XPost: Has anyone heard of an MD not doing a swallow test after RNY?

My friend had her RNY on Monday (different doctor than mine). They do no swallow test at all to check for leak before advancing to liquids and foods or sending the patient home. Has anyone heard of this? Seems to me this would be risky. Supposedly, the reasoning is that they look to other tests to see if there are signs of leak (for increased blood pressure, tachycardia, fever, abdominal distension), but from what I saw, the nurses were doing very little to check BP, heart rate. The patient was going 7-8 hours at a stretch with no one even coming in the room. How would they know if there is leak if they aren't checking anything at all? I thought virtually all doctors did some sort of swallow test the day after surgery. Has anyone heard of this? I'm worried about by friend. She seems good so far, but I just have never heard of them not even checking post-op.

I know the DS doesn't normally do a swallow.. I've not heard of RNY not doing it, though..

Icky.. I'd be worried, too.

I was actually kind of appalled at the aftercare so far. They've been in the room to check on her only every 6-8 hours or so, and even then not always to check vitals. VERY different than when I had mine at ECU. I got GREAT care. I'm not sure how they are going to use heart rate and blood pressure as a guide to if she has a leak if they aren't checking it. Makes me very nervous. She's also getting her drain out post op day 1-1/2.

I did not do the swallow test but my surgery was done open. They may have tested while I was still open. Iconsider my care excellent and I have no complants. I do believe his lap patients may do the swallow test but am not sure. Was her wls done open?
Myrtis

I did not have a swallow test after RNY and before i had the surgery, i asked the doc about it.   He advised there are many other signs and he feels it is not necessary and while he has done over 700, that is not an issue.  I was in a hall for Bariatric Patients at Presby in downtown Charlotte and the nurses were in at least every hour checking vitals, making sure i was drinking my liquids and jello, checking urine output, etc.  I really do believe every doc has their own opinions but not checking vitals for 6 to 8 hours seems to be neglectful.

Pam

My surgeon didn't do a swallow test and I had my RNY done lap.  I asked about it beforehand and he used to do them but I was told that he no longer does them because they now look for other symptoms after surgery similar to what you mentioned.  I also didn't have to have a drain tube although I have read several peoples accounts of surgery where they did.  I'm not sure why my surgeon didn't do this but I never had any problems and I received excellent care while in the hospital.  I hope your friend continues to do well.

My surgeon does not do a swallow test routinely, and there are other ways to identify leaks.  We watch the JP drain output (color, amount), "strip" the JP drain every 4 hours and record the drainage, watch vital signs every 4 hours (more often if we identify a reason to check more often), and we do hourly rounding on our patients as well.  We also monitor things like urine output and the patient's general condition ... and any subtle little change will lead to more advanced testing, but the swallow test is not necessary in all cases.  If we suspect a leak, a lot of times the patient is given blue ice cubes to chew/swallow, and we watch the JP drain to see if the dye ends up there (because it will if there is a leak).  I've had patients who developed leaks before ... trust me, you do pick up on the signs quickly, and a patient with a leak doesn't "act" like a normal patient.  And, we do not send patients home with JP drains, either ... they are removed sometimes as early as 1 day postop, but our patients only stay 2 nights on average and the drain is usually removed on postop day #2.  It's patient dependent, and depends on the amount of drainage coming out of that JP. 

No swallow test here either, I had the same surgeon as new-beginnings and she already explained why.
However, not seeing a patient 7-8 hours is insane - Presby Hospital nurses checked on me numerous times the first night (Id say almost hourly) and the second night they still came in but less than the first night.

I did not have a post op swallow test either. When I talked w/my surg. about it at preop appt, she said it's only ordered if they have reason to suspect leakage.  However, just as others have said, 7-8 hrs w/o checking on is completely unacceptable!  Not sure where she was, but she needs to file a complaint with the patient services representative/coordinator.  Most hospitals have them these days, and most will need to do some follow up.  She also needs to share her experience w/her surgeon's office, so they know what's going on too.  Sorry to hear she's had a bad inpatient experience, but hopefully she's doing well otherwise!!