3 weeks after surgery

You may be wondering how I have been doing these past few weeks. For the most part, okay. There are many adjustments I've had to make so I'm just going to list them as they come to mind: 

1) Food intake - At 2 days after surgery, I could start intaking more than just clear liquids. For 12 days, my daily food intake pretty much consisted of one protein shake (Orgain 11 oz. Chocolate fudge), 1/3 cup of Oikos Triple Zero Vanilla or other flavor Greek Yogurt, 1/3 cup of Sugar-free Jello, 1/3 cup of chocolate pudding, and sugar-free popsicles. I drank water and water with Stur (a stevia-sweetened flavoring). I was getting between 300 and 400 calories a day. At day 15 after surgery, my daily food intake changed to 1 protein shake in the morning (consumed over an hour or so), 1/3 cup of mixed blueberry Mush (prepackaged overnight oats) with Greek yogurt, 1/3 cup of low-fat cottage cheese or goat cheese, 1/3 cup of pudding, and another 1/2 of a protein shake at bedtime. I had a bit of scrambled eggs and cheese at a breakfast I went to over last weekend. I can start eating more mushy foods now like mashed potatoes and canned peaches. As of 4 weeks, the stomach stitches will be healed and I can return to normal foods as long as my stomach tolerates them and in very small quantities still.

2) Medication intake - This was probably the most unexpected change. I usually took 4 or 5 pills at a time in the morning and at bedtime plus a few others throughout the day. I now need to space them out to keep my stomach from hurting. I also have to take 2 chewable bariatric tablets (think large bulkier Tums) twice a day for the rest of my life and a special pill to stave off gallstones twice a day for 6 months. I have realized that taking them with a protein shake instead of water does help a bit. As far as pain medication goes, I took Dilaudid at night for the first 6 nights and liquid Tylenol during the day. I don't take any most days now.

3) Incision healing - The small incision in my upper abdomen is pretty much fully healed and has no pain. The 4 incisions in line with my belly button are bigger and are taking longer to heal. The surgical glue is still attached to at least part of each incision and there are sizable lumps under two of the incisions. The doctor said "they will improve" when I asked him about it. The lumps are a bit painful and noticable, especially the biggest one when I bend over,  but overall it is much better than it was right after surgery when it hurt every time I stood up. The surgical glue is supposed to come off by itself eventually.

4) Work and other activities - I took off work until 6 days after surgery and then eased back into it. Due to the low calorie intake, my mind is still a little spacier than usual but it is getting better over time as it gets used to the new calorie level plus starting the bariatric vitamins on day 7 was very helpful. I volunteered at the performing arts center 11 days after surgery and that was probably not the best idea but it was the national tour of MJ: The Musical and I actually trained my first volunteer in training that shift as well. I wore an abdominal binder to make the incision area less bouncy and that along with standing through the show took a lot out of me. I need to start walking about 10 minutes a day to help with my stamina.

5) Weight change - I've lost 20 pounds so far so about 1/5 of what I want to lose. I was warned that the fat I'm trying to lose is full of hormones since I gained it in the last few years. This means that I may feel depressed or at least not as elated as I think I should feel by losing the weight. Right now, I feel like I'm just too tired to celebrate much. I was also told that feeling like a truck hit you is common for the first month or so. I agree that's pretty accurate.

I have no regrets about having the surgery. I just need to be patient with my recovery and food intake retraining.

Thank you all for the well wishes and for following my journey. 

Blessings and love,

Jennifer

Bariatric Surgery Day and the day after

My surgery was on September 2nd at 8 am at Baptist Floyd Hospital. My arrival time was 5:30 am. So John drive me there. I went in to check in. He came in until my make was called and instead of making him wait for them to call him back before I went into surgery, I just told him to go home. I'm not one for having people wait for me plus my last 2 surgeries didn't really let family members stay (2021 and 2022). 

They asked me to wipe down my belly and really clean out my belly button with surgical wipes. Then I just laid there as the pre-op nurse took vitals, hooked up heart monitoring stickers and leads, and 2 IVs were started and kept on my left arm (one was on the top of the hand and the bigger one was on the forearm underarm area).

The registration person from the hospital got me registered for surgery. I got my advance directive scanned and will be included in my medical record as well. The anesthesiologist, the operating nurse, and the doctor all came in to make sure I was me and I knew that plus why I was there. Luckily, I answered all of the questions correctly. 

Then I was wheeled to one of the furthest surgical rooms (at least it seemed that way). They checked my name, etc. again and then they put medication in my IV that put me to sleep. I woke up in recovery around noon. I was very sleepy and kept falling asleep. They didn't have any postsurgery inpatient rooms available until around 3pm. Everyone working in the recovery area was wonderful. They had compression devices on my legs and I had an oxygen tube plus the IV fluids. I could not focus my eyes on any text on my phone, probably due to the pain medication. I was also wearing a large abdominal binder which stayed on the whole hospital stay. 

When I got up to the room (4120), I met my day nurse and medical assistant. They set me up in the recliner type chair with a pulse ox meter, took my vitals and gave me a Gatorade. It was a huge single room. Felt like I won the lottery or something. Then John arrived and stayed until 4:30 when he had to leave for a meeting. The staff gave me painkillers when I asked for them and I even got a lunch tray.... Jell-O, decaf iced tea, chicken broth, and a small bottle of water. I got nauseous after eating a couple of spoons of the Jell-O  but didn't vomit. I then got some Zofran antinausea medication. I was ambulatory, walked to the bathroom and a little around the room. Then I got a dinner tray with the same items. I ate half of the Jell-O this time. John came back from 5:30 to 7 and I walked some more. Then the night nurse, Christine, and medical assistant, Sheila, arrived. 

Christine came back in about 8 pm and was surprised that I was not on any IV fluids. I was moving myself to the bed at this point. So she set up the fluids, set up the compression devices on my calves, and had the medical assistant set up the heart monitoring leads. She made sure I had everything I needed, including more Dilaudid. I feel asleep until 2:30. Then I rang for help to the toilet (with the IV) and Shelia came to help. Once that was done, I mentioned going for a walk and Christine unhooked the IV and I took a walk around the whole floor. Got some more painkillers. The other excitement was that I tooted which showed my digestive system was working. 

I slept again until 7:00 am when the shift change happened. I was given a vitamin B12 shot and some folic acid via the IV. I got another bottle of Gatorade and a breakfast tray. I walked around a bit more. Then the doctor came by around 10:30 am. He said everything looked great and put in my discharge orders. John arrived around 11:00 am. 

The home prescriptions were delivered to my room. A medical assistant came in and read off the discharge instructions. My IVs were removed by a wonderful medical assistant. I got dressed and we headed home. We arrived around 12:30 pm 

I made it into the house and then sat down on the couch and zonked out.

 After that nap, I opened up two packages that were waiting for me. My best friends sent me a robe and slippers for my recovery (see picture at top). 💜

Then I slept some more, ate a bit of Jell-O, and 3 sugar-free Popsicles plus sipped lots of water. I watched some TV with John and Rose and then zonked out again on the couch. Around 2:30 am, I took my first Dilaudid and went to bed. I tried lying down without the binder on and my belly said no. Even with the binder on, It hurt at first but was fine once the painkiller kicked in. 

My Bariatric Surgery prep

You may be wondering what preparation for bariatric surgery looks like. For me, I didn't have to lose any weight before surgery, at least my insurance didn't require it. This may have been due to the fact that I have followed a weight management plan within the past 5 years and lost weight with it or because my BMI was lower than 50. Some folks have to do this for 6 months before instance improves the surgery. I did have to pass psychological screening to make sure I didn't have a binge eating disorder or other eating concerns. 

The bariatric surgery program recommended i start changing eating habits in advance of surgery. Most of them followed information provided by previous weight management plans I have done. Others were new, such as cutting up meat into "pinky nail" size pieces, sipping drinks, avoiding carbonation, avoiding straws, eating protein first, etc.

There was a group class about 3 weeks before surgery. This consisted of going over educational material for the surgery including prep and post-op expectations (all already given to me in a binder with my name on it). Plus, there was a weigh in. 

A few days later I got the call from preadmission testing and was told what vitamins, supplements, and medications to not take for the next 2 weeks. This included multivitamins, fish oil, Vitamin D, and caffeine (which I took to offset the drowsiness of other medication - I stopped my diet Coke habit last year). Then I went in for lab work last Monday (all normal). 

For the last 8 days, I have been following the required week before surgery diet which is designed to reduce the size of the liver. It consisted of 3 protein shakes, 4 oz of lean protein, 1 cup of vegetables, and one 100 calorie or less snack (String cheese is my snack of choice) per day. It consisted of at least 100g of protein a day but only about 600 calories a day. 

Last Thursday, 5 days before surgery I had to go in and make sure I had lost weight, ideally 5 pounds. My body overachieved and lost 7.5 pounds.

As a result of the diet, my brain has been spacier than usual. For example, I missed posting on Facebook about my oldest's birthday yesterday,  I've placed numerous Kroger orders this week because of forgotten items, and work tasks took a bit longer than usual. But now hopefully my liver is out of the way of my stomach.

Today, I have eaten Triple Zero Greek yogurt so far and will have 2 protein shakes before 3 pm then it's just water, sugar-free Popsicles, and sugar-free Jello until midnight. Plus I get to have 20oz of Gatorade Zero before I leave for the hospital. I report to the hospital tomorrow at 5:30 am for an 8 am surgery time. I will pack my hospital bag later today and take a shower tonight and prep with medical wipes. I will have to pack up my CPAP machine in the morning as I will be staying overnight in the hospital tomorrow night. I haven't done that as a patient in almost 20 years. 

Overall, I'm feeling pretty chill about it all. I'm just hoping for a successful surgery and uneventful recovery. Wish me luck!

What's Next? Bariatric Surgery

In February, I attended a webinar about bariatric surgery options at my health care system here in southern Indiana. I asked the surgeon, Dr. Gore, at the end of the session if he had any patients with Hypermobile Ehlers-Danlos Syndrome and he said he did and they did well. Then I asked him about the pancreatic enzyme insufficiency I have been diagnosed with since January 2024. He said the Gastric Sleeve Surgery would be best as it only involves operating on the stomach and not other organs (including the pancreas) as well. 

I looked into it some more, filled out the paperwork, and attended the information class in April. They gave me a binder of information and I had a consult with Dr. Gore after the endoscopy and lab work was completed. It turns out I am a good candidate for the surgery. Plus, since my BMI is over 40, my health insurance covers it and I've already spent my deductible and maxed out my out-of-pocket expenses this year, so the surgery itself has no expenses.

I am doing this surgery for the following reasons: 

1) I need to weigh less to prevent diabetes (I am prediabetic now) and I have lost over 100 lbs in the past (Dec. 2020 - Jan.2022) and could not maintain the weight loss. I have close relatives who are or were diabetic so I'm at a higher risk.

2) When I gained all of the weight back this time (between March 2022 and November 2023), it landed in my midsection instead of evenly distributed as it has been the rest of my life. (Thank you menopause). I now resemble what my aunts and grandma on my mom's side looked like at my age and they had health problems later in life I'd like to avoid if possible.

3) I'm really hoping that keeping the weight off will help with my joint health and with recovery from the future surgeries I will have (I already know of one I need, and 2 possilbe others). 

4) I worked with a dietician for most of 2024, after I was diagnosed with the pancreatic enzyme insufficiency in January of that year and now have figured out the foods that do not upset my digestive system. I have maintained the same weight - within 5-10 pounds for over a year so I feel I'm in a good place to be able to maintain the weight loss I will have as a result of the surgery and postsurgery diet. 

5) When I moved to Indiana in 2023, I chose an NP who worked in a DO's office as my primary care provider. She was sweet as can be but she was way into Wegovy and how it would help me with weight-loss and heart health. Due to insurance not covering Wegovy, she got Ozempic approved and I tried it in early September 2024 and felt awful with heartburn and reflux after the first dose (0.25) which was only 1/4 of the regular dose. It took a week to feel back to normal so I didn't take a 2nd one. Then I found out that my NP had left the practice. So, I got a new primary care NP and she told me that people who suffer from heartburn don't usually do well on GLP type drugs. I've had heartburn since I was a child so I never really should have tried it or been prescribed it.  

I hope you see that I have put lots of thought into this decision. I'm now one week away from surgery (September 2nd) and only wish for positive thoughts and prayers in the coming weeks. It will take about 4 weeks to get back to my normal foods, though some soft foods will be allowed sooner. I hope to share my progress with y'all.

Happy heavenly 80th Birthay, Dad!

Happy heavenly 80th Birthay, Dad! 

My dad had always said that 80 was a good age to die because you're still young enough to not be SO old. He felt that, at 80 years old, he would be ready to call it quits before things got too bad. He didn't make it that far - he died last year at 78 (which was a blessing considering the Lewy Body Dementia). 

I always thought that 80 was a pretty young age to want to call it quits but when you lost your wife (my mom) over 3 decades before, it made some sense. In reality, however, most of the people in my dad's life didn't live past 80. 

His mom, Alice, died at 75 and his dad, also Fred, died at 84 in January 2004, but also had dementia (probably Lewy Body) for his last 4-6 years. The last time I saw my Grandpa Jewell was at my Grandma Kelly's funeral (my mom's mom) in December 1998. We were a bit concerned that he would make it home okay on his own, but he assured us he would and he did.

My Grandpa Jewell had 2 brothers (George & Bill) and a sister (Marie) and only one of them lived past 80. His Uncle Bill was 86 when he passed. My Grandma Jewell (Alice) had 3 sisters. Her older sister, Agnes, died of tuberculosis at 22 and my grandma got TB from her. My grandma lost a lung and spent a lot of time in sanitariums in her 20s and 30s. Of her two younger sisters (Sylvia and Virginia - called Babe), the youngest (Babe) died when Babe was 28. Sylvia lived a few months longer than Alice did and died at 76 years old. 

Looking at these facts, I am now not surprised by some of my grandma's behavior that I thought was odd. She always said she would not live to see my brothers' or my next big accomplishment - graduate high school, graduate college, get married, have kids, etc. - and she always got all over her sister, Sylvia, about what she ate and her health. With her other two sisters dying so young and having lost a lung to TB, she really beat the odds making it to 75. So her behaviors and thoughts make more sense to my 52-year old brain. By the way, all three of us grandkids were college graduates, married, and two of us had a kid before she died.

My dad grew up in the household with his mom (when she was healthy enough to be there), his dad (after WWII - which ended when my dad was 2), his 2 aunts, and his maternal grandma and grandpa. My dad's maternal grandma, Joan (Jennie), pretty much raised him as a young child and through his youth. She died at the age of 61 when my dad was 17 (another reason for my grandma to think she wasn't going to live as long as she did). My dad's maternal grandpa, John, was a Polish immigrant and he lived to be 83. I remember Great-Grandpa Janus as a bald and intimidating man who didn't smile much. I was 4 when he died and he's the only great-grandparent who was alive when I was.

Looking at his paternal grandparents, my dad probably didn't even know them well. His grandpa on that side (Dyer) died at the age of 63 in Michigan when my dad was 7. His grandma on that side (Mabel) died at the age of 69 in the Chicago area when my dad was 14. 

So, to sum it up, only 3 people in my dad's biological family lived to be older than 80. They were all men, which in itself, is surprising.

Being heavily involved in church communities for almost 30 years, I've learned that 80 is not that old. I know many, many vibrant, with-it, and active 80+ year old folks. Many of them have become friends, surrogate moms, or grandparents in earlier years. Of course, I wish my parents had been healthy enough to live longer. Cancer and dementia both suck (though my dad was blessed to die of a pulmonary embolism before the dementia debilitated much more than his very unique brain...which was bad enough). 

So, I remind you to hug those you love and appreciate the older people who bring you joy and happiness. May they live longer and healthier lives than most of my recent ancestors - at least those on my dad's side.

COVID-19 - Bleh.....

Well, it finally happened. One of us got COVID-19 and it's me. I'm doing pretty well, all things considered. I thought I had gotten the "cold" that has worked through everyone else in the family starting with Jonahtan, then John, and then Joanna. Everyone else had tested negative at different points throughout the month.

I even felt a bit better on Monday and Tuesday, but I had a pre-op doctor appointment scheduled for Wednesday afternoon. So, I was a good person and did the at-home COVID test that morning and behold it was positive. Woohoo!

I quickly moved into the bedroom over the garage which is our most colorful room of the house at least - two pink walls, one yellow wall, and one blue wall. I've had 2 out of 3 of the cats come visit. I have gone with a mask on to the bathroom and downstairs when no one else is home (followed by Lysol being sprayed).

The room is the one I have worked on the most in the last month in preparation of moving. It is the room Joanna lived in before moving downstairs in fall 2019 when Rose left for The Evergreen State College. Although, many toys were given away before that day, not everything was. The fall of 2019 included the whole family being involved with a beautiful production of Les Miserables. Joanna was in the ensemble, John was the sound designer, Jonahtan ran the spotlight, and I volunteered in lots of other capacities. My dad and Mary were still in independent living at Waterford Terrace but needed weekly medicatoin management and help with anything Waterfod did not provide for them. They actually came to the performance with my brother Andy when he came to town. 

Then there was a holiday show at Young Actors Theatre and then Matilda in February where Joanna was one of John's sound operators instead of in the show. However, I still did all my normal volunteering. So, when the pandemic hit in March 2020, some of our lives stopped, the theater part, but the remote church part got much busier for John and myself. Therefore, I was not the type that used the "shutdown" for cleaning out the house as I never lost my job (blessed) and I was taking care of my dad and Mary as described.

That makes this house cleaning out quite the task. This room had a combination of toys, memorabilia, old school items, various odd and ends from around the house, and outgrown clothes. I spent time going through it all in case of missing some important memorabilia or toys that we wanted to keep for little ones that may come over once we are in Indiana. In the end, we had 8 boxes of items to give away to the Disabled Vets, 1 box of Monster High type dolls for a friend, 2 large garbage bags of trash, 2 large garbage bags of recycling, and a couple of boxes worth of stuff important enough to keep.

However, havnig this room mostly cleaned, with all of the furniture drawers cleaned out and the bunk beds cleared off, has allowed me to move into it quite comfortably all things considered. I have turned Joanna's small desk/vanity into a computer area with my tablet playing "Criminal Minds" on Hulu in the background. 

Plus I have a drawer filled with water bottles, kleenex, Extra-Strength Tylenol, Diet Coke, Canada Dry Ginger Ale Zero, and other necessary items. For the most part, I'm feeling mainly just fatigued and achy. There is nasal congestion and a cough. No fever, still can taste (yay!), praying for no long COVID. I checked in with my primary care doctor's office who asked me about my symptoms and did not recommend that I take any anti-viral medications so I'm hoping that's the right call primarily due to any long COVID issues that can surface later. 

I leave you with the view of the door from the bed and Bubba watching to see if any cats come in through the cat flap. Hoping I can leave isolation soon.

One Year Later

A year ago my life changed dramatically. I went from being a caregiver of a parent to not being one very quickly - had plans to go see Dad and Mary that afternoon and received a call from the memory care nurse at 11:53 am that I needed to come right away and he passed before I got there 30 minutes later. Even though my dad didn't live with us, his presence in my daily life had a huge impact on my family and I for 3 years and 7 months. His last four weeks on this planet were documented on his CaringBridge page (caringbridge.org/visit/fredjewell-justme). The support received through this page and elsewhere was greatly appreciated. 

My father was primarily a nomad a lot of his adult life. Even if he had a place to call home, he traveled for business a lot. Mom died from breast cancer when I was a freshman in college in early 1988. That summer, my dad moved from the rental house we had with her to an apartment and then into a condo he bought a few miles away in 1989. That was his bachelor pad with a 2nd bedroom upstairs for guests. There was no consistent contact with a home base for me after my mom died - no set weekly phone calls with my dad, no relying on him for any basic needs aside from some monetary funds or help moving the 5 times I moved when in college like some dads provide, not even set birthday celebrations or anything like that. My mom's family worked like clockwork for celebrations down to knowing who hosted which event each year until my grandma on that side passed away in 1998, 10 years after my mom did. That was the same year that my dad retired and abandoned having any home base for about 10 years. My kids didn't grow up going to visit grandpa's house. My dad showed up here for 3-4 weeks once a year and lived with us - many times when the kids were starting back up at school in August. He hoped that the kids connected better with him this way than short visits throughout the year. I think that worked better for my brother Andy than it did for me since Dad loved Oregon and they'd do minivacations while he was there. Dad was worn out when he arrived here and was ready to diet. The kids, especially Joanna, usually enjoyed his traveling companions more than him on his visits, especially Mary, who would play with them at their level. These visits would add stress to the family dynamic and throw the kids' routines out of whack, on top of the stress of school starting. The last such visit was in 2015. In 2016, he only stayed a week and he was already showing signs of Lewy Body Dementia but we didn't know what it was then. When he did establish a home base in 2009, it was 3,000 miles away. We went there as a family once in 2010 for a couple of days between Disney World and Washington DC on a 2-week trip. 

Although Dad's death was a blessing considering how awful Lewy Body Dementia made him feel and function and my life is considerably easier since his passing, I guess I miss him and his huge personality. I know he loved me and having one less person in the world who loves you has an impact. 

Since before his death - probably in a large part due to the pandemic - I've felt disconnected from everyone except a few close friends (local and faraway) and my kids and husband. This feeling is what led me to a strong belief that I needed to return to the Midwest. It hit me like a wave in January 2022 after I returned by myself from Indiana - a week before John and Joanna did. John's dad turned 90 on January 2nd and we were there to celebrate with all of my husband's family who live in Indiana. John and Joanna stayed to spend more time there and visit some colleges. I am incredibly grateful that John listened to my feelings and that we are moving to Indiana but wish there wasn't so much to do to make that happen. But we'll get there.

Leaving San Diego will help my healing journey as well since this place is now associated with him having Lewy Body Dementia more than anywhere else. 

I'll try to write more about my life as I do find it to be cathartic. Thanks for reading.