23 Days Post-Op: All in Due Time

For the sake out housekeeping, I know you've been chomping at the bit to find out what breed Casey is.  So, drumroll please..... he's primarily Siberian Husky and somewhat less Chow Chow.  Crazy, right?  Crazy!

Also, I felt like the old blog needed some updating so enjoy the new, fresh look!

Ok, now down to business.

I saw the doctor for the first time yesterday.  I was feeling so discouraged after having lost only 2 lbs between weeks 2 and 3.  I have the LRNP's voice in my head saying "...20 pounds the first month" and while this wasn't a full month, I was super disappointed.  What had I done wrong?  I'd followed the diet to the letter, I'd gotten on the recumbent bike as much as possible, I'd taken my vitamins.  I'd done it all right.  What happened?  The only real change is that I added pureed food into my diet.  But, Jen, everyone does that, yet that number was in my head.  It was eating away at me (no pun intended).  I went into my therapist's office on Tuesday feeling incredibly down and we had a discussion about how each person is an individual and everyone's body is going to react to surgery differently, etc.  I still couldn't get that 20 lbs out of my head.

I went in to the appointment a bit ambivalent, but my doctor is wonderful and put my mind at ease right away.  As always I took my recorder with me.  This is the first appointment I've been to alone, but even when there's someone with me I take it.  With my brain being that of dirt, it's important to make sure I don't remember something incorrectly.  With this, it could make a MAJOR difference, and not in a positive way.

At the downtown office, they have a scale.  In the suburban office, there may be inconsistencies, so he sticks with the weights I give him from my scale here at home.  While I lost only 2 lbs between weeks 2 and 3, he wasn't concerned.  If memory serves (haha), I have lost about 12 lbs since surgery.  I've also lost almost exactly 50 lbs since I first met him on 12/30/15.  He's pleased with my progress.  He also said something that really struck me.  He said that I'm with myself everyday so I don't notice the change, but he can clearly see it.  I expressed my frustration at not being able to wear clothes that I have fit into at this weight in the past.  He essentially said "all in due time," but I wasn't offended.  I guess when the person who monitors your weight says something like that, it doesn't come across as trite.  He really means it.  He knows it for himself through other patients.  All in due time.

There are some areas which have puckered, specifically the two he used to do most of the work.  I wasn't concerned.  I figured that after losing the weight they'd go away anyway.  But he assured me that it's because in those areas which were used the most and suffered the most "trauma" the dissolvable stitches are attached to pretty deep tissue, hence the puckering.  No biggie.  I've had enough surgeries and have enough scars that these things don't bother me.  Heck, if that's the worst that comes from this surgery, I'll be thrilled!

I start "real/people" food next Tuesday.  On the same day, all restrictions will be removed.  The biggies are my lifting restriction and being able to get in the pool.  The lifting: tonight, for example, is going to be pure chaos.  Keith had to take Bert to the vet so they could do a day-long blood sugar monitoring (a bell curve test).  Then, tonight, we have to take both dogs for their annual appointments and to update their vaccinations.  I'm neither allowed to lift Bert nor "walk" either dog; given their sizes and the fact that they pull, there is a danger internally that they could do some damage.  Even after my restrictions are lifted, I am to take it easy as far as walking them is concerned.  Shoot!  I will have the pool and I have my bike, but left to walk by myself I wind up too much in my head and then start to think about the pain or "I've walked 'x' far and will have to walk it back" so I'll go easier.  If I'm walking the dogs, I'm focused on training them not to pull (it's an uphill battle!).

So, food.  I am a bit confused by some of the papers the dietitian sent me.  I am not really supposed to snack - and I get that.  If I start to snack and it becomes a habit, I just set myself up for failure, even if they're healthy snacks.  At the same time, some of what is listed on the paperwork sounds snack-y.  But, I am allowed to do some vegetables now.  3 high-protein meals (with a total protein intake of 60-80 grams, so 20-30 grams each meal).  I can do 3 oz of protein and 1 oz of veggies, which I think is where I'm getting the idea that some of those foods are snacks, because it's things like roasted chick peas or certain veggies with hummus.  For maximum weight loss, they have found that people who continue to do one shake daily have the most success.  It's also an incredibly easy meal!

I saw the EOB (explanation of benefits) from my primary insurance company the other day.  It's absolutely insane!  Granted, they took extra precautions because of the first attempt, plus there are oodles of bags hanging from my IV pole,

(crazy, right?), the 2 nights in the hospital, doctors, a test the day after surgery, blah, blah, blah.  You can imagine how the list goes on and on.  Also, it's a teaching hospital and I'm not sure how that works as far as billing for services of residents - I'm assuming it's ok since they're not interns, although I have no idea if they can bill for interns... all irrelevant.  Let's just say the bill is monstrous!  Praise God that I will have to pay less than $1500 and while that's not chump change, it's a tiny percentage.  Now, my secondary said outright that they do not cover bariatric surgery.  I don't know if that includes everything that goes with the surgery, like the hospital stay.  Whatever happens, Keith and I are SO thankful that insurance is picking up the majority of it.

So, all-in-all a very positive visit with the doctor.  Next week I'll be pushing the exercise as I test out foods and see what my pouch can tolerate.

And the journey continues....

Day 7 Post-Op

Alrighty then...  Where to start?

Surgery day was a long one!  After an initial call to arrive at the hospital at 11:15, they called later and asked if 8:45 would work.  Heck yeah!  The earlier the better.  It meant leaving the house super early because of traffic headed downtown, but that's not at all a complaint!  I got changed into the hospital gown (the paper pre-op one -- it does have cute little paw prints on it, though), my Pastor and a church friend who had come to the last "attempt" arrived and we sat.  And sat.  And sat.  I think they finally took me back to the pre-op area around 1 pm.  Certainly none of us expected that.  I was there for a bit as the struggled to find a vein.  Again, they found one good enough to put me under and poked, prodded, stuck and tortured my poor body before even beginning the surgery.  One interesting note: I had anesthesiologists on either side of me looking for veins.
One of them finally went and got a vein finder (image courtesy of http://www.qtechnologiesgroup.co.uk/local-community-fundraise-for-new-vein-finder-accuvein/) although I have no idea of the brand.  I was too busy watching this thing and sort of fascinated by it.  I've always had difficult veins.  Pretty cool, right?

Perhaps I should pick one of these up (for upteen dollars) and carry it with me!  Yes, so while the vein finder was keeping my attention to my right, the woman on the left found a vein good enough to get me under.  I'll tell you, when I woke up I found all sorts of bandages from failed attempts.  Hey, at least I was asleep, right?

The one thing  One of the things I wasn't expecting was having a jugular central line.  The doc wanted to be on the safe side and said it's the easiest way to get meds to elevate blood pressure, should that happen again.  Sadly, they kept it in the entire time and it was a bit annoying, but I survived.

Remembering that I am.... well.... me, things didn't go 100% as planned and the surgeon found adhesions from my gall bladder removal which he had to address.  Once that was out of the way, he proceeded forward.

Something else I wasn't expecting was the level of pain and the amount of nausea.  Sure I knew there would be a ton, especially the first day, but when, by day 3, I was still having a hard time getting down the mandatory 4 oz of water hourly, I was taken aback.  Heck, once I had 5 oz and was sure I was going to lose it.  Yep, that's how small my stomach is - well, at least when it's all swollen and irritated from surgery.  While the surgery went (mostly) according to plan, I was given the option to stay at the hospital until Friday, while most leave on Thursday.  I was up and lapping the unit and was keeping up with my fluids so was ok'd to leave on Thursday.  I decided that I'll heal better with more sleep - because honestly, does anyone actually sleep in the hospital?  They gave me a special pillow to push against my belly when I cough or laugh or do anything else that puts strain on my core muscles and it has helped a lot.  So I know I'm super out-of-shape, but I had NO idea how often I use my core muscles.  Just getting in and out of a chair or (forgive me) on and off the toilet was downright excruciating the 2nd day (after they removed the catheter).

Sleep.  It's not as easy as one would think.  I'm not allowed to twist, nor am I to bend from the waist or lift more than 15 lbs.  It's absolutely better than being jabbed and poked all night long.  However, even sleeping in my usual position has me twisting a bit, which I never realized.  I have taken pillows and propped my middle section up a bit so I'm more aligned.  Bert, unfortunately, likes to lay there; it's his nighttime spot.  I've had to "encourage" him to move more than once since Thursday.

I'm keeping a book with everything that comes in (and goes out) of my body, as well as pain levels and I am supposed to take my temperature twice daily.  That all goes in my book.  I'm also keeping a general mood record in there for my personal record-keeping.  With my follow-up on Thursday, I don't want my horrible memory to kick in and wind up saying "I don't know" to a bunch of really important questions.

I'm still doing the liquid diet and am to get 4-6 oz hourly of liquid.  I started off with ginger tea when I first got home (iced it like crazy) and am now doing Crystal Light, and even doing some broth and consumee.  Some nights what Keith makes for himself smells delicious, but always simultaneously makes me nauseas.  That Thursday (although it may have been Wednesday -- it's so easy to lose time in the hospital) the nurse told me she was all-but prohibited from giving me anti-nausea meds.  This will be my "new normal" for a bit and I have to get used to it.  So, I've toughened up and done what I can.  Thankfully, all has stayed down.

I think I've mentioned before that I fear my depression meds will decrease my metabolism, hence slow my weight loss.  The surgery will absolutely affect my meds and how they are absorbed.  I don't know if that means I will have to decrease (hopefully) or increase dosages.  I also had normal blood pressure in the hospital and since I was being monitored 24/7 and not getting any BP meds, the doc sent me home not taking it.  My PCP was ok with that.  My sugars were also normal given that I was on a constant "sugar saline" drip.

I have essentially stopped pain meds, although did take a dose of liquid (i.e., kids) Tylenol for a headache.  There's no need to take narcotics for that.  I'll speak with the LRNP at my post-op appointment this week about what vitamins and supplements I should take.  I actually like the calcium - it's a nice sweet treat twice a day.

Poly was in daycare today (and all week).  Since I'm not allowed to bend over at the waist, I can't put her leash on and since she won't come when she's called (and will bark like a maniac), she needs to be leashed.  Casey has been bummed today, but he's good for me.  I just wish I could sit in the sofa with him so I could snuggle.  I think a good snuggle would do me good.

This evening, hubby had to rush home from work to pick up Poly from work so he could help me get Bert in the carrier so we could take him to the vet.  Just to add to the stress going on right now, Bert has to stay at the vet overnight (Tori isn't happy and will start howling/yelling at us when she realizes he isn't there at bedtime).  He hasn't been using the litter box to urinate; rather, he thinks the sofa in the spare bedroom is a better place.  Thankfully we have vinyl car seat covers for the dogs, so we put them down so there is no damage to the sofa.  He actually only ruined a pillow.  There were sheets covering some clothes I had there and the clothes on top were still in their bags - they never fit... that is not YET!

So, I know I rambled quite a bit and this is rather garbled.  Please forgive me.  I've been working on this on and off all day in the midst of a bunch of other things.  Any repetition is unintentional, as is any disjointedness.

I hopped on the scale yesterday - hubby was home and I can't bend at the waist, so I can't even get to it.  I've lost.... <drum roll please>...... 2.2 pounds.  Honestly I'm not upset about this.  I'm still swollen inside and my body is holding on to the liquids I'm consuming.  If it doesn't pick up in a month, that'll be a different story!

I think that's enough storytelling and drama for today.  Hopefully I'll soon be snoring away....

Counting the Hours

Yep, that's right -- surgery's tomorrow.  I have to be downtown on the early side, but that means surgery will be over earlier and hubby will be able to get home to our furbabies so they don't wither away to nothing (yeah, right -- spoiled kids).  My first call this morning said to be there at 11:15, but later got a call that there was a cancellation and asked me to be there at 8:45.  While we'll be in rush hour traffic ( which seems extra horrible around here with construction, lane closures, and roads not built for the amount of traffic traveling them daily... this area has been built-up beyond belief), hubby will be able to get home that much earlier.  Casey (the big pup) will be in charge and will eat anyone who tries to enter unauthorized!

So, it's the ol' gastric sleeve, attempt #2.  Same surgeon, same hospital, same anesthesiologist (I hope!) and same pacu nurse (I hope!).  I know I'll get top quality care and then the real work begins.  They want me sitting in a chair shortly after I get to my room (I imagine they'll let me take a snooze first) and then walking the halls by the end of the day.  I hope I'm up for it because all I've heard from anyone is walk, walk, walk.  Not only does it help prevent blood clots, but it helps with healing.  I don't understand the ins and outs of most things medical, but I suspect that if I'm in one position too long, my "pouch"/sleeve will get too comfortable there and it will be more painful to move when I finally would get up.

As far as the failure and my blood pressure:  I've been working with my PCP to stop one of my bp meds (first in half with 2 bp checks the following week, then stopped altogether with another 2 bp checks).  I saw my pulmonologist today and they said my bp was "just right" (or perfect, or something to that effect) to them.  In my eyes, it was a little elevated, but I was told by the surgeon's office not to take my other bp med today and that they'd prefer to handle high bp in the OR vs. low bp.

So, as it stands now, the plan is:

1. Arrive and go to the admission area (assuming that we got through traffic without being killed)
2. Put on the oh-so-fashionable hospital gown (and the paper one; I don't get the more comfy cloth one until after surgery)
3. Head to pre-op and hope for the wonderful anesthesiologist to find a good vein
4. Speak with the surgeon, who will tell me that he got a good night's sleep (he did last time)
5. Enter OR and go night-night
6. Wake up in PACU, hopefully to the smile of the wonderful nurse from last time.
7. Head to room and have ice chips  (hopefully)
8. Wednesday:  have a barium swallow test (which is as delightful as it sounds, although this one will be far less complicated than the one I had in the past because they are looking only to make sure the pouch is proper.
9. Sip water.  SIP.  WATER.
10. Thursday, if all goes according to plan, HOME!

Hubby will be working from home on and off Wednesday-Friday and is off for Memorial Day on Monday.  Then our problem child will go to daycare.  I won't be able to bend at the waist, so I can't put her leash on.  I also can't get them water if they need it and a number of other things.  I have my enormous shoe horn - again, not being able to bend at the waist.

Keeping prayers on my heart for a positive outcome and that my anxiety doesn't take over.  I'd love if you could do the same.

Over and out...

The Long and Short of It

Fact: I did everything asked of me between 12/30 and 4/26, including blood work, a drug test, a nuclear stress test, an echocardiogram, a psych clearance and more.
Fact: I've had countless conversations with the nurses and dietitian at the surgeon's office.
Fact: I did 2 weeks pre-op of a liquid-only diet (which is nothing shy of torture).
Fact: My husband took a day off of work the day of my surgery.
Fact: My attempt at a vertical sleeve gastrectomy on 4/26 failed due to dangerously low blood pressure and oxygen levels.
Fact: I had multiple checks of my blood pressure at my PCP's office after finally discontinuing one of my blood pressure medications

Now that we have that out of the way...

I am back on the liquid diet, but true to his word, the surgeon is only making me endure one week of liquids (oh, and FYI: don't bother plain broth unless you have no interest in taste).  Thanks to a dear friend from church, I was introduced to a whole new world (is anyone else singing the song from Aladdin?) of sugar-free coffee syrups and no longer limited to the 3 options at Target.  Don't get me wrong, but they were getting a bit dull.  So I discovered that there is an entirely separate brand of these syrups and it's life-altering.  Ok, that may sound extreme to you, but please know that I am not exaggerating.  Keith would have long-since killed me had I been limited to chocolate and vanilla.  I can also enjoy sugar-free Jell-O!  Who would have thought that would warrant a WOO HOO?!?

So, what does all of this mean?  It means that I am scheduled for surgery this coming Tuesday, 5/24!  I admit that I'm having a hard time getting as excited this time around.  I fear something else will go wrong and I'll be destroyed again.  Let me make it clear that LOGICALLY and INTELLECTUALLY, I know that I did everything I was supposed to, to the letter.  However, there is part of me that feels like, had I done something different or better, I would have a month's jump on my recovery.  I should be beyond another 2 weeks of liquids AND the dreaded 2 weeks of pureed food.  I should be adding in "human" food now.  I should be trying foods, a little at a time to see what the sleeve will tolerate.  As one of my doctors would say "I'm should-ing all over this situation."

Now that it's almost the weekend and then there's only one day left of Keith being at work, we'll be headed to the hospital... well, now I'm starting to get a little cheery.  I pray that will turn into outright excitement by Tuesday morning.

For now, I'll drink (sugar-free, non-carbonated, and while I rarely do, non-alcoholic) and I'll enjoy some Jell-O.  I think I should get a royalty for that one, but for now, I'll just enjoy it.

I have been consistent (since my initial junk food pity party), I have been on that exercise bike.  I'm up to 15 minutes and doing about 5 miles +/- .  In fact, I bought a TV for Keith to mount on the wall in the room where the bike is.  Right now, I spend the first part of my ride ( varying) praying, but after that, there is little to do but watch the numbers: the seconds tick by, the distance trudges along, and the calories... well, that's just downright depressing!  I know the TV will help and with Amazon Prime, I'll have a choice of non-daytime television options.

For now, let the countdown continue.

Short and Sweet: my Failed Attempt at Weight Loss Surgery

Ok, ok, I can hear it now - it wasn't your fault, you aren't a failure, you didn't fail, the doctors did what was in your best interest.  Yes, logically I know all of this.  Emotionally, well that's a different story.

And it begins.  April 26th, the day ingrained in my whole world.  I had a countdown clock on my phone and could look at any point how many days I had left until my life would change.  Yes, I've made plenty of positive changes since my first visit with the surgeon on 12/30.  Between then and 4/24, I lost 40 lbs!  Granted, I was on the mandatory 2-week  liquid diet, which certainly helped matters, but still - 40 pounds!  I'll tell you right now that I've gained about 14 of those lbs back since the infamous failure day.

I arrive at the hospital and am almost giddy with excitement.  I may have been the only person in pre-op who was joking around and happy to be there.  I was PUMPED!  The doctor came in, telling me he had plenty of sleep the night before... whew!  My mind was at ease on that one (not that I even considered it a factor).  I was there for one reason: to start an irreversible journey.  Yes, before I move on, I know several people who have taken this journey and wound up gaining some or all of the weight back.  Here's my reality, though.  I HATE to vomit.  While I've always had weight issues, I have never even considered (even as a dancer) purging.  I know life after this surgery will be radically different.  I know my relationship to food will forever be altered and that there are foods I won't be able to eat ever again (without the whole puking thing).  It's sort of very hard to fathom right now, but the thought of never having gnocchi or my Mom's red velvet cake again may be a reality.

So, returning to the hospital.  The anesthesiologist comes in and puts in an IV.  She said that she didn't really like the vein (especially considering I'll be on IV fluids for a few days and it needs to be a strong vein), but it was good enough to put me under so she doesn't torture me while I was awake - I sincerely appreciated that, since I know I have horrible veins.  She gives me a muscle relaxant, to which I'm nearly immune, given that I used to be on something like 2 mg three times a day of Xanax.  I remember them wheeling me into the OR and putting the mask over my face.  After that, the next thing I know is that they're rushing me through the hallways telling people to get out of the way.  I wasn't really alert to know what, if anything, this meant (I mean, it could have been people on break having lunch or talking on the phone for all I knew).  I am slightly conscious and am asked if I'm in any pain, I'm shocked to be able to say "no."  I mean - major surgery brings with it some discomfort - at least - and I felt ok.

When I'm awake enough someone (either the anesthesiologist or the Fellow working under my surgeon) says "you don't know yet, do you?"  Ummm... know what?

Well, I woke up to needle sticks all over my body - from my foot to all over my hands and arms.  I don't think twice about it because the anesthesiologist said she would try to find a better vein.

So, here's what I didn't know.  They didn't do the surgery.  You read that right.  It turned out that when they put me under my blood pressure tanked.  I can't remember how low it went, but I think hubby said something about the bottom number being in the 60-range.  I was also told that when they took the oxygen away, my O2 level dropped to 80.  They tried for 40 minutes to increase my levels, but to no avail.

Everyone in the Operative Waiting Room was getting calls that their friend/family member was done with surgery, because they would get up to go to the PACU (post-operative care unit).  Then hubby saw my doc.  In person.  Coming to speak with him in the waiting room.  No other doctor did that.  First he said that I was fine and took him into what has come to be known as the "bad news" room.

I spent the day sobbing, and the rest of the week crying on and off when I'd think about it.  The Fellow came to see me often.  They ran a chest CT to make sure I didn't have a pulmonary embolism and a blood gas (I can't remember what that was for, but they had to get blood out of my artery -- in my wrist - OUCH!  That thing still stings if I hit it the wrong way).  They wanted to make sure they ruled out all life-threatening causes.  It seems that it was probably because I was on 2 bp meds and the ace inhibitor (not the beta-blocker) likely kept them from upping my bp.  Just FYI: I'm working with my GP and we think we have it figured out -- that I lost the weight to the point where it affected my need for as much medication to lower my bp.  One time when the Fellow came in, she asked if I was ok.  My typical answer for the day was "physically."  I said, through my tears, that I felt like I was over-reacting.  I have to say, she was wonderful!  She assured me that I was not...that I was truly expecting something life-changing to happen...something I'd prepared for since 12/30 by getting clearances and doing testing.  She thought my reaction was normal.  This conversation happened after I had the CT.  Prior to that one of the nurses in the PACU got an order from my doc to have lunch.  When the doc came in, he explained again what happened I sobbed to him that I could NOT do the 2-week liquid diet.  That just about killed me!  He said that he's done it and wouldn't make me do it again.  I would later find out that he'd only require 1 week.

People were coming and going and absolutely not eating in that unit, but as soon as I got back from the test, I ate (somewhat differently than had I had the surgery!).  Hubby had gone to get lunch during this time, so my conversation with the Fellow was private.  I was on that unit for the entire day!!!  The protocol/rule is that there can be 1-2 visitors at a time for up to 15 minutes.  Hubby was there nearly all day and we had a friend there who stayed for probably an hour into the PACU, but there were no seats and he was getting uncomfortable.  When my nurse came back from lunch (she rocked, by the way - hugely rocked!), she made the "isolation" room available to us.  Rather than being surrounded by curtains, it was a private area with 4 walls so I could be with hubby (and he could sit) and it could all be very private.  I'm sure anyone who was there heard the sobs, despite how discrete they were (and they really were).  I was told that the doc said he'd re-arrange things to get me in asap, which I thought was incredibly thoughtful and kind.  I found out that he did feel guilty that it didn't work out, especially since I was so excited in pre-op.

It was up in the air if I'd be admitted for the night or go home.  When they left the decision up to me I made it clear that I was in no shape to make decisions.  My depressive symptoms had reared their ugly heads and decisions weren't my "strong" suit.  The Fellow came back a bit later and said that the doc would release me if I wanted.  Somehow when she put it that way, I felt free to say that I just wanted to come home -- see my furbabies, sleep in my own bed, wake up in my house in the morning (and avoid hubby having to drive downtown again, paying another $25 to park).

I called the office the next day and the nurse said she'd have the scheduling people call me.  I heard back from them and the woman said she could schedule me sometime in June.  JUNE?  HUH?  I asked if that was the first and went into a bit of what had happened before; she said she'd talk with the surgeon.  They could fit me in on 5/24.  It is two weeks from tomorrow.  While I'm not required to do the 2 weeks of liquids, I'm going to try to do as much as I can.  I am mortified at the amount of weight I gained from my post-failure-op emotional eating.  I can't even write it down.  Hubby and I were talking on the drive home about what I wanted to eat.  Trust me, I had a good long list.  Spaghetti and hoagies from a certain place topped the list!

So, I had spaghetti for dinner tonight (with pesto - yummy!).  I've been trying to do 2 shakes a day.  Now that hubby is going to the gym at night (since there is no pressure to cook for the both of us), I'm more free to do a 3rd shake.  I'm supposed to have one within the first hour I'm awake and then every 3-4 hours later until I go to bed.  This is in addition to my 64 oz of water.  Well, with my previous overnight incontinence issues, I've tried to stick to stopping any food or drink in my body within 3 hrs prior to going to bed.  It leaves me lacking and will be especially difficult after surgery when I'm forced to take only sips of a beverage.

Ok, that was my not-so-short-and-sweet surgical failure.  I find myself less excited this time around.  I guess I'm just more aware that it's not guaranteed.

On the good side of things, we had some great coupons and rewards dollars so went shopping and I got some 1x and 2x clothes.  I held up one of the 1x shirts and thought, as I teared up, is it possible that I might fit into this?  It was surreal.

And I'll leave it at that.

Just a Few Days Left

Well, here we are.  Surgery is in 5 days!!!  Ahhhhhhhh!

I've been on a liquid diet since last Tuesday and have to go through next Monday (obviously I can't eat or drink the day of surgery).  Let me tell you - this is HARD!  The first few days I was cranky as cranky gets!  I needed to CHEW something.  NOW!  My poor husband :(  Well, I went back to the paperwork and saw that I can have Jell-O!  Now there's something I can sink my teeth into - literally!  Let me tell you, I've gone through a lot of Jell-O, but it has kept me from causing anyone physical harm.  Ah, the power of Jell-O!

I had my pre-op appointment a few weeks back and loaded them with questions.  They say that they love it, but I can't help but question what it's like being burdened down with questions and if that hinders their schedule, etc.  It's me, being an idiot, being overly sensitive, being overly considerate.  I've been told that I have to take care of me and that I'm worth their time.  Now that's a hard pill to swallow. Haha ( you'll see why I laugh at that soon enough).

I've learned so much about nutrition and reading specific things on food labels in the past few months.  This will be an uphill battle.  I'm not ignorant to that fact.  We will be taking a LOAD of stuff to the local food bank because I'm not strong enough to have it in the house and not eat it.  I can't go to the grocery store at this point because even the smells from the bakery will have me wanting to give up on the whole surgery (ok, so maybe that's a bit extreme, but you get the idea).

I'm having protein drinks every 3-4 hours and trying my darndest to get in my 64 oz of water.  The thing is, I'm trying to perfect the art of "sipping" pre-op so it won't be such a transition afterwards.  Who knew sipping was an art?  I'm thankful that my program allows the use of straws, which is a variable among programs.  My doc's program told me (I asked specifically) that there is no definitive research to prove they provide a risk.  I know there are other programs who prohibit their use.  While it's going to make it difficult to get in 64 oz (which doesn't include the protein shake... BOO!), sipping also makes it very difficult to get down all of my meds (the list seems endless) and supplements/vitamins.  Some of the supplements are ordered by the bariatric surgeon; others I take because they're healthy or one specifically I take to prevent or slow down macular degeneration which is now in 2 generations of my family.  Well, my psych meds are a must - I absolutely, 100%, no question cannot miss those!  There are also my meds for blood pressure.  The cholesterol med isn't necessary for the day of surgery, nor are many of the others.

So, I guess that's the latest in the wonderful word of the hippopotamus.  Now, as the world of bariatrics says: I'm getting ready to climb onto the loser's bench.

Taking the Plunge - Here's the Skinny

So it's true.  I've decided.  I'm going to have bariatric surgery!  I know there are a couple of choices offered by my doctor's office and that the lap band isn't one of them.  I think they were finding issues with it being a foreign body and slipping, but I'm sure that's not the case for everyone.

First, I should offer some info on the two procedures my doctor does.

Gastric bypass is the more drastic surgery, as it re-routes your digestive tract.  It is also a longer surgery.

There are two steps during gastric bypass (emphasis mine) surgery:

• The first step makes your stomach smaller. Your surgeon uses staples to divide your stomach into a small upper section and a larger bottom section. The top section of your stomach (called the pouch) is where the food you eat will go. The pouch is about the size of a walnut. It holds only about 1 ounce (oz) of food. Because of this you will eat less and lose weight.
• The second step is the bypass. Your surgeon connects a small part of your small intestine (the jejunum) to a small hole in your pouch. The food you eat will now travel from the pouch into this new opening and into your small intestine. As a result, your body will absorb fewer calories.

(from https://www.nlm.nih.gov/medlineplus/ency/article/007199.htm)

In [sleeve gastrectomy, aka: gastric sleeve]

Your surgeon makes 2 to 5 small cuts (incisions) in your belly.

• The scope and instruments needed to perform the surgery are inserted through these cuts.
• The camera is connected to a video monitor in the operating room. This allows the surgeon to view inside your belly while doing the operation.
• Your surgeon removes most of your stomach.
• The remaining portions of your stomach are joined together using surgical staples. This creates a long vertical tube or banana-shaped stomach.
• The surgery does not involve cutting or changing the sphincter muscles that allow food to enter or leave the stomach.
• The scope and other tools are removed. The cuts are stitched closed.

(from: https://www.nlm.nih.gov/medlineplus/ency/article/007435.htm)

First I have to say - Praise God for laproscopic surgery!

I have chosen to have the sleeve procedure.  Of course there are a plethora of tests before I am fully approved, but some of them I've had and others are simple.  I do not drive in the city.  Period.  I saw the doctor in a satellite office and would like to see other docs in the general area.  Hey, I'm open to 4-5 counties but not, I repeat NOT the city!  While he operates in the city, my husband will be taking me and bringing me home (I'll be in 1-2 days barring any unforeseeable complications), so no city driving for me!  My doc is so fabulous and is willing to work with me.  For the psych eval, he will take a letter from my psychologist (an eval with their doc will offer far less in depth information.  I have already had a sleep study and use a C-Pap machine.  I can use an affiliated cardiologist here in the 'burbs.  For the endoscopy, he knows my gastroenterologist and said he'd like to coordinate that so he can be in the room and view the procedure.  I've had phone consults with both the nurse and the dietitian, who have encouraged me to call with questions and they will be in touch on a regular basis to ask if I have questions and to guide me through the steps both pre-op and post-op.

Certainly, as with any surgery, there are risks.  I have researched them extensively.  I know how my lifestyle MUST change after surgery.  Not only will I be incredibly limited with what foods and how much food I can eat, but I know I will get sick if I go against the set regimen.  Right now, I am trying different protein drinks to see what I like and what I don't.  That way, when I get to the time where I am limited to only those drinks, I won't have to mess around with them and learn that some are downright disgusting!  I am prepared to follow the plan and to exercise as soon as I'm medically cleared and have lost enough weight that the strain on my back is minimal.  I'm not so much focused on the scale, but as a self-proclaimed "fat chick" the scale will always be a tool in gauging where I stand.  Of course the way clothes fit and the ability to do more and more exercise will be huge indicators as well.

Because I take so many meds and drink intake at one sitting is limited, I am concerned about that, but have already alerted my doc to that concern.  I'll speak more with the dietitian and RN about that.

That's all for now.  If you've had the sleeve, please let me know what your experience was.  If you have questions, I have a huge binder full of information!

Title-less

It's January 1st and here I sit at my computer.  I have no "resolutions."  I don't care.  Maybe because it's the fact that I'm stuck in an incredibly deep depression and my marriage is a mess.  Maybe it's because I'm super cynical find resolutions to be ridiculous.  I mean whatever we say today is usually broken by the end of the week or the month.  Very few of us actually do those things we resolve to do.  Whatever it is, I don't make them.

Ok, I got that out of the way.  I want to share that I've seen a bariatric surgeon.  He believes I'm a good candidate for a gastric sleeve.  Here is some information about the sleeve, but the site also includes oodles of information about bariatric surgery, including an hour-long webinar which offers a lot of information.  It's basically a doctor talking while you stare at Power Point slides.  It's not the most interesting of things, but it gets the job done, plus I had to watch it before my appointment.  It's not anything that's inserted, nor do they re-route any part of your digestive system.  They simply staple off part of your stomach.  This both makes your stomach smaller, but releases your body from experiencing the hormone that makes us feel hungry.

The doctor was wonderful.  He spent nearly an hour with me!  I recorded it so that I can refer back to it.  The city where the doctor will perform the surgery is in the city.  I saw him at a local office (30 mins, which is local for this area) and during the course of the appointment, told him that I don't drive in the city and he is totally willing to work with me.  There are a number of tests and evaluations necessary for the surgery to be performed.  One is a sleep study - already had one done and I use the C-Pap; one is a psych eval - since I've seen my psychologist for nearly 16 years, he will take a statement from him (who is the one who brought it up in the first place).  They also need an endoscopy.  I had one several months ago, but despite me telling them that I vomit with Propofol (they said it is the med of choice for those who do experience nausea and/or vomiting after a procedure), they gave it to me and the doctor couldn't finish the procedure because - guess what (?) - I vomited in the middle of it.  The bariatric doc wants to be in the room so he can watch the screen and know what to expect if there are anything which would interfere with the surgery, since my upper GI tract is involved.  Additionally I need a cardiac eval and he is comfortable with me seeing one locally.  I saw one many years ago and know that he's in the same practice as my husbands doc, but may wind up seeing whoever has an appointment available.  There is also a consult with a nurse practitioner and a nutritionist/dietitian, but he said those can be done over the phone.  I love this guy!  It doesn't hurt that he is the husband of one of the docs in the practice where my Mom (an RN) works.  It makes trusting him easier.

When we talked about the psych eval and my doc, he said that I understand the procedure and have done my research (I have a very full binder with tons of info, using page protectors, of course!).  He also said that I was asking all the right questions, so he feels comfortable with my psychologist covering that end of things.  Oh, and I have my entire medical history and a bunch of other things typed up since I'll never remember it all - it's too long and complicated, plus I'm on so many meds there's no way I'd know them all, especially if they want dosage and times!  He can see that I am "together" mentally, especially after seeing my OCD paperwork.

I asked how long it usually takes from the initial appointment.  I expected him to say 6+ months, especially after all of the testing.  Granted some of my testing is already "taken care of" but his answer was 6-8 WEEKS!  Ahhhhhhh!  That's soon.  While I'm excited, I'm also terrified.  This is an enormous lifestyle change and I guess it feels like that's a fast time to prepare mentally.  On the other hand, the sooner the better, right?

In other news, I became a consultant for Thirty-One.  My timing is pretty terrible as I'm dealing with the surgical stuff, but hopefully I can get something out of it, even if it's just a good group of Christian women supporting each other... and hopefully there are some close to me.

Well, "life" calls, so I have to say good-bye for now.  I'll try to write again sooner next time - I know I say that every time, but if I'm going to be down for a couple of weeks I expect to be online more.  So, happy new year!  I wish you all the best.

When is Enough Enough?

So, my appointments have been somewhat scattered and for that I am thankful.

As for the past few days:
Friday: migraine
Saturday: migraine hangover (which you understand if you get these monsters)
Sunday: left in the middle of Sunday school to head to the ER with what turned out to be kidney stones (which had, thankfully, already passed)
Monday: kidney stone hangover day

On a better note, a friend posted this blog entry to her Facebook page and with summertime nearing, I just had to share.  She is a woman I inspire to be; a woman who is comfortable in her body and accepting who she is.

I want to be a woman who accepts who she is as she is, even while trying to make changes.  We are all on a journey and if we can stop at any given moment and say "hey, I'm ok exactly as I am," well, that's success.  I know that God accepts me.  The problem comes in when I enter the picture.

Who else is touched by this blog?  Who can relate?  Who is accepting of yourself, regardless of height, weight, brain power, disability... and the list can go on and on...  Who respects themselves?  Where are you on your journey??

A Fistula? Huh?

To get this out of the way:

A fistula is an abnormal connection between an organ, vessel, or intestine and another structure. Fistulas are usually the result of injury or surgery. It can also result from infection or inflammation. (as defined by the NIH)

Now, getting back to the topic at hand.  I did a test this morning which would rule out a fistula.  I got the results (something required to be done on my end) and called the doctor.  She said "hmmmm.... let me talk with <another doctor in the practice> and I'll call you back."  Ok?  She called back and said it would be rare for me to have a fistula so far out from my hysterectomy (years!) and that she would like me to re-do the test (which is no fun, by the way) and go to the office on Tuesday for her to do the final part of the test so she can see the results for herself.  Gee, this isn't nerve-wracking at all!

It's important to understand that "rare" is the kiss of death for me.  With one injury alone:

1. most people don't need surgery for this injury
2. it's strange that PT didn't work
3. surgery: finds 5 torn ligaments in my ankle when only one showed up on the MRI
4. post-op I thought I popped a stitch, so call the doc.  I get his associate who says to go in.  It turns out I had a large burst hematoma (a pocked of blood beneath the skin)  It's uncommon in your situation and to be directly under the incision, says the doctor
5. I go and see my doctor a bit later (I can't remember if it was no more than 2 weeks later, but I'd imagine it was the sooner part of that) who says that in all his years of practice he's never seen such a this happen (it was ugly, people, super nasty - I won't disgust you by posting a picture)
6. There's nothing else I can do (says the surgeon) but it's odd for it not to heal by now so you'll have to go to the wound care clinic.

This was all in December 2013 when I had my ankle surgery and had the rollator, so that's why I'm saying it was within a shorter period of time.

You get the idea?  Rare = my world

So, I did some research.  I know, I know, the internet is a dangerous place for research, but I try to stick to the NIH, Hopkins, Mayo - reputable sites.  They all basically agreed with my doctor, although she is amazing and I'd expect no less.  There are some pretty uncomfortable tests which could be done after I see my doc on Tuesday.  Surgery is a possible cure.  Yep, rare.  Sigh....

We All Do It

Yes, we do... and I, for one, don't enjoy it!  It's painful, it makes me feel stupid, and I've done it enough for a lifetime.

My guess is you all think I'm talking about sex, or that I've lured you into reading this hoping it's about sex, but it's not.  It's about falling.  Indeed, the simple act of falling.  Being fat alters one's ability to maintain a good center of balance.  While I've had weight issues almost my entire life, I'm most embarrassed about it at this moment.  It's the fattest I've ever been.  It's the most at risk I've been for injury (and I've had a LOT of injuries in the past; it wasn't a big deal for me to enter my High School on crutches... nobody took a second look).

I was at a baseball game two weekends ago.  No, I'm not a huge fan, but it was a birthday gift from my parents to my husband.  Anyway, I have a handicapped permit due to my arthritis and disk disease so of course we parked in those spots.  I noticed that the only ramp I saw served probably a dozen parking spaces.  I was in the middle of making a comment to my husband about it (and how the curb in front of the many handicapped spaces should really be ramped) and the next thing I know I'm on the ground.  I'm yelling "ouch. ouch."  Now I go up steps every day at home and I successfully navigate ramps all the time at a variety of stores but this one had to get me... it had to win.

As I try to get up, I hear someone yelling at me to stay where I was.  It turned out to be a security guard.  As I hear her, I see ballpark paramedics coming towards me.  The next thing I know my parents, along with her pastor (also a PA) and bunches of professionals have surrounded me.  Fortunately I was far enough away from the actual park that my fall didn't cause a huge hullabaloo.

It takes two medics to heave me up onto the curb (you know, the one which should be a ramp).  "What hurts?  Are you okay?  Do you need an ambulance?"  The barrage of questions continued for a bit.  "I don't think anything's broken."  I'd have to agree, I can move all of my extremities and there are no bones sticking out from under my skin.  My right shin was pretty cut up and my left ankle hurt (later my right ankle took over as the pain-ridden appendage, so was the one to get medical attention).  As for the ambulance - how silly would it be to take the ambulance to a hospital I don't even like?!?

The medics squished (and I mean Squished - with a capital "S") me into a wheelchair and we took the elevator up to the box my Mom's church had gotten.  The next thing was to pry me out of the chair - an adventure all of its own.  They iced my abrasions and my right ankle and I spent the entire game in our air-conditioned box.  As time went on, I noticed my right ankle causing me more pain, but I didn't think it was worth hunting down the paramedics.

Oh, did I mention they did an incident report?  I mean, I guess they had to, but it all seemed so over the top.  I fell.  So what?  Yeah, and I had to sign a "refusal of treatment" form.  My father was there to make sure I wasn't signing my life away.

That was Saturday.  Sunday comes along and I'm barely able to walk, with my left ankle swollen as if there was a baseball under the skin.  I try to get up and nearly fall to the ground.  My lower half has been beaten up, or so it felt.  I decided that after church I needed to have x-rays done.  Off to OUR ER we go.  The x-rays were negative, but both ankles and my right knee were sprained.  Since my left ankle and right knee were the worst, I was given an air cast and immobilizer, respectively.  They gave me an ace bandage for my other ankle.  And off I went.

Fast forward to over a week later; Tuesday.  I see a new doctor who gives the most attention to my worst injury, giving me a (huge, ugly) boot for my left ankle and ignored the rest of my injuries.  He wanted to do an MRI and PT (with PT first), but I let him know the severity of my pain, so he ordered the MRI.  Oh, did I mention that he wants me to see some friends of his at a local family practice to test me for diabetes.  Yeah, more joys of being fat.  Yes it runs in my family.  Evidently given those two facts I must have fallen because my lower extremities were numb.  No, they are far from numb - they hurt like the dickens!  I've not done anything about the diabetes.  I just got out of 3 weeks in the hospital and am certain their bloodwork included a sugar level!  Remember, I'm fat and it runs in my family.  Everyone assumes, yet somehow I've managed to avoid the beast.

So, the MRI was Friday and I await the results.  I haven't scheduled a follow-up with this guy.  I did NOT like him.  He didn't listen to me and a medical student spent the most time with me.  He was in and out and spoke so fast I couldn't follow.  I was overwhelmed and didn't even have time to process what he had to say enough to tell him that even Vicodin wasn't helping the pain, so I said it to the student, who ordered an anti-inflammatory (yeah, Aleve didn't work either).  Just so there is no confusion, I don't mind having med students in with me, but when he spends three times the amount of time with me than the doctor himself, I have a problem.  I'm paying to see the doctor!  Anyway, I had ligament surgery on my other ankle several years back and loved that doctor.  I sent the MRI results to him, but unfortunately his first available appt isn't until early August.  Ugh.

To sum up: being fat leaves one vulnerable to falling; being out of shape makes the likelihood of injury greater.  If one is fat, s/he is bound to have diabetes so we'll just chalk this up to that and essentially ignore the pain of said fat person.  Actually, I wonder if often my ailments are assumed to be fat-related.  I KNOW losing weight will improve a lot of my pain issues, but in the meantime, I'm still in PAIN!  I rambled about that in another post, so I'll let you go back and read that one - haha.

And I leave you with a word of gratitude for making your way through this incongruous post - in which the topic was far from your initial suspicions.  Once again, I say that I will try to post more often - and hopefully with shorter posts and good news of any sort!  :)

Seriously?

It's been an interesting week.

I've had this cough for a month now.  Last Wednesday I started feeling dizzy/light-headed when I coughed when standing.  Life goes on.  Thursday I woke up with a migraine and started to feel dizzy all the time, even when sitting down and not coughing.  Then I noticed some vision changes in my right eye.  I called and spoke with a couple different nurses at my doctor's office and together we decided that it would be best if I go to the ER.  Ok, arrived at the ER at 5pm and saw the worst nurse known to man.  He had no personality and made me feel like I was bothering him and angering him when I asked to go to the bathroom and when he had to do things like get my vitals or check the IV fluid.  By the way, he put the automatic blood pressure cuff on the same arm as the IV.  Can you say OUCH?

After all was said and done - a CT showed I did not have a new stroke and the bloodwork showed no abnormalities explaining my symptoms - they admitted me.  I got up to my room at 1am on Friday morning and was awakened every 2 hours for neuro checks.  Good times!  The docs did all sorts of checks and I saw a bunch of different specialists on Friday, but they would not discharge me, despite everything coming up basically normal.  I do have a visual field deficit from my previous stroke, which was sometime between 2003 and 2009.

Saturday - my BIRTHDAY - I woke up and saw both the hospitalist and the neurologist.  The hospitalist said he wanted to keep me another day.  WHAT?  I said that I really wanted to go home, plus explained that it was my bday.  After disagreeing with me about it being my bday (evidently my chart said it was Thursday - or he misread my admit date), he agreed saying that nobody should be in the hospital on their birthday.  Whew!!  Shortly thereafter, the neurologist came in.  He is an colleague of my regular neuro and is quite young.  He did his checks and told me he wants me to get a sleep study -- that I am at high risk for sleep apnea, which can explain a number of my symptoms, including weight gain (!).  I had heard the recommendation from another doctor so was not surprised at this.  They did decide that the symptoms were due to the migraine (even though the headache part of it went away Thursday morning).

What came next, though, blew my mind... in fact I still can't wrap my mind around it.  He said that he did not want me driving and that I have to take a driving test/evaluation.  Is he serious??  Evidently he is concerned about my visual field deficit and how it affects my driving.  HUH?  I've been driving with said deficit since I had the stroke, more than 3 years ago!  I have not gotten in an accident, hit anything, heck, I have never gotten a speeding ticket!

I call the facility which performs these evaluations and they have to have the doctor complete a form before I can schedule.  Oh, and they are booked through February (and this is before waiting for the doctor to fill out said paperwork)!  Of course I have more than a half dozen appointments in the next month.  I have to rearrange and reschedule everything on my calendar and rely on my husband to drive me places.

I suffered from agoraphobia for years and was afraid to go anywhere, having panic attacks.  I stayed in the house, except to go see my therapist - for years!  Now I'm forbidden to drive so am stuck in the house and going bonkers after a very short period of time!  I did beg of the neuro to allow me to drive to see my therapist yesterday.  It was his last day before going out on medical leave for 6-8 weeks and I needed to go.  He worded his order in such a way that I could drive there.

Now I'm stuck - and going to lose my mind!!  You may read some pretty irrelevant blog posts for a while.... me trying to keep busy.  Don't judge me ;-)