Monday, February 22, 2010
It has been a bit of a while since I posted (although truth to tell, I do have a lot of drafts languishing in the bin). I've found if I'm keeping a traditional journal, I don't blog as much (and vice verse). So, sorry for the long silence. Recently I had to go out of country for surgery and there have been a number of questions about that, so I thought doing a blog would help clear up some of the mysteries. (OOh!!)
February 10th this year found me in Utica NY at Faxton-St.Luke's hospital, being prepped for a Roux-n-Y gastric bypass. I had to get up at 4:30am to be at the hospital for quarter to 6, which was about as pleasant as it sounds! As well, this was day three of my 72 hr liquid fast, so I was not in a pleasant frame of mind. Plus I was scared shitless (no kidding!)
It was cold and dark and the wind was up when we pulled into Parking Lot A of the hospital. Parking is free, which is nice, considering the hours that my Mom spent driving back and forth from our little room a the Red Roof Inn and back to the parking lot. I had my shoulder bag with all my paper work with me (no idea if I'd need it or not!) Plus over the other shoulder, my CPAP machine (sleep apnea therapy device) that the folks in Utica said I'd need to bring. Mom had my clothes' bag, the bag with all my drugs in it and a half bottle of distilled water (didn't know if I'd need it for the CPAP machine, but better safe than sorry!)
In no time, I was getting prepped. Shucked off clothes for a stylin', backless robe (arg), all my clothes went into a bag. It looked a bit pathetic seeing my stuff in a plastic bag with a tag on it. Like I'd possibly never see them again and they would be all that was left of me. Pretty much all the stuff we'd toted up to the hospital through the howling wind was unnecessary, so Mom ended up having to hump it back to the car. Sigh!
We waited in a small ward and I got fitted with an IV port. (*expletive deleted*) It hurt like hell getting that rammed into my left hand. And that is the hand with the nerve damage in it, so you can imagine how it would've felt in the right hand! I was eventually encouraged to hop up on the bed and just tried to breathe a bit. Finally a friendly orderly wheeled me out into the hall and Mom followed along, until she was directed to the 'waiting room'. At least they are fairly pleasant rooms with comfy chairs and no fluorescent lights...
Now I was in the 'Holding Tank', the room you are to lie in until you're queued up to be wheeled to surgery. People asked me questions, ticked off ticks, checked me and waited for Dr. Fitzer to appear. It was 8:20am and I was full of immense dread, doubt, fear, second thoughts, cold feet... well, actually my feet WERE cold, so that explains that...
Dr. Fitzer arrived and explained once more about the procedure and about post-op care of the pouch that he was going to try and make. He basically laid everything on the line about the dangers of not over-filling the pouch (which leads to pouch failure and death). Way to go! Thanks for helping me feel even more terrified right before surgery. But, I have to say, these guys were utter pros and let you know everything up front. I could've said "No" right there and hopped off the table, but I recommited to the damned thing. It was a no-brainer at this point and I had fought so hard to get to where I was lying, I knew that I had to go through with it.
Finally I was wheeled to the elevators, then down one level (no! Not the basement!) It was hushed and the orderly wasn't making any more jokes. I was quiet and apprehensive. The doors to the surgery swung open and I was in a large room chock full of machines and monitors. The lights directly above me put me in mind of the opening to the 'Six Million Dollar Man'.
There were also some lovely flat screen TV's surrounding the surgery area. At that moment I'd completely forgotten that I was to receive laparoscopy surgery and the nature of the TV's eluded me. I was about to pipe up that they must enjoy watching movies during surgery when I finally clued in! Yeahhh.... ok... :-) (Laparoscopic surgery uses cameras to guide the surgeon in their work..they watch via television).
The bottom of the gurney I was on was an inflatable matress. With the touch of a button, the mattress inflated with a wooshing sound and lifted me up from the gurney. With the help of the team, I was moved onto the surgery table, riding the air mattress and making the transfer a snap. What a great idea!
Finally a familiar face from the Holding Tank appeared; it was the anaesthesiologist. Ahh, how nice... finally I could leave the hammering heart panic of a rabbit with its leg in a clamp and just ease right out. I wished the surgeon well (in my head) and followed the directions of the fellow with the gas. A few half-hearted prayers vaguely directed to my Dad and any other supreme power that might be taking an interest wafted out of me as the anaesthetic took hold, then all was black.
Back in the waiting room, Mom had been patient over the time that a normal procedure would normally take; about 1 1/2 - 2 hrs. Finally, a little after lunch, Dr. Fitzer came to her, looking tired. It had taken over 4 hours for the work to be done and he let her know that I finally had my 'pouch'. I'm not sure if it was simply my weight, of the way my body is put together with all of the organs and fat very much centralized (I'm a potato/apple shaped person) or what. Thankfully, these guys are the best, and I was in professional hands the whole way through. The Dr. told Mom I'd be in the recovery room for a few hours, so she headed to the Hotel to rest and get a bit of lunch.
I don't remember much of the Recovery Room. It was brighter than the Holding Tank, and I felt a bit raw. My throat was dry as a bone and sore as hell. I felt a bit numbed out. During the stay people would often ask for my full name before proceeding to either give me drugs or do various things. Two hours seemed to pass very quickly for me, and once again I found myself traveling on the wheeled gurney, under the guidance of a different orderly and possibly a nurse?
They brought me to the bariatric patients' area of St.Luke's and lost my admiration by whanging the gurney into the doorjamb of my room. The pain that came up from my belly was unlike any I'd endured. I let out a protesting howl of agony and glared at twinkletoes who'd pulled the move. The nurse(?) had a few tart words for him, but I don't recall any apologies. Hmm, one can tell that we're not in Canada any longer...
The room was small but well appointed with medical gear, a bathroom, a broad window facing the parking lot and a tall spruce. I was pretty disoriented and sore and unsure of what was going on. A woman took that opportunity to stick her head in the door and say "TELEVISION??" with a foxlike face and bright eyes darting back and forth. I said "No thanks", and got a surprised look in return. It took her 3 days of trying to finally give up on me. I was happy to be in a land with no TV.
Mom appeared soon after that and it was wonderful seeing her. Just squeezing her hand and knowing that it was over and I was safely on the other side felt like a million gold sparkles. Her face was tight with worry, but I let her know I was ok. I'll never be able to make up that time for her that she spent worrying over me in the Waiting Room, but at least now, on the other side, she could see I was alright.
An enormous bouquet of flowers and a balloon from Chester's Flower Shop was brought in shortly after that. It was from Fiona, with the card reading "Love doesn't accept distances. Hugs and love, Sue -- FI". Well, I got all teary seeing the beautiful roses, daisies and carnations. Mom set up all my cards of encouragement from everyone around the flowers and then pressed a fuzzy stuffed animal in my arms. It was a red-brown dachshund. "What do you want to call him?" She asked. I thought for a second, petting the plush ears and looking into the cute face of the critter "Hank Jr.?" We both laughed, and of course it hurt.
Now began a series of days involving not drinking enough fluids, getting my IV taken out (and then put back in), learning to walk without pain, learning to haul myself out of bed without having to rely on a nurse. Getting asked if I had peed or passed gas (critical things when people mess with your insides I suppose). I regarded my wounds curiously; there were six of them, and of those six only one had been 'bad' (leaking a little for the first few days). The time was a blur of rotating nurses and care attendants, always with thermometers, blood pressure machines (that didn't work on me), blood sugar monitors and then injections of insulin (at this point I was borderline Diabetic --sigh!) There were also injections of blood thinners to avoid the danger of blood clots, and the Spirometer in which one inhales deeply to help the lungs recover from the anaesthetics during surgery.
What I still can't figure out is why these poking, prodding, injecting and taking of readings has to be done in the middle of the night? Like 2:30am? 4:00am? Are these women (98% women anyway) trained in the art of sadism? Why is my 4:00am temperature so important? It was annoying. It was very difficult to sleep anyway, and finding yourself being woken up to have your blood pressure measured didn't help.
Asking for pain medication became a game as well. If it was under the allotted time (4 hrs.) the nurses simply ignored the request. Sometimes, they did that even though 4 hrs. had passed. I was on percocet and was later told by Dr. Fitzer's weekend replacement that I wouldn't be released as long as I was on the narcotic. So, once I clued into that, I stopped asking for pain medication. Unfortunately, the hospital didn't seem to believe in an interim pain reliever, like percocet..then to Tylenol 3 or something? Or even extra-strength Tylenol? I just rode it out and knew it was worth it, if it meant I'd get out of the place sooner.
One of the nicer events was having a shower. It felt good to walk carefully down the hall with the attendant to the Shower Room. It was full of home-made giant PVC chairs on wheels, designed for people who were not in the normal range of weight (say 300 lbs. +) The shower was delightful. It was quiet and I got to just spend time in the warmth, getting clean and feeling the grime and ick of the last few days go away. I wandered back to my room when I was done and of course there were a bunch of people wanting to take my temperature waiting. I dried off and tried to comb my hair but had to wait for the nurses to do their thing.
Sunday, I was finally given the go-ahead to go home (after abstaining from my pain meds for far too long). I was given yet another scare speech about the dangers of pushing my pouch before it was ready. And that it took 3 weeks, not 2, not 2 1/2 weeks for the tiny pouch that Dr. Fitzer had made to heal. If I broke it, the results would be fatal. At least I was in a better frame of mind to accept the speech than when I was on my back in the Holding Tank.
The outside air smelled cold and fresh. I was so happy to be out. It was snow/freezing rain, but I didn't care. Mom pulled the truck up to the front doors and I gingerly climbed up and inside. Every jounce and bump on the road translated to instant pain in my belly. It was curdled with pain and I wanted an acetaminophen (Tylenol). The ones I had were simply to big for me to handle and when we got back to the hotel I used a pill splitter with moderate success on one of the pills (which turned into 3 shattered and pointy fragments). I took the biggest one with a bit of water and juice mixed together.
The hotel was heaven compared to the hospital. The bed was huge and comfy and once I set up my CPAP device, I was ready to nap. I was still extremely tired and sore from the drive down. We watched a bit of the Olympics (skiing) and parts of movies. My attention span wasn't that great. Finally we settled on competitive cooking shows and that was mindless fun. I propped myself up on cushions and snuggled down under the blankets and watched chefs try and make wonders of the world out of chocolate.
I wasn't hungry at all, I sipped my juice/water, later had 1/3 of a Popsicle. This has continued since I've come home. I have protein/soy for my meals, and am slowly integrating soft foods into the rotation. I'm taking B12, 2 multis, a pill to help with my blood pressure and a couple to reduce the effects of stomach acid (to help protect the pouch). I also had to self-inject the blood thinner medication for the first 5 days at home, which was awful. I suck at self-injection (and trying to pretend I was William Burroughs didn't help--thanks Troy!)
Over the last two weeks, I've lost an average of 3 lbs. a day, this morning it's a total loss of about 40 lbs. My legs actually look pretty good (have had continual problems with them for the last couple of years) and I am walking better, and with less pain in my joints. I still fatigue quickly though, but that is because I'm continuing to heal.
I want to thank everyone for their kindness, support, love and hope during this very scary ordeal. It means a lot to me that your thoughts were with me, that your flowers came and uplifted my spirits, that your cards and words helped me get through some of the fear and doubt of the surgery. It is love that lifts us up and the light that sees us through. More news to come! (I hope ;-)
Resources & Info
Dr. Graber & Dr. Fitzer
Dr. Bishop's Ottawa Weight Loss Center
Ottawa Weightloss Support Group
British Obesity Surgery Patient Association
Illustration of William S. Burroughs by Robert Crumb.
Sue with flowers photo courtesy of Keith Savage.