Sunday, September 4, 2016

Looking at having Weight Loss Surgery?

I've been in contact with a few people in various pre-surgery stages, who have had a few questions for me. Although some of them may have been answered in previous posts - I felt like I should dedicate one post to things I think helped pre-surgery, things I wish I would have known, things that worked for me. Hopefully it will help at least a few people heading into one of the biggest days of their life....

**Disclaimer** I'm learning that all programs are different. Please listen to your doctors, nurses, nutritionists, psychologists and surgeons. This is just my take on my experiences, and should not replace the words of medical professionals. =)

Pre-Surgery

For those of you that have started, you are likely feeling like the whole process is a bit daunting. So may appointments, approvals, etc just to get to the actual surgery! I know I just got burned out on the whole thing, thought I had approvals I didn't have and thought I was further along than I was. Ask the questions. Have I been cleared for surgery by this department? I thought I had been by 2 departments, when I wasn't - and it just caused more delays. 

Exercise. I am certain the fact that I pushed through the enormous amount of pain and discomfort to exercise prior to my surgery played a huge role in how well my recovery went. Having done some abdominal work...having gotten my body used to walking...just making myself move - - I'm am confident it helped me after my surgery. 

Going on a bon voyage tour with all of your favorite foods. Even though I was told by my nutritionist that I would be able to basically eat everything post-surgery (eventually), my brain felt like I needed to eat all of my favorites. Repeatedly. I can vouch for the fact that you will be able to eat your favorites after surgery. It may take a bit for your new baby tummy to toughen up a bit - but you will be able to have your favorites...just less of them, and in moderation. I haven't run into anything that's "off limits" except my beloved Diet Coke. Damn you carbonation!

When you are heading into surgery, and still weigh well-over 400 pounds, you have to sign extra forms. Forms that detail the issues that might come up post surgery: leaks, blood clots, etc. The issue is, that if you are over 400#, the machines/scanners that they would normally use to detect said issues won't work for you, because you're too heavy.  If you're like me - this is when the nightmare scenarios will start taking over your mind. When you will start to believe that there is a pretty good chance you're just not going to wake up after the surgery because you're too damn fat to have weight loss surgery. But you will wake up. You will be fine. They just have to cover their asses, while helping you to shrink yours.

your life during the liquid diet
Liquid Diet. Now this is where I see the biggest discrepancy amongst the different programs. For me, and my program, I could only have liquids, jello and sugar-free popsicles. Some can have a no-carb meal once a day. But that is not how it worked for me. The minimum number of days to be on liquids with my program was 10. I had to be on liquids for 21 days. THREE WEEKS, people. Because I was so heavy they wanted me to drop as much weight as possible to get me into a safer weight range prior to surgery. There is just no way to sugar coat this for you....the liquid diet is absolutely the hardest thing I've ever done. I was miserable the entire time. I was hungry, the entire time. I'd be at work and people would make food....I swear...someone was going to get hurt. The issue is that you still have a human sized stomach, but aren't getting anywhere near enough to put in it. The reason I was having surgery is because I love food - - and you have to go cold turkey! It's just awful. We can really only be grateful that I survived, and so did everyone else. =) 

The night before / Day of surgery

sticky towelettes & directions
The night before my surgery I was advised to take a 1 hour shower. Seriously. 1 hour. I couldn't have stood for an hour at that point of my life if I needed to, so I soaked in a bath for 30 minutes, and rinsed for 15. I was given these big towelettes of antibacterial solution to use in a very specific order after the shower. They said it would dry, but it never really does. You'll be sticky. It's gross. And then in the AM, you cannot shower again. I got to do a PTA (pussy, tits and ass - - thank you Grandma Betty) wipe down before heading to the hospital. You will feel kind of icky.

 Then you get to try to sleep. I wish you well, on that. I was like a kid before Christmas. Probably got about 2 hours of sleep due to the aforementioned nightmare scenarios running through my head.

There were to be no liquids after midnight. Gratefully, I was to check in pretty early in the AM, so I didn't have to sit around thinking about all the things I couldn't eat and drink. But as soon as you get put into your pre-op room, they'll ask you to pee in a cup. Good luck with that, as we weren't able to drink for hours... 

You get weighed, blood drawn, temp taken, etc. Strip and get into your surgery gown. If you're anything like me, your anxiety manifests itself in the form of perspiration. Lots and lots of perspiration. But luckily my hospital had these really sexy gowns that hooked up to a hose and they could pump cool air into it. Never been more grateful for anything in my life. Then your family, or friends, or whoever you want can come in to visit...trying to keep you calm and sane prior to them wheeling you off. The nurse will get you hooked up to your IV - make sure that's comfortable - it will be in for like 2 days. 

They'll wheel you off into the surgery room - or at least I think it was the surgery room - I was only conscious for about 2 minutes. They had me transfer to the table. Strapped my arms down. Put the compression things on my legs (that tighten & loosen to keep the blood moving and avoid clots during, and after surgery). They'll warn you they'll put you under, and then you're gone...off into sleepy time. 

the look of nausea
When I woke up after my surgery I was in a room with tons of other people. The nurse started talking to me right away. My first thought: "YES!!!! I WOKE UP!!!". My 2nd thought: "holy shit! what's sitting on my chest!?!?!". By far the worst part of the next few days was the gas pain. They pump you full of air during the surgery - but sadly haven't figured out a way to suck it back out. You have to wait for it to "pass"...and mine was in no hurry to do so. Eventually they wheel you to your actual room. Through what feels like the whole hospital. On elevators, in hallways, with complete strangers. The good part is you're so drugged up you don't even care that you're likely drooling, and possibly snoring for part of it - - but this move made me so nauseous. I never actually got sick, but it had to have been close. The nurses take off your surgery gown, and basically just cover your cloth gown. Another perk - they do have larger beds for their larger patients - so I didn't feel like I was spilling out of the thing! And then you sleep on and off. They start the pain meds - take them. Trust me. And start the anti-gas meds as soon as they offer. 

A few hours after getting back into your room they want you up, out of bed. I had to move to the chair next to my bed. I was sure my legs would give out, but they didn't. I had to sit there and attempt to drink water. They gave me 2 cups like the size that come with Nyquil. I had to try to drink one in 30 minutes. After that test, they want you to go for a short walk. This is when they cover your shoulders with a robe (because you have the IV in one hand, so can't use the sleeve) and hope like hell it doesn't fall off so you moon everyone. 

The first night for me sucked. The gas pain was pretty bad. My CPAP machine kept making my oxygen reader I was wearing on my finger go off. It was anti-restful. The next day I was feeling a little better - - but then I slept the entire day. People came to visit, but I barely remember, and didn't really participate at all. When I did wake up, I'd take a short stroll. They also put this thing in your toilet to catch your urine. I think they track it in some way - but that was kind of gross/annoying. 

 The first week

The 2nd morning I was free. My sister drove me home. I barely remember it. I was on Oxy for the pain - and I was out of it to say the least. I do not understand how people take that every day. Be prepared for more nausea on the way home. Once you get there, you will likely sleep on and off for the next few days. I was lucky enough to get a recliner that had been my uncle Dan's. I slept in that for over a week, probably closer to 2. My incisions were too tender to try and lay down, and I was nervous I'd never be able to get back up if I were to lay down. Mobility was much less of an issue than I thought it would be. I had serious concerns that I wouldn't even be able to wipe myself - which ended up not being a problem. I kept a pillow over my stomach most of the time - especially when standing up. Something about the pressure helps your incisions not scream at you. I did a few short walks a day. I filled a gallon freezer bag with water to make a big ice pack. I used that on my stomach after the walks to keep swelling down. 

Be prepared - - you will have to give yourself (or talk someone else into) giving you shots in your stomach for a week. I guess that helps with blood clots too. I got pretty good at it by the end of the week - but I gave myself a number of huge bruises. I was off all of my anti-nausea and pain meds within 2 days of being home. I finally took my first poop on day 4 or 5. And seriously - the first time I farted I was ready to throw a party! It is no time to worry about being lady-like! It is necessary to feel better. Embrace it. And ladies - - be prepared for your cycle to be insane. I had my period for 2 weeks straight after surgery. Then mine went back to normal. Some others weren't so lucky. Just one more thing to be aware of. 

Toward the end of the first week I noticed that water was starting to taste like metal. I also had a metal taste in my mouth that I just couldn't get rid of!! I was brushing my teeth like 10 times a day trying to get rid of it! It took about 3 weeks for me to find out that that is normal. It's Ketosis, I believe. Something that happens when you're dropping weight really quickly. I was told lemons & limes in your water would help. Nothing really seemed to help, so everything had to be flavored for me. I still drink watered down Powerade Zero. 

I was warned I might have an aversion to sweets after surgery, and boy did I. I couldn't choke down a protein shake without feeling nauseous for 3 hours. I tried to power through - but finally had to go to my nurse for some advise. I stopped the protein shakes, and started drinking Fairlife milk. I HATE milk, but it was a must according to my program. I'd drink 7oz of white w/ 3oz of chocolate. It did the trick. I didn't feel like I was going to vomit most of the day. The moral of this story is - if something isn't working for you, call your nurse right away! Don't make yourself miserable. 
 

And then....

My program moved...sloooooooowwwwwwllllllly to say the least. I finally got to have watered down yogurt or tomato soup after that first week. Everything the consistency of apple sauce. After 2 weeks of that nonsense, I could move onto pureed foods. I took a hardboiled egg with some mayo, mustard, and a little milk and threw it in a food processor. That first bite may have been the greatest thing I've ever eaten! I lived on those eggs and refried beans with hotsauce for the week. Then finally, the next week, I got to have berries. Still a really limited list of things - but at least a couple things that required chewing. So it took me a month to get to the point that I had to chew. It took me another 2 months to get to the point that I could actually have something that made a sound. It was right around the 2 month mark post-op that I seriously almost lost my mind. I was so tired of the limited diet. I was so tired of being told "no". I was so tired of the extremely long list of things I still couldn't have. I just wanted a raw vegetable, damn it!! 

It was toward the end of the pre-op liquid diet, and the first couple of months of my limited post-op diet that I realized just how comforted I was by food. How the act of eating soothed me. It helped me understand why I would have larger than needed (by needed I mean I would have been content with less food - wouldn't have gotten to the point of stuffed, but definitely wouldn't have felt hungry) meals. It was like my security blanket. Anything that was going wrong...or right... could be made better by food. The act of eating was therapeutic for me. Now that I'm 4+ months out, those feelings are much less frequent...but it was really rough there for a while. 
  
But hang in there. One day they'll tell you to go for it, but be smart. And even though you can have anything you want, you won't even need it. Just being able to have it is such a huge step! And your body will tell you when to slow down... your mouth will start to water if you go too fast, or try to eat too much. And that reminds me - don't eat, and then lay down! I made that mistake just one time. Not sure on the cause, but it took me about 5 minutes of deep breathing and lots of swallowing to make the "holy shit, I'm going to puke!" feeling pass. 

I've been very lucky. I see, and communicate, with a few people who have gotten sick a number of times when trying to eat or drink. I, knock on wood, haven't. Other than the protein shakes right after surgery, I haven't had any issues. I urge you to touch base with your nurse if you're having consistent issues. 

I will say - I have followed the rules. I've eaten what I was supposed to, when I was supposed to. I was advised not to drink for a year (concerns about addiction transference, I believe) and I haven't. Maybe that is what has made my recovery fairly easy? Or maybe it is just luck. 

Exercise: I would do my walks after my surgery. I started to work weight-training in after about 6 weeks. I was somewhat concerned my abdominals might rebel, but I haven't had any issues. I also work with a trainer who knows what he's doing, and helps start me off slow, and build up. 

I just have one more thing I want to touch on. This is really none of my business what you choose to do - but I'm going to throw my 2 cents out there anyway. Regarding the Scale - - I weigh myself once a week. That is it. I feel like most of us are so damn excited by those numbers going down that we want to check in on it frequently. I feel like that's just setting yourself up for a letdown. Our bodies inexplicably fluctuate. Trying to make sense of what you did, or didn't do, on a daily basis to see the number you're seeing is just a recipe for disaster. Please - don't put that extra pressure on yourself. Allow yourself to enjoy your non-scale victories as much, if not more, than your scale victories. At the end of the day I think we all did this to feel better, to be healthier, to be able to do more. Yes - a lower number is awesome, but if you're feeling good who gives a shit what the scale says?

Good luck to you. I hope your surgery goes well, and your recoveries are a breeze. Don't hesitate to contact me if you have questions. I'm more than willing to share anything I have that might help. Good health to you all!

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