Emergency Surgery on Vacation!!

I posted this in my profile, and on the main message boards the other day, but wanted to share it with you all here too. ( Sorry if it's a little long!) Remember to listen to your bodies if something doesn't feel quite right and get it checked out ASAP. My husband Phil had RNY on 8/2/04, and I also did on 1/31/05. Where do I begin? We just returned from a family vacation to Myrtle Beach, South Carolina. It was a heck of a 2 weeks! The first week was spent with 12 other family members in a beautiful 7-bedroom condo on the beach - well that is everyone but my husband Phil spent that 1st week there. We arrived on Saturday, July 30th at about 2:00pm. After checking into the condo, and unloading everyone's stuff - the "girl's" went food shopping, and the "guys" stayed at home. When I left, Phil was starting to have some pain in his lower back, and was going to lie down. Just when we were almost finishing shopping, Phil called and said he was in terrible pain and couldn't take it anymore ( he has a high pain threshold, so I was concerned.) I rushed home, and my brother-in-law came to the store to pick up the girls and the food. I took Phil to the only emergency room that we knew of in the area at the Grand Strand Medical Center ( a place we have driven by over the last 16 years while vacationing in Myrtle Beach, and had always hoped we would never have to visit!) I informed anyone who would listen of Phil's medical history - specifically his RNY G.B. They asked his symptoms, took a urine sample and did a CAT scan. We had also called our Gastric Bypass Dr's office (Dr. Abkin), and Phil spoke to Dr. Popkova as we were entering the emergency room, and she asked that we call her and let her know what was going on. They diagnosed Kidney stones, even though the urine test came back with no blood in it (not uncommon we were told) and the CAT scan was not conclusive, but did show something in the lower right of the kidney. We took a BIG sigh of relief that it wasn't RNY related, and were sent home with pain meds and a strainer. Kidney stones are not "fun" at anytime - and even worse on vacation! They almost sent us home with a prescription for an anti-inflammatory, but I questioned the nurse, and she then questioned the Dr., who thanked me for pointing this out to him again. We contacted Dr. Popkova, to advise her of what was going on, and to confirm the pain meds (tylox) were OK, and she also said no anti-inflammatory drug. She told us to call her if we needed her. Phil spoke to my Dad, who had a stone in the past, and his symptoms were identical, so that's what we thought it was, and I kept making him drink to flush out the stone so he would feel better. Now Monday night comes - no stone - same pain and running out of pain meds. The E.R. said he had to come in to be re-evaluated before he could get any more pain meds. Phil didn't want to spend the night in the E.R., so we got up early and were there by 7:00AM. ~~ Please note - it is Tuesday, August 2nd, 2005 - EXACTLY 1 year to the day of Phil's G.B. Surgery!!) ~~ I again advised every one of his past RNY surgery. They did another CAT scan, and this E.R. Doctor came in and said they didn't see any stones, but saw fluid in his belly, and he thinks it is something bypass related. I immediately called Dr. Abkin's office and told them what was going on, asked them to have Dr. Abkin call the E.R. Dr. ASAP! Dr. Bertha, his associate called an about 8:00am advised the E.R. to suspect a hernia and call in a surgeon. The surgeon, Dr. Mark Borowicz, came in and said that he wanted to do a CAT scan with contrast first - he didn't want to cut if he didn't have to. That takes some time to do this test, drinking some stuff, then waiting etc... Meanwhile, Phil was given pain meds and wasn't in too much pain. I was very scared. We were 700 miles (@ 12 hours ) from home. We didn't know these Dr.s or their abilities. This hospital or this Dr. did not perform RNY's. I called Dr. Abkin's office again, and was a little upset with the response of the staff. I understand that Dr. Abkin was in surgery, but 2 of the people in the office basically said there is nothing the Dr. can do from 1000 miles away. He can't diagnose from the phone. (I will take this up personally with Dr. Abkin when I see him later this month.) I was insistent that I speak to him, since Dr. Borowicz came back with the results of the new CAT scan and was of the opinion to wait it out overnight, admit Phil and see if he felt any better the next day. The staff agreed to email Dr. Abkin, who called me on my cell phone immediately, and said they had been waiting to hear from Dr. Borowicz. Dr. Abkin said we could not wait. Things would only get worse. He needs to speak to the Dr. and Phil needs to at least be explored right away. I walked back into the E.R. with Dr. Abkin on my cell phone, tracked down the E.R. Doctor, and handed him my cell phone to speak with Dr. Abkin. After their conversation, he assured me that he would have Dr. Borowicz speak with Dr. Abkin right away. About 10 minutes later, Dr. Borowicz came in, and said they were brining Phil into surgery in the next few minutes. He would explore laproscopically, but any hernia repairs would be through an open incision. We had no choice. It was 4:30 when they wheeled him toward the O.R. and said it would take about 1 hour. Boy was I scared, boy did I pray! About 1 hour and 15 minutes went by, and the Dr.'s assistant came out to tell me what was going on. They did have to make an open incision (about 8 inches in length from the bellybutton up.) They did find a hernia in the bowel (they referred to it as a Peterson's Hernia.) The Dr. repaired it, and the bowel looked fine - all pink and healthy. While was there, he found his gall bladder to be distended and filled with stones, so he was in the process of removing it when she came out to tell me what was happening. Phil's vitals were all great, and he was doing fine. The Dr. came out when he was all through and told me Phil did great, and he was glad he listened to Dr. Abkin and didn't wait, or Phil would have been in real trouble. Phil would be in recovery for a little while, and then go to his room. By 8:00 pm, they brought him to his room. I must say the rooms were quite large, and all private. They had no problem with me staying the night, and even brought in a cot for me. Phil was in terrible pain, and I kept telling him when every 10 minutes had past to push the button on this morphine pump. The nurses were great at the hospital too, and Phil received excellent care. The only problem was the food. Clear liquids to start. It was difficult to get sugarfree jello. They gave him Boost Protein Drink - which is full of carbs and sugars! I brought him Isopure shakes that I made at home later in the week. Phil was able to leave the hospital on Friday at about 2:00pm. He got to spend the last night of the 1st week with his sister and brothers, and we all went out to dinner. Phil had a crab cake appetizer for his first meal. All his new size 34 shorts didn't fit him since he was so swollen ad filled with fluid. He had hoped to reach his goal of 160lbs by his one-year anniversary, but weighed 173 upon returning from the hospital. (He had been 164 when we started vacation, and yes, we did bring a scale - although it wasn't my idea!!) He was pretty upset by this, but I kept telling him its water weight and swelling! On Saturday, Aug 6th, the rest of our family ended their vacation, and Phil, Nick (16) Jake(10) and I moved to a smaller 2 bedroom condo that we rented, since we had planned on staying for 2 weeks. It was on a golf course, with a pool, and good luck would have it be on the ground floor. It was the ideal place for Phil to continue to recuperate from his operation. Nick was a big help and I am thankful he has grown into such a strong young man, since Phil was unable to lift anything. His pain did lessen the 2nd week, but was still always there. The pain meds made him very tired too. We were able to sit by the pool on the days it didn't rain, and go out to dinner each night. My usually shopping spree's were skipped this vacation, and we had a very relaxing time. We were together, and Phil is healthy and healing. That is what is important! Our original plan was to drive home - straight up Hwy 95 on Saturday, Aug 13th. Since Phil could not drive, and didn't want to spend 12 straight hours in the car, we decided to go half way on Saturday and arrive home on Sunday. I ended up driving 6 ½ hours on Saturday, and we spent a relaxing evening in Fredericksburg, VA at a very nice Wingate Inn. We left on Sunday at 10:00am, and arrived home a little before 3:00pm. Phil took pain meds and slept a little. Even though this vacation did not go as we had planned, we are thankful for many things! We are thankful we were not on a cruise ship, or in a foreign country! Thank goodness we had our family there to take care of our sons while I was at the hospital with Phil. If this had happened the 2nd week of our vacation, when it was just the 4 of us, I don't know what we would have done! I thank each of them for being there for our sons and us. They took them to the beach, out to dinner, for ice cream and to mini golf. We are truly blessed for Phil's health, and for their love and support. I want to thank my boss who took my frantic phone call and tracked down one of our employees who lives in Myrtle Beach, and I thank John, (that co-worker) who came out of a meeting and called me within 5 minutes to assure me that he hasn't heard an horror stories out of that hospital, and he an his wife are available if we need them for anything. Also, thanks to our families, friends and co-workers at home. Their prayers, love and support helped us get through this scary time. Thanks also to Dr. Abkin, for his insistence on having the surgeon proceed and not wait. Dr. Borowicz said at least times after the surgery, and in his office when Phil had the 30 staples removed on Thursday, " I'm glad your guy pushed me and we didn't wait." Lessons learned: 1) Just because you tell a Dr. about your surgery, doesn't mean they know what to look for. I think we should have questioned the first Dr. more on Saturday when the Kidney Stone diagnosis was questionable, but I think we were too relieved to hear it wasn't bypass related. Phil never had Kidney Stones and was lucky no damage was done to his bowel by waiting. 2) I would not let this experience keep me from traveling. What I will do in the future is try to research hospitals in the area where I am traveling to, before I go. There was a hospital 30 minutes away that does do bypass surgery, and probably could have performed this surgery on Phil laproscopically, which would have cut down on his healing, pain and recovery time. 3) When choosing a surgeon for your bypass - ask him what is his policy for emergency phone calls - especially when you are traveling or away from home. Again, we are blessed to have Dr. Abkin! 4) Be insistent ( but nice) with the Dr.'s office staff if you think you need to speak to your Doctor. If I had been put off by their comments, and listened to them, I may have agreed with the surgeon to wait a day and who knows what kind of trouble Phil might have been in. 5) While at the Dr's office to have his staples removed last week, we showed the Dr. and his staff Phil's "before" picture. They were all amazed and couldn't believe it was the same person. One of them asked, would he do it again, I guess figuring on all that he just went through. In a heartbeat, Phil answered "Yes - with out a doubt." Friday, Phil got on the scale and weighs 157 lbs. He is getting back his appetite and will work on getting in more protein now that we are back home. I weighed 196.5 on Friday too - so I lost some through all that craziness! It's great to be home and I am so thankful all went well. I get to go back to work tomorrow, while "lucky" Phil has a few more weeks off! Thanks for letting me share! All the best, Sherri

Thank you for your post. I never thought about another doctor not having a good knowledge of gastric bypass surgery. Im glad Phil is doing good, and Im also greatful that I too, have Dr. Abkin as my surgeon.

What an adventure! I have heard that many people end up with gall stones and removal after GB surgery. I have no gall bladder so I thought I was in the clear. Are the symptoms he had from the stones or from the hernia? I will look into the hospitals in the area when planning a vacation from now on! Thanks for the story and the heads up! Best of luck to both of you and continued good health. The best is ahead! Rossana Kearny, NJ

An adventure it was Rossana - that's the nice way of putting it! My opinion is that it was the hernia that caused the pain - I'll have to ask Dr. Abkin what he thinks when we visit him on the 25th. The surgeon in S.C. says it was the gall bladder - but I don't think so. I just put 2 new pics at the bottom of my profile to accompany the "Our Vacation Emergency Surgery Story!!" Phil is doing better each day, but this open surgery has really knocked him down. He's very tired. Who would have thought 1 year ago he would be trying to "gain" a few pounds!! For having had surgery a little over 1 week before the pics were taken - he looks pretty good I think! He goes to the Nutritionist on Tuesday, and then his 1 yr and my 6 month check up is on Thursday 8/25. It's such a shame because he was at the healthiest point in his life the Friday before "the pain" began, and so looking forward to our vacation. I told him this was a Heck of a way to get the rest of the summer off of work!! All the best to each and everyone of you!! Sherri