Remember: The tubes are only temporary. However, they are necessary for you to heal and help minimize the potential risk of infection.

Discharge from the Anal Area
Your anal muscles were stretched during surgery. Therefore, it is common to experience some anal leakage. Swelling can also contribute to anal leakage -- much like a swollen hand, your anal muscles cannot grip tightly.

The drainage can be watery to bloody. This is normal. It can also have a strong odor and look like stool. This drainage may continue until the ileostomy is reversed in the second operation.

Remember: It takes time for the anal area to heal. For added comfort, some patients find that a cotton pad helps - especially at night. The most absorbent and least expensive pads are pressed cotton "make-up removal" pads that are sold in the cosmetics area of most grocery or drug stores.

Diet
Initially, after surgery you will not be allowed to eat or drink until bowel function returns. You will be able to have ice chips and will continue to receive intravenous fluids. In fact, most people are not hungry following surgery.

How soon bowel function returns varies among individuals, which is normal. For some people, bowel function returns in 24 hours, while in others it may take several days.

Most folks wonder how they can have a bowel movement when they have not eaten in days. This is possible because you produce a quart of digestive juices every day, whether you have eaten or not. The passage of this liquid waste is a sign that your bowel function has returned.

Once bowel function has returned and you are not nauseated, you can expect your diet to be gradually advanced - beginning with clear liquids (i.e., chicken broth, Jell-O, popsicles). You will graduate to full liquids (i.e., ice cream, milk, cream soups) and then soft, bland foods (i.e., eggs and toast). This is your meal ticket home.

Remember: Most people don't have much of an appetite at first. It is best to begin your intake slowly. Eat and drink what you can, but do not force yourself to eat. And be sure to chew your food thoroughly.

Restrictions
With a temporary ileostomy, it is best to proceed slowly with any bulky fiber in your diet. Non-digestible dietary fiber can cause a food blockage in the small bowel near the abdominal wall or stoma. Foods to avoid include:

Remember: If you had to restrict your diet before your surgery because of diabetes, heart disease, high blood pressure or other medical reasons, you will have to continue to do so.

Getting Out of Bed
On the first day after surgery, your healthcare team will help you get up to walk. Pain medication might be given beforehand to make it more comfortable for you.

Even if you can only take a few steps in the beginning, walking is important for the recovery process. It also helps decrease the risk of pneumonia as well as other postoperative complications. Additionally, walking helps bowel function to return more quickly.

What You Should Do

• To get out of bed, turn to your side and use your arm to push up, avoiding strain on your abdomen.



• Deep breathing exercises are important to prevent pneumonia after surgery. Periodically, let out your breath and inhale as deeply as you can, let the air out slowly. Repeat 3 times in a row. You will probably be given a small breathing exercise device that will help you with this.



• If you need to cough, bend your knees up, and press a pillow to you stomach and hug it as you cough.

Remember: Everyone heals at his or her own pace. Try to eat sitting up in the chair, rather than in bed. Walk as much as you can. Don't be shy to ask the nurse for assistance if you need it. Every step, however large or small, counts towards your recovery.

Ostomy Nurse
During your hospital stay the enterostomal therapist (ostomy nurse), will teach you how to care for your stoma, advise you where to buy your ostomy supplies, and address any other personal concerns you may have.

Remember: If you have any questions, your ostomy nurse is just a phone call away.

Reaching Out
You may have periods of depression, either while in the hospital or after your return home. It may be reassuring to know that your enterostomal therapist is there to provide support and can even arrange for you to meet someone else who has had colorectal or coloanal anastomosis surgery.

Sometimes, talking to someone who has "been there" and is now living a happy, active life may be a great source of comfort and encouragement to you.

Remember: You have just had a major operation -- a grieving process is normal. Don't keep feelings bottled up -- express your feelings and go with your emotions. Talk to your spouse, a close relative, or friend who can listen. Most importantly, be patient with yourself, adjusting to a different lifestyle takes time and perseverance.

We're Here for You
Your doctor, her nurse and assistants are always happy to answer any questions you or your family may have about colorectal or coloanal anastomosis surgery and the recovery process.

Remember: Read and discuss the postoperative instructions with your nurse. Ask questions if you are unsure about something or need further explanation. There is no such thing as a "stupid question." If it's important to you, it's important to your doctor.

Going Home
You will be discharged in four to seven days, when you are eating and not showing any sign of infection. You will be given a prescription for pain medication. Before you are discharged, your physician and nurse will arrange for home healthcare, if needed in your case.

You also should be given the name of the agency and its telephone number should you need assistance before the first visit.

Remember: Call your physician or nurse if you experience any problems after you get home.

Postoperative Appointment
Be sure to contact your surgeon's office if you have not received a postoperative appointment. Most appointments are within two to three weeks of discharge from the hospital.

Remember: You must bring all of your ostomy supplies needed for a change of your ostomy pouch with you to your surgeon's office so that he or she can examine your stoma. Your pouch will also need to be refitted.

Being informed about your surgery, asking questions, and sharing your feelings will help your recovery go as smoothly as possible.

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