Would you believe...?

Well my dears... I have taken most of my life off-OH and onto FB but this is an important message that is ESSENTIAL TO ALL DSers and DS wannabes. I'd shout it from the rooftops if I could.

KNOW YOUR BODY, KNOW YOUR SURGERY, KNOW YOURSELF!

I say this because--as a post-op for more than 7 years--I just had a bowel obstruction caused by abdominal adhesions and ended up in a situation where no one basically had a clue about the DS.

Although in relatively close proximity to go back to my rock star God bariatric surgeon (Mitch Roslin), I had no choice at the time but to go elsewhere for surgical assistance. The bariatric surgeon who ultimately removed the adhesions ("adhesion lysis") knew about the DS but does not perform them. At least he knew my doctor and they consulted swiftly, professionally and knowledgeably.

But all the years of carrying around the card with a diagram of our anatomy, my surgeon's name & phone paid off in spades. I clutched it like a prayer card in my hand (and keep a copy on my smartphone, BTW****il I made sure someone made a copy of it to put in my hospital file since it was the first time there.

Still, I had to educate staff ad infinitum about my specific needs (e.g., I take mostly liquid and powder supplements whenever possible, avoid unnecessary sugars, and protein ALWAYS first). (You wouldn't believe the mess of sugar and sugared water they handed me for my first clear liquid meal. Mermaid don't do that. Kindly asked that they replace what they handed me with everything sugar-free. Imagine, an 8 oz protein drink with 45 freakin' carbs??)

First, the symptoms: For me, it was what seemed like gas pain starting about 8pm and escalating, refusing to dissipate to the point that I could feel my intestines throbbing from the stress with my hands. I took two chewable gas relievers and sipped water. At first I could pass a little gas and a little loose bowel movement. Then the throbbing got worse and the pile of intestine felt hard and totally immobile. I sweated through a night of this before throwing up the gas relievers and water and starting to bring up food I had eaten nearly 24 hours before. Then I knew I had no choice but to go to the ER.

Being a NYC girl you take for granted that even on LI they have a working knowledge of certain things--especially in the bariatric community--but when you find yourself versing a surgery intern on the procedure (and one more time justifying one more time "Why the DS?" when in virtually unspeakable pain), would I have made any other choices?

Absolutely, unequivocally, NOT.

HOWEVER, prove to others how smart you are by making this decision: DSers, EDUCATE YOURSELF TO THE POINT OF INSANITY because another's ignorance shouldn't be our fate. We shouldn't setlle because another doesn't know ALL the options available and we did.

With all this being said, don't just have the DS because you believe it's a foodie's dream. Believe me, I enjoy food more than ever and have multiple FB postings of my international culinary achievements but that has made it less important and less of a priority (i.e., to eat the world). I have the freedom, that's what counts.

What did I have for breakfast as soon as I was back in control of my food? A big juicy red grapefruit and 20oz of my homemade coffee-protein elixir. I now have homemade chicken soup steaming away in the pressure cooker and hard boiled eggs ready for a beautiful egg salad. Because that's what makes me stay 175 lbs lost and convinced I did the right thing. It's also the best way to eat for me. Five small meals a day (maybe as small as an apple) but I never stretched my stomach out and never felt the need to. I proudly call myself a DS success story because why go through this **** to be anything less?

Let no one else decide for you, judge you, or convince you. Just get informed. Stay informed. And be able to back up what you know in your heart, mind and soul what is right for you and you alone.

Blessings to you always, whatever your position on this journey. 

Melissa, it's always good to see you here, and your cautions about both bowel obstruction symptoms and knowing the DS well to avoid getting the wrong care in the hands of the ignorant is always valuable.
    Just to add that adhesions can be caused by ANY surgery in the abdomen, not just wls. It's more difficult to diagnose after DS or RNY because we have a portion of the small intestine where food doesn't go, but that's really the only difference.

And Melissa, most of the veterans are now posting more on another website - I'll send you a pm.

Larra

Absolutely correct, Larra and for full disclosure, I did have an (open) appendectomy/ovarian cyst removal at 13, although my open DS did not reveal any adhesions at the time of my DS 30 years later.

I've always been a big believer, however, that after any abdominal surgery, pushing for maximum strength and doing too much too soon is a big danger zone often causing unnecessary hernias/adhesions. 

I agree that pushing too much too soon after abdominal surgery can cause unnecessary hernias as well as setting you back by causing fatigue, but no one knows what causes adhesions, and as far as we know, they are not subject to any control by the patient.
     Some people simply are more prone to adhesions. And if there is internal inflammation, from infection or an inflammatory condition such as diverticulitis, that can cause adhesions, but I have never seen anything to suggest that undue physical activity post-op causes adhesions.

Larra

I'm so glad you're doing well now, Melissa. Thank you for sharing your lessons learned with us.

--gina
 

 Any time at all "MM." 

Timely post, Melissa...at least for me.  I spent a good deal of last night pacing the floor, VERY uncomfortable, changing into looser jammies--the ones I had on were uncomfortable with a belly that was growing by the minute.

I diagnosed a possible bowel obstruction for me...and then had to decide if the obstruction was "high up" as all I seemed to be doing was pooping.  And pooping...and pooping.  

Eventually, I belched and there was some relief.  So I took a bunch of Gas-X and kept walking around.  Finally, I joined Mr. Sue in bed but warned him that we might be driving to see Keshishian...and hoped he was in town.

And then SOMETHING--I don't know what--moved around in there and I knew I was going to get better.

But posts like yours keep us informed (even folks like me who are 6+ years out) that we have to start thinking out what to do IF we end up with an obstruction...and have a plan in mind if that problem strikes.  Last night, my plan was that transporting me past MANY other hospitals...going in a private car, not an ambulance...going an extra 30+ miles...would probably be a much better idea than going to the closest facility where I would be the first DS patient they met. 

Thanks, Melissa. 

That's the whole point of this fellowship thing... and most certainly, the most important factor in making sure we always have each others' backs. I'm glad to know it was helpful for you. Hang tough, Toots!

And then SOMETHING--I don't know what--moved around in there and I knew I was going to get better

Sue, that really rang true for me, too.  I"ve had lots of these episodes.  Been to the hospital twice.  The last couple times I've tried to be more conscious of what's goings on - despite being out of my mind with pain.  When it's over it seems like a drain valve has suddenly opened up and I get alot of gurgling that I can hear and feel on the right side of my abdomen.  Last time I sat with both hands on my abdomen's right side and I could feel it that way, too.  It's like everything is suddenly moving along the digestive track. 

I usually poop once or twice, also.  I have the idea that the digestive track is trying to expell stuff one way or the other. (by that I mean, poop at one end and throw-up at the other)  Sometimes I'll get better not long after I throw up, but I'd say more often, not.  Sometimes, I just have dry heaves.

I try the pacing, too.   I think it helps the intestine work better, although sometimes I'm almost too weak to walk (and I have bad chills.)

But ya know, lots of people have bowel obstuctions, whether or not they have had WLS.  So hospitals handle this frequently.  We just have to explain that with the DS our biliopancreatic limb can't be seen with imaging and the fact that we can poop and pass gas doesn't mean  we don't have and obstruction there. 

Mine also seem to be "high up." as you decribe yours.  I'm never constipated, so I don't think that's a factor in my case.  I also take a bunch of Gas X, though I don't know if it helps.  My tummy get hugh and hard as a rock.  I usually also try applying  hot packs and laying on my left side.  But sometimes being upright is a better position.

Did you throw-up the other night?

Nope...no vomiting...but I *WAS* freezing and ONE reason I got in bed was to put my ice-block feet on the legs of my unsuspecting husband.  Poor thing.

Yes...and an obstruction is more likely in people who have lost a lot of weight.  We've got "loose" intestines that essentially "blow in the wind" in there and can get twisted.