It happened again - is it only us !!!

Hi Gumnut,

I am so sorry that your husband had to suffer with such a pompous jerk! Some doctors should have opted for lab reasearch instead of human interaction!

I was mostly fortunate with my surgeons once I took over my medical care but in 2000, needing ER pouch surgery I was sent to the 'top man'. He was president of the board of surgeons, had a troupe of dozens interns following him bowing and kissing his feet. (the nurses generally hated him...Bad sign)

He claimed he was the only one here who could fix me, I had to rush. We did. I trusted him. 

I woke up with an NG tube sucking like a hoover vacum up my nose, nausea, pain and my stoma move to the worst possible spot on my body. 2 inches below my belly button and to the right. The first night no one came in to check on me...I cried all night (the call button had fallen off the bed and I couldn't call for help)...My worst nightmare.

Forced food on me at 7 days...I ate...But I did not know that he had put a urinary catheter into my k pouch (it usually needs a 30 or 32 caliber)...I blocked. Nothing came out. Nothing moved... blockage. 3 days and orders to Not irrigate my pouch (makes the stuff liquidy for it to run out of the tube)...full blown occlusion. 

I was feverish, screaming, crying and ignored. The nurses avoided me (except for 1 angel of mercy)...

I finally got up in the middle of the night, took a bottle of water, a syringe and a knitting needle and irrigated my pouch using the needle to push up the blockages (the tube was sewn in to me so I couldn't remove it to clear it out). It took all night. 

The next day he came back (was away for a long weekend), asked what all the fuss was about and that I looked fine...that I was a ba patient.  Wouldn't listen and removed my sutures too early (I need 2-5 weeks, I don't heal) and my stoma sunk. Refused to fix it. No other surgeon would touch me. 5 yrs of hell & hemmorage thanks to him and a full blown refusal to fix me...told me that one day I would end up in his ER and he woud yank out my 'useless and old fashioned' k pouch and give me a bag whether I liked it or not!

I was traumatized for years afterwards. It took me 8 full yrs until I found a French surgeon that I could trust.

Some people should not be allowed to touch human beings!

I became a victim because of him and hate him for that. He is a tyrant. He is retired but consults now...his son has taken over his practice and is worse...I pray to never have to deal with him.

I hope that your husband heal quickly, get home and never needs to go back to a hospital.

Sharon

It is not only you.  I went in for bilateral total knee replacement back in '09.  My doc (HSS) knew my gastro history well and liaised constantly with his peers next door at NYP.  Still, one day post-op, my pouch decided to shut down.  Perhaps a small blockage.  Perhaps all the meds.  Perhaps a combination.  Anyway, started to vomit. 

HSS is perhaps the best ortho hospital in the world.  But a vomiting j-pouch patient isn't exactly in their wheelhouse.  So, a resident comes in to put in an NG tube.  I'm kind of zoned but my wife (an ER doc!) is right by my side.  Getting ready, he lays out the kit. 

My wife says, 'are you sure that you have the right kit?'  He looks down, says yes, he does and picks it up.  She says, in a sterner voice, 'are you absolutely sure?  you wouldn't want to put an incorrect device into my husband.'

That makes him pause and he looks at the kit in his hand.  I'm looking at it too.  Seems like an odd shape for an NG tube but, hey, I probably couldn't tell you what day it was.

Recognition sort of hits his face.  He mumbles something and grabs the kit and leaves.  I look at my wife.  'I've seen a lot of things,' she says, 'but I've never seen someone try to put a catheter in a patient's nose before.'

My knees are great now.  And my nose is just fine too (thanks to my wife).

Oh dear Michael - that is a classic !!! I wonder, did they give any final explanation as to why the pouch closed down ( it has happened to my husband with each operation since his J pouch op in 1991 )

IF there is a next operation, we will insist that the nasogastric be put in whilst the operation is being done and that will hopefully save the upset and discomfort ( pain really ) that comes from the build up - to having to have it finally done a few days after surgery . . .

Thanks so much for your reply and all the best - we are in Australia by the way - cheers to you, and your wonderful wife !!!

Thanks so much Sharon, and all the very best to you in your continuing journey to good health . . . not to make light of it in any way, shape or form, I do like your description of the nasogastric tube . . . I have also had one after an operation several years ago ( twisted bowel ) and you have described it perfectly !!!!!!!

Take care and thankyou once again xox

A very kind and wise doctor changed my life when I was 18. He was a G.I. consultant at Duke U hospital and I was having my 2nd gracillis muscle graft done...he decided to check my guts before allowing the surgeon to operate (non-confirmed suspicions of Hershsprung's disease)...I walked into his office and basically started to strip...I was ready for 150th butt exam that year. 

He stopped me, told me to sit down, that he wished to speak with Me first, before he exmained me, If he decided to examen me.

He then explained to me that I was a person and not a patient. That I deserved to listened to, heard and respected. He asked me what a Case was...I told him that I was one...He said NO, you are a person...a case is a leather bag where you carry files...it does not bleed, hurt or suffer...and that if I ever encounter a doctor who treats me like a piece of luggage instead of a person that I should run...fast. 

I sobbed for days afterwards. I had not been treated that kindly, ever. 

I do not remember his name but I bless the man daily...Your husband is a person, not a piece of luggage.

Don't allow his doctors to forget it.

sharon

But if you were at a J Pouch facility they would have gotten it right.  Back in the day (early 1990s) there used to be a "one size fits all" NG tube that looked too big to be thrust down my tiny nostrils.  I resisted while vomiting and it was forced down by a doctor that physically overpowered me. I must say that it went down much more smoothly than I would have expected (which is not to say the experience didn't suck, because it did).

Since then they developed pediatric size NG tubes and adult sizes that are a little thinner based on the internet videos I have seen of them. Most size tubes will do the job so long as they are connected to a machine that has sufficient suction capabilities.  An NG tube, at least the one I was stuck with, is mechanically similar to a vacuum cleaner or a gasoline siphon.  It depends on proper suction to do the job.  The actual width of the tube is probably not terribly relevant as long as there is sufficient suction to draw the fluid out.  Obviously with the wider the tube, a greater volume of liquid can be removed quickly which is crucial with a patient that is vomiting, as were you and I at the time of insertion, and as are many other patients.  After all, a postoperative ileus only becomes realized when you start getting nauseous and start vomiting.

Actually, a catheter will not do the job of a NG suction tube. For one, it is too short, and it is designed for gravity drain, not suction. 

A nasogastric suction tube has a second line for air to come in. This prevents the tube from sucking up against the the stomach wall and causing an ulcer. There are also feeding tubes that are smaller diameter, and as long as the suction tubes, but do not need a second line for the air to come in. I actually had both in place after my surgery, with the feeding tube placed beyond the stomach, into the small intestine.

Thankfully, both were placed while I was under anesthesia.

Jan