Re: Must Read-Babysitter-Liquid going into old stomach and not Pouch

[Guest guest]

Sounds to me like a staple line disruption. Was

her surgery open or lap? If it was lap, then she

was transected. This means that after rows of

staples were put in, the surgeon cut between the

rows, actually separating the pouch and old

stomach. The equipment that is used for lap

procedures automatically cuts between the rows of staples.

If her surgery was indeed open (as is my

suspicion), then it is up to the surgeon whether

or not she was transected. I do NOT understand

why so many surgeons do not transect, although it

is becoming much more common that they do.

It is important to realize that staple line

disruption does NOT mean the patient did anything

wrong, although a lot of surgeons have the

attitude that if anything goes wrong, it is the

patient's fault. That is, er, BULLSPIT! For some

reason, some people's bodies are very efficient

at getting rid of foreign bodies, like staples.

It might be helpful to think of a down comforter

or jacket, with the staple line being like the

stitching between the channels of down, keeping

the down where you want it. If the stitching

comes undone, then the down (food) can go where

you don't want it. If the patient is not

transected, then the body does not seal the area where the staples are.

Think of fastening your fingers together. If you

bandage two fingers together, they just aren't

going to fasten themselves together. If however

you create a raw edge on the fingers first, then

bandage them together, they are much more likely

to heal together. Well, same thing with the

stomach. If the patient is transected, then the

raw edges of the cut are much more likely to heal

together, forming something like a heat seal.

It does happen that the body can form connections

from the stomach to the pouch even when the

patient is transected, but this is VERY rare, and

is called a gastro-gastric fistula. Staple line

disruptions are, sadly, VERY common. Having one

does NOT mean the procedure needs to be reversed.

It just means that the stapling needs to be replaced and TRANSECTED this time.

If the doc who was so concerned is not used to

dealing with RNY patients, he may not understand

that yes, RNY patients lose weight VERY fast.

Yes, it's possible that her labs were perfect.

After all, her surgery has effectively reversed

itself, so if she's been taking her vitamins, she

doesn't have any of the malabsorbtion issues the

rest of us do. In particular, her duodenum, which

is where a lot of vitamins are absorbed, is NOT bypassed.

I wish her luck! I hope she gets the appropriate

treatment, rather than just letting a doc who is

not that familiar with RNY mess with her. Remind

her that she has the absolute right to say NO to

anyone wanting to perform surgery that she is not

comfortable with. It is vital that she fully

understand anything that any surgeon wants to do,

without being bullied into anything.

At 06:59 06/06/2006, Pam Marsh wrote:

>Good mornings. When I stopped to pick up my boys yesterday

>afternoon, my babysitter informed me that she went to the doctor

>after the kids were off to school. She had been having a pain for

>six days in her belly but could no longer take it. She had open RYN

>and had a hernia and a tumor removed at the time of her gastric

>bypass. When she went to the doctor, they did a CAT Scan. She had

>to drink this barium liquid and then they did the scan. The doctor

>called last night to inform her that the liquid went into her old

>stomach and not the pouch and that she should come in today so they

>could discuss options. She had her surgery in mid October of 2005.

>She has lost 173 pounds as of yesterday.

>

>The doctor was concerned that her weight loss was too much too fast

>but her labs were off the chart (perfect). Before this, she had no

>problems. She could not take any type of medicine except for extra

>strength tylenol so that is all she had post surgery (she has very

>high pain tolerence).

>

>I will let you know what they say the reasoning

>is behind this. That is so strange that stuff

>is going into her old stomach. I wonder how

>that could be. She had surgery at

>Airforce Base and not at Kaiser as her husband is military.

>

>Once I hear something from her today, I will let you know. She

>probably has some type of tear or something. I thought this was

>worth reading. Has anyone else known anyone else who had this to

>happen to them. Thanks in advance for your comments.

Eleanor Oster

eleanor@... (personal address)

www.smallboxes.com/gastricbypass.htm

San , CA

Open RNY (100 cm bypassed) 07/15/2003

P. Fisher, M.D., Kaiser Richmond (CA)

~5'9 " tall

05/09/2003 319 Orientation

07/15/2003 ~290 Surgery

Current 157±2 Goal until plastics?

[Guest guest]

Eleanor, thanks for the information. She was

performed open because of the hernia and tumor. Wow!

The surgeons there are fimiliar with the surgical

procedures he is the one that does the surgery there

at Airforce Base.

She said she will call me as soon as she hears

something. The other thing is he had told her that

the barium fluid would come out in her stool and she

said that she had four since the scan and saw nothing

white (which is what he told her that she would see in

her stool). I suppose now she is worried about the

stuff being stuck in the old stomach with no way of

coming out. I will keep you posted about what the

surgeon tells her and thanks again for everything.

Pam Marsh

--- Eleanor Oster wrote:

> Sounds to me like a staple line disruption. Was

> her surgery open or lap? If it was lap, then she

> was transected. This means that after rows of

> staples were put in, the surgeon cut between the

> rows, actually separating the pouch and old

> stomach. The equipment that is used for lap

> procedures automatically cuts between the rows of

> staples.

>

> If her surgery was indeed open (as is my

> suspicion), then it is up to the surgeon whether

> or not she was transected. I do NOT understand

> why so many surgeons do not transect, although it

> is becoming much more common that they do.

>

> It is important to realize that staple line

> disruption does NOT mean the patient did anything

> wrong, although a lot of surgeons have the

> attitude that if anything goes wrong, it is the

> patient's fault. That is, er, BULLSPIT! For some

> reason, some people's bodies are very efficient

> at getting rid of foreign bodies, like staples.

> It might be helpful to think of a down comforter

> or jacket, with the staple line being like the

> stitching between the channels of down, keeping

> the down where you want it. If the stitching

> comes undone, then the down (food) can go where

> you don't want it. If the patient is not

> transected, then the body does not seal the area

> where the staples are.

>

> Think of fastening your fingers together. If you

> bandage two fingers together, they just aren't

> going to fasten themselves together. If however

> you create a raw edge on the fingers first, then

> bandage them together, they are much more likely

> to heal together. Well, same thing with the

> stomach. If the patient is transected, then the

> raw edges of the cut are much more likely to heal

> together, forming something like a heat seal.

>

> It does happen that the body can form connections

> from the stomach to the pouch even when the

> patient is transected, but this is VERY rare, and

> is called a gastro-gastric fistula. Staple line

> disruptions are, sadly, VERY common. Having one

> does NOT mean the procedure needs to be reversed.

> It just means that the stapling needs to be replaced

> and TRANSECTED this time.

>

> If the doc who was so concerned is not used to

> dealing with RNY patients, he may not understand

> that yes, RNY patients lose weight VERY fast.

> Yes, it's possible that her labs were perfect.

> After all, her surgery has effectively reversed

> itself, so if she's been taking her vitamins, she

> doesn't have any of the malabsorbtion issues the

> rest of us do. In particular, her duodenum, which

> is where a lot of vitamins are absorbed, is NOT

> bypassed.

>

> I wish her luck! I hope she gets the appropriate

> treatment, rather than just letting a doc who is

> not that familiar with RNY mess with her. Remind

> her that she has the absolute right to say NO to

> anyone wanting to perform surgery that she is not

> comfortable with. It is vital that she fully

> understand anything that any surgeon wants to do,

> without being bullied into anything.

>

> At 06:59 06/06/2006, Pam Marsh wrote:

> >Good mornings. When I stopped to pick up my boys

> yesterday

> >afternoon, my babysitter informed me that she went

> to the doctor

> >after the kids were off to school. She had been

> having a pain for

> >six days in her belly but could no longer take it.

> She had open RYN

> >and had a hernia and a tumor removed at the time of

> her gastric

> >bypass. When she went to the doctor, they did a

> CAT Scan. She had

> >to drink this barium liquid and then they did the

> scan. The doctor

> >called last night to inform her that the liquid

> went into her old

> >stomach and not the pouch and that she should come

> in today so they

> >could discuss options. She had her surgery in mid

> October of 2005.

> >She has lost 173 pounds as of yesterday.

> >

> >The doctor was concerned that her weight loss was

> too much too fast

> >but her labs were off the chart (perfect). Before

> this, she had no

> >problems. She could not take any type of medicine

> except for extra

> >strength tylenol so that is all she had post

> surgery (she has very

> >high pain tolerence).

> >

> >I will let you know what they say the reasoning

> >is behind this. That is so strange that stuff

> >is going into her old stomach. I wonder how

> >that could be. She had surgery at

> >Airforce Base and not at Kaiser as her husband is

> military.

> >

> >Once I hear something from her today, I will let

> you know. She

> >probably has some type of tear or something. I

> thought this was

> >worth reading. Has anyone else known anyone else

> who had this to

> >happen to them. Thanks in advance for your

> comments.

>

> Eleanor Oster

> eleanor@... (personal address)

> www.smallboxes.com/gastricbypass.htm

> San , CA

> Open RNY (100 cm bypassed) 07/15/2003

> P. Fisher, M.D., Kaiser Richmond (CA)

> ~5'9 " tall

> 05/09/2003 319 Orientation

> 07/15/2003 ~290 Surgery

> Current 157±2 Goal until plastics?

>

>

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