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Port removal and still having complications

Had the port removed due to infection and incision not healing on April 26th the 29th I went to urgent care with 102.6 temp and dry heaves severe pain in left side under rib area. My surgeon told me to tell them I needed stronger antibiotics so they gave me a pain and antibiotic injection and sent me home with a script for more antibiotics, and said if it gets worse I need a CT scan. well a week goes by and I constantly telling my surgeon that I can’t eat severe pain still in my side temp running from 99.6- 102.9, and he says that it will take time for the antibiotics to start working so May 4th I’m up all night same issues as previous week so I called the surgeon to let him know I was going to the ER. The ER DR. sent me for CT scan and come to find out that I have fluid built up in abdominal cavity (left side under ribs)and a bad infection where the port was and at the incision. He tells me I need to be admitted to the hospital but needs to call my surgeon to see which hospital and he tell the ER DR to prescribe me antibiotics two types this time of course and wanted me to call his office Mon. morning. The surgeon called me Sun night after my long stay in the ER and told me he wanted me to come in this morn, and he would draw out the fluid. OK I took in the CD from the CT scan he looked at it then came in and asked me where the fluid was built up at of course I told him I’m not the DR but I can tell him where the pain is. He drew out almost two syringes of fluid and asked me if I felt any relief of course I tell him no. He says call me Wed. and he will let me know what’s next. I asked him if he has ever seen this before and he said no that this is a challenge. I don’t know what to do next it’s been 8 mths and still issues .Any advice is appreciated.

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Personally I'd find a New Surgeon ASAP

Did he remove the port AND the band? Either way something is seriously wrong,did he bother to explain WHY the infection is in the abdomen?

Port-site infection

Port-site infections can be classified as early and late. Early infections will manifest with the cardinal signs of erythema, swelling and pain. These infections typically occur within the immediate postoperative period and may be reduced by the use of perioperative antibiotics. Early infection with cellulitis alone may be treated with oral antibiotics. If the response is inadequate, then intravenous antibiotic use is warranted. When the infection does not respond to intravenous antibiotics and is limited to the port, the port should be removed and the tubing knotted and left inside the abdomen. Once the local infection is resolved, a new port may be placed and tubing connected with laparoscopic guidance. Late port site infections are often caused by delayed band erosion with ascending infection. This usually manifests several months after surgery and can be associated with loss of restriction. These infections typically do not respond well to antibiotic treatment. If left undetected, band infection can evolve into potentially life-threatening intra-abdominal sepsis. Gastroscopy will confirm the diagnosis of band erosion. This complex clinical scenario is treated most expeditiously by removal of the band.

Demand a second opinion. Don't ask, don't suggest. DEMAND! This is your body, your life and it sounds to me as though you are being screwed around.

Definitely get another opinion. Where is this doctor located? I want to make sure I don't use him. It sounds as if he's using you as experiment! If your insurance paid for your surgery let them know. Who knows what will happen but it's YOUR body, not the surgeon's. Don't let that surgeon give you a "let's see and wait" attitude.

Your life is precious and remember doctor's are not gods so everything your surgeon is telling you is not gospel. You deserve the best and I wish you well.

  • Author

Personally I'd find a New Surgeon ASAP

Did he remove the port AND the band? Either way something is seriously wrong,did he bother to explain WHY the infection is in the abdomen?

Port-site infection

Port-site infections can be classified as early and late. Early infections will manifest with the cardinal signs of erythema, swelling and pain. These infections typically occur within the immediate postoperative period and may be reduced by the use of perioperative antibiotics. Early infection with cellulitis alone may be treated with oral antibiotics. If the response is inadequate, then intravenous antibiotic use is warranted. When the infection does not respond to intravenous antibiotics and is limited to the port, the port should be removed and the tubing knotted and left inside the abdomen. Once the local infection is resolved, a new port may be placed and tubing connected with laparoscopic guidance. Late port site infections are often caused by delayed band erosion with ascending infection. This usually manifests several months after surgery and can be associated with loss of restriction. These infections typically do not respond well to antibiotic treatment. If left undetected, band infection can evolve into potentially life-threatening intra-abdominal sepsis. Gastroscopy will confirm the diagnosis of band erosion. This complex clinical scenario is treated most expeditiously by removal of the band.

He only removed the Port the band is still there.No he did not explain anything.

  • Author

Definitely get another opinion. Where is this doctor located? I want to make sure I don't use him. It sounds as if he's using you as experiment! If your insurance paid for your surgery let them know. Who knows what will happen but it's YOUR body, not the surgeon's. Don't let that surgeon give you a "let's see and wait" attitude.

Your life is precious and remember doctor's are not gods so everything your surgeon is telling you is not gospel. You deserve the best and I wish you well.

He is in Arizona Thats kind of funny because when I was calling him with severe pain in my side he acted like that had nothing to do with the surgery I had two days earlier until the ER DR had the CT scan done I don't think he believed that I was in pain or having any issues.

I'll attach the link to the previous information http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038361/

This Link is a SURGEON'S GUIDE to LB complications: I'd copy it and take it to him.

He is in Arizona Thats kind of funny because when I was calling him with severe pain in my side he acted like that had nothing to do with the surgery Unfortunately..too often the Doc's negate our feelings, it's madding that they think were too stupid to understand our own bodies :angry: I had two days earlier until the ER DR had the CT scan done I don't think he believed that I was in pain or having any issue

I believe that so many surgeons only know what has been reported in the manufactures literature and DON'T know how to treat problems from the LB as they arise.

I'm even MORE AMAZED that when things occur, that they EXPECT immediate improvement? If you damage a nerve, and experience pain , once you remove that source of irritation the nerve doesn't immediately respond in the positive just because you removed the source of irritation. It's going to take time.., Sorry ... I just hate that he asked you, now that I removed the Fluid all your pain is gone right?

I sure hope that your feeling better from the antibiotics !! AND find a resolution.

You stated that this has been going on 8 months? has this been infected since your placement surgery sept,20,2012?

Please keep us posted.

HOLY SMOKES!!!! What Dr. did you use, I have my surgery in Phx, I'm going through true results off of raintree.

  • Author

I'll attach the link to the previous information http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038361/

This Link is a SURGEON'S GUIDE to LB complications: I'd copy it and take it to him.

He is in Arizona Thats kind of funny because when I was calling him with severe pain in my side he acted like that had nothing to do with the surgery Unfortunately..too often the Doc's negate our feelings, it's madding that they think were too stupid to understand our own bodies :angry: I had two days earlier until the ER DR had the CT scan done I don't think he believed that I was in pain or having any issue

I believe that so many surgeons only know what has been reported in the manufactures literature and DON'T know how to treat problems from the LB as they arise.

I'm even MORE AMAZED that when things occur, that they EXPECT immediate improvement? If you damage a nerve, and experience pain , once you remove that source of irritation the nerve doesn't immediately respond in the positive just because you removed the source of irritation. It's going to take time.., Sorry ... I just hate that he asked you, now that I removed the Fluid all your pain is gone right?

I sure hope that your feeling better from the antibiotics !! AND find a resolution.

You stated that this has been going on 8 months? has this been infected since your placement surgery sept,20,2012?

Please keep us posted.

I called the office twice yesterday with severe pain in left side pain dry heaves once again and was so ill I could barely walk I had to call twicw because they didnt return the first call 4 hours earlier so the second time they ask me to leave my name and number I got a little upset and let them know I had already left a message with no response, so DR Nirmul called me back and had me go in at 5:15 this morn to have emergency surgery to remove the lapband and suck out all the fluid built up and after the surgery Dr Nirmul didnt even come out and say anything to me or my son, The last 3 times I have gone to the surgery center he always came out and told you what was going some nerve huh. I can tell you I feel better then I have in the last 8 months dealing with this. I will continue to get support from here and continue with my diet plan and work out plan at the gym and will continue to lose the weight. And yes I have been having issues and when you call the office they take a message and dont return your calls they act as though you are bothering them.

I'm sorry that you've had to go through of this. unfortunately too many have to deal with Surgeons that feel they are "too busy" and negate our feelings. When we are NOT Stupid and KNOW better than anyone when something is wrong with our bodies. I myself would have gone to the office and made it clear to the entire office staff, doctor and patient's that might be waiting to see this apparently INEPT Surgeon..that you had called numerous times, and that you didn't appreciate having to come to the office to get answers since you were IN PAIN for >>>>>DAYS . I would have let anyone in the office hear how UNPROFESSIONAL the doctor and staff have been to your requests for help IF need be mention the word Malpractice and for some reason that ALWAYS gets someone's attention. (makes other patients understand what type of treatment they can expect , which sound like little to none) And I'd call the hospital and get a FULL Pre and Operative report so that you can see what exactly what was Done, what he removed and what the findings were. It's YOUR RECORD and all you have to do is request it :)

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