After Decades of Intestinal Problems, Georgia Woman Finds Relief at University Hospitals
March 13, 2021
Peggy was born and raised in Hoyt Lakes, a small town in northern Minnesota. As a young adult, she grew tired of the extreme cold in her home town and, in 1984, bought a one-way bus ticket to Dublin, Georgia. She had a job waiting for her there and before long, she met her now-husband on a blind date. Peggy, a trained microbiologist, had a career she loved, was happily married and lived in a state were warmer temperatures were the norm. Her future looked exceedingly bright.
In 1988, Peggy and her husband started their family and it grew quickly. By 1990, she had given birth to three children, pretty much back-to-back – two girls and one boy. The pregnancies were normal and all three babies were healthy but there was a toll taken on Peggy’s body. After the birth of her third child, she experienced a uterine prolapse and underwent a total hysterectomy.
“After the hysterectomy, I began to experience severe and chronic constipation,” says Peggy. “I would take handfuls of laxatives but still couldn’t go…basically, only rabbit pellets came out.” This continued for years until, in 2010, Peggy needed surgery to repair a rectal prolapse that had been caused by over a decade of straining. Unfortunately, her constipation continued after the surgery and she was desperate for answers, and for help.
Peggy turned to a local gastroenterologist who referred her to a colorectal surgeon in Augusta, Georgia. After testing, Peggy finally had a diagnosis – colonic inertia – a condition in which the colon is unable to modify stool to an acceptable consistency and move it through the body.
In 2011, Peggy underwent surgery again. This time, the goal was to remove the entire colon (colectomy) and attach the small intestine to the rectum, which would essentially allow her to go to the bathroom normally. Unfortunately, her previous surgery for the rectal prolapse had not left enough remaining rectum for this so the surgeon had to change plans. “I woke up with an ileostomy bag and J-pouch surgery,” said Peggy. Also known as ileal pouch-anal anastomosis, J-pouch surgery is for patients who have had their entire colon and rectum removed. Using tissue from the small intestine, a pouch is constructed and attached to the anus. Ultimately this allows the patient to eliminate waste normally after a healing period of about three months. In the meantime, an external ileostomy bag is necessary to collect the body’s waste products.
Three months later, in April 2011, Peggy’s ileostomy was closed and she began to rely on her J-pouch. Unfortunately, there were complications and the J-pouch did not function properly. “For two years, I had 30 or more bloody bowel movements each day, ranging from constipation to diarrhea,” says Peggy. “I continued to work during this time but needed to have a bathroom in sight at all times.”
Her colorectal surgeon knew of a doctor in St. Petersburg, Florida who was experienced in performing continent ileostomy – a procedure that creates an internal pouch to collect waste materials from the intestines. The patient then empties the pouch several times each day through a small opening (valve) in the skin using a catheter. A “collar” made out of small intestine tissue is stitched in place to help prevent the valve from slipping and make drainage easier. Peggy traveled to Florida to consult with the surgeon and had her continent ileostomy procedure in 2013.
Again, the results were disappointing. Over the next seven years, Peggy experienced complications from the procedure including leakage, the formation of fistulas (abnormal openings) and adhesions (bands of scar tissue) and valve blockages. She traveled back to Florida multiple times over this time period for open surgeries to repair these problems. But still, her problems persisted.
Her surgeon in Florida had retired, but knew of a colorectal specialist in Cleveland, Ohio with advanced training in continent ileostomy procedures. That doctor was UH colorectal surgeon, David Dietz, MD.
Peggy consulted with Dr. Dietz and gladly traveled to Cleveland multiple times for surgery. Dr. Dietz first did a valve repair in March 2020. Three months later, in June, Peggy came to Cleveland again for an exploratory laparotomy (open abdominal surgery) and a revision of her continent ileostomy. During the procedure, however, there were too many adhesions (bands of scar tissue) to proceed with the revision. Dr. Dietz cut the bands of tissue and sent Peggy home for three months of healing.
Finally, in October 2020, Peggy was ready for her final surgery and returned to Cleveland for the revision procedure. The surgery was a success. Since then, “it hasn’t leaked once,” says Peggy and she is now back home and doing well. After one post-operative appointment, there are no additional follow-ups scheduled but Peggy appreciates her access to the UH team via telehealth consults. “Most of my telehealth appointments are with Vicki Rumpler, CNP, the nurse practitioner on my team. She is so good at what she does – if I have questions, I know who to call and they are great at scheduling me quickly,” she says.
“Everyone at UH has been so good to me and I am unbelievably pleased with the care I received from Dr. Dietz, Vicki and the whole team. I want to tell my story and let other people know they have options.”
Peggy is now retired and still lives in Dublin, Georgia with her husband of 34 years and their 14-year-old miniature poodle, Jackson. “I had my kids in rapid succession so they also left home in rapid succession,” she says. “Jackson really helped us get through the empty nest phase. I am also a member of the Quality Life Association, a great national support group for people with continent ostomies which has helped me a great deal.”