Because of a combined trip with our transportation service, we got picked up two hours earlier than originally planned this morning (5:15). Fortunately the urology nurse practitioner at Riley's was able to adjust her schedule and see him soon after we arrived. The wound ostomy nurse was able to as well.

So at 10:30, the time of Daniel's first appointment, we were finished with both.

His appointments went well. Daniel's scar is healing up nicely. His stoma looks good. He has had no trouble with skin rashes.

The catheter tube in his belly button actually came out on its own last night, which wasn't that big of a deal since we were coming in today. The NP was able to snip the stitching off and Daniel said it felt much better. 

Now that the temporary post-surgery tube is gone, she showed us how to use a disposable catheter for nightly MACE flushes in his colon. Dr. Roth said we can now increase the amount of water for his enema to 700 ml. Daniel can control the speed of the drip from the gravity bag to what feels comfortable for him.

She put in a plastic belly button stopper with a three inch long extension into his body that he should wear for 6 months to ensure that the opening (canal to his colon created from his appendix) stays open. It's covered with a bandaid.

She also removed the temporary stents that had traveled through the ureters into his stoma, so now his urine will come directly out of his stoma. When changing his urostomy bag (about twice a week) I'll just need to pay more attention to dabbing the stoma dry in order to get good adhesion with the skin.

From the wound ostomy nurse, we got some questions answered about ostomy supplies: adjusting the overnight bag when it doesn't fill, getting rid of air pockets in his urostomy bag, how and when to use the extra supplies, what a fungal rash would look like with anti-fungal powder to use if we see it...

She also helped us practice using the stealth belt that I ordered for Daniel and just came in the mail.

Daniel's next f/u appointment is May 3 with urologist Dr. King, including a renal ultrasound to make sure the kidneys are still functioning well. 

He will start back to school on Monday, and will be able to return to sports activities 6 weeks after his surgery date.