Bowel Surgery After Effects

[iloveglee]

I posted a question some time ago about a friend who was not doing well after a partial colectomy for bowel cancer. since then he has made amazing progress, the medical staff at his first follow up discovered an infected fluid collection, and with treatment improved 100% straight away. given his other medical conditions, heart failure, blood pressure problems etc. he is doing exceptionally well. except ..... during the period before surgery and for several weeks after he was very immobile, and lost a considerable amount of weight, some of which has been regained - enough according to his doctors. however, he is finding he has lost strength and power in his legs and centre, is quite stooped and sometimes wobbly. I suggested perhaps he has lost muscle mass and maybe a physiotherapist consultation could help him to rebuild some of it. he raised the subject with his gp, who said he was going to speak to a neurologist about it? he didn't go into detail, and said something like 'this can happen' My friend is a bit deaf so not sure whether he heard right. I am wondering what he could be considering and why. some responses I had were from people who had undergone surgery, and I wonder if anyone else has had this experience. it is now 7 months since the surgery, but he is 78 so is this to be expected.

[Sqad]

Patients with malignant disease of loose muscle mass due to many reasons, poor appetite, problems swallowing, immobility and many due to spread of the malignancy. Your friend also had another reason due to the infected fluid for which there is little detail on site and treatment.

Your friend also has had some degree of muscle recovery for which the doctors seem well pleased.

The referral to a neurologist seem to be odd but clearly your doctor has something in mind which is not readily apparent from your post.
Sorry that i cannot be more helpful.

[iloveglee]

I am a bit mystified too. he has most definitely lost muscle mass, and as you get older of course this happens anyway. inactivity also will make it worse. hence the thoughts about the physio. i believe that chemo meds can affect your nervous system, but there has been no chemo, no radiotherapy, nothing only surgery. the infection was treated in the usual way with iv antibiotics, none of which are known to affect the nervous system. i have read somewhere that older people need larger amounts sof protein than younger people, so as a happy meat eater that hasn't gone down too badly!! i think its the wobbliness that is the concern, especially with the risks of falling, and all the poor outcomes that can happen with falls. oh well, i daresay all will be revealed eventually, although i think appoinments, should he need one, with a neurologist will be some time in coming.

[Sqad]

Patients with malignant disease often suffer from muscle and fat loss and it is known as Cancer Cachexia, but again, I am not sure what a Neurologist would have to offer.

[Peter Pedant]

If it is on offer go for it
( I frequently disagree with Sqad )

I have HAD a hemi colectomy and am very glad that in your friend, it was probably due to chronic infection ( which really makes you feel crap - pun intended )

Regaining muscle mass after a big big operation and slow recovery ....
good diet and exercise is the only answer

passive exercise ( they actually at one time hoisted ventilated patients onto electric bicycles and set them to 'go' at one time ) doesnt work
Steroids dont work - the stuff you get in gyms - Chen looked at this in the eighties - MRCP and Ph D in radiochemistry - He showed that the Na+ and K+ went up in treated muscle ( radiochemically geddit ? ) but the markers for protein didnt

so you are back to good diet and exercise ....
I felt really crap for around a year post op aged 47

see what the neurologist says - perhaps he is into that as well ....

[Sqad]

PP

\\\\\I have HAD a hemi colectomy and am very glad that in your friend, it was probably due to chronic infection ( which really makes you feel crap - pun intended ) \\\

His hemicolectomy was due to cancer NOT chronic infection.

[Scarlett]

If he needs to exercise but finds standing upright difficult, or is in pain or too weak, see if you can find a gym with an Alter G treadmill. They are amazing and perfect for people recovering from operations who need to build up muscles but who can't exercise in the normal way. www.lalterg.com

[Peter Pedant]

Hi sqad

blue line of deletion not detected and restored

we both had a hemi colectomy for cancer and he had a chronic consequent infection ( infected collection ) which could account for the delayed recovery by itself

Chen was looking at ITU patients but since I am a lumper and not a divider I dont see that makes much difference

[Sqad]

PP...sorry but i disagree.

\\\\I dont see that makes much difference\\\

PROGNOSIS and recovery. The prognosis would be much better if the surgery was done for chronic infection rather than malignancy and the recovery may well be quicker.

I cannot see the enthusiasm of a Neurologist when he is presented with a 78 year old patient 7 months post bowel resection who has cachexia.

Just a practical point.

[iloveglee]

Yes to make it clear, sorry if it wasn't, surgery done for bowel cancer but no spread so surgery 'cured' that problem. i.e. no chemo or any other followup. infection was post op, evidently not unusual after this kind of surgery and drs were on to it quickly. but yes, definitely both hindered recovery, and also hindered ability and desire to eat, hence more weight loss than there should have been. due to other health conditions, enhanced recovery programme was not possible afterwards. the replies are interesting, he has tried step exercise to help built up thigh muscle, but also has an intermittent knee problem which flared up, hence the suggestion of physio. myself and his wife are members at a gym although we only do classes, not the gym machinery. I will ask if they have equipment suitable. we are long standing members, so between us we have loads of guest passes so he could possibly try it out before making a commitment to joining. I personally think pilates would be a great help but unfortunately the fact that these classes are full of women puts him off a bit. I was just rather curious as to why there could be something a neurologist might be interested in. and its true, at his age, maybe this is something he is going to have to live with. thing is, his wife is extremely so they are both noticing his disabilities more than perhaps if she was the same as he is. it may be also that at his age, and other health conditions a longer (much longer) recovery period is to be expected.