Bariatric Patients & Emergency Rooms: What You Don’t Know Could Hurt You

I know the title of this blog post sounds alarmist, but a few months ago my friend Pam told me a disturbing story.

Pam is six years post-op gastric bypass. Her mother and sister have also had bariatric surgery. A few months ago, Pam’s mother brought her sister to an emergency room complaining of abdominal pain. It was not the hospital at which she had bariatric surgery and the bariatric surgeon working for the hospital was off duty.

After a certain amount of time, Pam’s sister wasn’t getting much relief from the treatment she was receiving, so Pam’s mother called her in to help. Upon arriving at the hospital, Pam, who writes a blog about various post-operative issues, began to ask questions about how her sister was being treated. Her questions dealt specifically with things that could be wrong related to her bariatric surgery. Pam reported the doctor would not contact her sister’s bariatric surgeon because he didn’t believe there was anything wrong with her sister. He did, however, give her some advice on her eating habits.

The doctor was ready to release Pam’s sister, by which time Pam was, understandably, at her wit’s end. She insisted they at least call the hospital’s bariatric surgeon and after she was finally able to convince the ER doctor to do so, the bariatric surgeon recommended transferring Pam’s sister to the hospital where she had surgery.

Once there, doctors quickly identified that she had twisting in her bowels and she was rushed into surgery to correct the issue.

Since this story was told to me, I don’t know whether Pam’s experience was the result of an ill-informed emergency room doctor, patient neglect or something else entirely. What I can say is that by all accounts, Pam’s advocacy may very well have saved her sister’s life.

That story stayed with me. As a six year post-op, but especially as a single mother, I know that getting proper care is important. It scared me to think about what would happen if I ended up in the emergency room. I don’t have a Pam (locally, anyway). I wanted to know if this had happened to other people.

I write a blog called Bariatric Foodie, which has Facebook and Twitter pages, so I polled my readers and got a number of responses. Here are a sampling of them (names removed):

      • One of my readers began experiencing extreme pain soon after having gastric bypass surgery. The post-op’s spouse elected to take them to the ER because it was a weekend. The patient told emergency room doctors that she’d had gastric bypass, but also that she was on blood thinners. Those blood thinners had caused her to bruise and the post-op felt there was the implication of domestic abuse, although the patient assured medical staff that was not the case. To the patient’s knowledge the doctor did not consult with a bariatric professional before discharging them with a prescription for pain medication and the advice to hold off on taking her blood thinners. Early the next week, the patient saw their bariatric surgeon (who confirmed not having been contacted by the ER doctor) who discovered that the patient had internal bleeding, rushed the patient into surgery and now the patient has recovered.
      • Another reader went to the ER of the hospital where they had surgery complaining of upper right quandrant pain. They encountered one doctor upon arrival, however a shift change occurred. When informing the new doctor of their medical history (including gastric bypass surgery), the patient reports the doctor replied by saying, “So you took something that was working and broke it?” The patient reported feeling judged by this statement but wanting to receive care. The patient was admitted and asked if hospital staff had contacted her bariatric practice. Medical staff told her that was her responsibility. Upon discharge, the patient was able to see their bariatric surgeon and learned they had a condition known as Sphincter of Oddi Dysfunction, which was surgically corrected.
      • Other readers shared with me stories of seeking out care at urgent care centers or emergency rooms where there was a basic familiarity with procedures like the bypass, but not with the Gastric Sleeve. Several readers told me they were given prescriptions for NSAID pain relievers (which cannot be taken by many bariatric surgery patients) despite telling medical staff they could not take them.

Obviously, these stories did little to quell my worries about interacting with medical staff I don’t know. (To be fair, I have a generally uneasiness about seeking out medical care that has nothing to do with any of this, but I believe the stories exacerbated it!)

As I said earlier, I don’t have a Pam locally to fight for my care if need be. Thankfully most hospitals in my hometown have bariatric practices associated with them and have at least a base familiarity. But what about if I went on vacation and needed to be hospitalized? And what about the people who live far away from their bariatric practices in places where bariatric practices aren’t so common?

The purpose of this mini-blog series (there will be one additional installment) is not to admonish emergency room medical staff. There are myriad of honest reasons why emergency medical staff could offer incorrect treatment options to a bariatric patient.

Instead, these two posts will give some tips — from hospital staff, from bariatric patients who have experience visiting the emergency room, and from bariatric staff — on what to do if you are a bariatric post-op in need of urgent or emergency care and you feel you may not be receiving the correct treatment, considering your needs resulting from surgery.

I hope this series of posts helps to prepare you and your family to be health advocates should the need arise!

I’m still gathering experiences and tips for the second installment of this blog post. Are you a bariatric patient with an emergency room story to tell? Please email me at bariatricfoodie@yahoo.com with the subject line “ER Visit” for possible inclusion in the next part of the series.

If you are a bariatric or emergency room professional, I’d especially love to hear from you! What are some helpful tips bariatric post-ops can use to advocate for proper care in the emergency room environment? Please leave your responses here or email me at bariatricfoodie@yahoo.com!

Part 2

To view part 2, click here.

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.



3 Comments for this Post
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  • Karen
    February 2, 2014 at 10:28 am

    Thank you for this article….is so important that bariatric patients understand that in an emergency situation three path of treatment can mean life or death! Last year was a rough year for me…most of my year spent in the icu and critical care unit at my hospital.

    Happened that one night i started bleeding internally, my husband called the paramedics and they started to take me a medical center that had no doctors who had any experience with bariatric patients…..and by the grace of God….Devine intervention the road was blocked leading to the emergency room and the ambulance had to take me another 10 miles the hospital that was familiar with my medical history. Had that road been open….surely i would have died that night.

    I can’t stress enough how important it is wear a medical bracelet and also have your family and friends who may escort you to an emergency room understand your full medical history and needs. i would also suggest that you keep a “medical diary” and take it with you to the hospital or er if possible!



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