"Though we travel the world over to find the beautiful, we must carry it with us or we find it not."
-Ralph Waldo Emerson

Wednesday, January 27, 2016

My Surgery and Recovery Story

My Surgery and Recovery Story

I wanted to share my story with others because my recovery involved complications.  First I want to say that bariatric surgery--of any kind--is NOT the easy way out.  It is a difficult road, and you still have to do all the work.  Yes, it is an invaluable tool for weightloss.  The surgery gives you time to set up good, healthy eating habits.  It causes restriction on the amount of food you can eat, helping you control your portions.  You get full very easily.  You lose weight fairly quickly at the beginning, which gives you encouragement and belief in yourself that you can do this.  I cannot even begin to tell you how amazing this tool is.  But it is not easy.  I still struggle with the desire for food--for that quick fix for everything.  Food was my coping mechanism, my way of feeling whole and satisfied in every way possible.  I can no longer turn to food for that fulfillment.  I have to turn down types of foods that I really enjoy because I know they are not a healthy choice for me, or because I know I will have trouble controlling my eating.

With that said, let me tell you my story…

I had researched bariatric surgery for 2-3 years before my surgery date.  I even did Ideal Protein for a number of months as my kind of last chance with diets.  I had to save up my own money for the surgery since my insurance specifically excludes bariatric surgery.  I read books, articles (scientific and personal), and read through blogs and forums for information.  I did my homework.  I attended information sessions at the hospital and at the surgeon’s office.  I know two other women in my circle of acquaintances who have had the vertical sleeve.  I asked questions and put together an information binder for myself.  I saved and I planned.

Once I had the funds I made my consultation appointment with my chosen surgeon.  Let me point out here that I researched my surgeon too.  I chose one who was well-known and respected.  I chose him because he was a Surgeon of Excellence with the Bariatric Board, and also because his office offered BLIS insurance for self-pay patients.  I should also point out that if you’re self-pay, the process is a lot faster.  I could have had my surgery within a few weeks of that initial consult, but I chose to wait until after our family vacation last July.

I had no issues with anything leading up to the surgery.  I had all my appointments and tests and there were no issues.  I also didn’t have too much difficulty with my two-week pre-op diet.  It lacked variety, which kind of sucked, but I was also excited about the surgery so I was able to get past it.  I told only my closest family and my boss about the surgery.  I only told one friend in advance because I knew she wouldn’t judge me.  I didn’t tell any of my co-workers.  I was trying to avoid any negativity going into the surgery.  I did intend to be absolutely honest about my weight loss once people started asking questions.  I planned to tell people about the surgery--I’m not ashamed of it.  It’s a personal decision and I absolutely understand why some people choose to be a little less than honest about how they lost weight.

So I had my vertical sleeve gastrectomy on August 31, 2015.  The surgery went fine with no initial complications.  I stayed overnight in the hospital.  Yes, there was pain that first night.  It was not fun to get up out of the bed to pee or go for a walk.  But I eventually managed to do both.  I was released the next day and went home to recover.  I think everything for me was pretty normal that first week.  I tried to walk a little every day--even if it was just around the house or up and down the driveway.

Monday, September 7, was Labor Day Holiday, but I did return to work the following day on Tuesday, September 8--only one week after I went home from the hospital.  I took it easy those four days and I was super tired.  The recommendation for recovery is 2-4 weeks, but I have a tendency to return to work early.  I didn’t want to use up all my leave and I figured if I didn’t feel well then my boss might allow me to work a little from home.  I always worry about taking advantage.  I did okay that week too.  I didn’t really notice any problems.  I was pretty exhausted, but that’s to be expected with so little calories and a liquid only diet.

That weekend I started feeling kind of bad.  I felt really tired and I had a bit of a stomach ache.  I returned to work on Monday and just felt kind of blah.  Tuesday I called in sick.  When I was getting ready for work that morning I had felt a horrible muscle cramping near my stomach--I almost fainted from the pain and panic.  I told my boss that I think maybe I had overdone it.  My husband had to drop something off at work for me and he spoke to my boss about my being worried about missing any more work.  My boss commanded that I take off the rest of the week to recover.  Have I mentioned that I have a fabulous boss?  I also called my surgeon because by that point I was not getting in all my fluids.  I would feel overfull from just a sip and I felt yucky.  My surgeon suggested that it was probably just a cramp from where they stitch the muscle from the surgery, but he also suggested that I could go to the ER to have it checked out just in case.  The ER he recommended was a hospital about an hour from where I live because he is a surgeon there plus they accept the BLIS insurance.  He didn’t seem terribly concerned and I held off.  I figured that I had just overdone it and just needed some rest.  Plus I wasn’t sure how I could get there.  My husband and I share a car and he had to work that week.  So I just waited.

By Friday there was no improvement and my surgeon called me back to see if I was any better.  When I told him no, he highly recommended that I go to the ER that day--preferably before noon so he could look in on me.  I started feeling a little concerned, but at the same time I didn’t want to inconvenience anyone.  My husband was at work and wouldn’t be home until early evening.  My mom was working and although she’s flexible I knew she had planned to leave work early that day to drive out of town to babysit my niece and nephew.  When I talked to my mom, though, she expressed worry and offered to take me.  At first I turned her down, thinking I would wait until she got home on Saturday or Sunday.  Then I gave myself a quick kick to the pants and called my mom back.  I knew that I wasn’t feeling well and was probably dehydrated.  It would be a bad idea to wait a couple more days.

It was early afternoon when we arrived at the ER.  They took blood and sent me for a CT scan.  I waited a long time for the results--I think it took a few hours.  Then they told me they would be admitting me--the CT scan showed an abscess near my stomach.  The abscess was about the size of a softball.  No wonder I didn’t feel well!
The following six days were really pretty terrible.  I will try to remember the details of my complications as best I can, but so much happened.

They decided that they would do a CT-guided drain rather than open me up and do one surgically.  The thought was that with the CT, radiology could thread the drain tube in precisely where the abscess was.  Let me just say that this was excruciating.  Although there was some pain management for the procedure, I could feel everything and it was horrible.  I remember moaning and crying out in pain during the whole thing.  It was horrible--probably the worst experience of the whole situation and up there with my two or three top worst experiences in my life (and I’ve been through a lot of pain in my life!).  I could also hear the radiologist say something about what was coming out being brown.  All I could think in that moment of pain was that maybe they pierced my bowels.  I remember that something smelled off, but I was very out of it--I was totally wrapped in my pain at the time.  Well, they didn’t pierce my bowels.  The abscess was a hematoma--infected blood.  So that explains the dark color and the bad smell.  They drained what they could at the time and left in a drain for the rest.

When they wheeled me back into my room afterwards, I remember I could hear the voices of my family, but I just kept my eyes closed.  I couldn’t deal with them or with anything.  I moaned with pain.  I was in a lot of pain for a number of days following the drain.  During that hospital stay, one of my blood cultures came back positive for staph, so then they had to redo the cultures and I was put on some crazy antibiotics.  I was just miserable.  I didn’t sleep well.  I was in constant pain.  The pain meds didn’t last more than an hour or two.  They had to switch my i.v. because my vein started collapsing.  It was horrible.  I was miserable and I just wanted to go home.  I was told that with the staph I would need a central line and I’d have to be on i.v. antibiotics for 2-4 more weeks at home.  Well it turns out that the first culture was wrong--I didn’t have staph!  Yay!  I stayed in the hospital for six nights and was sent home.  I was told that I should feel better in a few days.

A few days later I was not feeling better.  I still felt horrible and really wasn’t having much to drink.  When my symptoms hadn’t really improved, my surgeon sent me back to the hospital for a CT scan with contrast.  I will pause here to express my dislike and fear of needles--especially i.v.’s.  I’m irrationally terrified of needles and my previous hospital stay had not helped my fear.  So I was freaked out a little about the contrast.  They went ahead and did an i.v. for it.  The scan came back that the abscess had returned :(  So the surgeon on-call came in and performed outpatient surgery on me that same evening to put in a drain laparoscopically.  I was disappointed and upset that they had to go back in and that I was still so far from being recovered, but at least I wasn’t being readmitted!  And I will say that although it sucks to have surgery of any kind, this was waaaaaaaaaaaaaaaaaaaaaay preferable to the CT-guided drain.  

I went home and was told to expect to feel better in a few days.  Once again I wasn’t recovering like I was supposed to.  Six days after the drain was put in, I saw my surgeon for a check-up and he was concerned.  He didn’t like the color or the amount of stuff draining.  Plus, I still wasn’t getting in the fluids that I needed and I still wasn’t feeling well.  They had me wait at my surgeon’s office while the hospital prepared a bed for me to be admitted.  I was in tears and horribly upset.  I had had such a bad experience during my last stay, and I just didn’t seem to be getting better.  I was admitted to the hospital.  This time the CT scan showed that not only did I still have fluid draining, but now I had a small stomach leak.  When you have a stomach leak after bariatric surgery, they can’t just go in and stitch it up--your new stomach won’t hold stitches well.  So instead they decided they would put a stent in my stomach to stop the leak and to protect the stomach while it healed.  In the meantime, a nurse showed up at my room to pick me up for a central line.  I totally freaked out!  I’ve mentioned my absolute fear of needles and this was a much crazier i.v.--in my neck!  I was terrified and I had a total meltdown.  They backed off immediately.  It seems that they thought I had been informed about the procedure when I had not.  I calmed down and even spoke to my sister-in-law (an ob/gyn) who explained what a central line was and why it would be beneficial for me.  Not only could they “feed” me proteins and fats, but it would mean that they could draw blood without my regular i.v.!  That means no more collapsing veins!  So I calmed down and told them I was willing.  They still held off another day--I think I scared them with my freak out.

That stay was the longer stay.  They put in the stent and I was on the central line.  Let me say now that the central line was awesome.  My pain meds would go through so fast!  I would be asleep before they even finished putting the meds in the central line.  Plus they were able to give me vitamins, fats and proteins so I was finally getting some nutrition!  I think my only problem at that point was that I felt pretty nauseous from the stent.  By the end of the stay they also had to remove the central line (which was a little scary too).  My veins would burn when they’d give me pain meds.  So by the time I left the hospital, I was ready to go home.  I honestly don’t remember how long I stayed at the hospital that time.  I think it was about 10 days, but it may have been more like 12 when I look at the calendar.

I finally had my final CT scan a couple of weeks later and it came back clear!  It was such a relief!  Once the drain was out, I started feeling better and could finally start eating.  I stayed home another couple of weeks and then returned to work.

It was an interesting and difficult journey.  I did not expect complications when I went into this surgery.  I just assumed I’d make it through okay.  And I was lucky that I did okay considering the complications I had.  That original abscess could easily have killed me.  I feel incredibly lucky.  I am also very thankful for everyone who supported me during the whole damn thing.  I have even made “Gratitude” my word going into 2016.  I have written lots of thank you notes and created gratitude gifts for everyone who stood by me.  I think that I have put so much of myself into becoming healthy in part due to the horrible experiences I went through.  It’s even more important to me that I not waste this opportunity to be healthy.

I will write again soon about my weight loss and what I’ve been doing.

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