Procrastination update - RNY surgery

Nov 26, 2012

It will be three weeks tomorrow since my surgery, and I'm feeling great!  I meant to post blog postings after my surgery but was posting a lot more in the "What are you eating/doing today" threads in the Ontario forum and neglected updating here.  And the longer I've procrastinated, the longer I knew the post would have to be in order to update...well, I'll bite the bullet now and get caught up so I can post regularly here again without a big gap in the journey.

I think I'm ready to get rid of my pre-op timelines in my OH signature since they take up a lot of space, so maybe I'll stick them in this blog posting, just so that I don't lose track of them completely:

Referral to Bariatric Registry: October 21, 2011     Orientation class at TWH: Feb 22, 2012    
Nurse Practitioner: March 14, 2012                         Social Worker: March 27, 2012
Psycho-Social Assessment: April 3, 2012                 Nutrition Class: April 16, 2012
Nutritionist Assessment: May 4, 2012                     Meeting with Surgeon (Dr. Cyriac): August 17, 2012   
Pre-op Assessment Clinic: October 15, 2012          Starting Optifast: October 17, 2012
Surgery Date: November 7, 2012, Dr. Aarts, Toronto East General

So, the surgery...

It went very well.  I was really nervous (okay, downright scared) before it.  I rushed to get my will done and signed before surgery (morbid, I know).  I was reading a bunch of posts on OH the week or two before surgery where people were talking about some pretty extreme complications they were having.  What I was most worried about is that I would get there and not be able to go through with it.  I was also pretty scared of being put under - the idea that the OR could be the last thing I would ever see was really scary to me.

So my mom came down the night before surgery and she and my husband both encouraged me and made me feel better.  My husband had been doing that all along - he's been amazing during all of this.  I would be fine during the day, but at night around bedtime, all the doubts would choke me, and he would calm me down, reassure me, hug me, tell me it would be okay.

Surgery day came and luckily it was first thing in the morning so I didn't have much time to agonize about it that day.  I had it done at Toronto East General with Dr. Aarts.  I met her on the day of the surgery since Dr. Cyriac did the pre-op surgeon meeting with me.  One thing I really liked at TEGH is that the anaesthesiologist came out and talked to me before they brought me in for the procedure, just so he could introduce himself without the mask on.  It calmed me a lot.  I think Dr. Urbach was there too, assisting Dr. Aarts - he introduced himself in the operating room, but that was a blur for me.  I only realized who he was when he came to my hospital room the next day and introduced himself again.

I was so zoned out after surgery.  It took me about 4 hours in the recovery room because I have sleep apnea so they wanted to keep an eye on me for longer, they said. 

One thing I noticed is that they're a bit stingy with the pain meds.  It seemed to me that they waited for me to ask for them before giving them to me, and the only time I would think to ask for them is when they'd worn off so much that I was actually in pain again.  I didn't like that much - I figure they should know that there is going to be pain, and keep a regular dose going so you don't slip back into pain again before having to have more meds.  So once I was a little more lucid, I found out what the schedule was for meds (a dose of morphine every 4 hours, and then on the second day, up to 2 percocets every 4 hours), and I demanded my pain meds half an hour before they were due so that I wouldn't have to wait in pain for them.  That worked better for me.

That was my only complaint, though - otherwise, my care was absolutely top notch.  The nurses and personal care assistants were extremely friendly, professional, and very helpful. 

I was worried later on in the day after surgery, because we hear about how they'll have us up walking the evening of the surgery.  Well, I wasn't walking anywhere the same day!  I was zoned out, in pain, and I could barely make it to the bathroom myself!  It's the first time in my adult life that I've ever needed someone to wipe me up after going to the washroom, because I just couldn't bend enough to reach.  A little embarrassing, but after giving birth over a decade ago, I pretty much lost all modesty in medical settings! :)

In the middle of the night the first night, I had to get up to go pee several times.  Each time was easier than the last, although I still needed help every time.  Then, the next morning, it was incredible - I got up by myself, went to the washroom myself, and was able to walk around a bit.  It was like a 1000% improvement, overnight! 

I had my period during surgery.  That was pretty special.  And the worst part is that I didn't have to have it. 

My gynecologist got the idea that she could do an endometrial biopsy on me just before the surgery so that I could be under a general anaesthetic for it.  She told me that she made arrangements with Dr. Aarts, that Dr. Aarts had agreed, and so the gyn got me to come into her office to sign a consent a couple of weeks before the surgery.  And she gave me a prescription for a pill that would open my cervix (but also brings on a period) that I had to take at bedtime the night before surgery. 

So, I took the pill and then woke up at 3 a.m. the morning of my surgery with severe period cramps (that's a lovely side effect).  And of course I couldn't take any painkillers for them!  So I got to the hospital, still in pain, and having my period.

I get into the operating room, and Dr. Aarts tells me that my gynecologist didn't send my consent over for the biopsy procedure, and that she would call the gyn (she was on call at the hospital that day) to see whether it would be "feasible" to do both at the same time.  I thought it was all arranged, but it turns out that they had just spoken briefly about possibly doing this, but hadn't completely made arrangements.  That would have been nice for me to know before taking a pill that brought on a heavy period and gave me severe cramps that I couldn't take medication for!

It turned out that they couldn't do it, because it didn't occur to my gynecologist that she would need me to be in a completely different position than Dr. Aarts would - she would need my butt at the edge of the table and my legs up in stirrups, while Dr. Aarts would need me lying straight along the table with my head at one end and my feet at the other.  And they wouldn't be able to move me properly after I was put under.  So they didn't do the biopsy after all.

Other than that little wrinkle, the surgery went really well - it was "textbook" as Dr. Aarts told my husband and mother afterwards.  And it really was!  My incisions have healed perfectly so far - no oozing, no infections, no problems.  And they were stitched up nicely - it looks to me like the scars will be quite minimal.

I've been following the food and exercise plan since surgery and things have been going very well - I've lost 37 lbs so far, since the beginning of Optifast.  But more importantly, I feel much better, I can walk for half an hour now without getting out of breath (although I still get tired after walks), and I'm much more flexible now.

It just keeps getting better and better!  No regrets so far!

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