Inflammation after surgery

Posted By Patrick Sheffield on July 25, 1998 at 01:15:57:







Hello Doctor,
   My son is 4 years old and has tuberous sclerosis. He has escaped most
of the neurological symptoms of this disorder, but suffers from cystic
kidneys. He has approx. 10% of normal kidney function, but his creatinine
numbers are stable at around .8 or .9. He has an elevated blood pressure
of around 115/80 which his nephrologists do not find high enough to
medicate at this time.
   Developementally, he is far ahead of the game, having taught himself
to read at 3 years of age. He is a bright, caring, happy boy.
   Around 8 months ago he was hospitalized with a twisted large intestine,
seemingly unrelated to his TSC. This was caused by his colon being too
long. The damaged section of colon was removed and the two ends were
reconnected.
   This surgery was not successful as the lower 6 inches of colon (in-
cluding the rectum) developed a severe inflammation which was apparently
caused by reduced circulation to this area due to the surgery itself. We
spent about 6 weeks at Cedars Sinai Medical Center trying to get it to
heal. He could not eat, and was on TPN thru a central line. He lost alot
of blood and required 2 transfusions. It was touch and go for a while
and a trying time for all.
   When it became apparent that he was not going to heal, he was given
a temporary colostomy with the thought that the inflammed section would
heal given complete rest for 3 months or so.
   After 5 months he continued to pass extremely foul smelling mucus
containing blood clots and a few drops of fresh blood on a regular
(almost daily) basis. The surgeon's feeling then was that the rectum and
lower colon were non-viable tissue caused by compromised circulation and
felt that it should be removed and his colon would be sewn directly to
his anus.
   I asked if there could be complications, including incontinence,
and the surgeon said, "Oh no, we do this all the time". He said that
we needed only wait until his colon had lost it's distention in order
to perform the procedure.
   Seven months after leaving the hospital a colonscopy reveals the
inflammation to be the same. Now the surgeon is not optimistic. Doing
nothing at this time should cause no complications so we have adopted
a wait and see approach.
   Sorry to take so long to give you the particulars, but to get to my
questions - Are there any therapies, supplements, or drugs that you know
of that might foster increased circulation and/or help his damaged tissue
to heal? (bearing in mind any any dangerous side effects given his lim-
ited kidney function).
   We are in no rush. My son has accepted "the bag" as normal and it
has become routine. However, if there is something we can be doing
instead of just waiting, I'd like to know about it.
   Thank you for your time.
            Sincerely,
                    Patrick Sheffield