My surgery story; the lead-up and week of

Jun 20, 2016

The entire pre-op process was pretty breezy.  I had 6 months of a medically supervised eating program where I had to log my food every day, then attend a meeting once a month to read a 'module'.  During these meetings, we were privately weighed in by Lindsey, one of the program's dietitians.  Lindsey is the give-it-to-you-straight dietitian.  If you're screwing up and need a kick in the pants, then Lindsey is your girl.  She's not going to sugar coat it, and if your log book looks too good to be true, she's more likely to say "now what are you REALLY eating, because this shouldn't be happening based on your logs.  There's something that you're leaving out, and lying to yourself is only going to hurt one person-- you."  I heard her say that to someone during a module.   She doesn't play around, and she does it because I get the feeling that she genuinely cares about each patient's surgical outcome.  

The whole time I was doing the medically supervised diet, I had several doctor's appointments and procedures to check off.  The first one was bloodwork.  Then I had EKG, chest x-ray, psych eval, endoscopy, and I didn't need to do the necessary sleep study because I had one done a couple years ago.   The blood work came back with abnormal coag results.  I tested positive for lupus anticoagulant and abnormally high PTT, so I needed to make an appointment with a hematologist to the tune of a $50 copay.  ouch  The outcome of the hematologist was pretty uneventful.  He said that sometimes morbid obesity causes people to have abnormal antibody present in their system, and that sometimes folks need to give themselves lovenox injections after surgery.  Fortunately, my levels weren't high enough, and I didn't have any symptoms or familial history that made him feel as though I needed to take this precaution.  

The psych eval made me feel pretty good about myself, to be honest.  I told the psychologist about my fears, about how I often overeat, and about how I was doing many active events in my life which helped me to lose 70lbs, yet despite these efforts I was still obese.  I also told her that this was my second time approaching bariatric surgery-- that the first time I did, I was talked out of it by some 'scared straight' tactics.  I told her that this time I didn't tell anyone but my husband, my parents, and a friend who was also having the surgery (she ended up having surgery the exact same day as me-- we even got to hang out together in the pre-op area).  I also told her that I had been through counseling for my weight, and had developed some coping mechanisms but there was still something missing.   After approximately 2 hours, she asked me one final summarization: "why exactly are you having this surgery, what is your goal weight, and what do you expect the outcome to be?".  I told her that I was having this surgery because I wanted better mobility and a better quality of life.  I was sick of not being able to perform as well as 'normal weight' individuals at every day tasks, something as simple as bending over to tie my shoes or reach around myself to wash. I told her that I was upset that despite my best efforts at diet and exercise I was still an obese individual.  I said that I wasn't sure what I wanted my goal weight to be, exactly, because I've never been thin.  That I had no idea what my frame size even IS because I've been overweight since the 2nd grade.  I said that I would like to be between 130-160 and I would arrive at my decision based on how I feel and how my body performs as I approach my goal weight.  After all of this she told me "You are the ideal candidate because you've done the necessary self-reflection".  Talk about feeling humbled! 

Fast forward to the day of surgery.  I was extremely nervous the few days prior, but walking into the hospital I had this extremely peaceful feeling wash over me.  All I could keep thinking was that I am giving myself a gift.  I'm giving myself the gift of mobility, of being able to shop for clothes at a normal store, of not sweating all of the time because of my blood pressure, of not having to hold my belly up so that I could position my legs to fit into a chair.  I'm giving myself the opportunity today, to completely turn my life and my health around.  I was very at peace as I checked in.  

They were gearing me up for surgery, and for some reason, my veins were not cooperating.  I generally have very very good veins, but not today.  I got stuck 4 times to start the IV, but I stayed calm.   If you can imagine zen, that was me.  Everyone kept apologizing, and I'm like "these things happen, I'm not worried"  Next thing I know, my doctor Giselle Hamad, her PA Mike, a med student Callie, Jen the nurse anesthetist, and a resident, Dr. Tam, were in the room squeezing my feet, smiling, and telling me that they were ready to see me in the OR.  Gosh, I really love my surgical team-- they were so great.  

 When I came out of surgery, I didn't feel a thing.  I remember the PACU nurse saying to me "hey, quit being a hero.  I want you to press this PCA pump, now."  Well, I wasn't being a hero, I didn't feel a daaaaamn thing after surgery.  So, I had no idea that I needed to press the pain button.  haha!  But, that pain button, it did a number on me.  For the next 24 hours that I had the PCA, I was fighting bouts of extreme nausea and dizziness.  I was able to tell when my 30 minutes was up because this flood of nausea and that salty-pre-vomit-saliva started pooling in my mouth.  I'd look at my PCA, and sure enough, it was lit for me to send myself off to sleep again.  Thank god, though, that when I had to be awake for the barium swallow, they gave me Reglan and Zofran.  Although that didn't help with the dizziness.   I ended up vomiting twice-- the first time was when I got up to walk the night of surgery. It was black, and that scared me A LOT.  They said that it was normal-- blood from the operation most likely.  The second time I threw up was after the barium swallow the next morning.  That stuff tastes like lemon pledge, coffee grinds, and Mr. Clean had a demon baby.  It was awful, and this was the very first thing I was allowed to swallow after surgery.  Every time I stood up, the room was spinning, and they almost had to reschedule my barium test.  The nurse said that I wasn't able to eat or drink anything until after I had the test, and that if I wasn't feeling well they would have to reschedule it.  Well, I wanted to tell the nurse that I sincerely did not give a shit if I could eat or drink anything because I would just throw it up.   However, I didn't want to be that asshole who needed them to reschedule the test for me.   So there I stood on the x-ray platform sipping the tiniest sips of lemon pledge chemical cocktail, and watching the barium drip through my stomach like legs of wine on a glass.  It was neat to watch, but man I was circling the drain.  When I got back to my room, I immediagely vomited the barium on my nurse, Wayne.  Poor Wayne.  He stood there holding my stomach tight with one hand, and my emesis basin with the other hand-- no gloves-- while I hurled my guts out.  I didn't have any warning to give, just "EMESIS BASIN PLEASE" annnnd go.  After that, I stopped using the PCA.  I was willing to hold out to avoid vomiting on someone else.  

My first week home was relatively uneventful.  I camped out on the couch with a pitcher of water, my oxy prescription, and the remote.  I was in a moderate amount of pain, and I knew from my triathlon days that movement helps with pain.  Active recovery its called. It worked with this too.  I was surprised.  During the entire week my friend and I have been keeping in close contact to compare notes.  We were both surprised at how easily we could drink fluids, and it was a little concerning.  My nurse said that this was actually a good thing, and I relayed the message to my friend.  I also had a bit of head hunger towards the end of the week.  Nothing smells the same as it did before the surgery, nothing tastes the same either.  What I noticed, was that I no longer have this highly intense urgency around hunger.  I was also able to decipher between thirst and hunger for the first time ever-- I didn't know that people could do that.  Color me impressed.  More realizations about my body to come in the future-- stay tuned!

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