What happens in the ER if you show up and have a blockage?

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Hopeso
Regular Member


Date Joined Jun 2004
Total Posts : 231
   Posted 12/18/2005 2:42 PM (GMT -6)   
My last trip to the ER made me wonder about the knowledge of the staff where an ileostomy is concerned.  I told the nurse I had my whole colon removed, and she said "no you didn't or you would be dead"!  See what I mean?  So what is the normal proceedure if you are an ileostomate and think you have a blockage, pain, etc.  What should you let them do and what is off limits?  I did get the cards from the ostomy association, that you are suppose to give to the ER staff, if you get into trouble, but I am confused about some things on it.  It mentions an irrigation sleeve, and putting the finger into the stoma.  my stoma is so small I don't think a finger could get in there.  And I thought the irrigation sleeve was for those with colonostomies.  Please someone explain it to me.  I hope I don't end up with a blockage, but if I have learned anything, I realize that you are your best advocate in a hospital setting.   I like to be somewhat aware of the way things should go.
Thanks, Leslie
 


Suzy2
Regular Member


Date Joined Aug 2003
Total Posts : 335
   Posted 12/19/2005 3:53 AM (GMT -6)   
It's amazing how little knowledge some nurses and even Doctors at times seem to have about Ostomies. Especialy I think when it is in the ER.

I am hoping that Shaz will see your message because she has many years more experiance than me with her ostomy,so she can put me right if I get the info wrong. I have read many times that it can be quite dangerous for someone with an Ileostomy to be given an enema through the stoma. Partly I think because the stoma is so delicate but also because we are much more at risk of dehydration than people that have their colon.I understand that if any procedure has to be done at all via the stoma then they would have to use special tools although I am not sure about what this involves. i have always thought as you do that the stoma looks too small to even get my little finger into it. I believe that you are right about the Irrigation,that is meant for colostomies not Ileostomies. We shouldn't take laxatives either,again because of the dehydration risk.

Sorry I cant be of more help but thankfully I have never been to hospital due to a blockage. I hope that neither of us has to either.

Sue


Shaz032
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Date Joined Feb 2003
Total Posts : 1246
   Posted 12/19/2005 10:35 PM (GMT -6)   
I can't comment on the correct procedure since I've been lucky and never had a blockage in 30 years so have never experienced a hospital visit due to this. However, the card explains it for the staff from what I've heard.
 
You are right in that irrigation sleeves are for usually for colostomates as we know them but this is a different type and used for all sorts of ostomies for helping to clear blockages. Also, your stoma may seem small but remember that 'normal sized' stool used to pass through it before it was placed on your abdomen. It can stretch quite a bit and will accommodate a finger easily. Remember though, that only a medical professional who knows what they are doing should ever stick anything in your stoma.
 
Hope this helps.
 
http://www.ostomates.org
I'm not a complete idiot - some parts are missing!
________________________________________________

Ileostomy for 29 years since I was 10 years old, due to UC.


Sherrine
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Date Joined Apr 2005
Total Posts : 17462
   Posted 12/29/2005 3:20 PM (GMT -6)   
     Hi!  I have been hospitalized four times with a partial bowel obstruction.  When you go to the ER, they will run tests, like bloodwork and an x-ray, to see if you have a partial obstruction or a complete obstruction.  With a partial obstruction they put the NG tube in your nose and down into your stomach.  Ask for a numbing agent.  They have an ointment that helps a lot.  Also, get as small of a NG tube they will allow.  I didn't know the tubes came in various sizes and I suffered the first time...actually my nose and throat ended up hurting more than the obstruction!  I broke my nose years ago and have a deviated septum so they use a pediatric NG tube for me.  The size is #12.  It's much more comfortable.
     Then, if you are in a lot of pain, which I usually am, they give me morphine through the IV to help with the pain and help me relax.  I'm also given something for the nausea if I have nausea.  Then they send me to my room and let me slelep.  I'm only allowed ice chips and they request that I only take a chip if my mouth is extremely dry.  The NG tube sucks the water out of your stomach anyway.  I don't take advantage of the ice chips because I sure don't want them taken away from me!  I'm usually much, much better within a day.  They then take a cat scan of my abdomen.
     When you are feeling better and not much is coming out of the NG tube, they remove the tube and then you will be given a clear liquid diet.  If that's fine, you are advanced to a full liquid diet and finally real food.  Then you are sent home. 
     How many days in the hospital, you ask?  It depends.  Ive been in as long as 8 days and as few as 3 1/2 days.
     I go to a hospital that has a department that specializes in digestive diseases so I'm sure this is the right treatment.
     As far as putting anything in the stoma, that is a "no no" for you.  But, I have had my surgeon stick his finger in the stoma.  They will do that to see if they can feel anything blocking it.  I imagine that if they felt something there, they might try to irrigate it to get it to come out.  This is only a guess, because that's never happened to me.  Hope this helps you.
 
Sherrine
    

Hopeso
Regular Member


Date Joined Jun 2004
Total Posts : 231
   Posted 12/29/2005 10:00 PM (GMT -6)   

Thanks for the great info.  It really helps to hear your experiences.  I hope I never have to go thru this ever.  How could I tell if my hospital is a good one for digestive problems?  I know they have a GI lab where they do a ton of scopes, and biopsies, but other than that I don't know. 

Hopeso


 


Sherrine
Forum Moderator


Date Joined Apr 2005
Total Posts : 17462
   Posted 12/30/2005 9:03 AM (GMT -6)   
     Hi, Hopeso!  You can go online and check out your hospital.  Most hospitals these days have a website.  Also, if you live near a university, you can probably find a great hospital.  I live in Tampa and my doctor is also a professor for University of South Florida's medical school.  Tampa General is affiliated with USF and train doctors as well.  I used to live in Cleveland, Ohio and they have five teaching hospitals there!  I had my original surgery at the Cleveland Clinic.  This has been my experience with my health problems.  I've gone, once, to my local hospital for the partial bowel obstructions and I won't do that again.  They are the ones that hurt me with the NG tube, plus, I was allowed nothing by mouth, not even an ice chip, for four days!  Also, the surgeon assigned to my case stood there and literally wrung his hands and said over and over again that he hoped he wouldn't have to operate and what a difficult surgery it would be!  That sure didn't give me any confidence!  tongue    I told my daughter not to allow him to touch me and to get me to a different hospital!  (This surgeon, by the way, is considered the best general surgeon in my suburb!)  I've never had an experience like that at a teaching hospital.  They know what they are doing. These teaching hospitals usually have speciality departments but the bottom line is that you can find out the info online.  I even found out information on my doctor!  Give it a try!
 
Sherrine

Hopeso
Regular Member


Date Joined Jun 2004
Total Posts : 231
   Posted 1/2/2006 10:50 PM (GMT -6)   
That sounds good Sherrie,
My insurance has changed now and I can go to many different doctors and hospitals. However it would be great not to ever have to go back!
Leslie
 


sparkn
Regular Member


Date Joined Apr 2003
Total Posts : 273
   Posted 1/26/2006 9:18 PM (GMT -6)   
I haven't been on in a while but just read your post, unfortunately I have become an expert at going to the er for blockages lately. The only thing I would add to the info everyone gave is that the er also usually has me get a cat scan to get a better look at what is going on. Of course this means drinking a ton of icky stuff...which seems ridiculous since you are blocked up, but that is the typical procedure when I go in. Then they do the nose tube for a couple of days. They also told me that for some strange reason, something in the stuff you have to drink for the cat scan often triggers the blockage to open up. This also seems strange to me, but then again....my blockages usually open up after the first day and I have avoided emergency surgery so far. Although I am having surgery to remove a stricture in 2 weeks, trying to avoid another er trip. As far as choosing the right hospital, it depends on where your doctors are. I would recommend asking them what hospital to go to, also it is probably good if the hospital has a good colorectal surgeon, or at least a surgical department familiar with ostomies as they are the ones who keep track of you when you are in the er and hospital. Good luck, I hope you don't need any of this advice!
Happiness is a journey not a destination - Souza


Hopeso
Regular Member


Date Joined Jun 2004
Total Posts : 231
   Posted 1/29/2006 5:49 PM (GMT -6)   
I hope so too, thanks.
Leslie
 


Sherrine
Forum Moderator


Date Joined Apr 2005
Total Posts : 17462
   Posted 2/3/2006 5:28 PM (GMT -6)   
     Well, guys, I just got home today from another hospitalization for blockages...the third time since October.  This time I was in the hospital for five days.  Believe me, I'm now an expert on them since I've been hospitalized five times in three years.  UGH.
     I forgot to mention the CAT scan.  They do that to see if you have a partial or a total blockage.  Also, I believe it would show if your bowel was strangulated.  But, from what I understand, you'd KNOW it was strangulated because the pain is extremely bad. 
 
Sherrine
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