My RNY to DS Revision Story (Scary)

Feb 15, 2012

I went for a RNY to DS revision on August 15th of this year.  I had regained about 70 pounds of 180 pounds lost eight years ago with my RNY and had an enlarged stoma so I was always feeling hungry and was grazing too much.

I had the DS revision lap (which turned out to be part of the problem) on 8/15 -- all seemed to go well, and I was released on 8/19.  Within one day, I was spitting up black dark stuff and getting pains in my chest and back.  Called the Dr early on Sunday (he had left on vacation but his partner called me back) and was told to come to the ER -- but being 3 hours away from where I had surgery, that wasn't happening -- I was in no shape, so after discussing with surgeon's partner - I went to the closest hospital that did have a small bariatric program.  Was told to request a chest x-ray, abdominal CAT scan, and blood work.

Chest x-ray showed pneumonia in my left lung, blood work showed drastically low hemoglobin, and abdominal CAT scan couldn't be read clearly, but they thought it showed a possible blockage in my newly reformed stomach.  ER docs spoke to my surgeon's partner, they decided to admit me, but make arrangements to transfer me back to NYC hospital the next day.  I was given blood, put on antibiotics, fluids, etc.

Well - trying to get a NJ Shore hospital, a NYC hospital, an insurance company and an ambulance service to agree turned out to be like asking for peace in the Middle East -- it ain't easy!  I ended up not getting transferred till Tuesday night -- and I was progressively getting worse -- the black stuff coming up was getting darker and happening more and more. 

At NYC hospital, all sorts of tests performed including the same ones done in NJ -- Wednesday, I'm told that they are rushing me back into surgery -- that they think there is a blockage in my stomach but won't know what they are dealing with until they get in there, and that they are going to have to cut me open --- so much for choosing lap surgery! That was 8/24.

Woke up in the ICU and was told that my 'stomach had died' -- had turned black and necrotic -- and that they had to remove it entirely (gastrectomy).  They connected my esophagus directly to the jejunum of my small intestine and inserted a feeding tube.  Said the only thing that kept the infection from spreading throughout my body and killing me was that a sack had formed around the stomach keeping the infection intact -- they said that was unusual, but had no further explanation for the sack.  (I choose to believe that my angel (my first husband, Chuck who passed in 2004) was taking care of me!) 

Further examination of the removed stomach in pathology showed that the arteries on the left side of my stomach were damaged and not functioning, and the surgeon speculated that it appeared that had happened eight years ago when I had my original RNY -- he had never seen that before and was at a loss to explain how or why that might happen.  There was nothing to mention it in my original RNY surgical report.  In any case, he explained that when he reformed the stomach in the DS revision and removed the right part of the stomach to create the 'sleeve' he was effectively removing the arteries on the right side -- which was not a problem in theory cause there were enough arteries on the left side, but doing the surgery lap -- he had not been able to see the damage on the left side.  In any case, the revision ended up removing all sources of oxygen and blood flow to the stomach which is why it 'died.' 

I had a filter inserted in my groin to prevent blood clots.  I remained in ICU and seemed to be healing, when spontaneously on 9/2 my blood pressure bottomed out and I had severe pain -- they rushed me back to the OR.  I again woke up in ICU to be told that when they opened me up again, they found old blood and infection which needed to be cleaned up and out, but could not find any active source of the bleeding.

Again I remained in ICU -- weak, sad, removed from my support system three hours away, etc.  On 9/9 one of my daughter's friends was visiting me, and according to her, one minute I was asking her to hold my hand, the next I was unconscious and blood was coming out of my mouth and belly.  She immediately got a Dr and I was rushed back into the OR -- again woke up in ICU and was told that for some reason my spleen ruptured and had to be removed (splenectomy).  The spleen is not located anywhere near the surgery site internally, so again the Dr was at a loss as to what caused the rupture - but speculated that the old blood and infection they found in the last surgery may have come from the spleen and migrated to the site where the intestines were joined.....

Again in ICU when on 9/13 -- again my blood pressure bottomed out -- waking up in ICU was told that we had a repeat of the situation on 9/2 -- they found old blood and infection which needed to be cleaned up, but could not find any source of active bleeding.

Six weeks in hospital -- five weeks in ICU -- five surgeries in six weeks -- they all took their toll on me physically, mentally and emotionally.  Gene was told in each of the last three surgeries that he should come to the hospital, and that I might not make it through the night!  I started suffering from what I am told is ICU psychosis -- I was having panic attacks, waking up pulling tubes out of my nose and chest -- it was definitely hell.

I was released from hospital on 9/30 and went home to being on a feeding tube for 12 hours per day -- not being able to walk, extremely weak, etc.  I was able to get small amounts of fluid down, jello and yogurt, but not much else.  I also had three openings in my belly that were not healing and had to be cleaned and packed daily. 

During October and November, I had physical therapy 3x weekly to get my strength back.  Once I started being able to get in at least 2-3 protein drinks daily, I insisted that the feeding tube be removed -- I hated it and being tied to that pump!  I returned to work on Dec 1st so I wouldn't lose my job.

Today, I am eating very small amounts every 2-3 hours, consisting of protein and low fiber.  It must be very moist --  I have lost 45 pounds from the time I entered the hospital, and have really not lost any more within the last few weeks.  I am grateful to be alive and still be here for Gene, children, family and friends!

While I would still like to lose another 30-40 pounds, it is not so important to me any longer.  I am still a believer in WLS for those that have done their research and know what to expect, but once again, there is always the chance that something you don't expect can happen!

2 Comments