Shannin Update - 4/2 - Long but Detailed
Great news - I have been released from Methodist! I'm resting at home while Don is out getting my RX and supplies for the next few days. Here is the skinny -
Dr. W found adhesions around the "Y" part of my surgery site. Adhesions are actually very common after any abdominal surgery. Although most begin forming shortly after surgery, sometimes won't start showing until months or years later. As the adhesion develops, the intestines can twist and begin to form a kink or blockage, making it more and more difficult to pass food through the intestine. Left untreated, blood flow can become restricted causing tissue death.
My symptoms began about 1.5 weeks ago. I was able to eat, but really dense protein seemed to get "stuck." In some occasions I was able to lie down and let it pass. A few times, it felt better to throw up. Because I was still able to eat, especially soft or slider foods, and I was having regular BMs, I didn't think it was a blockage. I did have pain, but it was fairly mild and I thought I was just eating too fast, not chewing well enough or eating too much.
Finally, on Sunday evening, I was trying a turkey burger and after about 3-4 bites, I felt like I was getting stuck but this time I experienced a severe pain near the left side of my rib cage. The pain radiated from left to right across my upper abs. It hurt to take a deep breath, sit straight up or even bend over. I could not get comfortable - either by sitting, reclining or laying down. Tylenol wasn't touching the pain. I did get some relief as what I had eaten made its way through my digestive tract.
The initial pain was sharp and stabbing, eventually becoming a dull but constant pain. I did go to work Monday morning. Coffee and water seemed to go down OK as long as I took little sips. I tried some plain yogurt at about 8:30 AM but, again, after a few bites, the sharp, intense pain returned. I went to my office nurse, who encouraged me to get to the ER or at least see my PCP. By noon, the pain was still intense, I couldn't drink water without cramping and sitting was painful. I opted to go straight to the ER at Methodist. It took awhile to get into see a doctor, but after a ultrasound he could see that my gallbladder was enlarged and my stomach was becoming extended as gas built up. He decided to do a CT scan, which meant drinking contrast liquid.
The ER staff was very good - they knew I had WLS so they didn't force me to drink 24 ounces of the stuff and they mixed it with diluted apple juice. I got about 12 ounces down and began to have severe nausea. After the CT scan I did start throwing up which only distressed my insides even more. They had me on anti-nausea meds and dilaudid (pain meds) via an IV. The CT scan showed a blockage around the "Y" part of my WLS. They could not tell from the scan if it was an internal blockage or internal hernia. Adhesions can't usually be diagnosed with a CT scan, only by surgical means.
Because of the WLS, they consulted with Dr. W. We could have gone two ways - admit me to the hospital and see if the blockage would resolve itself (using stents or enemas) or surgery to see if there were adhesions. I got into a room at around 11:00 PM on Monday. The pain meds were working pretty good so the pain wasn't as intense.
The surgeon on call recommended a Nasal Gastric tube (NG tube) because of the nausea and the build up of liquid in my pouch. The nurse put one in at around 1:00 AM. For those who have never had one - it hurt like hell. They figured they needed 52 cm of tube to go from my nose to my pouch. Once it was in, it felt like I had a bone in my throat. I couldn't breathe and started to have a panic attack. I was crying (a huge deal for me) and begging for them to take it out. They didn't want to, but I threatened to pull it out myself, so they consulted the on-call surgeon who allowed them to remove it. While it was in, the contents from my pouch did drain. There wasn't a lot in there since I only had water and the contrast liquid, but it was still a horrible ordeal.
I didn't sleep great, but Dr. W saw me around 8:30 AM on Tuesday and said they had decided to do surgery at 3:00. They kept me on the IV pain meds, which helped with my comfort level while waiting.
I went into surgery a little after 3:00 - Dr. W advised that he might have to re-do the connections of the pouch/intestine/bowel depending on where and how big the blockage was. In the end, it was a lot less invasive as the adhesion was easily removed without having to cut into the intestine or bowel. My pouch was untouched. I was in recovery at 5:15 and back in my room before 6:00 feeling pretty good. I didn't need any pain meds until 10:00 before bed, and did several laps of the 7th floor. The best part is that I FINALLY got to drink water. I had not had anything by mouth since 11:00 PM Monday (18 hours!). I have 6 more little incisions to go along with my original 7, but if they heal as nicely as those, they shouldn't be noticeable.
My pain level was at about a 4 prior to getting Roxicet to help me sleep through the night. It felt like I had done too many sit-ups more than anything. Compared to RNY, this was a breeze. I got a good night's sleep. I was told that my release date would probably be Thursday around 10:00 AM, but after Dr. W saw me and listened to my stomach and seeing my urine output, pain level, movement, etc. decided to send me home today. I was able to get down 3 pitchers of water between coming out of surgery and being released as well as some yellow Jell-o, apple juice and black coffee. I came home with liquid Roxicet (combo of acetaminophen and oxycodone) and will be cleared to go back to work on Monday (I was pushing for Thursday or Friday, but Dr. W said don't pu****). I'm on a bariatric diet meaning full liquids and then soft foods through the weekend.
Just a few notes about my stay at Methodist - the wait in the ER was long but I got good attention and they were very detailed with my history and diagnosis. I was sent to the 7th floor (usually for orthopedics) because there wasn't room on 4 where most WLS patients are. The downside was that I had to share a room with an older woman who just had a knee replacement that day and was in a lot of pain. The good news is that the staff was just wonderful. Every nurse, nurse's assistant, lab person, etc. was nice and seemed to really know what was going on with me and my condition. There was a lot of poking, prodding, drawing blood, inserting IVs, taking vital signs, asking the same questions but they were all so great. I got a lot of compliments about my weight loss (the on-call surgeon didn't believe I hadn't had a tummy tuck) and how quickly I was up and moving around. As I was doing laps, they were even calling me "Speedy."
The nurse who watched over me in recovery had a lap band with Dr. Jones, so we had a lot to talk about. She said she had never seen someone come out of anethesia so fast and so alert.
I really think that my weight loss contributed to how quickly I recovered and how little pain I felt after surgery.
Adhesions can happen to anyone at any time. This was not a direct result of my WLS, but something to watch for. My suggestion is that any abdominal pain should be checked out by a doctor. It could be "just gas" but it could be something serious. Remember to be your own advocate when it comes to your health. Do your research but don't self-diagnose or self-medicate.
Thank you for all of your prayers and thoughts. It really means a lot to know that there is always a group of friends to support you whether in person (thanks to Jen & Lynn who stopped by to say HI), on the phones (Barb J. - the best nurse ever) or on-line. If anyone has any questions, feel free to ask. One of the most important things about this board is that we can share experiences and hopefully offer help to those who might be in the same situation.
Hugs,
S
Shannin
336>162>170 Below GOAL!!
"Every now and then, somewhere, someplace, sometime, you are going to have to plant your feet, stand firm, and make a point about who you ar and what you believe in. When that times comes you simply have to do it" ~Pat Riley
336>162>170 Below GOAL!!
"Every now and then, somewhere, someplace, sometime, you are going to have to plant your feet, stand firm, and make a point about who you ar and what you believe in. When that times comes you simply have to do it" ~Pat Riley
Shannin,
I am glad to hear that you are recovering well and that you are starting to feel better. Thank you so much for sharing this with all of us so that we can know what to look for. Take it easy and let your body recoup after this ordeal.
"When you see only one set of footprints, it was then that I carried you."
I'm glad to hear you're doing fine, but can't believe you'll be ready for work on Monday! Wow!
Take care and rest up!
Connie B. 
What what an ordeal!!! I am glad you are on the mend!! Thanks for keeping us informed!!
Healing Hugs!
~Sandie~ 
-147!!WLS:12-12-06:Preop 268,Ht.5'4",BMI 44.9
Click on link to see my journey!!!
http://www.onetruemedia.com/my_shared?z=2bfaca5561a1d558fceb
87&utm_source=otm&utm_medium=text_url
"Do unto others as you'd have done to you"~ The Golden Rule to Live by!
You are what you EAT and WHO you hang out with! Choices=Outcome~ what's YOUR choice??
I'm not perfect but I am going to die trying!!!
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