Bowel Obstruction, Hernia, Diet Help
I had my DS in July of 2009 at 445 lbs. Last September (2012), I was at work and began experiencing horrible abdominal pains, chills, vomiting, etc. I went to the ER, and after much testing and talking and explaining the DS repeatedly (I had my surgery in central Illinois, now I live near Louisville, KY), they determined I had a bowel obstruction caused by the omentum (spelling?) tearing mostly loose in my abdominal area and causing my bowel to stick together. I had surgery and was off work for 6 weeks, etc. I felt fine afterwards, but had no idea how to eat: all the post bowel obstruction information was to eat white carbs, basically. In November/December I got the flu and kept feeling a hard lumpy area near my incision cite: one particularly bad coughing fit sent me right to my doc with the pain: I have an incisional hernia. In January I went back to the bowel obstruction surgeon who verified it. I have the best insurance my current job provides (my ex husband had the insurance on my when I had my DS, so it's different, crappy insurance), but due to deductibles, etc, I have to give them $600 up front. I make barely minimum wage and had a huge backlog of bills due to being off work for 6 weeks, so I'm having to slowly save up the money for hernia surgery. I'm almost 1/2 way there, no thanks to huge HUGE car repair bills last month.
Before the bowel obstruction, I was working out 5-6 days a week with walking/running and lifting weights. I was eating a paleo + dairy based diet: nothing but meats, cheeses and veggies, eggs and various fats. Very compliant with vitamins and keeping up with labwork. My only real issues were all this excess skin and huge hanging apron on my stomach that hangs over my pubic area. My insurance has already denied me surgery to fix it once. I've tried. I was 177lbs.
Since the obstruction and hernia, I can't do more than walk, and then not for long periods or distances or my hernia starts to hurt. I can't lift things... it all sucks. I've gained 20lbs. I'm scared as hell to go back to veggies/meat/cheeses, but I still keep my protein up with shakes. I eat more hamburger than steaks. I've cut out most things like raw broccoli and only eat it cooked. A few weeks ago, I thought I was going to have to go back to the ER: I was having similar issues with chills, stomach pain, vomiting but it passed after a few hours. I'm eating breads and mashed potatoes too much, that I know. I feel it's easy on my bowel, but not good for me DS wise.
So the point, I guess, is: after a bowel obstruction with a DS is there a different way I need to eat to keep it from happening again? I know I can't for SURE avoid it with diet, but I want to help as much as I can. Someone suggested that the compression garments I was wearing to run in and keep my hanging apron from slapping against my thighs contributed to the obstruction. Can that happen? I know I can't wear them now with the hernia; it hurts too badly. I tried. Just any general advice? I want my hernia surgery so badly so I can exercise again and get this 20lbs back off. And stop wearing baggy jeans that I can pull off without unzipping because ones that actually fit make my hernia hurt.
Exactly. There are doctors out there that are willing to do a bit on the side for the business. Just have to get creative in hunting them down.
Now the apron fix you get is slicing from one hip to the other - where as a real PS doctor would cut all the way around your body and lift the whole thing up. They leave a 4 inch piece in the back uncut, the rest they pull up and sew together. At least that was what one woman told us in support class. Cutting only the front flap off tends to create little "tuck point" over both hips - but I'd rather have that then the full apron. I'm not going to do any runway modeling in the near future.
In many respects, you are really lucky you have a hernia cause that is the perfect time to toss in the apron fix for little money. And honestly, I would go into debt for it. Make payments on it - hell, get a second part time job. You wouldn't have to exercise if you got a second job that was moving around. I've seriously thought about stocking groceries, or working at a drug store after my regular job.
Hi, Rhayne (love the name!)
I too am a member of the SBO club (small bowel obstruction). I've had several SBOs, two that resoved with IV fluids and meds and NG tubes, and about 4 that required surgery. The first thing that any of us ask is, did having the WLS cause the obstruction? Everyone feels great concern that something we did for our health may cause a problem that we didn't forsee. Any abdominal surgery can cause adhesions. Also, conditions like endometriosis and ulcerative colitis can cause the inflammation and adhesion development. Basically, surgery inflames the surfaces of organs and healing can cause them to clump together like sticky sphagetti. In my case, I already had adhesions. I had a hysterectomy several years prior to WLS, and already I had extensive adhesions.
The longer an adhesion exists, the weaker it gets. A new adhesion is strong and tough, an old adhesion can be as insubstantial as tissue paper. So, adhesions are most likely to cause problems in the first year or two after surgery. As the adhesion deveolps and shrinks, it can capture intestines like a spider web, then as it shrinks, it can pull them together, or pull them out of place. My appendix ended up on the left side of my body, due to this traction of the adhesions.
About the only thing can do is to help prevent undigested clumps from being stopped by a narrowed intestine, which can cause mechanical obstruction, like water being stopped where someone steps on a water hose. Soft easily digested foods like breads and rice are often suggested if you are susptected of having a narrowing of your intestine (BRAT diet: bananas, rice, applesauce, toast) . But I don't see why you could not puree your normal foods to a thin consistency, and eat them in small portions at a time. I know this is not the ideal food consistency for WLS folks, but it would be better nutritionally than that carb rich, protein poor BRAT diet. This will not help an obstruction caused by a loop of intestine being twisted by adhesions, so any severe pain, or pain that lasts more than an hour, are your warning to get to a hospital immediately. If a strangulated loop of intestine is not freed within a very few hours, it will die and will have to be resected out, leaving you with less normal bowel.
When I started having the bloated, achey feeling of an impending obstruction, I would drink only hot tea, and would lie down with a heating pad on my belly. For food being backed up by a narrowed intestine, this would help me. For a strangulated loop of bowel, pain would get worse, so an immediate trip to the ER is needed.
I also have hernias. For me, the hernia did not cause my obstructions, it was the adhesions. Surgery to repair hernias can cause more adhesions. I have had my hernias repaired 3 times. My most severe SBOs happened after the hernia repairs. And each time, my hernias came back. My belly muscles are weak due to so many years of obesity, and so many surgeries. And I have gained a lot of weight back years after my surgery, so trying to patch up my belly, even with mesh, put so much tension on the repair that it failed. I am looking into a revision of my WLS that may help me lose weight again. I am not going to do anything about my hernias until I have lost weight, because I believe that the repair will not hold as I am now.
I hope my story may offer you some information to help you ask your sugeon questions that pertain to your own situation. Best of wishes to you.
