Sleeved at Last

beforehospital

We left for the hospital Monday morning around 7 am, since I had to be there at 7:30 for check-in and pre-op vital signs and such.  We arrived and went up to registration on the 2nd floor, where I checked in, paid my balance and began the longest waiting process of my young life.

After about 30 minutes, I was escorted to a back room where I had to give a urine sample, have my vitals recorded and got to wear this season’s hospital haute couture–a gown by Seymour Hiney.  An IV was started in my left wrist.  Then I waited.  And waited.

My parents and siblings had taken the day off to come and spend it with me at the various stages of surgery:  pre-op holding and then post-op delivery to my room when all was said and done.   My surgeon came in around 10 am to talk with me and remind me of what he was getting ready to do, and was I still good with that?  He told me about the leak test he was going to do and let me know that if my urine was green later, the reason was that the chemical he used would metabolize to a green color.  I said, “Ah, methylene blue!”  He smiled and was impressed that I already knew what was going to happen.  I explained that I’d been doing my homework about this whole procedure and that the scientist in me asked a lot of questions.  He said, “More patients should be like you.”  Then he explained that he was running a bit early and that I should expect to be taken away to the OR in about 20 minutes.

My family waited with me until I was whisked away by the anesthesiologist and one of the surgical nurses.  The anesthesiologist gave me something for sedation in the pre-op holding area, which finally hit me once I made it on to the operating table.  I remember being wheeled into the OR, seeing the lights and table and I said, “Hey, it’s just like TV!”  The surgical staff chuckled, and I was certainly loopy by this point.  All I remember after being moved onto the table was that I had an oxygen mask on and then everything went black.

I woke up a couple of hours later in recovery in excruciating pain.  I remember hollering out, “OW OW OW OW IT HURTS” and the recovery nurse asking me where it hurts while trying to position me so that I didn’t hurt as much.  I think I might have had a PCA pump given to me at that point.  I was only half conscious so I don’t remember much of what went on in recovery other than me shouting out in pain.

I woke up around 3:30 in my hospital room, family surrounding me.  I wasn’t fully conscious and drifted in and out of sleep for the next few hours.  I do remember that my nurse put the pushbutton for the PCA pump in my hand so that if I was hurting, I could give myself a dose of morphine, which I did as frequently as the machine settings would allow me to because I was in a LOT of pain.  I did attempt to get up and walk around a little tiny bit but because I was semi-conscious, I only made it around the floor once before being sat up in a recliner, which was much more comfortable than the bed.

I had a couple of visitors–good friends of mine who I consider to be family.  I wish I had been more lucid then, but it couldn’t be helped.  My throat was also quite sore, most likely from the breathing tube they put down my throat before surgery while I was out.

After my friends left, I continued to sit up in the recliner, drifting in and out of sleep.  My husband, the saint, stayed with me until right before I was put to bed for the night.  After everyone left, he said to me, “You did it.”  I nodded.  I looked down at my belly, saw some of the incisions and that’s when it hit me:  I did it.  I really, really did it.  As doped up as I was, I kind of felt like that kid in the David Goes to the Dentist video:  “Is this real life?”

The pain reminded me that yes indeed, this was real life, and that I had crossed the Rubicon, picking up incisions along the way and was well on my way to improved health.

I was woken up to walk again, and this time I tried to walk another lap.  Success!  I was more awake at that point but was still in a great deal of pain.  I was also thirsty, even though I had an IV line in.  My mouth was dry and my throat hurt, so I wanted something to drink.  I got to order from the kitchen whatever clear liquids my heart (and mouth) desired, so I ordered bottled water, a sugar-free popsicle and some decaf iced tea.  I managed to eat the popsicle pretty well, but I did feel some nausea after I tried to take a sip of tea.  I don’t know if it was triggered by the temperature of the liquid or if I was already full.

I got up and walked again later that night, making 3 laps around the floor.  After that, I was exhausted and got into bed to lay down for sleep.  The night wore on, and I slept lightly since every couple of hours, the nurses would come in and take my blood pressure and blood sugar.  I’d been given a steroid in the OR to prevent nausea, and my surgeon said, “The tradeoff is that your blood sugar will be higher than usual.  So we’ll give you insulin while you’re here.”  I agreed and said, “Anything to keep me from throwing up.”

I was woken up at 5 am yesterday morning to go to the bathroom and to walk again.  Walking is key since it prevents blood clots and gets you breathing so that your lungs stay clear.  I’ve been coughing (gingerly, I should say) and bringing mucus up in an attempt to avoid developing a respiratory infection.  The walking has also helped dissipate the gas in my abdomen somewhat.   During surgery, they have to pump your abdominal cavity with CO2 gas so that everything can be visualized.  Dr. Nicholson warned that I would have gas pains for a few days, and that they could reach up into my shoulders and chest, which in his words, “really sucks.”   Thankfully, I haven’t had gas pains in either of those places.  The gas pain is localized to my abdomen, and is really uncomfortable.  I’ve been burping which has helped tremendously.

I drifted in and out of sleep yesterday and was visited by my surgeon’s PA, several nurses, the hospital’s dietician, and the charge nurse who gave me an insulated lunch bag with a plastic measuring cup and bottle to drink from.  I was told that I would be discharged to go home, since I had no complications and was recovering nicely.  At first I didn’t want to go home just yet.  The bed, while not the most comfortable, could have its feet and head raised and lowered, which helped with getting into and out of bed.  Not so much at home!  It was also nice having people wait on me hand and foot.  But one of the nurses made a good point–she said, “Well there are a lot of germs in a hospital that you are not used to and because your immune system is kind of at a low point, it’s better for you to be at home where your immune system IS familiar with what’s in that environment.”  I couldn’t argue with that logic.

So my husband came up, packed my things and helped me get ready to be discharged.  This is when the worst thing happened to me:  the removal of the JP drain from my abdomen.

A JP drain removes excess fluids from a cavity post-surgically.  It works by squeezing a bulb that is connected to a hose that is left inside the cavity.  As the fluid to be removed is suctioned out, it fills the bulb.  I didn’t realize how deeply this drain was placed until the nurse pulled it out.  Holy shit, it hurt worse than my incision pains did!  I seriously thought I was going to pass out, it hurt that bad.  I cried the entire time the nurse pulled it out and didn’t stop crying for about 15 minutes afterward because the pain was that intense.

After calming down from that ordeal, I dressed and was ready to be taken home. I thanked the nursing staff for taking great care of me, and they congratulated me on my surgery and asked me to visit there in a few months once things had healed up and I’d lost some weight.  I assured them that I would.  I was very well taken care of by the staff at Baylor Plano, and have no complaints about them at all.  They were extremely professional, compassionate and did an outstanding job of taking care of me.

My husband brought a pillow for me to place across my abdomen for the ride home.  Even though the seatbelt didn’t hit any of my incisions, the bumps in the road made for a tricky ride home so the pillow was quite useful!

Once I got home, I sat up for a bit and began sipping water from the 1 ounce dosage cups one of my nurses gave me.  I’m using an interval timer now to keep track of my fluid intake as I learn what my new stomach capacity is.  According to my doctor’s PA, he used a 34F bougie to help craft my new stomach.  This means I will have great restriction.  And while fluids just pass right on by the pyloric valve (the valve leading to the small intestine), I still have to be careful about the volume of fluid that I take in lest I cause myself to vomit, which I don’t want to do.  So I’m learning slowly how much fluid I can take in before my mouth salivates excessively and waves of nausea wash over me.  I’ve had a couple of close calls so far, but nothing that’s pushed me over the edge.

I did it.  I actually did it.  And now the hard work begins.  Surgery was the easy part.  The hard work begins with learning to use this tool to my advantage so that I can lose weight and get healthy.  So far I think I’m doing an okay job.  I’ve been sipping and walking, sipping my protein drink and taking my meds like I’m supposed to.  These next three weeks will be a challenge since everything is still swollen and raw, but I’m equal to the task.  I can’t wait to see what happens next.

Onward!

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