Stoma blockage

[Gunsweat]

Hello,

I NEED HELP IN THE FORM OF YOUR EXPERIENCE!

I know this is unusual. I do not have Crohn's.
My partner does. He's 39 & has had it since he was 14.
I've been with him 7 amazing years. He is the only man i've ever been in love with, my best friend, my confidant.

He has had 9 surgeries for the disease. Well - 5, and another 4 to clear up complications. These were all before i knew him.

He was fitted w/ an illeostomy in 2001 and has had no problems since... and no meds!!

Yesterday he ate something that made him uncomfortable. He soon realized there was a blockage.

They 1st did an X ray....then another X ray....then did a CT scan & it told the doctor there was a food blockage behind the stoma but no 'Crohn's' (GOOD news). Then the nurse said they were keeping him for 1 more day & doing ANOTHER Xray tomorrow & then maybe surgery (BAD news). I have no idea why another Xray would help after a CT scan, or why surgery would be needed when it's a food blockage.

Do they open you up when you're constipated? No.

Usually, from what we both know - the done thing is that they irrigate the area, clear it, & send you on your way.

The man has had NINE surgeries & we'd rather not have another. All this was especially annoying as the doctor wasn't actually there today...this was all being copied to us by a nurse who was not comfortable answering questions asked by someone who was knowledgeable about his own condition.
Eventually they gave in & gave my partner an enema to use on his stoma to irrigate the area. Things started moving, then stopped. He started to sweat & then vomited a bout 30ccs after not eating for more than 24hours.

Basically - I'm scared. here's a list explaining why!

- That hospital is a dump.
- This doctor seems very keen to operate.
- The place has ants. Lots of ants. SERIOUS.
- I've overheard at least 2 nurses say they were pulled off of breaks for emergency situations....this is after they've been working 9 hours.
- After hearing that the Dr wanted to operate, I asked what would happen if we asked for another doctor .....or discharged him & went to another hospital?
Answer: There's some 'doctor code' about refusing to treat a patient another doctor has already seen.... and chances are the 2nd hospital would send you back to the 1st & bill you for the ambulance ride.
- He admitted himself yesterday at 5.30pm. Today at 5.30pm he finally got a bed to lie in within the emerg ward (meaning he gets a curtain!) . He's lucky - there are people in beds all over the hallways, including the waiting room.

This is our wonderful Canadian socialist health care system right now!

 

[Catherine]

Sorry no advice. Bumping your thread.

 

[xmdmom]

I am a doctor by training (not GI and not surgery) in the U.S, and the mother of a teen who was recently diagnosed with Crohns.

I have never heard about a "'doctor code' about refusing to treat a patient another doctor has already seen.... and chances are the 2nd hospital would send you back to the 1st & bill you for the ambulance ride." It's hard to believe this is a real policy in Canada.

I do not know about treatment for blockages (medical vs surgical) but I do know that patients and family should speak up and do whatever they can to prevent doctors and hospitals from doing inappropriate or clearly incorrect tests or treatment. When someone has a chronic disease, s/he oftens know more about his/her body and disease than some doctors. In U.S. hospitals, there is often a patient representative or an ombudsman who can help a patient when there is a conflict or problem. Do Canadian hospitals have such a person?

Sending best wishes!

 

[skippy111]

Even if they do charge you for the ambulance ride, Id rather pay it and go to a clean safe hospital than risk getting an infection there at that place...

I read that taking a stool softener is good for constipation of the stoma, I am not sure where I read it tho so don't quote me, maybe XMDMOM can answer?

Glad to know we have a DR on Board here.

My advice is to get away from that place as soon as possible, you have the right to refuse treatment and tests...

If the Staff is overworked then they are probably underpaid, which most likely means the morale is low and the quality of care is poor...

There is no Code that I know of where one Dr wont treat someone based on problems with another, that goes against the oath that Dr's take when they get their liscence..

When you do get to see a new GI, sometimes they will want to have their own tests done and start fresh..

 

[Terriernut]

There is no dr code like that...perhaps that 'dr' should remember the hippocratic oath!

If the stoma is blocked, irrigation would be the first thing to do. And they can also pedia scope through the stoma. You most certainly ARE entitled to see another Dr, and I suggest a GI, and a colorectal surgeon specialist!

 

[PsychoJane]

Herrr..... I've never heard of such a code either.
From what I know, here in Quebec, If you request to leave an hospital to go to another, you most likely need to sign discharge paper to assume the refusal of the care from that establishment. That is regarding care that they can provide, if they could not they would just agree for the transfer.

I think it's in their right to refuse to give you the patient files and results from exams that have been performed in that hospital (for you to bring them to the other one). They will most likely charge you for a copy of the document and there might be bureaucratic works that needs to be done to access it. I don't know if you could be billed for the second round of exam that would be requested by the other hospital but I've been told that might be a possibility(It's really just what someone told me, I ain't sure about that part).

I know that here, if you decline a certain hospital services to go to another one, then, the transfer in ambulance will be at your expense. It is just the same as if you were calling the ambulance to go from home to the hospital. I don't know if it is the same in BC but here it is something like 125$+ 1,75$/km. I think it's refundable through health insurance.

 

[PsychoJane]

Also, I don't know how bad is your partner situation but, normally, "a physician may not refuse to treat/accept a patient in an emergency situation if they have the skills required to do so" ( that comes from the Canadian Medical Association Code of Ethics). I don't know what defines an "emergency" though... but I seriously doubt they would tell you to go back to the other hospital. I've done it, one day apart, went to one hospital then the next day I went to my "main" hospital rather than the one I went for emergency. They sure looked at me with big eyes telling me I should have went back to the same I went first since it was for the same matter but never did they even seem to consider not treating me.

Do they open you up when you're constipated? No.

The problem with stoma is that we don't suffer constipation, it's really a mechanical issue and can cause serious complication if the blockage don't "dissolve" on it's own. I don't know what he did eat, but the thing is that at first it is mechanical, but then, it somewhat lead to a vicious circle that the food stay stuck in place and cause inflammation of the digestive tract at that specific spot which makes the obstruction even more complicated to resolve. That's at the least how things were explained to me.

I know it is standard to have the surgery team involved as every time I would show up at the ER for sub-occlusion they would call them. I don't know how long they can wait before opting for the surgery though. I guess it's case by case but mine usually resolved within 12-18 hours... 24hours of that pain must be horrible.

I hope they find a solution quickly, or even better, that it will get fix naturally and soon. Also, I really don't know what surgery they need to perform in that situation, but if it were needed, let's hope it is something "easy".

Good luck to you both.

 

[glum chump]

My experience (across the water from you in Victoria) is that there should be a GI or a surgeon "on call" at the hospital, particularly now that it's the weekend. This second person should be able to provide a 'second' opinion. I had started throwing up without any movement from my bowels and after not having eaten anything for four days. In my case, the surgeon on call said it was peristalsis and put an NG tube in to make sure nothing was going in (NIL by mouth) to my stomach while trying to pump out excess fluids in my stomach.

I would find out exactly what they're hoping to accomplish by surgery. I've also not heard anyone talk about this doctor's code. I had asked for different opinions while I was in the hospital and while the specialist got rather 'snitty' with me (egomaniac with a God complex is a dangerous combo), I was able to get a different opinion.

Not sure if he has a private health plan, but ambulance rides are usually covered by various health plans. Even out of pocket, it's $75 and might be worth avoiding the headache. I've found VGH and St. Pauls to be really good hospitals.

Good luck to both of you, and hoping you'll find some positive answers soon.

Kismet