Looks like I need to seek help from another RNY surgeon

Lora, I have wondered how far you are from OSU to get a surgical consult there. When I was very young, my ex had serious health problems, including repeated bouts with painful adhesions. We were in Ann Arbor st the time, and the resources of a big teaching hospital were fantastic.

Also, my RNY surgeon has relocated to eastern KY and is top flight. I would recommend her in an instant. She gives her cell phone # to her patients for 24/7 access. It's not next door, but maybe worth keeping her name as an option.

Best of luck to you, Lynn

OSU is less than 2 hours from here (MUCH closer than Cleveland).  I guess I could do some searching to find out who they have there that does RNY...  Thanks for the suggestion.

Lora

The whole "adhesion" thing really is an issue.  I also know personally of 2 people who could have no more open abdominal surgeries due to adhesions.  Both have had multiple bowel obstructions.  One actually died - he had had two open bowel obstuctions surgeries, was still in the hospital and had another bowel obstruction and  they couldn't do another surgery.  The other friend lives in fear of another bowel obstruction (her history is ovarian cancer, radiation, 3 rounds of chemo and 2 open reductions of bowel obstructions) - she has had a couple since her last surgery but they resolved with hospitalization, NG tubes, relaxants, etc.

Could you  be referred to a pain control specialist who could help you through these times of pain.  If the pain is from bowel getting twisted in adhesions (horrific pain), maybe narcotics, being NPO, IV fluids and relaxants can get you through it.

Still a good idea to try to find another surgeon, but I do understand the reluctance to do an "exploratory" surgery on someone with alot of adhesions.

Thinking of  you.

If bowel is twisted in adhesions, then it needs to be taken care of, not just masked with pain meds.  Back in 2009, I had terrible pain for months and my NP kept blowing me off until I insisted on seeing the surgeon.  He said I needed immediate exploratory laporoscopy to see what was going on.  I had 4 sets of adhesions, 1 causing my intestines to be twisted.  He said if I had left it any longer, I would have had a bowel obstruction.  Let me tell you bowel obstructions are no fun. 1 year later in 2010, for other reasons I had a bowel obstruction, 1 week later a perforated colon, septic - needed an iliostomy and 3 months later had to have it reversed.  We can't just ignore things. Pain means something is wrong and masking it with pain killers is wrong.

I have been complaining excruting back pain for a month and also some abdominal pain.  Finally when I saw my Endocrinologist they thought I had a bladder infection but after lots of tests it turns out I had lots of kidney stones - on both sides.  The left side - one was obstructing my ureter.  I had to have emergency surgery the  next day with a scope and laser to blast it.  I had tons of complications and ended up in the hospital for 6 days - just got home yestarday. They had to insert a stent into my kidneys and my blood is really screwed up. Severely anemic, severely low platelets and very low white count.  I have to follow up with the hematologist on Thursday.  So, all that time I was complaining that my back was hurting much more than usual, my pain management doctor didn't want to listen.  Thankfully for my Endocrinologist.

 Wow I am shocked that your dr can just abandon you like that.  I am also surprised your pcp isn't able to help - he surely has some connections with surgeons.  I was not aware that surgeons did not like to operate on RNY patients.  This is scarey.  I wish I could come up with some kind of answer for you but have none.    I am so sorry you are going through this.  You are such an intelligent and logical woman  I am just shocked you have all this to go through.  Thinking of you and hoping things go well,  and soon.  Lori

Hey Lora!.....sorry you are having so much many problems....I will give you my lil story and maybe it will help give you a solution.....

RNY 10-15-08, then panniculectomy 3-3-11 (which ended up being a full abdomnioplasty) just read my operative report.

last week I was hospitalized directly from bariatric surgeons office for severe weakness, fatigue, abdominal pain that comes and goes, sometimes painful gas when I have ate nothing to fart (oops sorry sometimes I give TMI).....but anyway......Dr. Titus Duncan who is the main surgeon of the practice and widely known on TV, etc.

he explaines to me that after you have a panniculectomy or abdomnioplasty following RNY, sometimes it leaves a space for the intestines to flop back and forth through this newly created space and when you eat and the intestines get kinked up, green fluid, etc will come up......That has never happened to me (green part) but yes the pain.

I was given oral contrast, IV contrast, and CT scans taken.....I was given lots of IV fluids because my veins were like a flattened hose or straw and I was stuck over 6 times from collapsing veins

This is the plan...........My surgeon, his partner will be performing a diagnostic EGD the next week or so.....If the space is seen from the removal of all the excess skin and work from the abdomnioplasty, the surgeon during the EGD stitches the area up.....This is what causes the intermittent pain.....if the intestines are not flopping through that space if you have one while the CT scan is being performed then nothing will show up, so the EGD is used to determine if that space is present and the stitiching up of that space fixes the problem.........

hope that helps you.....pm me if I can be of any additional help and keep me posted of your progress!

Three of my 4 CTs have been done while I was having the pain, so I would expect that something like this would have shown up on one of them. 

I'm confused (but maybe I'm just not thinking clearly because of the pain meds).  How would there be space in your abdomen from removal of excess skin?  After having the abdominal muscle tightened during a tummy tuck, I would think that would significantly limit the ability of the intestine to move in and out of any small amount of extra space that did exist in the belly.  Also, how would an EGD  -- been there, done that already -- which takes pictures from inside the pouch and intestines show space in the abdominal cavity?  Or are you saying that the EGD might show the kinking (in which case, you would also have to have the EGD done right when the problem is occurring... because it would not show anything otherwise)?

Lora

did you have contrast with the CT scans?........now at the Dr. visit prior to my direct admit this is exactly what the surgeon explained to me......and upon discharge another Bariatric surgeon came in and explained the same scenario.....

my assumption is that te PS after removing the amounts of skin only goes so deep and may create a pocket.....I do not know the medical terminology but I understood what they were saying and I hope I do not have that space........I will keep you posted after my EGD and when I get my discharge papers I will pm you all the details so there will be clarity...

I know it sounds strange but both Bariatric surgeons.....one who is main one of the practice, Dr. Titus Duncan and very well known in the field explained this to me.....and the solution they say is simple with the stitching during the EGD and will solve the problem of the possible space or gap and the recurring abdominal pain........................or hopefully not it could be something else wrong with you......but I will keep you posted on my experience and hopefully we can figure this out!

Because I was sent to PCP, then pain management center and for the last 3 months I was on massive amounts of high dose narcotics and built up a resistance to where they did not remove my pain......................gone are the wonderful days of just reducing the inflammation and pain with NSAIDS

Yeah, two CTs without contrast, one with IV contrast, and (Monday) one with oral contrast...

Lora

Lora, I'm so sorry that it has come to this and that you have to see yet another doctor.  Hopefully, a new set of eyes and ears with a fresh new perspective will help get to the root of the problem.  You should NOT have to just "live with it".  That is unacceptable in this day and age.  It's one thing if a person CHOOSES to live with pain for whatever reason, but you have been actively pursuing help and not getting the help you deserve.  Please keep us posted on what's going on!