Has anyone heard of an MD not doing a swallow test after RNY?

charleston-mom
on 7/23/08 5:06 am
My friend had her RNY on Monday (different doctor than mine). They do no swallow test at all to check for leak before advancing to liquids and foods or sending the patient home. Has anyone heard of this? Seems to me this would be risky. Supposedly, the reasoning is that they look to other tests to see if there are signs of leak (for increased blood pressure, tachycardia, fever, abdominal distension), but from what I saw, the nurses were doing very little to check BP, heart rate. The patient was going 7-8 hours at a stretch with no one even coming in the room. How would they know if there is leak if they aren't checking anything at all? I thought virtually all doctors did some sort of swallow test the day after surgery. Has anyone heard of this? I'm worried about by friend. She seems good so far, but I just have never heard of them not even checking post-op.
maureenofoh
on 7/23/08 5:10 am
My surgeon does not do a swallow test.  He checks for leaks in the operating room.  I was never alone in the hospital for more than an hour.  My blood was drawn every 4-6 hours, blood sugar levers checked every 4 hours, I was walked every two hours (even in the middle of the night), and in general well checked and monitored.  Seemed like I could not get any rest.
andrea K.
on 7/23/08 5:10 am - near Huntsville, AL
I also didnt have to do the swallow test. I had heard from different PPL that i would have to (not patients of my dr) so the next morning I was ready for them to do that and the nurse came in with a SF popcicle and said "if you can get this down with no pain, you can ggo home." 9 months later and havent had a problem. i guess some drs just trust they did it right.
 

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charleston-mom
on 7/23/08 5:12 am
Wow - I guess I'm just so surprised. My doctor wouldn't allow anything by mouth (liquid or otherwise) till after a swallow test.
Terri R. R
on 7/23/08 5:13 am - 'bout 45 minutes from San Francisco, CA
My surgeon doesn't do a swallow test.  He says he checks very thoroughly before closing.  He's done thousands of these and has never had a leak.  He believes the swallow test is not necessary for his patients so why put them through it.

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Tara K.
on 7/23/08 5:13 am - Kuna, ID
I didn't have one either.
RNY April 7, 2008 - from size 24/26 to size 6/8Photobucket
(deactivated member)
on 7/23/08 5:15 am
WOW!!!  that is strange......

that's the first thing my surgeon did after a few hours in my room.  I hear some people getting it down the same day or at least the next day ~ after surgery.

Start researching on the internet...make some phone calls to other bariactric surgeons in your area.  I know this sounds like being a "nosey Nellie"...but really, if it doesn't sound right...and it doesn't feel right...your friend is so new to this ~ she needs you as an advocate!!!
If you find out that more surgeons than NOT, perform a swallow...ask her to request one before she is discharged.  Get the patient advocate's office involved.  Involve them now, just to give them a basis of what is going on...so if **** hits the fan, they won't be side swiped and can back you up....

good luck,
Dawn
Cindy O.
on 7/23/08 5:19 am - Bryan, TX
OK, takes a lot to shock me, but this post has done it.  As the RN program director of Bariatric Surgery this seems to fly in the face of the standards of care established by the ASMBS and ACS. WOW.  From this point on, I'm speechless.  But, I will be adding this as a topic of discussion at our monthly bari surgeons meeting next week!
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Tara K.
on 7/23/08 5:24 am - Kuna, ID
I was confident in my Dr when he said he didn't do them. I had the most experienced Dr in my state at a Center of Excellence.
RNY April 7, 2008 - from size 24/26 to size 6/8Photobucket
Cindy O.
on 7/23/08 5:33 am - Bryan, TX
That's awesome!  I'm adding this to the agenda to get the  discussion and research going on our end to see if it is indeed a necessary step.  They do the leak test in the OR and if "eyes on" doesn't show a leak, then is a swallow needed?  Things for them to ponder.
We've never had a leak show  up in the swallow study, but have had 3 leaks in 4 years that occured after the first PO fluid intake.  Makes one stop and think, huh?
Great information.
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I do not give medical advice.  I offer my opinion, nothing more. 
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