Saturday, October 31, 2009

Day 3

Today has been an exciting day for me.  The best thing was that I got to take the dressings off of my incisions.  Not so thrilling on its own, but taking the dressings off meant I was allowed to take a shower.  Yay!  That was a nice shower.

I also moved from clear liquids to full liquids.  I was living on water, Crystal Light, and popsicles, so it was nice to be able to drink something that has nutritional value.

The suggested meal plan has six small meals throughout the day.  I'll have to work up to that.  I was able to get to three of them, and I'm still working on the third.  It turns out that a four ounce protein shake takes me about two hours to finish.  Yikes.  It'll improve as I move forward, but there's no way I'll meet my protein needs for the day.  I'll end up with about 45g of protein.  I'm supposed to get at least 60g.  It'll happen eventually, but it doesn't look good for today.

My meals for today have been a protein shake for breakfast, sugar-free pudding thinned with milk for lunch, and another protein shake for dinner.  

I'm not going to hit my goal for liquids today, either.  I'm trying, I really am, but I feel full really quickly, and I'm afraid I'll burst my banana if I try to swallow more.

I still have zero hunger... I don't even have head hunger.  Food commercials do nothing for me.  An hour or so ago, someone tried to deliver a pizza to me (he had the wrong apt.), and I wasn't at all disappointed that I couldn't eat it.  I'm sure eventually it'll come back, but for now I'm loving this lack of appetite and especially the lack of head hunger.  Head hunger is what got me into this mess in the first place.

I went through most of the day without any pain medication.  I wouldn't be a good drug addict at all.  I can't stand the blurred vision that impedes my ability to read.  Yuck.  I did eventually take some, because a couple of my incisions were bothering me.  Beyond that, I do feel a little bit of pain when I bend or twist certain ways, but following the surgeon's order of "if it hurts, don't do it" takes care of that quite nicely.

The other exciting thing from today is that I pooped!  Twice!  The first one was a big surprise, as I hadn't eaten anything in 72 hours, so I didn't think there was anything in there.  The second time was after I'd had a protein shake, so that seemed normal.  I also learned, to no surprise, that liquids in equals liquids out.  Fun!

That was my eventful day.  It may not have been exciting, but the fact that I feel this good two days after surgery is something to celebrate, even if I celebrate by going to bed early.

Day 2

Not a lot happened the day after surgery.  I wasn't allowed to shower yet, boooo.  I had to go back to the surgical center to get pumped full of fluids.

While I was getting set up to get my fluids, a guy was placed in chair next to mine, separated by a wall.  He somehow drank three liters of fluids the same day he had surgery.  I got in maybe one liter, though I don't think it was quite that much.  He was praised for that.  I was reprimanded for drinking out of a bottle and for something else.  I can't remember what it was, now, but I know there were two reprimands.  It was probably about pulling out my IV line.

I raced with the guy next to me to see who would finish their fluids first.  I won!  I won because she found a good, big vein in my arm.  If I hadn't yanked out my IV, it would have been in my hand and would have taken quite a bit longer.  Plus, I was constantly pumping pressure onto the IV bag to make it go more quickly. 

I did very little the rest of the day.  I wanted to read fanfic, but my vision was blurred all day.  Sad.  I was able to watch TV, so I caught up on a couple of shows. 

In addition to water and popsicles, I tried a cup of sugar-free Jello as well.  One of those little cups that you get in a six pack took me about two hours to eat.

My fluid intake was pathetic.  I need to do better, but it's so difficult.  I feel full after just a few sips, and I'm afraid of hurting my banana if I take in more.

I only woke up once in the middle of the night, so that was a definite improvement over the first night. 

Pretty boring.

Surgery day

I'm two days out from surgery now, and it feels like a good time to tell the story. 

My surgery was scheduled for 7:30am, so I had to be there by 6:30am.  Mary and Lori were with me, and we got there a little early, so we had to wait out in the hall until someone realized we were there and unlocked the door.

I did not pass go, nor did I collect $200.  I was immediately let in for prep.  Of course the first thing I had to do was step on the scale.  The nurse, Beth, was awesome.  She said, "Take a good look at that number, because you'll never see anything like it again."

Once I was weighed, I had to put on my hospital gown, hair cover, and booties with tread.  The only thing I was allowed to have on under this was socks.  At first I wasn't sure how the gown went on, but they had cute directions on the wall which said, "Remember, rated G in the front; rated R in the back."  Hee!

After that she had to start an IV for me and take my vitals.  I sat in a very comfortable reclining chair and was covered with warm blankets that felt like they were just taken out of the dryer.  My blood pressure and pulse were surprisingly low for the anxiety I was feeling. 

I was left for a few minutes while fluids, antibiotics, and more anti-nausea stuff was pumped into me.  Soon after, Dr. Landerholm, my surgeon, came to talk to me for a bit, then the anesthesiologist.  He explained a bunch of things to me, letting me know the risks of anesthesia and also some of the things that would happen.  For example, he reminded me that I would have a breathing tube in my throat, but it would be inserted after I was under, and taken out before I woke, so I wouldn't remember it, but I would have a residual sore, scratchy throat.  He also dumped some anti-anxiety something or other in my IV bag for me, so that was nice.

Lori sat with me for a little bit, but I'm really not sure at what point that happened. 

Finally the time came to go to the surgery room.  I remember getting myself onto the surgery table, some nurses tugging my gown off, the anesthesiologist saying he was going to give me a little more of the anti-anxiety stuff, which I'm assuming was the actual anesthesia, because I remember nothing else until I woke up in recovery. 

The surgery was uneventful, which, of course, is the kind of surgery you want.  I rocked the pre-op diet.  I lost 14 pounds on it, plus the surgeon complimented me on my beautiful liver.  Hee!

I was a little sore, but not in any real pain.  When the nurse realized I was awake, she went to get Mary and Lori, so I would have someone there, and so they could see I was OK.  Soon after, Dr. Landerholm showed up and said, "There it is!  They (Mary and Lori) asked how they would know you were OK, and right there (pointing at the big grin on my face) is what I told them to look for."

I can't tell you how long I stayed there in recovery, because I was still groggy from the anesthesia, but it wasn't that long.  Soon, the nurse shipped Mary and Lori out to move the car closer to the door, then helped me to get dressed.  I got a little impatient and ended up pulling out my IV line as I tugged my shirt on.  That wasn't a good thing, because I had to go back in the next day to get more fluids pumped into me.

I rested and walked around my apartment for the rest of the day.  They wanted me to get at least 60 ounces of fluids in, which was laughable for me.  I maybe got 30 ounces in.  I felt full after just a couple of sips.  Sugar free Popsicles were the easiest for me to get down, but I tried to get as much water as I could.

I did take my pain medicine regularly.  What I was feeling was really more discomfort than pain, but the stuff really helped with the discomfort.  Unfortunately, it blurs my vision, so I want to stop taking it, but I was advised to keep taking it for 72 hours.  Still, it's been twelve hours since my last dose, and I'm fine.  Yeah, there's some discomfort and cramping, but I have the feeling this is the dreaded gas I was warned about.

Surgery day was completely uneventful.  I drank as much clear liquids as I could, took my medicine, took my temperature a million times (fever is a sign of a leak), and went to bed early.  I did have a bit of a reflux issue once, but it wasn't bad, and I just have to take some Maalox to deal with it until I get to purees, then I'll be able to take my prescription acid blocker.  It's a big capsule that I won't be able to swallow (can't take pills bigger than a baby aspirin), but I can break it apart and sprinkle the insides in some applesauce. 

I was up every two hours or so during that first night.  Drank what I could, sucked on some popsicles, took my temp, walked around, and eventually went back to sleep for another couple hours.

Oh, I forgot to mention, that I was home by 11:30am.  Every other place I looked into had at least an overnight hospital stay, and some had a two night stay.  I loved that I could spend the day comfortably in my home.  I did have to go back in the next day to get more fluids pumped into me.  No big deal.  It went faster than expected, and now I don't have to go back in until my one-week check-up.

So far, so good, no regrets at all.

Wednesday, October 28, 2009

Less than 12 hours away

So yeah.  I'm panicking a little.  Scared about the surgery, nervous the anesthesiologist won't clear me for surgery, afraid I'll be the 1% who has complications, and this may sound trivial compared to the other things, but I have vomit anxiety. 

I have an anti-nausea pill and an anti-nausea patch, but people still often throw up quite a bit the first couple of days after surgery.  Not everyone, but enough that it makes me nervous.  I hate throwing up (does anyone like it?), but I'm terrified that it'll somehow hurt my new teeny stomach, like it'll spring a leak or something.  Ugh.

Honestly, there is a tiny part of me that wonders if I'm doing the right thing.  For the post part, I believe this is the best decision, but there's that scared little voice saying, "You've stuck to the pre-op diet so well, you haven't craved carbs, you never once had to talk yourself down from the ledge of ordering a pizza.  Just lose the weight on your own!"  Sigh.

I know that's not the problem, though.  I can lose 50 pounds like a pro.  But I can also gain back 70 like an all-star.  I need this tool to help me keep it off.  The complication risks exist, but they're small.  I have a much better chance of developing full-blown diabetes than I do of having a leak. 

Still, it's scary.  It's 8pm here.  If all goes as planned, I'll be in the middle of surgery 12 hours from now.  I have some prep things to do tonight, I still have to keep drinking tons of water until I go to sleep (or until midnight when I can't drink anything anymore)(and let's face it, I won't be sleeping much tonight), I have to get up at 4am to get ready, take my anti-nausea pill.  I still need to mop the kitchen and bathroom floors, and finish the last load of laundry.

I can't even read fanfic or watch TV.  I cannot pay attention to anything for more than a minute, then I back to obsessing about tomorrow.  I'll be so happy when it's over.  Even if I am ralphing all over the place.

Tuesday, October 27, 2009

Fear and anxiety

As my surgery day gets closer, it's starting to feel more like a reality.  As it starts to feel more like a reality, my fears are bubbling up to the surface.  There are two major things causing me anxiety right now.

First, of course, is the fear of surgery itself.  The closest I've ever come to surgery is having my wisdom teeth pulled.  This is a big deal for me.  And really, even though it's out-patient with a short surgical time, it's still a major surgery.  They're removing most of my stomach!  Complication rates are low, but there's always a risk with surgery.

The other anxiety I'm suffering from right now:  What if it doesn't work for me?  There's a small percentage of people for whom WLS fails.  What if I'm one of those people?  When I really think about it, I believe it'll be fine.  I don't believe that WLS fails people, so much as people fail at WLS.  It's not a magic pill, it's a tool.  It is going restrict how much food I eat.  I still have to exercise, I still have to pay attention to what and how I eat.  There are ways to "eat around" it, but I would have to work at that.  I certainly do not plan to do that. 

Still, it's a fear I have, and it probably won't go away until I really start losing weight.  That being said, when I can get past the anxiety I'm feeling today, I'm very much looking forward to the great things this is going to bring to my life.

On a different note, I have ketosis breath.  It's nasty.  I can actually smell my own breath at times.  I keep rinsing with mouth wash, but it always comes back.

Monday, October 26, 2009

Pre-op diet

As I was researching VSG (vertical sleeve gastrectomy), I saw many different versions of the pre-op liver shrinking diet.  The majority of them were some version of an all-liquid or mostly liquid diet.  Protein shakes and sugar free jello, two meals of protein shakes and one meal of lean protein and vegetables, some lasted two weeks, some up to four weeks, some allowed only clear liquids for the final three days before surgery.

Mine came with only one restriction:  no more than 40g of carbs a day.  It hasn't been difficult at all to stick to it.  In fact, the only thing that has been difficult is to get in as many calories as I should.

The scale went insane, and I lost nine pounds in the first five days.  Crazy!  Right around then was when I started to have a hard time getting enough calories, and for about a week, the scale didn't move much-- just a fraction of a pound here and there.

Over the weekend I got my 1200 calories each day, and I'm happy to say I was down another 2.4 pounds this morning.  Yay!  That's 13.6 pounds I've lost since I started this almost two weeks ago.  That is insane for two weeks.  Yeah, I know a lot of it is water, but it's fun to see anyway.  Too bad I can't trust  myself to stick with this for the long haul without the help of a teeny stomach.  I could save $20,000 (actually, with all the pre-screenings and PCP visits and prescriptions, there's another $2000 added to that).  Unfortunately, my problem is less losing weight than it is keeping it off.

I don't know what sparked the scale to move again.  I hate to believe it was getting the calories in, because after surgery it's going to be quite some time before I'll be able to get that many calories in one day.  For the first couple of days it'll be almost no calories.  Once I work up to full liquids, which should start around the third day after surgery, I'll be lucky to get 500 calories in.  I'll only be able to drink/eat around 1/3 of a cup at a time, and I'm sure I'll have to work up to that.

Whatever.  I should stop worrying about that.  This surgery is a proven weight loss method.  I might post more later about my fears there.

Wednesday, October 14, 2009

I'm a mess

So many unexpected (no, not unexpected... just... I don't know... just bad, I guess) things have come up for me since I've been going through the process of preparing for weight loss surgery.  It's all my fault, though.  Before starting this, I hadn't been to a doctor in more years than I care to admit.  I can't really complain about the surprises, because if I'd been seeing a doctor, I would have already known about it.

I had very high blood pressure.  Not shocking, most overweight people have high blood pressure.  But most people also get pills prescribed to take care of it.  I didn't, so I had to visit a physician to get a prescription.

My blood test results were awful, too.  High overall cholesterol, high LDL, high triglycerides, high glucose (scary pre-diabetes levels).  The good news is that nobody seems to be too worried about any of these numbers.  If I weren't having surgery they certainly would be, but they have a pretty casual attitude about it saying, "These numbers will come down nicely after surgery."

On the other end, my numbers are low in the things that should be high.  I'm severely vitamin D deficient.  My nutritionist, whom I love, high-fived me when she saw my vitamin D level and said, "Cool!  Lowest I've ever seen!"  Heh.  They have me on some prescription that's so potent I can only take it twice a week.  That's along with a multivitamin that has 200% of the recommended daily allowance.  And I take two a day, so that's 400%.

What else?  Oh, an irregular heartbeat.  Again, they're not too concerned and figure it'll probably go away after I lose some weight.  The good news is that everything else looked fine on my ekg. 

My surgeon, whom I also love, thinks there's a good possibility that I have a hiatal hernia, which he'll fix during surgery (at no extra cost) since he'll already be in that area.  It'll add about 10-15 minutes to the surgery time, so nothing huge.

My hormones are out of whack, which accounts for the lovely chin hair, sideburns, and irregular periods.

My knees and back hurt, I have acid-reflux (some OTC Prilosec has taken care of that)(if it turns out that I have a hiatal hernia, fixing that will help as well), I get out of breath just walking up a flight of stairs (fixing the possible hiatal hernia will  help that also), and I'm tired all the time.

So yeah, I'm a mess.  The good news is that most of this will be gone (or at least improved) after surgery.  Once I made the decision to have surgery, I've never second guessed it.  If I do in the next two weeks, I'll have to read this post to remind me of where I'm headed if I don't.