Question:
Surgeons taking you seriously when psych issues
I had Roux en Y, Proximal surgery in January. I've lost 76 lbs. since then. Up until 3 weeks ago I thought I was doing well. I still had little energy and what I thought was exercise induced asthma, so I got an inhaler (albuterol) from my PCP. I didn't really think much about it and NEVER bothered my surgeon. 3 weeks ago I caught what I thought was the flu: Nausea, diarrhea, sore throat, headache and severe dizziness. I saw my PCP, who determined I was dehydrated and he sent me to the ER at my surgeons hospital, where I got fluids. They took blood before starting the fluids, but all the cells were hemolyzed. They didn't bother taking blood again until after I had 1.5 liters of saline. Surgeon's conclusion: wasn't dehydrated, but they kept me overnight to run some tests. Mind you, I never actually threw up, just severely nauseated. So the next day they do an upper endoscopy, which showed my pouch was fine. The surgeon says to rest that day and tomorrow they will do a CAT scan to check out my abdomen. At that point I admit, I lost it. I'd been in pain for 2 weeks, my Wellbutrin SR was losing it's effectiveness and I was beginning to doubt my own sanity. Supposedly there was nothing wrong with me, my vitals were fine, my bloodwork was fine and my pouch was fine. Enter, the psychiatrist, at the wrong moment. Pain does funny things to your mind, as well as having no food for 2 weeks. He sent me to the psych unit. Next day, no CAT scan as promised, surgeon medically cleared me to be transfered and stopped my IV first thing in the morning. He stated I was eating and drinking and I actually had not had a bite of food or even a sip of water, and I was in so much pain. I was basically ignored until I was transferred that evening. When I complained of pain and nausea in the psych unit I was simply told "you were medically cleared", I can give you tylenol. When I got up to go to the bathroom, I got so dizzy, I fell and injured my leg. I was called a "drama queen." I finally found a night nurse who was sympathetic and tried to make me comfortable, but that was all he could do. Fortunately, the next day, I started feeling a little better, although very lightheaded, coughing and short of breath, but not as nauseous. I started trying to drink as much fluid as I could and eat small amounts, which was difficult as they had no provisions for a WLS patient, no protein, very limited house menu. I was still very sick and it was clouding my judgment. Over a period of 3 days my heart rate continued to rise, until on the last day it was 133 after waking up. My coughing and shortness of breath continued to get worse. I was discharged with no medical followup. I have been awake all night, unable to breathe lying down and my lungs feel water logged. I used my inhaler with very temporary relief. It just helps me cough up some mucous. Bottom line is, I trusted my surgeon with my life. How can I count on him trusting me that when I complain about a problem to take me seriously, and do a thorough diagnostic workup, as he would do any other patient. I am labeled a "psych case", so I doubt I could get proper care from any medical doctor. I am hesitant to try. And I know I need to rely on my surgeon for followup for life. Any medical people or others, I would appreciate your opinion on this situation. Thanks so much. Karen — Karen W. (posted on May 17, 2006)
May 16, 2006
Oh, my, you poor thing! You need to do two things immediately! First, get
yourself to a hospital. Same one as you were in, or a different one,
doesn't matter. And be up front about the "psych" diagnosis,
tell the intake people that you are not crazy, that you feel there is a
definite medical problem. Then you need to get a smart and nasty lawyer.
He or she will push things and get you the care and testing you need.
Don't depend on the patient advocate at the hospital, they are employees,
and have a vested interest in keeping their bosses out of court. Trust me,
having a lawyer show up on the floor and request copies of your medical
records will make a world of difference in how you're treated. Also, do
you have a friend or relative who can make a nuisance of themselves, asking
questions about every thing, and, most especially, taking notes? Keeping a
big notebook handy, and writing down every test and drug and treatment, and
most importantly, writing down names, lets the hospital personnel know that
you mean business. Don't let them get away with it! Just keep saying,
"I always wanted to own a hospital!" :) It's always possible
that you've worked yourself into a tizzy, and that's causing the physical
symptoms, but they need to do a little better job of ruling out all other
possible causes. And please, write back and let us know how you're
doing!!!! Email me, I'll be praying for you! --Mary
— mwilson523
May 17, 2006
I am so sorry that this happened to you Karen. It makes me so angry when
someone is mistreated at a hospital. My treatment hasn't been the greatest
but my experience is nothing compared to yours. I agree with what the
other person posted. Get yourself a lawyer. When your surgeon cleared you
and said you were eating and drinking when you weren't, jeez. That is just
plain negligence. Please be persistent in getting to the bottom of
whatever is really wrong with you, psych label or not. It is really sad
that although they say that label isn't supposed to be a black mark on you
anymore that that is just what it is. I will keep you in my thoughts.
Please don't give up.
Chris Rinn
— rinnchris
May 18, 2006
See another dr and get another opinion. But to me it sounds like anxiety
attacks. I have them often and it is due to family and financial stress.
They come on anytime with no reason. I take meds for them but our bodies
does not absorb meds as before so I deal with them as best that I can until
the meds finaly do kick in some. It is sort of like a dumping episode with
the foamy feeling in mouth or thick mucous. I get all flushed hot and sweat
profusely. I went to dr several times and had tests ran and was told that
pouch was fine and everything looked ok. Til this one ER dr asked me have I
ever had anxiety attacks before and that what they seemed like to him. Gave
me a script for meds and they worked if I take them without eating anything
and take with something to coat my pouch. Get another opinion. I pray you
are better.
Irish aka Ms Pisces
— mspisces
May 18, 2006
You poor thing! If you trust your pcp more that your surgeon I would go to
them first. I have been on Zoloft for a while. I had surgery in March and
in mid April I noticed that my depression was back in full force. I never
went off the meds, but absorbing less made it not work anymore. I went to
my pcp and she upped my dosage to compensate for not absorbing. In some
situations a lawyer will work, in others it won't. If your surgeon said
one thing, but wrote another in your chart, you could have more problems.
I would talk with your pcp and get your self feeling better. Then I would
get a copy of your medical records from the hospital, look them over with
your pcp and go from their. Good luck!
— Tiff
May 18, 2006
Hi Karen, I had RNY 9/03, surgeon refused to see me at about the 6 month
point when I FINALLY got a upper GI which showed ulcers and gastritis in my
pouch. 2 and 1/2 yrs later, have gotten some answers to my problems, but
have also been labeled a "psych case". I've also had 2 heart
attacks and a heart bypass before RNY, but all the chest and abdominal pain
"is all in my head". The one ER in town refuses to let me see a
doctor there anymore. I don't have any great answers for you. I have also
had a NUMBER of doctor's reports that have flat out lied on their reports,
it's amazing to me how often this goes on and how little the patient can do
about it. Last week I had a cardiac stress test which shows I have two NEW
areas of damage to my heart, but - remember- "it's all in my
head"!!!! I've been told that ulcers and gastritis don't cause
pain???? I will hope and pray you find someone that will help you soon. I
do understand and don't hesitate to email me if you want. Hang in there.
Sue
— Nut Picker
May 19, 2006
I do understand your frustration. It can be frightening. About a year
ago, I had such pain in my upper back that radiated down to my shoulder and
down my arm. I was in such horrible pain, I called the doc and told her
for the time being, I was upping my pain medication. Nothing was said
about that....and I was sent for an EEG and an MRI. The doc became upset
that I was taking my pain meds around the clock...and when the results were
in, degenertive disk, arthritis, bone spurs and a large hemangioma on my
spine in the VERY spot I was complaining about (not to mention my
fibromyalgia)...the doc told me that she had NO IDEA why I was hurting as
much as I claimed to be. duh! Thankfully, the pain has gotten better, and I
no longer need the pain meds as I was taking them before. I think we all
can tell horror stories...being overweight automatically makes you a head
case, because everything physical is due to obesity right? And we just
have no self control because we are obese....yeah...right! I'd defy any of
those docs to live the life of self deprivation in the food department that
I did on an every day basis. Yet, I continued to gain weight. I had to do
a very distal surgery in order to lose...Oh..I could go on and on. I hope
you get the help you need. Just know that you are not alone at least.
Regards~
— Statuesque
May 20, 2006
Okay, let's start at the top
1. Wellbutrin SR is (sustained release) you need something that is NOT
extended or sustained release. I myself take Paxil (regular)
2. ANY medical personnel that would call you a "drama queen"
needs to be reported.
Start with going back to your family doc and changing you depression
medication. Those who have never been clinically depressed will never
understand how debilitating it can be.
Go back to your surgeon an make sure you let him know everything that is
happening symptom wise. I would suggest writing everything down and
CONFRONT him about how you feel about that way he and others treated you
(try not to get emotional).
Good LUCK!
— SJP
May 23, 2006
So after your difficult hospital stay, what was detirmined to be wrong with
you? Taking the albuterol can dramatically increase your heart rate and
make you jittery. Albuterol is a rescuce drug to be used only when having
an acute attack. You don't mention who diagnosed the asthma? Did you have
pulmonary function tests? If not I would make sure to have them and get a
correct diagnosis before self medicating with a dangerous drug. While on
the psych floor did you have a chance to see a psych doctor and have your
meds adjusted or reviewed? Did any family member or friend advocate on your
behalf with both the surgeon and the psych doctors? Were you given any
meds for nausea, since that was your main complaint? Unfortunately a
stomach flu is common and they don't put people in the hospital for it.
Honestly I see that your surgeon did give you the workup and you had no
SURGICAL issues, But obviously he doesn't have the greatest people skills.
He could have handled things better. If your feeling are as strong as you
say, time to look for a new surgeon, might be hard though, I would talk to
the surgeon and tell him about how upset you are.
Good Luck
— goldroses
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