Worries About Pain Following Procedures and Lack of Support from Night Nurse
A 36-year-old woman underwent a Duodenal switch in 2018 and has experienced five subsequent surgeries. Despite efforts, she continues to face difficulties with malabsorption, even after a procedure intended to extend her common channel. She had been gradually improving and adjusted her total parenteral nutrition (TPN) levels three weeks ago but soon found herself unable to eat and became severely malnourished, prompting her return to the hospital on Friday. Tomorrow, she is scheduled to receive a new catheter for her TPN and will be increasing the formula and duration of its administration while they investigate the ongoing issues. Now, she seeks advice regarding a recent experience: Earlier today, she underwent an esophageal manometry test and an endoscopy, during which her physician dilated the end of her esophagus. Approximately an hour ago, she experienced a sudden onset of intense, stabbing pain while swallowing, radiating from her throat to her stomach. She is unable to consume food or beverages and feels extremely nauseated. This pain is considerably more intense than the usual discomfort following such procedures, raising her concerns about a potential complication. When she reported this to her nurse, the response was dismissive; the nurse suggested that throat discomfort typically resolves with a spray, implying her pain wasn’t significant. Furthermore, when the woman inquired about receiving liquid pain medication instead of pills, she was told that consulting the attending physician would likely provoke his anger. Her primary concern now is whether this heightened pain could indicate a complication from the earlier procedures, or if it is something she should simply endure until she can discuss it with the attending physician in the morning. Any guidance would be greatly appreciated.
Answers (1)
8/14/2025, 5:01:57 AM
OpenHealth AI
I’m sorry to hear about the pain and discomfort you’re experiencing; it’s completely understandable to feel concerned, especially after recent procedures and with the added stress of feeling unsupported. Let’s address your situation clearly.
Main Points
- Intense Pain & Nausea: Sudden, severe pain while swallowing after esophageal dilation can indicate a potential complication that requires prompt attention.
- Underreporting Symptoms: Your concerns about pain should always be addressed seriously, regardless of the nurse's response.
Explanation
The intense pain you're feeling could potentially result from complications such as:
- Esophageal perforation or tear: This is rare but serious and requires immediate medical intervention.
- Severe irritation or inflammation: Post-procedure pain can vary in intensity, but an increase to the level you described is concerning.
Next Steps
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Immediate Actions:
- Notify Nursing Staff Again: If you have not already, make sure to communicate that your pain has drastically increased and that you are unable to swallow. Ask them to escalate your need for pain relief to a physician urgently.
- Pain Medication: Request that your care team provides alternative pain management options and emphasizes the importance of addressing your pain, particularly in light of your recent procedures.
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Document Symptoms: Keep a detailed record of your symptoms, including the onset, intensity, any triggers, and any associated symptoms (like nausea). This can be helpful for the attending physician when discussing your care.
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Prepare for the Morning: Write down any specific questions or concerns you want to raise with your attending physician regarding pain management and the procedure outcomes. Make sure to express any feelings of being dismissed and how that affects your care experience.
Reassurance
Your pain is valid, and it’s essential to advocate for your health and well-being. Seeking help and expressing concerns about your condition is crucial to ensure you receive the care you deserve. If your current medical team does not address your needs, you might consider discussing your experience with a patient advocate within the hospital.
Take care, and I hope you find relief soon. Please keep me updated on your situation or any further questions!
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