ObesityHelp

Post Date 4/26/09 2:58 pm
Topic: RE: Pain

Pain Meds-
(old post from past...skip if not helpful)
I was asked recently by a Pre-Op –
“What was the pain like?”
I was very quick to respond
That it wasn’t so bad really,
And the Drugs were Great!

This was awfully Flip and Glib of me,
And after giving it some more thought,
I had thought of a wealth of info
That I wished I had passed on.

So,
Some babble about Pain Meds while at the hospital-

Expect the best.
If you're in pain, ask for more drugs,
Or a change of Medication.
Tell the Dr. exactly how you feel.
If the Dr. won't be around for awhile,
Tell them to give him a call.
And They Will!
Successful Pain management should be just that!

Now, many angst over the whole 'Catheter Issue.'
Yes, more than likely, (But not always)
A tube will be shoved up your Goober to drain the urine.
You will be asleep under anesthisia when it's put in...
So, No Worry.
You'll most likely be aware/awake (but probably still on good Pain meds)
When a nurse pulls it out.
Little to big yank on the Root like they are testing
To see if it's actually attached.
Over very quickly. A Non-issue for most.

The pain from the surgery completely takes precedence.

For The Post-Surgical Pain?
Most important-
You will need to be able to describe your pain
On the universal rating of-

“On a scale of 1 to 10, 1 being no pain,
And 10 being absolutely unbearable,
How would you rate your pain?”
(Here's the "Scale" that is used most often)

Do not be deceived. If you speak in terms of
Extreme Discomfort, or “Very Un-comfortable,”
That has no place on the nurses’ or Dr.’s radar.
Speak in PAIN 1 to 10 lingo,
And something will be done.
Do be Completely Honest,
But don’t lie there felling terrible
Because it’s “Not time for your pain meds again yet.”
That just means that they are not adequate to do the job,
And should be adjusted.

The Nurse can not adjust the level, frequency or type
Of pain management.
Only your Dr. can do this,
So let him or her know ASAP while they are there.

If the Pain Medication you are receiving
Is making you nauseous
Tell the Nurse, and ask her to contact the Dr.
To ask for a Drug that does not make you nauseous.

For Example-
If you have a problem with the Morphine
Making you Nauseous,
Tell them to try something else. Demerol,
Or a Demerol/Phenagrin Mix.

It’s your care. They’re getting paid,
So they are working for your well being.
And keeping your pain at a “managed level”
Is part of that care.
Have someone with you who can
Be your advocate. (Most Important!)
You should be comfortable, calm and
Get the rest you need to heal.
We have the technology!

Your Nurse, if like most nurses,
Will be stretched very thin
Looking after more patients than
They should be asked to serve.
Hospital Administration is fighting to
Keep the overall “bottom-line” in the Black,
And it is the Nurses that are carrying Most of that burden
Be understanding, yet,
Don’t accept the-
“Do you want your pain medication or Not?
Because This is all I can Do!”

Your Key to Getting the attention of your
Health Care providers, when it comes to Pain
Is the simple Phrase-
“This Level of Pain is Unacceptable / Un-Bearable
And something must be done.
Would you please put a call into my Dr.?
Or get me a CONSULT?”

In the Very Litigious Society we live in
Every Hospital knows that failure to provide
“A Consult,”
In an area of expertise outside or beyond
The expertise of your Dr.,
Opens them to future Liability
Should something go wrong.
I’m not saying be a bully and a horrible patient,
But know that you will only get results if you
Know how to ask the right questions.

I’ve had 8 fairly Major Surgeries
In the last Two Years and have amassed
A good bit of Anecdotal information.

Some of this is just from comments from multiple Nurses,
Some is from a touch of web research.
Look it up for yourself and be informed
Before you head in to the Hospital.

So, if your pain is coming on up
And part of your discomfort is from
Gas and constipation,
The Dr. will explain to you that Pain Medications
Cause more constipation and Gas.
This is Very True of Morphine and Demerol.
However, Nubaine, which is just as effective
Does not typically have this side effect,
Nor do most of the Synthetic Opioids.

Morphine tends to cause a number of people to itch.
If this is the case with you and the itching is causing
You to lose rest, ask the Dr. if he could put
Benedryl on your list of medicines on an “As Needed Basis.”
Not only will it make the itching go away,
It increases the effect of the Morphine’s Sedation properties.

The Most used IV Pain Med, early on is Morphine.
It is the “Go To Drug” because it does its job well.
One of it’s draw backs, if you have to have it
For 5 days or more, is that it is Very Addictive.
One can also build up a tolerance to it
And it’s effectiveness decreases over time.

I have had Morphine on a self administering pump
And as an IV injection every 4 hours.
The IV injection was far more effective than the
More frequent lower doses.

Morphine also has side effects
When interacting with most Anti-Depressants.

It’s noticeable side effects for the average patient include-
Nausea, Itching, Increased Constipation.
It also aggravates Urine retention.
If this is the case with you,
Ask for a substitute.
Sustained use will also contribute greatly to Temporary Dementia.
In combination with the constantly interrupted sleeping schedule
The result is common “ICU Psychosis.”
Hallucinations that would leave Timothy Leary in the Dust!

Demerol is the second most popularly used IV Pain Medication.
It also is rather addictive, but not quite as bad as Morphine.
It tends to give many patients a feeling of “Floating” or “Bed-spins”
That lead quickly to nausea. For this reason it is often
Given with Phenagrin.

When paired with Phenagrin it is very sedative and
Will put the patient to sleep usually.
Demerol, like Morphine also can cause constipation,
Just not as bad as Morphine.
It doesn’t have the reputation for causing patients to itch,
However, that is listed as one of it’s side effects.
It also lists the same drug interaction problems as Morphine.

I have been given Demerol to slowly replace Morphine
When it’s effectiveness was reduced by my increased tolerance.
The Demerol / Phenagrin “****tail” was very effective
In keeping pain to a minimum while not giving me nausea.
As with the Morphine, I found the direct IV injections to
Be the most effective.

I have also been given Valium IV a couple of times,
But this was during procedures in radiology were they
Were setting a drain. It’s mostly an extreme sedative - anti-anxiety drug but
When used in conjuncture with pain killers and local anesthesia
It’s great.
So is SUBLIMAZE® (or Fentanyl Citrate)
It has an odd “out of body” sensation that’s very pleasant
And similar to AQUAVAN® (which is also very soothing)
(told ya I’d had my share of the Drugs!)


Nubaine would be my IV drug of choice.
The Pro’s and Cons of Nubaine are-
It is No Where Near as addictive as Morphine and Demoral,
But, it seems to have little to no effect on about 20% of people
And therefore is not a completely reliable Pain Management tool.
It also doesn’t increase incidence of constipation,
Therefore if your pain is predominantly
Being caused by extreme gas, it is very effective
In “breaking the loop” of more pain meds causing more pain.
So,
If you are having pain and the Dr. is not wanting to
Give you a higher dose of Morphine or Demerol due to
It’s ill effects on the digestive tract.
Ask about Nubain.
It has a much lower incidence of nausea, dizziness, vertigo, etc…
And is very effective when you are not in EXCRUSIATING PAIN.

Now all of this is not to suggest that you second-guess your Dr. at all,
BUT, do be very open and frank with him or her.
Pain management is however, just that.
Management.
They Cannot get rid of it completely.
And it is better to take something for it
Before it becomes intolerable.
But because pain is such a subjective aspect of surgery
And one that you are the authority on,
The system tends to err on the side of not “Over Doping” the patients
And will, if allowed, sometimes treat your complaints as
Less than objective, driven by the knowledge of the
Addictive powers of most drugs.
Full and open communication from you or from your
Advocate or loved one is the best way to insure that
You will have a fairly pain-free time of recovery.

There are many benefits of pain relief ....
You are much more likely to walk,
Cough and deep breathe effectively if you are not in pain.
You get no points or benefits for suffering....
As a matter of fact, it will slow your recovery considerably.
(Another hint, if you are awake,
Try to change position in bed every two hours after surgery....
If you have had surgery you already know how difficult this can be,
Yet it is a very effective tool in speeding recovery
And preventing pneumonia and atelectasis (lungs not breathing deep enough).

Expect the Best, and ask for it if you’re not getting it.

Once you have gotten past the first couple of days
Or even after the first day for many,
You may be moved onto oral pain management.
You certainly will before you are allowed to go home.

Lortab Elixir is very common for Gastric Bypass patients.
It is during this transition from the “Big Guns”
Of IV pain meds,
To the “Kinder, Gentler” oral pain meds,
That many people experience MOST of their pain.
It’s that transition from “too much,”
To- “not quite enough,” that is tricky.

Know that if you have moved off of the IV’s
You are on your way to merely discomfort
Rather than Pain, and it’s soon to pass.
The Lortab elixir and the 2nd most popular-
Vicodin, as well as Hydrocodone,
All increase your gassiness and constipation,
So use them sparingly.
Once you are home, Walking is one of the best
Long range pain management tools and
Since most of the pain will be from “trapped gas,”
The Walking targets the problem rather well.
Once home, also try a simple
Heating pad. Place it on your back and not on your
Actual incisional area.
The comfort from the heating pad comes from increasing your
Blood flow in the area where applied,
And increasing blood flow to your incisional area
Could increase your odds of having a Seroma.
(Blood or Fluid Trapped within tissue.)
Another great pain reliever is a loved one willing
To rub your hands or your scalp.
Any such stimulation releases endorphins and causes
You to just “feel better.”

This long of a post surely makes up for my Glib-
“Not so bad, and the Drugs are great!”

Any of you out there with pain info- add on ....
(PS- Howdy Old Timer Dudes! I just dropped by....) __________________
Best Wishes- Dx

Post Date 10/11/08 9:07 pm
Topic: Sunday Weekly Weigh-In!

The Sunday Weekly Weigh-In
October 12th!

ongratulations to All for your accomplishments this past week!
I'm keeping A "Weekly Weigh-in" here as well as on the  New-Men’s-Only-Board
Because many of the Guys, both here and there (newly arriving from OH)
Have used it for over a year to keep track of their changes, and see how they and others are doing over a sustained period of time.


...just in your first weeks home? Hang in there,
It DOES GET EASIER!
.... just hitting your first stall?   It happens to many....
Eventually you will be able to scan back over the last months of this weekly post,
And get a fairly clear picture of the fact that there isn’t a "Typical" progress,
Just persistent, overwhelming - PROGRESS!


Yes, using the scales can make some crazy,
(Slower loss is Still Loss!)
-But-
Keeping track and forcing myself to "Watch It!"
Has been the "What works for Me," for maintaining my loss.
I’ll eat, but know that I need to exercise a little bit more
If the numbers climb just a little.
That way,
I only make "Little" adjustments to my weekly routine.
If the "Scales Make You Discouraged?"
Then STAY OFF of Them!

But for those who Are weighing in-
Drum roll--------------------------------------

Hop your Azz up on the Scales!

How much have you lost?
Since Surgery?
Or in Pre-Op Diet?

And has the Scale moved this week for you?
If so, How Much?

My Starting Weight? – 385 +
All Time Low – 179

Me?-   [Saturday Night Weight, so hoping it's maybe a touch lower in the morning...]
188 (no change this week...)


____
Best Wishes-
Dx

Post Date 10/7/08 9:31 pm
Topic: RE: Back Exercises?

Lance,
just dropping through...
here's a 'copy/paste' of an old post of mine from The Men's Locker Room at Quix-
(hope some of it it Helps)
------------------------------------------------------------------------------------
Back Pain.

I never had any until after I dropped my first 100 pounds.
My Physical Therapist explained that it was from
Adjusting to the New Body.
That, and in my case my Abdominal Muscles
Were missing in action and then out of their normal position.

Also, the “drooping” skin from the Abdomen
Causes an odd pull/strain on back muscles that have
Grown accustomed to the “Previous You.”

No matter what your present state,
Back pain is one of the most common work-related injuries for Men.
It is the second leading cause
Of missed workdays for Men after the Common Cold/Flu.
Guys with jobs that require lifting aren't the only ones at risk.
Working in front of a computer in the same position all day
Is also a major risk factor for developing back problems.
And statistically because of the typical Male tendency
To carry excess weight on our Stomachs rather than our asses,
Back-Strain is the common result, even for guys who are not Obese
But have just the “Beer Gut.”

There are many ways to prevent non-accidental back injuries,
Such as making sure your workstation is user-friendly,
Taking breaks to stretch and walk around,
And to strengthen your back muscles.

There are some specific exercises
You can do to relieve the aching.
Keep in mind, however, that the back is very sensitive
And that performing exercises incorrectly
Could have serious consequences.
I had mostly Lower Back Problems after my Surgery.
The following exercises concentrate on the lower back.
After all this is the most common site of pain.

This is the Top Ten List
of stretch exercises for helping reduce back pain.

All 10 won’t help everyone.
But 4 or 5 done alternatively could be Most Beneficial.

These should be done on a firm but soft surface,
Such as a carpeted floor or Firm mattress.
And remember-
If one hurts, stop immediately.

These are from a handout from my Physical Therapist
That he showed me how to do first then I’ve kept them
Up at home since.
These are just Stretches.
There are others for strengthening back muscles
For Long Range improvement.
I’ll get around to typing those one day.

Here Goes-

1.) “Spread eagle”
Lie on your back
With your arms stretched above your head, palms facing up.
Make sure not to bend your neck so you don't strain it
And pay attention to your lower back throughout the exercise.
Tilt your pelvis toward the sky and suck your gut in,
So the entire surface of your lower back is touching the floor.
Simultaneously reach above your head with your right hand
While you push down (into the "air" below your foot)
With your left leg. Hold the position for four seconds,
Then change sides (left hand up, right leg down).
Repeat three times on each side.

2.) Pelvic lift
Lie on your back with your knees bent
And your feet flat on the floor.
Keep your legs together and cross your arms over your chest.
Tilt your pelvis up and push your lower back to the floor,
Then slowly lift your butt off the floor
As far as you can WITHOUT straining.
Maintain the position for five seconds,
Then lower your butt to the floor.
Repeat three to five times.
Remember to Breathe normally throughout.

3.) Hip twist
Lie on your back with your arms stretched out
On either side of your body.
Bring your Right knee up toward you
So that your forms a 90º angle with your chest
And bend your knee so that your lower leg is parallel to the floor.
Keeping your shoulders stuck to the floor,
Slowly lower your knee to the left until it touches the floor.
Relax for five seconds, then slowly bring your leg back
To rest beside the other one. Repeat three times with each leg.
(This one works really well for me)

4.) Knee to chest
Lie on your back and clasp your hands together
On the back of your thigh, right below the knee.
Keeping the opposite leg flat on the floor,
Pull your thigh toward your chest.
Maintain the position for 15 seconds, then switch legs.
Repeat three times with each leg.

5.) “Cat and camel”
Get down on all fours and keep your neck straight
So that you are staring at the floor.
Slowly turn your face toward the ceiling
While allowing your lower back to "sag"
Comfortably into an arch; don't push or force it.
Next, arch your back in the opposite direction,
Contracting your abs and pushing your lower back
Toward the ceiling while lowering the top of your head
Toward the floor.
Make sure that all movement is initiated
And controlled by your lower back.
Repeat three times in each direction.

6.) “Tail wag”
Get down on all fours and look down at the floor.
Keeping your shoulders still,
Slowly push your right hip as far as you can
Toward your right shoulder.
Then, slowly return to the starting position
And repeat the on the other side,
Pushing your left hip toward your right shoulder.
Like a dog wagging it’s tail in Slow Motion.
Repeat three times on each side.

7.) Hip extension
Get down on all fours (yet again)
And keep your neck straight so that you are staring at the floor.
Simultaneously lower the top of your head toward the floor
While bringing your right knee in toward your head.
Then, tilt your face up toward the ceiling
And extend your leg out behind you
Until it is parallel to the floor.
Return to the starting position
And repeat with your other leg.
Repeat three times on each side.

8.) “Rag doll”
Sit in a chair (finally off the floor)
With your feet flat on the floor, knees shoulder-width apart.
Look straight ahead and relax your neck and shoulders.
Slowly curl your neck, then your upper back,
Then your lower back forward
Until your chest is between your thighs.
Let your palms rest on the floor
Or as close to it as they can reach
And hold for 10 seconds.
Straighten up by doing the same movement in reverse,
lifting your head up last. Repeat three times.

9.) Upper back stretch
Sit on a stool with your head and back flat against a wall.
Lift your arms over your head and hold for five seconds.
Try to make your shoulders touch the wall
While keeping your back flat,
And hold for another five seconds.
Lower your hands to the starting position.
Repeat three times.

10.) Side bend
Stand up straight with your arms at your sides
And your feet shoulder-width apart.
Lower your right shoulder to the side,
Running your hand down the outside of your thigh
And bending your entire trunk at the waist
As far as you can without straining.
Hold for five seconds and slowly straighten up.
Repeat three times on each side.

10 minutes every other day doing simple stretch exercises
Can really reduce or eliminate Lower Back Pain.

Hope these are useful to some. They were for me... __________________
Best Wishes- Dx

Post Date 10/5/08 8:13 am
Topic: RE: Plastics Surgery Perspective - Please Share

Taz,
I had my panniculectomy about 3-1/2 years ago.
I was up and going in about 3 weeks.
The swelling lasted way beyond what I was expecting.
(About 6 months)
Other than that, it was a breeze for me.
I resisted having it done for quite awhile,
But have been very pleased with the results.
One thought to consider----
I did shop around for a plastic surgeon who had done
The exact surgery on Men.
So many of the plastic surgeons are used to doing
Boob jobs and lifts for women.
A few of the Docs I met with had only done a couple of
Tummy tucks on men.
I found a surgeon who had done panniculectomies
On 6 men in the last 2 months.
That’s what sold me on that doc.

I have also seen folks who swear by PS post-op pain management
using “On-Q.”
http://www.vqorthocare.com/Products/Miscellaneous/Pain_Pumps/On-Q.php My pain was minimal and I got by on just some typical
Narcotics from the doc.

(Just a thought)
There are quite a few guys with PS experience over at Quix…
http://quixoticwls.org/forums/index.php The Men’s Only Forum there is ‘invite only,’ (Drama Free) so if you drop by
Give me a holler to log on to the Men’s Forum.

Congratulations on your continued success,
And may your PS be just as beneficial.

Post Date 10/5/08 5:52 am
Topic: The Sunday Weekly Weigh-in

The Sunday Weekly Weigh-In
October 5th!

ongratulations to All for your accomplishments this past week!
I'm keeping A "Weekly Weigh-in" here as well as on the  New-Men’s-Only-Board
Because many of the Guys, both here and there (newly arriving from OH)
Have used it for over a year to keep track of their changes, and see how they and others are doing over a sustained period of time.


...just in your first weeks home? Hang in there,
It DOES GET EASIER!
.... just hitting your first stall?   It happens to many....
Eventually you will be able to scan back over the last months of this weekly post,
And get a fairly clear picture of the fact that there isn’t a "Typical" progress,
Just persistent, overwhelming - PROGRESS!


Yes, using the scales can make some crazy,
(Slower loss is Still Loss!)
-But-
Keeping track and forcing myself to "Watch It!"
Has been the "What works for Me," for maintaining my loss.
I’ll eat, but know that I need to exercise a little bit more
If the numbers climb just a little.
That way,
I only make "Little" adjustments to my weekly routine.
If the "Scales Make You Discouraged?"
Then STAY OFF of Them!

But for those who Are weighing in-
Drum roll--------------------------------------

Hop your Azz up on the Scales!

How much have you lost?
Since Surgery?
Or in Pre-Op Diet?

And has the Scale moved this week for you?
If so, How Much?

My Starting Weight? – 385 +
All Time Low – 179

Me?-
188 (still up a pound...back to more exercise this week...


____
Best Wishes-
Dx

Post Date 9/27/08 7:53 pm
Topic: RE: 10 Months today!

Dale,
Amazing!  It seems like just yesterday......
Congratulations on your continued success!
Keep it Up!
__________________
Best Wishes- Dx

Post Date 9/20/08 10:13 pm
Topic: The Sunday Weekly Weigh-In

The Sunday Weekly Weigh-In
September 20th!

Congratulations to All for your accomplishments this past week!
I'm keeping A "Weekly Weigh-in" here as well as on the  New-Men’s-Only-Board
Because many of the Guys, both here and there (newly arriving from OH)
Have used it for over a year to keep track of their changes, and see how they and others are doing over a sustained period of time.


...just in your first weeks home? Hang in there,
It DOES GET EASIER!
.... just hitting your first stall?   It happens to many....
Eventually you will be able to scan back over the last months of this weekly post,
And get a fairly clear picture of the fact that there isn’t a "Typical" progress,
Just persistent, overwhelming - PROGRESS!


Yes, using the scales can make some crazy,
(Slower loss is Still Loss!)
-But-
Keeping track and forcing myself to "Watch It!"
Has been the "What works for Me," for maintaining my loss.
I’ll eat, but know that I need to exercise a little bit more
If the numbers climb just a little.
That way,
I only make "Little" adjustments to my weekly routine.
If the "Scales Make You Discouraged?"
Then STAY OFF of Them!

But for those who Are weighing in-
Drum roll--------------------------------------

Hop your Azz up on the Scales!

How much have you lost?
Since Surgery?
Or in Pre-Op Diet?

And has the Scale moved this week for you?
If so, How Much?

My Starting Weight? – 385 +
All Time Low – 179

Me?-
187 (back down a pound, Saturday Night Weight)

So, What about YOU?
__________________
Best Wishes-
Dx

Post Date 9/19/08 3:56 pm
Topic: RE: i'm here

Glad to see you!
I thought Ike must have gotten you!
Hope ya'll get headed back toward normal down there soon!
__________________
Best Wishes- Dx
 

Post Date 9/9/08 7:16 pm
Topic: RE: Weird Question

  Gottcha!
Get quick, full answers at -"The-Men's-Locker-Room"

__________________
Best Wishes- Dx

Post Date 9/7/08 3:09 pm
Last Edit: 9/7/08 3:11 pm
Topic: RE: FART

Just a joke from the past, that kept on going---
"Fantastic Awesome Remarkable Tremendous (FART)."
Fart-Origin
      

Post Date 9/6/08 9:17 am
Topic: RE: What's the 5-day pouch test??

The 5-Day-Pouch-Test,
Is another Fad-Diet, just one specifically geared for WLS Post-ops.
It’s a Quick Crash Diet like “The Plateau Buster.”
A quick Starvation like a fast.
Not recommended by ANY Dr., Nutritionist, or Medical Bariatric Professional.
Just some well meaning Post-Ops
Who got the idea from other well meaning Post-Ops.

People who get antsy about not losing fast enough
or experiencing some regain,
Turn to such “Quick-Fix-Magic-Solutions,”
Because they prefer (small) instant results to long term Health.

If someone is after a quick drop in a few pounds
From severely limiting their calories for a week,
This fits the bill. 
But, like all other Fad-Crash-Diets,
It reinforces “Diet Mentality,” and undermines
The establishment of Habitual Lifestyle change
That will keep the weight off for the long haul.

Checkout- Real-Plateau-Buster

__________________
Best Wishes- Dx

Post Date 9/3/08 11:56 am
Topic: RE: BajaAddict? Anyone?

Duh, ...  Read Much?!
He IS going about his merry way, Still as fun as ever,
In "The Men's Locker Room."
Just not here at OH contributing to this site's wealth.

Shoo on along crickett
Nothing for you here either.