A Smaller Target

Relentlessly Good Labs Continue

Weight: 165

Although my labs have been excellent post-op, I was a bit worried following my meeting with Dr. Kaufman and his concern that my body might be burning protein following surgery.  I talked to his nurse Ilene today and the results are in.  My labs are still rock solid.  In fact, the only anomaly  is that my iron is a bit high.  Given the problems with low iron that my friends and fellow bloggers Beth, Kim, Alison and Marybeth have had, I can only say I feel totally fortunate.

It should be easy enough to fix this problem.  I've been doubling up on the pre natals since plastic surgery with the thought I was using more iron trying to heal -- guess it's time to stop that and go back to taking just one a day.

New Switch Sister!

Weight 166.2  (was up to 168 Sunday -- for no reason I can guess.  Paul thinks it was an extra strong gravitational field.)

Yesterday following what may sadly be my last formal appointment with Dr. Kaufman, at least for a while, as he's going back to his colon / pelvic floor specialty and no longer doing either RNY or DS surgery, I went and visited Leslie who had DS surgery with Dr. Crookes on Friday.

She looks, in a word, fantastic.  Really!  Her color and spirits were both great.  She had a bit of a rough patch with fever and coughing over the weekend, as I'd heard from Sandy on the boards, but definitely seemed much passed that.  I stayed and chatted with her for an hour and a half.  Leslie was in no pain (USC is, in both our experience, totally great at pain management) despite having been taken off of the epidural that morning. 

Her incision line is longer than mine was, but she explained that Dr. Crookes had both repaired a hernia she had and, while they were in there, had also repaired some mesh anchors on an earlier repair that had been sharp enough to slice through someone's gloves (!!!).  The incision closing was done amazingly well.  Apparently the resident who closed is training as a plastic surgeon.  I suspect she'll have little to no scar at all once it heals up.

The plan is that she'll be released today.  I'm so happy for her!

They're Out!

The PA at Dr. Soo's office decided yesterday that she could yank both my remaining drains.  That's four drains gone!  Sooo happy.  I had no idea how much the drains were making me feel gross and icky until they were gone.  Now to ditch the binder ASAP....

Getting them out also means I was cleared to fly to Portland this morning.  We're on a 6.50 am flight.  Christmas here I come!

Yesterday was also very cool because I got a chance to meet two wonderful pre-ops before my appointment (they were going to see Dr. Crookes).  Leslie, who I'd met before and is always awesome to see and Sandy, who I met for the first time and is the most amazing lady.  God only knows what they thought of me as because of the drugs I chattered non-stop for 45 minutes, but they felt like old friends I was seeing after too long.

And then I got to meet two grad school friends for tofu soup.  Mmmm...

It felt so good to have a busy day after so long just sitting in the chair.

Home

Two nights at USC Hospital and I'm home, minus Fred and a small hernia. It was strange being back there, as my only other surgery had been the duodenal switch surgery eighteen months ago. Because the location was the same, much felt like the previous surgery, but with key differences.

First off, although Dr Kaufman was there, and visited me after surgery, he constantly made it clear that this was Dr Soo's show, in every real sense. His part was only a very small hernia repair, while she was responsible for removing the tissue from my abdomen, and deciding how the remaining tissue would be arranged. This was not as serious an operation as the duodenal switch, however it was and is significantly more painful.

I was happy to get to go home today, but leaving the hospital with four drains attached is rather disconcerting. The suggestion that they be tucked in pockets makes it look like I'm syphoning gasoline. I admit I'm squeamish, but there's something just unbelievably gross about plastic devices made to drain bodily fluids hanging around outside my body.

That said, I had a close evaluation of the surgery site by Dr Soo today, and she seemed happy with how it was healing, and reassured me that my belly button seemed healthy and would "probably not" die and fall off. The stitches go from my far left hip to my far right hip (part way around the back on both sides), and from my pubis to the bottom of my ribcage. There are hundreds and hundreds, in three layers, two of which are below the surface. All of them are supposed to dissolve, so nothing except the drains should need to be removed.

That's about it for now. Except, this is really really painful, and I feel quite fragile and useless. However, it was emphasized today that I have "good bowel sounds" all over my abdomen.

Ezpy is home

Tired and sore, but home!

Quick Ezpy update

Hi all,

Got back from the hospital late this morning for some sleep and to do some laundry. Ezpy continues to do well. As was the case when she had the Duodenal Switch surgery, she's itching to get out of there as soon as possible. She's having a bit more pain this time, but then she had an epidural for the DS surgery, and this time they've had her on IV pain meds. They want to switch her to oral pain meds today (liquid vicodin, plus morphine if the pain breaks through), plus get rid of the catheter if she can manage the bathroom. It still looks like she'll be out tomorrow (Friday), but Saturday is possible.

I did get to see the surgery wound when the doctors were changing dressings. It's big - an inverted T from about the bottom of her ribs down to the lower abdomen, and also horizontally across the front of her abdomen - but it also looked immaculate. Very neat and tidy. She has four drains, but there doesn't seem to be too much drainage - a good sign! As usual, she's craving sugar-free popsicles, but also had some solid breakfast this morning. The only minor problem she's had is that since she came out of surgery she's had little or no feeling in her hands. She can use them, but can't feel pressure or heat/cold. Her surgeon thinks this was caused by the position she was in for the (long) surgery, with her arms outstretched away from her body, and hands dangling somewhat. She did seem to be getting some feeling back in the fingers this morning, so it's not a worry.

Okay, that's all for now. More tomorrow, perhaps dictated by Ezpy herself.

Paul

Surgery This Morning!

So I've been really terrible about updating this week.   

The news?  I'm about to leave for the hospital.  I did all my intake work and testing yesterday, met with Dr. Soo who spent almost two hours measuring and drawing lines on me.  My plastic surgery starts at 7:30 AM and is expected to last until late afternoon.

Paul will update this later when I'm recovering!

Complications and Side Effects

Weight 180.3

I probably should have written this a while ago.  But it was like I needed to know the end of the story before I started telling it.  And now I do.  So where to start?

First, with the reminder that weight loss surgery, whether RnY or duodenal switch or whatever, isn't a minor or trivial thing.  Those of us who've opted for surgery have made major (and to a degree irreversible) changes to our body's plumbing.  Not something to do without knowing that there can be very serious consequences and, at the very least, that we're going to need a life-time of follow-up lab work.

So, as many of you know, my sister Eloise had RnY surgery on Valentine's Day, 2005.  She's lost over 200 pounds and, generally speaking, seemed to be having a great recovery. 

Except that she ended up being one of the people who can't absorb vitamin B-12 post-op. 

Not to worry.  She was given / prescribed fast dissolving supplements.  But her testing 3 months later showed that the B-12 levels were still falling.  So she started on B-12 injections.  Those didn't work either.  By June her B-12 levels were critically low and the side effects of that were causing terrible and scary things to happen: irregular heart beat, extreme fatigue, anemia. 

Not good.  Her doctor told her she could have a heart attack at any time and said she couldn't work.  Eloise is paid hourly and, though primary caregiver to my nephew, must work or risk losing health insurance as Ohio has no domestic partnership laws. 

Just before she came out to Oregon for my grandmother's 100th birthday party, the doctors tried the first of many IV B-12 treatments.  Three months later we know they're working.   Had they not, Eloise would be looking at needing her surgery undone -- a process that, given her state of health, had its own risks.   

Right now it looks like she'll be needing these treatments 2 - 3 times a month for the rest of her life.  Fortunately, though her RnY surgery wasn't covered under her health insurance, this treatment is. 

But what's really important to remember is that complications can happen to anyone.  Though she eventually ended up feeling bad, this B-12 problem started when she was feeling great.  Had she not been being good about her follow-up care, she might have had a heart attack or suffered other permanent damage before the problem was caught . 

So don't forgo follow-up care.  Please.

And me?  So far as I know I have only side effects -- namely a small hernia and a huge amount of excess skin.  But I've got my 18 month follow-up come the end of the month!

A Century and a Half!

Weight: 206.6

On March 24th, the morning of my duodenal switch surgery, I weighed 357 (which was down 10 pounds from my high weight at my PCP's office in November of 2004).  This morning (yes, I still weigh everyday) I'm 206.6 which means I've lost over 150 pounds since surgery and 160 from my high weight.   I'm so excited.  If we had the cash right now, I'd try and see if I could talk Paul into a trip to Disneyland to celebrate. 

After trying the scale again 4 times just to be sure, I took a picture of the numbers as I did on September 10, 2005, the day the scale said I'd lost 100 pounds. 

Wow!  Even though it's felt like the losses have slowed down, I've lost this last 50 pounds in just over 4 months.  And check out my BMI.  While I'm still considered "obese" I'm no longer "super morbid" or even "morbid"-ly so. 

No Disneyland today.  I guess I'll have to celebrate with Law and Order at the gym.  ;-)

Just for fun... on the left is a picture of me last year on our wedding day.   It was the closest thing I allowed to a "body shot" -- but you'll have to trust me when I say that the size 4X dress barely used to reach to my ankles.   

And on the right is a picture Paul took of me today in the same wedding dress (though sadly without the lovely flowers).  Six inches of the dress now puddles onthe ground around me and it was all I could do to keep the neckline from plunging beyond decency.

Part of me is kind of sad that it just doesn't fit at all anymore.  As you can read in an entry on my other blog (which has definitely suffered as this one has gotten more and more of my attention) I went through an awful lot trying to get the dress on-time for our wedding. 

That said, I'm obviously not sorry to be down 160 pounds.  And it's great not being a 4X anymore.  These days I wouldn't have to go through all that hassle to get a wedding (or any other kind of) dress at short notice -- I could go into a store and actually try something on and buy it off the rack. 

PS.  Seems like it's a day for celebrations.  Check out Kim on her 6th month DS anniversary!  Isn't she beyond gorgeous?  Go Kim, go! 

Back at Work

Weight 210.0 

Yesterday was my first day back at work.  It went really well with all sorts of people commenting that they could tell I'd lost weight.  That left me a bit confused.  I have lost weight of course, but mostly not in the 3 weeks since they last saw me.  I ended up feeling so confused that I called Paul to ask about it.  He came up with the very obvious solution that break had them looking at me with fresh eyes.  I'm not sure he's right, but I'll take it.

I felt pretty good yesterday and was eating really well and managed to get 80 oz of water in just at work (so I was kind of being paid to pee, but whatever).  Then 4pm hit and with an hour to go at work my body suddenly realized it was midnight.  Dragging myself home was hard and I ended up in bed at 8pm.   

Guess that's one way to avoid eating at night.

Replying to someone on a message board yesterday, I thought about what my recommendations would be for someone who was pre-op.  At first I was about to pull out my standard advice about getting started on walking and taking before pictures, but then I realized that to the degree I've had success post-op (and it's really weird for me to think of my experience being inspiring to anyone), it's been because I've had the opportunity to focus on myself.  This was especially true in the first few months after surgery.

So here's what I wrote for what it's worth:

My suggestion is one that probably isn't possible for a lot of people, but I know it made a HUGE difference for me.  It's to give yourself as much time as possible to recover.  Not just for your wound to heal from surgery, but for your head too.  Learning a new way to eat is HARD work. Food means so many things to me,  not least of all is comfort.  I'm still struggling with finding comfort other ways.  But for the first few months I really babied myself emotionally and avoided stress the way a cardiac bypass patient might.  I took lots of walks, wrote in my blog and a private journal and really was in touch with how my body and mind were doing.
 
I was lucky in that while we don't have much money, my being a grad student allowed me to focus on recovering for those 3 months until I felt really strong. 
 
So I guess my advice to a pre-op is not to take this lightly.  You're about to embark on an adventure that changes so many things.  I've really enjoyed this process, but it's painful too.  I don't think we should expect to feel "normal" in a couple weeks or even a month. Probably some people do, but I know I'm still sort of finding my way both out of my fat security blanket and figuring out how to cope with stress without eating sugar.

That's it for now.  I think I'm going to get Paul to take my measurements later today.  If so there'll be another post.