Amyiable

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My surgery was 12/9/10, and I returned home late on 12/13/10.  Alex had scheduled my surgery at Fairfax Hospital, but after some reseach and bad reports, I asked Alex to change me to  Fair Oaks Hospital.  So very glad I switched locations..  

The staff at Fair Oaks was wonderful.  First & foremost, I wanted a hospital that would not skimp on pain meds, because I would have an open incision, and have a lot of adhesions (a lot of cutting).  I actually have two stories where Fairfax Hospital limited post op pain care for their patients.  I throught the first story was a fluke, the result of one bad nurse.  Then the second story was posted on 12/1/10.  That's when I started to do some hospital research (Checkbook.com) and asked Alex to switch me to Fair Oaks Hosp.  True to the report from Checkbook.com, Fair Oaks was excellent on post op pain care!  I had 4 full days on the pain pump, and they didn't take me off until a couple of hours before discharge.  Hosp staff constantly asked and recorded my pain level.  They would adjust the pain pump level as needed. Two different anesthesiologists came by to check on my pain level.   

Staff were willing to come disconnect me many times a day for bathroom and walking breaks. Everything was disconnected except for pain pump - the pain pump always stays connected.  They gave me cloth baths, changed my gown & bed linens.  i knocked over the water cup wetting me & my bed.  Helped me get my socks on 1-3 times a day, and tried to make me comfortable.  I have hot flashes, and a wonderful technician (Aleiishia) brought me a fan!  Heaven.     


A Plus to Fair Oaks Hospital! 

My original surgery was in 1997. 
1) The surgeon removed the bottom of the pouch.  A recent endoscopy measured my pouch at 4 inches diameter and 3 inches long.  The operative notes indicate the stoma was designed to a "fingers breadth."  The recent endoscopy measured the stoma at 2 cm, which is a little more than 1 inch.  

The sleevers today get a pouch about 1 inch or less diameter.  For my revision, a narrow pouch will be the goal.  The stoma will be measured to a 38 fr bougie, which is slightly greater than half an inch.

2) My total small bowel measured at 700 cm, according to the operative notes.  The notes say that my alimentary was set at 350 cm, and the common channel at 100 cm.  

Using Dr. Hess' standards for DS, the 700 cm small bowel should be sectioned 40% or 275cm for total alimentary.  And the common channel should be 10% of total small bowel, or 75 cm.

So tomorrow, the surgeon will do these things.  Will give me the DS limb structure, but without a pyloric valve.  Unfortunately, changes to the limb lengths are not expected to produce much weight loss.  So says Dr. Keshishian.   The new lengths aren't much change from what I have.  It's too risky to bypass more so I am at the end of the line, so to speak. 

The biggest benefit from my revision tomorrow would seem to come from correcting pouch and stoma.  The original surgeon didn't believe in restriction, so that is why I've never had any.  This was compounded by a wide stoma, meaning that the small bowel served as a pouch.

I hate having to go for another surgery, but I hate my current state and have to try something.  Wish me luck.

Just wanted to add a final update to my blog.  SP was a complete waste of money that I didn't have. 

I feel that Dr. Overcash should be doing the preliminary scoping to find out whether pouches are suitable for the surgery.  Dr. Overcash didn't find out that I was not suitable until he got in there during SP surgery. 

To recap, my original surgery was a BPD with a 16 oz 'pouch'.     I never had a small pouch.    My original surgery was in 1997,

Dr. Overcash knew about this prior to surgery, & he said he could still make my pouch 75 - 90% smaller.   Those were his words.  It didn't happen. 

After surgery in the recovery room, Dr. Overcash said he made my pouch 50% smaller.   Later,  I received his operative notes, which say he made it 40% smaller - but I can tell you that 40% was yet another gross exaggeration.    

For the record, I was totally compliant with post op diet.  For now, I am trying traditional diet and exercise to get my weight down.... or at least to not expand more. 

My restriction continues to 'loosen'.  I started regular foods about a week ago.  I suddently got strong cravings for all of the foods I hadn't been eating.  Mostly meat and potatoes.  

I haven't been on the scale.  I pretty much wear the same clothes ... but they are much looser now.  I was able to fit into a smaller pair of shorts.  Since starting 'regular' foods, I suspect I've regained a bit... not sure those shorts will fit today.  

I am still trying  to lose weight.  If I eat dense food, I have a better *chance* that food gets 'stuck' in my pouch ... this is desirable to me.  Then I won't feel like eating.  

Amy 

Around the 6th day  post op, the restriction I had felt, was substantially looser.  I guess the original restriction I felt was just from swelling. 

I lost 11 lbs in the first week.  I haven't been on the scale since.  I don't feel that I've lost much since.   My calories are higher now.

I have another week on liquids.  Right now, I'm eating mushed up chili and thicker soups.  I'm trying to eat slow... like 45 minutes, and not more than 1 cup at a meal.  This idea is to not distend the pouch much.  I get the idea that it would be better to drink a shake than something solid.  I only say that as an example, not to promote a shake.  I have not had a shake. 

I don't feel much restriction.  However, I'm trying to NOT feel restriction now, because I don't want to push anything in the pouch.  I'm trying to let it 'set'.