Friday, December 30, 2011
Beginning of 3-week pre-op (November 8, 2011)
And 1 month post-op, taken just before we left for my follow-up with the surgeon.
I don't personally see a whole lot of change, though the pants are one size smaller. Ugh - you guys can look at these, I'll continue to close my eyes and sing "la, la, la, there's no pictures of me on the internet".
Thursday, December 29, 2011
I've also been feeling fairly weak the last 7 to 9 days, with some blood pressure readings lower than I'd really have liked to see. This morning didn't start out well in that regard, after getting up I took a hot shower, which normally is quite a treat - but suddenly I was feeling light headed, and starting even having a bit of trouble breathing. I hurried to finish rinsing the shampoo out of my hair, and as my vision started getting wobbly, I yelled for the Man to come help me. He got me out of the shower, wrapped up in my towel, and seated on the toilet until I came back around to normal breathing and didn't feel quite so woozy. After I was able to get dried off and into my robe, I sat down at my desk to check my blood pressure: 77/49 - um, not good. I drank some of my protein shake and about 10 minutes later I was at 92/67 - still not great, but 5 minutes after that I was up to 103/70 - normal, if somewhat low-normal. That wasn't fun, so we decided to put me to bed until time to leave for my appointment at the hospital.
One of the things I love about working with Wake Forest is that - at least in Dr. Fuzz's clinic - they're always so prompt. We waited no more than 2 minutes between the nurse's evaluation and Fuzz coming to the room. He was very pleased with my progress - quickly identified that my weakness and low BP issues were the result of dehydration (apparently I've been throwing off ketones like whoah - he could smell it on my breath just sitting next to me). He said to worry less about the "no drinking for 30 minutes before/after eating" rule, than about getting in at least the minimum 48oz of water, and preferably more toward 60-80oz until we get the dehydration under control. He also suggested I add a bit of juice to each bottle of water - just enough to get a small bit of sugar for the extra calories, which should help stabilize the woozies. They sent me on my to the lab (no results back yet) and to see the nutritionist, who gave me some suggested foods information and other materials. One interesting item was a laminated card that identified me as a bypass patient, asking any restaurant that I might choose to show it to, to allow me to order either off the children's menu, or perhaps be served a reduced portion. Any agreeable restaurants would be listed by the program as "bariatric friendly". Not sure I'll use it, but it's an interesting thing to have in your wallet.
We got home, and I tried to eat some left-over "strata" of sorts (not as fancy as most, but more than a scramble), that we'd originally made for breakfast on Tuesday. I'd been able to eat a very small portion then, but today - not so much. It immediately started feeling like it wasn't going to sit well, and unfortunately resulted in my second bout of vomiting. The Man was in the kitchen cooking up some squash for his lunch, and didn't immediately hear me in distress down the hall, but as my last heaves hit - so did the searing pain at the base of my skull again. Thankfully this time not the triad of death pain like last week, but excruciating none-the-less. I cried out several times, and heard the Man come rushing down the hallway. He helped me to bed, and asked if I needed any painkillers or what he might do. I decided on a half dose of the liquid lortab (hydrocodone and tylenol), and a bag of anything frozen we might have in the freezer (a dubious proposition in this house, we use fresh veggies almost exclusively). Amazingly he came up with a bag of peas, and so I knocked back the happy juice and laid back on the peas and hoped it would pass quickly. It took about 20 minutes to take most of the edge off. Our mechanic called while I was waiting for things to kick in; the Man's car was being serviced. Turned out he had a broken water pump - they promised to be finished by the end of the business day, so I snuggled in to watch TV and wait for the call that his car was done.
When the garage called back I was feeling much better. We packed up the presents for his brother, sister in law, niece and her 2 boys, and his nephew, and set out to pick up his car, and then continue on to his brother's house for a belated Santa delivery. Only his brother was home when we arrived, but we had a nice chat for a few hours, looked through a bit more of his mother's things (she passed away back in June), and selected a few of them to take home. As it was getting late, we decided to stop for a quick, cheap dinner - and settled in Chili's. This would be interesting - I went in thinking maybe a cup of soup, or something I could ask for a box to take the bulk of it home. After looking over the menu, I settled on their slider plate - 4 mini cheeseburgers (and fries and such that I'd not eat). I managed to eat one of the slider patties, and nibble a couple of onion strings. The waiter first gave me kind of a quirky smile when he saw me attacking the patty with a knife and fork after removing the bun from the first slider - but didn't say anything to me until the Man was clearly done with his meal, and I was slowing down. He simply asked if I needed a box, and I answered "Yes, please!" with a big smile, and the Man made sure he got a nice tip for not commenting on my eating habits. There's 3 sliders in the fridge - I might end up eating 1 or 2 more patties over the next 2 days, but that's probably it. As time passes, I'd definitely have been able to eat a bit different, and it felt silly eating so little of a $8 meal, but I'll get some more out of it than I did tonight, and I was able to successfully eat out with my husband, so that felt good.
Tomorrow's objective is to find some mini ice-cube trays - a friend suggested putting some of my dilute juice into ice cubes, so I can suck on them. That seems like a fun way of getting some of my liquids in, so I'm going to try and pick some up tomorrow if I feel up to going out.
So - mixed results on food today, but one day at a time, that's all I can do.
Monday, December 26, 2011
Tuesday, December 20, 2011
Saturday, December 17, 2011
I did discover that taking my morning meds with a protein shake made them go down better than just trying to space them out with water - perhaps having something else in my stomach to digest helped prevent the cramping around them as they were breaking down.
I saw Libby on Thursday afternoon - she said she could already see some results in my face, and though I've lost nearly 50 pounds total on the program (15 post-op), my only real indications of loss have been that my wedding rings are spinning freely around my finger, and when I did put on my normal pair of jeans, that the back of the legs right under my butt were puffing out. But that certainly doesn't feel like 50 pounds of loss.
I had taken some measurements in mid-November, to help measure progress from a size perspective as well as a weight perspective. I'm rather shocked, because I don't see these changes, but apparently they are there - a tape measure doesn't lie when utilized properly:
|Hips:||- 4 inches|
|Waist:||- 2.5 inches|
|Chest:||- 3 inches|
|Bicep:||no change (dang flabby underarms)|
|Thigh:||- 3.25 inches|
|Calf||- 2.5 inches|
So lots of changes, though I still honestly just don't see it. I suppose when my incisions heal up a bit more and I feel safe trying on some pants that aren't knit/sweats, I may find myself in a size or two smaller that I'd outgrown before.
I think it's going to take a while before what my eyes see in the mirror catch up to reality - that should be an interesting journey.
Monday, December 12, 2011
We've finally got the scale issue settled down - I wrote to Amber, the program nutritionist, last week and laid out my concerns - she said it was absolutely typical. After such a major surgery - and it was major, despite being done laparoscopically - your body does hang on to waste, water, and all sorts of things as it tries to figure out what it will need to heal. In just the day or two after I wrote her, I was steady enough on my feet and apparently my body got back in the grove, that I was getting steady readings on the scale again - and wow, it really is sliding right off of me. That too shouldn't be much of a surprise, given that I've gone above 500 calories in a day just once since my return home - and that was something like 517.
I'm still quite hot and cold with what I can actually eat (vs. drink). At least half of my protein is coming from a protein shake - mixed with 1% Lactaid milk I get 32g of protein for a 1 cup serving. With my protein goal of 60-65g, two of those would fill that need. However, I'm trying to get the remaining 28-33g of protein from pureed items. That's been a challenge - their guide of 1 to 3 tbsp of food at a time has truly been my limit - even half a spoonful more than that leaves me with uncomfortable pressure in my new baby stomach. The toughest challenge still is getting all my water in - minimum of 48 ounces is a lot when you can't chug it - I have to remember to reach for the bottle every 5 minutes or so and sip, sip, sip. The best I've really done so far is about 38 oz. That's what I'll have to work on most this week.
I had been chatting with my dear friend Erica a bit before surgery, about how I was anxious thinking about what this would do to my "foodie" tendencies. I'll clearly have some sugar and fat restrictions that I'll need to work around, and of course there's just no going into a restaurant and having a 3 or 4 course meal anymore. There's no reason I can't eat amazing food, I'll just have to plan very carefully to be able to enjoy bites of all the dishes I want to taste. I'm also a pretty damned good home cook as well - I have several famous dishes that are always requested for the holidays, and am very comfortable putting on a dinner party for 6-10 people. Obviously during the puree and soon-after stages, I won't be making full gourmet meals, but as the months pass, I'll eventually be moving toward 800-1200 calories a day. I'll be able to eat a full, albeit small portioned, meal. I mused about writing a cookbook geared toward the bariatric eater - portions sized for our needs, fats and sugars balanced appropriately, and even hints for when an item could successfully be turned into a puree.
The more I think about it, the more committed I am to undertaking this project - I'll be working on recipes as I begin eating more regularly. Erica's husband "R" has offered to test cook for me, and I'm sure more of my friends will join in that endeavor. I'll be challenging myself to use ingredients that I may have passed over in the past (I'm not a big seafood eater, and have a textural aversion to mushrooms), in large part to be accommodating to palettes that are different than my own. Ironically, much of my television viewing these past two weeks has been on the Food Network and the Cooking Channel - something you'd think would create unsatisfying urges, but it's not been an issue for me. Something can look very tasty, but I can skip right by it without thinking I'm hungry, or feeling the need to go rummage in the kitchen for a substitute. I've been watching, taking notes on inspirations, and generally plotting how I might go about all this. It should be quite fun. As I begin, watch for pages dedicated to recipes to be added to this site - probably in about 2 months or so.
So finally - the dirty details of my progress:
Tentatively off high blood pressure meds - taking home readings until I see surgeon on 12/29 - but have been within normal ranges.
Insulin dosage down by half, still taking oral meds. I wish this was going away quicker, but it should adjust as I lose more.
Getting the exercise in - today's treadmill jaunt will be 13 minutes at 1.5mph - going up a minute a day and .1 mph as tolerate until I hit 20 minutes and 2 mph as my initial goal.
Today's weight: 293.4 lbs
Total loss: 44.6 lbs
Post-op loss: 10.6 lbs
Saturday, December 3, 2011
Apparently the first thing I said when the Man walked into my room post-op was "Ouch" and passed back out. I suppose that was succint!
Doc says that everything went really well, no concerns or complications. Obviously I felt like I had been hit by a truck, but they had me initially on an acetaminophen product and morphine, so I was also quite stoned, and slept most of the day immediately post-op. I did get up and walk part-way down the hallway and back.
Things you don't think about #392: For women at least, you have to relax a lot of muscles to pee - you don't think that it would hurt to do that, it took a lot of concentration to be able to relax the right ones.
Overnight Tuesday, my pain levels had gotten pretty high - and the lortab they switched me to (vicodin and tylenol) was really only taking the worst edge off it, and not relieving much, so they switched me to oxycodone. That knocked me back out, but it made getting up harder, as being settled in the same position too long made the gas move around worse when I got up. The hospital had incredibly dry air, so between cotton mouth from not drinking much, I also had painfully dry sinuses to deal with as well. I was allowed 2oz of 50/50 diluted grape juice an hour, so that didn't do much to help the mouth, let alone hydrate me elsewhere.
I was a good patient and walked the halls a much as I could, and was definitely doing better at it by early Thursday morning. Fuzz came and saw me about 9am and said he would discharge me, and the residents would be around a bit later to remove my drain (something they glossed over) and get all the paperwork done. Finally about 2pm they came - and the resident removed the tape around the drain, then asked if I was ready - after nodding, he pulled - and the Man says I got a look on my face like "the alien is eating me alive from the inside" - because the dude pulled out nearly TWO FEET of drain tubing. I had no idea - and will definitely be suggesting that people be prepared for that. Yikes!
We got home about 4pm Thursday - and unfortunately the Man went on a wild goose chase trying to fill the liquid oxycodone prescription for me - nobody had it in stock, at least anywhere near the quantity prescribed (yes, I know it's a highly trafficked drug, particularly in pill form). But, we'd filled the post-op prescriptions before going in, so I had the hydrocodone at least, and have been relying on it until we can get the oxy (should I still need it by the time it comes in to our pharmacy).
Being at home on the sleep number bed has been much more comfortable than the very stiff hospital bed, but the head tilt feature there was certainly nice. The Man has been awesome in taking care of me - getting my meds every 4 hours, making sure I have water in my sport-top water bottle, and generally making sure I'm comfortable.
He helped me take a shower yesterday afternoon, which while it felt good, apparently took a lot out of me, as I didn't feel well enough after to be upright, so I spent the rest of the afternoon/evening in bed.
Today I've been up and sitting on the couch with a tray table with my laptop and my knitting since about 9am, which is definite progress. I'll probably lay down again shortly (next pain dose is due in 15 minutes), but be up again for "dinner". Yesterday I struggled with yogurt as part of my "full liquid" diet, but today so far I've had a protein shake, and have finished about 3oz of yogurt without too much complaint from my new stomach. Should be able to get the 2nd shake in, we'll see about anything else - as long as I get that protein, I'm not going to push myself for sugar free jello chemicals.
So many of my knitter friends have been wonderful about checking in on me and offering kind words of support and encouragement - I love you all. I'm definitely going to take things slowly, and work on doing what's best for me over the next 5 weeks while I'm off work.
Oh - the Man has decided that the scale is possessed - it says he weighs 15-20 pounds more than normal (he's not overweight, fluctuates only with a 5 pound range). So he'll be getting new batteries, and we'll likely be getting that new mechanical balance scale I wanted, so no updated weight report, but I wouldn't be surprised if I'm down in the 2s when we get me on it.