Kari J.

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I cannot believe it's been 6 weeks since my surgery!!  The time has flown by and things get easier every day.  I got through my 4-week emotional low fairly quickly (not that it made it any easier).  The bitterly cold, constantly snowy weather didn't help the problem, so I hit the tanning bed to get myself some extra rays to cheer me up.  I also started losing again after my weeks 2-4 stall.  As of today I'm 240#, which is a 39# loss.  I have been here for several days so I think I'm entering stall number two!  They are annoying but Janelle (the office dietician) says this is normal. 

I had my 6 week appnt on Tuesday and they seem happy with things so far.  My port sites are healing very nicely and they say I'm on track for weight loss.  I just get to keep up the same stuff and at my 3 month appnt they will check all my labs.

Eating and drinking are getting a lot easier (thank goodness)!  So far I haven't found anything I don't tolerate, although meats are difficult.  I can only get about 2 small bites down before I get a pressure/pain under my left ribs that lasts a few minutes and I obviously have to stop.  I'm eating a lot of cheese and fruits and am starting to integrate raw veggies into my diet.  As for drinking, I'm able to take larger drinks at a time now so it's getting easier to get fluids in.  I'm still not at goal with this, but I'm getting better!

Christmas was easier than I thought with all the food everywhere.  My family is super supportive and made sure we had "snacky" foods that I could eat.  They are getting used to how I eat now and what I can/cannot have. 

I'm also trying to integrate into the whole dating world that has always eluded me!  I went out with friends a few weeks ago and even though I really haven't lost a lot of weight yet, the increased male attention was quite apparent!  I think maybe it has a lot to do with the fact that I'm already feeling more confident and I'm sure this is showing.  So I decided to sign up for eHarmony and see what is out there.  I was straight forward and said I recently had the surgery in my profile so that those who had an issue with it were weeded out right away.  So far I've gone on one date with a really nice guy and I've been continuing to talk to him at least once a day...and another date is in the near future. :) 

I also went back to work yesterday.  I really thought 6 weeks off would be excessive but I honestly really didn't feel ready to go back until the past week.  It's like everything finally clicked and I started really feeling well without all the fatigue, etc.  I was very happy I took the full 6 weeks off!  I usually work 3 12hr shifts per week and I'm starting off the first 2 weeks only working 3 8hr shifts per week to ease back into normal life.  Although I thoroughly enjoyed being away from work, I think it will be good to have some structure back in my life.

Well, that is my 6 week post-op update in a nutshell!  More to come!

It's been a while since I posted so I thought I'd write up a quick update.

First off as of this morning I'm down 31 pounds, which puts me at 248#.  That's 15 pounds down from my last post.

So far things are going pretty well.  I am having some serious problems with fluids and proteins as a lot of people experience.  First, the proteins.  My wonderful protein supplement I liked that I finally found prior to surgery makes me nauseous and I can't finish it.  So in the last couple of weeks I've been on the search for a new one without any luck.  Either the taste makes me nauseated, the consistency makes me gag, or a combination of both.  Who knew protein was going to be my problem!

Second problem, fluids.  I always used to be a fluid gulper so this sipping thing is really difficult to adjust to.  It's proving to be difficult and I have yet to reach the goal of 64oz/day.  I am getting dehyrated (working on getting out of it) but it's a vicious cycle!  I get dehydrated which in turn makes me fatigued which makes me sleep more.  The more I sleep the less time I have to get the fluids in.  Grrrrr.

The eating is going pretty well and today was the first day I was able to eat solid foods.  I'm experimenting and seeing what I tolerate.  So far I haven't found anything that I can't eat.  I do have trouble with the amount of food I can eat.  Today I struggled to get down half of a hamburger (that's just the meat, no bun). 

My surgeon stressed over and over that most go through a phase in the first month where they aren't really dropping the weight yet and are still working on getting used to the new way of eating and they start getting depressed--and start thinking "what have I done?".  This past week this is the perfect description of me.  Even though I'm eating I'm mourning the loss of food.  I have never been so aware of how much I used food as comfort.  Two bites (okay, maybe an exaggeration) doesn't quite cut it.  I've been trying to spend a lot of time with friends to keep me positive.  I do well and then as I'm sitting home alone by myself I start getting in the dumps again.  They say this phase passes quickly, I'm hoping they know what they're talking about.

I did decide I needed to start doing some more structured exercise and get out of the house--so today I got a pool pass and started doing some lap swimming here at the local indoor pool.  I swam for an hour.  One does not realize how much of a workout this is until you get OUT of the pool.  Holy cow I am still exhausted.  I think I need to start out a bit slower so I don't kill myself off.

Anyway, that is about it for now.  I will continue to update!

Just thought I'd type a quick update.  Things are improving each day!  Each day I feel a little less sore and a little less tired.  I've started weaning off my pain meds.  Yesterday I only took one dose in the morning and one dose right before bed.  This morning I only took 1/2 a dose so we will see how that goes.

My weight is dropping quickly!  As of this morning I've dropped the 11 pounds I gained in the hospital plus an additional 5 pounds putting me at 263#.  It's exciting to see the scale dropping!

Nothing else to report as of now!

I’ve been home since Saturday at about 1:00pm and I think I’ve got some energy to start writing about my experience. This will probably take several sessions as I still get tired very easily, but I’ll get it all written and posted!  

I had fully expected to have a mini-breakdown prior to surgery. I tend to get anxious about things and considering I had never been hospitalized much less had surgery I figured this would be one of those times that really got me. However, the night before surgery came and I slept no problem. I got up and got showered, loaded my things and my dogs in my vehicle and went to my parent’s house. I got my girls (aka the dogs) settled in and put some things for after surgery in my parent’s house and loaded my hospital bag in their car and we were off to Methodist!  

I had to be at the hospital at 6:00am to prepare for my surgery, which was scheduled for 8:10am. As soon as I checked in I was taken to a room with a gal from admitting and she asked me a bunch of questions about my next of kin, etc and put an ID bracelet on me. Then I sat with my parents and my cousin who had come for the big day for about 30 minutes before a nurse came and got me.   

They immediately weighed me (starting weight as of surgery day was 268# according to their scale). I had weighed myself on my scale at home that morning and was 265#. They asked me a bunch more questions then drew some blood and got an EKG. After that a different nurse came in and had me sign consents and she started an IV. During this process Dr. LaMasters and her PA Alissa stopped by to see if I had any last minute questions and to go over some of the finer details—like how long the surgery would take so my family members that were with me that day could have an estimate.  

I am a nurse at the hospital I had surgery at and I know all the anesthesiologists and work with them on a daily basis so I had called surgery scheduling a couple days prior to surgery to request a certain anesthesiologist. I let the nurses the morning of surgery know my request and I had seen the anesthesiologist so I knew he was there. But then they informed me that apparently the person I talked to didn’t write down my request and that anesthesiologist was unavailable. I was fine with who was assigned to me (Dr. Quinn) I was just a little annoyed that they had “lost” my request. Dr. Wilson, who I had requested, stopped in my room to tell me he was also upset about it and wanted to care for me but unfortunately was already involved in another case. I thought it was nice of him to stop in but I assured him I knew Dr. Quinn would take good care of me.  

After all the little details were in place and I was completely ready for surgery my parents, brother, and cousin all came back to hang out with me until I went back for surgery. My Aunt and Uncle would also show up shortly after I was whisked away to spend the time waiting with my family.  

I told my brother as we were waiting that I thought I would be horribly anxious, but I was eerily calm. I think I was just excited to get the surgery done with and move on to take a seat on the loser’s bench.   

At 8:10am the surgery nurse came to get me and take me to surgery. I said bye to my family and told them I’d see them when I woke up. Dr. Quinn and the surgery techs were in the OR when I got there and we immediately started chatting about trivial things. Apparently the surg tech and me had both graduated from Ames High, though in very different years. This is the last thing I remember before waking up in recovery!  

As I was waking up I remember being in a lot of pain and I could see through slit eyes that there were several nurses around me and they were telling me they were hooking up my PCA to get pain medication. They handed me the button then I think I went right back to sleep. Pretty soon I could hear the nurse talking giving report to what I assume must have been my nurse on the unit I was going to. They were talking about my intake/output and what room I was going to. Then I remember being wheeled to my room and how every time they went over a bump it hurt. In my room they rolled me side to side and moved me to my bed. I remember being rolled hurt a lot but that’s about it and then I recall my family all coming in. I guess the first thing I said to them was “Do I look skinnier yet?!?”. They were apparently all pretty amused that I hadn’t lost my sense of humor!  

Then my family was explaining to me that my surgery ended up taking 5 hours because they ran into some issues. Apparently my Falciform ligament is enormous—in fact the biggest one my surgeon had ever seen! It’s a ligament in your abdomen that attaches to the blood vessels through your umbilical cord when you are in-utero and shrinks as you age. Well mine hadn’t shrunk! It went from the top of my liver all the way down to my belly button. So it made for some issues during the procedure and I have a couple more port holes as a result. They ended up having to dissect through the ligament, which in turn causes more pain for me after surgery. YAY.  

I guess my family had a good old time waiting during my surgery! My Aunt had packed a big cooler with healthy beverages and snacks for the wait. And they basically hung out talking and laughing the whole time. Sounds like I missed out on some good family time!  

The first day was basically a big blur. I do remember the nurse aide and my mom getting me out of bed the first night to try to walk. Let me just tell you I was in my own little Dilaudid PCA world! I couldn’t focus on anything and in fact couldn’t even open both my eyes. I made it to my door before we had to turn around because I was so dizzy. The pain was also quite bad, especially in my left side under my ribs. This has continued to be where the worst pain is which Dr. LaMasters said is normal because that’s where they put the big stapler through to make my pouch (which I call my tiny tummy). As I was trying to get out of bed the first couple of times I remember trying to roll both directions to try to get to my side so I could push up with my arm but it just wouldn’t work because of the pain. I ended up sitting myself upright with the bed and hanging my legs over the edge then I could pull myself up with my arms using the siderail.  

The first night was okay until about 4:00am. I was having horrible pain and gas pressure all across my abdomen under my ribs. I told my nurse and told her I had some Gas X thin strips in my suitcase if she could get them. She of course told me she couldn’t give them to me because my doctor didn’t order them. She was giving me anti-nausea medication that she claimed would help with the gas discomfort—apparently she thought in my dilaudid stupor I would forget all my nursing knowledge. She told me she would see if anything else was ordered and get back to me. Well as soon as she left the room I woke my mom up (who thankfully stayed with me each night) and she got me some Gas X…which didn’t really help as I think it was more incision pain. I started getting REALLY uncomfortable so we put the nurse call light on to get more pain meds. 45 minutes later and 3 trips to the nurse’s station by my mom the nurse finally showed back up with some more IV pain meds. It was instant relief, thank goodness. This was really the only issue I had the whole time—all the other nurses and nurse aids were wonderful!  

The morning after surgery radiology came to get me to take me to have my barium swallow study to make sure there were no leaks in my new plumbing. It was once again a struggle to get out of bed! But I managed and I walked to the door and got on the cart to take me down. I was still completely out of it and couldn’t focus on anything. Dr. LaMasters met us in radiology to watch the study. I had to stand on a platform and drink this really icky white stuff while they watched with an x-ray machine. All was well so they advanced me to a clear liquid diet. Until that point I was NPO, which means nothing by mouth. Let me tell you this is a whole new brand of cottonmouth! Those little swabbies don’t quite cut it but it helped to dip them in Biotene mouthwash before using them. Luckily this time flew by, as I was basically asleep the whole time. 

The rest of the first day after surgery I don’t remember much of. I had to get up and try to walk some more and by evening I was able to walk ¾ of the way around the unit. They took my Foley catheter out of my bladder at 2:00pm and they stopped my PCA Dilaudid at 6:00pm. They brought me broth, jello, tea, and popsicles for meals but I would take a couple of sips and I would be done. The two times they brought me popsicles I did manage to get them down. Nothing really tasted good and I had absolutely no desire to eat. Dr. Quinn also came to visit me that day. He was checking to make sure things were going well. I thought it was really nice of him to stop by.  

The big annoyance the day after surgery was peeing after the catheter was removed and figuring out pain meds. I couldn’t pee for about 4 hours and when I finally did it took total concentration. Until yesterday, I still had to concentrate just to pee, very annoying! Pain meds were another issue. They started me on Lortab elixir when they stopped the PCA. This made me pretty out of it as well which I was trying to avoid because I was still in a big dilaudid blur. So they decided to try Darvocet. This isn’t as powerful of a narcotic and they would have to crush it and put a little water in it and I would swallow it. It was horrible! I did this twice and both times had initial pain relief but it wore off quickly. So I switched back to Lortab but only took half a dose—gave me the same effect as the Darvocet. So during this time they still had to give me IV doses of Dilaudid. I finally switched and just did the full doses of Lortab and this has worked since then. It makes me a little sleepy but I’m functioning!  

The second day after surgery was spent figuring out my pain meds and doing a lot more walking. Dr. LaMasters decided to keep me in the hospital an extra day due to the complexity of the surgery and my extra pain as a result. I was thankful for this because I was not ready to go home on Friday. I think it was sometime Friday as well that I started pooping liquid. Everyone seems excited about this but me! I continue to pass a lot of gas and liquid stool. I’m wondering when this little joy is going to come to an end.  

Saturday morning Dr. Eibes (Dr. LaMasters partner) stopped in and gave discharge orders. He also removed my JP drain…not pleasant! It didn’t hurt, it just felt like he was pulling my intestines out my side. Weird stuff!   A little later I got up and took my first actual shower (sponge baths don’t quite cut it), which felt absolutely awesome. I felt like a new woman! 

By about 1:00pm we were home—aka at my parent’s house. My dad would stay with me during the day in the hospital and he was officially branded as “Nazi Nurse” because he was all about making certain I was walking and using my inspiratory spirometer…he continued on this after getting home. I was tired and enjoying hanging out in the recliner, but he made sure I was getting up and walking around the house.  

I was thrilled to see my dogs when I got home. My parents thought for sure they would be jumping all over me which obviously wouldn’t be good as they are all 3 quite large German Shepherds…but I had more faith in them! My mom went and got them (they are staying in their heated barn) and brought them up to the garage. They all knew (even Gerdi the crazy 1 year old) that I wasn’t feeling well. They just stood there and let me love on them. I could tell they had missed me as much as I missed them. Since then my mom and I make our nightly outing to the barn. We feed my girls dinner, feed the horses some apples and carrots, and give the kitties all some love. It gets me out on a bigger walk and seeing all my animals keeps my spirits up.  

I also decided to weigh myself the first night I got home. I knew from other’s experience that because of all the IV fluids and swelling weight would go up in the hospital…this was true for me as well! Day 1 home I was 279# (that’s an 11 pound gain in the hospital). Day 2 I was 275# and today I’m #273. So it’s coming back down and hopefully will continue to fall quickly!  

As of today I am doing much better. The pain is still there on my left side under my ribs, but the Lortab takes care of making it very tolerable. I’m much more mobile and I was even able to bend over in the shower enough to shave my legs! I will say the first couple days were NOT fun at all. The day after surgery I said to my mom several times that it was much harder than I thought. Now at home I’m just working on getting in protein and fluids. It is a lot harder to do than I thought it would be! You have to really concentrate on drinking small sips constantly because you can’t play catch-up. If I take too big of a drink I get a bad pain in my sternum area that goes away after a few seconds—but it’s a good reminder to slow it down.  

Well I think I officially have the whole experience typed out! I probably missed a few little details but if anyone wants to know, just ask!

It's now Monday evening and I am scheduled for surgery on Wednesday.  I can't believe how quickly this day is arriving!  I am in my second day of general liquids and doing fine with it.  I was really nauseated, tired, and weak this morning but I think that is a result of lack of calories yesterday.  I was trying to keep myself occupied so I wouldn't think about the fact I was just drinking liquids--and I ended up hardly getting anything in (other than water of course).  So today I've been on top of getting in some calories and my protein shakes.

I'm not looking forward to tomorrow's clear liquids and bowel prep.  I have had to do a bowel prep in the past and I remember how miserable I felt all day!  I still need to pack my bag for the hospital and get my dogs' gear packed up to spend a couple days with "grandma and grandpa" so I'm hoping to get that done in the morning before the "fun" starts.

Right now I'm just really excited and looking forward to having the surgery behind me.  I'm certain I will be a nervous wreck the morning of, but right now I'm trying to focus on the future!

When I write my next blog I'll be sitting on the loser's bench...

It's hard to believe my surgery is just two weeks from today!  Since I got surgery approval and my final consult was scheduled I was in the bad mentality of I needed to eat all the things I knew I wouldn't be able to after surgery.  Bad state to be in, but I do think it's pretty common.  I managed to pack on 6 pounds **gasp** in 3 weeks.  It will come off during my 2-week pre-op diet---which started today!  I had the very sudden realization last night as I was getting off work that it was my last day before completely changing the way I eat.  So I decided to treat myself to one of my favorite restaurants on the way home from work last night.  There's nothing quite like Outback Steakhouse's Curb-side to go!  I just had to do that one last thing before letting it all go.

So now today I'm starting my 11 days of 1200cal/day followed my 2 days of general liquids and 1 day of clear liquids and bowel prep.  I need to head to the store today and pick up some more protein supplements and other little supplies that I will need (like a good strainer).

I've also now been having some serious issues with anxiety related to the surgery.  I have a couple days where I'm beyond anxious then I'll calm down a bit.  Dr. LaMasters suggested I get on something like Effexor to stabalize my emotions.  I have a call into my PCP so we'll see if I can get something to help me out.

This is all becoming very real!!

Just a quick note to say that I had my final consult with Dr. LaMasters today and my surgery is all scheduled for Nov. 12th!  I cannot believe it is just over 2 weeks away! 
I'm really started to get anxious/nervous now.  I know it's only going to get worse as the big day gets closer.
Wow, it's finally happening!

Within a few minutes of writing my last post Dr. LaMaster's PA called to talk with me.  She had a few questions about meds I was taking and some instructions for my final consultation.  My final appnt before surgery is all set up for Oct. 27th!!!  Surgery will be scheduled on that day and the PA said it is usually 2-4wks after the appnt.  This means I am most likely going to have surgery within the next month! 

So now that it's becoming reality I am incredibly excited, but SO nervous now.  Not for the changes that lie ahead but for the actual surgery itself.  I have never had surgery or any anesthesia before--heck, I've never even been hospitalized!  Even though I am completely confident with my surgeon and the hospital--and I know all the anesthesiologists because I work with them--I am still so nervous about it.  What if there are complications and I die during surgery?  Morbid thoughts but things I worry about. 

But as much as I worry, I can't help but be excited for the changes that will happen.  I'm in Tulsa, Oklahoma right now for the Arabian National Championship horse show to watch my dad show our stallion.  I come every year and I'm always very self-conscious about my weight when I'm here.  The bigtime horse world is filled with beautiful, trim women.  And this year--I'm looking around thinking 'Next year, I'm going to fit in better--and maybe I'll even be showing one of our horses'.  These thoughts are what keep me going and keep me focused on the excitement that will follow the surgery!

Hell has frozen over!!!  (Oh yeah, and I got insurance APPROVAL!!!!!!).  Wow, I haven't been this excited in a long time.  I have been trying so hard to get this accomplished and I never thought that one little word would mean so much to me.  Now I am going to impatiently wait for the PA at Dr. LaMaster's office to call me and set up my final consultation.  The Big Day is nearing!!!! 

I just received even more GREAT news!!!!!  Sue from HR called me and they approved the ammendment to the requirements for approval!!  They changed the requirements from a 12 month to a 6 month supervised diet beginning November 1st.  This is absolutely perfect timing for me because I will finish my 6 month diet on October 10th!

So I called the case manager they now have me working with to make sure everything falls into place so I can have surgery as soon after November 1st as possible.  Thank you to the fabulous case manager she set me up with her fax number so I can get my records for my 6 month diet faxed to her the same day I finish so she can review them immediately.  Because my Bariatric clinic requires written approval prior to being able to schedule your final consult with the surgeons the case manager is going to send the letter as soon as she reviews my records October 10th with a clause saying the surgery has to be after November 1st.  That way I can get my final consultation done and schedule my surgery anytime after November 1st!!  I am absolutely elated--just a few days ago I was beginning to wonder if this was ever going to happen for me and now it is finally beginning to feel like a reality!!!  From the looks of it I'm going to start 2009 as a brand new me!!! :)