Out with colon, in with semicolon

Two weeks since the operation. Colon out. Groggy and lightheaded. Throat permanently dry. No amount of brushing takes away the taste of old leathery boots off the tongue. The post-op ward is always full, kept occupied by one of the largest surgical teams in the country.

It is a miracle that nurses remain cheery despite being run off their feet, keeping their eyes on patients’ vital signs, checking saline drips, administering medications, taking bloods, tidying beds, coaxing truculent patients to drink, supporting a walk to the loo, and helping relieve bedsores by turning the bedridden. Then there is the endless paperwork, which even in my morphine induced torpor, I could not fail to notice. 

My nurses are marvellous. Encouraging me to eat a little and sip protein supplement, they assure me that I shall soon be fit and able to go home.

Aah! The protein supplements. Disgusting. Synthetic, chemical, concocted libations, neither fruit nor milk. Physical weakness and loss of taste be damned: vanilla strawberry orange coffee stand firm in democratic solidarity, all equally unpleasant and unrecognisable.

I am learning to live with my ileostomy stoma.

A stoma is any opening in the body. Unlike natural ones, mouth, nose and “bottom end”, an ileostomy is an artificial opening created to empty food waste. After the diseased colon is surgically removed, the valve where small intestine and colon join, is protruded out through the stomach wall. An artificial bag with a flat adhesive face which safely sticks to the stomach is then “worn” around the stoma to collect waste.

What didn’t the stoma nurse tell me before the operation? What have I missed on the web? Does my 28-year-old reference patient’s personal testimony mean nothing? Is there anything in life that has prepared me for this?  A student, coach, and mentor, feeling incompetent, inadequate, insecure.

My stoma nurse teachers are good. Bloody marvellous, in fact. Between them, they have taken hundreds of patients on this journey.

We stand in the bathroom, in front of the mirror so Kish can show me. A bright young Black Country lad, Kish is the antithesis of the stereotype: he is male, Indian AND a nurse! Mental images of Meera Syal’s caricature Indian mother in “Goodness Gracious Me”, disconsolately shrilling “everyone’s boy in the temple is going to medical school and MY son wants to be a nurse!”, passes through my mind.

Kish measures the profile of my stoma to create a template with which to cut a hole in the flat face of the stoma bag. He shows me how to peel off the current bag from my stoma. I flinch in pain as the hole edges bite into tender tissue. As the bag of semi-digested watery waste peels off, out escapes an unpleasant odour.

“Pop the used pouch into this disposal bag”, says Kish, as he hands me what looks like a high-quality dog-dirt bag.

Then, using a sterile wipe, he shows me how to clean the stoma and skin surrounding the valve, red and raw, reminding me that is has no business being exposed to the elements. Gently wiping off the remnant adhesive, I learn how to prepare to “wear” the replacement.

 Just as I am about to put the new bag on, the valve goes squelch! Plop! Without warning, spurts loose yellowy motion.

“Shit!” I scream instinctively, and immediately, as if pre-rehearsed, Kish and I both cry out laughing.

The mirth does not last. My brain remembers the body’s pain, and I take a breather. Kish gives me towel and wipe to keep the sporadic volcanic eruption from soiling my pyjamas. Under Kish’s watchful eye, I reclean the stoma and dry the surrounding skin so that the new bag sticks cleanly. He explains that this is important to keep the bag secure and avoid accidental leaks.

I learn that it is more complicated to put the bag on than to take it off. It must fit snugly around the stoma, for orientating it causes pinching and bruising, which is only avoided through practice.  The new bag is on. Kish tells me what a great job I have done, then he guides me back to my bed.

I slump into the chair, posed in a naval gaze. The contraption on my belly “feels” abnormal. Well-hidden under shirt, no one would know it was there, but I “know” it is there. Its’ fragrance-infused fabric cannot hide its essence – I can “smell” it, and it is not citrusy. 

My eyes wander towards the bedside cabinet to “Bose and his Statistics”, a Quantum mechanics primer and biography of Satyendra Bose, a great physicist of the past century. The man after whom the Boson, or “God” particle is named.

I wonder: is the bag a blot on my being? Surely, quantum mechanics is easy compared to managing this bodily transformation.

 And yet, because of this semicolon, I am alive. To resume and enjoy reading about Bose.