Proctocolectomy (aka: Laparoscopic Total Proctocolectomy; J-Pouch Surgery).  This topic had come up a couple of times in the past 8 years, but it was supposed to have been the very last angle of pursuit; the last action I would take to extinguish this terrible condition.  That was the plan at least.  The thought of permanently removing a functioning piece of my body did not sit well with me.  Wisdom teeth?  Sure, no problem.  Tonsils?  Throw ’em out, I say!  Appendix?  Donzo!  Each of these body parts eventually cause pain (and sometimes are terminal) if left unchecked.  But my colon?  My friggin’ large intestine!  C’mon, man!

All of the examples cited above are body parts that are removed on a regular basis.  Surely you know someone who has had one of these operations.  Shoot, you may know someone who has had all three of them.  Any one of these: wisdom teeth, tonsils or appendix, can be removed because they do not serve a vital need to the human body.  They can be removed and life goes on as it did before pain free.

On the other hand, the colon is functional – albeit bloody and hemorrhaging – but its still trucking along serving a purpose.  It’s still expelling waste and absorbing water; however, like the three body parts mentioned above, the colon is causing damage to my body and mind.  I mean, let’s look at this!  It bleeds.  It cramps.  It pains.  It is not a friend.  It hates the work place (particularly airports for some reason), and by-golly it hates a good party.  It’s a Party Pooper plain and simple.

What does this procedure entail?  A Laparoscopic Total Proctocolectomy is when they remove the colon (large intestine), pull down the small intestine, sew it to about a centimeter of your your remaining rectum and run a ileostomy (a bag for solid waste) out the side of your stomach.  A not-so-layman-description can be found here.

During my first 2014 hospital visit I began researching the surgery, and learning as much as I could from published studies, online forums and chat rooms.  My physician also had my surgeon-to-be come visit me and answer questions I had.  It was after this meeting that the complete removal of my colon seemed like a likely option.  It got pushed up on my now-short-list of treatment methods.  Below you will find a list of the questions I asked, and the answers I received.

Questions for Surgeon

How much weight will be lost?

• Other than the weight of the actual colon, it is hard to say.  Some folks lose 20-40 pounds while others may gain a few pounds.  It really varies per individual.

How long should I plan to be out of work?

• Approximately 4-6 weeks.

How often will I need to go to the bathroom?

• The first couple of weeks you may need to go 15-20 times a day; however, eventually this will taper down to 4-8 times a day – the latter being your typical day.

What kind of effect will this surgery have on my sex life?

• None. Have fun!

Will I be the smelly kid in class while I have the ileostomy bag dangling out my side?

• No, unless you decide to stop bathing or wearing stink bait.

Will my body be shaped differently?  I mean, I am losing 5-6 feet of my insides.

• No, but you will feel differently for a while until your body gets used to its new mode of operations.

What will my diet look like throughout the recovery process?

• The first few days after your operation you will be on a clear, liquid diet* which will then give way to a full-liquid diet*.  Once you are able to handle a regular diet then you will be sent home.  Your diet for the following 4-6 weeks will be a low-residue diet*. 

I work with a lot people each day which requires me to be present and productive during meetings with clients.  If I feel like I need to go to the toilet, will I have the muscle control to hold it until the meeting is over or should I get to the toilet immediately?

• You will have control of your bowels just as you do now.  With that being said, though, it is not a good idea to hold it for extended periods of time.

Can I get back to the physical activities and workouts I did pre-operation?

•  Yes, but with exceptions to high-impact sports and heavy weight lifting (so no UFC this year).

* Clear, Liquid Diet example:  apple juice, gelatin, popsicle, beef broth, tea

* Full-liquid Diet example:  all of clear, liquid items, cream of wheat, oatmeal, cream of chicken, ice cream, pudding

* Low-Residue Diet example:  baked chicken, white rice, cooked spinach, baked potato (no skin)