Emergency Surgery and my
"Second" Recovery Period.

What Happened?

One nurse, one wrong action…

First it is important to remember that I have a severe case of Sleep Apnea. This is important because it added additional risk to the surgery. The corrective procedure for my Sleep Apnea is to use a CPAP breathing machine. When I am going to sleep, whether it is nap time or bedtime, I put on a mask that fits tightly over my nose, turn on the CPAP and go to sleep. At present my CPAP machine is running at a pressure setting of eleven (11). Dr. Cowan tells me that any pressure setting over five could blow out all the sutures inside me after the surgery. For this reason, Post Operatively I did not go through the usual course for recovery. The reason is because when I am unconscious after surgery great care had to be given to maintaining my open airway. And for that reason my doctor decided not to take me off the ventilator for an extended length of time. My family had brought me a small chalk board to write on since I could not talk and this was really a pain in the butt! Although the alternative was to play a game of trying to talk with my gestures, and that did not work very well at all. Then when I did come off the ventilator I was placed on CPAP at a setting of 5.0 cmH2O. This proved to be sufficient post-operatively to prevent any apnea episodes. I was happy to get off the ventilator because now I could talk and take some liquids by mouth.

Now this is what happened: During the 11pm to 7am shift on 11/16/98, an RN that was to be my nurse came into my cubical and checked me all over. Looking at my dressings and each piece of equipment I was connected to. During this time the nurse adjusted the CPAP to a pressure setting so high that not only did it keep my airway open but it also inflated my guts. My guts inflated to the extent that it ripped open the sutures inside me, thus flooding my abdominal cavity with air and stuff from inside my guts. This is not good ....

I started having terrible pain, but my doctor told me that there would be no pain. And if there was pain, something was wrong. I was thinking about the pain and wondering if I was just being a weakling or was there really something wrong? When I got ready to go back to sleep after trying to eat my breakfast a new nurse came in and she saw the CPAP set to high, so she turned it down to the proper setting. This got my attention very fast. Now the setting was so low I felt like I was having to pull air through the tubes. This feeling of struggling to get air made me think this new nurse had set the settings to low. But she explained these settings were correct and the prior settings had been to high. Now I knew the pain I was feeling was not my imagination, something Was Wrong. So I started trying to get help, I finally got my family to understand that I needed my doctor NOW!

My doctor came and X-Rays were taken. Then I was rushed to Emergency Surgery. Dr. Hiler told me later that when they opened me up my guts popped out like the spring snake in a fake can of nuts, (you know, one of those gag gifts). Also Dr. Cowan told me that my guts were all inflated like big sausages. He had to deflate them before he could even start repairing the damage. Then they had to flush out my abdominal cavity and rinse off all my organs to try to get the bacteria and stuff cleaned up. The hospital notes show where they used about 10 liters of sterile saline. You see we all have this bacteria and stuff in our guts and that’s okay - as long as it stays in your guts! If it gets out of your guts and into the abdominal cavity the result can be very bad -- even death.

That is what happened. After the emergency surgery I was in a comma like state for about a week. There was a lot of concern now not only by my family but also by the medical personnel involved with my case. I came dangerously close to dying not only in the emergency surgery but afterwards also. Things got even more complicated: I developed pneumonia (11/20/98) and then my lung collapsed. On 11/23/98 I went back to surgery. This time I had to have a Tracheostomy, I was in respiratory failure.

My story is not as bad as it may seem. I did have problems, but the problems I had were not connected to the Weight Loss Surgery. That part went fine and I was recovering better than expected. Everything was going just fine -- fine that is until the "Nurse from Hell!" I tell my story for many reasons, none of which are to scare anyone away from Weight Loss Surgery. Morbid Obesity Kills, and WLS gives the morbid obese a chance to live a better life: Happier and Healthier than otherwise possible.

One reason I tell my story is to make others aware that there are dangers other than the actual operation. Care givers are people just like you and me. And occasionally they make mistakes. But we as patients do not have to just lie back and let them have their way with us -- we should participate in the recovery process. You do not need medical training in order to get involved in your recovery process -- you just need common sense.

I still feel that the problems like mine were that one in a million type of thing and I don’t think anyone else should worry about this happening to them. But if you have sleep apnea and it is very bad, remember what did happen to me and talk to your doctor about the pressure settings post-operatively. The type of WLS you have, may not put you at the same type of risk I had. Then the next thing I tell everyone, is to be sure your family, as well as you, watch what the nurses do - and ask questions. If something does not seem right -- question it until you are satisfied with the answers you are given.

I found that when you are in the hospital you have to be involved in your care and recovery. If someone changes something that is connected to you, ask questions. If they bring you medicine and you were not expecting it - ask questions. There were several times I saved myself from other dangers by asking questions. And if the answer is not satisfactory have the nurse bring in your chart and show you the doctor’s order for the action in question. Be bold.

November 24th I am AWAKE!

Six days after the Emergency surgery I began to wake up and the first thing I saw was my lovely wife. Just like when we were newlyweds so many years ago, I opened my eyes and saw Diane beside me. Our eyes met and she smiled a very relieved and loving smile.

This is a picture that Diane's first Cousin Wanda had taken of the two of us after the first surgery, when everything was going so well. After the trip back to the Emergency Surgery one of the nurses had told her supervisor about the camera and pictures Diane had been taking. And as I told you earlier Diane had to make a quick move and get the camera out of the hospital. So I do not have an actual, "of the moment," picture to put here. But I did think this one was in the right spirit of how we felt once I started to come out of the coma. Diane and my family tell me that a picture of me at this time would not have looked very good. I was hooked up to so many machines, and had tubes and gadgets everywhere.

I had no idea that so many days had past since I last saw her. All I knew was that she looked so very good to me!

A note here: Although many days passed without my consciously being aware of it, I was aware of some things. I remember hearing the nurses talking about me while they cared for me. They thought that since I was unconscious, comatose, they could talk openly -- Ta Ta! not so!

Maybe it was a dream, maybe not, but it did seem very real and what they were saying did fit what was happening as Diane told me later when we talked about what I was aware of through the ordeal. Also there is something else, Diane did not tell me about this but I did feel very closely connected to her feelings of support. I felt a warmth from her that I did not understand at the time. But many months after the hospital ordeal Dr. Herson was talking with me about the time while I was comatose and his visits. He told me that when he walked into the Critical Care area where I was with all the equipment buzzing and whirring doing the things needed to keep me alive -- there was Diane, sitting by my bedside holding my hand talking to me. She was only supposed to be allowed visiting on a schedule but the doctors felt it was important that she have more time with me due to my condition. Dr. Herson said it almost made him cry to see her sitting there giving me her strength for hours and hours that went into days and days. She never gave up hope and never gave into negative thoughts even when my family got mad at her and told her she had no idea what was happening. They wanted her to give in and admit how bad things were -- but she held her ground and kept the belief that I was going to get better, and I did.

It makes me get teary eyed even now as I write this, thinking what "she" went through. I thank God for the wonderful wife he has given me.