So I just got out of the hospital from an abdominal obstruction and had one of the worst ER experiences ever.

I've averaged one or two blockages a year requiring hospitalization for the last eight years and many others that just worked themselves out so I know what they feel like.
I've been trying to not wait so long to go in lately. I go in when the pain gets moderately bad and I start to get nauseous. Apparently I need to wait until it's so bad I do require an NG tube and possibly surgery.

The ER staff thought I was just a punk kid coming in to get good drugs and my boyfriend even heard them out in the hall saying, "I'm done with that girl, I'm done!" They tried to release me when I was in worse pain than when I showed up and hadn't had a bowel movement yet.

I said, "I'm not comfortable being released with just a bottle of pain pills if I'm only going to end up coming back here; can't you admit me and let someone else take care of me?" I don't think they liked that I came in with my medical records and a summary of all my 11 surgeries and every time I've had a blockage.

I was also concerned when the doctor asked if I'd had my appendix taken out. I said, "Uh, that's kind of connected to the colon so it went with the rest of it."

I'm frustrated because now I'm second guessing myself. Maybe I shouldn't go to the ER so early on. All that shows up in the x-ray's is gas and not a real "blockage." Maybe I should wait till I'm vomitting and in so much pain I can't stop moaning. Maybe I should wait till surgery is my only option. That way ER doctor's and nurses won't be bothered with someone that seems to know more about their situation than they do.

Sorry this was long but I'm still upset. And I'm still hurting quite badly. Yesterday I couldn't sit up without help.

On the plus side though, this was the first time my boyfriend has witnessed this and he was great. He took such wonderful care of me and none of it bothered him at all. He is definitely a keeper!
Thanks for letting me vent. And thanks to you in the Chat room on Monday night that answered my questions, unfortunately, I ended up in the ER anyway.

Well, my two cents is that if you know more about yourself than the ER docs, there really isn't much point in going to the ER until you know you are going to need NG suction and/or IV fluids. Hopefully, you can get in before the point that surgery is required. Why waste your time and theirs, particularly when they think you are a nut...

This may be something to bring up with your surgeon or GI...how to best handle these situations. The last thing you need when you are having this sort of pain is the stress of uncaring ER staff.

The reason is that there really isn't much for them to do until you get to that point. It's sort of like taking your kid in to the pediatrician at the first sign of an earache. They look, nothing there. Two days later, the kid is REALLY sick and there is something to see in the ear and they can do something.

Jan

I guess my question is this: if you catch a blockage early enough can't you treat the symtoms and possibly prevent the necessity of an NG tube and/or surgery? It seems that when I've gone to the ER in the past and I've been given IV fluids, pain meds, and something for the nausea that my GI tract can stop tensing up and fighting so much. Usually after a few hours of this, things work out by themselves. Is early detection and treatment of symtoms not a good thing?

A new doctor I'm seeing here that might actually know about Jpouches (I hope, since all my surgeries were done at a different hospital a couple hours away) said that next time I could call whatever doctor is on call and see if they could just admit me and bypass the E.R. Maybe that will get me treatment instead of making me live in ridiculous pain but not deal with the ER doctors either.

I'm curious to know if you were at a teaching hospital. Many years ago, at a teaching hospital, I was in the ER when a not-so-brilliant ER resident thought whatever was bothering me might be my appendix. Duh, no colon, no appendix. This was in July, the time of year when all of the shiny new first-year residents are unleashed upon the unsuspecting public. Also a time (from then on) when I will avoid being in an ER at a teaching hospital for anything short of eminent death.

Hope you're better soon.

Sadly no, this was a regular hospital. But I was at a teaching hospital for all my surgeries and an intern nicked my lung and it collapsed

I may be going back to the hospital; I'm still not right. My stomach is completely distended and I'm still in pain and I could be paranoid but I haven't passed anything since 6am and I've usually gone 3 or 4 times by now on a normal day. I will just try to avoid the ER this time and call the new doctor first.
Is this normal? How many others remain in pain with a distended belly after a blockage?
Oh, and I was doing some research today on small bowel obstructions on the web and from what I learned in medical journals, on x-rays, gas and liquids is all that shows up so I'm not sure what the ER doctor thought was supposed to show up.
Hopefully things will start moving through again soon.

Olive Oil, I'm so sorry to hear you're in so much pain. No advice, I'm afraid, just a hug and wishing you a compassionate person at the ER if you end up there again.

Once you are distended, you are in trouble. It does not mean that surgery and an NG tube are next, but observation may be necessary. I think your new doc's idea is a good one to just bypass the ER and get focused treatment. Remember, ER's are for crisis type emergencies and they just don't seem to be able to deal with issues that are not critical in some cases. What happened with me was I got stuck on a gurney in the hall for 8 hours and by the time they had time to deal with me, the obstruction had resolved on its own.

But, yes, you are right that the right treatment early on can help prevent it from getting worse. Perhaps you can have a standing order prescription for pain meds and something for nausea for when you feel this coming on. If you take something orally early, it can have the same effect as IV.

Jan

My surgeon works through a teaching hospital- University of Pennsylvania. I found them to be very competent.

I was told if I experienced any problems to call first so I wouldn't have to wait in the ER. When I did have an obstruction 3 weeks after Step 1, I quickly was taken into a room, got the NG tube and luckily my surgeon was there to admit me.

I haven't had an obstruction since but that was horrible horrible pain.I am sorry you didn't receive the attention and care you needed.

Well it was a little rough this weekend but I think I'm finally on the mend. I did have to go back to the doctor and monitor things but have managed to stay out of the ER. Oh, I had to get a shot and get more antibiotics because the site of one of my IV's is infected. My arm is killing me. Since I've had a shot and I'm taking antibiotics should I not worry about the fact that it still hurts one week later?
I don't want to be paranoid but I can still barely use my arm. How long before the pain should go away if I just got the shot and started the meds on Friday?

The few times I've been to the ER for a blockage, they've given me some dilaudid/versed for the pain and phenergan for the nausea. I had an NG tube (which I welcomed greatly) the first time.
Besides the NG tube, does any of those drugs actually help a blockage to pass?

The main reason I went to the ER was the pain (that and the nausea). Rolling around on the floor groaning doesn't cut it. Plus, taking 2 Percocet left over from Step 1 does nothing to control the pain.

Treating the pain can help the obstruction pass because it relaxes you and also slows peristalsis. The gut works harder and harder to push through the obstruction, and that just makes it worse because the intestines swell.

Olive, You should be using hot, moist compresses on that infected IV site (2-4 times a day). If you see a red streak going up your arm from it that is new, you need more or different antibiotics.

Jan

Olive, I was at a teaching hospital, too. I couldn't even tell you all my complications. My lung got punctured by my central line because an resident moved me.

I know this is off topic but as I was reading your post I was shocked to find out the I didn't have an appendix.
Is that right?? Did they take my appendix too?

Thanks for the info, Jan; I'll keep my eye on it. The heat does make it feel better. I wish I didn't have to teach dance for two hours tonight but that's life.
Chelsea, my lung was punctured and collapsed by an intern putting in a central line. And my surgeon was quite upset because he wasn't told and didn't find out until he came to my room and saw me on oxygen. I think someone's head rolled for that one. But I bet an intern learned how to be really careful putting in a central line
Oh, and yes, Shawanna, your apendix is gone since it was connected to the colon One less thing to worry about
Thanks for the comments everyone; I'll let you know if my arm falls off

All I can say is, "Oh my gosh!"...sometimes, these Dr.s!!! I hope your on the mend Olive Oil. ---Peace, Sue