Tuesday, May 31, 2016

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....

Monday, May 23, 2016

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...

Thursday, May 19, 2016

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.

Monday, May 9, 2016

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.