Be AWARE!!! May save your life.

This was posted by Jupiter on the main board. This OHer named Vicky died from an intestinal blockage. We have to know the signs and symptoms in case it ever happens to one of us. It happens to 5 out of 100 WLS patients. It can happen to anyone, but it happens to us more often.

Know the signs and symptoms so that when you go to the hospital you can speak with authority about what is happening to you. They have about 72 hours before a blockage will kill us.

Dianna

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Written by Jupiter


Post Date: 7/19/08 6:54 am
Last Edit: 7/19/08 7:04 am
I've been reading a lot of threads about a dear OHer who passed away from an intestinal blockage, and how we need to advocate for ourselves-- and I wanted to make something clear--

If you are suffering an intestinal blockage, all the noise in the world may not save your life. Or better said, if you think you're being loud enough, BE LOUDER-- and arm yourself with knowledge so you recognize it beforehand.

My story: 3 days after having my gallbladder out in June, I started feeling very nauseous and suddenly could not keep food down. (That'd be hard for some to note because they have trouble keeping food down anyway.) I hadn't had gas or a bowel movement in 7 days, but having just had surgery suspected it was just slow in coming.

After 6 hours of this nausea and pain not passing I paged my surgeon and his assistant. I was told that neither were answering their pages. I was able to get in some water eventually and went to bed.
 
The next day the nausea and pain intensified. By 6pm I could take no more. I was home alone, and so instead of driving to the metro hospital where I had my RNY, I could only drive as far as the local ER. This choice almost cost me my life.

I was sweating and crying when I went in. I explained to the triage nurse that I had an RNY and a gallbladder removal just days before and suspected I had an intestinal blockage, and that the pain was excrutiating. An emergency. I could die. 

But It was a holiday weekend, and people who cut their fingers on beer pull tabs were taken back, women who were upset over boyfriends, the general ER riffraff BS that takes place on a holiday-- and I was left standing (couldn't sit) in the waiting room for FIVE hours-- even though I returned several times to triage to say, "I can't take this much longer-- I am very afraid I have had a blockage and need a doctor NOW."

When I was finally seen, the CAT scan was "inconclusive"...the doc told me he saw a lot of fluid in my belly but thought it might be from the gallbladder surgery, and I should follow up with my surgeon in the morning. I was discharged at 6 am with nausea meds and pain pills.

When I called my surgeon, I read him all my tests-- enzyme levels, etc. He said he didn't hear anything alarming-- but he was listening for something gallbladder related-- a bile duct blockage etc. would skew the numbers. When it didn't, he more or less said, "You'll be fine." This was Monday.

By Wednesday the pain at night was unbearable. I cried and screamed into a towel. Wednesday morning I had a regular check up with my surgeon. Luckily, his assistant knows me very well and said, "Shari, you don't look right. Seriously." The surgeon said, "I don't know what to do-- want us to admit you and run some tests?" I think he expected me to say no, but I said, "PLEASE!"

So I was admitted around 4 pm. By 7 pm the pain was back, but they wouldn't allow me pain meds until after I had a CAT scan. I didn't hve the CAT scan until 3 am. They left me on a gurney in the hallway for an hour and a half  aftyerward, sobbing in pain, because they didn't have anyone in transportation to come get me. By the time I finally received pain meds at 5 am, I would have shot myself if I'd had access to a gun.

I finally fell asleep. At 7 am, my surgeon breezed in, threw open my curtains and said, "You're having surgery today. You have a bunch of fluid back up in your belly, and we need to find out why." He explained he's use the lap incisions he'd made for the gallbladder and go back in.

By noon I was in surgery.

At 4 pm, I awoke in the worst pain I had ever felt in my life. I focused on a spot on the ceiling. I could not talk. I had tears streaming . The dilaudid wasn't even touching it. 

They explained to me, "You're a lucky woman. Your bowel (intestines) had twisted and actually permeated the wall of your excluded stomach. Generally when this happens, and days pass, we find a bunch of dead bowel which we have to remove. But for whatever reason when we reconnected you, you pinked up right away. Now we just have to see if it works-- if you can move your bowels or pass any gas." I was told that the lap procedure went open suddenly when they couldn't locate the source right away-- I had a large open incision now from my sternum to my navel. I'd been gutted and beat up pretty badly in the process. But I was alive.

For five days, nothing passed. My urine was dark brown, I was losing kidney function. Then it started to lighten, and returned. And finally on the fifth day, while walking in the hall, I passed gas. Sounds stupid, but I was so happy I cried. I gained 25 pounds in fluid and unpassed stool in 3 days--but within two weeks lost 40. My recovery took many weeks, but I finally  feel better now. I am grateful for the opportunity to live, and feel obligated to warn anyone who will listen.

Blockages like mine are 100% fatal if not caught in time-- usually within 72 hours. Why mine didn't take me down in the FIVE days that had elapsed, I am not sure.
 
I wanted to make sure you know what we're really discussing-- how it feels, what it looks like, how you might be treated. Your local ER will NOT be able to help you. You need to educate loved ones so that they can speak FOR you-- a medical alert bracelet will not help you. The beloved poster who passed away may have done all of the above, and still they missed her blockage until it was too late. You need to do everything you can to make sure it doesn't happen to you-- and this sort of herniation-- sometimes called a Petersen's hernia-- happens in about 5% of post bypass patients. Five out of one hundred. One in twenty. Could be anyone.

Symptoms in an RNYer include nausea, vomiting, abdominal pain and distention, inability to pass stools or gas. (Apparently in DSers, gas will still pass.)

Know the signs and symptoms. Don't allow anyone to dismiss you. Do NOT ignore pain that will not pass. Insist on prompt and appropriate treatment, and train your family to know how to help you if it should happen. You may save your own life.

Thanks for the information.

This is very serious. I had 2 internal hernias and as soon as I mentioned it to my surgeon he scheduled me for surgery. I now have another one but was informed of what signs to look for if it becomes a blockage and I am to get to Ochsner immediately. I have already been told I need another surgery and that this time it will be open.

Dr. Richardson thinks I have one too. I did get a CT scan, but that really doesn't show anything. I felt the knot inside when I was doing sit ups, and let him feel it when I went in for my 1 year check up. I have so much more weight to lose that I'm going to try to hold off on getting the hernia fixed until I can get a LBL at the same time....unless it starts hurting, then it gets fixed immediately.