Kim M

Revision from Sleeve to Bypass complications

Recommended Posts

I am about 10 days post op and thought I was doing well.  I do have a lot of pain but thought it was normal as this is a different surgery than the sleeve.  Also, one of my incisions has been leaking since day one.  I had called the surgeon last week and his PA told me to cover it with gauze and use some warm soaks for the pain.  I did all of what I was told but no relief.  I called the doctor this morning and saw his PA as he is at a conference until Thursday.  She spoke with him and they did labs.  Depending on how they come back she discussed  going to the ER and having a CT scan.  

Not looking for medical advice but since I am unfamiliar with the recovery of the bypass does any of this sound normal?  They do not want me taking any pain meds as I have not had a BM since surgery( not unusual for me).   She wants to me move up my food plan and add applesauce and pears to get some fiber.  I just had 2 teasponns of applesauce and feel like an elephant is seating on my chest.  I have been adding ground flaxseed to my protein shakes. 

Felling alone and confused.  Any information about your experience would help.  I know everyone is different but feeling lost.  I have a high tolerance for pain and took no meds after my sleeve while in the hospital or at home.  This is a very different experience.  TIA

Share this post


Link to post
Share on other sites

I'm sorry you're dealing with that Kim. 

I didn't have much in the way of pain at 10 days out but as I didn't have a revision, I don't know that I can compare my surgery to yours.  But hopefully others who had revision surgery can jump in to share their experience.

Share this post


Link to post
Share on other sites

While I did have some ongoing pain for a couple of weeks it doesn't sound like yours. Mine tended to be intense but random.....pain meds wouldn't have helped me out at the time. To prevent constipation I added frozen berries and benefibre to my smoothie drinks....that kept things moving along. Depending where your pain is coming from, constipation could be a major contributor to your pain. Even though its your " normal" I'd be throwing everything at that issue right now. People often have issues with one incision (generally the one all the hard work was done through) so as long as it isn't infected I wouldn't worry too much about that other than to keep it warm, clean and dry. In the long run I do think it is best to follow the advice of your surgeon's office, but I'm surprised they'd be suggesting a CT Scan rather than a barium swallow even though a CT is easier on you. It's likely too early for them to do an endoscopy without a lot of risk, but in a couple of weeks that would be a likely intervention to find the cause of pain if it is in the upper abdomen. I'd be wanting my bariatric surgeon doing that though, definitely not some random ER doctor. Even after 18 months post surgery my bariatric surgeon did my endoscopy, and made it clear he had no intention of allowing another general surgeon do it.  He knew exactly what to look for (potential ulcer and hernia locations), how hard and far to push the equipment, as well as the size he had made my pouch and opening so knew if it was remaining how he made it. If you can hold off I'd be waiting until my surgeon was back from his conference,  if not then I guess your only option is ER. Only you can decide that.

Edited by Aussie Bear

Share this post


Link to post
Share on other sites

Thanks.  Labs are still not back yet so no further testing until they are.  The PA wants me to add some more food.  She did say berries to my shakes as well as some mashed avocado.  She also suggested thinned oatmeal with chia seeds.  My oatmeal has both chia and flax seeds in it.  I have no idea how I am going to incorporate all this food into my day.  

The pain is concerning to me as I thought I would be so much better.  I am scheduled to go back to work on Thursday.  I don't see this happening at this point.   The pain is also constant...np relief.  I almost passed out in the shower the other day.  I got out and sat on the toilet unit I got some strength back.  

Thanks for your ongoing support. 

Share this post


Link to post
Share on other sites

I know you're sore and feeling confused. But first, are you getting enough liquid? That's the number one cause of constipation or poor BM's. Drink drink drink. Like  @Aussie Bear said, second add some Benefiber to your water to help your body actually have something to push out.

I left the hospital with a drain tube, that was removed at 7 days. After that, it took a good 3 weeks or better for it heal up and stop draining and oozing. 

You have a lot of support here , ask all your questions :-)

Share this post


Link to post
Share on other sites
20 hours ago, Michael_A said:

I know you're sore and feeling confused. But first, are you getting enough liquid? That's the number one cause of constipation or poor BM's. Drink drink drink. Like  @Aussie Bear said, second add some Benefiber to your water to help your body actually have something to push out.

I left the hospital with a drain tube, that was removed at 7 days. After that, it took a good 3 weeks or better for it heal up and stop draining and oozing. 

You have a lot of support here , ask all your questions :-)

I am getting all my fluids in.  This constipation has been an ongoing problem for many years.  I suppose made worse by only protein.  I did see a covering doctor today and she had to burn the one incision I guess so it will form a scab.  I didn't have any drains.

The doctors won't let me use anything that will cause volume in my belly. TMI...suppository today with no luck.  They believe this is the source of my pain.  I disagree as I deal with this all the time and have no pain.  

I am seeing my surgeon on Friday but not hoping for much.  He is a good surgeon but no leaks his job is done.  I don't know why a surgeon would think Tylenol would help this type of pain.  I have tried.  I guess my real concern is that the pain is constant and has not improved since I left the hospital. I have a high tolerance for pain.  I did a bilateral knee replacement last year and weaned myself off pain meds. 

Thanks for the support.  I am hoping that time will improve things.  

Share this post


Link to post
Share on other sites
15 hours ago, Kim M said:

I am getting all my fluids in.  This constipation has been an ongoing problem for many years.  I suppose made worse by only protein.  I did see a covering doctor today and she had to burn the one incision I guess so it will form a scab.  I didn't have any drains.

The doctors won't let me use anything that will cause volume in my belly. TMI...suppository today with no luck.  They believe this is the source of my pain.  I disagree as I deal with this all the time and have no pain.  

I am seeing my surgeon on Friday but not hoping for much.  He is a good surgeon but no leaks his job is done.  I don't know why a surgeon would think Tylenol would help this type of pain.  I have tried.  I guess my real concern is that the pain is constant and has not improved since I left the hospital. I have a high tolerance for pain.  I did a bilateral knee replacement last year and weaned myself off pain meds. 

Thanks for the support.  I am hoping that time will improve things.  

So sorry you are having problems Kim.  Hoping you get some answers and relief soon.  How is the GERD ?  Is it gone now ?

Share this post


Link to post
Share on other sites
19 hours ago, Kim M said:

I am getting all my fluids in.  This constipation has been an ongoing problem for many years.  I suppose made worse by only protein.  I did see a covering doctor today and she had to burn the one incision I guess so it will form a scab.  I didn't have any drains.

The doctors won't let me use anything that will cause volume in my belly. TMI...suppository today with no luck.  They believe this is the source of my pain.  I disagree as I deal with this all the time and have no pain.  

I am seeing my surgeon on Friday but not hoping for much.  He is a good surgeon but no leaks his job is done.  I don't know why a surgeon would think Tylenol would help this type of pain.  I have tried.  I guess my real concern is that the pain is constant and has not improved since I left the hospital. I have a high tolerance for pain.  I did a bilateral knee replacement last year and weaned myself off pain meds. 

Thanks for the support.  I am hoping that time will improve things.  

I'm so sorry you are having so much pain.  Do you think the constipation pain could be different because of the surgery?  Seems reasonable that "normal" constipation could feel differently from constipated bowel that's just been cut and stitched?? Whatever the cause I hope you get some relief soon as I know you must be feeling desperate.  Are you able to do any walking yet?  I know that always helps me get things moving.  You know what works best for you of course.  Does a heating pad to the belly help your discomfort at all?  I'm just so sorry you're hurting, wish I could help!

Sending gentle hugs and hopes for a better day tomorrow!

Share this post


Link to post
Share on other sites

Hi Kim - I hope a new day is bringing you some relief from pain. That doesn't sound fun at all. Sending healing vibes!

Share this post


Link to post
Share on other sites

Checking in to see how you're doing this morning Kim.

Share this post


Link to post
Share on other sites

I met with my surgeon on Friday.  So I am not sore and a slow healer.  He told me that when doing the surgery the instrument they use kept falling and that I have a very thin stomach wall.  He explained that the pain I am experiencing is nerve pain. He said the nerves have to grow into the incision.  He tried to do a shot of steroids into the area and said it would help right away or not.  It didn't.  He prescribed medication to help with the nerve pain.  I had taken it when I had my knee replacements.  He said it would take awhile.  

I was suppose to return to work on Thursday but he said give it another week and see how I am feeling.  Weird thing is he said I could take Advi as there is a lot of inflammation.   I know this is a medication that I could not take with the sleeve and from what I have read can cause ulcers with bypass.  He doesn't want me on the narcotics as they constipate.  So I wear a large tight band around my belly to hold everything in place.  Otherwise just trying to manage the pain.  I haven't been able to sleep in bed more than a few hours and then I have to sit in a recliner. 

Hoping i get relief soon.  Otherwise all is well.  He pushed my food up a week and I am tolerating everything well.  I do admit I am not eating as much as I should.  No appetite. I also need to start my vitamins which I received the other day.  

I have no sense of hunger or fullness.  I just measure how much I am suppose to eat and usually can finish.  Does this change?  I know my stomach is healing but when will I feel a sense of fullness?  this is a very different experience than the sleeve as I knew immediately when I felt full.  

Thanks for all the support.   Hope all are doing well.  

Share this post


Link to post
Share on other sites
2 hours ago, Kim M said:

 

I have no sense of hunger or fullness.  I just measure how much I am suppose to eat and usually can finish.  Does this change?  I know my stomach is healing but when will I feel a sense of fullness?  this is a very different experience than the sleeve as I knew immediately when I felt full.  

 

This does change once your consuming dense protien. For now though all the liquid and purees are flowing through the opening from your stomach to the intestine. With the sleeve, your pyloric valve was stopping that flow and only allowing food and fluids out when it was open. With bypass there's no valve anymore to stop fluids flowing straight through. You'll know soon enough as you progress through to a more diet, when your full. I have to say it is a something I don't like to feel, so I tend to portion very carefully and not give myself enough food to actually get that full sensation.

Share this post


Link to post
Share on other sites

@Kim M Prayers that you heal fast and start feeling better

.

Share this post


Link to post
Share on other sites

Glad to hear you got everything checked out, but sorry that you're still in pain :( 

You're probably not feeling "full" exactly because of the nerves - they need to recover to the point where you can actually feel what's going on in your stomach. Right now, you're not getting reliable signals from there. As you're doing, measure your food until then (and probably after, tbh). @Aussie Bear is absolutely right about the pyloric valve thing. As soon as liquid goes in, it flows right out because there's nothing to stop it now. I was lucky enough to be allowed to watch my leak-test in the hospital, and watching the X-ray live was really fascinating. The liquid flowed straight down to my new pouch, did a loop-de-loop, and shot straight out into my small intestine, in one smooth motion. That will change with denser food, as Aussie mentioned.

Weird about recommending Advil - I'd double check that if I were you. NSAIDs are a definite no-go as far as I know.

Share this post


Link to post
Share on other sites
6 hours ago, Jen581791 said:

Glad to hear you got everything checked out, but sorry that you're still in pain :( 

You're probably not feeling "full" exactly because of the nerves - they need to recover to the point where you can actually feel what's going on in your stomach. Right now, you're not getting reliable signals from there. As you're doing, measure your food until then (and probably after, tbh). @Aussie Bear is absolutely right about the pyloric valve thing. As soon as liquid goes in, it flows right out because there's nothing to stop it now. I was lucky enough to be allowed to watch my leak-test in the hospital, and watching the X-ray live was really fascinating. The liquid flowed straight down to my new pouch, did a loop-de-loop, and shot straight out into my small intestine, in one smooth motion. That will change with denser food, as Aussie mentioned.

Weird about recommending Advil - I'd double check that if I were you. NSAIDs are a definite no-go as far as I know.

Many surgeon's will allow NSAIDS as long as acid blockers are also taken..... Not mine as he is anti NSAIDS even without WLS. Sounds like @Kim M is taking enough of those to cover the Advil.

Share this post


Link to post
Share on other sites

So glad you got information from your doctor.  

You may get a different full feeling.  Mine was a tightness.  But further out if your stomach is sending the full signal and your head is sending the it’s only one more bite signal, listen to your stomach.  It may be months, if at all before you get hunger.  Eat according to the clock as you don’t have much to lose.  

Hope things get better!

Share this post


Link to post
Share on other sites

@Kim M

How are you doing today? Hope you are doing better. 

Share this post


Link to post
Share on other sites
6 hours ago, BurgundyBoy said:

@Kim M

How are you doing today? Hope you are doing better. 

Thanks for asking.  I am pretty fatigued.  I was weak yesterday and finally began my vitamins.  Hope this helps. Also making sure I get enough protein in today.  I was probably a scoop short yesterday. I think pain is also a factor as it is draining.  I got up and did a few things around the house and had to rest in between.  

I am hosting Thanksgiving, having it catered, as this is a tough year.  My Dad passed away in July,  having been the patriarch of our family for 99 years, I felt we all needed to be together.  Ii will be very different without him here.  I thought I would be up to having people over and entertaining.  My daughter and niece will be here and I know they will help.  In the meantime I am following doctors orders.  

Hope you are well and have a wonderful holiday.  

Edited by Kim M

Share this post


Link to post
Share on other sites

I'm glad to hear you're doing a little better at least.  Take it slow and don't overdo with your family...glad you're having it catered!  It will be good to be together this year; all the "firsts" are so difficult and it helps to bear them together.  99 years of memories, what fun you will have reminiscing!  I hope it brings you joy and peace.

Share this post


Link to post
Share on other sites
2 hours ago, msmarymac said:

I'm glad to hear you're doing a little better at least.  Take it slow and don't overdo with your family...glad you're having it catered!  It will be good to be together this year; all the "firsts" are so difficult and it helps to bear them together.  99 years of memories, what fun you will have reminiscing!  I hope it brings you joy and peace.

Thank you so much. I'm sure there will be some tears shed but also gratitude for how long we were privileged to have him with us.  Wishing you a joyous and peaceful holiday.  

Share this post


Link to post
Share on other sites

@Kim M how are you doing?

Share this post


Link to post
Share on other sites

 

On 11/26/2018 at 9:45 AM, tracyringo said:

@Kim M how are you doing?

HI Tracy, 

I am in a lot of pain.  I have been taking Nuerotin and have increased the dosage to 300 mg 3x a day.  The bypass is fine.  No issues.  However, what ever happened during the surgery to cause the nerve pain is quite debilitating.  I still have not been able to go back to work as I can't drive.  I would never be able to sit at my desk or go out in the field.  I am really concerned as I do not feel I am progressing.  I would thing by now 1 month post up things would be getting better.   Kind of bummed out today.  However, I know someone who had the same surgery, for the same reason, with the same surgeon, and was doing great after 2 weeks.  It has been a year since her surgery and she is doing fine.   

How are you doing?   Are you considering a revision due to GERD?  I had GERD for quite some time but it was well managed with 1 PPI a day.   I would not even have thought about a revision. It was only when it became unmanageable that I had to make the decision. It was a tough one.  I really did not want the surgery but I was getting into serious issues with the acid. coming into my lungs at night. Also some days I sounded as if I had laryngitis.  

I hope you are doing well.  Thank you for checking in with me.  

Share this post


Link to post
Share on other sites
4 hours ago, Kim M said:

 

HI Tracy, 

I am in a lot of pain.  I have been taking Nuerotin and have increased the dosage to 300 mg 3x a day.  The bypass is fine.  No issues.  However, what ever happened during the surgery to cause the nerve pain is quite debilitating.  I still have not been able to go back to work as I can't drive.  I would never be able to sit at my desk or go out in the field.  I am really concerned as I do not feel I am progressing.  I would thing by now 1 month post up things would be getting better.   Kind of bummed out today.  However, I know someone who had the same surgery, for the same reason, with the same surgeon, and was doing great after 2 weeks.  It has been a year since her surgery and she is doing fine.   

How are you doing?   Are you considering a revision due to GERD?  I had GERD for quite some time but it was well managed with 1 PPI a day.   I would not even have thought about a revision. It was only when it became unmanageable that I had to make the decision. It was a tough one.  I really did not want the surgery but I was getting into serious issues with the acid. coming into my lungs at night. Also some days I sounded as if I had laryngitis.  

I hope you are doing well.  Thank you for checking in with me.  

I am sorry to hear about your nerve pain. So the GERD is gone now though?   My pill is working for me and I hope I never have any issues later.

Hopefully you will start feeling better soon so you can get back to work and doing the things you enjoy.  Keep updating us on your progress.

Share this post


Link to post
Share on other sites
On 12/1/2018 at 12:04 AM, tracyringo said:

I am sorry to hear about your nerve pain. So the GERD is gone now though?   My pill is working for me and I hope I never have any issues later.

Hopefully you will start feeling better soon so you can get back to work and doing the things you enjoy.  Keep updating us on your progress.

I am still managing the GERD with meds.  It has been 2 PPI a day.   The last few days I have had to get up about 4 am and take another PPI.  I will discuss with my surgeon on Friday.

Share this post


Link to post
Share on other sites
12 hours ago, Kim M said:

I am still managing the GERD with meds.  It has been 2 PPI a day.   The last few days I have had to get up about 4 am and take another PPI.  I will discuss with my surgeon on Friday.

Hmmmmmmm, I suppose when you get farther out and not so swollen inside, you will be able to get off those ?  Hoping you have a fast and speedy recovery.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now