Patient in Brazil has passed.....

I don't enjoy posting this but felt that it should be shared as this is very close to all of us who go out of the country for procedures (including me). God Bless all who mourn this loss. I'm copying the message below from another board: From: "mednetbrazil" Date: Sat Dec 3, 2005 7:00 am Subject: I have tragic news to share with you all.... Hello Friends, I have some tragic news to share with all of you... "All things in Divine Order" they say... and although I feel it is something that always "made sense" in the grand scheme of my life, I have truly felt and seen it manifested since my own journey began in May 2001 and I began the most gratifying steps of helping others on theirs. However, what has transpired during the last 24 hours or so seems little remedied by such a powerful statement. Last night, we lost one of our WLS siblings, her journey complete. Carole was about 36 hours post op from her first round of plastic surgery and complaining of abdominal pain and cramps. An enema seemed to help for a few hours, but the pain returned and so by early the next a.m., mere hours after the pain returned, Dr Fabio and his assistant surgeon decided to bring her back into surgery to see if they could find the reason for her pain. Reopening the tummy tuck incision, they found nothing related to the plastic surgery to cause her symptoms; no hematoma, seroma or compromise of the internal suturing. Luckily, Dr Fabio always operates with a general surgeon, Dr Renato, who knows bariatric procedures and he realized that there was slight abdominal distention that could indicate a more severe problem internally. Opening the abdominal cavity confirmed this. The bypassed loop of her intestines (she was a BPD/DS) was kinked, twisted, a dark liquid was present and the blood supply was compromised. They quickly removed the dying tissue but the real problem was the bacteria from the compromised intestine that had already entered her bloodstream and was being spread throughout her body by her beating heart, more quickly than any surgery could prevent. This is known as septicemia. While obvious they caught the problem within hours of its occurence (tissue starts to die in just an hour or two with no blood supply), the real threat had already occured with the entrance of the bacteria in to the bloodstream, the body essentially poisoning itself. Once she was stabilized and transferred, they did the only thing they could - began treating the infection (septicemia) with numerous and strong antibiotics. Unfortunately, this type of infection has a more than 80% mortality rate because the infection spreads quickly with each beat of the heart and consequently, causes septic shock. Within 8 hours, she succumbed to septic shock. The autopsy showed that while she did die of septicemia, the reason for the twisted bowels and subsequent bursting of the blood vessels was due to thrombosis in this bypassed area of the intestines. Thrombosis is defined as the formation of a clot or thrombus inside a blood vessel obstructing the flow of blood. If the clot is eventually pushed through, it can lodge in another area of the body and cause an embolism. Apparently this did NOT occur in Carole. The clots remained localized, the vessels burst and the septicemia set in. The Medical Examiner even expressed that she had never seen such a concentrated blockage of such a large area of the bowels and so many adhesions. We learned today that perhaps her pre-DS suffering with severe IBS (Irritable Bowel Syndrome) COULD have created some scar tissue, giving a pre-disposition to such an occurence. Of course, thrombosis and subsequent risk of embolism (which is a risk in ANY surgery you undergo, performed anywhere in the world) we have always expressed and gone out of our way to avoid, by manditory submission to the Embolism screening upon arrival, the now mandated used of Clexane (heparin) pre and post surgery, as well as the compression stockings. But this was NOT a typical case of thrombosis/embolism and was VERY concentrated in the intestines. Such intestinal problems, although they can happen to anyone, are one of the possible complications we face after gastric bypass procedures, although certainly one we least expect. I had already been in contact with her family in the US and helping to make arrangements to get her husband here quickly, but he could have never arrived soon enough. Dr Fabio and I are handling arrangements with the US Embassy and Brazilian Medical authorities to facilitate her final journey home to her family. Words cannot express the shock and sadness we are all feeling. I am in Vitoria right now trying to see everyone through this and expediting her family's wishes for her return. We never imagined we would have to face something like this, and unfortunately, the first fatality in Dr Fabio's career was not even directly related to plastic surgery. With her husband's approval, we hope to be able to make the autopsy report available. All of our current patients here are continuing their plans to finish their surgeries while they are here. Their show of faith and confidence is helping the healing process for all of us, including Dr Fabio. Those of you who know Dr Fabio, have looked into his eyes and know how he feels about what he does and why, can imagine how this has affected him. What now does this mean for all of us? Those of us that hold true to our spiritual beliefs must embrace the fact that there are simply things that are "Divine Order." It actually is our only solace, and with it, the realization that our individual journeys touch the lives of so many others... impacting them forever, in ways we cannot begin to fathom. Therefore go purposefully and with conviction and strength and know that... "through Wheatfields of Blessings, blow Winds of Tragedy, and, THROUGH Winds of Tragedy, RISE Wheatfields of Blessings..." May God Bless Us All, Christi http://health.groups.yahoo.com/group/mednet_brazil Comments are being archived there and will be passed on to the family.

I am deeply sorry to hear about the loss of a fellow WLS friend. Though I didn't know her, I am deeply saddened by her loss and those that are close to her...my heart goes out to them. No one ever knows what lies ahead of them, this is truly a shock. I hope somehow someone will be able to explain why this happened in order to prevent other tragedies from occuring. My heart and my prayers go out to Carole's family...May God comfort them in their time of sorrow. I also feel bad for the doctor, there's already such controversy about going out of the US, I hope this will not mar his reputation. I know alot of doctors take their work just as serious as those in the US. Again, I hope there will be some information that comes out shortly so that all may understand what truly happened. ~Deepest Sympathies... Kelli

You should post this on the DS board. I'm sure they would like to know this. How sad, my sympathies goes out to the family and friends.

I am so sorry for your physicians and the rest of the staff in addition to the family of the patient. It is clear that your team really does care. My prayers go out to you all and of course the patients family. My daughter narrowly excaped the same fate Aug. 1st. She was 3 years out from her RNY. Her surgery was done in the states. She made it to the hospital and had 6 major surgeries to continue correcting the problem by removing necrotised tissue. Her surgeon said her intestines got tangled in her messentary. No emobolisms were mentioned. She survived. She received an heroic treatment a medication known as xygris. Please post your message on the other boards. People need to know the risks involved with these surgeries.