Bowel Obstruction Update - by Lisey herself!

Before I fill everyone in on details, I just want to say how grateful I am to everyone for their continual support, even when I go all incommunicado for a couple of months :)  you know - living life & LOVING IT!  Your wealth of support literally brought tears to my eyes.  Thank you all from the bottom of my heart (as I tear up again!)

Quick recap for those who might not have been on the boards this weekend.  I went to an urgent care unit Thurs night with severe stomach pain, swelling, vomitting, nausea.  I was literally crying at times, it seemed to come in waves (peristalisis??) & had cold sweat/ hot shivers.   They did a regular x-ray & couldn't find anything wrong with my stomach.  Dr. sent me home & told me there wasn't anything more they could do for me & if I wasn't feeling better soon or worsened that I should go to the emergency room.  My white blood cell count was 15,000 at that time, which he stated was "mildly" concerning to him.    That was around 11:00pm Thurs.

I actually decided to go to the ER at around 2:00am Sat morning because, aside from the nausea & vomitting being gone, & slightly less pain, the majority of the symptoms were still present & my stomach was feeling more hardened & tender to the touch, from the lower abdominal above the mons to the lower undersides of my breasts - yes, my actual breasts.  The entire abdominal cavity hurt A LOT.  I considered driving myself, but didn't think I would actually be able to do it, especially b/c I drive stick, which requires a lot more abdominal muscle use as you switch your feet.  My mom, whom I live with, has significant health problems herself & she was in A LOT of pain from taking care of me while not getting much sleep - that led me to choose to wait until 5:15am.  I was seriously debating walking into her bedroom & apologizing, but insisting that I/ we need to go to the ER.  Why didn't I just call an ambulance, right?!  I DON'T HAVE HEALTH INSURANCE.  That's right folks.  It was a *VERY* expensive weekend for Lisey.  I was still hoping that I was wrong, that it wasn't an obstruction & the ambulance call fee would be like icing on the cake for expenses following urgent care that hadn't helped.  So, that factored into my decision to wait for my mom to get up.  Well, she got up to go pee & I told her that I really, really thought something bad was wrong, this was not a normal pain, I might very well have a BO & would she please drive me to the ER in the neighboring county where I know 3 DS surgeons practice.  She asked me to wait until 7 & we agreed/ negotiated for 6:30 instead.  She really has significant health problems & the mornings for her are really horrible.  I've seen her fall to her knees in pain many times when attempting to get up in the morning, so please understand she was b/w a rock & a hard place herself in what she could physically accomplish so soon upon waking up & helping me.

At least I had the presence of mind to spend my mostly sleepless night doing a little bit of basic research to optimize my odds of getting a DS surgeon - WHICH I DID!!!!  The DS surgeon was the on call surgeon when I walked into ER.  How's that for God looking out for me?!!!  Karma or whatever you believe, I'm one LUCKY LUCKY girl.  I chose the hospital that was closest to these 3 DS doctors main business office & saw that it was a center of excellence in digestive health care.  BINGO.

I walked into the ER room & the first words out of my mouth were, "I suspect that I have a BO, I'm actually pretty sure of it at this point b/c blah, blah, blah" (insert surgery, WL, etc).  The ER doctor (not the DS surgeon) immediately said you need a CT scan with contrast - can we say halleluliah?!  Can I spell it while on drugs??!!  Oh yeah, I'm on perkosets right now.  Who knows if that's spelled right either.

I walked into the ER initially at 7:00am.  I had my CT scan completed by 8:45am.  The ER doctor walked into my room and tells me quite cheerily, "Well, it's not very often a patient walks into my ER & tells me exactly what's wrong with them, but you managed to do it!"  He said that it was *VERY* obvious in one glance that I had a big blockage & that surgery was definitely indicated, ASAP.  By this time, I'm already on drugs too, so the timeline gets a little hazy, but my sister told me they started surgery at 11:30am & I was out by 2:00. 

The DS dr who did the surgery - Dr. Wu - told me he was most displeased with the urgent care doc who didn't follow up with a CT scan.  He felt that he should know, given his position, that anyone who is a post- WLS patient (which he knew) is at an elevated risk of a BO & that a CT scan with contrast should always be done as a precautionary measure if nothing else.  Who else here thinks that wasn't done because I don't have health insurance??!!!  Am I just a cynic??

Dr. Wu told me that I was very, very lucky that I came in when I did.  He said that my entire bowel was swollen, distended, & stretched paper thin.  He said that he would normally have checked the entire abdominal cavity after solving the original BO, but that the tissue was stretched so thin, he was scared that the instruments would puncture it & so he chose to just sew me back up after fixing the BO.  Understandable given the cir****tances.  On the flip side, I had told him that I had suspected that I may have a small incisional hernia (I had it open) & he checked the length of the scar - no hernias  there :)  Hopefully, this will be my last BO.  If I had waited longer, there's a very real possibility that he may have had to remove some of my intestine & well, who knows just how much - it was very extended, inflammed, etc.  The BO itself - my intestine (I think large, not sure right now) had wrapped around the appendix, cutting off its blood & oxygen flow.  He showed me pictures, it was dead black.  Literally.  Black as black can be.  The appendix, in turn, had twisted around the circumference of the bowel & was cutting off its blood flow - that was thankfully caught in time.  He said that as soon as he cut away the appendix & removed it from around the bowel, it pinkened right back up.  THANK GOD.  I really think that given a few more hours, I would have lost some of my bowels from blood & oxygen starvation.  The dr said that that was likely the case & that I was very fortunate to go in by the time I did.  Dr. Wu said he was going to write a letter to the urgent care dr & explain the increased risk of WLS patients & given these symptoms, a CT scan should always be ordered with contrast.  While the urgent care unit itself did not have a CT scanner, they were literally connected to a hospital, yet he neglected to refer me to it.  My mom's sister is a nurse & she told her upon hearing all this that this hospital (the one associated with the urgent care) is known for referring people away with medical emergencies if it's not a heart-related problem, stating that they specialize in heart health.  Um, if they have a CT scanner, they could have simply done the procedure to ascertain whether it was in fact life-threatening & then referred me out if its not their specialty.  ****** *******s.

Now that I've vented about that . . .  they were able to do it laparscopically, which Dr. Wu didn't expect to be able to do, so another plus for Lisey!  He said he would try, but not to expect that he wouldn't have to revert to an open procedure.  In addition, Ungson, my DS surgeon, does a horizontal scar & Dr. Wu said he didn't feel that he would be as competent doing a similar incision & that, for safety sake, if he had to revert to open, he would do a vertical incision.  I'm so glad that didn't happen.

Soooo, my current piece of advice that's needed is when to  go back to work.  I started my job in the middle of June (hence no health ins yet) & so I have no short-term disability, sick days, etc.  I am working as a waitress at an upscale restaurant.  It is VERY fast-paced - a lot of quick pivoting, bending, lifting of things that are 6 - 7 pounds.  I was told not to lift anything more than 10 pounds.  Dr. Wu seems pretty confident that 1 week will suffice, but I'm frankly concerned that it wouldn't be enough recovery time given the fast-paced environment.  Going slower to start is simply not acceptable b/c tips are pooled.  I'm confident that my manager would be okay with my taking off 2 weeks, but then that's yet another week of no pay.  Those who have had lap surgery before - what do you think?  I need to let my manager know by Tue, preferably Mon (today) if I'm going to work that second week b/c that's the schedule he will be creating today & tomorrow.  It's posted on Wed for the upcoming week.  They already have me off for the rest of this week.  But, basically, I don't have a few days to judge to see how I'm feeling to let him know to schedule me or not.  As a compromise, I'm thinking of asking him to schedule me for next week Fri & Sun, having Sat off as a recooperation day.  What do you guys think?

THANK YOU ALL AGAIN.  IT IS VERY MUCH DUE TO YOUR URGING & LONG-TERM EXPERIENCE THAT I HAVE MY ENTIRE BOWEL & I AM ALIVE.

Here's an understatement in gratitude . . . 
                   

Lisey~

Lisey, big hugs to you, I am so glad everything came out so well....
...so to speak .

Good for you for acting so quickly.  Take good care of you and Mom...

WoW Lisey!!! Thank goodness you got this taken care of!!

I heard Dr. Wu was a very skilled lap surgeon.

I do hope you take it easy, and hope everything works out at your job!!

Feel better soon!

Lisey, I am so glad that you're ALIVE and updating!!!  Very very glad that things worked out as best they could, considering the cir****tances.  Now, go get some rest!

YIKES YIKES YIKES kiddo!!! ***hugs**** OMG this could have been SUCH a different story. Thank heavens you're okay and got the right treatment soon enough to save you from a far worse fate. I want to sucker punch the urgent care doc. Our combined mojo will be punishment enough for him, I hope.

I also hope EVERY preop *****ads this will get the memo: If you have a bellyache, DEMAND a CT with contrast AND a consult with your surgeon. Real medical professionals will have no problem with this. Real medical professionals LISTEN TO THE PATIENT. Oh dear I'm about to rant, so I'll stop myself now.

Okay Lisey, you asked a big question, about the going back to work thing. You appear to understand that you've just barely escaped a brush with death, and that a lap procedure does not minimize the slicing and dicing underneath. Yes?

OKay. Regarding work.. This might be REALLY hard to do in your cir****tances, cuz it sounds like work is scarce and the situation is pretty scary.....BUT BUT BUT: If you push too hard at this point, what are you risking for the future? If you aren't genuinely well enough to run like a fiend and lift heavy loads (good Lord, in a WEEK after this????), then it's time to stop and wait and take care of yourself with an eye to the long term. I hope you don't lose your job over this. But you need to listen to your body and be realistic.

I know jobs don't grow on trees hon. But jobs are a LOT easier to find than a replacement body or life, right?

Lisey, Thank you so much for your well written post. It could possibly save someone else a lot of pain and even a life. I am so glad you are OK.

Lisey,

  I'm so glad you went in and you're all fixed up!  How lucky that you were able to have a DS surgeon. 

  As for the time off....You probably don't want to hear it, BUT, I think it's too soon.  You need to take that extra week off.  Granted, when I was out in October with mine I had some complications, but I was out for six weeks.  I probably would have been able to go back at three if all had gone smoothly.  I have a sit down job for the most part, and I had an open incision.  Kudos for wanting to go back so soon, but listen to your body and take your cues there. 

  Best of luck to you!

It's so good to see you posting, Lisey.  

I would think a minimum of 2 weeks off and then assess how you're feeling. You're in great shape and much smaller than when you had your DS. I would do everything in my power to boost up the protein, fluids, vitamins and easy-does-it walking the next 2 weeks and make a decision at that point. 

Take care,

--gina

 

 

 I am sooo happy that you are OK.  I'm glad that you got such great care in the ER.  Kudos to you for taking care of yourself and advocating for the care that you needed!  This is a good ending to something scary that none of us want to deal with, but is always a possibility.  I hope others will listen to you and learn what to do when you have pain.

Take care of yourself and rest.  I would say that 2 weeks off would be good considering the pace of your job.

Wonderful news! Very, very happy for you.

jan