Medical alert bracelet

Jennifer A.
on 8/1/14 11:40 pm - Canada

I've been told that once I have my surgery I should wear a medical alert bracelet stating that I've had gastric bypass surgery.  Just curious, do any of you where these?

Steps78
on 8/2/14 12:07 am

I had surgery back in January and didn't get one until July. The only reason I did was because I'm travelling through Europe all summer and sometimes will be on my own. However now that I have it (not a nice one really) I may get another permenant one when home. It just gives me peace of mind. I'm going to further discuss it with my doctor to see what are the concerns in an emergency situation and make my decision then. The one I have now was an 8 dollar bracelet from shoppers that I got engraved for 20bucks lol

As I began to love myself I freed myself of anything that is no good for my health - people, food, situations, things, and anything that drew me down and away from myself. At first I called this attitude a healthy egoism. Now I know its "love of oneself". Charlie Chaplin

    
Karen M.
on 8/2/14 12:44 am - Mississauga, Canada

Many years ago it was considered a "must do" with a whole host of reasons why. I considered it, but never got one. There are many things that others were listing on their bracelet that quite frankly, could be more dangerous than helpful in an emergent situation. Like "no nsaids", "no sugar", "no blind ng tube", etc. If a first responder needs to give me nsaids, sugar, or use an ng tube on me to save my life? GO FOR IT.

If you feel the necessity, I might suggest having the type of surgery you had (specifically - not just RNY, but also gastric bypass**** information and of course any other severe allergies you may have.

My biggest fear was the "no blind NG tube" - in reality, these are trained personnel and the chance of them poking through or ripping my rny pouch are next to nil. That procedure is pretty much completely done bedside, while in the hospital, by nurses or doctors.

I understand wanting to be safe - just some things to consider before putting things on it that aren't necessary.

K.

 

Karen

Ontario Recipes Forum - http://www.obesityhelp.com/group/ontario_recipes/

Jennifer A.
on 8/2/14 2:05 am - Canada

Thanks for the information.

RNY-Wife
on 8/2/14 12:47 pm

As an RN, can confirm this (NG) is a pretty basic nursing/medical skill. 

We had a patient recently that initially refused it b/c of the 'no blind NG' thing but they eventually convinced him ... It's a teaching hospital and they were pretty confident they weren't going to perforate anything. 

I wonder how solid this evidence (against blind NGs in WLS patients) is ... Also, if you shove hard enough you can perf a 'normal' stomach too.  

Steps78
on 8/5/14 8:02 pm

Can you go into more detail about this? The temporary bracelet I have says "no NG tube, VSG" because I was only concerned about the perforated stomach etc and thought the warning for sugar and NSAIDs was silly in an emergency situation. 

Is it easier to puncture through with a VSG? What happens if there is a perforation to begin with? Is it true that this procedure is mainly done in hospital and not on site? Thanks for any info you can give. 

(And yes I will talk to my doctor but don't see him for a few weeks)

As I began to love myself I freed myself of anything that is no good for my health - people, food, situations, things, and anything that drew me down and away from myself. At first I called this attitude a healthy egoism. Now I know its "love of oneself". Charlie Chaplin

    
Soon_to_Shrink
on 8/2/14 3:11 am

Ottawa gives you a wallet card explaining your new anatomy, risks e.g no blind placement of NG tube as well as symptoms of various complications for your own reference and for first responders.  Not sure how you'd get all that info on a bracelet, but I've been considering a bracelet that simply says RNY and the web address they give for info on the wallet card.  If I'm conscious I'll just hand them the card.

4-Jane
on 8/2/14 7:14 am - Canada

Could you type the infor that's on the card here so that others could creat one as well?

 Respectfully Jane
pegawatt
on 8/2/14 11:31 am - Canada

I was told it was a very good idea and I agree and got mine. Better safe than sorry. You never know when you might need it. Peace of mind is worth a lot!!!

Soon_to_Shrink
on 8/2/14 1:31 pm

The card says:

Side 1

ROUX-EN-Y

gastric bypass sugery

surgeon's name and date the surgery was performed

Side 2

picture of your new anatomy with labels for gastrict pouch, gastrojejunal anastamosis, remnant stomach, biliary limb, jejune-Juvenal anastamosis, and alimentary limb

Post-surgical emergency presentation of bariatric patients:

1) Unstable vital signs

a fever more than 38.3/101

b hypotension

c tachycardia >120bpm x 4 hrs

d tachypnea

e hypoxia

f decreased urine output

2) bright red blood by mouth or rectum, Melina, bloody drainage

3) abdominal pain/colic > 4 hours

4) nausea with or without vomiting > 4 hours

5) abdominal pain with or without vomiting.> 4 hours

bariatric complications

iterabdominal bleeding, leaks, sepsis

obstruction/ pulmonary embolism

abdominal compartment syndrome

Side 3

Principles to guide management of bariatric emergencies

Diagnose in 6 hours

to OR in 12-24 hours

call bariatric surgeon early

These are not typical abdominal surgery patients; they do not exhibit expected or typical signs and symptoms, and have no physiological reserve to deal with complications.

NG Tube

-avoid blind placement, risk of perforation

-will not decompress distal stomach

Avoid NSAIDS, ASA, Plavix, Steroids

-greater risk of ulcer erosion or perforation

-place on PPI for gastric erosion safeguard

Thiamine deficiency

-initially avoid glucose in IV fluids unless hypoglycaemia is confirmed

-use RL or NS with 100 amp of multivitamin.  Can result in Wernicke's syndrome, characterized by ataxia, confusion, blurred vision, IV dextrose will increase the risk of permanent neurological impairment.

-avoid overloading the gastric pouch with oral fluids or contrast-should only give 180 ml.

for more info http://goo.gl/V7TtO

Side 4

request by hospital for restaurants to accommodate the patient ordering off the kids menu

 

Seems to be too much for a bracelet to me.  I understood the NG tube instructions were more for paramedics/ first responders rather than in hospital type situations

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