Well, I suppose it's time to create a record of everything that's happened in the past couple of weeks so I can look back on this some day and realize just how far I've come!

I had my surgery on Tuesday, February 9, 2010.  We drove to the hospital just as a blizzard was getting under way - it made for one heck of a white-knuckled trip, that's for sure!  But we got there safe and sound with plenty of time to spare.  I went through the pre-op rigamorole (yeah I'm sure I butchered the spelling on that!), and got in my "Bair Paws" gown.  Let me tell ya, those gowns are awesome.  They're kinda like paper, but they have ports that air hoses hook up to - and they blow warm air!  So no blankets off the warmer that get cold in 2 minutes flat, just this paper gown with hoses - and YOU control the temperature.   They let my family come in and pass the time with me until it was time to wheel me down.  I must say, I love anesthesia!  I made it clear that my #1 BIGGEST FEAR of the whole process was of nausea / vomitting.  I can't imagine having those issues immediately following abdominal surgery!  And my last experience with anesthesia had been hugely unpleasant and left me sick for 3 days.  I wanted none of that!  They assured me that they were loading me with anti-nausea meds and that I should be fine.  I accepted that (what more can you do, right?).  I received my pre-op cocktail, scooted onto the operating table, stretched my arms out... and the next thing I knew I was being wheeled down the hallway into my room!  (Little did I know then just how much time I'd spend in that brand new, pretty little room...)  I shooed my family home; I knew I was going to be out of it for several more hours, and with the snow storm the way it was, I wanted them home before dark.  

I clearly remember watching a gentleman roaming the halls, and someone told me he had had the roux-en-y the previous day, Monday.  Let me tell you, I didn't feel well and found it difficult to believe that the next day I'd be parading down the halls as he was!  But it gave me hope.  I did have a fair amount of pain but wrote it off as me being my usual wimpy self.  I used the pain pump regularly as recommended so that I wouldn't have to play "catch-up" with the pain at any time.  I slept fitfully for the rest of the day and through that night.

Wednesday morning I went downstairs for the upper GI to ensure that there were no leaks.  Man, I hate that test!  I went back up to my room when it was done.  As the day progressed, I began feeling worse, not better!  Meanwhile I was watching that same gentleman POWER-WALK up and down the hall, no more IV pole, just hoofing it like nobody's business!  And here I was, laying in bed, feeling more tender in the abdomen and just generally BLAH.  

It was Wednesday night when the vomitting started - yep, my biggest fear came true.  Ohhh, I felt so sick, and I had abdominal pain, and now this!  I received meds to make the vomitting stop, but I still wasn't right - and I couldn't maintain a stable temperature for nothing!  Well, Thursday morning they took me down for a CT scan.  I got a visit from my surgeon around noon with the news - I had a bowel obstruction.  One of those times when it's NOT in my favor to be a 2%-er!  He told me I'd be having surgery AGAIN that afternoon.  So at around 6:00 on February 11th I had surgery #2.  I was fortunate, they didn't need to create any new holes, they used 3 that had just been opened 2 days prior.  Let the recovery begin AGAIN....

Friday was another long, painful day.  Dr. Lalor said it was to be expected and that I needed to be patient with myself, but I was still envisioning the other RnY gentleman - who was released to go home the previous day - power-walking the halls.  I was SO FRUSTRATED that I wasn't able to do the same!  And of course, Friday was the day I had planned on going home too.  

By the time Saturday rolled around I was still having difficulty getting my temp stabilized, but I was just starting to feel a bit better.  I was still very down on myself, so my husband brought the kids for a visit.  It was my first time seeing my family since Tuesday, and it was so nice to see them!  I also started walking the halls that day, and it was rough but I did it.

Sunday my hubby came to see me again, and he walked with me and kept me company.  My tummy began feeling strange - kind of heavy.  But I didn't think anything of it, just assumed that due to 2 surgeries within 2 days I was going to have issues.  My temp was still kind of erratic; it would be normal for one reading, then it would be 99° - 100° the next time.  They were still saying that I'd be going home the next day, however, and I began to make my departure plans once again.

Well, Monday morning rolled around.  I had the IV removed, all tubes, drains, everything was GONE.  It felt good, and it felt good to put my clothes on.  But, I didn't FEEL good.  I couldn't even walk without using both arms to support the weight in my abdomen.  When Dr. Lalor came in to see me, I explained how I was feeling.  I was told it was normal, and that each day it would get better.  Well, I wasn't going to be picked up until late afternoon, and about mid-morning I went in the bathroom.  I looked in the mirror and HOLY MOLY, my whole abdomen was red, and I had new rolls on my hips!  I immediately called the nurse (Jeana ROCKS!), and she reported everything to Dr. Lalor.  He came back to see me, and informed me that I had an infection in the abdominal wall.  This also explains the unstable temp!  So guess what?  Back in the hospital gown, back with an IV (side note: the IV was put on the underside of my arm, about halfway between wrist & elbow.  NOT comfortable!), and back in bed - no going home for me!  I was put on heavy duty IV meds and antibiotics.  Jeana used one of those markers they use for plastic surgery to mark how far up the abdomen the redness extended so we could keep track to see if it was getting better or worse.  They also got me an abdominal binder, and the support from that binder made SUCH a difference.  I was able to be more mobile, and be more myself and less reliant on others for help - woohoo!!!

I called my daughter to let her know of the change of plans.  I tried to hold it together, but I ended up a blubbering mess on the phone.  My kids, though, they're awesome.  They knew how upset I was, so they drove down to see me (the hospital is an hour from home).  But guess what?  Monday night?  Normal temp.  Tuesday morning?  Normal temp!  I was finally stabilizing, and by Tuesday  Feb 16th (this is now 1 week, for those keeping track) I was finally walking the halls.  

Once again they started talking about my discharge, but by this time I was taking everything with a grain of salt.  Well, lo and behold, Wednesday morning I woke up and felt decent!  I received my discharge papers, put on my clothes, and this time didn't wait for my hubby to get off work; my mom drove me home that morning!  So my hospital stay lasted 2/9 - 2/17.  Yikes!

The first few days at home were rough, but not nearly as rough as being in the hospital.  I slept in the recliner for my first week home; I'm usually a side sleeper, and it was NOT comfortable to be in a bed.  But each day I felt better and got stronger.  By the time I went for my 2-week follow-up on Feb. 24th I was down 30 lbs since starting the pre-op diet!  The doctor was very happy with my progress, and put me on soft / pureed foods, which is an experience for another blog post!  He also cleared me for exercise, so the next day I rejoined the gym.  

So that's my experience in a (very large!) nutshell.  The whole things was frustrating and depressing, because I never saw any complications coming - I mean, who does?  So if you take anything from this, especially as a pre-op, please remember to hope for the best, but be prepared for anything!

PS:  They keep telling me that in the long run I won't regret this.  The only thing I regret so far is the extended stay!

 Good morning and happy Monday.  It's the first official day of my medical leave, and I don't feel the least bit guilty about NOT being at work!  I hope you'll allow me to ramble a bit here, because I have a lot on my mind.  

I have completed the 2-week pre-op full liquid diet (today is clear liquid), and I must say, while I did have a few rough moments all in all it was ok.  I didn't cheat - and I am PROUD of that!  Was I tempted?  Heck yeah!  But all I kept thinking was that if I cheat I am not only cheating myself but also running the risk of making my surgeon's job more difficult.  Now if anything goes wrong I will not have myself to blame!  lol  There were some comical moments; I had to go in to work one evening for a meeting, and in this room of 15 people my stomach started making these awful gurgling noises... this was day 3 of full liquids, and I guess my body was adjusting!  The people sitting nearest to me heard it, and I got a few chuckles.  I also had some moments of great temptation, but managed to walk away without eating the venison (one of my weaknesses, thank goodness it's a healthy protein!).

I did learn one thing about myself through this process:  I am a terrible "picker".  You know, such as when a little chunk of taco meat falls off the spoon - you just reach down, pick the little bugger up off the counter and pop it in your mouth, right?  I can't tell you how many times I almost took a bite of something I shouldn't have.  And it's so MINDLESS, I am so glad I was paying attention each time because it was just almost done, without thinking.  There was a bite of bacon left on my daughter's plate - normally I would snag it and pop it in my mouth!  Well, I did snag it, but caught myself and instead popped it in the dog's mouth.  But this is something I need to remain cognitive of going forward!

So tomorrow is the big day.  I'm nervous (finally), for many reasons: what if I get sick with nausea and vomiting?  What if I rupture something?  The "what ifs" are starting to pile up, and the fact that I just finished 2 Robin Cook novels (both relating to in-hospital deaths) doesn't help!  lol  I'm also worried about my family, primarily because we're expecting another snow storm and the hospital is nearly an hour away in good weather.  I know, I know, I am a worry wart and things will be fine.  Right?  The one thing I am NOT nervous about is whether or not I should be doing this.  I don't know if I mentioned this, but on day 2 of the liquid diet I received a phone call, and it's official: I am now considered a diabetic.  The timing couldn't be better to have this procedure done!

So there's my saga for this morning.  If you're still reading, then thanks - and my apologies, you must be having a slow morning!

 So it's day 4 of the pre-op full liquid diet.  While it's harder than I had hoped, it's not miserable - yet!  It was funny though, I had to sit in on a meeting at work last night with 13 other people, and my stomach was just rumbling and grumbling... fortunately only a couple of people heard it, and they understand what I'm dealing with, so we had a few chuckles out of it.  I did find out that some of the things I had purchased for my "full liquid diet" are unuseable - so long, regular pudding!  And thank goodness my son likes cottage cheese.  So it's soup (strained, of course), high-protein Slim Fast, water, yogurt (without floaties), and sugar-free jell-o and pudding for me.  Oh yes, and more of my Syntrax Nectar protein samples. 

I got a phone call from my PCP yesterday.  He had just received my lab work from the surgeon.  My thyroid levels were ok, but apparently I am now officially a diabetic and have cholesterol issues.  This news comes less than 2 weeks before surgery.  I guess the timing is pretty good, eh?  

 These last few weeks have been... wow, what a roller coaster!!  General time line:

12/1/09:  Appointment with nutritionist.  Up 0.50 lb.  Not good!

12/1 - 12/18:  I made 3 attempts at structured exercise - namely, Curves.  Love the concept.  My plantar fasciatis disagrees.  30 minutes of exercise resulting in roughly 3 days of limited activity?  Sooooo counter-productive.  Will need to get more weight off before I can commit.  Meanwhile, very depressing!

12/21:  Had to put my beloved Jessie to sleep.  She was a great dog, her 15th birthday would have been 1/16.  I hated to do it, but it was the best I could do for her.  Really put a damper on everyone's holiday spirit though...

12/24 - 12/25:  Self-explanatory.  Slim pickin's under our Christmas tree this year, hubby works in the auto industry.  'Nuff said.

12/27: Daughter becomes engaged to a wonderful guy, we couldn't be happier.  Finally, good news!  Wedding sketched in for 10/23/10, yikes!  Time to get moving!  

12/31:  The "dream" wedding dress is found!  Put on layaway.  NYE party?  Hah!!  We were in bed by 10:00!

1/3/10:  Wedding rescheduled, now looking at 10/22/2011.  I'm gonna be a grandma!!  We were all shocked, most of all my daughter and her fiance.  They had no idea, otherwise we would not have planned for a 10/23/10 wedding - nor would we have bought a wedding dress already!  They really want an October wedding though, so 10/22/11 it is.  Fortunately it's my daughter's first child, and she takes after my hubby's side of the family, so most likely alterations to the dress should be minimal.

1/4/10:  We found (we think) the reception location!  Oh, and I had my final nutritionist appointment today too!!  Everything will be submitted to insurance no later than Thursday.  I should have a surgery date within a couple of weeks!!

Man, I need a vacation!!  But again, this is why I haven't been around much.  I don't think my life has ever been so chaotic!  So I apologize for my lack of participation and support, honestly I do.  I hope everyone else is doing well and had a great holiday!!

Let me preface this by saying I am not looking for sympathy.  I think I just need to vent and get it out of my system.

We had to put one of our dogs down yesterday.  It's the first time I've had to deal with that.  It sucks, there's no other way to say it.  It especially sucks because once the appointment was made she suddenly decided to start eating again.  She decided not to spend the day lying around.  Suddenly she appeared steady on her feet.  And I'd swear she could hear again.

I don't know how much of this was factual and how much was feelings of intense guilt.  She would have turned 15 next month.  She dropped from 72 lbs to 60.  She had no quality of life.  I know all of this.  But it still sucks.  I could have canceled the appointment.  And who knows, I may have ended up spending yet another hour in the middle of the night on the floor with her in the hallway, because she had yet another seizure and couldn't move.  I could have gotten up this morning and cleaned up yet another puddle or pile because she couldn't make it through the 5 hours or so that I sleep at night.  I could have taken her out this morning and had to help her up the stairs once more.

Everyone keeps saying to remember her when she was an active, vital dog.  Truth is, she's been steadily declining over the last several years.  I have more memories of her as an old lady with ills and ailments than I do of her being a young and active dog.  Yeah I know, that right there should tell me a lot.  But my other 2 dogs miss her.  My grown children are inconsolable.  And I will always pray that I did the right thing.

Rest in peace, Jessie.

 

Source:  http://lapsf.com/weight-loss-surgeries.html  

Modality of Weight Loss	Restrictive and Malabsorptive (stomach and intestines)		Restrictive(stomach only)
Type of Operation	Roux-en-Y Gastric Bypass (RNY, RGB)	Vertical Gastrectomy with Duodenal Switch(DS)	Vertical Gastrectomy (VG)	Lap-Band®(LAGB)
Anatomy	Small 1 ounce pouch (20-30cc) connected to the small intestine.Food and digestive juices are separated for 3-5 feet.	Long vertical pouch measuring about 4-5 oz (120-150cc). The duodenum (first portion of the small intestine) is connected to the last 6 feet of small intestine.Food and digestive juices are separated for more than 12 feet.	Long narrow vertical pouch measuring 2-3 oz (60-100cc). Identical to the duodenal switch pouch but smaller. No intestinal bypass performed.	An adjustable silicone ring (band) is placed around the top part of the stomach creating a small 1-2 ounce (15-30cc) pouch.
Mechanism	Significantly restricts the volume of food that can be consumed. Mild malabsorption  "Dumping Syndrome" when sugar or fats are eaten	Moderately Restricts the volume of food that can be consumed. Moderate malabsorption of fat causing diarrhea and bloating	Significantly restricts the volume of food that can be consumed. NO malabsorption NO dumping	Moderately restricts the volume and type of foods able to be eaten. Only procedure that is adjustable Delays emptying of pouch Creates sensation of fullness
Weight Loss  United States Average statistical loss at 10 years	70% loss of excess weight More failures (loss of <50% excess weight) than the DS	80% loss of excess weight More patients lose too much weight or develop nutritional problems than the RNY	60%-70% excess weight loss at 2 years Long term results not available at this time.	60% excess weight loss. Requires the most effort of all procedures to be successful.
Long Term Dietary Modification (Excessive carbohydrate/high calorie intake will defeat all procedures)	Patients must consume less than 800 calories per day in the first 12-18 months; 1000-1200 thereafter?3 small high protein meals per day Must avoid sugar and fats to prevent "Dumping Syndrome" Vitamin deficiency/protein deficiency usually preventable with supplements	Must consume less than 1000 calories per day in the first 12-24 months, 1200-1500 thereafter Consumption of fatty foods causes diarrhea and malodorous gas/stool Failure to adhere to vitamin supplement regimen and consumption of high protein meals more likely to result in deficiency than RNY	Must consume less than 600-800 calories per day for the first 24 months, 1000-1200 thereafter No dumping, no diarrhea Weight regain may be more likely than in other procedures if dietary modifications not adopted for life	Must consume less than 800 calories per day for 18-36 months, 1000-1200 thereafter. Certain foods can get "stuck" if eaten (rice, bread, dense meats, nuts, popcorn) causing pain and vomiting. No drinking with meals
Nutritional Supplements Needed (Lifetime)	Multivitamin Vitamin B12 Calcium Iron (menstruating women)	Multivitamin ADEK vitamins Calcium Iron (menstruating women)	Multivitamin Calcium	Multivitamin Calcium
Potential Problems	Dumping syndrome Stricture Ulcers Bowel obstruction Anemia Vitamin/mineral deficiencies (Iron, Vitamin B12, folate) Leak	Nausea and vomiting Heartburn Severe diarrhea Kidney stones Stricture Ulcers (less than RNY) Bowel obstruction Nutritional/Vitamin deficiencies (Vitamin A,D,E,K)?Loss of too much weight requiring reoperation Leak	Nausea and vomiting Heartburn Inadequate weight loss Weight regain Additional procedure may be needed to obtain adequate weight loss Leak	Slow weight loss Slippage Erosion Infection Port problems Device malfunction
Hospital Stay	2-3 days	3-4 days	1-2 days	Overnight (<1 day)
Time off Work	2-3 weeks	2-3 weeks	1-2 weeks	1 week
Operating Time	2 hours	3 hours	1.5 hours	1 hour
Our Recommendation	Most effective for patients with a BMI of 35-55 kg/m2 and those with a "sweet-tooth". Virtually all insurance companies will authorize this procedure.	Best for patients with a BMI of > 50 kg/m2. Those with BMI of <45 kg/m2 may lose too much weight. Higher overall incidence of complications than other procedures. Most insurance companies will NOT authorize this procedure.	Utilized for high risk or very heavy (BMI > 60 kg/m2) patients as a "first-stage" procedure. Very low complication rate due to quicker OR time and no intestinal bypass performed. Insurance companies will authorize this procedure in select patients.

 When I saw my nutritionist Thursday she gave me a few vitamin samples.  I'm going to track them here, as I'm tracking the protein powder.

As we were going over different kinds, she did mention Flintstones Complete as an option.  I've seen a lot of debate regarding those vitamins on the boards here, and I did mention that to her.  Her response was: "Many people aren't comfortable ordering online, and it's nearly impossible to find the types of vitamins that bariatric patients need in the stores.  For others, it's simply a matter of cost.  The doctor and I have discussed this, and we both feel that while Flintstones Complete may not be the ideal choice, we'd rather see people get SOMETHING rather than NOTHING."

Also, if anyone knows where / how to get samples other than those I list below, please feel free to leave me a message!  Thanks!!  

Celebrate
Mandarin Orange
Do-able.  Not the best, but do-able.

Cafe Latte
Eww eww eww!  Never again!

Bariatric Fusion *
Strawberry


Orange Cream


Mixed Berry
Pretty good!  I'd order!


Optisource
Citrus
Taste-wise so far this is the easiest to tolerate - it's actually GOOD.  Nutritionist did say that this one would be needed 4 times per day, and it does not contain iron so an additional supplement would be needed.



* Bariatric Fusion claims to be cost-effective, as it is the most complete and "no other supplements needed".  For the record the taste is decent and it dissolves quickly.

**********************************************************

When you compare the so-called industry favorite from Bariatric Advantage side-by-side with competitor it becomes obvious they all have their advantages and disadvantages!  From BA's own website:

http://www.bariatricadvantage.com/page/compare?title=Multivitamin%20for%20Mal%20Absorbtive%20Procedures


**********************************************************


From the website: http://bariatricfusion.com/supplementcomparison.php

Gastric Bypass

 

		Optisource™	Bariatric Advantage™ Complete	Celebrate™
SWEETENER	Sucralose	Aspartame	Sucralose	Sucralose
CALCIUM	1200mg (citrate/carbonate)	1000mg (carbonate)	200mg (citrate)*	NO*
VITAMIN B12	560 mcg (methylcobalamin)	500mcg (cyanocobalamin)	100mcg (cyanocobalamin)*	350mcg (cyanocobalamin)*
MINERALS	Chelated minerals	No chelated minerals	Chelated minerals	Chelated minerals
VITAMIN D	2000IU	400IU	1000IU	800IU
BIOTIN	600mcg	300mcg	600mcg	600mcg
IRON	30mg	30mg	No iron*	No iron*
VITAMIN K	NO	YES**	NO	YES**
VITAMIN C	180mg	60mg	120mg	180mg
THIAMINE	12mg	1.5mg	6mg	12mg
SUGAR-FREE	YES	NO	YES	Yes
FLAVORS	Orange Cream, Mixed Berry, and Strawberry	Orange Citrus only	Multiple Flavors	Multiple Flavors
PRICE	$24.99/mo.	$26.99/mo.	$50.00/mo. price includes additional calcium, iron, and B12	$45.00/mo. price includes additional calcium, iron, and B12
ADDITIONAL SUPPLEMENTS NEEDED	NO	NO	YES	YES

*Additional supplements required
** Interferes with anticoagulants



                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       

 Well, I had my nutritionist appointment this morning, and for the first time in I don't know how long I got on the scale and it read LESS than the previous time!  I managed to lose 6.75 pounds in the last 3 weeks or so.  She's really happy with my progress, and is writing glowing reports for the insurance submission.  

I go back 12/1, then she said probably 1/4/10 for my final pre-op visit with her.  So surgery is going to happen earlier than I thought, probably mid-February!!  

All in all today's visit made me feel better.  Progress on the scale and discussing the coming appointments sure has made it feel more real... wow.  The anticipation is killing me!
   

 I have never blogged before!!  But the time has come.  I have received some protein powder samples, and I'm tracking my personal preferences so that when the time come I have the info handy.

Chike
Chocolate Bliss
Made with skim milk (I can't remember to call it fat free milk, it is SKIM milk, dagnabbit!  lol)  ANYWAY, made it with skim milk, and it was yummy!  Definitely a keeper.

Vanilla 
Made it with skim milk, and it was good.  Would reorder.

Strawberry
Made with milk.  In a word:  No.  Maybe there's a better way to make it.

Banana Magic


Orange Creme




About Time
Birthday Cake

Cinnamon Swirl

Syntrax Nectar
Chocolate Truffle
Made with milk.  Expected to like it, but I didn't.  Very bitter, will not purchase.

Twisted Cherry
Fuzzy Navel
Roadside Lemonade
Caribbean Cooler
Apple Ecstasy
Crystal Sky
Vanilla Bean Torte
Strawberry Kiwi
Cappuccino
Strawberry Mousse**

**the picture shows actual strawberry mousse, and it looks de-lish!

If there's no comment then it's still in my handy dandy box and I have not yet tried it.  

If ANYONE out there has tricks and tips to use these besides as beverages PLEASE feel free to contribute - I am wide open to ideas!