The Easy Part is Over

DISCLAIMER: My post-op experience is unlikely to be your experience, with respect to the complications I’ve been dealing with. I am saying this because I see so many people go on bariatric support group forums and tell horror stories about their surgery. It doesn’t do anyone any good who is coming to the page looking for support to read a bunch of scary shit, right? But this is not a support forum. It’s my private(?? LOL) diary of what started my journey from being so heavy and having such hip pain that I was waddling through the airport–to now. So I’m cautioning you now: stop reading if you don’t want to read about what was a fairly awful experience for me. (Of course I also have nothing to compare it to, so….)

When rule-following is a bad idea…
Two days before my gastric sleeve surgery last week (on Thurs. 3/8, my birthday), my husband and I were discussing the perception that some people believe that gastric sleeve is the easy way to lose weight.
Having been hospitalized about 36 hours longer than I was supposed to be, allow me to divest the “You’re taking the lazy way out” folks of their belief. Or not. I don’t really care, and here’s why: I’m so relieved to no longer be throwing up that the complete sigh of relief you imagine you hear is actually every cell in my body relaxing.

I’m a rule-follower. I’m a teacher in my day-job. I’m an over-achiever, and let me tell you, it’s a double-edged sword, my friends.
The post-surgical instructions are to work up to 64 oz of liquid per day. In the hospital, the goal is 2-4 ounces every hour/1 oz every 15 minutes. So, Thursday night when I was good and awake, I started trying to comply with this requirement. That triggered intermittent vomiting for the next 30 hours. I had a severe reaction to the anesthesia. My doctor told me that I was one of a handful of patients she has who go through what I experienced. I cycled through 3 different anti-nausea medications; when I threw up even though I was on one medication, the nurse put another one into my I.V.: Zofran, Reglan, and Phenergan. The Phenergan made me fall asleep, but I never slept for longer than 90 minutes at a time. The most relaxed I got at the hospital yesterday was a nap from 3:00-5:00, but I was still constantly aware of my arm hurting.
Oh, and spppppppeeeeeeeeaaaaaking of I.V., because of my completely crappy veins, I had to have 3 different I.V.s put in, the last one being done by an ICU nurse friend of my daughter’s. Even though I wasn’t in ICU, I was fortunate enough to be on a floor where an ICU nurse (and person with a connection to us) was “floating.” She used a sonogram to find a suitable vein, and I won’t go into more explanation of what happened after that, because thinking about the process makes me queasy.
Almost forgot about this: at one point, a nurse crushed medications, had me dump them on my tongue, and try to wash them down with liquid Gabapentin. Any guesses as to what happened next, y’all? Hmmm? Any at all?

I didn’t realize how hard it would be to “get in” enough fluids. I’ve been such an all-star on every. Single. Requirement. Leading up to this procedure, and I haven’t found it all that hard to comply, because I had this goal in mind: to get to March 8 and have my surgery. It’s like at this point, an announcer should come in and exclaim, “But, wait! There’s more!”

The #1 reason patients end up being readmitted following surgery is dehydration. This was something that made my doctor keep me over an extra day. At one point, I was told to leave a 15 minute gap between tiny sips of fluids. Therefore, I thought that even when my nausea began to fade away, I was still supposed to be taking in only 1/4 of the required liquid per hour. Credit me being drugged when the doctor spoke to me Friday night, but I didn’t pick up on the fact that that was a temporary amount to go for. My daughter told me about it when she came back to the hospital. When I was able, I began taking in a one ounce cup (30 ml) per 15 minutes, as regularly as I could. I also got my ass out of bed as often as possible and walked the halls. I had already been more than willing to walk, but wanting to go home was a major incentive for me.  I was feeling so crappy as I dragged the hallway, looped the nurse’s station a couple times, and headed back to my room, that my give-a-damn was broken when it came to whether or not my underwear was visible. Did. Not. Care. One. Bit. It was hard to re-tie my hospital gown because of my fucked up wrists/arms from the IV and/or pain from having had the IV go wrong, and worrying

This pic is not mine- it belongs to the Doubletree Hotel site, but it is indicative of how stunning Dallas at night is.

about people getting a glimpse of my colorful Granny Panties didn’t matter to me. Besides, at 3:45 in the morning, the main folks I ran into were nurses, one whom was kind enough to offer to help tighten up the back of my gown. AND, I will pause to add here that I wish I’d had my phone with me to take a picture of the Dallas Skyline at night from 8 floors up, because it was magical-looking. So beautiful. The hospital I was at was in this perfect position that showed off this beautiful white bridge called the Margaret Hunt Hill Bridge.

The main drinkable fluid they gave me in the hospital was called Isopure, but I also had clear broth. You know those little medicine cups that come with liquid medications like cough syrup? Those are currently my best friend. And if I go too fast “sipping,” I become nauseated. I’m also taking Gas-X. The surgery is done through laparoscopy, so the abdominal wall is distended from the stomach. (MUST BRAG–because, hey, let’s be positive, shall we?–I followed the presurgical directions so well that my liver shrunk up a lot and I “saved myself 2 incisions” because the doctor did not have to use the tool (the name escapes me) to retract my liver to get it out of her way…(I’ll bet it’s called a retractor, but what do I know?)

I was finally released last night around 6 P.M., and we arrived home just before 9:00. I always love being home more than anywhere else in the world, but it was especially wonderful last night…until I went to the bathroom and there was blood. I called my surgeon and she was baffled as to how that happened, since I was not catheterized, and the test strip I did last night was negative but a new one was positive this morning. I was sooooo dismayed, because I honestly do not think I can cope with being stuck with needles any more than I have been in the past few days. Just. Can’t. Luckily, I was able to confer with my primary care doc via phone this morning; he called in an antibiotic, but between that phone call and the soonest I can take it–this evening–the blood has stopped,

I was SO GRATEFUL to have my daughter Kristen with me. She even assisted her friend in putting in a new I.V. I love that she is so knowledgeable and such an advocate for others.

as has the shooting pain. So I think it was a side effect of dehydration and blood thinner shots I got daily in my stomach. Oh, and here’s a brave new world problem: the tablet is huge and had to be cut into smaller pieces. I am going to hold off on starting it. My nurse daughter suggested that I do that, and I’m all for it. Plus, one of the few antibiotics I can take is Cipro, which annihilates germs. It’s the go-to drug for people who were exposed to Anthrax, and it is soooo hard on the system.

Lovely, lovely flowers sent to me from my daughter and daughter-in-law in North Carolina. Such a treat to come home to, as well.

So, I woke this morning, burning up (sweating heavily) & weepy, as well as catastrophyzing my situation, and I remembered, “Hey! I have not had my HRT or my antidepressants since Wednesday!”–so I started back on those. Plus, I am able to rationalize enough to know that since Thursday morning, I was in a high stress state. I could not relax because the I.V.s hurt nearly all the time. Even the one started by the ICU nurse began hurting. As I type this, my left wrist and forearm are still very sore from having catheters in them. I’m lucky enough to have my husband home with me today and he has been taking care of everything we need. He hung out with me all day at the hospital yesterday, too; he brought his iPad so I could watch TV that does not suck, because most of the channel choices at the hospital were bleh. I’ve been able to rest.

So now what?
First of all, the advice I have heard from a lot of people, including my fellow English teacher who had the sleeve surgery 4 years ago, is that the first 3 months, I will be convinced that this is the worst thing I have ever done in my entire life. Another teaching colleague whose husband had the surgery said that after the 4th day, he began feeling better and able to meet his liquid requirement. Once that’s going better, this whole endeavor is supposed to suck a lot less than it currently does.
My eldest daughter–her weight loss inspired me to go for this– has also assured me that this fresh hell of attempting to get enough liquids in will not last forever. At this point, it seems my entire being is focused on consuming liquids in tiny amounts, resetting my timer for every 15 minutes, and trying to consume more when the timer goes off. I’m working on a 3 oz tub of sugar free Jello for the past hour, and it’s only half gone.

This was me before the pre-op stuff started. I was freshly changed out of my clothes and thinking this was going to go smoothly, or at least having no idea of how badly it would go…

Second, I know that every single day, this is going to get easier. My newly-made stomach is quite swollen, and the swelling has to go down in order for me to be able to take in more liquid more quickly. I have to believe that if I keep doing what I’m supposed to do, it’ll all work out, but also remind myself that trying to jump in with both feet from the start is what made me have to stay in the hospital a day and a half longer. I’m supposed to start my multivitamins up again as well as my B12 supplement, but I’m not rushing it.

Third, I am working at walking to the end of my driveway and back to my house–supposed to walk to get rid of gas pains and to prevent blood clots, as well as continuing to use this instrument of torture: Incentive Spirometer. It involves breathing in deeply and trying to keep this little piece jumping up and down between 2 arrows. It’s supposed to prevent pneumonia. In the hospital, using it kept triggering my gag reflex and set off dry heaves. I’m trying to use it as often as I remember now that I’m home. Supposed to do it every hour… [insert look that says “Oh, for sure I am…trying…”] But I really hate it because it puts air into my stomach which is no bueno.
Fourth, guess what: I’m off Gabapentin completely and my migraines have not returned. I have no intention of going back on it unless absolutely necessary. I can tell you this much: if I DO go back on it, I will be swallowing the little capsules, NOT opening it up on my TONGUE.

Oh, one more thing?
I thought I had it figured out: I had made up my mind to have some pelvic repairs done this summer. But after this? Oh, hellllllll, no. My situation is going to have to be a helluva lot more than “optional/elective” before I ever consent to have surgical anesthesia again. NO. NO. NO. You can say this will fade, but just you watch. There is no way it’ll happen again unless I will absolutely die without it.
I have always had some nausea following surgery, but in the past, it has been prevented to the point that I do not feel traumatized from it. But this was the worst possible scenario, anesthesia reaction-wise. I did not expect it in any way, shape, or form. I had the patch behind my ear that people wear for seasickness, and it didn’t matter. I had powerful anti-nausea meds overlapping with each other, and it didn’t matter. NOPE.
On that note? I’m going to trek down my driveway and back…

I promise…
Next you hear from me here, I will be positive and hopeful again. Today is just not that kind of day. It’s not easy any more. Nobody said it would be, and things that “count” never are, but I committed myself to honesty here, so that’s what ya got.

I just can’t leave it like that…so here’s a gem for you that my daughter overheard while in the surgery waiting room:

“Remember when he put his adult diaper in my toilet? Golly that thing was stopped up! Had to go buy a snake to get that shit out of there!”

Note to self:



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