23 Days Post - Op and Still Have My Drain In

So here I am 23 days post-op, and my doc is keeping my drain in because he is concerned about an imbalance in amylase levels between my drain fluid and my blood serum.  Higher levels of amylase in the JP (surgical) drain can be an indicator of a leak.  My barium and dye tests were both negative for a leak.  A week ago, my levels were:

Blood Serum: 79
JP Drain: 91

Yesterday:
Blood Serum: 66
JP Drain: 87

Three days post-op my levels were around 140 for the drain and in the high 90's for blood serum.

I've looked all over the web, and the only studies I have found indicate that post-op levels below 215 are NOT indicative of a leak.  I've traveled away from my job to get this surgery at Walter Reed/Bethesda Military Medical Center, and have been missing a lot of work as a result.  I have felt fine, never nauseaus, have never thrown up.  He kept me in the hospital for 12 days over this, and extended my liquid diet for another two weeks.  He doesn't want to remove the drain until the levels balance.  I'm not sure that's going to happen, and I'm also not sure it's a problem.  I'm only getting 4ml of fluid out of the drain these days, so it may dry up before the levels get all that close.

So my question: did anyone else have amylase levels that concerned their doctor, and if so, what were they?  I need some data points.

I had the amylase test of my JP drain fluids as well (and no barium or dye tests, thank God).  I asked my doc what level(s) were acceptable to him and he indicated that below 50 was normal.  He'd seen patients as high at 75 that were ok.  But that was rare and he'd only had a few that were above 50 immediately post-op.  And they dropped quickly thereafter and ended up fine.

So, based on this limited info, it sounds like your doc may be right to be concerned.  Maybe it's a teeny tiny leak and is currently healing while you are taking it slow with liquids only.

I'm really sorry you are going through this.  Not fun.  Keep us posted on what you learn and how things turn out.

I found this study which might suggest that you are within normal ranges.  What does your doc say?

http://www.sages.org/image_library/details.php?id=101401

That's the one I found as well.  I e-mailed it to him this afternoon, but no reply as of yet.  I started purees today, no issues with pain or nausea.  So far, whenever I've eaten anything (yogurt for the past week, now purees) I have to go to the bathroom within 10 minutes.  After 35 days of a liquid diet (2 weeks pre-op + 3 weeks post), I dont' think that's unusual.  My energy level is fine, and no other worries.

It may indeed be a "microfissure" leak, but if so it isn't leaking much...reference the small amounts of fluid I'm getting in the drain.  Bottom line is I have to get back to work or I could lose my job, so I may be going with the drain.  I can get blood draws and drain analysis from any lab, so I don't need to stay here just to get that done once a week...especially since he seems to have no intention of any other diagnosis or treatment options.

I don't think anybody ever checked the fluids for anything in my drain and I had my surgery performed at a top rated facility. They just dumped them down the toilet. This is the first I have heard of this.  On the subject of leaks, my doc also has told me most leaks with VSG occur around the 3 week period. I hope you get that out soon.

They were dumping mine too, but late on day two I developed a fever.  It went away and never returned, but that's what spurred the test.

I've heard in the first 3 weeks of surgery leaks will appear if you have them in most cases

So sorry you are going through this.. I did not have a drain with my surgery. My doctor said all the new seminars he had been to say they really aren't nessisary on most sleeve surgeries..
Hoping for the best for you.
Julie

this is your health, so better safe than sorry.
I feel for you though I too would be pulling teeth in frustration    or hair lol