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!