9/26/08:

What a rough week.  Having some professional problems causing a great deal of stress.  For some reason since having the DS I have no appetite when I’m upset.  I just eat the minimum protein requirements and that’s it.  Then to add to my difficulties, the gynecologist felt a lump yesterday and told me I had to get to the radiologist ASAP.  I’ve lost more weight and just can’t seem to eat more.  Thankfully, the radiologist did a mammogram and sonogram & it’s just one of my cysts that has gotten bigger.  Apparently, when you’re pre-menopausal cysts tend to enlarge. 

You can’t begin to imagine the tension my family has felt the last 24 hours.  It’s been unbearable.  I plan to relax this weekend and part of next week (a mini-vacation) and tackle the professional issues later next week since (thank G-d) the medical issue has been resolved.  I’m just exhausted.  I also bought some pastry to eat.  Maybe put on some weight.  I need to add about 10lbs. but until things get settled I’m not sure how successful I’m going to be but I’ll try.

Oh, and I might have an answer to why my thumb nails look ridged.  Apparently, there’s a condition called Koilonychia [the nails are flattened and have concavities].  Generally, one gets it due to an iron deficiency.  My iron has been ok but it’s being rechecked in a mini-bloods this November -- so when I see those results I’ll check them next to my preop iron and see if there’s any major difference.  Just b/c my iron has been good doesn’t mean it wouldn’t help to maybe get it closer to preop levels.  After all, once I saw what my zinc was preop and brought it up that horrible itching I suffered from for so long has gotten incredibly better.           
 

Sunday is the Walk From Obesity.  No matter how tired I am, I sure hope to go.  It’s a fun day and a good cause.

8/28/08:

Saw the endocrinologist today.  Lost 5 lbs. since I saw my surgeon in July.  I really have to put the weight back on.  He wants 8-10lbs.  I figure 5-7lbs. would do.  So it’s more carbs. for me.  Just not in public.  Don’t want the gas ;).

PTH is high, Vit. D3 is ok, calcium is too low.  He’s going to go along with what my surgeon’s nutrit. said in July about upping the Vit. D2.  If that doesn’t help, he may prescribe something called Activated Vit. D [http://www.naturalnews.com/003142.html].  Even though my D3 looks ok, my liver may not be processing it that well.  The Activated Vit. D would help here. 

Dexa bone scan has more osteopenia but he said for my age and the DS it’s not worrisome yet.  Have to go back in late Nov. after mini-bloods checking to see if Vit. D2 prescription is helping.

He said I look too thin but energetic so that’s good!

Still have the contact dermatitis from the betadine and steri-strip combination used when my gallbladder was removed last month.  Thankfully, it’s a lot better due to the steroid ointment I was given by the dermo. but it is still here.  Looks like rings around the incision points.

8/6/08

So, I'm at a great DS dinner Thursday night, July 28th. We go Moonstruck Diner and I order a cheeseburger and fries. I eat a handful of fries and figure to take the burger home and eat it the rest of the evening.

Half of the DSers left around 8PM (some had just had PS and needed their rest) and the rest of us were talking. I started to get pains in my rib cage. I thought it was gas. I got up and walked around, massaged the area -- nothing helped. It got worse and worse. Finally, around 9PM I said I had to go home and lie down. I took a taxi with another DSer (you know I must be hurting b/c I almost never take a taxi) and went to my apt. Lying down was terrible. So was sitting up. Finally, I called home and my mother suggested Ginger Ale and Tums. I tried both and nothing worked. I took my temperature and it was 99.9F., orally. My mother suggested I call my internist. At 11PM, I did. He called back in 10 mins. and said to go to the ER as they needed to feel the area, take tests, etc. At 11:25PM, I got to the ER (I went to Weill Cornell Hospital where my DS was done in '05) and waited an hour till I was seen (pacing up and down the waiting room groaning).

At 12:10AM, it was like a miracle happened. The pain went away. I was fine! Just a little tenderness around the upper stomach area. You never would've known anything was wrong. But 15 hours later (in the ER) and a battery of tests (blood, ultrasound) I was taken to a care unit in the hospital to be monitored. Stones in my pancreas (pancreatitis) had caused the pain and my gallbladder had to be removed. However, they had to wait for it to settle down. So from THURSDAY NIGHT 7:30PM till SUNDAY MORNING 9:30AM, till they removed the gallbladder, NO FOOD OR DRINK. Just intravenous. They were afraid if I ate anything I could have another attack. (BTW, when I arrived in the care unit they wanted to put in a catheter. I said no and said I'd been peeing all night from the IV and was still doing so. So no catheter was needed. I prevailed and the whole time I was there I had no catheter except for the time in the OR. I learned from my DS that you need to speak up so I did. Sure they're often right and a catheter is needed but if you think you have a good point of view I've learned it's impt. to speak up). Oh, and the nicest thing. My internist called Saturday night to see how I was doing. He’s just so great.

Oh, and the funniest thing (I forgot to mention).  While in the ER, no less than 4 drs. and nurses asked me if I drank.  The reason was that my liver enzymes (and some others) were so high.  I explained to each one, “I don’t drink.  I don’t smoke.  I EAT!”  I understood why they kept asking b/c apparently drinking can make the liver enzymes explode upwards but it was just funny they all kept on coming over to ask me.  Of course, once they did the ultrasound they saw what the problem was.  The other funny thing that happened in the ER was the girl next to me.  She really felt badly.  I heard what was doing with her and when she finally started to feel better we talked for a couple of hours (since I felt fine).  She’d just had an RNY (done by Pomp) 2 weeks ago and was she having buyer’s remorse!  I was able to let her see a bit down the road (as I was at over 3 years out) and that it does get better.  She began to remember why she did it (for her young kids so she’d be around) and cheered up.  She really thanked me for talking w/her and helping to remind her that better times were ahead.  I felt good and, in a way, kind of like it was meant for me to be there that night.

So Sunday morning one of my DS surgeons (Dr. Pomp) came and explained the procedure. They did a lap gallbladder removal. Still NO FOOD TILL MONDAY 8:30AM. So about 3.5 days with no food or drink, whew!

Got home very late (to my parents’ home) Monday night and returned to my apt. on Wednesday. Healing slowly but ok, till Friday when a rash developed and terrible itching around 2 of the incision areas. Got the on-call resident Friday and Saturday and we're trying Benadryl creme and an antihistamine but neither is working much. The resident thinks it may be an allergic reaction to the steri-strips and/or iodine used in the surgery.   Heading to a dermo. this week to try and figure out whether it’s a fungus or I’m allergic to the steri-stips they use after surgery.  I’m just a red, itchy, blotchy mess all over my stomach.

So there you have it and I guess the lesson is LISTEN TO YOUR BODY. When it says something hurts, don't ignore it.

7/18/08:

Saw WLS surgeon (and his nutrit.) for my yearly visit yesterday.  Blood pressure is 100/66 so that’s good.  Need to add more copper (which I figured) and a Rx of Vit. D2.  That was so interesting b/c I didn’t think D2 was important – but the nutrit. said mine was so low it was affecting calcium absorption (which is down a bit).  Vit. D3 is still ok.

Neither of them knew what was going on with my peeling fingertips (which began in February 2008).  The nutrit. said she researched it and found nothing.  The surgeon asked me to email him in a couple of weeks and he’ll see if he can find anything.  Both said I’m the first WLS patient to have this.

Here’s some more video taken July ’08:

http://youtube.com/watch?v=l130jUUfVe4

http://youtube.com/watch?v=_lr_-XN05fo

7/11/08

Feeling fine today.  Just wanted to stress again how important having a colonoscopy is.  I’d have it again tomorrow if I had to.

7/10/08

Well, it’s the day after my colonoscopy and I thought I’d share some things I’ve learned.  [I want to stress, this is how it went for me.  It doesn't mean it'll be like this for anyone else]. This is really the first medical procedure I’ve had done since the DS.  Oh, I’ve had bone density scans and things like that, but this was different.

First, as a DSer, I asked my WLS surgeon for a referral to a gastroenterologist who might know something about the DS.  I met with the doctor and he was familiar with it, though he hadn’t done a colonoscopy on a DSer.  He said it would prob. take longer than the avg. time (15 mins) due to scar tissue and that I was correct and shouldn’t drink the Golytely (also called Colyte, or Nulytely) as I would barf it up.  I should, instead go with the phosphate tablets (Osmo-Prep or Visicol).  In addition, as a DSer, there’s always an increased risk of dehydration.  So I was to eat until 3PM Tuesday -- the procedure was scheduled for Wednesday at 9AM -- (average people stop eating at 12PM) and drink until 4AM the day of the procedure (others stop at Midnight).  Also, beginning Monday, I should only eat protein.  Nothing else until after the colonoscopy.  Finally, all vits/minerals/iron were stopped as of Monday morning.  (Honestly, this was the weirdest.  I felt like an addict without my fix.  I was walking around after meals going nuts.  I just wanted to throw down my usual handful of pills).

When you take the phosphate tablets you do it like this.  Tuesday at 3PM you take 4 tablets.  Then 4 more tablets at 3:15, 3:30, 3:45, 4:00 for a total of 20 tablets.  They taste like salt pills as they sat on my tongue waiting to be taken with a full glass of water.  Well, that didn’t happen.  At 3PM I managed a full 8oz. with the first 4 tablets.  Every 15 minutes, though, I could drink less and less.  My stomach just couldn’t handle that much liquid.  I barely got in a quarter of a glass of water as time went on.  I did sip lemonade Crystal Light after that but I knew I wasn’t getting in enough liquid.  But I did my best and couldn’t do anything more.  I didn’t ‘go’ till after 5PM.  I thought it would’ve begun more quickly but it took 2 hours till it started.  Then I went four times from 5PM till 5:45.  This part wasn’t bad at all.  No pain, no cramps, nothing.  Just ‘going’.

At 6PM you take another 4 tablets with a full glass of water.  Then 4 more tablets at 6:15 and 6:30 for a total of 12 tablets.  That’s it.  Again, I drank what I could.  I ‘went’ a lot during the evening and then again at 1:30AM and 3:00AM.  Of course, I had a drink each time I went till 4AM when no more drinking was permitted.  I also went a few little times at 6AM when I got up for the day but not much would come out.  By this time, I was pretty woozy and very tired. 

I wasn’t going to have anyone come with me as his office is very close but my mother wanted to come.  Good thing.  I was pretty weak.  I won’t go into the office problems but suffice it to say the patient before me had been late and made them late by ½ hour.  Believe me, for a DSer (who eats every few hours) who hadn’t eaten since 3PM the day before (and I didn’t go into the procedure room till 9:40AM) it wasn’t a fun feeling.  The one good thing was I wasn’t super starving b/c I’d passed that point.  But at various times, I’d really start to think about what to eat when it was over.

Here’s where it gets hairy.  I generally have low blood pressure. Even preop I was low normal.  But when the anesthesiologist took it it was 70/40.  That’s really low.  The anesthesiologist wasn’t happy.  She began (intravenously) pumping fluid into me.  1,000 units went in before my pressure came up to about 90 (another 500 units went in while I was in the recovery room).  She also had the staff run down and get Gatorade for after the procedure to get my electrolytes up.  She kept talking to me and asking questions re: the DS and I realized it was to ensure I was still making sense.  J  Finally, after ½ hour of doing this we were able to do the colonoscopy. 

After I woke up, I met with the doctor.  Thankfully, they found nothing (after all, that’s what’s important) but he said he always sends tissue samples to be looked at just for routine screening.  He also said it took much longer than an average colonoscopy as there were twists and turns and scar tissue.  [He was also curious if I’d been awake at all during the procedure b/c they gave me much less anesthetic than an average person b/c they were afraid my blood pressure would bottom out.  I said I’d heard nothing and felt nothing.  No pain before, during or after.].  He knew this was prob. going to happen so I’m surprised he didn’t schedule more time for me (my mother told me the waiting room wasn’t happy, but hey, I can’t do anything about that).  I had asked the anesthesiologist to tell my mother (in the waiting room) that we hadn’t started yet, so she wouldn’t worry why it was taking so long, but it didn’t work.  She was pretty much a mess when she found out about the blood pressure.  Thankfully, she came into the recovery room and saw I was ok.

I ate nuts I’d brought and drank Gatorade and then took a taxi home.  I ate and dozed.  Couldn’t eat as much as I wanted b/c my stomach got full real fast.  But I happily got to take my vits/minerals/iron!

I knew my body was different post DS.  But there are things that have to be done differently for me and I’ve learned some of them.  The anesthesiologist said when I have this done again it must be done in the hospital [due to my low blood pressure and the fact that dehydration can occur].  Either the night before (so I can have intravenous fluids) or that morning so they can monitor a lot more of my vitals and also give me potassium with the fluids.  I’m glad she said this.  It made me realize extra care is prob. needed for me if/when I have a gynecological procedure done that my gynecologist has been talking about.  I have to realize I may need more time in the hosp. than the avg. patient.  Not that I’m more fragile than I was preop.  Just that things need to be done a bit differently now.

Please don’t let this scare you from having a colonoscopy.  It’s a necessity.  Just wanted to give DSers a heads up on what they might want to do to make it easier on themselves.

Today, I’m tired and have a headache.  Prob. from the mental stress (which didn’t really catch up to me till today) and the physical stress as well.  But I’m eating and well on my way to normal.

5/4/08:

Time once again to talk about Zinc.  IT RULES MY WORLD!!

*fingertips peeling (check out some video taken March ‘08):

http://tinypic.com/player.php?v=210byaf&s=3

http://tinypic.com/player.php?v=9l9weu&s=3


*thumbnails ridged & thick
*white lines on some nails

*discoloration under the nails
*little to no sex drive
*getting 2 colds in the last 3 months
*taste sensation severely diminished.  Chocolate, sweets, savory things just don't have that oomph.
*itching a bit worse.  Whereas I was down to 1 pill for itching (Doxepin) every three or four weeks, I'd had to increase that to at least once a week.
*wound healing problems.  Cuts were taking forever to heal & I'm heading into my 5th week with stitches b/c a wound on my knee just won't heal.  (I learned this at the National Institutes of Health website...that lack of Zinc can lead to wound healing problems).

I contacted my surgeon's nutrit. and she agreed it was time to up the Zinc again.  Went from 350mg/day to 400mg/day and from 6mg/day of Copper to 8mg/day.  [Gotta watch the Copper as Zinc can interfere with Copper's absorption so you often need to up the Copper when you up the Zinc].  We'll check the bloods in July as per my 6 mos. schedule but I'm so glad she agreed my symptoms sounded like Zinc deficiency.  

Hard to believe it's been only 4 days but I think the fingertip peeling is better & I the itching has quieted down.  Plus, I think my knee looks better.  So another lesson learned...Zinc.  IT RULES MY WORLD!!

4/11/08:

Well, today is my third anniversary.

It's not always been easy.  In fact, I was not one of those who felt it was “the best thing I'd ever done.”  It was a very rough first nine months and then things started to turn around.  However, I will admit it took till about 2 1/2 years out that I finally felt it was the right thing to do and I was glad I did it.  While it's made things more difficult in some ways, it's made things much easier in more.

Ah, and one more thing...even at 3 years “it” can happen.  What is “it”?  An accident.  Yep, two days ago I'd had a grumbling stomach all day (gassy).  Could have been some sugar free cookies I'd eaten (I'd certainly had them before) but I'm not sure.  However, I was gassy all day and then while walking down the hall to my apartment I had some gas and said to myself, "No, it couldn't be, could it?"  It was.  I came inside and saw the proof.  Not much, but still an accident.  Thankfully, I was at home with no worries, but it reinforces my decision to always have a spare pair of panties (in a Baggie) with me in my knapsack.  I haven't ever needed them (and they're probably way too big since I've been carrying them since the early days of postop ;)) but I'm glad they're always there.

3/24/08:

An odd thing happened today.  I had to go for a sonogram and to ease my nerves I brought some valium.  I’d found over the last year that when I took valium (as I’ve needed it for MRI’s, etc.) I’ve needed more than preop.  Same for Aleeve for my period, etc.  At first I thought this was odd, given that my stomach was now ½ the size it was before, but then someone reminded me that the malabsorption could be interfering with the medicine necessitating more of it.  For instance, the last MRI I had I needed 2 ½ valium to really feel it.  However, since it was only a sonogram, I figured 1 valium would just slightly relax me – and I felt that would be enough since the sonogram wasn’t too tough a test.  Wow, was I mistaken.  I took 1 valium and 20 minutes later the room was spinning.  I got home an hour later and my speech was slurred and I fell asleep for 2 hours.  This was so weird since it was such a small dose compared to what I’d taken over the past year when I had a test.  Guess it goes to show the malabsorption is always changing and it’s a good idea to start small with meds.

3/9/08:

Things are pretty quiet.  No tests needed till yearly bone density next month (it’s nice when things are quiet).

Endocrinologist was very interested to see PTH levels from my preop bloods.  It totally changed his outlook on things.  He noticed that my vit. D was very low preop (I told him I had to take prescription vit. D for 4 weeks before they'd do my WLS).   He feels that since the vit. D was so low preop that totally affected the PTH preop and after.  He feels it could take at least another year before it should come down (esp. as it’s holding pretty steady now – albeit much too high).  I’m glad I thought to get those preop blood test results.

Had some vit/mineral tweaks after last bloods were done (end of January ’08).  Nothing different about that.  Happens all the time.  Only thing is I’m now at 31 pills a day!  And I don’t take low dose.  I take 10,000 i.u., etc., lol.  Oh, well.  Just part of what I signed up for.

Zinc really has helped incredibly with the itching.  Hard to believe how long I itched and no one could figure out what it was.  My fellow DSers were the ones and I really thank them.  Taste still is off a bit (prob. a by- product of Zinc, too) and sex drive is still pretty low.  Hope those pic up as Zinc level stays good.

Will decide within the next couple of weeks what kind of new job to look for.  I don’t have enough security in what I’m doing now and I want it.  It’s scary and exciting.

1/27/08:

Good results from both tests.  Nodes in neck are nothing.  Biopsy was done and it's just a goiter.

Interesting result re: left ovary.  Looks like a dermoid cyst which is nothing.  However, they can't see the right ovary (in MRI) as it's blocked by either the bowel or scar tissue from DS.  This is something I thought about pre-DS.  I realized any future abdominal surgeries or pics of that area would definitely be more difficult.  Definitely something to think about preop.

Taste has fallen a bit again.  Am not tasting as well as I did and the itching is a bit more (still only taking an anti-itching pill about once a week so that's great).  I have a feeling my zinc isn't where I want it to be so I hope to increase it even more after I get the blood results from tests I did two days ago.  Also interested in why some fingertips are sometimes peeling and why my thumbnails are ridged.  Pretty sure all are vit/mineral deficiency so I'm glad I just had the 6 mos. DS bloods done.

A bit too thin now so am going to try and eat some carbs and pull my weight up.  What a nice problem to have :D.

11/7/07:

Just a quick update.  Itching is better.  We think it's the increased zinc.  Had some bloods done today for the endocrinologist so I'll find out if the zinc's gone up in December when I see him.  Zinc is supposed to be involved in the sex drive too.  Sure hope so.  Mine died 2.5 years ago after I had the DS.  I read it can take up to 6 mos. of upping the zinc for anything to happen.  Will just have to wait and see.

Also did something I’d been thinking about for a while.  I got my preop bloods from my surgeon and looked at my PTH and zinc.  The PTH was too high preop so that may help lead us to some conclusions about what’s going on:  is it the DS or not the DS that’s causing the PTH problem?  Is it a combination of the DS and something else I already had going on preop?  (If I had to guess I’d assume so).  Also checked the zinc   and now I have a number in mind I’d like it to be (around the same as I saw it was in preop bloods).  Hopefully, this will help w/itching and low sex drive.  Will speak to endocrinologist about this too.

Radiology at Mt. Sinai said the nodules in my neck were filled w/water and didn't need to be biopsied.  Will also discuss this w/endocrinologist since radiology at Weill Cornell felt they should be biopsied.  What's kind of neat about this is we'd never have known about any of this if not for the bloods done every 6 mos. b/c of the DS.  My PTH has been high since preop and is still way too high.  My endocrinologist has had me take several tests because of this and one of them discovered the nodes in my thyroid.  Guess I have to be thankful!

Also found out I have cysts on both ovaries.  Left one is the size of the entire ovary.  Need another scan in December to see what's what there.

Interesting and somewhat anxious times but I'm taking it in stride.  Still eating protein and taking vits/minerals.  That's what's still important!

Oh, and I might have an answer to why my thumb nails look ridged.  Apparently, there’s a condition called Koilonychia.  Generally, one gets it due to an iron deficiency.  My iron has been ok but it’s being rechecked in a mini-bloods this November -- so when I see those results I’ll check them next to my preop iron and see if there’s any major difference.  Just b/c my iron has been good doesn’t mean it wouldn’t help to maybe get it closer to preop levels.  After all, once I saw what my zinc was preop and brought it up that horrible itching I suffered from for so long has gotten incredibly better.                      .