I thought I would repost this here in case someone was looking for a thread on this topic.
Well @GloHo you do have quite the questions that I will be happy to field the best that I can.
So to answer your first question:
Is there anything you could share with us that would be helpful to know if we have not yet experienced an obstruction? Yes, they are painful. Some can come on suddenly and some are a gradual that reach a crescendo that one can't ignore. They are more common than we think especially due to the surgeries that we end up having due to our Ovarian Cancer. Sometimes it is scar tissue that causes them and other times, it is tumour growth that starts to impede the function of our organs by pressing on them that does it. It is different for everyone. I, unfortunately, have many that impede a lot. I have one in particular that has affected my kidneys for a long time and now my right kidney remains at severe hydroureternephrosis but my left one has changed from mild (months ago) to now being moderate on my latest CT scan. This means that at some point, my kidneys could fail me. I was offered intervention a long time ago but am thankful I have not as I did not want to live with 2 tubes emerging from my back and bags to empty both ureters on a daily basis. I have tumours along my small intestine which sometimes get irritated for whatever reason and causes me to have the ileus (partial obstructions). I have ones along my descending colon and throughout my peritoneal cavity as well which all have an impact on the organs inside. So, long and short, this is possibility for many that have had surgery. I truly wish they had educated us more on diet etc from the onset of recovery from surgery.
Are bowel obstructions different for everyone or are the warning signs similar for everyone? They are typicaly the same for everyone. I would say it usually starts with a sense of fullness or bloating that does not go away. This seems to get worse and one doesn't feel like eating. Sometimes I have been hungry and did eat but have grown to know now to not when I feel like that. There is extreme pain in the abdominal cavity and I can feel the intestines moving trying to move things through. It often feels like spasms but very painful. If this does not pass what usually ends up happening is that one will vomit to rid the body of anything in the stomach. Often there is no flatulence or bowel movements when someone has an obstruction. One becomes very weak and I have to call my nursing team either before I feel I will be sick or after to administer medication and help get me through it. They do this with my SRK kit I have at home that the Palliative Doctor ordered. In it, they have the ability to administer drugs intramuscular with a little port that I usually get them to put in my legs. One leg is one drug and the other leg is the other. I sleep a lot and take tiny sips of water initially as that is all I can do when I am experiencing an obstruction. If the obstruction is a complete one, meaning it is being strangulated it two spots, one can go to the hospital and they will do a CT scan then probably instruct that a NG tube be used or if someone decides not to, there are measures they can do to keep one comfortable until you pass away. Not something anyone wants to think about but it is the truth of the matter.
Are there usually warning signs or can it occur without warning? Yes sometimes (as above) there can be warning signs. Other times, mine can come on suddenly and I gradually feel worse and worse and know it is coming. I think I covered most of this in the question above.
Questions to ask? Do you mean to your team or what do you mean by this? If you explain a little more, I would be happy to answer.
Medications that help? Most of my meds are in my SRK kit which is something a Palliative doctor orders to have in your home. One can always discuss this with their Oncologist, Family doc etc to see if this is something that applies to you or not. In my oral meds, I have Dexamethasone and now a stomach coater one to take with it. I also have my break through pain meds that are short acting that I can take. All of that depends on whether I can ingest and keep down medication and any bit of fluid. I have both an oral and sublingual Odansetron to help with the nausea portion that goes with an obstruction. Again, all ordered by my Palliative doctor so that I am prepared when something like this occurs.
Diet restrictions - should the low residue diet be started immediately or would modifications to diet suffice? I think this is an individual thing and something to be discussed with your surgeon or team at the time. If I had known when I was starting to have these that there was a way I could have monitored my diet earlier, I would have appreciated it. I knew to go to a clear fluid diet after having one but nothing beyond that was explained to me until I had that hospitalization and NG tube earlier this year. If this is something that is known to affect oneself, I would say to start or be aware of the Low Residue Diet (which I have posted before) and follow it as you see it fits your situation. I was told by the nutritionist that one will phase in and out of the 3 phases and for some that they can eventually go back to a regular diet. I know now that I won't be able to do that. I really miss my fresh fruit and veggies. I miss having wraps and salads, eating nuts and popcorn and many other things like whole wheat bread and grained breads. It is what it is to keep me upright and this side of the grass so I deal with it. But I can tell you, normal food smells amazing. I am thankful that I can appreciate the aroma of that food but not feel like I am missing out so much or turned off by it. One thing I can say that I have noticed is my sense of smell has been heightened and will often tell my family they have to remove their plate once done eating or sometimes not be in the same room as them when they eat depending on the aroma.
I hope this helps some or many of you and these are my experiences due to the frequency I have been experiencing them. Everyone can present a little differently. If anyone has anything to add, please do so.
Thanks again for asking such valuable questions that may help someone and possibly prevent some of what I have gone through.