I'm a Monther - 4 week update

Sep 18, 2012

I am 4 weeks out and had my one month post-op visit today.  Let me start off with some stats. So far, I have lost 42.6 lbs, more than 6" in my waist (I'm a guy, so I never measured, I just know based on the jeans I'm wearing), have my BP totally under control - 114/73 today at the doc's office, zero sugar issues, no more fat and swollen ankles and generally, I'm feeling pretty good. All that said, I am taking five different pills, four times a day, eating five different meals and snacks, five times a day, cannot eat within two hours of this pill or suspension, can't take this pill within three hours of that pill, can't eat after I wake up or before I go to sleep, can't sleep if I eat, can't drink before or after I eat, but definitely not during and have only pooped twice in three weeks!

Holy sh*t, I'm out of breath just typing that out. So, I went to the doc's on a mission. This needs to be simplified. I need to drink more water, eat my food (no matter how much, or little, it is) and take the meds that I need to get back to my life. I can barely tell if I'm coming or going, and it's taken something that's really going great and just making it confusing and a little exhausting.

So here's the scoop. First the PA - on the scale, BP, incentive aspirometer and check my incisions - this is pleasant because she's easy on the eyes and British (I think) but has a sexy accent nonetheless. I'm tall, and carry my weight OK, so I can easily picture her batting her eyes at me as she's "checking my pulse" and touching my incision sites... Good job on the scale, dropped around ten since last appointment two weeks ago, BP is great like I said, I breathe in the tube for her and my wounds look great - straight vitamin E twice a day after showers while the skin is soft, supple and the pores are open - you can barely find two of the five. So, she tells me I'm awesome and goes on her way to send the doc in. Oh, by the way, I brought my wife so I restrain myself from making any of my typical little comments or trying to act cooler than I am. She knows I dig the British chick and this will come back to haunt me later, somehow. Oh well, I do great with her and wait for the doc.

Alright, so in comes the doc and he immediately starts by discussing the pain that sent me to the ER a week ago. He put me on a reduced dose of nerve blocker and I have been weening myself off the vicodin and, honestly, I'm feeling pretty good. We (he still seems to count on me, and my wife, to make decisions) decide that the suture must be working its way out and that a steadily declining dose of Neurontin should do the trick. That's great. One pill down, four and a liquid to go.

Next subject is Actigall - for those of you who aren't this far along yet, Actigall reduces the threat of developing gallstones in post WLS patients. Since we soon-to-be ex-fatties are much more likely to develop them, I am into this one. Of course it causes nausea, vomiting and diarrhea in some patients, so I'll probably get those, but they're all better than gallstones and two out of three are better on a Sunday. So, Actigall, plus one, right back to where I started.

Having already undone my progress, and wanting to switch the subject, I start talking about exercise. Even as a fatty, I was an outdoorsman. I do a lot of boating and fishing. I love bicycling and my new hobby is sea kayaking. After a spin in the Channel Islands with my daughter and I in a tandem, I got reinvigorated on the sport and bought myself a new boat. I want to start... well, he looks at me crosseyed - check back in a month. I see where this is going and tell him, I went offshore fishing for tuna and swordfish Sunday and yesterday and he says, "a little too soon, don't you think?"  Ah, screw it. Back to food, this is going nowhere.

Now onto what's up with my eating. I have been on purees for two weeks. In those two weeks, I have found some things that are just fine to eat. Very normal fare which, in fact, has helped me out because I can sit down with my family and eat dinner. Not the same food mind you, but at the table nonetheless. Those of you on liquids understand that even sitting at the dinner table sucks, blows, or both. But purees actually involve putting a fork into my piehole, I feel like I'm eating, therefore, I must be. During the same two weeks, I have also encountered a problem. Four or five times, I have woken up at 2 or 3am with a mouthful of puke. Well, it tastes like puke, but not as sour. Turns out it's reflux. So, what's the cause?

Doc says to sleep with the bed elevated 30 degrees. No problem, I am lucky enough to have a Tempurpedic bed with adjustable head, feet, massager, etc.... but, no dice because my wife is a side sleeper, so I need to choose between sleeping without puking in my mouth and ever getting fancy with my hot wife. So, I have to stack up the pillows because even though I prefer sleep to vomit, I prefer sex to both. No big deal, but the doc also wants me to not eat or drink (even water) three hours prior to sleeping. Sh*t. I'm plus one pill and minus three hours of food scheduling.

Worse, though, I had to open my big mouth about the PMAS (puking myself awake synodrome), so now, I just bought myself another week on purees to find out if I am eating too much, too fast, the wrong foods or if I am still in post-op stress and not ready for even pureed food. Dumba$$. Plus one pill, minus three hours to eat, no graduation to soft solids...

So, after the PMAS discussion, the no soft-solids fiasco, don't enjoy your new kayak yet schpiel, and the gallbladder health clinic, I'm off to see the nutritionist, who I previously dubbed the "Prosecutor". She winds up, delivers and strike three goes screaming across the plate right in front of my face. She opens her interrogation by saying, "So, did the doctor say it's alright to eat soft solids?"

I immediately answer, "Yes," only to be instantly corrected by my wife. Puree-gatory it is. So, the prosecutor continues with her interview... "what did you eat?", "uh huh, hmmm, and how did you feel?", "I see."  "Have you tried the fat free one?" Mostly she's just talking with my wife who has now cost me a possible flirtation with the British PA and at least a week of food... oh brother. Anyway, I get the coveted soft solids menu and program. But, I only get to hold it for a second before the wife rips it from my hand so fast that I get a paper cut that would put a soldier down. I should even look at the menu yet, I can't have it anyway. OK, thanks. First we need to figure out why I have PMAS. The nut wants me to eat the same amount of pureed food every day - 6-8oz - only an ounce at a time, and separated by no less than an hour and take fifteen minutes each time!

Oh my God. Walk through this with me. assuming I eat 6oz of pureed food a day under this new plan, It will take me 7 1/2 hours to get my meals in. I have to finish three hours before bedtime, which makes it 10 1/2 hours, I can't eat for an hour after I wake up because of the nerve blocker, which means it's now 11 1/2 hours. I also can't take my Prevacid within two hours of the Neurontin, but I must take it 30 minutes before eating, and then I need another dose of the Neurontin and I need another hour break before eating, which is technically impossible without spacing out two of my meals by 1 1/2 hours on each side. Now my food zone is a whopping 14 1/2 hours and I have to get up at 530 if I want to eat all my food, take all my meds and go to bed by 1130pm. Is anyone else exhausted? I didn't even mention that the 6 times I eat it's a single ounce of food and that leaves no space for snacks. If I were to be bold and try to eat 8oz I would need to tack another 75 minutes onto this program, which means get up at 445 and go to bed around midnight. Hold the freaking phone people! This is not happening. I'm just gonna eat slower and shave back a quarter oz here and there and see how I do.

So that was my 4-week post-op checkup. Crazy right? Darned straight it was. But, do you know what? I walked out of that office grinning ear-to-ear. Maybe it was because I lost a bunch of weight. Maybe because I don't think the pain meds are with me much longer, maybe because I scored a bunch of points with my wife by bringing her and letting her ask the questions, interpret the answers and be involved in the process.

Ya know, I don't care about the plusses and minuses that today brought. I will be med free in six months and should be close to my goal (which my doc forcefully revised up on me - we'll see about that). My wife loves me, I have some friends that check on me a lot and are having fun at my expense (like eating a big pile of ribs from the Fire Pit BBQ place next to my office and telling me they suck... I'd do the same, so I appreciate the humor) and most of all, I have my kid who is just the light of my life and I know that soon, there will be almost nothing that my weight will keep me from enjoying with her.

I am getting close to halfway there and it's only been a month. I have had nothing but trouble and pain, but I wake up smiling and go to bed smiling. I hope this is what being a "regular" sized person is all about. I'm sure I will continue to have my share of problems, but for some reason, they have all gotten easier to deal with. My first milestone is going to be at 50lbs and I think it will be my next post. See you then.

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