Deb CarrRight Hemicolectomy Due to a Complication of Crohn's Disease - Psoas Abscess
Updated: Nov 7, 2021
Earlier this year I had a major operation; a right hemicolectomy due to a complication of Crohn's disease. The Crohn's had caused a leak on to my Psoas Muscle and it turned into a dangerous abscess containing 300ml of pus (sorry I know that is gross). A Psoas Abscess is actually unusual, and I had been unknowingly suffering from this life-threatening condition for months. When I say unknowingly, that is not 100% correct because I had been suffering in dreadful pain for a long time, it was so intense that I limped and I had great difficulty moving in bed, driving the car and straightening my leg. I had been sent home from the Emergency Department three times whilst this was going on with steroids.
I had also been to numerous doctors and all of them 'assumed' it was Crohn's disease pain. I have been living with Crohn's disease for over twenty years and I have never suffered anything quite like this. A CT scan discovered I had a 4 cm mass on my cecum (I do not have a cecum anymore as you will find out when you read on). This mass was Crohn's disease and quite frankly I did not believe any amount of drugs could get rid of it, so I suffered and prayed it would all go away. Which of course it did not.
On my fourth trip to the ER over a period of about 4 months, I was finally admitted into the hospital. They did not really have a choice, I was grey in colour, I could hardly walk and the pain was obvious on my face. Later, my friends and family told me that I looked so sick and in pain and once when I had not seen my youngest daughter for a few months she did not even recognise me because I was so frail. I went from 69 kg to 56 kg in less than a year.
During this time I thought I would never be well again. I've written more about this on one of my other websites - "How A Psoas Abscess Could Have Killed Me".
Once I was admitted to the ER ward, I was later transferred up to the surgical ward that night. The next morning Dr Ghaly, informed that I was having an operation this day. This news overwhelmed me and although I've had over a dozen laparoscopies for endometriosis, I've never had a major operation like I was about to have. I was wheeled down to theatre at 11.00 am, and I woke up again in recovery after 2.00 pm. I was in agony, felt nauseous, and wished I could go back under the anaesthetic.
I had a catheter for urination and a drip feeding me copious amounts of strong antibiotics and painkillers. If there is one piece of advice I will give you if you are facing an operation like this, take the painkillers! I was on Fentanyl for two days which was heaven, but when I came off it all hell broke loose. I have never experienced such pain. I was given Targin, Morphine and Endone for the next 5 days, and although these drugs took the edge of it all, the pain was horrendous. I actually spent the next two months sleeping upright on my back as I simply could not move without pain. In hospital, I also had a drainage tube under my scar and I found this distressing and uncomfortable. On top of all this I was nil by mouth for six days. I dropped down to 52 kg. For those who do not know, a right hemicolectomy is the removal of the right side of the large colon.
I am writing this post for those of you that are facing a hemicolectomy to give you an understanding from a patient's perspective of what goes on. This story is also for anyone that has been diagnosed with a Psoas Abscess that is searching to relate to someone else that has been through it. Below I relate in sections different parts of my journey. I hope it helps you if you have found this page because you are scared of what is ahead or you have just been through it and maybe still in shock. It is now 3 months since my operation and I think I may have some post-traumatic stress as I do get a little bit of anxiety of what could have been. However, I'm still here to tell the story and I have the scars to prove it.
MY PSOAS ABSCESS SYMPTOMS
Fatigue: like I have never experienced in my life. This fatigue is not like being weary. It is an overwhelming collapse of the body! That might not make sense, but all I can say is even hanging out the washing was like climbing a mountain. I would be desperate to get up and be active and go for a stroll, do the washing, clean the house, but my body would not let me. I spent hours flat on my back and would go to bed at 6.00 pm and stay there for 12 hours. It was one of the worst symptoms of the whole experience.
Pain: the pain was on a scale of 1 - 10 on the day I went to hospital 10! Prior to that between 6-8. It was so painful I could not drive the car without using my arm to help my right leg use the brake. I could not even walk properly.
Night sweats: I knew this was not menopause as I had breezed through that ten years ago. I would wake up 4-5 times a night drenched so intense I had to change my clothes and sleep on a towel.
My right leg would not straighten: It was excruciating pain to try and straighten my leg. When I tried to get out of bed, it was actually a planned manoeuvre to avoid pain and it still hurt like hell.
MY CROHN'S SYMPTOMS
Fatigue: Initially not as troubling as the Psoas abscess (see above note).
Pain: I always had pain on my right side. A few years ago I had a carcinoid cancer scare due to the pain but thankfully it turned out to be Crohn's scarring.
Frequent bowel motions: mainly during the morning up to 6 times in two hours. I have been fortunate that this doesn't happen all day like other Crohn's patients but believe me when you have to go, it is very hard to control not having an accident. In severe flare times I avoid walking in the mornings.
THE HEMICOLECTOMY OPERATION
When I arrived at the theatre, there were a lot of identification questions and cross-checks
The theatre was freezing!
I was transferred from my bed to the slim operating table and that is when I started to get a bit panicked.
I distinctly recall being amazed how many medical staff were in the theatre that would be part of my surgical team (I guess all up 8).
I heard the medics talking about putting a catheter in me, and I piped up "I hope I will be asleep when you do that" I was quickly assured I would be.
My nerves were getting up now, I remember two of the surgical team counting the instruments and cross-checking with each other.
A pair of boots that went up to the knee were put on me (they electronically massaged the legs to help prevent blood clots). They felt heavy.
My heart was pumping now, I just wanted them to knock me out I was so nervous.
The anaesthetist had already put the cannula in my poor vein (it was hard to find one that would take it as I have very tiny veins) and I remember he was preparing the drugs.
I remember the team surrounding me and Dr Ghaly gazing down at me.
The anaesthetic nurse put an oxygen mask on me and told me it was to help me to breathe. Within two seconds I was asleep.
The operation took over two hours. They removed my right ascending colon and drained 300ml of pus from the Psoas abscess.
POST HEMICOLECTOMY
I woke up in agony and scared
The boots were kept on me for a few days. They were heavy but I quite liked having my legs massaged by them.