Sleeve Stricture Or Obstruction?

[Capt Kirk 2]

So, my wife had a VSG done about 5 weeks ago, a week out she started having extreme nausea and dehydration. They admitted her 3x before they decided she had an obstruction and put a stent in.

She was discharged with a stent and about 12 days after having the stent placed, she could no longer get Water down. Back to the hospital she goes, and they find out the stent has folded over and they take it out. She feels great, and is sent home. For the last 10 days she's been eating and drinking just fine, but the cramping and nausea started again 2 days ago. Today, she can't get any Water down, it immediately comes back up.

She called the surgeons office again and they seem clueless. She mentioned that she read that she may have another stricture or obstruction. The Physicians Assistant (by the way, the Surgeon refuses to talk to us directly) says it can't be an obstruction and that it's just what sleeve patients go through. I'm at a loss of what to do here. They want her to come in for "hydration and anti-nausea medication"

Any thoughts on what might be causing this? Can't keep anything down, extreme nauea and vomitting, and cramping.

[NicholePerlatti 7]

Go see a different doctor? Or go to the ER would be my suggestion. Obviously this Dr is not taking the situation seriously.

[Capt Kirk 2]

Well, that's a good question, do I just randomly call up a different WLS at a different hospital? How does one go about doing that? Going to the ER wouldn't do anything, simply because he IS the only WLS at that hospital, so the ER is just going to refer to him.

Even when the stent was placed, it wasn't placed by him, he had it done by a different GI doctor not even related to his practice.

[notime 340]

How about trying the other GI doctor?

[Ready4success 380]

Well' date=' that's a good question, do I just randomly call up a different WLS at a different hospital? How does one go about doing that? Going to the ER wouldn't do anything, simply because he IS the only WLS at that hospital, so the ER is just going to refer to him.

Even when the stent was placed, it wasn't placed by him, he had it done by a different GI doctor not even related to his practice.[/quote']

If she goes to the ER, she'll be seen by an ER doctor first. They should do a full work-up before deciding what the diagnosis is. When she was diagnosed with the structure, what diagnostic studies did they do to determine that diagnosis? Demand those same diagnostic tests, and start from there. It could be the same thing or it could something else, but considering her history, the doctor and PA shouldn't take it lightly. I would call the surgeon's office first, and tell them you're heading to the ER, so they can expect the consult call.

[Capt Kirk 2]

If she goes to the ER, she'll be seen by an ER doctor first. They should do a full work-up before deciding what the diagnosis is. When she was diagnosed with the structure, what diagnostic studies did they do to determine that diagnosis? Demand those same diagnostic tests, and start from there. It could be the same thing or it could something else, but considering her history, the doctor and PA shouldn't take it lightly. I would call the surgeon's office first, and tell them you're heading to the ER, so they can expect the consult call.

Thank you... the last time she was in the hospital, they diagnosed her with "constipation" and loaded her up with Zofran and as soon as she could get fluids down they discharged her. 6 hours later, back at the hospital because all fluids were coming up. This time they did a barium swallow and said she had narrowing but this was due to her throwing up lots. Once again, lots of fluids, and sent home. Fast forward overnight, back to the hospital in the morning, fluids coming up again. This time I basically yelled at the PA (because we still had not seen a real doctor yet, in over 72 hours). This time I basically said WTF are you guys doing??? Barium swallow and endoscopy. Before she had even returned to the room for the endoscopy the nurse had came back to her room and told me she's being prepped for surgery the next day to have a metal stent placed.

So, I've done some research on these metal stents that are placed for strictures, and there is over a 40% recurrence rate for obstructions due to the way the metal stent works. Most hospitals use silicon now. Now, I'm not a doctor, but I sure as hell can read a medical article and understand it.

[lessofmeismore 1,405]

When was her surgery? What is she Eatting? And how much?

It could just be her sleeve, I had rough days/weeks but I'm not sure what she's been eatting and how much etc.

If she is becoming dehydrated, the ER would definitely need to see her.

Your both in my prayers!!

[Capt Kirk 2]

She had surgery on the 16th of August and has been eating bits of this and that. The last few days she hasn't eaten anything, not even Protein shakes, as she can't hold anything down.

The last thing she ate was a chicken taco (just the chicken inside).

[lessofmeismore 1,405]

Okay. Bless her heart, she is still very fresh in her recovery and has already been put thru it. My diet at 5 weeks was only mushie puree foods. Things like Soups and oatmeal, yogurt, mashed pot.... I did try some moist canned tuna with a lil mayo and it hurt my sleeve at that stage. I still drank two Proteins shakes a day and a few bites of food was pretty much my days intake.

I would see if she can SIP some pineapple juice. Tiny sips.

Wait a while then try just Clear Liquids for 24 hours and then a very mushy diet for a week. If this helps.

If it doesn't she should seek help for hydration.

Try and avoid meats for another week.

Please keep us updated.

She is very lucky to have such a loving husband!

[Spatters3 315]

um... no. Take her to a GI doctor or the ER at a different hospital as soon as you are able. Write down everything that has happened so far (copy and paste your own postings into a Word doc and print it out) and take it with you to show the doctor. This sounds like a medical emergency and not just her sleeve "acting up".

[lessofmeismore 1,405]

Spatters is right.

Try and get some Fluid in her til u get to the ER.

Ask them what type of diet she should start once she is home and on her way to recovery since she has had so many complications.

I only mentioned the above info. to help until your decision was made...