RYGB Surgery for duodenal stenosis

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Petra (a patient from Gtr. Manchester, United Kingdom)

I had quite a few complications, and this was my first ever surgery!

I was in a lot of pain post-surgically, mainly in a knot about 1-2cm under my breastbone – no medication could bring it below 6/10, and the first time I could drink I vomited the small amount of water I’d drank that day… A contrast x-ray was done only an hour or so afterwards, at about seven pm on a Tuesday – the original procedure took place on the Saturday immediately before. After managing to swallow maybe three tablespoons of contrast fluid (it should have been two cups!) I saw on the screen that the fluid wasn’t moving. At all…

The radiologist looked quite worried and raised the table to see if gravity would help… Nothing. After going back to my room the surgeon came to see me a little after eight, and told me that he’d never seen this complication before (not something you want to hear from your surgeon), had no idea what had caused it, and told me that he’d be redoing the procedure immediately – cue me totally freaking out, but quietly as it was really late!

At nine pm I was back on the operating table (even more freaked out as the last time I was anaesthetised in an ante-room, now I was actually on the operating table, complete with those big circular reflecting lights on the ceiling that you see on t.v. right over my head, with a total of three surgeons scrubbing in as another had to come in specially to help!).

The last time I had the procedure I didn’t dream at all during anaesthesia – I just switched off (the anaesthetic wrecked when it was administered, I remember that!), but the second time I did dream after what felt like a period of not dreaming, if that makes sense? I woke up on a bed that was moving up and down, which felt really weird, and a nurse asked if I knew where I was… I replied that I thought I was in Recovery, as that was where I woke up last time – the nurse told me that I was actually in ICU.

On Thursday.

i.e. 48hrs since I was anaesthetised…

This time, I was also in quite a lot of pain, but not in the same place – now my left shoulder hurt so much I would have happily ripped it off! One of the nurses didn’t actually believe that my shoulder hurt instead of my abdomen, but the next nurse I mentioned it to told me that it was referred pain from my diaphragm. Interestingly this meant that my stomach barely hurt at all!

I guess that my body couldn’t cope with everything that had happened as I ended up having some sort of fit a few hours after waking, during which I was conscious but couldn’t control neither my muscles nor the groaning noises I was making – I must have frightened a lot of the other patients and I still feel horrible about that! Plus I was still in my surgical gown so I’m pretty sure half the nurses got to see my behind when I was rolling about 😀

It took a few different medications to calm things down, and as one of them caused vomiting they emptied my stomach by suctioning through my NG tube – a very unique experience, which didn’t actually stop me throwing up anyway! It feels like my stomach is now just below my left rib, but I’m not sure how much is actually located there, if that makes sense?

I was in hospital for a total of two weeks, with four laparoscopic incision sites, two drains (BTW the nurse didn’t know how deep they were and so removed them without pain relief, an extremely unpleasant and unexpectedly noisy experience), along with the NG tube, a catheter, and a central line for IV nutrition, drug administration, blood samples, etc. so it got a little complicated when trying to get out of bed for physio!

It all went comparatively smoothly from then on, aside from an episode of extreme dumping syndrome after being prescribed the “new concentrated” Ensure – in other words, very concentrated corn syrup… I was so happy I had a private room as there’s no way I would have made it to the bathroom of I was on a ward! I was initially unable to tolerate milk, but as I have always pretty much lived on the stuff and couldn’t tolerate meal replacement drinks like Ensure, I surprisingly managed to build up a tolerance during the first week after discharge.

I still can’t manage most sugars, and sometimes it doesn’t make a lot of sense (I can manage two spoons of sugar in a cup of tea, but a centimetre long piece of a strawberry lace sweet will make me feel ill within 30 seconds of eating it!) and I’m still feeling quite weak just under two months post-discharge, but I’m going back to work tomorrow on a phased return, which I’m glad of as I still need to take naps during the afternoon! Stretching in the morning is weird as the incisions have healed closed, but the muscles aren’t fully back to normal as they hurt if I stretch too much…

I’m currently using silicone gel patches on the incision sites as they are the only form of scar reduction for which there is any scientific evidence proving that they make any difference. I used E45 moisturiser when the incisions weren’t quite fully healed but were close enough to use a product on (just over a week post-discharge, or two weeks post-surgery), and layering it on thickly with Vaseline on top really helped with itching and dissolving/removing any stitches that were poking out. The patches are a little expensive but I only needed half of one to cover all six scars/wounds: 3cm scar under left rib (main surgical site and the largest & most painful incision wound); 2 further, very slightly smaller scars in the centre of my abdomen and on the right under my rib (second laparoscopic instrument and camera?); drain tube site immediately under my navel with a second, wider drain slightly above and to the right of the right scar (both were about 1cm when fresh but are now half that length), and finally one small scar (2-3mm) on the right side of my neck where the central IV line went in, with a teeny dot of a scar just above where the line (essentially a small tube) was stitched into the skin to stop it from being pulled out accidentally – after all it did go straight into my jugular vein! I’m really happy that I was unconscious whilst all those tubes were fitted…

My experience was very unusual, so I hope it doesn’t scare anyone or put them off – the vast majority of people are absolutely fine, but I’d had the stenosis for almost a decade and was chronically malnourished – I only managed to keep going so long, including working full time, as I was living off coke (the drink!) to the point where I was drinking 10 – 15 cans a day… It’s still hard to believe that all this happened during my first ever surgery though 😀

Question now is whether I can build up a tolerance to sugar, at last in small amounts – I REALLY miss chocolate!

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