GreenBayGirl's Report - 3rd Time NOT a charm.....(long)
At the risk of being beaten silly by both sides, (I told you so *VS* I don't believe that happened) I will post our experience. I am making every effort to post this without drama, exaggeration or too much emotion.....bear with me.
Hubby's surgery was Friday, May 14th at 4. He was the 3rd and final sleeve of the day. The sleeve at 2 pm was our friend Julie. Both Julie and Robert opted (wisely IMO) to have their gall bladder out for an additional fee as both myself and sister had alot of issues and had to have ours removed anyway 6 months later.
Dr Almanza had no problem doing his sleeve, but his gall bladder was unusual because it was atrophied, attached itself to his liver and was difficult to remove, so surgery took a bit longer. Initially recovery seemed to be fine, but within an hour or so his gown was soaked with blood, and his JP drain full, and there was blood coming out of his penrose port. The nurse came in and changed his bandages, got him another gown and emptied his drain. Within 2 hours, we went through the same issue, and this continued throughout the evening. In the morning I insisted on speaking with Dr Almanza, who is not normally available on the weekend. (he was doing a sleeve Sat. morning on one of the floor nurses)
He and Betencort both came in to see Robert, and said not to worry about this as it was dark blood, meaning old blood from the stomach. By noon, he was getting worse and it was clear it was NOT old blood, but bright red. It was soaked through the kotex type pads they had started using and through his gown and onto his sheets and dripping onto the floor. He was in alot of pain and very weak. Since Dr Almanza was still there, I asked for him again. We discussed what might be the issue and ordered a CBC, EKG and possibly an ultrasound. Although Robert was reluctant to go for the ultrasound because he was so weak, they stated if the CBC came back fine, it would not be necessary. EKG was normal, CBC was at 13.6 (normal range) so it was a wait and see deal. At ALL times his vitals were stable. (I took a BP cuff and thermal scan thermometer with me)
*added* * It was also discussed what would happen if he were to need blood, and it was verified that there is a Red Cross Blood Bank 2 blocks away that is able to get it there within 20 minutes, that was reassuring.*
Saturday evening, he was bleeding much worse, and by Sunday at 5 AM I called Melissa and said "I don't feel like this is being taken seriously" She immediately called Betencort, who has to call Dr Almanza......I called her again at 7:30am and was told Dr Almanza would be there within the hour and if not by 9 am to call her back. I called her back at 9, and she said she would keep trying. We were then taken to the Radiologist Office for the final leak test. Although it was not a terribly long wait, Robert became so weak he could not sit in the chairs well, and I took him out to the van. Dr Almanza arrived, retrieved his X Ray, and came over to talk to us. He took one look at Robert and his bandages, and immediately said "we have to go back to the hospital." He told us it was a surface bleed in the surface of the stomach wall and he would take him into the Recovery room and cauterize it, no problem, about 30 minutes. It's about a 15 minute drive back to Jerusalem, and Dr. Almanza beat us there by at least 5 minutes.
When we got there, they had him put on a gown, but then came in to wrap his legs, which we thought was odd. Then they brought him a surgical hat....hmmmmm.....with 1-2 minutes they had him walk into the OR, and he was gone. I was quickly on the phone calling Melissa because neither Robert or I had any idea what was happening. I believe at this point Dr. Almanza simply mis spoke when he said recovery room, and meant OR. Melissa confirmed to me that he was going into the OR and that he was in fact only going to be 30 minutes, and a minor deal of cauterizing with twilight sedation.
Within 15 minutes of hubby and I getting to Jerusalem, Dr Almanza had his surgical team in place, scrubbed and gowned.....very impressive. Again, this was not an emergency situation and his vitals were all NORMAL. Dr Almanza stated again that this was not serious, but it was more blood loss than he was comfortable with.
At the one hour mark, I knew nothing, at the 1 1/2 hour mark, I was getting really concerned. I was able to look into the OR and see them working, so I went back into his room and sat down. At 1 hour 45 minutes he was finished. Both Dr Almanza and Dr Lopez came out to tell me he had a leak on the staple line at the very tip. It was very very small, but they used a small gall bladder size staple and then cauterized. They were unable to use twilight sedation because he had drank his blue juice and contrast, and it was safer to intubate him. It was NOT a gastric leak, but none the less a leak on the staple line. They said he would be fine, albeit weak for a few days. I was relieved. I was also impressed they told me about the leak and such, because they were honest. They could have just said it was that surface bleed in the stomach wall, but they didn't. It was now 2:30, and everyone left but one "nurse."
This is where it gets ugly.
The building is empty except for Robert and I in the Recovery room and "Israel" his nurse. Robert is on oxygen and a Pulse Ox on his finger. As he is coming around, he is in alot of pain. He has now had 3 surgeries in 48 hours...to be expected. Within the first 30 minutes, his bandages are again soaked with blood as is his gown and sheet and blood is dripping on the floor. Where is the nurse?
No idea.....we press the call button only to later find out it doesn't work, I yell for him.....nothing......
without going into all the details....this is how it went all night and into the next morning. Most, but not all, of the evening his vitals were stable. Israel does not speak or understand ONE SINGLE word of English. We were left alone with him for 16 hours. I had to continually call Melissa, who had to call Betencort, who had to call Israel in order to get ANYTHING! He went through about 10 gowns, which I had to bug him to go and get, 5-6 sheets which I had to insist he change......etc. Much of the time I could not find him at all. I do know that he cleaned up the OR at some point, but I don't remember what time that was. Robert finally settled down at 2 am.
At first I was not concerned because both Melissa and I believed Sevarro was coming on at pm. He speaks perfect English and is truly a top notch nurse. When I was informed that we were stuck with Israel, it was quite upsetting, and I believe dangerous. I spent the entire night changing his gown and bedding and wiping up the floor and continually trying to find his nurse for toileting, etc It was not a good situation. At one point over the course of about 3-4 of those hours his blood pressure was very low, he had lost alot of blood and it was becoming alarming.
*added* Hubby just reminded me I should add this part. He had a terrible reaction coming out of anethesia also. Not dangerous really, but not the norm. He was agitated, beligerant and rude (to me) and didn't make any sense. At one point , he took his own IV pole and walked across the hall to another room. I told this to Betencort the next day, and he stated that this is not all that unusual, it just happens. It was so out of his character, he is terribly embarassed, and remembers nothing.
By 6:30 am Monday, Betencort was in, and although Robert was weak, he was feeling pretty good. I asked him to call Dr. Almanza to see if he was medically safe to fly, and he said he was. Once surgery was over at 2:15 pm Sunday, we never saw him again. He never came on Sunday evening or Monday morning to check on him, no one did til Betencort arrived the next day.
His vitals were normal, and although they did offer to have us stay another day or two, since he was stable and in all the normal ranges, we decided to go ahead and head home. He definitely needed the wheelchair on both ends of the airport as he was just too weak to walk that far. We had someone pick us up as I was also too tired to drive having been up many days with nearly no sleep.
We are home now, he is weak, but seems fine. All in all there were some really good things, some not so good, and some really dangerous (in my opinion)
Really good...
Speed with which the surgical team was in place once Dr Almanza saw Robert on Sunday. He must have made calls very quickly on his cell between the X Ray clinic and Jerusalem
Melissa - although she has NO DIRECT ACCESS to Dr Almanza, she made absolutely every effort to do whatever she possibly could to help Robert and I.
The staples and gauze, etc are all perfectly fine, despite the crazy rumors.
Sevarro is a really good nurse, perfect English, but after 5 am on Saturday he was gone.
Honesty in telling me what really happened in the OR.
Dr Lopez is top notch, speaks perfect English, and most of all genuine and reassuring.
Not so good-
Being continually told by the other 3 nurses when we asked about all the blood....."it's normal"
even when it was OBVIOUS it was not.
3 of the 5 nurses speak NO english at all........and I personally am uncomfortable with Claudia administering anything through an IV or starting one, etc. She is a "nursing assistant" and only 16 years old. When I was there in Jan, I only saw her doing bandage changes, etc, but not this time.
The dangerous - (in my opinion) Being left completely alone, for all practical purposes with no way to communicate to anyone other than Melissa who was in Las Vegas at her home. When his blood pressure dropped alarmingly low again, Israel was no where around. If it had continued, I am not sure he could have done a thing, IF I could have found him. The OR was left exactly as it was when they finished. Looked like a tornado hit it. I am sure this is how it looks everywhere after surgery, however, had he needed to go back in, it would have taken a fair amount of time to clean and restock.
Although they felt certain they had found the leak causing all the bleeding, he continued to bleed rather uncontrollably for quite some time. For 16 hours I changed his sheets, re gowned him, and wiped up the blood on the floor. Israel did almost nothing. Is it fair to punish the whole place for the fact that not only was he a crappy nurse but lazy? Absolutely not. However, the buck stops somewhere.
This is their staff, and it was woefully inadequate and in *my* opinion dangerous.
While this was not life or death, it was serious, and COULD have been more so over night. We were left with an incompetent/lazy person who cannot speak or understand any English. I personally question whether he OR Alejandro are nurses, but that's another debate.
Had Hubby coded or started bleeding again, I fear this might not have ended the way it did.
What could they have done differently? Betencort, or Dr Brenda or anyone bilingual should have been left with us to make sure he was safe. It's just that simple. After what had just happened, at the very least, that should have been the norm, and it wasn't.
My deepest fear is that some day their luck is going to run out, and somebody is going to die. It won't be because of something in the OR, but because the staff is simply not as qualified or attentive as they should be. I hope and pray that I am wrong.
I am happy to answer any questions by PM or email or phone, info at bottom.
Please refrain from bashing, as we have been through enough.
One last thing to make clear:
WE IN NO WAY HOLD ANY ILL WILL TOWARDS DR ALMANZA. We still feel he is a competent qualified surgeon and the leak was not his fault, rather a complication or possibility of surgery. He was in that 1-2 % group....bummer. However, Robert was his ONLY patient at this point, as the 2 others had been sent to the recovery house, AND he had just had a second surgery. One would THINK that he would have come to check on him at some point Sunday evening or Monday before we left at 8:30 am. He did not.
We also hold him absolutely accountable/responsible for what we feel was a frightening and dangerous situation being left at the clinic basically on our own. The buck stops with him, it is his clinic and his staff, such as it is.
Since this was my 3rd trip, I feel I have a fair view of the process here. I have now spent 13 days on 3 seperate trips here. You can read any of my other posts from my other two trips and conclude that this was NOT an easy post to write. I am as surprised and disappointed and upset as anyone. I can only post our experience. I believe I was fair.
Our friend Julie who had a sleeve on the same day is great, and other than the language barrier has no real complaints. I personally would conclude that the people in that 98% with no complications at all will do great. My concern is those people in the 1-2 %.
*added* I had talked to Dr. Almanza before the FIRST surgery about the masks over the nose and he assured me that they would do so. I don't know about the first surgery, but I do know about the second one, because I saw it with my own eyes, and they DID NOT have masks over the nose, not any of them.
I have posted as honestly and accurately as possible, thanks for reading.
[email protected] 920-434-8053
Thank you so much. I believe there is something you and maybe ONLY you could do.....
Continue to offer information and advice, but be nice!!! You could be such a great help to so many, and I believe you are passionate about the whole process, but if the info comes laced with barbs, it's just thrown away and labled as non credible.
You have ALOT OF GOOD THINGS on your page, I have seen it, but please reconsider your approach.
Like you , I want everyone who needs this surgery to have it, and also like you, I want everyone to be safe! (and not go through what we did)
Keep posting......with little old lady kind of niceness!
thanks,
Jean
Thank you so much. I believe there is something you and maybe ONLY you could do.....
Continue to offer information and advice, but be nice!!! You could be such a great help to so many, and I believe you are passionate about the wole process, but if the info comes laced with barbs, it's just thrown away and labled as non credible.
You have ALOT OF GOOD THINGS on your page, I have seen it, but please reconsider your approach.
Like you , I want everyone who needs this surgery to have it, and also like you, I want everyone to be safe! (and not go through what we did)
Keep posting......with little old lady kind of niceness!
thanks,
Jean
Problem is... I'm not a little old lady so I don't know how to do little old lady nice. ;o)
I've been watching this stuff for 3 years now, three years! It doesn't get better, it gets worse. I have no patience left. People can listen to what i have to say or not, it's their choice. It's no skin off my nose who someone goes to, but as a WLS patient myself I do care. They can choose to research or not, I have no control over this. All I can do is offer the information but the problem is, people see cheap and they can't see beyond that. They don't stop to try and figure out WHY it is so cheap. They can't get beyond, "Oh, i can have surgery for close to nothing... bad things happen to everyone else, I'll be fine!"
Three years ago I was nice about it. Today I'm fed up. There is a whole lot going on that you don't know about and I suspect if you knew, you might understand my stance on this.
I just want for your husband to heal and be well. I want us all to be well and lose weight. That's why we are all here.
At the risk of being beaten silly by both sides, (I told you so *VS* I don't believe that happened) I will post our experience. I am making every effort to post this without drama, exaggeration or too much emotion.....bear with me.
Hubby's surgery was Friday, May 14th at 4. He was the 3rd and final sleeve of the day. The sleeve at 2 pm was our friend Julie. Both Julie and Robert opted (wisely IMO) to have their gall bladder out for an additional fee as both myself and sister had alot of issues and had to have ours removed anyway 6 months later.
Dr Almanza had no problem doing his sleeve, but his gall bladder was unusual because it was atrophied and was difficult to remove, so surgery took a bit longer. Initially recovery seemed to be fine, but with an hour or so his gown was soaked with blood, and his JP drain full, and there was blood coming out of his penrose port. The nurse came in and changed his bandages, got him another gown and emptied his drain. Within 2 hours, we went through the same issue, and this continued throughout the evening. In the morning I insisted on speaking with Dr Almanza, who is not normally available on the weekend. (he was doing a sleeve Sat. morning on one of the floor nurses)
He and Betencort both came in to see Robert, and said not to worry about this as it was dark blood, meaning old blood from the stomach. By noon, he was getting worse and it was clear it was NOT old blood, but bright red. It was soaked through the kotex type pads they had started using and through his gown and onto his sheets and dripping onto the floor. He was in alot of pain and very weak. Since Dr Almanza was still there, I asked for him again. We discussed what might be the issue and ordered a CBC, EKG and possibly an ultrasound. Although Robert was reluctant to go for the ultrasound because he was so weak, they stated if the CBC came back fine, it would not be necessary. EKG was normal, CBC was at 13.6 (normal range) so it was a wait and see deal. At ALL times his vitals were stable. (I took a BP cuff and thermal scan thermometer with me)
Saturday evening, he was bleeding much worse, and by Sunday at 5 AM I called Melissa and said "I don't feel like this is being taken seriously" She immediately called Betencort, who has to call Dr Almanza......I called her again at 7:30am and was told Dr Almanza would be there within the hour and if not by 9 am to call her back. I called her back at 9, and she said she would keep trying. We were then taken to the Radiologist Office for the final leak test. Although it was not a terribly long wait, Robert became so weak he could not sit in the chairs well, and I took him out to the van. Dr Almanza arrived, retrieved his X Ray, and came over to talk to us. He took one look at Robert and his bandages, and immediately said "we have to go back to the hospital." He told us it was a surface bleed in the surface of the stomach wall and he would take him into the Recovery room and cauterize it, no problem, about 30 minutes. It's about a 15 minute drive back to Jerusalem, and Dr. Almanza beat us there by at least 5 minutes.
When we got there, they had him put on a gown, but then came in to wrap his legs, which we thought was odd. Then they brought him a surgical hat....hmmmmm.....with 1-2 minutes they had him walk into the OR, and he was gone. I was quickly on the phone calling Melissa because neither Robert or I had any idea what was happening. I believe at this point Dr. Almanza simply mis spoke when he said recovery room, and meant OR. Melissa confirmed to me that he was going into the OR and that he was in fact only going to be 30 minutes, and a minor deal of cauterizing with twilight sedation.
Within 15 minutes of hubby and I getting to Jerusalem, Dr Almanza had his surgical team in place, scrubbed and gowned.....very impressive. Again, this was not an emergency situation and his vitals were all NORMAL. Dr Almanza stated again that this was not serious, but it was more blood loss than he was comfortable with.
At the one hour mark, I knew nothing, at the 1 1/2 hour mark, I was getting really concerned. I was able to look into the OR and see them working, so I went back into his room and sat down. At 1 hour 45 minutes he was finished. Both Dr Almanza and Dr Lopez came out to tell me he had a leak on the staple line at the very tip. It was very very small, but they used a small gall bladder size staple and then cauterized. They were unable to use twilight sedation because he had drank his blue juice and contrast, and it was safer to intubate him. It was NOT a gastric leak, but none the less a leak on the staple line. They said he would be fine, albeit weak for a few days. I was relieved. I was also impressed they told me about the leak and such, because they were honest. They could have just said it was that surface bleed in the stomach wall, but they didn't. It was now 2:30, and everyone left but one "nurse."
This is where it gets ugly.
The building is empty except for Robert and I in the Recovery room and "Israel" his nurse. Robert is on oxygen and a Pulse Ox on his finger. As he is coming around, he is in alot of pain. He has now had 3 surgeries in 48 hours...to be expected. Within the first 30 minutes, his bandages are again soaked with blood as is his gown and sheet and blood is dripping on the floor. Where is the nurse?
No idea.....we press the call button only to later find out it doesn't work, I yell for him.....nothing......
without going into all the details....this is how it went all night and into the next morning. Most, but not all, of the evening his vitals were stable. Israel does not speak or understand ONE SINGLE word of English. We were left alone with him for 16 hours. I had to continually call Melissa, who had to call Betencort, who had to call Israel in order to get ANYTHING! He went through about 10 gowns, which I had to bug him to go and get, 5-6 sheets which I had to insist he change......etc. Much of the time I could not find him at all. Robert finally settled down at 2 am. At first I was not concerned because both Melissa and I believed Sevarro was coming on at pm. He speaks perfect English and is truly a top notch nurse. When I was informed that we were stuck with Israel, it was quite upsetting, and I believe dangerous. I spent the entire night changing his gown and bedding and wiping up the floor and continually trying to find his nurse for toileting, etc It was not a good situation. At one point over the course of about 3-4 of those hours his blood pressure was very low, he had lost alot of blood and it was becoming alarming.
By 6:30 Betencort was in and although Robert was weak, he was feeling pretty good. I asked him to call Dr. Almanza to see if he was medically safe to fly, and he said he was. His vitals were normal, and although they did offer to have us stay another day or two, since he was stable and in all the normal ranges, we decided to go ahead and head home. He definitely needed the wheelchair on both ends of the airport as he was just too weak to walk that far. We had someone pick us up as I was also too tired to drive having been up many days with nearly no sleep.
We are home now, he is weak, but seems fine. All in all there were some really good things, some not so good, and some really dangerous (in my opinion)
Really good...
Speed with which the surgical team was in place once Dr Almanza saw Robert on Sunday. He must have made calls very quickly on his cell between the X Ray clinic and Jerusalem
Melissa - although she has NO DIRECT ACCESS to Dr Almanza, she made absolutely every effort to do whatever she possibly could to help Robert and I.
The staples and gauze, etc are all perfectly fine, despite the crazy rumors.
Sevarro is a really good nurse, perfect English, but after 5 am on Saturday he was gone.
Honesty in telling me what really happened in the OR.
Dr Lopez is top notch, speaks perfect English, and most of all genuine and reassuring.
Not so good-
Being continually told by the other 3 nurses when we asked about all the blood....."it's normal"
even when it was OBVIOUS it was not.
3 of the 5 nurses speak NO english at all........and I personally am uncomfortable with Claudia administering anything through an IV or starting one, etc. She is a "nursing assistant" and only 16 years old. When I was there in Jan, I only saw her doing bandage changes, etc, but not this time.
The dangerous - (in my opinion) Being left completely alone, for all practical purposes with no way to communicate to anyone other than Melissa who was in Las Vegas at her home. When his blood pressure dropped alarmingly low again, Israel was no where around. If it had continued, I am not sure he could have done a thing, IF I could have found him. The OR was left exactly as it was when they finished. Looked like a tornado hit it. I am sure this is how it looks everywhere after surgery, however, had he needed to go back in, it would have taken a fair amount of time to clean and restock.
Although they felt certain they had found the leak causing all the bleeding, he continued to bleed rather uncontrollably for quite some time. For 16 hours I changed his sheets, re gowned him, and wiped up the blood on the floor. Israel did almost nothing. Is it fair to punish the whole place for the fact that not only was he a crappy nurse but lazy? Absolutely not. However, the buck stops somewhere.
This is their staff, and it was woefully inadequate and in *my* opinion dangerous.
While this was not life or death, it was serious, and COULD have been more so over night. We were left with an incompetent/lazy person who cannot speak or understand any English. I personally question whether he OR Alejandro are nurses, but that's another debate.
Had Hubby coded or started bleeding again, I fear this might not have ended the way it did.
What could they have done differently? Betencort, or Dr Brenda or anyone bilingual should have been left with us to make sure he was safe. It's just that simple. After what had just happened, at the very least, that should have been the norm, and it wasn't.
My deepest fear is that some day their luck is going to run out, and somebody is going to die. It won't be because of something in the OR, but because the staff is simply not as qualified or attentive as they should be. I hope and pray that I am wrong.
I am happy to answer any questions by PM or email or phone, info at bottom.
Please refrain from bashing, as we have been through enough.
One last thing to make clear:
WE IN NO WAY HOLD ANY ILL WILL TOWARDS DR ALMANZA. The leak was not his fault, rather a complication or possibility of surgery. He was in that 1-2 % group....bummer.
We do however hold him absolutely accountable/responsible for what we feel was a frightening and dangerous situation being left at the clinic basically on our own. The buck stops with him, it is his clinic and his staff, such as it is.
Since this was my 3rd trip, I feel I have a fair view of the process here. I have now spent 13 days on 3 seperate trips here. You can read any of my other posts from my other two trips and conclude that this was NOT an easy post to write. I am as surprised and disappointed and upset as anyone. I can only post our experience. I believe I was fair.
Our friend Julie who had a sleeve on the same day is great, and other than the language barrier has no real complaints. I personally would conclude that the people in that 98% with no complications at all will do great. My concern is those people in the 1-2 %.
I have posted as honestly and accurately as possible, thanks for reading.
[email protected] 920-434-8053
Thank you Jean for sharing your story with us.
My heart goes out to you and your husband.
I literally am sitting here at my desk (at work) with tears in my eyes.
Please keep us updated as to his progress. Has he been to his primary doc yet?
I just can not even imagine the terror you went through. You are a tough cookie Jean, I couldnt of handled it.
I am keeping you in my prayers!!
big big hug!!
Thank you again!
Band Slipped -Emergency Removal May 2008
Dr. Lopez Corvala- Hospital Angeles TJ
VSG Jan. 28th, 2010
Dr. Almanza-Jerusalem Clinic
Highest/Surgery Weight 248 Goal Weight 165 Current Weight 165-175
Starting BMI 33.7 Current BMI 22.1
I'm 42 years young, my height is 6' and I've had no plastics!
I
my sleeve!!!We will all be keeping you in our prayers Jean!
~Kelly
Thank you for posting this. Anyone who goes to this group for surgery after reading your summary of the experience is crazy (IMO).
