Field trip to the ER

[Snowbutterfly]

I just got home from a 9 he trip to the ER. 2 nights ago I was woken up by intense right upper abdominal to back pain. It got bearable after sleep, but the moment I drank anything it came back full force. So this morning I headed to the ER. After blood tests, xray and Cat scan, the Dr said I had fluid around my pancreas, dilated loop bowel (?) That was not obstructed, and a UTI. She said the fluid was right around the new intestinal conection to the pancreas, but since my hospital doesnt do bariatric surgery she had no idea if that was normal or not. She tried calling my surgeon, but he's on vacation, and his covering is in surgery. So she sent me home with antibiotics, pain meds and directions for a bland diet. I'm curious, does anyone know anything about fluid around the pancreas and if it's normal after DS surgery?

 

[southernlady]

Sorry you are having issues. Have you contacted your surgeon's office or on call since you got home?

 

[Larra]

This doesn't sound normal to me. There is nothing new connected to your pancreas from your surgery, though the pancreas is very close to the part of the duodenum that was operated on. It's possible there could be inflammation in that area, i.e. pancreatitis, related to the pancreas being bothered (pushed on, whatever) during your surgery. I would think, if they thought it was pancreatitis, they would have said so. Among the blood tests, did they check amylase and/or lipase? These would be tests that might show pancreatitis.
If you don't feel better, and definitely if you feel worse, get yourself back to the ER. Even if your surgeon isn't around, docs know how to treat pancreatitis, as it occurs frequently from gallstones (even called gallstone pancreatitis) and also can be alcohol related. The treatment is bowel rest, IV fluids, and antibiotics. Even if you have pancreatitis for an uncommon reason, they treatment is the same.

Keep trying to reach the surgeon who is covering for your surgeon. This is serious.

 

[Snowbutterfly]

Thank you so much for your responses! No where I researched had anything about this so I've been totally confused. I know that you all here are more experts in this surgery so I've been eagerly waiting for your opinions.

@southernlady no I havnt contacted anyone. The ER Dr said she would continue to call the covering surgeon for the rest of her shift and when I got home I was in so much pain I just went to sleep. When i got up it was after hours so didn't think I could call.

@Larra thank u! I'm really good at research but in way too much pain to even begin. I didn't think the ds was connected to the pancreas but that's what the ER Dr said so I just went with it.
Yes they did those blood tests and Dr said they didn't show pancreatitis. Her exact words were "fluid around the pancreas". Then she said her and all the hospital surgeons had no idea if that was a normal occurrence after bariatric surgery or not. She did say they would tell pancreatitis patients to stick to a bland diet so i should do that. I was given antibiotics for the UTI so I think they figured that would cover things.

 

[Settledownnow]

This doesn't sound normal to me. There is nothing new connected to your pancreas from your surgery, though the pancreas is very close to the part of the duodenum that was operated on. It's possible there could be inflammation in that area, i.e. pancreatitis, related to the pancreas being bothered (pushed on, whatever) during your surgery. I would think, if they thought it was pancreatitis, they would have said so. Among the blood tests, did they check amylase and/or lipase? These would be tests that might show pancreatitis.
If you don't feel better, and definitely if you feel worse, get yourself back to the ER. Even if your surgeon isn't around, docs know how to treat pancreatitis, as it occurs frequently from gallstones (even called gallstone pancreatitis) and also can be alcohol related. The treatment is bowel rest, IV fluids, and antibiotics. Even if you have pancreatitis for an uncommon reason, they treatment is the same.

Keep trying to reach the surgeon who is covering for your surgeon. This is serious.

This sounds really serious. I would try to get a hold of your surgeon's office yourself. Go back to the ER if you do not feel better. If they do not have a bariatric surgeon at your local hospital, they can admit you and take you by ambulance to a larger hospital with a bariatric surgeon on staff. If you feel up to it, you can also have someone drive you to the larger hospital and go to their ER for a more definitive diagnosis and treatment plan. I can't recall is this a virgin DS or a VSG to DS revision?

Edited: I see now in your profile this is a revision.

 

[juliebird4828]

SO many years ago on one of my "journeys" I lost about 50 pounds and ended up with pancreatitis due to my gallbladder being sluggish and things backing up into my pancreas. I was very sick and had a lot of pain (thought it was an MI) The pancreas is a touchy organ. Things could be off due to many things. As mentioned- I would call your on call bariatric team to go over your case.

 

[writegirl]

Wishing you a quick recovery and following. Please listen to the vets here. They would not tell you to contact your bariatric team if it was not serious. Your health and wellbeing are serious matters and if the doctors at the ER don't know what they are looking at, their diagnosis can be completely wrong. Be your own advocate! Good luck with it all--sending healing wishes your way.

 

[Clematis]

I hope you feel better. Scary stuff.

Let me take this opportunity to remind you and all DS patients that it is important to have a diagram of the surgery performed on you with you at all times. I have a PDF on my phone and iPad and a hard copy in my car. I never go into an ER without a hard copy to give them. With that in hand, your ER doc could have seen that the anastomosis is not attached to your pancreas. Most docs are unfamiliar with DS but even if they do know, there are now several surgeries being performed that are called the Duodenal Switch but are NOT the traditional, well-researched DS. These Franken-switches are known as Loop-DS, SADI/SIPS or sometimes tragically just called a DS without the patient ever knowing the truth.

I've attached two files: one with the DS graphic alone and one with a small DS graphic and facts about a DS that a physician might need to know.

 

[Snowbutterfly]

This sounds really serious. I would try to get a hold of your surgeon's office yourself. Go back to the ER if you do not feel better. If they do not have a bariatric surgeon at your local hospital, they can admit you and take you by ambulance to a larger hospital with a bariatric surgeon on staff. If you feel up to it, you can also have someone drive you to the larger hospital and go to their ER for a more definitive diagnosis and treatment plan. I can't recall is this a virgin DS or a VSG to DS revision?

Edited: I see now in your profile this is a revision.

Yes, revision. Sorry, I should have given details.
So I'm native and get free healthcare at the hospital I go to. Despite that, it's actually the best hospital in the state. People come all over the world to see how our healthcare is managed. Plus, none of the hospitals have bariatrics surgeons working for them. The 3 surgeons in my state are all private. So getting transferred to another hospital wouldnt do any good Thanks for the suggestion tho, I wish Alaska wasn't so isolated.

 

[Snowbutterfly]

SO many years ago on one of my "journeys" I lost about 50 pounds and ended up with pancreatitis due to my gallbladder being sluggish and things backing up into my pancreas. I was very sick and had a lot of pain (thought it was an MI) The pancreas is a touchy organ. Things could be off due to many things. As mentioned- I would call your on call bariatric team to go over your case.

MI as in heart attack? Yes at one point the pain was in my chest and I was scared it was a heart attack. What did they do for u? How long did the pain last? Did anything help the pain? They had me on morphine in the hospital and that didn't even work.

 

[Snowbutterfly]

Wishing you a quick recovery and following. Please listen to the vets here. They would not tell you to contact your bariatric team if it was not serious. Your health and wellbeing are serious matters and if the doctors at the ER don't know what they are looking at, their diagnosis can be completely wrong. Be your own advocate! Good luck with it all--sending healing wishes your way.

Yes I'll be following their advice. Is it sad I trust the vets more then the Drs? Lol, thank God for this site.

 

[Snowbutterfly]

I hope you feel better. Scary stuff.

Let me take this opportunity to remind you and all DS patients that it is important to have a diagram of the surgery performed on you with you at all times. I have a PDF on my phone and iPad and a hard copy in my car. I never go into an ER without a hard copy to give them. With that in hand, your ER doc could have seen that the anastomosis is not attached to your pancreas. Most docs are unfamiliar with DS but even if they do know, there are now several surgeries being performed that are called the Duodenal Switch but are NOT the traditional, well-researched DS. These Franken-switches are known as Loop-DS, SADI/SIPS or sometimes tragically just called a DS without the patient ever knowing the truth.

I've attached two files: one with the DS graphic alone and one with a small DS graphic and facts about a DS that a physician might need to know.

Thank you!! I never even thought about that. I take it for granted that Drs would know these things.... or at least Google it lol

 

[Snowbutterfly]

So I will call the covering surgeon but it's Saturday. Do u think it would be bad to call on a weekend?

 

[juliebird4828]

MI as in heart attack? Yes at one point the pain was in my chest and I was scared it was a heart attack. What did they do for u? How long did the pain last? Did anything help the pain? They had me on morphine in the hospital and that didn't even work.

Yes,it was in my chest, and I felt like I wanted to vomit but couldn't. Some diarrhea for a little bit. I was in the hospital for 3 days and was on clear liquids. I did have narcotics for pain, but I don't remember what and it was in my IV. I then just stayed very low fat and they have watched my gall bladder ever since. I am grateful that is going to be removed!

 

[juliebird4828]

So I will call the covering surgeon but it's Saturday. Do u think it would be bad to call on a weekend?

NOPE! Not if the pain continues.