Post Op Update

So, my surgery was Thursday, Dec. 18th. When I got to the hospital they took me back to get changed into a robe and they weighed me, started my IV, and I answered the usual repeat questions (name, what surgery are you having, etc.). Then, they let my husband and best friends into that room with me. The anesthesiologist came in to introduce himself and we chatted for a little bit. I was scheduled for 2 pm but they must have been running early because about 1:30 they were telling me it was time to go. I walked into the OR with a team of nurses that were so sweet and got myself up onto the operating table. You lay with both arms out to your sides on separate arm boards to stabilize you. The last thing I remember the anesthesiologist and the nurses were asking me if I was ready for Christmas and I was telling them that I had finished all my shopping before the surgery so I didn't have to worry about that. The next thing I know I'm waking up in the OR in a lot of pain. I remember moving my arms around a lot and trying to sit up and hold my stomach and the nurses rushing to me and telling me to lie back down and try to relax. They must have knocked me out again because my next memory was being wheeled into my hospital room where I would stay the night. I don't remember much about that except that my husband was there and my best friend. I just remember saying over and over again that my chest hurts. 

As it turns out I had a very large hernia that needed to be repaired. The dr. said that if he had not repaired it, my tiny new tummy would get pulled up into my esophagus because the hole from the hernia was so large. I truly believe that hernia has been the cause of most of my pain. I had access to a morphine pump that I could push every 6 minutes if I wanted it. That was heaven. I took every advantage of that thing, and I'm not ashamed to admit it. I took the approach that I am normally a very strong woman, but at that moment I was at my weakest and I was going to allow myself to be comfortable and not feel bad about hitting "the juice" every chance that machine would let me. When I started waking with less pain I would space out my "hits" on the morphine drip. Then I transitioned into liquid Lortab, and managed fine with just that. 

Apparently I was peeing into my catheter like a champ because every nurse commented on how often they had to empty it. They said they wished every patient peed as much as me. I guess that's a good thing so I didn't retain too much of the constant fluids I was receiving. 

They had me up and walking a few hours after surgery. They would hook this strap around me, just under my boobs and the nurse held onto it just in case I was falling or passing out. Walking felt really great. Much better than I thought it would. 

Friday night about 6:30 pm I was discharged and came home. Since then I've been living in my recliner and I get up to walk as often as I think about it. Usually every hour or so. My husband has been my hero. He fills a small medicine cup with liquids or liquid protein and has me sip on it constantly and refills it every time it's empty. I takes about 6-8 sips to finish one medicine cup. 

The gas pains are no joke at all. I never got them in my shoulders or back, but my abdomen and chest have been very tender and painful, and you can hear my tummy making sounds from across the room. I've been living on Gas-X strips which do help a little and I have to take my spasm meds around the clock to control the spasms. Because of the hernia repair, each sip feels like a golf ball that is trying to travel down very slowly. Today is the first day that feeling has started to dissipate. Now, the most frequent pain I get is from filling up too much on liquids. Last night I tried a Jello. It was one of the small cups of the ready to eat kind. I ate about 1/2 of it and I'm not sure if it was dumping or what, but I had a horrible experience. My left ear starting ringing, and then my hands, feet and face starting tingling like they were "asleep" and I got really hot, dizzy, nauseas, and short of breath. It was pretty terrifying. My husband was able to walk me outside to get some fresh, cool air and it started to get a little better. When he finally got me back inside and into my chair it subsided even more, but it took about 30 minutes to get over it. If that was dumping syndrome from eating too fast or too much, rest assured I will NEVER do that again. 

I slept through the night last night for the first time since I've been home and today I'm doing a better job of tracking my protein in addition to just the liquids. So far today I've had about 40 gm of protein and that's not too shabby for 4 days post op if you ask me, but I'm shooting for 60 by this evening. I feel like today I am getting over the hump and finally recovering well. The lack of energy is the biggest challenge now, as just showering and the usual daily regime is too much sometimes. I'm taking it day by day. I don't know how people go back to work after 1 week, they are truly amazing creatures to do that. I go back on Jan 5th. 

Hope this has helped some of you newbies understand the post op process a little more, but remember that everyone is different. 

Last blog before sleeve surgery

This will be the last time that I post before I go under the knife on Thursday. I got off work early today to try and finish the last of my "to-do" list and have "the talk" with my husband about what to do if the worst happens. I fully expect that it won't, but I have to be prepared. It was an uncomfortable topic, but it's done and now we can move forward.

The last few months have been amazing in every respect. Honestly, facing this has opened my eyes to so many things. It has forced me to do some deep reflection and make some conscious choices that I likely would not have made otherwise.

One of the most meaningful things I did during this time of preparation was write letters to my family and best friend. If something terrible did happen, instructions have been left with a coworker on how to get those letters into the right hands. It may seem silly, but I wanted to do it. Writing those letters reminded me of how blessed I am and how fortunate I am to have the support system that I do. I am saddened by how many people going through this feel isolated. Not being able to share this life changing experience for fear of persecution is disheartening.

For anyone who may be considering this surgery, know this. It really is a very safe procedure and complications rates are very low. I urge everyone that asks questions to do their research. Look at both sides. Don't ignore the stories of complications, and certainly don't ignore the successes either. It's very important to have a plethora of information on both sides of the spectrum. Knowledge is power, and you'll make the best educated decision for yourself and your own circumstances if you collect information by the truckloads.

I've made so many new cyber friends through this process, too. We've all become so close and have really developed a deep bond that I am sure will last a lifetime. I'm excited about where we will all be in a year.

I'll be posting again from the "losers bench" once I am on the road to recovery.

Be blessed!

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That's the trouble with fear...

It always gets you when you least expect it. You’re cruising right along, doing your thing, and then something happens and that fight or flight reaction stops you in your tracks. Humans have fear to keep themselves safe. The fear of the unknown has kept us safe for thousands of years; we do what is most comfortable, hardly venturing out into the great unknown without a reasonable reason for doing so. In cases of elective surgery, it’s a tricky thing because as in the case of bariatric surgery, no one is saying to you something like, “Your appendix has ruptured and we have to remove it”, or “Your heart has a blockage and we must do a bypass or you’ll die”. It’s tricky because without bariatric surgery, oftentimes it’s only a matter of time until it kills us. Although in many cases it’s probably not in the immediate future, but definitely not a long way away, either. Or, maybe your health is pretty good like in my case. I don’t have heart problems, diabetes or high blood pressure, but rather my weight has robbed me of my quality of life. With degenerative arthritis in my back, the pain from the weight has taken away a lot of my joy. So, when I say that it’s only a matter of time until it kills us, it could be in the physical or emotional sense of the word.

I’m amazed at the change in emotion as I go through this process and it gets closer and closer to my surgery date. I’m still vacillating between excitement and fear, and I presume that’s going to be the case until I’m on the operating table on December 18^th. However, I no longer fear the procedure itself. I have the utmost confidence in my surgeon. Now, I am more apt to be fearful of the recovery itself, and occasionally the years ahead of me as I age. Since there is no long-term data specifically on my surgery type, the future is uncertain even though people have had portions of their stomachs removed due to various reasons including cancer. There are thousands upon thousands though, that have had successful surgeries and recovery times, and the number of those with life altering complications are slim. But, it does happen and I have to be educated and aware that the possibility exists. Nonetheless, the fear is an ever-constant subtlety that will likely remain. That’s the trouble with fear; it’s not something that is easily controlled.

There are only two kinds of days.

Ambivalence is defined as the state of having mixed feelings or contradictory ideas about something. On this particular journey in my life I've decided that I have but only two kinds of days. The only way I can refer to them is as positive days and negative days. The two never seem to cross paths, and each morning promises one of the two. A new friend of mine that I have begun to get to know through bariatricpal.com, the website that I'm admittedly an addict of, said it best; "It's almost like a strange retake on Groundhog's Day, where we've somehow got caught up in this (seemingly) never ending loop." That's exactly how I feel. I fall asleep at night thinking one of two things, either worry about the surgery and/or post op, or feeling excited about the surgery and/or post op success. I wake up feeling either anxious about how many days are left until surgery or hopeful about how positive my life will change for the better. I'm not quite sure why I keep vacillating so much between these two outlooks. The good thing about the website mentioned before is that you can read all sorts of varying experiences from literally thousands and thousands of people. The bad thing about it is the exact same thing. It's the epitome of a catch 22. Sometimes when I read horror stories that people have gone through or turmoil that people going through right now as a result of surgery, its sets my nerves on overdrive. One side of me says, "that won't happen to me", and the other side says, "the risk here is real, even the risk of death". Those two extremes are just that. Extreme. Granted, I'm relatively healthy other than morbid obesity, degenerative arthritis and fibromyalgia. I don't have blood pressure problems or heart issues. But, the clock is ticking. I am getting no younger and no thinner being incapable of exercise in this state that I'm in. I know that I've made the right choice and I know that the more positive I remain, the better I will do. If I don't go through this surgery, one thing is for sure, I will get sicker, I will get heavier, and I will face more health challenges. My mind is made up, I just wish I could stop this cycle.

Questions you should ask your gastric sleeve surgeon...

When I started this process I was just so excited to find out that my insurance covered bariatric surgery after researching the process for over a year, that I left out an important piece to the process. It was all kind-of a whirlwind though, when I got my consultation appointment literally for the next morning after trying to get in to see the surgeon that I was set on using. Once that appointment opened up at the last minute, there were so many emotions going on and so much excitement that the ball was FINALLY rolling, I neglected to make a list of questions to take with me to my consult. Now, to be clear, I had been researching this procedure and my surgeon and his center of excellence for a very long time, so I was already very much aware of the process and most of the national statistics, but I didn't make a list and that was a bad idea. Fortunately, the nurses and staff have been great about replying to my questions as I have them, but I wish I had been armed with them so that I could have spent more time with my surgeon in the beginning. If I had it to do over again, this is the one thing I would have changed. So, I have made a list of questions for you, the reader, to use for your consult. You may already have a list, and if so, just take a look at these and see if there is anything you missed. The more information you have in your arsenal the better prepared you will be and the more likely you will be to succeed post op!

How many years have you been performing bariatric surgery?
Do you perform other surgeries or only bariatric surgery?

What type of training have you had in bariatric surgery?

Are you board certified?

Are you FACS? (Fellow, American College of Surgeons)
Do you also do body reconstruction? (loose skin, breast augmentation)

Do you use staples, sutures, or both?

After the stapling of my sleeve, will you over-sew the staples?
Do you use a tissue sealant in addition to staples and/or sutures?

What is your complication rate?

What is your mortality rate?

More specifically, what is your sleeve leak rate?

How many trocars will be used for my surgery?

I have read that most leaks happen at the top, or at the bottom; are there any extra measures taken to protect against this happening?

Will you leave in a drain that will need to be removed a few days later?

Will you put me on Lovenox, Heparin, or other blood thinners after surgery?

What type of compression devices will you use on my legs to prevent blood clots?

If I have a hernia will you repair it at the same time?

Do you remove the gallbladder during surgery?

What size bougie will you use?

Is your center or your hospital a center of excellence?

Are you a member of ASBS? (American Society of Bariatric Surgery)

How many sleeve surgeries have you performed?

How many do you typically do each year?

How many nights will I be in the hospital?

Does your facility offer support after surgery?

When will be my first post op appointment and how often will I check in at the office after that?

Does your bariatric center offer a clothing exchange among other patients?

These are the most important questions that I think need to be asked. Feel free to add your own! Make sure you take a good pen and leave room to write in all your answers.

SUCK IT UP, BUTTERCUP!

I'm a part of a site for bariatric patients and those that want to learn about bariatric surgery called bariatricpal.com. It's an awesome site with some amazing support and you can learn just about anything and everything you need to know there. Of course, don't replace any of this good information for something your doctor or surgeon tells you, but there is a wealth of knowledge there. I'll admit, I'm a bit of an addict to this site. You can get tips on staying sane during the pre-op diet, you can hear first-hand from people who have had complications, and you can find the answer to just about anything you want to know. But, alas, there are those on the site that are perpetually negative and think they are experiencing "stalls" if they aren't losing 100 lbs a week. I'm not sure what these people expected. You didn't gain it overnight, you sure as hell won't lose it overnight either. One woman, we'll call her Stacy since that's not her name at all. This 61 year old woman is on there and she is deeply depressed because she's only lost 38 pounds in 5 weeks? WTH? I'm completely blown away when I read this. In case this poor lady has lost her calculator, she's lost an average of 7.6 pounds a week. That's over a pound a DAY. Look, I get it. You went through life altering surgery to lose weight. But, Heaven forbid you actually have to wait for it all to come off. The worst thing we can do is look at other people's success and use that as our barometer to measure our own personal success. Losing much faster than this is a risk in and of itself. Your poor skin, your gallbladder, your mental clarity, everything is affected by quick weight loss. Take it in stride lady, and...

My Top 10 Ways of Trying to PREVENT Loose Skin

I don’t want to look like a flying squirrel after my weight loss, so I’ve spent a great deal of time researching ways to combat loose skin, and while there’s no promise of perfect skin after losing a lot of weight, I’ve come up with the most common things that have supposedly been helpful when talking to and reading about people who have lost up to 100 pounds and more.

No, I’m not a skin specialist, but these are the top 10 things that I think I will do in these two months prepping for surgery Dec. 18th. None of these items would be negative, so any benefit that does come from them will be… well... a benefit!

These are in no particular order :)

1) Coconut Oil – I’m slathering myself in this every day. Coconut oil keeps the skin’s connective tissues strong and supple, and can even help with skin blemishes. I’ve already noticed a major improvement in my skin health since starting this regimen. I’ve always been prone to itchy skin and it has all completely stopped in a matter of days. Also, cooking with coconut oil is the healthiest in my opinion. Cooking with oils such as olive oil is counter-productive because once it reaches a certain temperature it starts to oxidize and release free radicals. That’s never good.

2) Body Brushing aka Dry Brushing - Releases toxins, stimulates the lymphatic system and improves circulation. Always dry brush in a circular motion, brushing toward your middle.

3) Water, Water, Water – Drink, Drink, Drink. If you’re an adult, you know this. Enough said.

4) Weight Training - Work those muscles. This one is tricky for me because I am so arthritic and have fibromyalgia and I have to literally micro-manage my every move in order to prevent adrenal fatigue, but I am so hoping, praying and wishing that once some of this weight comes off and I am in less pain, weight training will be possible again because I love it!

5) Say NO to sun bathing and chlorine – both of these dehydrate your skin. If you’re like me and love to be in the sun, use sunscreen or good clothing coverage. But, for me, I’m personally going to avoid too much direct exposure, at least between now and goal weight. It’s a healthy practice to get into anyway. Unfortunately it can be a catch 22 though, since so many sunscreens are full of skin harming chemicals. Your best bet = cover up! And for Heavens sake – stay out of the tanning bed! If you must go swimming, even in an indoor pool, wash that chlorine off ASAP. Can you say dry skin?

6) Regular Massage – I’m a big believer in massage for too many things to list, but treating your skin to regular massage stimulates your blood cells and lymphatic system. Your skin is your largest organ – treat it nicely ;)

7) Protein – Lots of lean protein will give your skin the collagen and elastin that it needs to stay healthy. If you eat a bunch of crap – expect your skin to be crap, too. I know this from first hand experience. Any time I get off track and start feeding my body junk food, my skin is the first thing to suffer.

8) Use Decent Soap – it doesn’t have to be the most expensive thing on the market, but cleanse your skin with a decent moisturizing cleanser and avoid over-cleansing.

9) Essential Oils – my sister has recently delved into the essential oil world and I’ve really been impressed with some of the studies that have recently been put out. Lavender oil and almond oil just to name a few are amazing things. I add a few drops to my bath when I feel like soaking. It’s good for the skin and the lavender is oh-so-relaxing, too!

10) Compression Wear – The support group meeting that I attend is lead by a bariatric surgery nurse who himself has lost almost 300 lbs. in about 18 months post sleeve. He swears by compression clothing and says it doesn’t have to be the expensive stuff either. Just a good quality compression undershirt and leggings makes a big difference, he says.

Some other ideas I’ve heard about on bariatricpal.com and in my other searches include things like taking beef gelatin, using or making body wraps, using lotion with caffeine, and eating lots of high antioxidant fruits and vegetables. Getting in “lots” of fruits and veggies is particularly challenging for VSG’ers because protein must come first and there’s often not a lot of room for extra. For this reason, taking a bariatric grade supplement for life is critical. A couple of funny comments that I got when I posted a question on a forum about ways to prevent loose skin was “youth” and “good genetics”. I got a good chuckle out of the youth one because now that I’m in my 40’s it’s certainly apparent that I’m not a teenager anymore. But, alas, healthy skin is something we should try to keep at any age.

The bottom line is that none of this may work at all, but if I don't try, and I end up with loose skin, I'll wonder if it would have been better if I tried. If I try them all habitually and I still have loose skin, at least I'll only wonder if it would have been worse if I hadn't.

Gifting myself

I've been thinking that since I have 2 months to prepare both mentally and otherwise, I would go ahead and start collecting little things for my new life. I'm traveling Mon - Thurs this week to New Orleans for work, so when I get back I'm going to take a nice box and cut off the top, then find some wrapping paper that makes me squeal with delight and put a big bow on it. This will be my gift to myself to celebrate my new birthday. I'll add things to it as I find them over the next few months. I'll start a tradition of giving myself a special gift (non-food, of course) every year on the anniversary of my new tummy! I was in the grocery store on Sunday and found the greatest little things that I think will be super helpful for post op, once I'm on semi-solids and solids. They are these adorable little 1 C. containers that come complete with a little removable ice pack that sits inside the lid. I've read that most sleevers won't come close to 1 C. of food for a long time (if ever), but these were the smallest ones I could find.

I can't wait to use these little boogers, and of course the pink one is my favorite! I've also got some adorable little cocktail forks and spoons that will make me take itsy-bitsy little bites of food. I'm hoping to find more of those in cute designs. If anyone has any suggestions for my gift box to myself, I'm all ears!

Picked a surgeon and got a date!!!

Whew! The last 48 hours have been a whirlwind! I went from considering Mexico if things were going to take forever with my Dr. to getting a call from my Dr. with some GREAT NEWS! My insurance has no preliminary requirements! They have put me on the "fast track" for VSG and I will be having surgery on Dec. 18th!!! I'm so excited. I got a date! I got a date! I got a date! I'm doing the happy dance! So many emotions going on right now. I jump from ecstatic to scared, and then from worried to anxious. Mostly just delighted though. I know the next few months are going to fly by, but I also hate the waiting. I've had an upset tummy for 24 hours now because my nerves are all over the place. This IS the right decision though. Even my other Dr's all agree this is going to be the best thing for me in my situation. December 18th will be here before I know it! Now I just have to wrap my head around it and decide how many people I'm willing to talk to about it. It feels very private, but I'm also not ashamed of it. Oh well, time will tell what I decide to do and I'll cross that bridge when I get there!