Missteps starting to add up

[Shorty5 44]

Hi all, Even though I know that every place is different, I am wondering how much of this is "normal" or standard. I am 2 weeks post-sleeve today. I had a terrible reaction to the surgery, almost uncontrollable vomiting for the first 24 hours. My doc said that about 1 in 20 people have that physiologic reaction to the surgery, and the only plus to it was that in her experience, those people tended to lose the most weight. The next morning, they finally thought to put the compression stockings on me, but never turned them on. They didn't squeeze once.

So Zophran did NOTHING for my nausea, but promethazine (Phenergan) help immensely, but it knocked me out. They gave it to me through my IV in my hand. They sent me home just over 24 hours after surgery, not having kept hardly any liquids down, but thankfully, they did prescribe promethazine suppository and fentanyl and scopalamine Patches. And that was it.

My left hand, the hand with the IV in it swelled up and the vein is hard now. I spoke with 2 of my nurse friends and they say that promethazine should never be used in a peripheral vein and that I was lucky I didn't get gangrene and need an amputation. It's real, look it up. I will likely never be able to use that vein again for an IV.

One and a half weeks after surgery, when I was trying to start the full liquids and some pureed stuff, I got HORRIBLE heartburn. I called in and they said take Pepcid at twice the dosage and Tums as needed. My friend who had had VSG last year couldn't believe that they hadn't put me on something preventatively. It was so bad that even the day after starting Pepcid, I woke up spitting up blood. I tried Prevacid and Mylanta and the heartburn turned off like a switch yesterday, thank the good Lord.

So then yesterday, I called them and asked how long before I should start using my BiPAP again, they had told me to quit using it after the surgery so I wouldn't get gas in my pouch. They told me a month after surgery. Yesterday was my routine recheck with my pulmonologist and she said that they were "trying to kill me." That the likelihood of getting air in the stomach was minimal and that it was even MORE important to use the BiPAP after surgery because of the lingering anesthetic effect in the body.

Since the heartburn is being treated, things are looking up for me, a little better every day, but I am wondering how much of this was preventable. Did you go home on antacids? Did they give you promethazine IV? Did they have compression stockings on you during surgery and after? And did they tell you to keep using your BiPAP or CPAP? Thank you.

Edited April 15, 2014 by Shorty5

[CDP1965 18]

I never had any problems after surgery. I guess I did give some fight in the recovery room when they tried to put me CPAP on so they left it off in recovery. But I used it the rest of my stay in the hospital and have been told to keep using it. I had compression socks on all the time. I was supposed to be in hospital two days because I live so far away. I ended up low on blood count so they kept me a third day just for safety.

They did give me a patch to put behind my ear the night before surgery. They also gave me anti nausea meds in my IV but not sure what it was but it never caused any problems. I never had any heart burn. But was sent home with promethazine that I think I used maybe 1 or 2 times. I am 5 weeks post op now and I do get a little heart burn from time to time depending on what I eat and how much but nothing bad and it don't last.

[KeeWee 470]

being preop, this is scary but I like to be preventative myself even if the dr's dont tell me how to be...which is why I love this site so much...my supply list was long but I feel totally prepared for all possibilities and comfort issues, thanks to previous patient's and who better to learn from.

So I'm just here to learn more...sorry you're in pain and I hope you get some answers soon here or there with your doc at least.

[AuntieLala83 81]

Hi all, Even though I know that every place is different, I am wondering how much of this is "normal" or standard. I am 2 weeks post-sleeve today. I had a terrible reaction to the surgery, almost uncontrollable vomiting for the first 24 hours. My doc said that about 1 in 20 people have that physiologic reaction to the surgery, and the only plus to it was that in her experience, those people tended to lose the most weight. The next morning, they finally thought to put the compression stockings on me, but never turned them on. They didn't squeeze once. So Zophran did NOTHING for my nausea, but promethazine (Phenergan) help immensely, but it knocked me out. They gave it to me through my IV in my hand. They sent me home just over 24 hours after surgery, not having kept hardly any liquids down, but thankfully, they did prescribe promethazine suppository and fentanyl and scopalamine Patches. And that was it. My left hand, the hand with the IV in it swelled up and the vein is hard now. I spoke with 2 of my nurse friends and they say that promethazine should never be used in a peripheral vein and that I was lucky I didn't get gangrene and need an amputation. It's real, look it up. I will likely never be able to use that vein again for an IV. One and a half weeks after surgery, when I was trying to start the full liquids and some pureed stuff, I got HORRIBLE heartburn. I called in and they said take Pepcid at twice the dosage and Tums as needed. My friend who had had VSG last year couldn't believe that they hadn't put me on something preventatively. It was so bad that even the day after starting Pepcid, I woke up spitting up blood. I tried Prevacid and Mylanta and the heartburn turned off like a switch yesterday, thank the good Lord. So then yesterday, I called them and asked how long before I should start using my BiPAP again, they had told me to quit using it after the surgery so I wouldn't get gas in my pouch. They told me a month after surgery. Yesterday was my routine recheck with my pulmonologist and she said that they were "trying to kill me." That the likelihood of getting air in the stomach was minimal and that it was even MORE important to use the BiPAP after surgery because of the lingering anesthetic effect in the body. Since the heartburn is being treated, things are looking up for me, a little better every day, but I am wondering how much of this was preventable. Did you go home on antacids? Did they give you promethazine IV? Did they have compression stockings on you during surgery and after? And did they tell you to keep using your BiPAP or CPAP? Thank you.

I was put on Prevacid as a preventative measure. I was given zofran once through iv but it didn't work so they quickly changed to Reglan. I was given rx promethazine to drink while home but I never had any reason to use it, and compression stocking were used during and after surgery until that night when I was up walking every hour. I had no complications. I don't have sleep apnea so I can't answer the cpap questions .

[Snufflegus 80]

So from support groups I'm apart of the vomiting is normal. So is the nausea. I was nauseous for the first 2 weeks. Simple things like plain Water gave me heartburn, so I took a ppi religiously. Just keep your head up and remember tomorrow will be better. You are doing great!

[TheWigster 70]

I was told to bring my cpap to the hospital and used it immediately after surgery and still use it today. In fact, they insisted that I do not stop using it under any circumstances, unless I get a new sleep study done. I too have acid reflux. I take Nexium daily and I was told to take it the morning of surgery and continued it after surgery and to this day. It has been a lifesaver. I also used compression stockings in the hospital up until I was up walking around.

[becogolfer 68]

I hope you're starting to feel better but if not don't worry. In time you'll get better. I used my cpap in the hospital the night of the surgery. I did have to stop it for about a week because my hiatal hernia repair didn't like me to take a deep breath in for a few days but that passed and I have used it ever since. I have lost enough that I think I can go without out it but am waiting till I hit my goal weight to have a sleep study to see if I still need it.

I did have the pumping booties in the hospital but not at home. If you've been moving your ankles and doing some walking you should be fine. I was pretty miserable the first 2 weeks and then not too happy for another month but over time the pain all fades and you're losing weight and finding you can eat more variety but not too much of course. Hang in there, it gets better.

[swimbikerun 1,045]

I'd want to know a lot about the background of the doctor and group that did this. This sounds like a surgery mill.

[beeteroo 166]

Wow you've had a rough time! Promethazine is ok to give IV in a peripheral vein. They give it all the time in post op patients. It can cause phlebitis which is an inflammation of the vein that should eventually improve. It's should always be diluted to try and lessen the risk of this. It was definitely worth using it in your IV if it helped. I order it on almost every one of my patients post op and patients usually do just fine.

Your bipap/cpap should have been used from the moment you got out of surgery and every time you've slept since. Your pulmonologist is correct....they messed up and you could have had some MAJOR life threatening complications by not using it. Especially since they sent you home on a fentanyl patch and phenergan! Wow! Glad you are alright! Wear that cpap! Get better soon! Hope your heart burn improves too!

[beeteroo 166]

Oh yeah and those compression stockings! Wow! You should call up the hospital and tell them you refuse to pay for those because they were never used on you! They usually use them in the operating room but you should have had those on every time you were in bed! As long as you are being active you don't need them but it never hurts to use them! Get well soon!

[Shorty5 44]

Thank you, everyone, for your encouragement and information. I should clarify. Promethazine saved me. It was the ONLY thing that kept me from turning my GI tract inside out. So I was very grateful to have it. I am just worried about my hand. It swells a little each night, like the veins aren't working right anymore and it is still tender to the touch in some places.

But I am getting better every day. 2 nights back on my BiPAP and I feel like a new woman. I am eating some green bean baby food and a small bit of tuna salad at the moment. First time for both. It appears to be sitting well. The heartburn disappeared once I started the Prevacid twice daily. Not sure I will ever quit taking that.

And I wish I could refuse to pay any of it. I was self-pay and they required payment up front. I negotiated paying $14K (They wanted $15.5K) and the week after mine was done, I saw a promotional price at another place, of $12K. Grrrrrrrrrr.

Oh well, just happy to be recovering. Thanks again, y'all!