Mistakes were made.  I admit it, but if I don’t learn from those mistakes then I’ll continue to suffer needlessly with blockages.  It was just over a week after I written about having partial blockage with my ostomy that I experienced what a full-blown, “get your ass to the ER” type blockage feels like, and I’ll be sharing that experience with you today.

Original post published April 14th, 2014.

First off, let me say that blockages can happen for a wide number of reasons: active IBD, adhesions (scar tissue), poorly chewed food, an ostomy appliance that’s too tight, hernia’s, etc.  In my case, it seems that my foolishness was the cause.

Last Wednesday, we planned on taking the kids out to go indoor rock-climbing.  Not wanting to come home late to eat dinner, I decided to have a quick meal before we left, so I opened up a few cans of beans, chopped up some tomatoes, seasoned it all and ate.

Now, when I say a “few cans of beans”, I mean two cans of BLACK BEANS and a can of red kidney beans, all split between me and my two kids (mostly me).  I’m a huge legume fan, and I’ll easily eat an entire can of kidney beans, chickpeas or lentils, but I’ve never eaten black beans like this and certainly not in such a rush.

We left the house and proceeded to the community center and about an hour in I felt some discomfort in my belly.  This did not get any better as the night went on and by the time 11 pm rolled around, I was in the bathroom massaging around my stoma to see if I could get something to come out.

Three hours later (yup), I did get some output from my stoma and was too tired to continue, so I put a new pouch on and went to bed. Sleep didn’t last long and at about 5 am I woke up to vomit.  It’s never good to see the food you ate 12 hours ago coming back up, but this did relieve some discomfort and resulting in some more output from my stoma.

Thursday started off normally, but I chose not to eat as I wasn’t seeing any output in my pouch and I still had a lot of cramping. My wife went out for the day, but when she returned late afternoon, we headed back to Mount Sinai Hospital in Toronto to get this checked out.  By this time, I had vomited several more times and my abdomen was distended.

We got there just after 7 pm and it wasn’t too busy.  I had some blood work done and waited a few hours before being moved to a small room down the hall.  After some x-rays were done, I spoke with an MD who admitted me.

At around 2:30 am I had some CT scans done to see where the blockage was and if it was caused by adhesions or not.  I’m glad I have such an appreciation for science and technology and asked the Radiologist plenty of questions while he was setting up.  I really hate the fact that CT Scans expose people to a LOT of radiation, but this scan was necessary.

NG Tube

Are we having fun yet?

As we waiting for the scan results (which wouldn’t come for many hours), I had an NG tube inserted to relive some pressure and to remove excess “stuff” from my stomach.  The process involves putting a tube into your stomach, through your nose – while you’re completely awake and without anything to prevent your gag reflex from going into overdrive.

I had another x-ray to confirm that the placement of the NG Tube was correct.  The hope is that once the tube is inserted correctly, the gag reflex will stop, but for me (lucky me), it didn’t, and I gagged and vomited into sheer exhaustion – many times over, for the rest of the day.

Moving, talking, bending, breathing ALL caused a gag reaction and by the end of the day, this all resulted in a very sore throat.

Just before noon on Friday, I was met by a doctor who said the CT scan shows that my blockage is close to the stoma, so he inserted a foley catheter into my stoma and we waited to see if anything would pass. It wasn’t until about 6 pm that I was seen by another doctor and we tried a different foley catheter.

I’m not sure if it was longer or wider, but it worked – oh boy did it work!

There was an immediate relief as the pressure was taken off my abdomen and lots of backed up stool left my body.  Finally!   We still needed to monitor the output, so the NG tube stayed in until the next morning. Removing it was wasn’t as traumatic, but it certainly wasn’t pleasant.

Call me weird, but I’ll look for stuff to observe no matter what situation I’m in, and every time I emptied my pouch, I’d check to see what was coming out.  It’s unsettling to see black bean skins from Wednesday still showing up Saturday, but it illustrates how easily things can stay “lost” inside us, and it likely accumulates if we aren’t careful.

Saturday was quite a different day, and without the NG tube, I felt quite a bit more comfortable.  I started on liquids, then by dinner was having a gourmet meal of pasta and applesauce (sarcasm aside, I’m not going to complain, it was a very welcomed meal!).  I walked around the hospital floor (estimated over 2km throughout the day) and anticipated my discharge the following day.

Hospital food

My “gourmet meal”.

Sunday, early AM, I’m seen by a doctor on the surgical team who cleared me as good to go.  My IV was removed and I had a bagel with peanut butter and orange juice and got my stuff ready to go. I chatted with a few other patients in my ward: one 77-year old, retired high-school teacher, who talked about his time in Australia before moving to Canada in the 60’s, and his fight with multiple cancers.

And another gentleman who, like me, has been fighting Crohn’s disease and has an ostomy.  Talking with these two men was bittersweet because while I enjoyed their company, I knew that our struggle to find good health wasn’t over and future “bad days” seemed guaranteed.

So now I’m home, completely exhausted by the entire ordeal, but glad that it’s over. I’ll be doing a modified post-ileostomy diet for a few days and then go back to regular foods (minus the black beans!).

A part of me feels that taking one day a week to just eat low-fiber, output-inducing foods might go a long way to preventing avoidable blockages, especially with the high-fiber diet I’m used to having.

My thoughts on the experience:

  • Slow down and chew your damn food! No more rushing to eat, no more bite and swallow.
  • Black beans.  Not even once. (Ok, maybe a few in some chili…).
  • I’m going to assume that my gut, like a drain, will accumulate stuff until it clogs.  Prevention is the key.
  • Move away from eating one or two huge meals a day to eating several smaller meals throughout the day.
  • I’ll consider a “purge day” where I’ll encourage looser output.
  • I’m realizing that the stoma pain and retractions that I’ve had off and on these past few weeks could be related to a blockage in the making.  Time to listen more to my body.
Happy-vs-unhappy-stoma

Left: What my stoma usually looks like Right: My stoma struggling to pass an obstruction

I’d like to thank the staff at Mount Sinai Hospital in Toronto, especially all the wonderful people on the 14th floor who helped me through this.