Bariatric Patients & Emergency Rooms: Advice from the Pro’s

So far we’ve discussed some of the bad situations bariatric post-ops have had in emergency rooms and we’ve gone over some simple things patients can do to help convey what they need during an emergency.

For this last post, I thought I’d share some of the advice I got from people who work in the medical field. I got responses from several ER nurses as well as a bariatric nurse coordinator. Here are the tips they have to share and their thoughts on why these tips are important.

Establish a Lifelong Relationship with Your Bariatric Surgeon
That’s what one of my readers, Kathy, who works as a bariatric nurse coordinator, told me. She says it’s one of the most effective ways to ensure proper treatment in any medical situation, especially emergencies.

Different bariatric surgeons have different ideas on how long you should see them after surgery. I can say that I was told up front that I’d see my bariatric surgeon at least annually for the rest of my life to monitor my labs and help intervene should I have any types of trouble.

But having a relationship with your bariatric office has several implications. “When you have good communication with your surgical practice, often you can come to them when things are still symptoms, before it’s necessary to go to an emergency room,” she says. Also, when you have a good relationship with your surgical practice, if you should happen to move to another state, they can help you connect with a good, local bariatric practice. “Often when one of our patients is moving, I look up surgical practices on the ASMBS Web site. Then I give the practice a call and make the introduction between the patient and the practice. Not all surgical practices take new post-op patients but usually when we introduce someone it goes well,” she says.

Finally, Kathy says, having a good relationship with your bariatric practice means you are more comfortable calling on them when you have a need. By calling your surgical practice when you have what you suspect are bariatric related symptoms, you can get specific instructions on how to seek urgent or emergency care.

Listen to Your Doctor!
Several readers told me they knew fellow post-ops who’d been advised to be seen in their bariatric surgeon’s office about symptoms — and that their surgeon would see them that day — but did not follow through on going to the appointment.

If you call in to your surgical practice and they ask you to come in right away, it is to your benefit to do so. One reader told me, “Doctors only really do that when they are truly concerned. And sometimes they do have to send you to the hospital but many times they also call ahead with instructions for your care.”

After Hours Care
One of the requirements for the American Society for Metabolic and Bariatric Surgery (ASMBS) Center of Excellence standard, says Kathy, is that bariatric surgical practices have 24/7 on-call schedules. That means if you had surgery at a Center of Excellence, you should be able to reach a doctor any time of day or night should you have an emergency.

That means if you are having severe symptoms that you suspect are related to your bariatric surgery, if at all possible, your first call should be to your surgical practice. Again, your surgeon can give advice on how to proceed. Even if you are out of town if it’s a true emergency, your surgeon (or their staff) may be compelled to help you find the hospital best equipped to treat you.

This connects with a piece of advice in my last blog post. Make sure you have your emergency information (including the name and phone number of your surgical practice and surgeon) written out and that you give it to the people you live with or who you trust to help you during an emergency.

Tell Somebody
Some post-ops are extremely private about their surgeries. One reader, who works in the bariatric field, told me that they experienced several patients who didn’t want to tell anybody about their surgeries, preferring to even take a taxi home from surgery than confide in someone.

In general, this reader said, that’s a bad idea. After bariatric surgery, a number of complications my arise. If one does, and you are unable to speak for yourself, the fact that you had bariatric surgery is a critical piece of information that needs to be conveyed to emergency medical workers as well as any other medical staff charged with your care. The absence of that information could lead a medical professional to make decisions that can harm you.

So consider telling someone about your bariatric surgery. And if you choose only one or two people, make those one or two people your emergency contacts.

Each year, more and more people have bariatric surgery. As more patients emerge, hopefully more medical professionals will become aware of the unique needs of patients in emergency situations. But, as I hope I’ve shown in this blog series, the goal of the bariatric patient, wherever possible, should be to avoid going to the emergency room. That means:

      • Reporting symptoms to your bariatric surgeon. You may think you’re being a pain, but you are not. Your surgeon wants to know if you are in pain or experiencing something out of the norm. Most of the time they give you a list of what to watch for. If you experience any of those symptoms, make the call!
      • Maintaining a good relationship with your bariatric surgeon. They can help you in times of emergency, if you are going to change locations and in general.
      • Having a good home support system. That’s crucial. You need someone capable of speaking for you if you cannot speak for yourself.
      • Knowing what you need as a patient. The ASMBS provides many resources on the most common complications following bariatric surgery but one reader told me she tells patients, “Any pain in the belly or gut, call your bariatric surgeon!” That’s good advice. It doesn’t hurt to call and the call could save you a lot of headaches – or even your life.

Do you have any advice for bariatric patients with regards to seeking urgent or emergency care? Leave a comment so that we can all be better prepared!

About the Author
Nikki Massie is a professional writer living in Baltimore, Md. She writes a blog called Bariatric Foodie, which helps the post-op community learn to “play with their food” for weight loss success. Ms. Massie had gastric bypass surgery in January of 2008 and has since maintained a weight loss of more than 125 pounds.

Disclaimer: This blog post does not reflect the views of the OAC, the National Board of Directors or staff. Information contained in this blog post is not based on scientific research and has not been validated. The OAC does not endorse any merchandise mentioned in this blog post.



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