Lyn Dell surgery

Posted Wednesday, October 5, 2005 @ 01:18 AM       Hello to everyone on this message board. I would like to introduce myself and ask for any and all advice that post-operative patients of Dr. Kruschinski can provide. My name is Lyn Dell Sowers, I am a 41 year old female from Harrisburg, Pennsylvania in the United States of America. I have recently discovered Dr. K and his site by the referral of Helen Dynda. She is truly a dedicated ARD survivor on a mission to help as many of us as possible.

I have suffered chronic abdominal pain since 1999 when I was recovering from a gastric bypass operation. Overall, the gastric bypass was a tremendous success aiding me in losing 174 pounds, but I was left with a pain that began in my back and moved to my shoulder and now has most recently (past 3 years) centered itself in my abdomen.. I'm really shortening the story because it is so similar to many of the stories that I have read on this board. By similar, I mean, there have been numerous doctors, endless tests, many hospitalizations, too too too many narcotics and all without ever finding what the root cause was for my chronic pain.

I just got out of the hospital less than 1 month ago, during which the surgeons decided that the only course of action they could suggest was for me to undergo a full gastrectomy (total removal of the stomach) The problem was, that even if I agreed to the surgery, they were only telling me that there may be a 20 – 30 % chance that the pain would diminish or cease all together. As desperate as I was, I was actually considering it. But fortunately for me, my loved ones, intervened and convinced me that I should at least obtain a second opinion.

It was during that time that a dear dear friend of mine came to my rescue and began doing research and found Helen and subsequently Dr. K. I have known for several years that my abdomen is full of adhesions. I was even operated on 1 year ago, by the same surgeon that did my gastric bypass to remove the adhesions. But the pain never subsided. So, it's my thought that either he didn't get them all, or they simply grew back immediately.

I'm scared and nervous about this commitment that I have made to travel to Germany for this surgery, but I feel that I have nothing else to lose. I have tried everything that the doctors have suggested, ie. pain management clinic, physical therapy, biofeedback, TENS unit, nerve blocks, acupuncture etc etc etc. So… I don't think I would ever forgive myself if I didn't try this as well. I am now (as of my last hospitalization) unable to go back to my job due to the heavy narcotics that I am taking. They leave me barely able to function and stay awake. I am a corporate trainer and love my job and cannot wait to return. Every day, I fear that my employer (whom has been endlessly patient with me) will grow tired of waiting for me and dealing with my problem. Doctors have even now begun giving me a difficult time when I call to request refills for the narcotics that they have added and added and added to simply mask the pain rather than dig in and find the cause. I remember begging them not to continue giving me narcotics because I was so scared of becoming dependant or addicted to them. Now there is no doubt in my mind that I am. But how dare they treat me as though it is my choice to be dependant on the narcotics. What a terrible position they have put me in. I almost feel guilty or ashamed when I call the doctors to request the medicine. I’ll bet some of you have even found yourselves in a similar situation. I’m even scared thinking about the future and what will happen to me when I am finally pain free after my trip to Germany. I’m terrified to think about how it will feel to go through withdrawal from all these medications. But I guess if I’ve dealt with this horrendous debilitating pain for this long, I can make it through the withdrawal as well. I’d like to hear from any of you that had to go through a period of withdrawing from narcotics. How did it go. Can you offer me any guidance or advice on how to handle it or approach the detoxification process?

It's scary to travel so far away and also alot of money, but if it helps me to get my life back, I will be forever indebted to Dr. K.

Dr. K has already informed me it would be wise to have a second "General Surgeon" to assist with the surgery, so that has added to the cost somewhat, but I realize that it is in my best interest to proceed this way. I've had so many abdominal operations in my past that I think he feels that he's going to find a mess in there. Plus I have asked that he remove a persistent ulcer that has formed at the site of my gastric bypass anastamosis while he is in there. Doctors in America have said that they are unable to remove the ulcer because they have already removed it once before (3 years ago) and it has grown back at virtually the same location. And since my stomach that is left since my gastric bypass is so small anyway, I think they felt that there would not be enough stomach left after cutting away the ulcer. But Dr. K didn't seem to think it would be a problem. What a wonderful man. I can only hope that he finds that to be true when he actually gets in there and starts looking around.

Well, I'll close my story for now so I can keep plugging along with my planning. I have a surgery date of December 2nd. I am to arrive in Germany November 30, 2005 and have surgery Dec 2nd. So it is fast approaching. I will wire the money by the end of this week (thats scary too – sending so much money off into the wild blue yonder). Did this scare anyone else? And then next I will secure the plane tickets. Did anyone have any difficulties with needing to change return travel dates once you were post op. I'm speaking of if there were any difficulties or anything prohibiting you from traveling back when you planned? That’s something we keep discussing – how much time to leave post op before trying to travel home? Any advice? If I'm being operated on 12/2/05 what day would it be safe to make return air travel arrangements? By the way, I'm from Pennsylvania in the US and I'm planning to travel on Lufthansa airline.

Again, thank you to anyone that takes the time to write to offer me any advice. I will greatly appreciate it.

Sincerely (and nervously)

Lyn Dell 

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Posted Monday, December 26, 2005 @ 06:07 AM   

Hello all, I am writing with the first of my journal entries to document my journey and progress as one of Dr. Krushinskis’ most recent adhesiolysis cases from the USA.

Name: Lyn Dell Sowers 
Age: 41 
Location: Harrisburg, PA USA 
Diagnosis: Frozen Upper Abdomen Chronic left quadrant pain following longitudinal laparotomy for gastric bypass, small bowel resection, revision of gastric bypass anastamosis, laparoscopic lysis of adhesions, colon adhesions. Adhesions to the spleen and through to the diaphragm and uterus adhesions. Previous History: Ovarian cystectomy and removal of fallopian tube and tubal salpingectomy. 
Surgery Date: December 2, 2005 (First Look) 
Surgery Date: December 9, 2005 (Second Look) 
Surgeon : Dr. Daniel Krushinski 
Accompanied by: Professor Vittorio Paolucci 
Surgery: Gas and Gasless laparoscopy, adhesiolysis of the left upper quadrant and on the abdominal wall, Spray Gel Application

My history includes multiple abdominal surgeries, stemming back as far as 1985 when I had a Ovary, and Fallopian tube removed due to a very large ovarian cyst that had caused the fallopian tube and ovary to adhere to one another. At that time and since, I have been diagnosed with recurrent endometriosis, but never attributed the pain of these later years to the Endometriosis. The remaining abdominal surgeries I have had over the years have included, an appendectomy, gastric bypass, abdominoplasty, gastric bypass revision, small bowel resection, exploratory laparoscopy (to address fertility concerns) and a lysis of adhesions via laparoscopy. All these surgeries were undertaken in the United States of America. The surgeries that were done to try to address the chronic pain I have been experiencing for the last several years were the gastric bypass revision – which was done to revise the surgical anastamosis where an ulcer had formed and was causing a terrible pain in my left shoulder. Believe it or not, when you abdominal areas of concern such as my ulcer, the pain can show itself as a referred pain, hence the terrible pain in my left shoulder. Then the lysis of adhesions was done to try to see if freeing up the adhesions could help my pain.

I was disappointed to awaken from that surgery in the US to find that the pain was still there and then to later review the surgical notes only to find that the surgeon mentioned that the adhesions were so extensive at one area around my spleen that he did not proceed any further for fear of causing bowel damage or making the wound site to large. During that lysis – there was no adhesion barrier used, and actually the doctor only hesitantly agreed to do the surgery at my pleading, he is a physician of the mind set that adhesions do not cause pain.

So finally, coming forward to December 2005:

The procedure undertaken for me was a combination of gas laparoscopy and gasless laparoscopy, due to the necessity of reaching abdominal areas that would have inaccessible without a portion of the procedure being done with gas.

Dr. Krushinski first addressed the adhesions in my upper abdomen. He described the left upper quadrant to appear "frozen" with adhesions. He went on to describe that he found several loops attached to the anterior thoracic and abdominal wall. In the lower quadrant he found the sigma adhered to the uterus. The surgery took six incisions. One at the belly button which seems to be the largest of all, and 5 others properly placed for the best insertion and mobilization of surgical instruments. They began on the left side using scissors to free the adhesions of small bowel from anastamosis site and through to the diaphragm. Dr. Krushinski and Professor Paolucci worked very carefully to free loop after loop from each other and from the thoracic wall where many loops of small bowel were twisted around amidst the adhesions.

Next they moved to the right upper quadrants where many adhesions were freed from my liver. Closer to my stomach many omental and bowel adhesions were found and were taken down very carefully. Next all the interluminal adhesions were removed from these quadrants.

The next step was to begin adhesiolysis in the middle abdomen by using the abdolift to retract the abdominal wall so that the adhesions in that area could be addressed. Dr. Krushinski decided that it was in my best interest to leave some areas of adhesions so that the wound site would not get much larger making the surgery all the more lengthy adding risks. The adhesions of the sigma to the uterus was left for this reason and also because we had discussed pre-operatively, that there are adhesion types that do not make pain, and Dr. Krushinskis’ judgment that we would address this area in the future only if it becomes an area producing pain, which it presently was not. Spray Gel was applied (4 kits) to all the areas of lysis and a drain was put in place and the incisions were closed in the proper order.

I remember awaking in the recovery area and being shown photos of the affected area, and briefly talking with Dr. Krushinski. whom was also on the same day performing adhesiolysis on another patient from the USA. I don't remember much from those first conversations, except that I did try to convey to the nurses that there was a good deal of pain, and I was very cold. Thankfully, they covered me with several very thick down blankets, and filled a hot water bottle and put it under the covers at my feet. I was quickly warmed and back in post operative anesthesia deep sleep. They moved to my own room rather quickly after waking up in that recovery area.

Throughout the first evening/night my husband stayed right beside me in the room and was able to do everything for me that helped to keep me as comfortable as possible. They told me to use my own narcotics from home to address the pain, but at one point I did ask for pain medication from the nurses there, and was given an injection in my leg. Then I went right back to sleep. Notably, I remember the pain as being more of an ache in the back and around the middle. I suspect it is from being place in the trendelenburg position for the surgery or possibly just for the length of time lying on an operating table. Or maybe even just the juxtaposition that is done to your rib cage/abdomen with the abdolift. But my husband continued to rub my back and that helped me get through those periods. When I was able to take a full inventory of what was attached to me that evening, I found that I had a drain which was being emptied fairly frequently, and also a urine catheter, and two iv ports, one in my right hand that was placed during surgery, and still had a solution running to it, and a port in my left hand which was used by the anesthesiologist to administer the anesthesia to begin surgery. It is worthy to mention, that the staff make you very aware at all times what to expect. I remember lying in a prep area just outside of the operating room, where the anesthesiologist started the necessary lines and explained to me, that when I awoke, that port would still be there, but I would have a different port in my right arm for the administration of post operative fluids and hydration. And that is exactly hat happened. I was wheeled to the operating room and asked to move to the operating table, and everyone very kindly with sweet smiles kept wishing me to “sleep well”. I felt as though I were in the best care possible. Interestingly enough though, as the anesthesia was applied, they said night night, you will begin to feel dizzy now – I didn’t feel anything. I just smiled back and said good night and waited, but no dizziness, so they gave me some more, and the same thing happened. But on the third push of the liquid it was truly off to a deep deep sleep with no pain whatsoever.

The staff at Emma Klinik does not unnecessarily waken you or bother you as you are resting. They answer the bells promptly, and do what they can to keep you comfortable and happy. They brought me drinks as I desired mostly hot camille tea was my preference, but I'm sure juices or other items were available as well. Things progressed well during the hospital stay; I was up and walking fairly quickly. Don't get me wrong, it felt like a truck had hit me, but I was walking just the same. Picture a little old lady totally bent over at her waist from osteoporosis…and that was me the first two days post op. My back was killing me and I didn't feel like I could walk straightened up.

The staff monitors you constantly via blood tests and blood pressure and temperature, but other than that, they just let you rest. The catheter was removed Saturday as well and the IV bag, this made me able to move around more easily. The second night after my husband left quite late, I had trouble sleeping, probably because I slept alot during the day, so I just walked slowly in the hallway as I could throughout the late late night getting prepared to be released the next morning.

Sunday I was released from the Klinik and taken by taxi to the apartment and met there by Dr. Krushinskis’ staff – Michele and Jutta. They explained the planned visits and steps for the next few days, and made me very comfortable and made me feel that they were available to me whenever necessary, just at the end of the telephone line. They call you on the cell phone which the Dr. provides for your use while in Germany. They set a time and always call when they say they will. Other than that they just allow you to rest and heal as you can. We were fortunate in that we had a beautiful day on Monday with bright sun, and my pain that I had pre-op was gone. The only pains I was complaining of were back pain, and gas bubbles moving throughout my abdomen. Those gas pains and ulcer pain that I was experiencing were bad. So anyway, we took a walk along the River Main, it seemed as though everyone had our idea as well, as the walkway and the marketplace were packed. There was a Christmas Village going on, so that was neat to see. I may have done too much that day, or just had some healing pains the next day, but I found that I stayed in bed most of the next day aside from meeting with Dr. Krushinski who assured me that the pains I was feeling were normal surgical pains. We were both gleaming from ear to ear, when we realized that the chronic pain that had brought me to Seligenstadt and Dr, Krushinski appeared to be gone. Dr. Krushinski reminds me and all patients that there will be good days and tough days for up to 3 months post op, but for me, any day without that chronic pain is a good day. I can deal with these healing pains for now if necessary.

We did find that for the next several days, we had to take some rather drastic attempts at trying to get the pain from my ulcer under control. I don't know what exacerbated the ulcer so badly but it was totally flared up and the second night I was out of the hospital, I did not sleep at all all night long because of the pain from the ulcer and acid. Dr. Krushinski did his best along with Jutta and Michele to find remedies to help control the pain, and I think it is somewhat better now but it gave me some bad days.

The following Friday we were taken by taxi in the early morning to the Emma Klinik for the second look and I do believe that the other couple from the US, my husband and I and Dr. Krushinski were the only people there in that early morning darkened hospital, so this was the first time we experienced any disorganization or miscommunications at all during the whole trip. But eventually we were processed, consent forms were gathered, the IV was started and I was taken to the operating room. I guess since I went first the previous week, as luck would have it I got to go first again for the second look (sounds logical). For some reason, I felt more apprehensive for this surgery than the first one, but I'm sure it was just all in my head because; Dr. Krushinski came out afterward and spoke with my husband. I cannot quote the length of the surgery but we were told it was quite fast and that no new adhesions were found. My insides were described as all over smooth and shiny. We breathed a collective sigh of relief. I again, awoke with a drain, was encouraged to walk, which became quite messy because the fluids, rather than exiting my body via the drain, decided just to pour out the incision site around the drain tube and all over the floor my feet and the gown. Not too pleasant. To add a bit more confusion to this day, unlike the day of the first look surgery, there were plenty of English speaking Klinik staff attending to us, so we could clearly understand what to do next, and communicate freely. This day, there was one rather flustered nurse trying to keep the crowded wake-up recovery room flowing. And it seemed that there were frequent lapses in communication this day. At one point after Dr. Krushinski asked me if I had a walk yet, he instructed the nurse to walk with me, She misunderstood, and put me in a room, with my street clothes and did a short pantomime, trying to make me understand to put my clothes on. I was fairly certain that was not Dr. Krushinskis’ intent as he had just told me that I needed to walk and I also still had the drain in and the IV connected. So to make a long story shorter, Dr, Krushinski came out of the operating room again (poor guy), and told her to walk with me, then told her to call me a taxi to go back to the apartment. The atmosphere was very rushed and not at all relaxing this day. But probably, because so many procedures were happening at the same time, and they only had limited space in the wake up and recovery area, they needed to move us around quickly. Anyway, Dr. Krushinski removed my drain, the nurse called a taxi and told us to go wait at the street. This was a big difference from the way the taxi pickup and delivery process had run up until then. Until then, whenever taxi service was arranged, the driver came and collected you to aid you getting in the car, and having the necessary documents signed by Klinik staff or Dr. Krushinskis' office staff so that the driver would have his fare taken care of. Well this day, did not happen like we were accustomed. The taxi driver did not speak English, and was not told where we were being taken to, and no arrangements for payment were made. Also, he drove like a maniac, so I had to do a little pantomime, to ask him to slow down trying to make him understand that I had just had surgery and was somewhat tender. Fortunately the apartment was directly across from a grocery store called Aldi, so we used that name and the driver understood where to take us, the only problem was that he dropped us off at the door to the grocery store instead of the apartment. The next funny thing was that we had left the apartment without any money that morning in our haste, and so we had to somehow get the driver to understand to wait while my husband ran to our apartment to get the money to pay the fare. So I stayed with the driver while my husband ran across the street to the apartment to get the money. We didn’t want him to think we were trying to get away without paying him. It was a little awkward, but we survived. So, as unlikely as it is that this type of confusion could happen, when something like this does happen it really makes you appreciate the precise planning and organization that Dr. Krushinski, his office staff, the employees of the Emma Klinik and all other affected professionals have put forth to put this awesome infrastructure in place. We survived, amidst a bit of confusion that day, but all in all, it was a great day because no adhesions were found at the second look – hip hip hooray.

Come forward to yesterday Friday, December 16, and you find me well on the mend. I am still incurring the general aches and pains around my middle (I described it to a friend via email as though I was the volunteer in a magic show and they cut me in half in the box with the big saw – how was that for a visual?) I ran a low grade temperature twice during the healing process. The incision sites are dry and nearly healed with the exception of the one at the belly button that site was used twice and is the larges incision of all of them. They itch a little bit, but that is to be expected with normal healing. I have had vaginal discharge – not blood, continually since the second look, but it is not extensive, and after discussing it with Dr Krushinski, we decided this was normal and I will just watch to make sure it doesn’t go on too long, get worse.

We opted to stay in Seligenstadt an extra two days where normally Dr. Krushinski would release his patients on the 5th post operative day after the 2nd look (Wednesday) My husband and I had discussed it in our planning stages and decided to add a few extra days for healing and I'm glad we did because although my healing is progressing exactly as expected, I was still very achy in my pack and around the middle for a long flight. So I'm glad we had an additional two days to try to get a little more healing underway. That decision may have been poor though, because I don't know if it is the time of year, or the fact that we traveled on a Friday or just some other factor came in to play, but the flight was over-booked, so there was no hope whatsoever for finding a few seats together on which I could stretch out. I was able to lie down the entire flight to Germany from the US at the beginning of this journey, and I was sincerely, hoping for the same situation on our return, but it did not work that way. It was an extremely rough flight, alot of bouncing and turbulence due to bad weather, and I wasn't feeling well at all, and the seat directly behind me contained a child that found great pleasure in beating his feet into the back of my seat and kicking me continually. So…loud kicking crying children, mixed with a cranky aching post op patient, didn't make for a great flight. My final note…that I would like to share is that even with the turbulence and bouncing and kicking en route to the USA, I was aching, not in pain. However, that changed 100% when we landed. I hadn’t prepared myself to think that there would be any difficulty with landing, as taking off was no problem at all, but here is what happened. We flew Lufthansa to Philadelphia, and part of the in-flight programming has monitors throughout the cabin displaying vital statistics such as ground temperature, miles to destination, air speed, ground speed, well, as we were on our landing approach, the plane was quickly decreasing in ground speed…700, 650, 500, 450 ….boom the wheels touch the ground and the brakes are engaged dropping our speed tremendously, well, my bowels and the contents of my abdomen, were still moving forward at a rate of around 500 miles per hour. So when the brakes were applied, a guttural scream came out of me as if someone had just punched me right in my belly – it felt as though my belly or my stitches were tearing. I know that wasn’t the case, but that is what it felt like and there was nothing I could do to stop the tears. It was just so totally unexpected. I should have thought the process through; possibly I could have had a pillow or something that I could have used on my abdomen to counteract the forward pressure or momentum. Needless to say, my yell caught a few people including myself off guard and scared the poor stewardess. But as quickly as possible I got myself and my tears under control and deplaned and began the remainder of the journey – 3 hours by car home. I must admit – it was too much for me. I was not a good passenger. When I finally got in the car, I could not get confortable, I took pain medication, but I was hurting and had cramps all throughout my sides and my abdomen and basically cried or whimpered quietly into a blanket and pillow for the remainder of the trip home. Not a great impression for my family, because I was sending them these upbeat emails from Germany, singing the success of the surgery, and here I was the first time they'd seen me in almost 3 weeks, and I didn't look like the happy person I was conveying in my emails. But I eventually explained the difficult flight and the pain on landing and then they understood.

Finally, I’m home – I took a long hot shower and went to bed but had very fitful elusive sleep due to the aches and pains of the travel day today. So now I’m back up after only about an hour or so of rest and I’ve compiled these notes for you to let everyone know how I made out. I will keep posting to let you know how the days and weeks etc progress and please feel free to contact me via cell at 717-343-0131 or email at lyndell_sowers@hotmail.com or via this discussion board. I will be glad to answer anything I can because even though this journal entry has gotten quite lengthy, I’m positive there is much more to be said and more questions to be answers. So, fire away, I’ll do my best to discuss any parts of this process whatsoever.

In closing, I want you to know how sincerely thankful that I am now to be on to the next chapter of my recovery and introduction back into life. I cannot wait to get back to work. I am a corporate trainer and speaker and have not been to work since my last hospitalization in June. I have a wonderful employer whom has had endless patience with me and I am so anxious to be able to return. I love what I do, and was operating at a severe deficit. A primary portion of the speaking engagements I have and training I conduct are on motivational topics and interpersonal skills, and the powers of positive thinking, etc. And because of the pain that I was enduring everyday, it was difficult to keep a positive outlook and keep a smile on my face. Most days is was nearly impossible to stand up in from of a hall of people and put on a happy face and deliver a motivational message. Now I can get back to the business of being me. Thank you Dr. Krushinski. I'm sure you understand the sentiment of love, and can appreciate that your patients love you and your positive, skillful, knowledgeable, understanding persona….I'm so thankful that our paths have crossed in this lifetime and I will do everything in my power to aid in spreading the message about what you do and what is available out there in this world for people like me.

Thank you from the bottom of my heart,

Lyn Dell

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Posted Saturday, December 17, 2005 @ 08:50 AM      

Hello all, I am writing with the first of my journal entries to document my journey and progress as one of Dr. Krushinskis’ most recent adhesiolysis cases from the USA.

Name: Lyn Dell Sowers 
Age: 41 
Location: Harrisburg, PA USA 
Diagnosis: Frozen Upper Abdomen Chronic left quadrant pain following longitudinal laparotomy for gastric bypass, small bowel resection, revision of gastric bypass anastamosis, laparoscopic lysis of adhesions, colon adhesions. Adhesions to the spleen and through to the diaphragm and uterus adhesions. Previous History: Ovarian cystectomy and removal of fallopian tube and tubal salpingectomy. 
Surgery Date: December 2, 2005 (First Look) 
Surgery Date: December 9, 2005 (Second Look) 
Surgeon : Dr. Daniel Krushinski 
Accompanied by: Professor Vittorio Paolucci 
Surgery: Gas and Gasless laparoscopy, adhesiolysis of the left upper quadrant and on the abdominal wall, Spray Gel Application

My history includes multiple abdominal surgeries, stemming back as far as 1985 when I had a Ovary, and Fallopian tube removed due to a very large ovarian cyst that had caused the fallopian tube and ovary to adhere to one another. At that time and since, I have been diagnosed with recurrent endometriosis, but never attributed the pain of these later years to the Endometriosis. The remaining abdominal surgeries I have had over the years have included, an appendectomy, gastric bypass, abdominoplasty, gastric bypass revision, small bowel resection, exploratory laparoscopy (to address fertility concerns) and a lysis of adhesions via laparoscopy. All these surgeries were undertaken in the United States of America. The surgeries that were done to try to address the chronic pain I have been experiencing for the last several years were the gastric bypass revision – which was done to revise the surgical anastamosis where an ulcer had formed and was causing a terrible pain in my left shoulder. Believe it or not, when you abdominal areas of concern such as my ulcer, the pain can show itself as a referred pain, hence the terrible pain in my left shoulder. Then the lysis of adhesions was done to try to see if freeing up the adhesions could help my pain.

I was disappointed to awaken from that surgery in the US to find that the pain was still there and then to later review the surgical notes only to find that the surgeon mentioned that the adhesions were so extensive at one area around my spleen that he did not proceed any further for fear of causing bowel damage or making the wound site to large. During that lysis – there was no adhesion barrier used, and actually the doctor only hesitantly agreed to do the surgery at my pleading, he is a physician of the mind set that adhesions do not cause pain.

So finally, coming forward to December 2005:

The procedure undertaken for me was a combination of gas laparoscopy and gasless laparoscopy, due to the necessity of reaching abdominal areas that would have inaccessible without a portion of the procedure being done with gas.

Dr. Krushinski first addressed the adhesions in my upper abdomen. He described the left upper quadrant to appear "frozen" with adhesions. He went on to describe that he found several loops attached to the anterior thoracic and abdominal wall. In the lower quadrant he found the sigma adhered to the uterus. The surgery took six incisions. One at the belly button which seems to be the largest of all, and 5 others properly placed for the best insertion and mobilization of surgical instruments. They began on the left side using scissors to free the adhesions of small bowel from anastamosis site and through to the diaphragm. Dr. Krushinski and Professor Paolucci worked very carefully to free loop after loop from each other and from the thoracic wall where many loops of small bowel were twisted around amidst the adhesions.

Next they moved to the right upper quadrants where many adhesions were freed from my liver. Closer to my stomach many omental and bowel adhesions were found and were taken down very carefully. Next all the interluminal adhesions were removed from these quadrants.

The next step was to begin adhesiolysis in the middle abdomen by using the abdolift to retract the abdominal wall so that the adhesions in that area could be addressed. Dr. Krushinski decided that it was in my best interest to leave some areas of adhesions so that the wound site would not get much larger making the surgery all the more lengthy adding risks. The adhesions of the sigma to the uterus was left for this reason and also because we had discussed pre-operatively, that there are adhesion types that do not make pain, and Dr. Krushinskis’ judgment that we would address this area in the future only if it becomes an area producing pain, which it presently was not. Spray Gel was applied (4 kits) to all the areas of lysis and a drain was put in place and the incisions were closed in the proper order.

I remember awaking in the recovery area and being shown photos of the affected area, and briefly talking with Dr. Krushinski. whom was also on the same day performing adhesiolysis on another patient from the USA. I don't remember much from those first conversations, except that I did try to convey to the nurses that there was a good deal of pain, and I was very cold. Thankfully, they covered me with several very thick down blankets, and filled a hot water bottle and put it under the covers at my feet. I was quickly warmed and back in post operative anesthesia deep sleep. They moved to my own room rather quickly after waking up in that recovery area.

Throughout the first evening/night my husband stayed right beside me in the room and was able to do everything for me that helped to keep me as comfortable as possible. They told me to use my own narcotics from home to address the pain, but at one point I did ask for pain medication from the nurses there, and was given an injection in my leg. Then I went right back to sleep. Notably, I remember the pain as being more of an ache in the back and around the middle. I suspect it is from being place in the trendelenburg position for the surgery or possibly just for the length of time lying on an operating table. Or maybe even just the juxtaposition that is done to your rib cage/abdomen with the abdolift. But my husband continued to rub my back and that helped me get through those periods. When I was able to take a full inventory of what was attached to me that evening, I found that I had a drain which was being emptied fairly frequently, and also a urine catheter, and two iv ports, one in my right hand that was placed during surgery, and still had a solution running to it, and a port in my left hand which was used by the anesthesiologist to administer the anesthesia to begin surgery. It is worthy to mention, that the staff make you very aware at all times what to expect. I remember lying in a prep area just outside of the operating room, where the anesthesiologist started the necessary lines and explained to me, that when I awoke, that port would still be there, but I would have a different port in my right arm for the administration of post operative fluids and hydration. And that is exactly hat happened. I was wheeled to the operating room and asked to move to the operating table, and everyone very kindly with sweet smiles kept wishing me to “sleep well”. I felt as though I were in the best care possible. Interestingly enough though, as the anesthesia was applied, they said night night, you will begin to feel dizzy now – I didn’t feel anything. I just smiled back and said good night and waited, but no dizziness, so they gave me some more, and the same thing happened. But on the third push of the liquid it was truly off to a deep deep sleep with no pain whatsoever.

The staff at Emma Klinik does not unnecessarily waken you or bother you as you are resting. They answer the bells promptly, and do what they can to keep you comfortable and happy. They brought me drinks as I desired mostly hot camille tea was my preference, but I'm sure juices or other items were available as well. Things progressed well during the hospital stay; I was up and walking fairly quickly. Don't get me wrong, it felt like a truck had hit me, but I was walking just the same. Picture a little old lady totally bent over at her waist from osteoporosis…and that was me the first two days post op. My back was killing me and I didn't feel like I could walk straightened up.

The staff monitors you constantly via blood tests and blood pressure and temperature, but other than that, they just let you rest. The catheter was removed Saturday as well and the IV bag, this made me able to move around more easily. The second night after my husband left quite late, I had trouble sleeping, probably because I slept alot during the day, so I just walked slowly in the hallway as I could throughout the late late night getting prepared to be released the next morning.

Sunday I was released from the Klinik and taken by taxi to the apartment and met there by Dr. Krushinskis’ staff – Michele and Jutta. They explained the planned visits and steps for the next few days, and made me very comfortable and made me feel that they were available to me whenever necessary, just at the end of the telephone line. They call you on the cell phone which the Dr. provides for your use while in Germany. They set a time and always call when they say they will. Other than that they just allow you to rest and heal as you can. We were fortunate in that we had a beautiful day on Monday with bright sun, and my pain that I had pre-op was gone. The only pains I was complaining of were back pain, and gas bubbles moving throughout my abdomen. Those gas pains and ulcer pain that I was experiencing were bad. So anyway, we took a walk along the River Main, it seemed as though everyone had our idea as well, as the walkway and the marketplace were packed. There was a Christmas Village going on, so that was neat to see. I may have done too much that day, or just had some healing pains the next day, but I found that I stayed in bed most of the next day aside from meeting with Dr. Krushinski who assured me that the pains I was feeling were normal surgical pains. We were both gleaming from ear to ear, when we realized that the chronic pain that had brought me to Seligenstadt and Dr, Krushinski appeared to be gone. Dr. Krushinski reminds me and all patients that there will be good days and tough days for up to 3 months post op, but for me, any day without that chronic pain is a good day. I can deal with these healing pains for now if necessary.

We did find that for the next several days, we had to take some rather drastic attempts at trying to get the pain from my ulcer under control. I don't know what exacerbated the ulcer so badly but it was totally flared up and the second night I was out of the hospital, I did not sleep at all all night long because of the pain from the ulcer and acid. Dr. Krushinski did his best along with Jutta and Michele to find remedies to help control the pain, and I think it is somewhat better now but it gave me some bad days.

The following Friday we were taken by taxi in the early morning to the Emma Klinik for the second look and I do believe that the other couple from the US, my husband and I and Dr. Krushinski were the only people there in that early morning darkened hospital, so this was the first time we experienced any disorganization or miscommunications at all during the whole trip. But eventually we were processed, consent forms were gathered, the IV was started and I was taken to the operating room. I guess since I went first the previous week, as luck would have it I got to go first again for the second look (sounds logical). For some reason, I felt more apprehensive for this surgery than the first one, but I'm sure it was just all in my head because; Dr. Krushinski came out afterward and spoke with my husband. I cannot quote the length of the surgery but we were told it was quite fast and that no new adhesions were found. My insides were described as all over smooth and shiny. We breathed a collective sigh of relief. I again, awoke with a drain, was encouraged to walk, which became quite messy because the fluids, rather than exiting my body via the drain, decided just to pour out the incision site around the drain tube and all over the floor my feet and the gown. Not too pleasant. To add a bit more confusion to this day, unlike the day of the first look surgery, there were plenty of English speaking Klinik staff attending to us, so we could clearly understand what to do next, and communicate freely. This day, there was one rather flustered nurse trying to keep the crowded wake-up recovery room flowing. And it seemed that there were frequent lapses in communication this day. At one point after Dr. Krushinski asked me if I had a walk yet, he instructed the nurse to walk with me, She misunderstood, and put me in a room, with my street clothes and did a short pantomime, trying to make me understand to put my clothes on. I was fairly certain that was not Dr. Krushinskis’ intent as he had just told me that I needed to walk and I also still had the drain in and the IV connected. So to make a long story shorter, Dr, Krushinski came out of the operating room again (poor guy), and told her to walk with me, then told her to call me a taxi to go back to the apartment. The atmosphere was very rushed and not at all relaxing this day. But probably, because so many procedures were happening at the same time, and they only had limited space in the wake up and recovery area, they needed to move us around quickly. Anyway, Dr. Krushinski removed my drain, the nurse called a taxi and told us to go wait at the street. This was a big difference from the way the taxi pickup and delivery process had run up until then. Until then, whenever taxi service was arranged, the driver came and collected you to aid you getting in the car, and having the necessary documents signed by Klinik staff or Dr. Krushinskis' office staff so that the driver would have his fare taken care of. Well this day, did not happen like we were accustomed. The taxi driver did not speak English, and was not told where we were being taken to, and no arrangements for payment were made. Also, he drove like a maniac, so I had to do a little pantomime, to ask him to slow down trying to make him understand that I had just had surgery and was somewhat tender. Fortunately the apartment was directly across from a grocery store called Aldi, so we used that name and the driver understood where to take us, the only problem was that he dropped us off at the door to the grocery store instead of the apartment. The next funny thing was that we had left the apartment without any money that morning in our haste, and so we had to somehow get the driver to understand to wait while my husband ran to our apartment to get the money to pay the fare. So I stayed with the driver while my husband ran across the street to the apartment to get the money. We didn’t want him to think we were trying to get away without paying him. It was a little awkward, but we survived. So, as unlikely as it is that this type of confusion could happen, when something like this does happen it really makes you appreciate the precise planning and organization that Dr. Krushinski, his office staff, the employees of the Emma Klinik and all other affected professionals have put forth to put this awesome infrastructure in place. We survived, amidst a bit of confusion that day, but all in all, it was a great day because no adhesions were found at the second look – hip hip hooray.

Come forward to yesterday Friday, December 16, and you find me well on the mend. I am still incurring the general aches and pains around my middle (I described it to a friend via email as though I was the volunteer in a magic show and they cut me in half in the box with the big saw – how was that for a visual?) I ran a low grade temperature twice during the healing process. The incision sites are dry and nearly healed with the exception of the one at the belly button that site was used twice and is the larges incision of all of them. They itch a little bit, but that is to be expected with normal healing. I have had vaginal discharge – not blood, continually since the second look, but it is not extensive, and after discussing it with Dr Krushinski, we decided this was normal and I will just watch to make sure it doesn’t go on too long, get worse.

We opted to stay in Seligenstadt an extra two days where normally Dr. Krushinski would release his patients on the 5th post operative day after the 2nd look (Wednesday) My husband and I had discussed it in our planning stages and decided to add a few extra days for healing and I'm glad we did because although my healing is progressing exactly as expected, I was still very achy in my pack and around the middle for a long flight. So I'm glad we had an additional two days to try to get a little more healing underway. That decision may have been poor though, because I don't know if it is the time of year, or the fact that we traveled on a Friday or just some other factor came in to play, but the flight was over-booked, so there was no hope whatsoever for finding a few seats together on which I could stretch out. I was able to lie down the entire flight to Germany from the US at the beginning of this journey, and I was sincerely, hoping for the same situation on our return, but it did not work that way. It was an extremely rough flight, alot of bouncing and turbulence due to bad weather, and I wasn't feeling well at all, and the seat directly behind me contained a child that found great pleasure in beating his feet into the back of my seat and kicking me continually. So…loud kicking crying children, mixed with a cranky aching post op patient, didn't make for a great flight. My final note…that I would like to share is that even with the turbulence and bouncing and kicking en route to the USA, I was aching, not in pain. However, that changed 100% when we landed. I hadn’t prepared myself to think that there would be any difficulty with landing, as taking off was no problem at all, but here is what happened. We flew Lufthansa to Philadelphia, and part of the in-flight programming has monitors throughout the cabin displaying vital statistics such as ground temperature, miles to destination, air speed, ground speed, well, as we were on our landing approach, the plane was quickly decreasing in ground speed…700, 650, 500, 450 ….boom the wheels touch the ground and the brakes are engaged dropping our speed tremendously, well, my bowels and the contents of my abdomen, were still moving forward at a rate of around 500 miles per hour. So when the brakes were applied, a guttural scream came out of me as if someone had just punched me right in my belly – it felt as though my belly or my stitches were tearing. I know that wasn’t the case, but that is what it felt like and there was nothing I could do to stop the tears. It was just so totally unexpected. I should have thought the process through; possibly I could have had a pillow or something that I could have used on my abdomen to counteract the forward pressure or momentum. Needless to say, my yell caught a few people including myself off guard and scared the poor stewardess. But as quickly as possible I got myself and my tears under control and deplaned and began the remainder of the journey – 3 hours by car home. I must admit – it was too much for me. I was not a good passenger. When I finally got in the car, I could not get confortable, I took pain medication, but I was hurting and had cramps all throughout my sides and my abdomen and basically cried or whimpered quietly into a blanket and pillow for the remainder of the trip home. Not a great impression for my family, because I was sending them these upbeat emails from Germany, singing the success of the surgery, and here I was the first time they'd seen me in almost 3 weeks, and I didn't look like the happy person I was conveying in my emails. But I eventually explained the difficult flight and the pain on landing and then they understood.

Finally, I’m home – I took a long hot shower and went to bed but had very fitful elusive sleep due to the aches and pains of the travel day today. So now I’m back up after only about an hour or so of rest and I’ve compiled these notes for you to let everyone know how I made out. I will keep posting to let you know how the days and weeks etc progress and please feel free to contact me via cell at 717-343-0131 or email at lyndell_sowers@hotmail.com or via this discussion board. I will be glad to answer anything I can because even though this journal entry has gotten quite lengthy, I’m positive there is much more to be said and more questions to be answers. So, fire away, I’ll do my best to discuss any parts of this process whatsoever.

In closing, I want you to know how sincerely thankful that I am now to be on to the next chapter of my recovery and introduction back into life. I cannot wait to get back to work. I am a corporate trainer and speaker and have not been to work since my last hospitalization in June. I have a wonderful employer whom has had endless patience with me and I am so anxious to be able to return. I love what I do, and was operating at a severe deficit. A primary portion of the speaking engagements I have and training I conduct are on motivational topics and interpersonal skills, and the powers of positive thinking, etc. And because of the pain that I was enduring everyday, it was difficult to keep a positive outlook and keep a smile on my face. Most days is was nearly impossible to stand up in from of a hall of people and put on a happy face and deliver a motivational message. Now I can get back to the business of being me. Thank you Dr. Krushinski. I'm sure you understand the sentiment of love, and can appreciate that your patients love you and your positive, skillful, knowledgeable, understanding persona….I'm so thankful that our paths have crossed in this lifetime and I will do everything in my power to aid in spreading the message about what you do and what is available out there in this world for people like me.

Thank you from the bottom of my heart,

Lyn Dell

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Posted Wednesday, January 4, 2006 @ 11:42 PM      

Hello all and Happy New Year! I must say it is a Happy New Year for me. By the time the Christmas and New Year Holiday rolled around this year I was about 3 weeks post op and none of my adhesion related pain has returned. Don't get me wrong, I am still going through the pain involved with healing from a major surgery, but the original pain that plagued me for so long is gone.

I'm finding that I am having a lot of pain throughout my bowels. Each time I must move my bowels or even when gas bubbles or air move around in my bowels, it sometimes doubles me over or brings tears to my eyes. I feel that this too, is related to the healing process. Dr. Krushinski did so much work clearing the adhesions from my bowel area that I suppose they will hurt for some time.

The other issue I am dealing with is trying to cut back on the narcotics. I was prepared for it to be difficult, but so far, it hasn't been too hard and I have really cut back substantially. Before I was taking 6 tsp of liquid oxycontin every 4 hours plus wearing a 75mcg duragesic patch every three days. Now, I have cut the patch back to sometimes a 50 mcg and even twice a 25 mcg and I take the liquid oxycontin 2tsp only twice a day. So the weaning off the meds is going better than I had expected.

I still have a good deal of back ache but I chalk that up to the crazy positioning during surgery and also the way I have laid in the bed over the last few weeks trying to ease that pain. It is definitely getting less and less painful with each passing day.

Well that's my entry for now. As I stated in my previous journal entry – having this surgery was the right decision for me. I am so thankful that it seems that my pain is gone. I know that Dr. K says that we have to wait the 3 – 6 months for total healing to make sure there are no further problems, but at least for now, I feel well and hope that things continue to improve with each day.

Thanks for checking back with me and reading my entry.

Until later,

Lyn Dell

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Posted Wednesday, January 25, 2006 @ 07:32 AM      

Hello everyone – today is 1/25/06 and it's been 53 days since my surgery and my recovery is progressing perfectly. I am so pleased to report that I have had no recurrence of the pain. The post-surgical pain (ie- soreness and achiness) hung on for several weeks post op, but is now gone. I guess I should qualify that statement by mentioning that I am still taking narcotics, so I guess I can assume that there may still be some healing type pain, but it is being covered by the narcotics to the point that I do not feel it. The pain that I had prior to surgery was just diminished with the use of the narcotics, but constantly broke through the heavy dosages. So, I'm happy to say that now, I feel well and pain free.

You probably wonder why I am still taking the narcotics if I no longer have pain – and I wish I weren't. But when I returned from Germany, I felt so well that I substantially tried to quickly reduce the dosage on my own and had some very bad withdrawal symptoms. So now, rather than putting myself through that "feeling" again, my family doctor is working with me to slowly decrease the meds so that it is not so hard on me. I guess there is no easy way to do it. He said to me the other day – that I just have to accept that I have been on those meds for 5 years and I cannot realistically expect to stop taking them "overnight".

The only pain that I still deal with is pain in my bowels when I have a bowel movement. But I attribute that to the fact that there is still healing going on in that area since there were so many adhesions cleared from throughout my bowels. And also because use of narcotics tends to constipate a person – so – probably when I can totally stop the narcotics – that may even be a problem of the past.

Well, I will close for now in hopes that these updates help those of you that are considering surgery with Dr. Krushinski to see the path of a recent post op patient – and updates the rest of my friends on this board of my progress.

Oh – one other milestone – after 7 months out of work due to the pain, I am preparing to return to work in two weeks. I am so excited. I love my job and cannot wait to return. All this – thanks to a wonderful, skilled man name Dr. Daniel Krushinski – I owe him my happiness.

Till next time.

Lyn Dell

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Posted Sunday, December 3, 2006 @ 07:45 PM       Hello All – I’m writing to mark the 1 year anniversary of my adhesiolysis by Dr. Krushinski at the Emma Klinik in Seligenstadt Germany.

I apologize for the amount of time that has elapsed since my last post –op journal entry. It seems that as my recovery progressed and my life became more and more active, I forgot the importance of remembering those years of pain and being thankful for and reporting on my progress since surgery.

I’m so happy to report that I have had no recurrence of pain. My surgery date was December 2nd 2005 and I have had nothing but success with the procedure.

I will put links here to my past entries in this journal so that if you are interested you may see the entire journey to date:

The journey begins. 
http://www.endogynserver.com/cgi-bin/210/cutecast.pl?session=xvec0fujMNqyVQkQLUByQctPZX&forum=53&thread=2027

Post Op Journal 1 
http://www.endogynserver.com/cgi-bin/210/cutecast.pl?session=xvec0fujMNqyVQkQLUByQctPZX&forum=53&thread=2190

Post Op Journal 2 
http://www.endogynserver.com/cgi-bin/210/cutecast.pl?session=xvec0fujMNqyVQkQLUByQctPZX&forum=53&thread=2205

Post Op Journal 3

http://www.endogynserver.com/cgi-bin/210/cutecast.pl?session=xvec0fujMNqyVQkQLUByQctPZX&forum=53&thread=2217

Now on to my 4th journal entry. Happily I report that I was able to return to work in February. I started back to work after nearly 7 months on disability. I began with a limited schedule and by March was back to a full time hectic schedule. My life has returned to normal. I’m totally active and have a zest for life back.

My journey involved many hospitalizations in the USA and many misdiagnosis for my pain. I had sunk into deep depression and feared that I was a young woman (41 y/o) that had nothing ahead but a life of pain.

When a dear friend of mine was researching my problems and symptoms on the internet she came upon this website and it seemed like a possibility. And for me, one who had lost all hope, to even feel that there may be an end to the pain, was remarkable.

I then began the research. I started calling past patients and doing as much leg-work as someone in chronic pain can do. But finally it came to the point where I had to make a decision. You know what my decision was….I went to Germany and had surgery with Dr. Krushinski. For me, it was the answer to a prayer. To go to sleep in excruciating pain, and to awake and know, intuitively, that THAT pain was gone was an amazing experience. Don’t misunderstand, I did have post operative pain. I had all the pains that you would expect to have after a lengthy surgery. But I knew that those pains would subside. And they did.

My experiences in Germany were wonderful. Everything was exactly as it was described to me in the Preparations for Germany section of this site. We were met by a driver when we arrived, we promptly met with Dr. Krushinski at his office, we were handled with the utmost professionalism by his office staff. The apartments provided were top-notch. The staff of professionals at the Emma Klinik far exceeded any experience that I have had with any US hospitals (and they have included some of the finest – even Johns Hopkins).

So, my story is one of success and thankfulness. Don’t get me wrong, I had plenty of reservations and worries when I began considering traveling internationally for surgery. But I was at the end of my rope. Many of you may be able to understand that level of desperation. I felt that I had no quality of life left. So, I did what research I could, trusted my instincts, prayed on my decision, and took a leap of faith. And my leap paid off. I am healthy and happy and healed. I have had no recurrence of pain. My decision was the right one for me.

I have had the opportunity in the months since my surgery to communicate with several people as they are themselves doing the research of considering this surgery. My comments to them are always the same. I share my story exactly as it happened, and then I tell them, that no one can decide this for them, but themselves. They must do the research and educate themselves and satisfy themselves that this is the right or wrong decision for them. Always trust yourself and your instincts.

My decision has been rewarded with a fulfilled life and for that I will always be thankful. And I know whom to be thankful to.

Thank you all for your interest in my journey and I hope my story has given you some insight in to the way the journey played out for one patient along the way.

Regards until my next post,

Lyn Dell 

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