Bleeding following abdominal surgery: how bad is this?

December 29, 2014 8:24 AM

Husband had an emergency gallbladder operation a week ago. He was staying put and feeling less and less pain, until this weekend he went outside, up and down a bunch of stairs, and lifted some heavy stuff. He started bleeding from either the belly button or the incision (they are very close) yesterday, it happened again last night, and is happening again this morning. How serious is this and what could this mean?

For what it's worth: it started laproscopic and went what I understand is "open chole", and also he started turning on his side to sleep which may have also caused the pain.

He doesn't think it's serious enough to go back to the hospital and I have not yet been able to get through on the phone. How bad is this? Please help. Specifics in particular would be very helpful, especially from medical professionals or people with medical training.

posted by corb to Health & Fitness (14 answers total)

Head to the ER. Let a doc assess it. Bleeding from an incision is NEVER good.

Your husband totally overdid it.
posted by Ruthless Bunny at 8:29 AM on December 29, 2014 [14 favorites]

Best answer: Unlikely to be really serious, but heavy lifting that soon after an open cholecystectomy is not a good idea. He may have opened up his incision a little or even torn out a suture; in the latter event the surgeon might put a stitch in under local anesthesia. If you have a follow-up appointment in the next 24 hours it can probably wait until then (although bleeding enough to soak the dressing would be more urgent). I would suggest calling the surgeon's office and asking them to take a look at it; they may want you to come by the office or may want to meet you in the ER, or something else, depending on how their schedule is set up. I work with a number of surgeons and all of them would be very willing to see a patient in the situation you describe, even if nothing more is needed than a dressing change and some reassurance (and possibly reinforcing instructions on post-op activities).

Among other reasons to let the surgeon check it out, if a wound is not properly closed/does not stay properly closed, you run the risk of developing an incisional hernia down the line. Not a major problem, but still best to avoid it all together.

If you want to memail me for a more detailed discussion feel free to.
posted by TedW at 8:35 AM on December 29, 2014 [5 favorites]

Best answer: Yes go to ER asap. You're not supposed to be lifting anything heavier than a jug of milk for weeks after for a reason. It's not to ruin all the fun you'll have by lifting things.

My wife had the same surgery this year, and was very careful not to lift, but managed to tear an internal stitch just with a poorly timed sneeze, causing her great pain but thankfully no bleeding. She had to take it extra careful for the rest of the healing process.

Bleeding is sure sign something is amiss, especially since it followed disobeying specific doctor's orders.
posted by The Deej at 8:36 AM on December 29, 2014 [13 favorites]

You need to have the surgeon paged. Period. No one here can assess your husband. Incision bleeding can be a big deal or not, depending on the surgery and location of the incision. Call the surgeon over and over again until you get a call back.
posted by PorcineWithMe at 8:36 AM on December 29, 2014 [1 favorite]

By over and over I mean every 20-30 minutes if you're dealing with the answering service.
posted by PorcineWithMe at 8:40 AM on December 29, 2014

Best answer: Call the surgeon's office and ask them what to do. It probably needs to get looked at - it might be as simple as throwing a new stitch or two in there under local anesthesia, but it could be more serious than that. (And tell him to stop lifting things - I had laparoscopic surgery and was told not to lift more than 10 lbs for 6 weeks.)
posted by bedhead at 8:50 AM on December 29, 2014

Best answer: After seeing some of the other answers I want to add that while going to the ER is not unreasonable (especially if the bleeding is severe or you are unable to contact the surgeon), the way things are set up in many practices is such that you may get a faster response if you contact the surgeon's office first. In the ER you may be triaged to the back of the line, then have to be evaluated by an ER doc, then wait for a surgeon to see you, especially if they are tied up in the OR or clinic. In contrast, the surgeon's office will know where the surgeon(or a partner) is and what the best way to get seen quickly is. This will vary from hospital to hospital and practice to practice, but unless the bleeding is severe enough to soak the dressing, I would start by calling the surgeon's office.
posted by TedW at 8:51 AM on December 29, 2014 [5 favorites]

Response by poster: For clarity on the calling - it's the "general surgery questions line", it is an answering service, and they say they will definitely get back within 24 hours but I have no idea if that means '24 hours for routine shit, sooner for nonroutine' or not. He was seen at a military hospital, so there's no specific surgeon's office that I'm aware of other than the general surgery line.
posted by corb at 8:53 AM on December 29, 2014

Since it is a military hospital I would be a little quicker to go to the ER since things are set up differently than in the civilian world; you might also want to try calling the patient advocate or similar if you don't hear back from the questions line soon.
posted by TedW at 9:02 AM on December 29, 2014

Just to avoid assumptions: if he was at Madigan AMC, have you been calling [phone] and [phone], which their website lists as direct contacts for the surgical department, or a different number?
posted by ROU_Xenophobe at 9:10 AM on December 29, 2014

(also found a number for 'surgical clinics' at Madigan AMC: [phone])
posted by ROU_Xenophobe at 9:12 AM on December 29, 2014

Response by poster: Called the first number, they referred me to that third number you posted which is where I got the message line.
posted by corb at 9:24 AM on December 29, 2014 [1 favorite]

Response by poster: Alright, kept pushing and found a new number and got told to bring him into the surgery clinic. Thanks everyone for the help!
posted by corb at 9:48 AM on December 29, 2014 [9 favorites]

I hope everything is well. But yeah, I had abdominal surgery this year and they told me not to lift anything weighing more than ten pounds for six weeks.

He went way overboard.
posted by winna at 10:38 AM on December 29, 2014 [1 favorite]