CC Notes: When Prolapse Happens.

That ^ is what I got instead of surgery, for Six. Weeks. In case you missed it, after chemo on Wednesday (16th), a couple of hours later, my colostomy prolapsed. These are the basics of a prolapse, and no worries, no pics.

A prolapse is much more psychologically damaging than physical. This is not at all uncommon in colostomy or ileostomy, but no one prepares you for the possibility either, which is why you end up so damn shocked, and dealing with all the mental and emotional fallout. It would be most helpful if medical would prepare for this possibility, and yes, I know there’s no desire to alarm people, but that’s a bullshit excuse in this case. Being forewarned, just in case, would go a long way in making a prolapse less traumatic.

First thing: When Prolapse Happens: DON’T PANIC.

*:Graphic descriptors begin: When the pain reached a point where I lifted up my shirt in the car to see what was going on, I saw six very fat inches of my colon protruding, completely filling the bag, and rather than the bright pink/red she should have been, Grimhild was a faded pink, with sections so faded they were white. It was with absolute shock I was staring down, and then saw that shock mirrored in Rick’s face. Fighting panic, I choked out “can’t go home, ER.” Rick was doing his white knuckled best to not speed; fortunately, we weren’t far from the hospital. After waiting too long inside a triage room the size of a fucking closet, with tears running down my face, and trying like hell to breathe when my muscles completely seized (this was almost exactly like it was post-op, in recovery after the colostomy surgery, which was freaking me out), when a nurse finally came in. She got vitals, and info, and I got that all too rare experience of seeing shock on a nurse’s face upon seeing the prolapse. I was hurriedly taken into a room. The doctor was in quickly, and they were one I had seen before, which was a comfort. I was all hooked up to every fucking thing, then the doc started poking about. I couldn’t see what was going on, but Rick was watching like a hawk*, and the doctor was doing a form of massage, working the gut back in. Grimhild wouldn’t recede past around 2 inches, but that was normal enough. I was then sent for a CT scan, which revealed no blockage, but a parastomal hernia. It’s likely I would not have surgery at all if it was just a prolapse, but the hernia will require surgery. *Rick turned out be to be very skilled at doing this massage later at home, and teaching me how to do it. *:Graphic descriptors end:.

Most people with a colostomy or ilieostomy have minor protrusions now and then, generally during a movement, as that is the natural function of your gut, to be moving things along. Generally speaking, any abdominal pain associated with an ostomy is when a protrusion happens. If you note your abdominal pain increasing, check your ostomy- if there’s more protrusion than normal, the colour, and place your hand over to check for the normal warmth. If any of that changes (lengthier protrusion, faded colour, especially if it goes gray, and cold rather than warmth), get yourself to a doctor, stat. Don’t wait to see if it gets worse. Better to get it checked and not have anything to worry about.

If you’re like me, and this just comes out of the blue, and you’re faced with something which sends you into shock, get your arse to an ER immediately. If it’s taking too long to see you, start screaming. That won’t be difficult. If this never happens to you at all, that’s a great and grand thing. That said, it’s best to know this is a possibility, and to be prepared for it. It’s quite scary to see, especially if you are utterly clueless as to what’s happening. If you know this might happen, you’ll be much calmer. This is easily treatable, and in most cases not a surgical emergency, so you don’t need to worry needlessly about that, either. Most of the time, the gut is easily and gently massaged back in. In some cases, where’s there is an excess of fluid, you might note your doctor calling for sugar – don’t have an attack. This is a semi-standard trick to get a stubborn prolapse to retreat. Sugar is sprinkled on it, which absorbs the fluid, allowing the gut to retract. I do not recommend doing this at home, leave that to a doctor. This isn’t something you want to fuck up, and end up making things worse.

If you have a positional prolapse, where your ostomy is likely to start slithering out upon standing, walking, or other positions, you can easily cope with this at home. Lie down, and gently cup your ostomy through the bag, while gently pressing in and down, massaging her back in. You’ll most likely notice retraction beginning as soon as you lie down. When you get the retraction accomplished, when you get back up, keep your hand in place over your ostomy, then get a binder, belt, pants, whatever, placed over your ostomy, and carefully go about your business. It will take more than a bit of experimentation to discover just what does work for you when it comes to keeping your ostomy in place.

I did have a an abdominal binder order placed, went and got fitted (more or less), and wore it for a while on Wednesday, when we went out to eat, and on the way home. The binders aren’t exactly made for smaller type people, and really not for seriously skinny people. Mine is much too wide – it goes over my hip bones, and impinges on my breasts, so not overly comfortable to wear. It’s also very tight, which is to be expected. One worrying thing is that while eating, I could feel Grimhild trying to move, which is natural when trying to expel something, gas or more solid. The binder was preventing this, and that you don’t want. I’m not altogether sure just how much this would prevent a prolapse, either. So, at this point, I’ll save the binder for when I’m going to be quite active and out and about walking. When I’m sitting at my desk, and Grimhild is fresh from an active massage retraction, I’ve found that moving my chair right up to the desk edge, then placing a firm pillow between it and Grimhild, is sufficient to keeping her in place, while allowing for gas and other passage. Some people make do with large ace bandages, or find that a hernia or ostomy belt is more efficient; some people find that pants which cross the ostomy with a good pressure to be workable. It’s a matter of finding what will work best for you. If you use a latch or two part bag system, you might find it much more helpful to switch to a one piece, as the latch and two piece systems can cause injuries to the ostomy in cases of prolapse. While these injuries, usually lacerations, don’t cause any pain, they might lead to infection, which you do not need.

You absolutely must check the colour and warmth of your ostomy every single day, and it’s a good idea to do it more than once a day. Any changes whatsoever, get to that doctor. You’ll also need to monitor your overall temperature every day, and be good about it, because an infection is more likely in prolapse. If you head over 99, get to that doctor.

As always, as I remember all the stuff I forgot, I’ll edit to add at some point.

ETA: It now occurs to me that I was helping to move furniture a couple of weeks before this happened. In retrospect, that was a very stupid thing to do. Don’t be moving furniture.

One thought on “CC Notes: When Prolapse Happens.

  1. Hope you’re more comfortable now, Rick is picking up a rather diverse set of skills recently.

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