One Week Post-op

Here I am, one week post-op and feeling pretty good.  Well, I was feeling good the past couple of days.  I didn't get much sleep last night because it's still very uncomfortable, so I've been dragging all day.  I've also stopped taking the liquid Roxicet and moved on to Liquid Tylenol.  For the most part it's worked well and I've only taken half a dose.  Today, though, I took a full dose, plopped my butt down on the couch and stayed there most of the day (well, I had to leave the house twice, make lunch for my daughter and dinner for all the kids, but other than that, lazy bones.)  The tv dinner stand I use to set my laptop on is becoming crowded with several items that I use frequently.  One would be the liquid Tylenol.  Also, lotion because my hands are so dry, chapstick because my lips are also dry, my Blackberry, a thermometer to check my temperature (trying to catch any early indication of a leak), my medicine cup full of clear fluids and an ink pen used to chart my fluid intake.

I'm having a little pain still.  Most of it is incision pain.  It's getting better each day, but now the pain seems to be moving from deep to surface.  My back hurts a bit, maybe because I've been sitting on my butt so much.  Maybe because I've been doing laundry without too much bending and no lifting.  I guess no laundry tomorrow.  I also drove for the first time today, I had to pick my daughter up from pre-k. 

I have my one week followup with my surgeon on Wednesday.  I'm looking forward to it because I have a lot of questions.  Mostly about my surgery, I wasn't expecting a hiatal hernia repair or fixing the scarring on my pancreas.  I'm curious about them and wondering if he has pictures.  I also need to talk to him about pain that I'm having when I take a really deep breath.  I assume that it's from the hiatal hernia repair.

When I stepped on the scale this morning, it said 250!  That's 8 pounds lost since surgery, 36 all together.  Wow!  I'm really looking forward to seeing 244 because that's what I weighed when I was married and my husband has never seen me below that. 

My clothes are almost too big to wear.  The shirts are getting very big on me.  Most of the pants are still wearable, but I think it's only because I'm bloated and my belly feels slightly swollen.  I'm looking forward to getting some new clothes in the near future (though I won't buy much because I know I won't be in them long!)

My Surgery Story

Weight loss surgery is like a butterfly coming out of a cocoon.

As I started this post, it reminded me of the birth stories I posted after my children were born.  There were details on their births, the whole experience, people involved.  I realized that's just what this is, it's a re-birth story.  How fitting is it that my room at the hospital had a picture of a butterfly. 

This whole experience was like living my life in a body that wasn't really mine, waiting to go into a cocoon and be reborn into a butterfly. 

I got to the hospital at 6:30 in the morning Monday.  My surgery wasn't scheduled until 8:30 am.  By 7:15, I was prepped and ready to go when my surgeon walked into the room and announced he was ready - an hour early!  I think this was actually a blessing, it left me little time to panic.  I said goodbye to Mike and they whipped me into a holding area.  There, they put me in some compression socks, loaded me up with good drugs and away I went.  I barely remember being wheeled into the OR, in fact, I can't be sure that's what happened because it felt like a dream.  The next thing I remember, I'm being wheeled into PACU, stating very loudly (which is highly unusual for me, I'm soft spoken)  "Oooooooh!  I'm going to throw up!!!"  I said this over and over.  They kept reassuring me that I wouldn't and brought me a wet cloth to place on my forehead.  I don't remember anything else about the recovery room.  I do remember being wheeled to my regular room was painful, every bump we hit, I said, "ooow!"  When we got in there I looked up and said, "Julie!"  then looked over and saw another friend, Sandra.  That's all I remember, I don't remember anything about their visit.  Julie told me they tried to get my dark secrets out of me and I told them I didn't have any.  LOL 

It took forever for my husband to get in to see me.  I don't know what was going on there, I guess there was a mix up in communication, but I was glad when I finally saw him.  I don't remember much about the rest of the day.  Tuesday morning, I was in a lot of pain.  I thought, "OMG, what have I done to myself?"  I was having some very serious regrets, thinking that I would be in so much pain for the rest of my life.  I really wasn't thinking clearly, and I got over those thoughts soon.  It was probably buyer's remorse, this was a major life change. 

They took me for my upper GI with gastrograffin at about 8am.  My nurse told me she should have the results by the time I got back.  I stood in front of a machine while I drank a chalky mixture.  I was afraid I was going to throw up before I even tasted it, but it was fine.  I got to watch it go down my esophagus and into my stomach, it was pretty neat to watch.  They wheeled me upstairs and an hour passed before any results came.  I was getting really nervous that they found a leak, but they didn't.  They just looked at it closer because I had some swelling in my esophagus that caused the drink to go down slowly. 

When my surgeon was operating, he also did a hiatal hernia repair and fixed some scarring on my pancreas (which I only assume was there because I had a life threatening case of pancreatitis about five years ago.)  I think the pain from that is worse than the gastrectomy. 

I know this is an awful picture, but look, I'm smiling!

Once we got the all clear on the leak test, the first thing we did was take out the foley.  I was so happy to have that gone!  The PCA was taken away and I was started on liquid roxicet.  That stuff sat in my stomach like lead!  It is only 5ml but felt like a gallon.  I also started on clear fluids.  Ice chips were first because of the swelling.  Then, water, followed by diluted apple juice.  Tuesday evening I even tried some chicken broth, which sat heavy so I didn't drink much.  I went back to water and decaf tea the next day.  Did I mention that I peed like crazy because I was still on iv fluids?  I walked a bit the first night, probably 4 or 5 total.  I started doing more laps, and was able to do 2 laps at once.  I think the nurse said that each lap was about 180 feet, but I could be wrong.  I did 7 or 8 laps that day.  I also got a shower in and began to feel human again.

Wednesday morning, the sequential compression device came off, though I kept the compression socks on.  I continued to do well with the incentive spirometer.  I only used the CPAP for about an hour the whole time I was there because they decided that it wasn't necessary (not to mention the pressure is way too high.) 

My surgeon came in that morning, saw that I was doing great and released me!  I went home at about 1 pm that afternoon and I was so happy about that.  I stopped at Walgreens on the way home to pick up some nausea patches, which I haven't needed at all.  I haven't had any nausea since I woke up from surgery screaming that I was going to throw up.  The nurses on the station were also very impressed with my progress.  They called me their star patient and said I even passed up Melissa (who was previously the gold standard.)

Yesterday, I was able to get in about 50 oz. of fluid on my own.  I say that's not bad for the first day!  I'll easily make 64 oz. today.  I'm alternating water, peppermint tea, sugar free cherry limeade drink mix and diluted grape juice.  I'm drinking 1 oz every 15 minutes.  When I saw the nutritionist yesterday, she said I could progress to 2 oz every 15 minutes when I'm ready.  But, I'd like to take it slow since I'm getting my fluids in just fine right now.

My husband made chicken alfredo for dinner tonight and it smelled *so* good!  It didn't make me hungry, though, I just wanted to smell it.  It was satisfying.  I haven't tried any jello yet, but I may tomorrow.  I've been able to keep down pill form medications just fine (I'm taking Axid and Propranolol.)  Last night, I skipped a dose of Roxicet and just took liquid tylenol instead and realized that was a mistake.  I really needed the extra pain meds.  Today has been a good day pain wise, but I haven't pushed myself either.  I did manage to make it 7 hours between pain meds so that's a huge plus.

I guess that's it for now.  I'm really doing great and hope I feel much better tomorrow!

VSG Pre-op Survival Kit

Only four days until surgery!  We are getting down to the wire now.  For real.  Tomorrow will be my last day to eat real food.  That's not really accurate because I have not been eating a "normal" diet since October 29, 2010.  I've been on the liquid protein diet since then.  Two protein shakes a day, plus a lean protein and one cup of veggies for dinner.  Have I always stuck to that?  No.  The fact is, I still have all of my stomach so it's been hard.  But, regardless of my little flub ups, I've still managed to lose 28 lbs since starting the diet.  As I mentioned previously, my goal was 30 lbs before surgery and I'm still hoping to hit that mark.

So what am I going to do on my official last day of eating real food?  Well, first of all, I'm going to St. Louis.  I may have mentioned before that my husband had a traumatic accident last year and had very serious injuries.  He's still not completely healed and will have some degree of being disabled for the rest of his life.  I'm taking him to St. Louis tomorrow for a followup with his surgeon.  This poses a little challenge being on the liquid protein diet.  So, I'm going prepared. 

I have made a VSG pre-op survival pack for this little trip (it's a two hour drive one way.)  I am going to take two or three very large bottles of water.  Also, one scoop of Unjury Chicken Soup flavor protein powder, two individual baggies filled with enough instant decaf tea and splenda to mix with 24oz. of water, one Great Value sugar free cherry limeade drink mix, one muscle milk light protein bar, one package of Extra sugar free gum chocolate mint flavor and one package of sugar free lifesavers.  The olive oil isn't part of my survival pack... it's just on the counter because I like to cook with it.  A lot.  Hopefully we can just hit a drive through and my husband can get him a fast lunch and I'll get some water to mix my Unjury with (or have the protein bar.) 

When we get home tomorrow, my family is coming over for a large dinner.  I'm cooking a big pan of mostaccioli for everyone.  And, yes, I'm going to eat some.  I have not had pasta in forever!  So, I'm really going to enjoy it.  I'm also looking forward to it because my sister will be up from Tennessee.  I miss seeing her since she moved, and while I just saw her at Thanksgiving, it's just too long! 

When I get up Saturday morning, that will be it, no more food.  I'll be on clear liquids from then on out.  I also will have to do a bowel prep using Magnesium Citrate.  Not really looking forward to it, was hoping I wouldn't have to, but it is what it is.  I will not be able to have anything after midnight Sunday.  The hospital is supposed to call me tomorrow to tell me when to be at the hospital on Monday.  The day after surgery, I will have an Upper GI to check for leaks.  If no leaks are detected, I'll be able to start clear fluids once more.  If I do well, I may get to come home Wednesday evening. 

I had a mini freak out the other night after talking with another patient of my surgeon's.  She had a leak and it progressed into sepsis.  He was out of town for six weeks and was not there for her followup.  It went undiagnosed and was told it was probably gas.  She ended up in a bad situation and that really scared me.  I called my surgeon's office with my concerns.  The assured me that if I presented with pain and a fever, they would do an upper GI and CT scan to rule out a leak.  I feel a little better about my decision to go ahead with surgery.  I know what signs to look for with a leak and can be pretty persistent.  She said she felt if he was there for her followup, it could have been caught, along with having a drain placed after surgery. 

Up until that point, I wasn't nervous at all.  I've had several surgeries in the past few years and it just seems like no big deal.  Now, I'm a bit concerned about complications.  I'll do a lot of praying between now and then and am confident that all will be fine. 

I also did my pre-op registration at the hospital the other day.  It was very simple, just a bunch of questions.  They did a MRSA swab in my nostrils.  That was something new to me, I've never had that before.  They said if it came back positive, the surgeon will treat me for it.  I've never shown signs of MRSA so it's a little confusing.  I guess it's a new thing they are doing.  

Well, I guess that's it for now.  I'll hope to post at least one more update before surgery.  I plan on taking my laptop to the hospital so hopefully I can update there as well.

One Week Left!

258 lbs - 28 lbs lost!

This past week has been a whirlwind of appointments and I expect this coming week to go fast.  I had my final pre-op appointment with the weight loss center last Friday and got the all clear.  I went to see my PCP (primary care physician) today to get clearance for surgery and she gave me the green light as well.  In fact, she was so impressed with my blood pressure and cholesterol levels that she said I would probably be going off them for good very soon.  Yay!  The only reason she didn't take me off of the blood pressure medicine today is because I also take it as a migraine preventative.  But, since my blood pressure was way down, she'll probably adjust the dosage on it.  Amazing!  I've only lost 28 pounds so far, but I'm already seeing the positive effects on my health.

Age 10

On Wednesday, I'm going to the hospital to finish my pre-op and registration for surgery next Monday.  On Thursday, I will be seeing a counselor at my doctor's office for an intake appointment.  When I had seen the psychologist, he recommended that I see a counselor once or twice after surgery.  My PCP said she's really hard to get an appointment with, so she is having me do the intake this week, before surgery, so I can see her soon after.  So, I mentioned that I have now lost 28 pounds.  This is only 2 pounds away from my personal pre-surgery goal!  My surgeon never set one for me, but I wanted to do this.  After the first month, I didn't think it was going to be possible.  But, I'm almost there! 

1997 - 2 Years after graduating high school.  About 180lb

It really is a sense of accomplishment.  I know I'm not yet thin, by any means, but 258 is a lot different from 286.   I was a normal weight when I was a little girl.  I didn't really start putting on weight until junior high.  When I graduated high school, I weighed about 175 and wore a size 16.  

2000 - About 220 lbs

2002 - 244 lbs

I really packed on the pounds after high school while working in a few different bakeries.  I learned how to decorate cakes in high school, and it turned into a career for the first part of my adult life.  I made birthday cakes and wedding cakes, and was just around sweets all day long.  It was so easy to grab a cookie for a snack. 

2003 - 172 lbs

When my husband and I were married, I weighed 244.  Shortly before our wedding is when I started getting serious about weight loss.  I joined Curves and started watching what I ate.  I wore a size 20 wedding dress.  I hated being a fat bride. 

After my first daughter was born, I weighed about 172.  I achieved the weight loss with the help of a nutritionist, who put me on a low carb diet.  It worked, but it was hard.  I got pregnant again shortly after losing all the weight, and I gained back 114 lbs.

2008 - 276 lbs

I'm a little teapot, short and stout.  But, not for long!

 

I started looking into weight loss surgery in 2006.  I was at my wit's end and knew something had to be done.  I kept losing and then regaining.  But, every time I regained, I put even more on.  It was so frustrating!  At that time, the closest place I could have the surgery would have been in Chicago, so that really put me off.  Chicago is about a 5-6 hour drive from here, and I did not want to leave my kids and go that far away.  Plus, at the time, the sleeve was not an option and I kept reading a lot of horror stories about RNY Gastric Bypass.  It really scared me.  Fast forward to 2009, a local hospital opened a bariatric center.  I attended the seminar and started my 6 month doctor supervised diet.  While I was doing the supervised diet, the surgeon was let go due to inappropriate relationship with a patient as well as prescription abuse.  I gave up at that time.  Then, I learned last summer that there was a new surgeon, and everyone was singing his praises.  I attended yet another info session in August 2010.  I got my first appointment on October 29, 2010 and here I am, five years later and finally just a week away from my surgery!

25 Pounds Gone Forever!

I finally did it!  25 pounds are now gone forever.  It feels amazing.  I weighed in yesterday morning at 261 lbs.  I also went ahead and measured myself, looks like I've lost a few inches, too!

Date	Weight	BMI	Chest	Waist	Hips	Thigh	Neck
10/01/10	286	50.6
11/11/10	274	48.5	58	53	60
12/12/10	265	46.9	55	52	58	29	15
01/04/11	261	46.2	53	51	58	29	14.5

I'm very proud of myself.  I've bounced back from falling off the Christmas wagon.  My original goal was to lose 30 pounds before surgery, and it looks like I may reach that goal.  At the beginning of last November, I didn't think it was going to be possible because I was always so hungry and wanted to eat all the time.  My appetite has already changed.  When it comes to dinner time, I even take smaller portions now.  I believe that I am prepared for this surgery, only 13 more days!  Unbelievable.  I go tomorrow for the pre-op group.  I'm really not sure what to expect, but it'll probably be about realistic expectations and how to take care of myself after surgery.

Revised Surgery Date

I just realized that I haven't updated in awhile!  I meant to, but Christmas kept me pretty busy.  The picture to the left is of me, making Christmas cookies with my family.  Sounds simple enough.  But, this was the gateway to unhealthy eating over the holidays.  I am a baker, I actually worked in a bakery for many years, mostly making birthday and wedding cakes.  I love to bake, and sugar cookies are probably my weakness.  Having all those cookies in the house was hard, and I caught myself sneaking one here and there.  This is why I don't buy sweets anymore, not even for the kids, because I just don't seem to have self control when it comes to certain things.  Aside from the sugar cookies, I also probably overindulged during get-togethers.  I didn't eat bad, but I did have carbs and I think they are a trigger for me. 

On Christmas Eve, my dad brought me a pumpkin roll.  His pumpkin rolls are delicious and I promised him I'd have a slice.  Three days later, it's still sitting on my counter, untouched.  However, when we went to my sister's yesterday for our Christmas get-together for my side of the family, my mom brought her legendary fudge.  This stuff is good.  Too good.  In fact, I use her recipe for our non-profit organization's annual fudge fundraiser and it always rakes in a lot of funds.  I had... gulp... 4 pieces.  And, when I stepped on the scale this morning, I had gained two pounds.  Now, I really don't think that I ate any more than any regular person (except the fudge, maybe) but look how fast those pounds packed on. 

It's clear that if I want to lose weight and keep it off, this surgery is a must.  When my brother asked yesterday about the surgery and I mentioned I had already lost over 20 pounds, he said, "Well why don't you just keep doing what you're doing and not have surgery?"  The answer is simple.  If I want to get to a healthy weight and stay there, I'd have to stay on 2 protein shakes, 4oz lean protein and 1 cup of veggies a day.  That's not very realistic, though.  With the sleeve, I'll be able to eat normally, but I will only be able to eat a certain amount.

Okay, now to the real purpose of this post.  My surgery date has changed from January 10th to January 17th because my surgeon will be out of town.  Now, I'm really starting to get nervous because classes start on January 18th.  My classes are online, but my husband's aren't, his will be on campus.  That leaves nobody to care for my kids.  I'm trying to figure it all out and hoping someone can help me. 

Also, the labs I had drawn a couple weeks ago all came back great!  My cholesterol is also way down.  My vitamin D is up, iron is fine, and everything looks great!  My psych eval is tomorrow, and I hope that goes well.  I also fell asleep with the cpap on last night and slept for about 4-5 hours, so we're making progress there. 

14 Vials of Blood

14 Vials of Blood on the wall, 14 vials of blood.  Take one down, pass it around....

No, it's not a lame song from Twilight Family Vacation.  It's how much blood they took at the doctor's office today!  Wow.  I was there for 45 minutes while they looked up codes and what colored vials they needed.  They said that I was only the second person to have needed this type of labwork before.  They tested for the following:

CBC/Diff CMP/BMP PT/PTT/INR Platelet Count Iron Levels Zinc Vitamin B1 Vitamin B12 Lipid Profile LFTs Copper

Calcium Phosphorus Magnesium Vitamin A,D,E,K Selenium HgA1c Thyroid Functions (T3, T4, TSH) PTH Intact Vitamin D-25 OH Total Folic Acid

 It looks like they are being very thorough.  It will also be a good comparison for after surgery so they can compare them to previous levels.  As far as other pre-op testing, I have already had 2 Sleep Studies (one with cpap titration), EKG, Nuclear Stress Test and Endoscopy.  I have already seen the nutritionist once and will need to see her one more time.  I also have a Psychological Evaluation scheduled for December 28th.

I am fortunate that I did not have any major health issues.  Some other bariatric surgery patients have to do the following:  Pulmonary Function Tests, Stress Echocardiogram, Dobutamine Echocardiogram, Regular Treadmill Stress Test, Nuclear Dobutamine Stress Test, Adenosine Stress Test, Wrist X-ray (bone maturity), pH study, Bilateral LE Venous Doppler, Mammogram, and Esophageal Motility Study.  Some patients must have an IVC Filter placed to prevent blood clots, and some must have an upper GI and Colonoscopy.  Some patients must be cleared by a Cardiologist, Endocrinologist, Pulmonologist or Hematologist.

This is not an easy process, and anyone who thinks it's just going to the surgeon and getting a surgery date is wrong.  It's a long, drawn out process and the patient must undergo a lot of testing before it's decided that they are a candidate for surgery.  It's more than medical, too.  There's a psychological component to it.  A person has to be ready for surgery and be willing to make a lifelong commitment.  This surgery is for life, it's not something that can be undone.  It also is not 100% fool proof, either.  It is possible to fail.  There are things called slider foods, mainly carbs - potato chips, french fries, etc.  Things that go down easy, that won't feel you up and are empty calories.  The sleeve is just a tool.  If you use it right, you will lose the weight.  If you don't follow the guidelines, you can fail.  It's really that simple.  Weight loss surgery is not something to go into lightly.  It's not the easy way out.  In fact, it can be much more difficult than conventional methods of weight loss.  The difference is that you have a tool in place to help you keep the weight off long term, to maintain that loss.  For a person with morbid obesity, it is almost impossible to maintain significant weight loss long term.  The body has a set point, and will try to maintain a certain weight, even if it's almost 300 pounds.


I have been keeping track of my weight and measurements.  I'm a bit methodical in it, and really rely on data to see where I stand.  I'm the type of person that likes to make a spreadsheet for everything.  So, here it is.

Date	Weight	BMI	Chest	Waist	Hips	Thigh	Neck
10/01/10	286	50.6
11/11/10	274	48.5	58	53	60
12/12/10	265	46.9	55	52	58	29	15

Seeing this in black and white helps me push forward.  I see that I am making progress and it's great motivation.  I love what I am doing for myself.  I'm already noticing a change in my energy level and have even noticed myself running up the steps to my front porch.  Amazing.  And, this is only a 20 pound loss, I can't wait to see how a 100 pound loss feels!  I've also noticed that my t-shirts are much more loose.  Looking at the chart above, I can see that's because I've lost 3 inches off my chest!  I just hope I don't lose too much of the girls.  I started this diet wearing a 48F and I'm now in a 46DDD.  I think my pant size has dropped from 28 to 26, but I can wear a 24 in stretchy pants.  I think my shirts have also dropped from a 28 to 24/26.  I don't think anyone notices yet, but I'm sure they will in a couple months!

Surgery Date!

I got some big news yesterday - my surgery date!  I've been stressing about this a little bit because I was afraid it may interfere with college.  Classes start back up on January 18th.  I'm scheduled for January 10th!  This is perfect timing.

I'll be able to send my twins on the bus to school, not a problem.  But, my daughter is in pre-k and I have to drive her to and from school.  I may have mentioned that my husband had a serious accident last January when he fell from a roof at work, and he's still not totally recovered.  He'll never go back to roofing again, so he has also went back to school, which also starts on January 18th.  So, he'll be able to at least take my daughter to school and hopefully I'll be able to pick her up. 

I also learned yesterday that my insurance does not require pre-approval, which is amazing.  It only requires documentation that the procedure was medically necessary (which is no problem!)  The only hurdle that I have left to get past is the psychological clearance.  Frankly, I am a little nervous about that.  Mostly, because it's the sleep study doctor who will be doing the evaluation and I'm having some major issues with the CPAP.  Hopefully those will be cleared up after I go to the CPAP clinic tomorrow, though.  The evaluation is scheduled for December 28th.  I hope that he will remember that I'm there for psychological clearance and not because I'm having issues with the CPAP.  I was told that I have to take the CPAP with me for the psychological evaluation.  I'm not sure why, it doesn't make sense, but that's why I'm worried about it.

Being a Social Work major, I have some knowledge of psychology and I really don't think he'll find anything to keep me from surgery.  I have no eating disorders, no major depression and no delusional disorders.  I've experienced some depression in the past, but it was after my daughter died, and I think that's pretty normal.  At most, I think he might find a bit of an Avoidant Personality Disorder, but since it really doesn't interfere with life functions, I really think it all boils down to my being shy and feeling awkward around everyone else - which most certainly can be weight related.  I'm embarrassed by my weight and don't like to draw attention to myself.  I do not think that losing weight will change my entire life.  I do think that it will make me healthier and will boost my self confidence.  I will go into the evaluation with an open mind and be totally honest.  I'm just worried that issues with the CPAP will keep me from surgery.  There is actually a lot of anxiety about that.