- Spent the week hospitalized after breaking a femur (but not my hip!) in a fall on a wet marbled bathroom floor (not mine). I had my DS here 11 years ago. I was on the ortho unit, in pain, on opioid painkillers, and trying to advocate for myself. Vitamin D was mandatory for all patients, but not dry D. Since it was over the July 4 weekend, my bariatric surgeon was not available, and despite my attempt to educate the hospitalist about dry vitamins after D.S, I was told I had to follow protocol. I was taking 50,000 IU dry a day at home but they said that was dangerous and gave me 2,500 IU oil-based. Other than calcium, none of my other vitamins were considered necessary. I was denied a high protein diet, and was told by the staff nutritionist that I was no longer considered a bariatric patient (!) and at my age (64) I should be on a normal protein diet. This is at a teaching hospital and one of the premier metabolic surgery sites in the US. I learned from the ortho surgeon that my bones were "pretty good for my age" and if they hadn't been, I would have had a hip fracture. Lesson #1. In retrospect, after discharge, I see that I should have called the bariatric resident to get involved in my vitamins and diet, but at the time, with all the stress and pain, I just didn't think to do it.
- Then, I randomly encountered another long time surgery patient (RNYer) who was there after developing chronic abdominal pain for at least 5 years that had not been traced to a diagnosis nor relieved. She vomited after most meals, had lost all her teeth at age 30, ate an unrestricted diet (hamburger with bun and chips), depended on painkillers and other psychotropic drugs year round, on disability, but was at a normal weight. Lesson #2. I am so lucky in my decision to have DS. She is paying a very high price for weight loss and I felt terrible that someone who chose RNY at age 25 may have forever changed her quality of life.
- lesson #3. I have to be part of the solution. I will follow up with surgeon so he knows the his institution's hospitalists and nutritionists in other departments do not know how to care for DS patients.
- Lesson #4. in the ER find out if your surgeon is in network. Terrible that you have to make decisions at a time you are least able to do so.
Hospitalization lessons
- Thread starter KathrynK
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aaa
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I'm sorry to hear all you went through. I hope you're feeling better now.
The thing about the bariatric resident is true. I was fortunate to go to the ER a couple of times where I'd had my WLS. They called the bariatric resident right away. I, too, learned that we need to do that when we come in.
The thing about the bariatric resident is true. I was fortunate to go to the ER a couple of times where I'd had my WLS. They called the bariatric resident right away. I, too, learned that we need to do that when we come in.
OMG! Not a "bariatric patient"? Denying you what you need? Unbelievable. I had total knee replacement and told my surgeon that I would need to continue my vitamin and supplement regimen. Not only did he have no objections, he was very implicit in his orders about my use of "at home" regimen. That including the use of protein shakes that were kept in a refrigerator. The nurses asked if I had taken them. This was with full disclosure of everything I took to make sure there was nothing that would cause an interaction. Due to the clotting properties of Vitamin K and the need for anticoagulants, I did not use that until I stopped the anticoagulants.
There has to be something that can be done. A letter to the hospital administrator or ombudsman? Complaint to the hospital board of your state's licensing agency?
I also appreciate your actions and sharing this with us. It's excellent reinforcement of the reality that we have to be our own advocates.
Best wishes in your recovery.
There has to be something that can be done. A letter to the hospital administrator or ombudsman? Complaint to the hospital board of your state's licensing agency?
I also appreciate your actions and sharing this with us. It's excellent reinforcement of the reality that we have to be our own advocates.
Best wishes in your recovery.
Hoping you are better now, now HEAL!
Getting a bariatric doc/resident only works if they KNOW about the DS and not the shit many of them spout about vits and food after a DS.
Fighting this battle is easier if you use the term "medically induced short gut syndrome" and tell them that protein is vital as you don't absorb at the same level as a normal person. Using the words "bariatric surgery" or WLS or DS only confuses most of them cause the ONLY one they are familiar with is the crap band or the rny.
When I had my last back surgery in 2013, it was a small local hospital with NO bariatric program. During my pre-op, I insisted on talking to the nutritionist. And we talked after I got to my room as well since the staff was clueless...She did the best she could given her limitations. Best option, have your spouse or S/O to bring your stuff along with protein to you.
Getting a bariatric doc/resident only works if they KNOW about the DS and not the shit many of them spout about vits and food after a DS.
Fighting this battle is easier if you use the term "medically induced short gut syndrome" and tell them that protein is vital as you don't absorb at the same level as a normal person. Using the words "bariatric surgery" or WLS or DS only confuses most of them cause the ONLY one they are familiar with is the crap band or the rny.
When I had my last back surgery in 2013, it was a small local hospital with NO bariatric program. During my pre-op, I insisted on talking to the nutritionist. And we talked after I got to my room as well since the staff was clueless...She did the best she could given her limitations. Best option, have your spouse or S/O to bring your stuff along with protein to you.
Bagaof4
Well-Known Member
You are so right here, Liz. I went in for my final preop appointment for hip replacement today. I have been told repeatedly that I need to stop all vitamins 2 weeks before surgery and so this time I went right to 'short gut syndrome' explanation. Telling anyone I have had a DS means nothing. This time, the doctor seemed to 'get it' and we went over every single supplement I take and other than the K and multi (I don't take E at this point except what's in my multi), he told me to continue taking all my vites! I almost fainted!
DSRIGGS
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If you are hospitalized again bring your own vitamins because the pharmacy won't have what you need anyway for vitamins. I have done that when I was in for severe malnutrition. The pharmacy will check them in and label them so your nurse can give you.
I have been in several times and had to do that.
Regarding diet you can definitely get a high protein diet.....yes, if happens again scream until they meet your dietary needs and call your bariatric or gp to get diet changed. When I had my revision Dr K put in high protein diet and somehow it restricted something and messed it up. The next morning the nurse told him and she told him what to do. Lol he grabbed her and went out to the desk and said no I am going to log in and you check the right boxes to make it work. After that I could order anything g I wanted and I wanted 3 meals instead of one they did it as well as if I needed food in between scheduled meals.
Now when I was I for my hernia repair they sent breakfast and there was literally no protein at all on the plate but the little egg wash on the french toast. They said owe you didn't order last night so we just brought you a standard tray....I said that is nice but I need protein and I need my eggs, bacon, sausage, peanut butter toast and coffee now....they brought it. I have been in hospital enough with my son or me enough over the last six years that I don't take no for an answer. Yes I can be a real Richard cranium if need be.
Finally, tell the asswipe who wouldn't give you your vitamin and protein needs that it is malpractice and your attorney will be contacting him to discuss the settlement unless he wants to go to court (won't go anywhere but hopefully you can scare the piss ant).
I have been in several times and had to do that.
Regarding diet you can definitely get a high protein diet.....yes, if happens again scream until they meet your dietary needs and call your bariatric or gp to get diet changed. When I had my revision Dr K put in high protein diet and somehow it restricted something and messed it up. The next morning the nurse told him and she told him what to do. Lol he grabbed her and went out to the desk and said no I am going to log in and you check the right boxes to make it work. After that I could order anything g I wanted and I wanted 3 meals instead of one they did it as well as if I needed food in between scheduled meals.
Now when I was I for my hernia repair they sent breakfast and there was literally no protein at all on the plate but the little egg wash on the french toast. They said owe you didn't order last night so we just brought you a standard tray....I said that is nice but I need protein and I need my eggs, bacon, sausage, peanut butter toast and coffee now....they brought it. I have been in hospital enough with my son or me enough over the last six years that I don't take no for an answer. Yes I can be a real Richard cranium if need be.
Finally, tell the asswipe who wouldn't give you your vitamin and protein needs that it is malpractice and your attorney will be contacting him to discuss the settlement unless he wants to go to court (won't go anywhere but hopefully you can scare the piss ant).
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Not sure why they understand short gut syndrome but not the DS but I will do whatever works.
Yeah, I have to stop my multi (due to the E) and the NSAIDS but the rest is fine...you just have to make them actually LISTEN...It's like the advice we, as DS'ers get from most surgeons...RNY advice because they are too lazy to tailor it to individual surgeries. Since MOST people having surgery are taking mainly a multi, they just tell people to stop all of them as a matter of course.
And I don't understand why he wanted you to stop the K since that HELPS the blood clot.
Good luck on the hip replacement! Glad you have educated your care-givers in advance!
Thanks! I am on a cane and in outpatient physical therapy, but glad to be home. I am composing a letter to the Patient Services Director and I will copy my surgeon in on it. If I had advance warning, I could have been better prepared. But, as an emergency admission, you throw your fate in their hands. I was not able to be my own advocate in my pain and shock, on top of being medicated with mind-altering drugs. I wonder if I should be wearing a medical alert bracelet that will direct the ER to my surgeons practice.
Great idea!
DSRIGGS
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No doubt when you are an emergency admit that if you don't have an advocate with you and a person that can run home and get things you need like vitamins, it is tough when you are dazed from everything to be your own advocate....especially when they hospitals don't carry our specialty vitamin needs.
The med alert bracelet is a good idea.
Yes, I did have the advantage of being prepared. I still think you were treated poorly. I hope your letter educates people. Hospitals are becoming more patient friendly as patient satisfaction data is more important to their reimbursement. In some ways that is unfair to the hospital when its ER doctor refuses to prescribe boat loads of narcotics to drug seekers. However, it also gives the patient some autonomy over her care.
I'm glad you're feeling better and ready to do some educating/advocating.
This made glad I'm not in health care anymore. Most electronic heath record programs suck. On one hand, it cuts down on mistakes due to illegible hand written entries. On the other, checking boxes often omits necessary detail. I remember when we went from paper to computers at the last place I worked. Good times. LOL
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