pagani27

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I love my bed.  We have a lovely waterbed that we bought when we moved here, about three years ago.  We love that it has underdrawers and lots of storage.  What is surprising is the height of the bed.  When we had our old bed, we had double underdressers and wanted the same for the new bed.  However, when the company went to deliver our bed, they called saying that they didn't have the size of underdrawers we wanted and, would it be okay if they filled our order with taller underdressers?  Well, we said sure and when the bed was assembled, it was a bit taller than we expected.  In fact, it came up to my chest and I'm 5'3" tall.  So, after laughing like crazy, we bought some stools to get in and out fo the bed and have been happy since.

Which brings me to now.  Since coming home from the hospital, we have been sleeping on the main floor.  Pam brought up her vintage 1960s Laz-Z-Boy recliner from the basement and we moved her club chair/ottoman over next to the recline and have been sleeping there.  Last night I put my foot down because I wanted to be truly supine again and demanded try sleeping in the bed.  Pam's been very conservative since almost losing me and it took some convincing (or pouting) but we finally tried it.  It hurt a bit more than I expected to hoist myself into the bed (with some bending and twisting), but I made it in and slept wonderfully.  Another step closer toward normalcy!

Surgery itself went well - swimmingly, in fact.  I was wheeled into pre-op at 7:25am and was done with my surgery by 9:55am.  That's when the adventure begins.

I woke up in recovery feeling nauseous and in pain.  That was not surprising - what was surprising was that I soon started throwing up.  I threw up both blood and clots.  The problem I had was that many of my muscles were either painful or just sleepy.  I had a terrible time trying to get all of the relevant muscles to work together to heave up the blood and clots.  To make matters worse, because I couldn't effectively heave, I had breathing problems because everything would stall out partway up my esophagus and trachea.  The recovery room staff were very nice and tried to be supportive but eventually they decided that there was too much blood coming up and that I neeed to be scoped to make sure that there wasn't a leak.  So, back to the OR I went.

In the OR, as they are preparing to scope me, is where the not-so-fun begins.  The team decided to re-intubate me.  This was somewhat more difficult than when I was first intubated because the throat tissues are swollen and there's less space to work with.  At the exact time that Dr. Miller (anesthesiologist) tried to intubate me, I threw up again and aspirated a clot that effectively blocked any air exchange.  My lungs moved and oxygen moved in, but no carbon dioxide moved out.  Dr. Miller's conundrum was whether to stop trying to intubate me and try to suction out the clot, or continue and possibly send the clot directly into a lung.  The challenge is that deciding to pull out could mean that I would die before he could re-establish an open airway.  He chose the latter (pushing the clot into a lung) because sending a clot into a lung means that one lung stops working, but there is still a second lung that works and will keep me alive.  They did a bronchoscopy (scope the lungs) and suctioned out the clot from my left lung.  Meanwhile I was alive and breathing, which was the best of all worlds.

It was a tense four and a half minutes in the ORand I scared Dr. Snyder (and everyone else) terribly.  Because I'm writing this, you can guess that things worked out well and I am alive.  In spite of the drama, Dr. Snyder and is team actually remembered to scope me.  There was no bleeding or leakage - it appears there was just a time of bleeding before the cut edges lined up and started clotting -perhaps a bit longer than anyone expected.  I remained intubated over night and was transferred to the ICU for critical care nursing since my near-death experience really messed up my electrolyte levels and shot my blood sugars through the roof.  What I remember is hazy - sometimes seeing Dr. Snyder or Kim Delamont and hearing them talk to me; once seeing Pam and Meggan in my room, hearing them tell me I was okay and that Pam loved me.  I don't remember being intubated at that time (probably a good thing) and do remember being too stoned to stay aware for more than 1-2 seconds at a time.  

FYI, if you should ever be intubated, they tie your hands down because everyone's basic instinct is to pull out things that are in our mouths.  And, once you really wake up, being tied down can be very frustrating.  All I can suggest is be patient because, if you are awake and frustrated, you are probably going get the intubation removed.  However, you will have to prove you can breathe on your own before they'll jump the gun and remove the tube.  Be patient because, overall, it's just a temporary state.

I don't think we're going to sleep much tonight.  I know I'm too worried about being late to want to relax enough to sleep.  Plus I get to sleep for most of tomorrow, so why worry about sleep tonight?

The all-clear liquid diet hasn't been the problem I thought it might be.  The Isopure does a good job of handling the nutritional needs and when I'm sick and tired of sweet drinks, I drink broth (or wonton soup minus the wontons).

Kim (the director of the Bariatric Surgery program at Rose Medical Center) called to see if I had any questions and the anesthesiologist left me a message to phone him if I had any questions.  He seems like a nice guy - I can't see Dr. Snyder working with anyone who isn't nice.

I'm painting ornaments and watching all of the "Standoff" episodes we taped but haven't had time watch.  I'm worried about weird things like pain control and the odd physical things that are going to be done to me (e.g. the catheter and putting the main IV line in my neck) while I'm out but I still feel this is the right decision for me.  I worry that Pam, in being the wonderful but intense person she is, is going to drive the hospital staff nuts.  I hope she's going to be okay through this process.

I've been in the process of wrapping up my caseload at work in preparation for being out for three weeks for surgery.  However, the best laid plans are still subject to Mother Nature.  Denver was hit with a huge blizzard effectively shutting down the city - me included.  Oh, well.  Now I'm just enjoying the opportunity to sit and read and plan for the next steps in my life.  Only five more days until surgery!

It's the end of my first semester as a graduate student, a full-time worker, and a bariatric surgery candidate.  Things are not ending as I had hoped because I am asking for a medical incomplete for the semester.  Between trying to find a job, getting a job, getting on my feet on the job, and accepting all of the medical problems I have as a result of being fat, I just haven't had the energy to devote to school.  Frankly, I'm pooped most of the time.

Yes, the job is much more physically active than I could ever imagine.  Yes, it turns out that I have severe sleep apnea and dimished lung function because my lungs are being compressed by the fat.  No, I am not in any kind of shape.  And, yes, graduate school is much much much more challenging than undergraduate.  All of these issues work together to create one tired woman who is now admitting she can't do it all (and I want to, darn it!).

So, now I'm petitioning my instructors for an incomplete for my two classes so I can stop worrying and focus on my immediate future: preparing for, having, and recovering from my surgery.  I'll see what happens.

I'm fairly certain that I hate sleep studies.

Turns out the study freaked me out terribly and I'm in the process of digesting what had to be the longest night of my entire life.

Now, I'm pretty good at using my innate "gay-dar" to find other non-straight people.  However, I was seriously fooled by one of the techs, and it turns out I'm kinda angry about that.  He was certainly a nice guy.  He'd had bypass surgery and gave me some good pointers about handling it, but that not being "family" thing really got to me.  But I digress...

Now, I don't sleep on my back and I don't sleep in a standard bed either.  And, it appears, I do NOT sleep in a hospital bed (aka a brick).  Nor do I sleep when I'm covered in wires and wearing a belt around my waist.  So, the fact that I got any sleep is amazing, much less on my back (since that is what they wanted to study).

Wearing the CPAP for the second half of the night was the big freak-out for me.  I didn't like it, found it intrusive and bothersome, and actually felt smothered for a while.  What was the final insult was waking up and learning that I should expect a phone call sometime in the future to set up getting a CPAP.

I don't know why, but that news crushed me and pushed me into a full-blown panic attack in which I ended up calling my PCP crying because I was so upset at the thought of having sleep apnea and needing to use a CPAP.  To her credit, she did a wonderful job of calming me and reminding me that I could choose not to use a CPAP because this was all an option for me, not necessarily a done deal.

So, I'm calmer, but still worrying.

I had my first visit to the pulmonologist and to Dr. Snyder.  Everyone was right - he has the biggest chairs in his waiting room!  No need to worry about fitting into the chairs - they make me seem normal sized.  The staff is wonderful but don't necessarily expect the office to run on time.  I think I waited for almost an hour before seeing Dr. Snyder.  However, I enjoyed myself just chatting with people in the waiting room.  I even noticed that one woman who was there for a post-op visit had lost a bunch of weight from her "before" photos and just looked fabulous.  My actual appointment was fast and Dr. Snyder signed off on the visits I had already completed (blood work with my PCP and the psych eval).  He explained that we would wait for the final sign-off from the pulmonologist and that he wanted me to go for a consult with a gastroenterologist (to rule out GERD).

The pulmonologist visit turned out to be much more intense than I originally thought.  Somehow I just expected that I would fly through since I thought my health was pretty good, all things considered.

Nope.

Turns out my oxygen saturation drops radically when I do any sort of activitiy, which does explain why I get out of breath doing what I think are simple things.  So, I was sent off to the hospital pulmonary lab for an arterial blood gas (hurts like crazy and leaves the most obnoxious bruise!), spirometry (not unusual since I have asthma), and a walking test to see how my sats behave.  Turns out they behave poorly.  It takes 3 liters of oxygen to keep my sats in the acceptable range of 93.  Because of this, I am also ordered to do a sleep study to see if I have sleep apnea.  I hope not, but we'll see.

I managed to scheduled almost everything for time outside of work since I start my new job on 10/2/06.  Now that I have a job, I'm going to have to explain that I'll need about 3 weeks off sometime in December.  I hope that my new bosses will work with me.