Surgery Notes

Feb 22, 2007

Sometimes things don’t work out as planned and such was the case with my gastric by-pass surgery on Monday Feb. 19, 2007.  An hour into my surgery, my wife received a visit in the waiting room from the surgeon.  He was concerned about my liver and had asked a liver surgeon at Penn to come to the operating room to take a look.  He explained to my wife that my liver was abnormal and that a normal liver is smooth while mine was lumpy with fat deposits.  His opinion was to do a lap-band procedure instead of the gastric by-pass.  The gastric-bypass because of the mal absorption factor may jeopardize the health of my liver.  The other option was to sew me up.  I’m glad that my wife and my surgeon decided to proceed with the lap-band procedure.

You might imagine my initial despair when I came out of surgery to receive the news.  I was quite depressed and it took a couple of days to sort out what is going on.  The full results of my liver biopsy are not definitive as of yet, but it appears to be cancer free with possible diagnosis of Non alcoholic Steatohepatitis or Non alcohol related cirrhosis.  I will know more next week after I have a consultation at the Penn liver clinic and a post op visit with my surgeon.  As you may imagine in the last few days I have been trying to find out as much as possible about my path for recovery.  I just would like to let everyone know that I am feeling great; I’m optimistic, and very thankful that I have such an experienced an d cautious surgery team handling my situation.  It appears that all that I may need to do is follow a fat free diet and continue on the path that I had planned.  The lap-band diet is almost identical to the gastric bypass diet and to lose the weight at a slower pace will definitely be of benefit to me.  Studies show that in the long run the results of the two surgeries are very similar.  Once again, my exercise program will not need to change one iota; I am looking forward to healing up and getting into the full swing!

Let me just say to those of you who are contemplating weight loss surgery.  If you have co-morbidities or have had serious health issues in the past. Please be aware of surgeries being performed in some weight loss clinics, if I had chosen such a path, I may have very well had my surgery and released in a few days without the issue of the abnormal liver coming to light.  I have the greatest confidence in the doctors and staff at the Hospital of the University of Pa.

 

February 17, 2007

Feb 17, 2007

Well, it is Saturday afternoon and I am quite anxious.  In two hours it will be time to start my pre surgery bowel prep.  How exciting!  I will drink a 10 oz bottle of magnesium citrate and then it is off to the races.  Five hours later I will take four Ducolax tablets for the grand finale.  Perhaps it will break the agony of the wait.  At this point there is really no more to do and strange as it may seem I really can’t seem to concentrate on doing anything else.  Perhaps I will reflect on what I had to do to get here.

 After the initial visit when my family doctor told me that the surgery was my only option I made two appointments.  One was to attend the weight loss surgery seminar at the Hospital of University of Pa and the other was at the Sleep Lab at Bryn Mawr Hospital .  The WLS seminar is a prerequisite to scheduling an appointment with the Bariatric Team at Penn.   It was very informative session that emphasized qualifications for surgery, insurance approval, complications of sur gery, diet and exercise, and the different kinds of weight loss surgery.  The sleep study was done to determine if I had sleep apnea.  I slept overnight in a sleep lab with electrodes on my head, face, chest, and arms.  A technician monitored my breathing, heart rate, and brain waves while I slept.  I was diagnosed with a moderate case of sleep apnea.  I had to return to the sleep lab for a second time.  This time the same apparatus was in place with the addition of a CPAP machine.  During this visit a therapeutic pressure was determined to suit my needs.  A week later I was set up with a CPAP machine at home.  I must say that sleeping under pressure has been a great help to me.  I definitely have more energy and I am sleeping much better.  If you are someone who is having trouble sleeping and find yourself running on empty during the course of your day, don’t hesitate to ask your physician about sleep apnea.  It is for real and can cause serious health issues even death if unattended.  It is required before WLS due to the fact that many obese people suffer from sleep apnea.

I also was required to see a cardiologist.  I had to have a two part medicated stress test with cardiac imaging.  Happy to say I passed with flying colors!  Another piece of the puzzle was to acquire endocrinology clearance.  At first my blood sugars were too far out of control.  I began to work out on a treadmill walking 30 minutes a day while my endocrinologist increased my oral diabetes medications.  It took about a month but my blood sugars came down into normal range.  Also, one is required to have a psychiatric exam.  Here the psychiatrist determines if one is emotionally fit to endur e the lifestyle change that is required after surgery. Finally because of my history of DVTs and PEs I had to see a hematologist to assure that my blood would not clot irregularly and cause problems during and after surgery.  So all this is behind me, yet here I wait.  This is the hardest part.  One tends to run the gamut of emotions during the wait!  I hear this from everyone who has had the surgery.  This is the norm, not the exception.

            I have the greatest confidence in my surgeon and his staff and I know I will come through fine but I doubt if I will finally relax until I awake in the recovery room.

 

Something that happened this morning.

Feb 09, 2007

Something that happened this morning.
 
 
Feb 9, 2007

 

This morning when I arrived at work there was a brightly wrapped gift bag waiting for me.  It wasn’t my birthday, anniversary, or any thing, so I said to myself what can this be.  Here it was a surgery survival kit that was delivered to me from a young girl who once worked for my employer.  This young lady of 23 years had had weight loss surgery last April after she had moved on to another job opportunity.  When she left our office she was just over 300 lbs.  Today she is 165 and still losing.  She looks terrific.  How thoughtful of her.  In the package was a cushy pillow, in a note attached, she said, “you will need this to hold towards your chest when the nurse asks you to cough to clear your lungs.”  There was a container of Flinstone’s vitamins with a note that read, “You get to be a kid twice a day”.  Deeper in the bag was a very soft acrylic blanket, again a note attached, “The hospital sheets can be thin and scratchy this blanket will be soft to your skin and keep you warm.”  There was a box of pre-mixed protein drinks.  “These are better than the powders, no air bubbles.”  Finally rolling around at the bottom of the bag was a tube of Chapstick.  “This to keep your lips moist, they will be dry after your surgery.”

 

This young lady is an example of the kind support that I have sensed all around me as I count down the days to my surgery.  Everywhere I go people are cheering me on.  Wow! Does it ever feel great to have this kind of support.

 


About Me
PA
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44.0
BMI
Surgery
02/19/2007
Surgery Date
Nov 25, 2006
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Surgery Notes
February 17, 2007
Something that happened this morning.

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