Boyfriend's Leak

[sleeversGF 4]

Hi everyone. I've been a lurker for a couple of months now, learning about this procedure. You guys are tough and have been through so much, and I truly admire you.

My boyfriend (of only 2 month at the time of his surgery!) had a band to sleeve revision the 21st of June. I'm a nurse, so I was skeptical (having cared for some patients with some pretty gnarly complications) , but I read and read --and read and researched some more about the procedures and felt pretty okay with it. I was and told him I would be supportive, regardless of the outcome.

His surgeon chose to do the revision and removal all in one day. He did great for two weeks and was moving forward perfectly on his full liquid diet, just about ready to graduate to softs. Right around day 15 or 16, he began getting nauseated with some vomiting. Then fever, so I told him not to ignore it anymore. He went in. Was dehydrated. They did an upper GI series and abdominal CT. Was seen by a gastroenterologist. They sent him in for IV fluids to rehydrate him. And they also did an endoscopy. All of this within 3 days. They found nothing but did widen/ dilate his esophageal sphincter a bit due to the appearance of some narrowing.

By the end of that week, he was in the hospital. They did a CT there. Gave him IV fluids, IV antibiotics and came home 3 days later on oral antibiotics. He got through a 10 day round and started vomiting again, violently 2 days later. He went BACK in to the surgeon and he ordered another round of antibiotics, but he could not tolerate taking them in and by the time Friday rolled around this weekend, he was hardly tolerating very small sips of Water and was vomiting several times an hour. The did another Barium swallow and found what they thought might be a small abscess, but the doc on call didn't want to treat it with his surgeon out of town, and then ordered the antibiotics again and told him to follow up in 1 week. One week and he would have been dead!

I talked him into going to the ER Saturday morning. He called me to tell me he didn't want to do that because he didn't want to be admitted. I did a little nurse magic, and told him they couldn't make him do anything. All he had to do was tell them he wanted to be hydrated only and go home. Luckily, when we arrived, they popped him a bag of fluids, zofran and a dose of pain meds and did a CT of his abdomen. They found the "abscess" but later determined the original CT on 7/15 (at the hospital) had been misread and he had a leak with some minor pooling outside of his stomach.

So now he has been in the hospital 5 days. He has a PICC line in for TPN, tons of IV fluids and antibiotics, is NPO. The gastro doc did the stent this morning, but I wasn't able to be there. She said she would be putting an NG (nasogastric) tube in as an alternate feeding source (in case the docs don't want to keep him on the TPN). He called a bit ago and has been vomiting pretty violently and the Zofran hasn't helped much.

Is the vomiting after the stent normal? He was doing it too much earlier to do the scan to check the stent's placement, so they are holding off until the AM. Someone tell me that this will get better? They found the leak without any major infection in his abdomen. No pain. No fevers. And it wasn't an abscess after all. Just vomiting. So, I certainly think that is a good sign overall, but I'm scared for him.

Thanks for listening-- to this book!!!

~worried girlfriend~

[Tiffykins 672]

I will keep y'all in my thoughts. .

My leak was repaired differently so I can not comment on life with a stent or NG tube. I was on TPN for over 2 weeks, and NPO that entire time.

Things will improve and I hope they can get the nausea under control. Zofran was my saving grace, and I hope he can get some relief.

Please keep us posted on his progress ! ! !

[sleeversGF 4]

Thanks for responding Tiffy. It's frustrating, and I'm trying to be the strong one, of course. I just want him better!! I'm headed up there to see him this evening, so I hope his tummy has calmed down. I'm sure having a foreign object in his esophagus is freaking his system out a bit, but I would hate to see it migrate from the vomiting.

[complex 0]

Hi everyone. I've been a lurker for a couple of months now, learning about this procedure. You guys are tough and have been through so much, and I truly admire you.

My boyfriend (of only 2 month at the time of his surgery!) had a band to sleeve revision the 21st of June. I'm a nurse, so I was skeptical (having cared for some patients with some pretty gnarly complications) , but I read and read --and read and researched some more about the procedures and felt pretty okay with it. I was and told him I would be supportive, regardless of the outcome.

His surgeon chose to do the revision and removal all in one day. He did great for two weeks and was moving forward perfectly on his full liquid diet, just about ready to graduate to softs. Right around day 15 or 16, he began getting nauseated with some vomiting. Then fever, so I told him not to ignore it anymore. He went in. Was dehydrated. They did an upper GI series and abdominal CT. Was seen by a gastroenterologist. They sent him in for IV fluids to rehydrate him. And they also did an endoscopy. All of this within 3 days. They found nothing but did widen/ dilate his esophageal sphincter a bit due to the appearance of some narrowing.

By the end of that week, he was in the hospital. They did a CT there. Gave him IV fluids, IV antibiotics and came home 3 days later on oral antibiotics. He got through a 10 day round and started vomiting again, violently 2 days later. He went BACK in to the surgeon and he ordered another round of antibiotics, but he could not tolerate taking them in and by the time Friday rolled around this weekend, he was hardly tolerating very small sips of Water and was vomiting several times an hour. The did another Barium swallow and found what they thought might be a small abscess, but the doc on call didn't want to treat it with his surgeon out of town, and then ordered the antibiotics again and told him to follow up in 1 week. One week and he would have been dead!

I talked him into going to the ER Saturday morning. He called me to tell me he didn't want to do that because he didn't want to be admitted. I did a little nurse magic, and told him they couldn't make him do anything. All he had to do was tell them he wanted to be hydrated only and go home. Luckily, when we arrived, they popped him a bag of fluids, zofran and a dose of pain meds and did a CT of his abdomen. They found the "abscess" but later determined the original CT on 7/15 (at the hospital) had been misread and he had a leak with some minor pooling outside of his stomach.

So now he has been in the hospital 5 days. He has a PICC line in for TPN, tons of IV fluids and antibiotics, is NPO. The gastro doc did the stent this morning, but I wasn't able to be there. She said she would be putting an NG (nasogastric) tube in as an alternate feeding source (in case the docs don't want to keep him on the TPN). He called a bit ago and has been vomiting pretty violently and the Zofran hasn't helped much.

Is the vomiting after the stent normal? He was doing it too much earlier to do the scan to check the stent's placement, so they are holding off until the AM. Someone tell me that this will get better? They found the leak without any major infection in his abdomen. No pain. No fevers. And it wasn't an abscess after all. Just vomiting. So, I certainly think that is a good sign overall, but I'm scared for him.

Thanks for listening-- to this book!!!

~worried girlfriend~

Hi there - you're very supportive and its great that you're asking questions and insisting that he keep going back. I too had/have a leak. Mine was caught about 10 days out - abscess had formed. They inserted a drain near the stomach and inserted a feeding tube directly to the small intestine, NPO. My doctor told me straight up that a stomach leak can heal on its own but can take up to six months. We tried the stents and I woke up from surgery vomiting and continued for 48 hours - when they removed them. My body has formed a fistula from the stomach leak to the surface of my stomach - it leaks very little and guaze bandage once daily catches everything.

Some people tolerate stents and others do not. It sounds like your boyfriend does not. As I said, I didn't either. Good luck - keeping you in my thoughts.

[smkeller 3]

What a nightmare and all because the surgeon didn't wait until he knew his patient was healed enough from

from the damage that the band had caused.

Hi everyone. I've been a lurker for a couple of months now, learning about this procedure. You guys are tough and have been through so much, and I truly admire you.

My boyfriend (of only 2 month at the time of his surgery!) had a band to sleeve revision the 21st of June. I'm a nurse, so I was skeptical (having cared for some patients with some pretty gnarly complications) , but I read and read --and read and researched some more about the procedures and felt pretty okay with it. I was and told him I would be supportive, regardless of the outcome.

His surgeon chose to do the revision and removal all in one day. He did great for two weeks and was moving forward perfectly on his full liquid diet, just about ready to graduate to softs. Right around day 15 or 16, he began getting nauseated with some vomiting. Then fever, so I told him not to ignore it anymore. He went in. Was dehydrated. They did an upper GI series and abdominal CT. Was seen by a gastroenterologist. They sent him in for IV fluids to rehydrate him. And they also did an endoscopy. All of this within 3 days. They found nothing but did widen/ dilate his esophageal sphincter a bit due to the appearance of some narrowing.

By the end of that week, he was in the hospital. They did a CT there. Gave him IV fluids, IV antibiotics and came home 3 days later on oral antibiotics. He got through a 10 day round and started vomiting again, violently 2 days later. He went BACK in to the surgeon and he ordered another round of antibiotics, but he could not tolerate taking them in and by the time Friday rolled around this weekend, he was hardly tolerating very small sips of Water and was vomiting several times an hour. The did another Barium swallow and found what they thought might be a small abscess, but the doc on call didn't want to treat it with his surgeon out of town, and then ordered the antibiotics again and told him to follow up in 1 week. One week and he would have been dead!

I talked him into going to the ER Saturday morning. He called me to tell me he didn't want to do that because he didn't want to be admitted. I did a little nurse magic, and told him they couldn't make him do anything. All he had to do was tell them he wanted to be hydrated only and go home. Luckily, when we arrived, they popped him a bag of fluids, zofran and a dose of pain meds and did a CT of his abdomen. They found the "abscess" but later determined the original CT on 7/15 (at the hospital) had been misread and he had a leak with some minor pooling outside of his stomach.

So now he has been in the hospital 5 days. He has a PICC line in for TPN, tons of IV fluids and antibiotics, is NPO. The gastro doc did the stent this morning, but I wasn't able to be there. She said she would be putting an NG (nasogastric) tube in as an alternate feeding source (in case the docs don't want to keep him on the TPN). He called a bit ago and has been vomiting pretty violently and the Zofran hasn't helped much.

Is the vomiting after the stent normal? He was doing it too much earlier to do the scan to check the stent's placement, so they are holding off until the AM. Someone tell me that this will get better? They found the leak without any major infection in his abdomen. No pain. No fevers. And it wasn't an abscess after all. Just vomiting. So, I certainly think that is a good sign overall, but I'm scared for him.

Thanks for listening-- to this book!!!

~worried girlfriend~

[smkeller 3]

What a nightmare and all because the surgeon didn't wait until he knew his patient was healed enough from

from the damage that the band had caused.

[sleeversGF 4]

Yep, the band has been a nightmare all in itself from what he has told me about it. He had significant scarring from the band, of course, just as most people have had and worse. So he wanted to do the revision. He poured over the decision the first two months I knew him-- whether or not to do the revision or just remove the band. Right now, like most people with complications, he is wishing he hadn't done the revision. But personally, and I told him so, that I think with the amount of scarring he had, the risk for leakage is there anyway when that band wears away at the GI tissue. Removal can be just as risky as revision in some cases I've read about.

The good news about all of this is that all of his back pain has vanished and he no longer needs his diabetic or hypertension medications. Go figure. I hope all will be well. Thank you for all your comments and those to come. I truly appreciate it. I've read about all of you!!

[sleeversGF 4]

Complex: how long before your leak healed? Are you eating now? So your leak has basically "surfaced" thanks to the fistula and any drainage comes out superficially through the skin? Interesting.

[complex 0]

Complex: how long before your leak healed? Are you eating now? So your leak has basically "surfaced" thanks to the fistula and any drainage comes out superficially through the skin? Interesting.

My leak is still not healed although CT shows it to be microscopic in size. I am eating - I eat anything I want and work to get 50+ protien grams each day. Some days are obviously better than others and I HATE the slow eating mainly becausse hot foods are cold by the time I get to the 20 minute mark. Yes the fistula formed where the drain had been - funny the drain never drained anything so it was removed. The drain line formed the fistula. I think its interesting too. My body found a way. Of course, if drainage amounts change or pain develops the doctor says that I'd have to have more surgery (I've had five including putting stents in and then taking them out) and I also had a bile leak from the liver - they caught that one first (from gall bladder removal) but that healed within three weeks. My original surgery was April 25 - but the feeding tube kept me from losing weight - so I'm just starting my journey.

[sleeversGF 4]

Well he is doing a little better this evening, but they had to dope him up pretty well... Ativan and Zofran. He was sleeping hard when I got there tonight. I don't know if he should still be this nauseated with the stent in, so that concerns me. He said it doesn't hurt inside, just feels funny and "hard to describe." The bariatric doc came around and said he would probably be heading home this weekend, so we will see what that entails. They didn't put the NG tube in, so I'm thankful for that. I would much rather manage TPN than the tube, and I think he will be less self-conscious than if he has a tube hanging out his nose over the next few weeks. I was glad to not see that when I walked in. The only thing I really worry about is changing the PICC dressing-- it's been a couple years. I will need a refresher.

He just called and had to be medicated again for nausea. I hope he gets more rest. Hasn't had much in the hospital with all the in and out from staff. I hope these 2-3 weeks go by quickly. This is day 1! They plan to pull the stent at about 3 weeks if he can tolerate it that long. ~fingers crossed and on my knees praying~

Complex: wow, not healed all the way? I wonder, do they expect it to close or at this size is it not much to be concerned over? How long did you keep the feeding tube in? I'm glad you're eating and drinking and doing well now. You sound like you feel to be in a good place. The leak is definitely scary but I don't feel like it's something that cannot be overcome. There are much worse complications, but this can be frustrating and not as short-term as we wish it would be. Our bodies certainly do find ways to get through pain and abnormal issues-- we're amazing creatures.

I thank you all so much for being supportive. There's not really a place to go as a family member or loved one of someone who's going through these complications, so thanks for the warm welcomes. OH has a forum, but it's not frequented too often (see, I've been all over the web in search of answers!!).

[complex 0]

For the PICC line, watch the nurse change the dressing, I walked my husband through it after I watched the nurses and it just needed to be changed weekly. I had a feeding tube for little over two months - but mine was inserted through the abdonminal wall to the intestine not down my nose. I could easily hide it under my clothes although I was" feeding" 16-22 hours a day, consuming 2100-2600 calories a day - thus no weight loss. My doctor is very cautious and had already removed the drains and tubes thinking there was no leak and tried to talk me into reinserting the feed tube to make sure my nutrition stayed on track - but I refused. Having it in had an emotional impact that I couldn't explain, having it out gave me mental strength. I have eaten steak, refried Beans, tilapia, tuna, Soups, yogurt, etc. I can't eat a lot - 3 oz at a time but I believe the natural protien is superior to the medical feedings for making me feel better and exercising. The hole will heal (doc promises) and it gets better daily. Your boyfriend's will too. I hope that he tolerates the stents. It is a very weird feeling but I had one in stomach and another anchored in esophgus (sp?) which is why it effected me so. I researched stents and they will help him eat and drink while leak heals. Again, good luck!!! Best wishes to you both.

[sleeversGF 4]

I understand what you mean about the tube. As a nurse I care for many people who have these temporarily or permanently. I think I would feel the same way that you do. There's something holistic about healing when you are doing it with things that are not artificial, like feedings, whether TPN or formula. I really hope he tolerates the stents over the next few days as well. I know they are helpful, and if they allow him to be able to take something in by mouth, he will feel 100% better about what he is going through. The idea that he is being fed artificially is wearing away at his positive thinking, but I told him that the means they suggested (NG tube) and are using (PICC and TPN) are meant to be temporary. If they felt he would need it long-term or forever, it would be through the abdomen. I'm glad to know you had yours removed! What a freeing feeling that must have been for you. But how grateful to know how far it has brought you and that it was available when most needed to offer the nutrition required to heal you.

I know I can take care of his PICC and TPN, it just makes me nervous, knowing that this "patient" is my boyfriend. It isn't just like going to work. Like the tube vs. real Protein, it just feels different.

smkeller: I don't know if that was the case or not. Only his surgeon knows the real answer to that. Regardless, having a band removed leaves weakened tissue behind that is scarred, making a revision risky, whether waiting or not to be sleeved. The tissue under the band may or may not improve over time, and I would trust a surgeon's decision on this, regardless, over my own minimal knowledge in this area of medicine. I feel that surgeons make decisions based on what they see and feel to be the right thing to do at the right time and that's why we put their trust in them. His surgeon's group received excellency awards in the field of bariatric surgery after having many cases reviewed. I trust they did what they felt was right at the time. We are all human. We all make mistakes. These are risks taken in life as a whole, and especially in a surgery setting. Whether a mistake was made or not (I don't, as a nurse, feel anything was poorly done in the OR), but I wish they had pushed treatment on what they thought was an abscess at the time. Either way, he would be in the same boat he is now, because he was treated, just not as aggressively as they are doing now.

[sleeversGF 4]

A small update this evening. Turns out they are finally going to put a drain in to drain the Fluid outside the leak that accumulated. His nausea and vomiting are about 50% of what it was, but when he vomits, it's pretty hard to get under control again. I know he's thankful his stomach is empty through all of this. I am sure the drain will be the biggest piece of making this all become history. I can't wait to see him out of there and back on the right path to healing. Right now, he just has to lay there and take it, whatever comes his way, fighting through closed eyes. Sucks.

[complex 0]

Thinking of you both

[june13sleever 223]

I am sorry to hear about all of this. I hope things go well. Keep updating on his progress.