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Recovery time for hemi-colonectomy
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So, I apparently need to have a chunk of colon removed. Roughly scheduled for January/15. Does anyone with knowledge about recovery time and impact to training and races later in the year? Even it it's bad news, I'd rather be prepared...

I am supposed to be doing age group worlds in Chicago next year, but am worried about loss of fitness during the downtime and the eventual impact upon performance come race day. On the plus side, there is a lot of time between January and next September. On the other hand, with this operation there are so many things that can go wrong. Ironically, I just bought a new bike (Trek SC7) for next year's race and I would hate not being able to use it for its intended purpose.
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Re: Recovery time for hemi-colonectomy [MEW] [ In reply to ]
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That's a tough one. Even quick and "unremarkable" recoveries for this type of surgery are pretty drawn out.

Is it going to be open? Or laparascopic?

There is such a huge assault on your microbiome in your gut that many people don't feel like their digestive system is running normally for months.

I would bet you'd be able/allowed to return to light exercise after a few weeks recovery, but you're really going to want to just be in consistent communication with your surgeon. Kind of like what happens with some orthopedic surgeons who think that "running is bad for your joints" you may get a surgeon that is so used to dealing with obese, sick people, they won't have a great frame of reference to give you perfect advice. You might luck out and get just the right guy or gal. But if you're not sure, seek out a surgeon that is a runner or triathlete -- they're out there, and they can speak your language

Endurance Nerd
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Re: Recovery time for hemi-colonectomy [MEW] [ In reply to ]
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hi- I have no idea what your medical situation is, nor the diagnosis for your surgery... however, I had a chunk of my colon removed just over a year ago due to cancer. My training and fitness level now is maybe 1/2-2/3 of what it was pre-surgery. Its taking a long time for the wheels to come back, and they probably (for me) never will come back fully. I'm 58 now, and was in great running and swimming shape beforehand. The thought of getting on a bike seat pains me.

But again, I don't know your situation, and of course everyone is different. I have yet to find a colorectal surgeon (and even an oncologist) who is also savvy to endurance training. Maybe next year doesn't work out for you and instead its 2016? Life goes on in disregard for your new spiffy bike purchase. Can't you go back and ask your medical team these questions?

Best to you! Bob
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Re: Recovery time for hemi-colonectomy [MEW] [ In reply to ]
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I had 13" of my colon removed and also my appendix at the same time in August 2013. Nine days in the hospital, and I actually got out two days early. Open surgery, cut from just above the belly button down to my pubic bone, on the table for just over 5 hours. I felt lucky to be alive, and also felt lucky that I picked an awesome surgeon. They had me out of bed taking a very short walk the next day, and I just took it from there. The recovery was smooth, the biggest issue I had was pain related to the incision. I feel great and my bathroom habits are better then they ever have been. I did a half ironman 69 days later.
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Re: Recovery time for hemi-colonectomy [MEW] [ In reply to ]
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Good luck and hope all goes well. I have crohn's and was spiraling down the drain for the last year so ended up having 11cm of my terminal ileum and colon removed last April. It was intended to be laproscopic but ended up being open. I was in the hospital for 4 days and was told to take it easy for 3-4wks. Soooooo.... I was back on the tt bike in 11 days after surgery with staples still in and back in the pool 2 days after they were removed at 2 weeks. 2 weeks after surgery I was up to 7hr/wk and was able to do an olympic 12wks later. Did half ironman 18wks later. The post op pain was pretty rough for 2 days so be prepared. The most painful tri activity was swimming with the reach (lots of abd stretching). Easiest was the bike but it was mainly on flats. Running was a little nerve racking with bathroom strategy. If you have any specific questions message me. I am an open book.
Last edited by: bsarapin: Dec 13, 14 4:37
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Re: Recovery time for hemi-colectomy [MEW] [ In reply to ]
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Thought I would provide an update on the process I went though and my current condition to add to the collective experience for anyone facing this in the future (and thanks to those who provided their experience in my original post). As a preamble, I note that I live in Calgary, Alberta, Canada - I'm pretty sure there are some that post here that live in the area so they can read this in that context.

Surgery was 22 January (Thursday) to remove ascending portion of colon (right side). The reason of doing so was that a colonoscopy a couple of months earlier revealed a "villous mass" which I understand is a potential precursor to cancer, so the affected section of colon is removed as a preventative measure. Laparoscopic so no major incisions. Only complication was that they couldn't immediately find the appendix to remove (apparently normally done as part of the procedure) - apparently it was a little higher in the torso than expected. I just tell my nephew that I am a mutant X-man now ;-)

Immediately upon achieving some level of consciousness, I checked for a bag - nothing. Back to sleep. They later moved me to a private room without asking - score! I would have asked if I hadn't got one, but then I would have had to pay for it (albeit with some insurance coverage).

Most of the pain over the next several days was along the centre line of the abdomen, as if I'd done far to many crunches. This gradually subsided over the course of a week and a half. Took myself off painkillers on Tuesday after surgery when the discomfort on waking (without a pill) was less than the discomfort the night before (with a pill). I am an Ironman after all, if only the one time.

The hospital used a new protocol which is apparently gaining popularity, the use of high protein and solid food to enhance recovery. I ate half a sandwich and pudding for supper a few hours after surgery - no liquid diet, and solid food for as long as I stayed in hospital. As endurance athletes, we would recognize this as being obvious, since that is what we do ourselves. Never would have thought to apply it to surgery though, especially involving the digestive system.

Multiple rounds of bloody diarrhea on the Saturday after surgery. This was apparently good enough to show that the digestive system was working well enough, and I was offered the door. I decided to stay on for another day in the mistaken belief that I needed a solid bowel movement before I could leave. I ended up leaving on the Sunday, three days after surgery, and didn't get a solid movement until Wednesday. Since then, I have recovered very well with daily bowel movements and was back to work full time two and a half weeks after surgery. Just didn't wear a belt for the first week.

Jumped on the bike trainer for 10 minutes a couple of weeks after surgery to see how it felt - still a little uncomfortable, so I let it go for another couple of weeks until I saw the surgeon again. Did a lot of half hour walks instead. After seeing the surgeon, I started swimming, biking and running again. All very light workouts, and it will probably stay that way for the next few months because...

Turns out that when the biopsy was performed on the removed tissue, a cancer tumour was found. Based on the size, I'm guessing it was too small to be detectable when the original colonoscopy was performed. I also had not displayed any of the symptoms that are associated with the type of tumour. So, I am very lucky to have had it removed already, even if only by pure dumb luck. Still have to have a CT scan done to properly stage the tumour, but I had my first round of chemotherapy yesterday, which is a good news/bad news situation. Good news is that I moved to near the top of the list for chemotherapy, based upon the type of tumour (rare and aggressive). Bad news is that they moved me to near the top of the list based upon the type of tumour. Still, I'm hopeful that this got caught early enough that I will get through this OK - early 50s and fairly fit. Does make filling out insurance forms awkward though since they assume that there were symptoms and diagnosis rather than a chance discovery.

So, Chicago, and any sort of real competition, is definitely out for this year :( The new Trek will have to remain under the dust cover for another few months.
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Re: Recovery time for hemi-colectomy [MEW] [ In reply to ]
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Glad to hear you're doing well. As a surgeon, let me clarify something you mentioned:

MEW wrote:
Turns out that when the biopsy was performed on the removed tissue, a cancer tumour was found. Based on the size, I'm guessing it was too small to be detectable when the original colonoscopy was performed. I also had not displayed any of the symptoms that are associated with the type of tumour. So, I am very lucky to have had it removed already, even if only by pure dumb luck.

That's not "pure dumb luck", that's good medical practice, based on years of research. You had a colonoscopy after age 50, as recommended by medical professionals. The reason we recommend screening colonoscopies beginning at age 50 for people without risk factors is that it has been scientifically proven to be an effective screening tool for colon cancer starting after that age, and a screening tool is useful for detecting diseases in the absence of symptoms. Once your doctors found the polyp, which was too large to remove through the endoscope, they biopsied it. For large polyps, biopsies sample only a small amount of the total cells involved, many of which are at different stages of change from normal. Villous polyps in particular have been scientifically shown to have a much higher rate of malignant degeneration (turning to cancer) than other types of polyps, which is the whole reason they decided to remove your colon in the first place. Once the tumor was out, further testing indicated there was, indeed, a cancer, and you have since been appropriately referred for further treatment, which is itself scientifically proven to be beneficial in your treatment. You will likely do very well.

Don't get me wrong, I am very glad that all this worked out for you. Yet don't diminsh the role that effective medical care at every level has had in your recovery by chalking it up to random chance. It's not like your doc just spun a wheel and you landed on "remove the colon", and then "Wow! You had a cancer! Who knew?". You are benefitting from decades of hard work from a variety of people at all levels of society. Please don't diminish their work by acting like it's a fluke.

Sorry for the rant, BTW. Just hits a sore spot.
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Re: Recovery time for hemi-colectomy [RJSuperfreaky] [ In reply to ]
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RJSuperfreaky wrote:
Glad to hear you're doing well. As a surgeon, let me clarify something you mentioned:

<snip>

Don't diminsh the role that effective medical care at every level has had in your recovery by chalking it up to random chance. It's not like your doc just spun a wheel and you landed on "remove the colon", and then "Wow! You had a cancer! Who knew?". You are benefitting from decades of hard work from a variety of people at all levels of society. Please don't diminish their work by acting like it's a fluke.

Sorry for the rant, BTW. Just hits a sore spot.

Sorry if I offended you. The point I was trying to make was that something that I understood to be "preventative maintenance", for the reasons you describe, turned out to be something that absolutely needed to be done. The fact that I had the cancer tumour removed before anyone knew it was there is the "dumb luck" part as I see it (Note: this is a neuro-endocrinal tumour which I understand to be particularly nasty, so early removal is definitely better for me, rather than finding it after I've already been displaying symptoms). Of course, it may be that this happens a lot (finding a previously undetected tumour in surgeries of this type) - I have no way to know. Let me be clear, I am nothing but impressed by the care I have received to date.

FWIW, I've strongly advocated a colonoscopy to one guy at work who refused to have one up to this point. I'm pointing to myself as the reason why he wants to do this.
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