Blockages: Fool me twice, shame on me

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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.

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18 thoughts on “Blockages: Fool me twice, shame on me

  1. I also have an ileo and am vegan. Prior to my changing to plant base eating I was diagnosed with colon inertia got my ileo in Nov 2010 had a permanent one in Jan 2012 and then found out about a vegan lifestyle. I have had 1 blockage while eating vegan and 2 prior to changing. I am just glad to know I am not the only vegan ostomy out there.

    • So nice to hear from you Debbi! It’s always nice to hear from another vegan ostomate.

      Did you find out what caused your blockage on all three occasions? Anything you avoid now?

  2. I guess the foley catheter was ideal because it was the right width, length, flexibility and non-damaging to the stoma (with care, since the risk of perforation is always a concern). It worked like a plumbing snake and it highly effective. The ensuing “gush” was very messy though. The catheter was left in my stoma and it was naturally pushed out with peristalsis.

  3. Oh my goodness!! So glad you are out of there now and feeling better. That is absolutely terrifying; blockages escelate so quickly :( Did they explain why the foley catheter is what worked to unblock you? So curious…

    Happy chewing! :)

  4. Oh my goodness!! So glad you are out of there now and feeling better. That is absolutely terrifying; blockages escelate so quickly :( Did they explain why the foley catheter is what worked to unblock you? So curious…

    Happy chewing! :)

    • I guess the foley catheter was ideal because it was the right width, length, flexibility and non-damaging to the stoma (with care, since the risk of perforation is always a concern). It worked like a plumbing snake and it highly effective. The ensuing “gush” was very messy though. The catheter was left in my stoma and it was naturally pushed out with peristalsis.

  5. It must be something going around – last week I too had severe pain that sent me to the Ajax/Pickering ER. I found doing child’s pose on the floor helped some but it was still the most painful thing I have ever felt and I gave birth to two huge kids without pain relief! After vomiting in the ER I felt much better. I got an X-ray and the doctor just said there were no obstruction but I was constipated. I got a fleet enema via my stoma and got cleaned out. A home care nurse I spoke with was surprised to hear I got a fleet enema – I guess because of applicator long size and the risk of perforation. Kind of freaks me just thinking about it now. I’ve upped my liquid intake and that seems to have helped.
    Glad to hear you are doing better. :)

  6. It must be something going around – last week I too had severe pain that sent me to the Ajax/Pickering ER. I found doing child’s pose on the floor helped some but it was still the most painful thing I have ever felt and I gave birth to two huge kids without pain relief! After vomiting in the ER I felt much better. I got an X-ray and the doctor just said there were no obstruction but I was constipated. I got a fleet enema via my stoma and got cleaned out. A home care nurse I spoke with was surprised to hear I got a fleet enema – I guess because of applicator long size and the risk of perforation. Kind of freaks me just thinking about it now. I’ve upped my liquid intake and that seems to have helped.
    Glad to hear you are doing better. :)

  7. I should have asked for some take home catheters, but there is still a risk of perforation if you aren’t using them correctly, and I don’t think most MD’s would trust everyone with that task. Just take care not to get a blockage (if you can help it) and you’re good to go!

    My NG tube was completely removed and inserted TWICE and then a third attempt was made to adjust it, but fiddling around just made things worse. Then you’d be talking to every nurse and MD that comes to see you and the gag/vomit/exhaustion cycle continues! Had I not been gagging so much, the NG tube would have just been a slight annoyance (after it’s already in, of course).

    Hope you’re doing well with your stoma :)

  8. It’s kind of funny (not funny “haha”) about a week or two ago I had just about the same experience except my blockage was caused from swelling from my ileo surgery 3 weeks ago. They did the same thing – NG tube and foley catheter. I also continued to vomit with NG tube in. Turns out that the resident that put it in, put it in too far (about 12cm). After another dr pulled it back 12cm, the vomiting finally stopped. Though, I was mostly dry heaving by this time, which in many ways is worse. The foley catheter worked like a charm for me! The hospital sent me home with a few catheters in case it happens again. My mom is staying with me while I recover and she was a nurse for 20yrs.

  9. It’s kind of funny (not funny “haha”) about a week or two ago I had just about the same experience except my blockage was caused from swelling from my ileo surgery 3 weeks ago. They did the same thing – NG tube and foley catheter. I also continued to vomit with NG tube in. Turns out that the resident that put it in, put it in too far (about 12cm). After another dr pulled it back 12cm, the vomiting finally stopped. Though, I was mostly dry heaving by this time, which in many ways is worse. The foley catheter worked like a charm for me! The hospital sent me home with a few catheters in case it happens again. My mom is staying with me while I recover and she was a nurse for 20yrs.

    • I should have asked for some take home catheters, but there is still a risk of perforation if you aren’t using them correctly, and I don’t think most MD’s would trust everyone with that task. Just take care not to get a blockage (if you can help it) and you’re good to go!

      My NG tube was completely removed and inserted TWICE and then a third attempt was made to adjust it, but fiddling around just made things worse. Then you’d be talking to every nurse and MD that comes to see you and the gag/vomit/exhaustion cycle continues! Had I not been gagging so much, the NG tube would have just been a slight annoyance (after it’s already in, of course).

      Hope you’re doing well with your stoma :)

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