I just had the most aggressive phone call with my surgeon, Dr. Cirangle. I had my sleeve done Monday (5 days ago) and left the hospital on Tuesday. I was given liquid pain meds (hydrocodone-something) - and it was prescribed as 10-25ml every 4-6 hours. I was taking the meds on a reactive basis and on Weds, the IV drugs clearly left my system and I was in horrible horrible pain. I called his office, his physician's asst. almost scolded me for not taking the pain meds as subscribed and that I should take them regularly every 4 hours if I was in that much pain.... BEFORE I got pain.

So I did. Exactly as told and as it was prescribed on the bottle.

I took my last dose this morning around 4 AM and my husband went to the pharmacy to get the refill. They said they couldn't refill it until Monday. So I called the Dr. Cirangle and was berated and told that I was taking too much and that I shouldn't even be in pain 5 days post op.

I did the math.

1 pint = 473ml

Prescription called for 25 ml every 4-6 hours.

473ml/25ml = 19 doses

24 hours a day/4 hours = 6 times a day I should take the meds

19 doses, 6 times a day = the medicine should last me for 3.16666 days. I'm on day 5. He said it was supposed to last for 10 days.

Am I missing something???

And at day 5 should I not be having sharp pains where I can't stand up, roll over, or bend over? (He says no.)

I have discoloration/brusing like color around the area that I have the pain. No where else do I have this discoloration. I'm supposed to have a follow up this week.

AND I never want to see him again. I feel so violated after being so vulnerable to trust and be open to him only to be screamed at and told to "stop being so dramatic."

Feeling totally alone and so upset.

There's one thing to not have bed-side manners... it's another thing to be a complete asshole to your patients who are reaching out to you for help.

You can take extra strength liquid Tylenol it should help with the pain. Sounds like your doctor is just jaded and not wanting to give you any more narcotics. He should have told you to buy some over the counter meds instead of being a douche. Pain should be low enough where you can manage with OTC pain meds instead of a narcotic. Chin up Tylenol won't constipate you like liquid hydrocodone. Make sure you are moving around walking gets all that gas out of your abdominal cavity which is what causes the most amount of discomfort.

Do you have pain and red bruising around your incisions. If yes, then go to the ER. If you are in severe pain that may not be normal five days out. I would go to the ER. Better safe than sorry! Best wishes and congrats!!

Thank you! Yes - I didn't take any tylenol because the post op instructions specifically said "no other pain medication." I'm not a fan of narcotics and would gladly just take tylenol.... I will ask the pharmacist what she thinks in regards to what I've had and the impact the tylenol will have on my liver. (I think that is the big concern.)

The bruising is just yellow and black - like when you bump into the edge of a table... almost as if it's 3 days old. (not red.)) It's on my top right side, I feel like I must be doing damage to myself every time I sit down, bend over, roll over, etc. It's like a knife is stabbing me in this specific spot everytime I move.

The rest of the incisions are totally fine. Mild discomfort, but nothing to lose sleep over.

((p.s thank you for your response and support. feeling so alone at the moment and, I don't know why, I feel stupid and like a total loser. I don't know why I'm so upset. I'm not a depressed person, nor do I normally feel this way - I guess I'm not used to being yelled at and attacked like this.... especially by a doctor.)

Thank you! Yes - I didn't take any tylenol because the post op instructions specifically said "no other pain medication." I'm not a fan of narcotics and would gladly just take tylenol.... I will ask the pharmacist what she thinks in regards to what I've had and the impact the tylenol will have on my liver. (I think that is the big concern.)

The bruising is just yellow and black - like when you bump into

the edge of a table... almost as if it's 3 days old. (not red.)) It's on

my top right side, I feel like I must be doing damage to myself

every time I sit down, bend over, roll over, etc. It's like a knife is

stabbing me in this specific spot everytime I move.

Stop beating yourself up. You are not stupid or a total loser. You called for help and guidance from your physician and was told to stop being dramatic. Really!!! First, you just had surgery so yoyr emotions are pretty raw right now. Trust me , in a few days you will probably cry for no apparent reason, I know I did several times in the past few weeks. When I was released I was given codine for three days and told to take liquid children's tylenol after as needed. I only took one dose of the codine and have no other pain meds in five weeks. Yes some of my incisions were painful, but for me the pain was very manageable. If you are unable to tolerate the pain go to the ER.

on another note, I have had several surgeries. I see a huge difference between ny Internist and surgeons. My Internist is comforting and really listens. While I believe the surgeon who did my sleeve is technically gifted, she appears to only be interested in the outcome of her surgery........how much weight I have lost. She glazes over my complaints and has not offer much support in my journey. I'm not in anyway putting down

surgeons, so no attacks please.

The rest of the incisions are totally fine. Mild discomfort, but nothing to lose sleep over.

((p.s thank you for your response and support. feeling so alone at the moment and, I don't know why, I feel stupid and like a total loser. I don't know why I'm so upset. I'm not a depressed person, nor do I normally feel this way - I guess I'm not used to being yelled at and attacked like this.... especially by a doctor.)

Ok, I have no idea what happened to my post. Weird.

Today is also my Day Five post-op (was sleeved on Monday, August 18.)

They also gave me a Rx for that monster bottle of liquid hydrocodone -- 400 ml. I took one dose the evening we got home. Had little hallucinations as I was going to sleep and the following day (Day Two) I felt depressed all day. IT SUCKED!

I never took a second dose. And I didn't need it. My pain was minimal. Yeah, my tummy's still a little sore, but not the same as "pain."

I'm sorry you're having a hard time. If you lived near me, I'd give you the rest of my bottle.

But seriously ... I really do think that drug has some crappy effects. It could even be fueling your current feelings and behavior. I am not a fan of it.

Edited August 23, 201411 yr by VSGAnn2014

Thanks, FineDiva. You are right. My internist is so amazing. I feel like he could be family. Perhaps you are right, some surgeons may just be focused on the outcome of their work which, in all honesty, that's the most important part. It is why I went with him in the first place.

ANd thanks for the note on the crying. I seriously don't know why but I could not stop crying after this phone call with him. Like... weird crying. I don't cry like that usually. Or like... ever! The tears just wouldn't stop! A few hours have past and I'm looking back already asking - why did I get so emotional??? That's so not a normal reaction for me.

(((Hugs)))) thank you - I am feeling so much better atm. xo

Yes VSG Anne - I'm going to switch to just Tylenol moving forward for the rest of the weekend. My husband, who is very supportive, wasn't neccessarily taking on all the responsibilities with our two young girls (2 and 5) - and so even as I got home from the hospital the first day, I was brushing their teeth and putting them into bed and bending over and moving around alot to make all that happen.

After the call this morning, he actually said - you stay in bed today and just rest. I'll take the girls out for the day.

So maybe he just didn't realize how serious it was for me to stay resting and not running around after 2 kids.

And yes - maybe it was the meds that were making me cry after that call when normally I wouldn't. But Dr. Cirangle was seriously very abrasive and incredibly aggressive and dismissive. I like the advice to move to Tylenol. I am going to do this.

thanks

So my post got into the middle of yours. Glad you saw it. My internist is like going bavk to the womb. So we both have great doctors. I'm sorry your surgeon was unkind. And at a time when you need him to be understanding and attentive. I hope you can move pass the incident and start feeling better emotionally. As for the hubby. Lord have mercy! What is wrong with men? You have a two year old!! I'm glad he is stepping up and helping better. I really think men believe us to be super womem. What is that anyway? Everyone is different, but I took care of no one but me for the first 10 days. Also don't have anyone under 16. I was sore, in mild pain from gas and basically moving like someone who had a major surgery. I wish you all the best and better days soon. The first two weeks can be rough, so go with the process. Most importantly, cry when you need to!!

Thank you! Yes - I didn't take any tylenol because the post op instructions specifically said "no other pain medication." I'm not a fan of narcotics and would gladly just take tylenol.... I will ask the pharmacist what she thinks in regards to what I've had and the impact the tylenol will have on my liver. (I think that is the big concern.)

The bruising is just yellow and black - like when you bump into the edge of a table... almost as if it's 3 days old. (not red.)) It's on my top right side, I feel like I must be doing damage to myself every time I sit down, bend over, roll over, etc. It's like a knife is stabbing me in this specific spot everytime I move.

The rest of the incisions are totally fine. Mild discomfort, but nothing to lose sleep over.

((p.s thank you for your response and support. feeling so alone at the moment and, I don't know why, I feel stupid and like a total loser. I don't know why I'm so upset. I'm not a depressed person, nor do I normally feel this way - I guess I'm not used to being yelled at and attacked like this.... especially by a doctor.)

PLEASE don't feel that way! Everyone reacts differently to pain and that is just the way it is. Dr, Cirangle sounds familar - I think he is in Sacramento or the Bay Area? He should be extra kind to you during this time as you are weak and vunerable because of the pain and the trauma of surgery.

I had surgery on Monday (18th) and I had severe sharp pains in my abdominal area at the top of my breastbone, where the drain was. Today it is no longer sharp but rather a dull pain. I also think that is the exact path they used to pull out my stomach because the incision is larger than all of the other ones. So, it makes sense that it hurts the most. When I first stand up, it's hard to completely straighten up. After I have been standing for a while, then I can straighten up all the way.

I have faith you will feel better as time goes on.

I would report that surgeon to the hospital medical board and tell the exactly what he said!

You will have the most pain on your upper right incision because that's where they pulled your stomach out. It was the last one to heal for me. I hope you feel better, does your surgeon have an associate you could see? Or maybe a nurse practitioner or pa? Im so sorry this has happened. Sending healthy energy your way!

You were treated poorly and I'm sorry that you had to endure such poor professionalism. He did instruct you accurately about taking the pain meds ahead of time. The problem was taking the maximum dose, and taking it every 4 hours. The range of up to 25 ml is the maximum, and the four hour time frame is the minimim. When you combine the two, you will max out or exceed the 24 hr dose of recommended acetaminophen, and run out of meds very quickly. He should have told you that when you spoke to him initially.

Everyone is different, but having acute pain that still requires narcotic medications five days post-op means your pain tolerance is lower than some other people. If you ever have to have surgery again, remember that and kind of plan ahead. Your bruising does sound ordinary / normal. I hope you begin to feel better soon. =)

Thanks for everyone's responses and support. I'm feeling so much better after taking the day to rest.

I'm not trying to be dramatic... but I just don't know how I am supposed to follow up with him??

I know a huge part of people's success is their follow up with their doctor and their staff from 1-2 years after!

I'm literally afraid to ever put myself in a position to have to speak with him ever again. Let alone be in a room alone with him. If he was that horrible over the phone... I can't imagine how he's going to be alone in a room towards me.

What should I do? What would I be missing if I never returned to his office? ((I am just 5 days post op)) :-(

Luciana,

I think if you don't go to follow-ups you will reduce your chances of long-term success.

My advice is to pull up your big-girl panties and resolve this conflict. You and your surgeon don't have to be best friends. But you do have to figure out how to work together.

To throw away your future medical follow-up resources because your feelings got hurt (and yes, that hurt!) is not acting like a grown-up.

You have to get over this and get beyond it.