients either.

    I actually began to meditate after I was referred to a therapist for mindfulness training during my recovery and referral for PTSD and that really helps me now. I would not have believed it before I did the training though, as I was always very cynical about this sort of thing but it has really helped me to deal with anxious thoughts. I use a programme that's free to start off called Headspace if you want to give it a go.

    Really hope you get a new date really quickly and relax a bit in the waiting time.

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