!! One week post op from Internal Hernia repair w/adhesions and 2nd ulcer!!

I am Feeling very depressed and in pain following a laparoscopic repair of an internal hernia, lysis of adhesions and 2nd ulcer.  I had an RNY on 4/3/12 and had a few early post op problems.  About 6 weeks following the RNY I developed a stricture and had to have a laparoscopy to "open/stretch" the anastamosis.  Then, 2 weeks later I had a gastric bleed which required a third hospitalization and transfusions.  I was diagnosed at that time with an anastomotic ulcer and have been on varying doses of omeprazole (protonix) and carafate since.  In mid July of this year I began have increased pain in my lower middle abdomen with pain radiating to my back.  As noted in many of the posts, routine radiography exams were negative for gallstones or obstructions.  The gastroenterologist insisted I was dealing with ulcer pain, but, frankly, I knew there was something much more serious going on as I began to develop an inability to eat without increased pain and ultimately began to avoid eating much at all.  I was admitted to hospital on 9/14 and again on 10/15.  In between these hospitalizations I insisted on having my bariatric surgeon consulted.  I have been frustrated with my post op care and feeling like I have to suffer greatly before the surgeon steps in.  The local hospitalist wanted to consult general surgery and that's when I put my foot down.  On 10/24/13 I had an outpatient laparoscopic repair of an internal hernia, lysis of adhesions and treatment for this ulcer.  Unlike my previous surgeries, this surgery has been very debilitating and painful.  This was done on an outpatient basis which limits effective pain control in my opinion.  I am unable to eat ANYTHING soft or solid without pain and vomiting.  I have no appetite and fear even taking my routine meds and supplements as swallowing even these with water causes pain.  I would appreciate any information and encouragement from those folks that have had a difficult recovery like mine.  I have seen almost a 100 lb weight loss, but the additional weight loss now is of concern because I am unable to meet my daily nutritional needs.  When I call my doctor's office I am met with staff that are obviously 'rehearsed' as to what to say to post op patients.  It is 3pm on a Friday afternoon and I am due back at work on Monday.  If anyone has had surgery for an internal hernia-is this normal?  How long do you remain on pure liquids?  Please help allay my fears!

Thanks!

Celtie

You said:

"I am unable to eat ANYTHING soft or solid without pain and vomiting.  I have no appetite and fear even taking my routine meds and supplements as swallowing these with water causes pain."

I would go to the ER.  Don't fool around with the doctor's office.  

Thx for the replies, ALL:

I am very aware of the need for fluids and push myself to have minimally 15-20 oz a day.  I have worked in health care for over 30 years and recognize symptoms of dehydration.  It's just very concerning for me (but somewhat reassuring) now to have heard that this IS a tougher surgery than the RNY.  I'm just very frustrated at not being able to speak directly to my bariatric surgeon and have her offer reassurance and suggestions to help make me more comfortable. 

If there's not significant improvement or if symptoms worsen-I know there's the ER.

Thanks for the opportunity to vent!

Celtie

Celtic

God bless ya and let us know how you are doing.  Good grief... 15=20 oz is just not good as you know.  

You are not alone in frustration with contacting your bariatric surgeon.  I have NOT seen mine or spoken to him since the surgery a year ago.  I get the staff at the office and the NP.  NOT ok.  Fortunately, I have had no complications but bless your heart... it IS so frustrating, eh?

at just over 6 months post op I had a hernia repair outpatient it was very painful and in my opinion far more painful than the rny. In fact my doctor will only write a note for 3 weeks off for the rny he was willing to give me 4-6 weeks for my hernia so that alone told me it was going to be pretty bad. I went back to work at 4 days post hernia because I had no time off and it was Christmas week so it was only a 3 day week before having another 4 day weekend for new year. it was horrible! My daughter had to drive me to work she went in with me and did any and all lifting that i needed to do and drove me home,. I worked for a center for independent living so I was fortunate that they are used to people needing PAs in order to do their job. If it wasn't for her there was no way I could of went to work. I couldn't even carry my purse. Fast forward to about 9 months post op when they went in to take out my gall bladder and check where all my left side pain was coming from. It was from scar tissue growing to and wrapping around things on my left side,. They cleaned it out and sent me home. I thought the hernia was bad! It had NOTHING on the cleaning of the scar tissue I was off for a total of 4 weeks recovering from that. Mind you I went back to work at 7 days from the rny and did just fine.

I didn't have problems keeping food down with any of them I just wasn't hungry. In fact with the last surgery I lost 7 pounds that week even after being pumped up with fluids. I was able to get my protein shake in that has the vitamins in it. If was unable to do that for more than a couple of days I would of been right back at the hospital. What concerns me with you is you are unable to drink water which can lead to dehydration which is going to make it even harder to keep food down as it makes you feel sicker. If you aren't getting anything in by mouth I would go to the ER bypass the doctors office and let them know you are getting in nothing by mouth. If nothing else they can get a IV in you to get some fluids in. Don't wait and mess around with it.

I had an internal hernia repair at 8months.  I am really lucky because the ER where I had my surgery and the surgeon are really really great.  the program is NOT perfect but when it comes to stuff like this they take it very seriously and are completely responsive.  I went into the ER with pain and even though the intial CAT scan didn't show anything they admitted me because they knew the surgeon would want to look at me first thing in the morning.  I am surprised yours was done outpatient.  They let me go home later in the day of my surgery but that was only because I was doing okay and wanted to go home.  They would totally have let me stay if I had wanted to. 

I was back to clear fluids and then protein shakes for about a week, it took a while to get back to normal.  I was able to keep down fluids though and the amount you are drinking is so little, I would seek medical advice about that, but obviously not from your center if they are not helping.  Through this whole process I am really learning how to insist on being an active member of my health care team.  I regularly fire people who are not helping me.  I hate those canned responses I get, I know just what you are talking about.  This is important stuff, drive as far as necessary, demand, complain, just insist on getting what you need. 

The recovery from any surgery is always a surprise to me, and you have had a long road up till now.  Treat yourself gently and take care of yourself. 

Hi Louise:

Thanks for replying.  I did finally speak to my bariatric surgeon on Friday night.  She said that she repaired a MODERATE internal hernia and dealt with some adhesions (though there was not a lot of them).  However, she thinks my current problems are likely resulting from this marginal (anastomotic) ulcer that keeps returning.  I have been dx'd w/2 since my original GBS.  I will contact gastro this week.She says that gastro needs to do another EGD to look at the ulcer.  That could ultimately require surgical intervention as well.   I don't have anymore sick time.  When I don't work-no money coming in.  Hubby is out of work just now.  All this doesn't help for sure.  I so appreciate you and the others' advice and support.  I will keep you all posted.  I have learned that this is a side of GBS that you don't get a real look at when you are just beginning the process.  I don't regret the surgery at all.  I DO REGRET having post op problems and not being fully aware of potential ongoing concerns.  I am a medical assistant of over 30 years.  I did not go into this surgery ill informed or wearing blinders.  I just was hoping I wouldn't have post op problems,  What FRUSTRATES me most now is the lack of cooperative healthcare and partnership in patient care that I see between bariatrics and gastroenterology.  I can't get these 2 groups to consult and cooperate.  Each thinks they are exclusive.  The egos of American physicians are going to kill me.  Like you...I am a SUPREME advocate for myself,  I make a lot of noise and often.  Ticks off the doctors, but I think it makes them culpable for their treatment or lack of such.  It's just very hard to rattle cages when you aren't on your best game.  BTW...I have begun to tolerate liquids and protein.  Soft foods increase my bloat and gas and cause some reflux/light emesis.  So...these symptoms do require re-evaluation.  I will call them tomorrow.  I will keep you posted and thanks ALL for your support.

Celtie