Obstructions - blockages - PLEASE READ

Here's the post from a survivor.....

Jupiter6 Thorofare, NJ John Meilahn, M.D., F.A.C.S. RNY (07/16/07) Member Since: 11/16/03 [Latest Posts]

Post Date: 7/28/08 4:58 pm Pardon the re-post, if you've already read this. _________________________________________ 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 backed up in your belly, and we need to find out why." He explained he'd 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.  "To be a revolutionary is to love your life enough to change it, to choose struggle instead of exile-- and to risk everything with only the glimmering hope of a world to win." -Andrew Kopkind, 1968  Consult(1/07):368 lbs Surg(7/16/07):300.8lbs Current:172.2 lbs.

Thank You so much for posting this...... We really need to listen to our bodies.  I am calling my surgeon in the morning and we will go from there.  I am glad you are better.  Thanks to Barb K for the phone call I wouldn't of guessed it could be like that.  Take care everyone!!!!!
Hugs Marsha

I didn't personally have the blockage, that's a post by Jupiter6 who did have the blockage

I'm so relieved you are calling your surgeon....first thing...k??

Knowing how bad the results can be, I'm glad Marsha and I talked.  If you don't advocate for yourself, nobody else will --- or be able to because it will be too late. 

I was very stubborn thinking something was just stuck and that's why I couldn't keep anything down.  I'm really regular with my bowels everyday, and hadn't gone for 2 days, but just thought I was backed a little. 

But my guardian angel said "no, you haven't gone to the bathroom for two days, your stomach is hard as a rock, and now, if you can't keep water down without pain and then , get to the hospital.  And I did go to the hospital where I had my WLS - which also happens to be where all the specialists of Park Nicollet would be anyway -- Methodist.  And even when I got there (drove my stubborn ass myself!!!), I actually sat in the parking lot for 15 minutes debating if that last  had dislodged whatever was stuck.  You all know how we hate to spend Friday night sitting for endless hours in an emergency room only to go home with pain meds and a crap kit.  But nope, when water drinking still hurt, something had to be wrong.  And because of the WLS, I knew it wouldn't be long before I'd be dehydrated. 

They had me back in a room, with pain meds and anti-nausea meds within 15 minutes (even with a 2 1/2 hour wait notice when I checked in), and an xray and CAT scan within 2 hours and surgery scheduled for a bowel obstruction.  Well, duh I thought to myself -- no wonder I'm so fricking sick.  

My blockage wasn't a twist but scar tissue from one of my prior surgeries pushing in on the bowel, pinching it off.  A clean up of the area and I was all fixed -- VERY thankful I didn't have to have part of my bowel removed or that it had burst. 

But I had ignored all the signs of something being wrong because we are so intensely set on  being normal with WLS, we forget not everything with our bodies revolves around our stomach. 

So pay attention to your bodies and get to a hospital knowledgeable in WLS.   The general practice areas don't know crap about WLS  ~~ sugar intolerance (I don't have diabetes), what meds I can take because of WLS (tired of cutting huge horse pills because they don't dissolve fast enough to go through), that puking quarts of stuff up with a golf ball sized stomach is not normal, etc. 

LESSON IN ALL THIS -- SCREAM FOR YOURSELF!!!!  BE YOUR OWN ADVOCATE!!!!  GET SECOND OPINIONS IF YOU DON'T FEEL RIGHT ABOUT THE FIRST ONE !!!  BETTER SAFE THAN SORRY!!!!

XXOO 

 

I highly recommend BOOKMARKING this post!
Between Shari's (Jupiter6) and Barb's information, it is chock full of good information.

I had an intestinal blockage last summer and was hospitalized for 5 days.  You will definitely know from the pain if there is something wrong - don't fight it - get to the hospital.  I waited about 6 or 7 hours, then at 1 inthe morning, ended up calling the rescue squad.  The ER doc thought for sure it was a blockage, sent me down for (I think) a cat scan and yep, that is what it was.  Good drugs and an IV with NO FOOD and it worked out by itself, but some folks do need surgery.

I hope to never have that experience again!!