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

    Thank you so much for sharing your experience. It has help me with coping with this. On September 17 2014 I woke up and was in excruciating pain and its funny you brought up the pain being worse than childbirth pains because I said the same thing.. I was crawling on the floor screaming and crying.. Got to Er and sat in er waiting room it seemed forever and the pain intensity just continued to get worse. They finally got me back in Er and I couldn't lay down I was walking the floor begging for them to help me .. They gave me toradol and morphine and sent me for ct scan and I had to have emergency surgery for a perforated sigmoid colon and resection with colostomy.. Was in hospital 8 days and it has been hard regaining my strength.. Fighting depression and insomnia.. Also going thru a bad divorce going thru all of this.. Fortunately Thanks to my Savior Jesus Christ I'm still alive.. My fever got really high 103 after surgery and lots of prayers went up for me.. I have my reversal in December.. I'm a month post surgery and healing physically from surgery well but emotionally I'm having a hard time with anxiety and depression but God will bring me thru that to.. Hang in there it will get better.. God bless everyone.
  • Posted

    Your a blessing to be alive. My mom complained of stomach pain for 4 days couldn't convince her to go to the hospital. On the 4th day I found her on the floor sent her to the hospital they discovered a perforated bowel went through with the surgery but it was perforated to long. Surgeon said he believes it perforated days prior to bringing her in she went into septic shock never recovered. I brought her in November 7th 14 at 9am stopped all measures or Dnr she died in my arms November 8 14 at 1:18 am. So please any sign of pain or discomfort go to a Doctor. Tomorrow is not guaranteed. I'm the last of my family I have no one left
    • Posted

      I am so sorry to hear your sad story, please accept my condolences for your loss. 

      You are so right to encourage people to go to the hospital with serious stomach pains as perorated bowel/appendix are serious life-threatening conditions. 

  • Posted

    Hi Barbs ,I re-read your 1st posting of "my perforated bowel" and have now come back to you for some more advise .

    As you will recall my emergency was April 2013 ,reversal (eventually) April 2014 ...and spending 3 weeks in hospital due to "ilius" .Now i am backwards and forwards to my GP (as i had been discharged by the consultant ) as i have developed a large incisional hernia  ,The GPs seem (well are ) unprepared to refer me ,at what point did you get the repair ,and was it successful ?

    Still 8 months on from the reversal and having left the hospital with an open wound and a Vac dressing ,it still hasnt completely healed ,i have now got a wound infection ..Is it just me that feels let down by the NHS aftercare ?

    The other hard part i have to look at is 18 months of being laid up ,is trying to lose the 3 stone ive put on by lack of exercise ,should i go for hernia repair if its offered ?

    • Posted

      I feel for you with the open wound/Vac dressing, been there myself, and it's not nice, particularly as it gets infected so easily, and smells horrid too. I think the District Nurses do their best but it is obviously hard to prevent infection. My wound was still open when they did the reversal and they then re-closed it and it healed much better because it was a year later (so none of the original infection around), they repaired the incisional hernia by sewing it up in the same operation so it was a full abdominal incision.  Someone in hospital told me later that after a failed wound closure, you often get an incisional hernia so they must be connected. I then had the ileostomy reversed 6 months later which is a smaller operation done through the stoma hole so didn't affect the central incision scar. I did then develop an incisional hernia again. I was referred to a consultant my GP knew who specialised in incisional hernia repair, and he said that just repairing it by sewing up again doesn't always work, and recommended the insertion of a large piece of mesh which goes all across the front of the abdomen to hold it all together and prevent it happening again. the mesh was about 10 inches square as I remember. It is done laparascopically, with a camera and small holes, which is a SO much easier operation, very short stay, much less painful and much quicker recovery, I was amazed how fast I got over it. It is permanently in place, although you're not aware of it at all, you just feel like you always did without the hernia bulge. 

      After I got through the original surgeries, I began to walk half-an-hour every day just a circular route in the streets near my house. I did that even when the hernia was quite large (I tried various hernia belts and so on but found Sloggi pants the most comfortable support.) I've carried on doing that ever since, and when the ileostomy was reversed I started gentle swimming too which I did with the hernia. I'm still a little 'fat' but I am quite fit and healthy. I think it helps to try and fit in some simple walking into your day, at the beginning I could only walk with a stick to one lampost, then to the second lampost and so on until I could do half-an-hour with a stick, and then I weaned myself off the stick (we're talking months here, it's slow and steady progress you want). 

      I can't recommend the laparascopic hernia repair too highly, it is fantastic....and no open wound to heal after. 

      I think you need more information about why the GP doesn't want to refer you yet? maybe they are waiting for the open wound to heal first? sometimes we do have to be patient and it is very hard. My own experience is that another incision to repair the hernia didn't work, so I would go for the laparascopic repair with the mesh.

      I think it would be reasonable to ask for a referral to the Hernia clinic to discuss your options, just so you don't feel so stuck, even if they say they won't do it for 6 months or a year, there is always a long waiting list (because it's not regarded as a crucial operation) so you want to at least get in the system and on the waiting list as soon as possible. It's possible they won't operate until you lose some wight anyway, but at least that would be a target to motivate you to do a little walking or whatever? 

      I did tell my GP that the hernia stopped me exercising as much I would like (because you get that dragging down pain after a while of walking) and that I felt quite depressed by it all, so you could try that. You really need the medical explanation of why they are not referring you yet, and whether they will in future, so you have some hope.

      Good luck with it all, hope your wound closes soon.

       I think they would perhaps try to repair the hernia and reclose the wound in one operation, so that would be worth going for.  

    • Posted

      Sorry last line mistake, can't find out how  to delete it! 
  • Posted

    Sympathising with everyone who is suffering from this painful disease sad I have 3 young children and am a single mum...i was rushed in 2 months ago with what i found out was diventicular disease after 4 different lots of antibiotics i was slowly getting better just to be rushed back in 2 weeks ago for another week stay waiting for results after ct scans, colonoscopies, biopsies and xrays. They know think i may also have chrons ......desperately trying to get better for christmas to get the children home and avoid another stay in hospital....im on steriods and multiple medication wondered of anyone can advise me as to what I can do to make sure i get well properly and avoid a perferation. I think you are all amazing to have got through scary experiences perforation sounds horrendous...amazing how you had the strength to pull through Em x

    thankyou in advance Em :-)

  • Posted

    Sympathising and wishing you all speedy recoveries and condolences. My dear dad was diagnosed with lymphoma late last year which was found with 2 cancerous lump glands around the outside of his small bowel. Chemo Treatment commenced within a week of diagnosis. He spent the first 10 days after the chemo in the cancer ward to be monitored incase the treatment caused perforation to his bowel. All went well and was to continue the next 5 chemo treatments as an out patient. The week after his 5th treatment he experienced severe abdominal pain and attended his GP where she then had him transported by ambulance to hospital. This was on the Wednesday afternoon. My dad was in extreme pain and was being medicated accordingly which didn't seem to be working. A CT scan had been ordered for the following day. My father endured excrutiating pain, a high temperature and an extremely distended stomach. All this on top of going through the awful things his body was going through with having heavy duty chemotherapy treatment.

    Saturday night when I visited my father, he was looking the worst he had ever looked. When I asked for more pain medication for him they decided to do blood tests and take him for the CT scan he was meant to have 3 days earlier. The head nurse decided to call a surgeon up to the ward from casualty to assess my dad. She seemed to know immediately what was going on with this poor man. Emergency surgery was ordered for 7.30pm that night. My mum and 2 sisters were present when the doctor told us it was a very serious situation. 

    Surgery took approximately 5 hrs with dad making it through. The surgeon very happy with how everything went. THIS WAS ONLY THE BEGINNING of his very long journey. He spent 2wks in ICU receiving expert care. He was then transferred to 4 different wards within a week because none of the nursing staff were experienced in his treatment and care plan.

    It has now been 6 weeks since his operation. He has a stoma which is being drain every 2 hrs. He is being feed with 2 separate feed lines as well as fluids and antibiotics. What is being drain from the stoma is being put through a sieve and put back through another line to keep his large bowel etc healthy and active. This procedure is apparently very unusual. So far the surgeon is very happy with his progress.

    Unfortunately he will be hospitalised for up to 6 months!! My strong body and minded father is slowly being broken down day by day. He doesn't have the strength to shower and toilet himself. Everything that comes out of his body is measured and recorded. He has no self preservation left. He is definitely not giving in although he is a mere shadow of himself. He is now allowed to have fluids.....soups custard ice cream every day. He doesn't have a lot of strength to feed himself.

    My mother is a rock although skating pretty close to the edge. Two parents very independent and extremely close. It is very hard for the family to see them both go through this. As much as I try to help out I feel I'm doing the wrong thing. We all have turns at visiting because he is often too tired to have visitors. I would like to help with taking him in soup or something.....he has only just wanted to have the tv and a paper today. He is extremely upset about having to stay hospitalised for so long. I believe that it is only the start of a very long road to recovery. Reading some stories of loss I think my dad has been extremely lucky.

    Any ideas or suggestions would be greatly appreciated. 

    Many thanks

    • Posted

      Deb I hope things are better today than they were two weeks ago. God gives his toughest battles to his strongest soldiers. At any age, this can rock your dignity. It sounds like you are an angel and your parents are lucky to have you.
  • Posted

    Barb, thank you so much for writing your story, I'm so glad you survived this horrific adventure. I've read that the pain may occur days before the bowel perforates. My question is, while the bowel is perforated and leaking toxins and for those unaware that this has occurred, how long can you survive and is the food/drink still processed accordingly or is there disruption?
    • Posted

      vic .i butt in here to answer the question about leaking toxins , if you read my story you will undersatnd that the perforation starts without your knowledge other than feeling sleepy , day 2 you will start to get minor belly ache ,day 3 you are in a coma due to untreated septasemia and (in my case ) be lucky to survive an emergency operation .The stomache prosses the food as normal and sends  your waste to the bowel ,this leaks into your abdomin causeing rapid  blood posioning  
    • Posted

      Thanks for your kind thoughts. I'm afraid I have no medical knowledge so I cannot answer your specific question, I only have my own experiece which I've recounted above. Possibly someone else on this forum will know more than I do.
  • Posted

    Hi. I've just had a diagnosis of Diverticulitis and perforated bowel and I'm trawling the Internet for any information about it. It seems I was one of the lucky ones. I was admitted to hospital with bad stomach pains, a ct scan was done and Diverticulitis confirmed, along with the perforated bowel. The weird thing is that although my bowel had perforated, and air and matter could be seen in my abdomen, the doctors explained that some fatty substances in the area had sealed the hole. I had to stay in hospital while the hole healed, as sealed wasn't enough. I was on clear fluids and iv antibiotics for 4 days and then sent home with oral antibiotics. I asked what caused it, what to avoid doing etc, but like others I was told it was one of those things. I am an aerobics instructor but I'm finding that I'm too scared to do anything physical now in case it perforates again... I want to send everyone my best wishes and hope we all get as well as possible..
  • Posted

    Barbs55 what a whirlwind story. I hope your incention has healed nicely.

    I found myself on life support and medical coma for 15 days, ICU for 21 Days, because of c-diff from a rupture, that was treated with round the clock antibiotics.  Total removal of my colon and large intestine, Stoma and Illiostomy bag. Open incision from breast bone to pubic bone.Total hospital stay 65 days. Not expected to live, I feel fortunate that I beat the odds. But now I seem to cry all the time I don't even know why. Thank you for sharing your story.

    • Posted

      So sorry to hear you awful story, and really not surprised you cry all the time. After such a traumatic experience it takes our minds as long (and longer) as our bodies to heal, and tears are one way of procesing what has happened to us. It does sound like it would be helpful to talk to someone about this (I had a referral three years later to a therapist for counselling, and I have found mindfulness to be very helpful, but everyone is different and talking to someone professional will help to find out what you need to move on from this awful event.)

      I have now healed both physically, and mentally, but I too still have days when I want to cry about it. That's normal I think! 

    • Posted

      It is so important to cry and grieve the loss of your former self. Your loss is great and grieving is a step to healing. Those on this forum understand and we're are so glad you reached out. The process takes time and the patience to allow yourself time to get through it all. Relax easy, and eventually you WILL recover completely and of course you WILL be stronger!

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