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highaim's Blog
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home yesterday and newly sleeved
on February 13, 2011 6:52 pm

ugh! i can't believe my laptop battery died!! i'll try this one more time.........


i had surgery thursday morning and came home late yesterday (Saturday). so, today has been my first full day home. i would say for me, the surgery was both easier and harder than i expected. first, i've had so many surgeries and so many complications, that i figured this would result in yet another complication. so far, so good (knock on wood- or praise God). but, by the same token having had other laproscopic surgeries, i thought this would be a breeze. it has NOT been.

first of all, anesthesia is anesthesia. it's really hard on me and i don't recover quickly from it. it takes a good week for my brain to feel 'normal' again and even today i still feel a bit 'foggy'. usually i wake up from it shaking, teeth chattering uncontrollably, and also with severe dry heaves. i warned the anesthesiologist before-hand though, so maybe he got out the 'good stuff' and dosed me up with it (the anti-nausea meds), because i woke up 'normally' (with no shaking or heaving). i did have to pee real bad, and waited in recovery for several hours because they didn't have a room ready. so they wouldn't let me get up- i had to use a bed pan. that was humiliating, but could've been worse. at least i didn't wake up peeing all over myself from the violent heaving.

i really had it stuck in my head to 'walk, sip, rest, repeat', so i worked through the pain, which was always from a '4-5' for me, to get up out of the bed. my saving grace is an over-active bladder and my impatience and determination, because at least every hour i was getting myself out of bed and into the bathroom, not waiting for the nurse. by the day they let me come home (day #3), i was walking 10 laps around the ward. but, like i said, my pain level stayed between 4-5. when i finally submitted to the loratab, i think my recovery went by leaps and bounds, because it helped the resting part of the healing. 

the walking did NOT help the gas escape any faster. but, i don't think it was just me- my surgeon and his partner do all their bariatric surgeries on thursdays, so we all went through pre-op seminar together and all saw one another in the hospital, having had surgery all on the same day. two of us were VSG, all the others (about 4-5) were RNY, as far as i know. we ALL were having the same issue with the stubborn gas not wanting to find a way out. i really think it was the beds though, because i came home and was able to lay flat and the gas seemed to find an easier route out that way. i still have pain in my right shoulder though, which i know is from the gas, so hope it subsides soon.

i am very swollen. i didn't have a drain, but kinda wish i would have because i have a big balloon-like swelling on my left side, right were my tummy was. i tend to be a 'fluidy' person, as i swell really easy though. my surgical drains from my mastectomy were in a whole 2 weeks and were still draining even then. so it's going to take a while for my abdomen to get a normal shape back and for the pain and pressure from the swelling to subside.

my surgeon said 24 oz. of water and 40g of protein per day. being my first full day home, it's been hard. i've had about 30g of protein (isopure form) and about 16 oz. of water (not counting isopure- just water, popsicle, and jell-o). my brain is revolting- it's telling me i am STARVING. but my tummy is in no way even asking for food. so i'm trying to stay focused on what i need to do - sip, sip, sip, walk, rest, rest, sip. i do feel better today than i did yesterday.

i can't tell much difference between the RNY'ers and the VSG'ers as far as recovery though. some people on the OH forum seem to jump right up like it never happened. that absolutely hasn't been my experience. i feel like i have had to work hard towards healing. i also passed several of my fellow bariatric patients in the halls, and the RNY'ers were doing just as well as us 2 VSG'ers. a couple of the older women were up and walking like 'normal' the day OF surgery. i walked, but i definitely needed assistance. i am ok now with getting up and walking, but slowly- my stomach is achy. i have 6 incisions- 2 closed with staples (about 1.5 inches) and 4 with steri-strips (small). every time i sip my tummy cramps. plain water seems to make it cramp the worst. i don't feel dehydrated, so i think i'm doing ok. post-op seminar and clinical visit is this Tuesday morning.

there was a girl who came into my room the day after me. she had a RNY with another surgeon. she came in from post-op recovery saying her pain was a "2", but by the time i left yesterday she wasn't doing well. she was sweaty, in agonizing pain, and her heart was visibly beating hard and fast. they were going to send her to CT and for a chest xray. she wasn't really getting up and out of the bed at all and wasn't doing her lung exercises. anyway, she didn't look good. please pray for her, if you're the praying type. (also remember to pray for those who have shared here they've had leaks and ongoing issues with that).

thank you guys for being here. if it wasn't for all of you and your willingness to share your journey, i wouldn't know what to expect. i have learned a lot and feel like i have a really good idea on what to expect in the coming weeks too. i wanted to also give back to those who haven't yet had surgery- i think for some people it's a 'cake walk', for others it's a bit more of a challenge, but with determination you can get a leg-up on the recovery pretty quickly
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My Story


I was always a little on the "chunky" side as a kid, but never what I would call "obese"; (maybe like 10 pounds overweight). When I was 13 years old I was pretty much my full-grown size: 5'2" and 130 pounds. I wore a size 7 jean. I guess, by medical standards, that was still overweight. And, what teenager doesn't feel fat? But really, as short as I was, I was pretty large-boned. I wore a size 9 shoe! Looking back on it, I don't really think I was overweight. My hip bones, my ribs, my clavicles, were all very visible, and there wasn't any 'fat' to pinch anywhere on my body. But, like most teenage girls, I thought I was "fat" and was constantly (mentally) worried about dieting. Sometimes I would try OTC diet pills (Accutrim, etc.), but I never liked how jittery they made me feel, so I never really got into a habit of taking those. I tried laxatives a couple times, but those always gave me cramps and unpredictable results, so I never really got into too much of a habit of that either. And bulimia is something I could never own because I HATE throwing up, and will avoid it at all costs. So I just kind of experimented with various weight loss techniques, not because I really needed to, but because I thought of myself as fat and was curious about the effectiveness. None of those experiments impressed me.

At 16 years old I gave birth to my first child. I gained 20 pounds with that pregnancy, and lost it within 6 months of delivery. However, at 19 I gave birth to my second child, and had gained 70 pounds during that pregnancy. I ate a LOT of sweets, as that seemed to be all I craved, and being uneducated about nutrition in pregnancy, I justified my eating on the basis of "eating for two". I struggled to get that weight off, and while I did lose about 20 pounds, I still remained about 50 pounds overweight. At 22 years old I gave birth to my third child. I was still about 50 pounds overweight when I got pregnant with that last child. It was a very stressful pregnancy, and I lost, then gained, but by the end of it, I didn't gain any weight. So I was still about 50 pounds overweight. My marriage of 9 years ended in divorce, and I decided to try to do something about the excess weight I had gained from my second pregnancy. I tried many diets: calorie counting, fat counting, vegetarian, etc. If anything, I tended to just resort to fasting because either I didn't have time to eat (3 kids, a full-time college student, and working, while going through a very stressful divorce), or I didn't have a good idea of what to eat that was quick, but healthy. But then when I would eat, I think I would overeat because I was starving from not having ate all day. So I struggled with getting that 50 pounds off. My PCP prescribed Fen/Phen, which was all the rage back then, and I easily dropped the weight. I was walking over a mile a day, had no appetite, and felt great!

So in 1997, back to my 'normal' adult weight of 130 pounds, size 7, I met another man and we started dating seriously. He convinced me to start exercising in a gym. I enjoyed that, but as always seems to happen to me when I start a serious exercise program, I gained weight. I think I just have one of those gymnast-type bodies- short, but muscular. It isn't  (or wasn't) hard for me to gain muscle weight really quickly. But that sure was discouraging- because I wasn't going to the gym to GAIN weight! Anyway, this man who was soon to be my husband, was encouraging me to exercise at the gym. But then, after every workout he would want to go out to eat. I wasn't used to going out to eat so much, but he seemed to enjoy that as part of the routine, so I went along. As time went on it just became a habit- eating out. Fast food, fast food, fast food. Well, by the time we married in 1999 I think my weight was about 145, size 12. I was overweight, but it was manageable, and I could still wear "cute" clothes and feel good about that. But a major move, job changes, etc. and I ended up in a very sedentary (desk) job. We still exercised, and did a lot of weekend activity (hikes, etc.), but that wasn't enough to combat the slow and steady weight gain. By 2001 I was about 165 pounds, and in a size 16. We made another major move, but I transferred my job, so I was still in a very sedentary environment most of the week. As most of us know, finding time to exercise while working 40+ hours a week and raising kids is awfully hard! So we slowly fell out of an exercise routine, and also stopped doing outdoor activities on the weekends (the kids were older and complained about any little trip we took, so we just stopped putting ourselves through that). So, frustrated about my weight gain, and now starting to feel the effects of it, I went to a local "weight loss" doctor, who was offering injections of B-12. After about 3 months of weekly injections I stopped them. It was making me feel ill, and I wasn't losing weight. On top of that, I had now developed my first co-morbidity: hypertension. I thought the injections may have caused that, so stopping made the most sense. Well, about a year later, in mid-2003, I was diagnosed with Stage IIIc Inflammatory Breast Cancer (that's a whole different forum)! I was 30 years old.

At the time of my cancer diagnosis my blood pressure was out of control (even while medicated). I was also hovering at 190 pounds- about 60 pounds overweight. The surgeries (biopsies), coupled with the immense fear (and other emotions), caused me to gain even more weight (eat without regard, really), hitting the 200 pound mark by the time I started chemotherapy. I fluctuated between 190-200 pounds during this time period. A lot of people think cancer/chemotherapy makes one lose weight. The problem is that they have to give you so much steroid to prevent your body from reacting to the chemo, that you can easily GAIN weight. The nausea caused me to want to eat to settle my stomach. The steroids gave me an insatiable appetite (and diabetic condition, which did reverse after chemo). And then the sedentary habits that happen from significant health problems left me very inactive. So it's no wonder I started gaining rapidly. Three years later and I had a metastatic recurrence to my ovaries and some lymph nodes elsewhere. That resulted in yet another major surgery- to remove my ovaries. So while I was in chemical menopause (at 30 years old) while I went through chemotherapy, this hysterectomy with oopherectomy left me permanently in menopause. Of course that didn't help my weight gain, or the fat around my stomach, as cutting through all that muscle in my abdomen (a 12 inch incision from my pubic bone to above my belly-button) really did a number on my muscle tone. So, from the months before my cancer diagnosis to the current day, I gained a whopping 100 pounds!

I've had a lot of complications from cancer treatment, and a good number of surgeries. It's a lot of medical trauma to go through. I am still in chemotherapy (every 3 weeks for the rest of my life, or until they find a cure, or my cancer recurs and I have to change treatments). I have fibromyalgia, which developed from all that chemotherapy I've had. I have pretty significant lymphedema in both arms, but mostly my right (dominant) arm. (This happens when they remove lymph nodes from the armpit area). I can't do repetitive tasks, lift heavy objects, or leave my arm hanging, as all will result in significant, painful, and debilitating swelling of my entire arm. I also have lower extremity lymphedema (not as severe as my arm) that resulted from my hysterectomy. I have neuropathy in my hands and feet because of the nerve damage caused by chemotherapy. And, because of the significant damage done through radiation, my right pectoris is basically fried. It's completely atrophied, and I'm left with hard, knotty scar tissue. So all of this, along with the extra 150 pounds I am now carrying, has made exercise a really, really big mountain to have to climb. I've tried repeatedly to get on an exercise routine, but I always seem to fall off that wagon. Over the past 5-7 years, as I have continued to gain weight, I have tried numerous diets: Atkins, Weight Watchers, The Zone, etc. I would have to say the two biggest problems I am going to have to overcome in my bad habits are 1) not eating, and 2) eating crappy foods when I do eat.

You would think, having been through all this medical stuff already, that surgery would be the last thing I want to have to go through. I hate it so much that I didn't even seriously consider going through breast reconstruction. But at 150 pounds overweight, with no ovaries to help me, and a really sluggish metabolism caused by lots of chemicals and being sedentary for so many years now, I just don't see any other way. I've tried and tried. And this extra weight is like a ticking time bomb strapped to me- it is raising my risks of recurrence by a whole lot. My C-Reactive protein levels have been more than twice normal for a good while now. My blood pressure is still high. My joints are already aggravated by auto-immune issues. And then, chemotherapy is dosed on a per-meter-squared basis, which means it goes by weight. The more you weigh, the more you get. So the less I weigh, the less I get. Ya. So I'm really ready for surgery, in hopes that it's the tool I need to help me regain control over my dietary choices, and allows me to lose enough weight that I can start exercising again.

I'm still not sure what procedure I will have. I really want a VSG because I worry about the malabsorption issues with RNY, since I am already osteopenic (because of loss of ovaries). This is only going to get worse as I age, and as I lose weight. Also, the neuropathy is B-12 sensitive, so I already have to take a HIGH daily dose to ward it off as much as possible. With my future health needs so uncertain, I just don't feel comfortable with the malabsorption issues. I also don't like the idea of the RNY being so much more difficult of a procedure- I've already had enough medical trauma! Laproscopic sounds so much nicer! But I'd like to talk to a surgeon who does all the procedures and can give me a straight answer. I've had the psych eval, talked to a nutritionist, have seen my PCP for monthly weigh-ins. So I'm pretty much ready............

While I'm excited to have the opportunity (and hope) of bariatric surgery, I'm also really nervous. I went through depression as a teenager, and then another serious bout while in aggressive chemo. I had to take an SSRI for a few years to get through that chemical change. I am already thinking I may have to get back on a medication, as I think the forced (although elective) change in diet and lifestyle if going to trigger things emotionally for me. But the positive side of it is that I'm realistic. I'm not going into this naive about it. I'm already expecting the worst, and have a plan to address it. I think it's really hard for people who haven't been struggling with their weight to understand how deeply tied it can become to our emotional selves. But I'm thankful there's a forum like this for us to safely share the struggle...on whatever level that sharing is!


I blog at: ladyminusbreasts.3three3.org, but my writing there is mostly about my spiritual journey with cancer.

I also have a vlog: youtube.com/ladyminusbreasts