Pain, Not feeling well, advice please

[mjb123 3]

So I am 5 weeks out now and had the sleeve. Have done great and getting better everyday, until when I got up today, I didn't know if I was hungry or if I just needed to take a zantac. My tummy wasn't feeling normal. I took the zantac and later had 1/4 of pb and jelly. I actually was feeling hungry or something all day which isn't normal for me now. I haven't been hungry for like 3 weeks. I made supper and told my husband I didn't know if my belly was upset or if I'm just hungry. So I ate a little because I hadn't eaten anything except the pb and j all day. I immediately started feeling all of this pressure in my lower ab area. Pressure like I had to pee or ... real bad. And my back is hurting too, between my shoulder blades and it hurt to even walk around. I laid down for a bit, but that was uncomfortable so I sat on the toilet for like an hour and tried to go but nothing. It started hurting so bad I was crying some. I called the surgeon on call and he thought since it hurt to put pressure on my lower belly that I should go to the hospital and have a scan.

Now for the "bad me" part. I listened to the surgeon and my husband took me to the emergency room. None of them had heard of my type of surgery, and they didn't understand when I said that the only pain meds I could have was tylenol because everything else was either not allowed or makes me sick. They questioned this. So they tell me I may have appendicitis (sp) which isn't at all where I feel the pain, it is more in my bladder and lower belly, not to the right or left. They wanted to hook me up to an iv and have me drink 300 cc of the contrast in a half an hour, then wait another couple hours befroe the scan. The doctor told me everything was going to take like 6 hours. I just thgouht OMG, no way possible could I get anywhere near that amount of Fluid down that quick and I can't possibly stay in this ER room for that long without going crazy. So then they tried to do the iv and let me tell ya, I have BEAUTIFUL veins. No one has ever had problems with my veins. This nurse stuck one in a place I've never had one, like right in the side of my arm, and after 15 minutes of trying and me getting so dizzy and nauseas like I was going to pass out, she decided to try someplace else. I stopped her there.

I was so discouraged at this point that I said to my husband, maybe I should just sleep on it, take some stuff for Constipation and see if that helps. He got furious and asked if I was serious. I wasn't comfortable with the lady doing the iv, I was so dizzy from her doing it, they had never heard of my surgery and I admit I was scared they were going to hurt me because if they hadn't heard of my surgery, how could they possibly know how to treat me properly. I asked my husband if I could leave and he left it up to me and I did. He is so mad at me, and I know I should have stayed but I just couldn't.

So I went to cvs and got some Milk of Magnesia to try incase I'm constipated. I haven't ever been constipated so I don't know what it feels like and I had a normal, but small bm yesterday. I know tmi..... sorry. I also don't know what a bladder or urinary track infection feels like. Could anyone enlighten me. Has anyone ever had this type of pressure and pain? I'm hoping it is a simple fix and that I am just constipated or something. I'm hoping to get better without going back to our local hospital. I would just die if I have to go back there.

[groovearmada 14]

Can you find another hospital with a bariatric department?I think i would have done exactly the same thing as you!

[mjb123 3]

Can you find another hospital with a bariatric department?

I will look into that. My clinic that I had the surgery doesn't have the ability to do the scan, or I definately would've driven there to get it done.

[Caliblonde 25]

Maybe ask your surgeon's office which hospital in the area they recommend?

[groovearmada 14]

RE bladder and urine infection, it certainly doest sound like that. Ive had a few over the years, used to get them a lot but that was never the kind of pain. Does it hurt when you pee? Usually that is the main sign, well for me anyway. Know everyone is different. I would pee and it would be sore then when i was finished i would still have a sharp stinging pain continue. UUUggghhh. Flashbacks. Horrible!

I have had consipation and what you describe does sound like that.

[Foxbins 625]

If you had a BM yesterday it's unlikely you are constipated today unless you are very dehydrated. With regards to your questions about bladder and urinary tract infections, mostly it hurts (burns) when you pee, you feel like you have to pee and can't, and you feel like you have to pee often. For a bladder infection the area just above your pubic bone is sore. Do you have a fever?

Appendicitis can sometimes feel like generalized abdominal pain early on and only localizes over the right side later. You should really have some blood work done. If you continue to feel this bad, go back to the ER; certainly I think that you should call your surgeon's office in the morning. Please let us know what happens.

[mjb123 3]

It sounds like I don't have the bladder or urinary track infection. It doesn't hurt to pee at all, just a lot of pressure there. I could be dehydrated. I stopped measuring thinking I was doing good just drinking as I needed to and getting the 64 in, but I'm probalby not, and definately haven't today.

Thank you for your words of wisdom so far!

[klus263 9]

What about going back to the hospital where you had surgery? There should be someone on staff that may be familier with VSG. Or if anything they should have called your doctor for a phone consult. Another possiblility could be your gall bladder. With rapid weight loss we are more like to get gall stones. As for the Nurse trying to do the IV, You should had requested a different lab technician for the IV, I would not have tolerated that more than 5 minutes.

My husband had to have his VSG done 150 miles away but mine was at a local hospital on the other side of town. We have already discussed that if either one of us has any medical issues and need the ER we will travel back to the hospital that did my surgery since are classified as a Bariatric Center of Excellance.

Good Luck and keep us posted on how you are doing.

[meggiep 57]

I don't want to come down on you but you could have something seriously wrong and you need to have this checked out. You had major surgery a short time ago. Don't let your discomfort keep you from getting this taken care of. Your doctor sent you to the hospital so you essentially left against medical advice. I really do not think you will die if you go back there but you are playing with fire if you don't.

Edited to add- I just re-read your post and noticed you ate pb&j- I know it is often mentioned that bread can cause extreme discomfort as is absorbs liquid and swells. I have heard t can cause a lot of pain. Perhaps that is the issue.

[Can'tweight 41]

It sounds like I don't have the bladder or urinary track infection. It doesn't hurt to pee at all, just a lot of pressure there. I could be dehydrated. I stopped measuring thinking I was doing good just drinking as I needed to and getting the 64 in, but I'm probalby not, and definately haven't today.

Thank you for your words of wisdom so far!

Try to pinch and pull the skin on the back of your hand and hold for 3 seconds, then let go. If it slowing goes back into place, you are probably dehydrated. The longer it takes the skin to return to normal the more dehydrated you are. If it springs back quickly, it's probably not that.

I would call my surgeon's office this morning!

[BajaMedGroup 6]

So I am 5 weeks out now and had the sleeve. Have done great and getting better everyday, until when I got up today, I didn't know if I was hungry or if I just needed to take a zantac. My tummy wasn't feeling normal. I took the zantac and later had 1/4 of pb and jelly. I actually was feeling hungry or something all day which isn't normal for me now. I haven't been hungry for like 3 weeks. I made supper and told my husband I didn't know if my belly was upset or if I'm just hungry. So I ate a little because I hadn't eaten anything except the pb and j all day. I immediately started feeling all of this pressure in my lower ab area. Pressure like I had to pee or ... real bad. And my back is hurting too, between my shoulder blades and it hurt to even walk around. I laid down for a bit, but that was uncomfortable so I sat on the toilet for like an hour and tried to go but nothing. It started hurting so bad I was crying some. I called the surgeon on call and he thought since it hurt to put pressure on my lower belly that I should go to the hospital and have a scan.

Now for the "bad me" part. I listened to the surgeon and my husband took me to the emergency room. None of them had heard of my type of surgery, and they didn't understand when I said that the only pain meds I could have was tylenol because everything else was either not allowed or makes me sick. They questioned this. So they tell me I may have appendicitis (sp) which isn't at all where I feel the pain, it is more in my bladder and lower belly, not to the right or left. They wanted to hook me up to an iv and have me drink 300 cc of the contrast in a half an hour, then wait another couple hours befroe the scan. The doctor told me everything was going to take like 6 hours. I just thgouht OMG, no way possible could I get anywhere near that amount of Fluid down that quick and I can't possibly stay in this ER room for that long without going crazy. So then they tried to do the iv and let me tell ya, I have BEAUTIFUL veins. No one has ever had problems with my veins. This nurse stuck one in a place I've never had one, like right in the side of my arm, and after 15 minutes of trying and me getting so dizzy and nauseas like I was going to pass out, she decided to try someplace else. I stopped her there.

I was so discouraged at this point that I said to my husband, maybe I should just sleep on it, take some stuff for Constipation and see if that helps. He got furious and asked if I was serious. I wasn't comfortable with the lady doing the iv, I was so dizzy from her doing it, they had never heard of my surgery and I admit I was scared they were going to hurt me because if they hadn't heard of my surgery, how could they possibly know how to treat me properly. I asked my husband if I could leave and he left it up to me and I did. He is so mad at me, and I know I should have stayed but I just couldn't.

So I went to cvs and got some Milk of Magnesia to try incase I'm constipated. I haven't ever been constipated so I don't know what it feels like and I had a normal, but small bm yesterday. I know tmi..... sorry. I also don't know what a bladder or urinary track infection feels like. Could anyone enlighten me. Has anyone ever had this type of pressure and pain? I'm hoping it is a simple fix and that I am just constipated or something. I'm hoping to get better without going back to our local hospital. I would just die if I have to go back there.

So here is some medical advice:

In regards to appendicitis, the pain begins in the umbilical area and then will localize in your right flank. In addition if you 'draw' a straight line from your hip bone (iliac crest) to your navel you should feel some pain to light pressure (specifically one third of the way there -- called McBurney's point). The other clinical sign we look for is a tender abdomen, called an 'acute abdomen'. If you take your index finger and literally 'poke' your abdomen with medium force and it hurts, we call that a positive rebound sign. If all three are present and you start to present a fever, I would go to the ER ASAP.

A word of caution: If you are taking pain med's they will 'mask' an appendicitis. What does this mean? When you clinically present appendicitis, your body sends out warning signs like the ones I described. If you take ANY analgesic it might 'hide' that clinical feature that your body is 'yelling out'. If you are taking acetaminophen, your fever will go down, which also, 'masks' the clinical signs. In any case, if they ran blood tests (which they should have) in the ER, then they would have seen if you have leukocytosis...which is a white blood cell elevation that is classically seen in appendicitis.

Furthermore, I am SHOCKED, that they do not know what a vertical sleeve gastrectomy is. I saw a ton of them as a 3rd year medical student!! Also, it sounds like you do not have a UTI, which some fellow 'sleevers' very accurately posted above, so I will not 'rant' about those.

My final warning: Take your blood pressure often (~3 times/day)!! Why? As many know, one of the risks of this surgery is gastric bleeding. If your BP drops below 105/60 (ball park), go to the ER. If your heart rate goes above 110 beats/min, go to the ER. If 'inside' your lower eye lid you see a very pale red to white color (it should be nice and red), it is a warning sign. If your nail beds get pale, it is also another warning sign. Finally, if you feel light headed and clammy/sweaty, definitely go to the ER...and PLEASE take a print out of what a VSG is!!

Best of luck and please keep me posted!!

(I hate to do it but here it is...)

**Disclaimer: No medical diagnosis should ever be made without the doctor present. This post is merely an insight as to what 'typical' medical scenarios turn out to be. If any doubt arises, go to your physician immediately. No diagnosis or medical evaluation is to be extracted from this text.

Best,

Dr. JSA

[mjb123 3]

My surgeon's head nurse called me this morning. I let her know I really think it was Constipation, after the milk of magnesia kicked in it was pretty obvious. She let me know, skip the local er and just come there next time and if I start to feel worse to come see them. Although they can't do a scan they could evaluate me and forward me on to a hospital close that would understand what i've been through. It's only a little over an hour away but worth it for the peace of mind since I'm so scared of people hurting me. My arm is very painful today where the er nurse failed to get the iv in. Horrible, ugly bruise. I am feeling better today. The pressure I was feeling is going away a little more with every bm, just still in a little pain, probably from being so backed up but the pain I was feeling in my back is gone. Temperature is good and I have done that skin test to see if I'm dehydrated and I think I'm ok there. I'm back on liquids for awhile, which is fine for me, and she wants me to make sure I am introducing more Fiber regularly, but to make sure I'm drinking plenty because even the benefiber can constipate me if I'm drinking enough with it.

I know looking back at what I did was foolish of me for leaving and I just should've let them get the scan done, but I just was so uncomfortable and really scared for some reason.

I was only eating about half a piece of bread with my pb and j and had actually only done that for a couple days. I started noticing as I increased my Protein through foods, which cheese is my go to food, that I was becoming less regular. So I'm thinking too much cheese.... But I will remember that about the bread.

Thank you for everyone's feedback. I really appreciate it.

[DonnaC 0]

Glad you got it figured out. This was a great thread and something most of us should read. My first thought was gallstones. I swear you had every symptom I had - and it comes and goes.

Lol - even with the band I swear I became obsessed with Bowel movements. It got to the point where I actually had to put them on the calendar to make sure I was doing what I needed...

It's going to be interesting with the plication as I think I will be eating even less than with the band for the first couple of months...

Donna