Avalon5
Surgery is over!!!!
Jun 03, 2009
Kids, I'm back!!!!!
Bruised, battered, sore, surly......but back. The surgery is over and my ass is firmly planted in the recliner at home. I managed to complete my ENTIRE to-do list before the operation. And much more. I was ready. My work at work was done, my work at home was done.
The night before the surgery, I had to do the normal pre-GI surgery prep. I arrived at the hospital at 7:30 the morning of the procedure for a 9:30 OR time. They signed me in, got my IV started, asked a bazillion questions. I was also weighed and realized, to my delight, that I had lost 18 lbs since beginning my adventure in torturous pre-procedure dieting. I was taken to the OR at about 10:00 a.m.
I remember being wheeled into the OR, sliding over onto the table and telling the anesthesiologist that I was really scared. He told me he would give me a little something to calm my nerves, and the next thing I vaguely recall was waking up in Recovery and my Mom holding my hand. The surgery, which is normally a 3 to 4 hour procedure took over 5 in my case, but my Surgeon told my Mother that all had gone as smoothly as possible considering what he had to do.
I have a few hazy memories of being taken to my room. And many, vivid memories of being seared up to my throat by the unrelenting Reflux. Once they doubled my IV dose of Reflux meds ( and they were shocked that I still had such horrible Reflux after the massive first dose), I slept most of that later afternoon and night. The pain of the actual surgery was comfortably controlled with IV Morphine, but the Reflux was still horrific.
The day after Gastric Bypass, most patients are sent for what is termed a "leak test", whereby you swallow a small amount of Barium and live x-rays track the path and flow of the Barium to be certain that there is nothing leaking out of the re-routed and/or sutured ares. If you pass the leak test, you are allowed to begin drinking tiny amounts of water. 1 ounce per hour.
I felt that something was wrong because the Reflux was getting worse instead of better, and I had also become chronically nauseated. With a 25 year history of Reflux, I am pretty savvy as to the signs of trouble.
The gave me the ounce of Barium to drink and began the x-ray process.
The Barium never moved.
It sat in my Esophagus and never moved into my newly formed stomach pouch or intestines.
They had me wait for 20 minutes to see if the Barium would start to flow. Not.
They took me back upstairs to my room, medicated me again for the Reflux and the nausea, waited 2 hours and brought me back to x-ray.
The Barium was still sitting in my Esophagus, refluxing back up constantly. Not a drop had passed.
I knew just how much trouble I was in when they told me it still had not moved. They brought me back to my room.
Because I was primarily having this surgery as a permanent cure for my Chronic reflux, and I already had one failed Reflux surgery under my belt, I knew that my surgery might be a bit more complicated than most. The landmarks had already been changed in my stomach from the prior surgery, and the current procedure would require a delicate, partial takedown of the previous work, pictured here:
It is a long, clear, fairly inflexible tube approximately the diameter of a pencil. It goes up one nostril, down the back of your throat and into your esophagus. It can be threaded as far as your stomach, and the the remaining end is hooked up to a bedside suction unit to continuously empty and contents.
The problem is that most patients are mercifully unconscious when the NG tube is inserted. If a patient needs an NG after my type of procedure, it is normally inserted in the Operating Room, prior to waking the patient. It is uncomfortable upon waking, but the real trauma of the NG tube is having to have it placed. When placed in a conscious patient, it simply is torturous.
When we used to place them in the ER under emergent circumstances, the patient was often awake, so we employed several methods to reduce the trauma. We would spray the back of the patient's throat with a numbing spray to reduce the inevitable gagging. We would also provide the patient with a large cup of ice water and a straw, so as the tube was snaking it's way down from the nostril into the back of the throat, the patient could take large sips of the water and that would allow the tube to essentially "float" with the water toward the stomach. It was still a painful, frightening and difficult experience for the conscious patient, but we made it as bearable as possible.
I was allowed none of these amenities. I was taken back down to Radiology, one day post abdominal surgery, and under the guidance of the flouroscope, I had to have the tube inserted dry. Had to swallow and swallow and swallow as I gagged and retched and cried and tried to keep from ripping the tube out as it was manually advanced. By the time it was in, I had vomited all over the radiologist, by abdomen was a ball of fire from the retching and I was certain that this surgery had been the biggest mistake of my life.
The next 48 hours were pure misery. I was constantly hooked up to the bedside suction, so I was only allowed out of bed to go to the bathroom. If I turned my head to either side, or tried to bend my neck up or down, the tube laying in the back of my throat literally caused me to begin to gag uncontrollably. The Reflux was worse than ever as nothing could drain past the tube and into my intestines. I couldn't lay down. I simply sat and watched the clock, willing the time to pass. Psychologically, it had a terrible effect on my state of mind.
Finally, on Friday afternoon they took me back to radiology, repeated the Barium procedure and watched expectantly. Slowly, the Barium drained.
The tube from hell was removed . I was still allowed nothing by mouth for the rest of Friday . By Saturday, I was allowed one ounce of water per hour, sipped s lo w l y.
On Sunday, I was advanced to a clear liquid diet. 2 ounces of Jell-o or broth per hour. When they saw that I was able to tolerate the clear liquids, I was discharged to home.
Since then, I have advanced to full liquids. My day of "eating" looks something like this:
Constant, sugar-free liquids throughout the day. Water, crystal lite, sugar free ice pops, decaf tea, ect. Trying to get at least 48 ozs in per day but failing miserably.
In between liquids, at least 3 "meals" per day with added protein. 2 oz maximum per meal as that is about all the newly created "pouch" can hold at one time. Creamed soups, protein shakes, sugar free Carnation Instant Breakfast. Again, failing miserably but doing my level best.
My ENTIRE day is focused on getting my protein and calories in. I go back to the doctor next Monday and hope to be advanced to the pureed stage which would include things like SF applesauce, baby foods, scrambled eggs, low-fat ricotta, etc. My protein shakes could be bulked up with pureed fresh fruit.
As of this point, I am still shedding water from all of the IV fluid that was pumped into me during my hospital stay. At one point, my hands were barely recognizable due to the swelling, as were my feet. I am spectacularly bruised over both arms from IV's, blood draws and clot-prevention shots. My stomach is covered with bruises, healing incisions and steri-strips.
My reflux is already improved, but finding a non-awful way to take daily meds is a challenge.
My family has been wonderful, my dogs were thrilled to see me and I was never so happy to sleep in my own bed.
I was down, but not out, and now I'm ready.
I'm not sure for what.........but I'm ready.
0 comments
Bruised, battered, sore, surly......but back. The surgery is over and my ass is firmly planted in the recliner at home. I managed to complete my ENTIRE to-do list before the operation. And much more. I was ready. My work at work was done, my work at home was done.
The night before the surgery, I had to do the normal pre-GI surgery prep. I arrived at the hospital at 7:30 the morning of the procedure for a 9:30 OR time. They signed me in, got my IV started, asked a bazillion questions. I was also weighed and realized, to my delight, that I had lost 18 lbs since beginning my adventure in torturous pre-procedure dieting. I was taken to the OR at about 10:00 a.m.
I remember being wheeled into the OR, sliding over onto the table and telling the anesthesiologist that I was really scared. He told me he would give me a little something to calm my nerves, and the next thing I vaguely recall was waking up in Recovery and my Mom holding my hand. The surgery, which is normally a 3 to 4 hour procedure took over 5 in my case, but my Surgeon told my Mother that all had gone as smoothly as possible considering what he had to do.
I have a few hazy memories of being taken to my room. And many, vivid memories of being seared up to my throat by the unrelenting Reflux. Once they doubled my IV dose of Reflux meds ( and they were shocked that I still had such horrible Reflux after the massive first dose), I slept most of that later afternoon and night. The pain of the actual surgery was comfortably controlled with IV Morphine, but the Reflux was still horrific.
The day after Gastric Bypass, most patients are sent for what is termed a "leak test", whereby you swallow a small amount of Barium and live x-rays track the path and flow of the Barium to be certain that there is nothing leaking out of the re-routed and/or sutured ares. If you pass the leak test, you are allowed to begin drinking tiny amounts of water. 1 ounce per hour.
I felt that something was wrong because the Reflux was getting worse instead of better, and I had also become chronically nauseated. With a 25 year history of Reflux, I am pretty savvy as to the signs of trouble.
The gave me the ounce of Barium to drink and began the x-ray process.
The Barium never moved.
It sat in my Esophagus and never moved into my newly formed stomach pouch or intestines.
They had me wait for 20 minutes to see if the Barium would start to flow. Not.
They took me back upstairs to my room, medicated me again for the Reflux and the nausea, waited 2 hours and brought me back to x-ray.
The Barium was still sitting in my Esophagus, refluxing back up constantly. Not a drop had passed.
I knew just how much trouble I was in when they told me it still had not moved. They brought me back to my room.
Because I was primarily having this surgery as a permanent cure for my Chronic reflux, and I already had one failed Reflux surgery under my belt, I knew that my surgery might be a bit more complicated than most. The landmarks had already been changed in my stomach from the prior surgery, and the current procedure would require a delicate, partial takedown of the previous work, pictured here:
Well, it seems that the partial takedown of the previous surgery had caused the surrounding tissue to swell. To swell enough that NOTHING could pass. Not even the tiniest dribble of liquid. My surgeon came up to explain all of this to me, and then gently broke the news that they would need to relieve the buildup of fluids and acid from my esophagus. He assured me that this would allow the swelling in my intestines to dissipate and heal, and if this didn't work, they would anesthetize me and do an endoscopy to determine if I needed another surgery to possibly correct a kink that may have formed after releasing the original surgery. He said that they would begin by inserting a "small tube" to take the backed up contents out of my esophagus.
And I knew exactly what he meant. I worked inn the ER for 11 years and had assisted on numerous occasions with "decompressing" by holding a patient down while a Naso-Gastric tube was inserted. The "NG" as it is affectionately coined by professional militants and historical torturers, is pictured below:
It is a long, clear, fairly inflexible tube approximately the diameter of a pencil. It goes up one nostril, down the back of your throat and into your esophagus. It can be threaded as far as your stomach, and the the remaining end is hooked up to a bedside suction unit to continuously empty and contents.
The problem is that most patients are mercifully unconscious when the NG tube is inserted. If a patient needs an NG after my type of procedure, it is normally inserted in the Operating Room, prior to waking the patient. It is uncomfortable upon waking, but the real trauma of the NG tube is having to have it placed. When placed in a conscious patient, it simply is torturous.
When we used to place them in the ER under emergent circumstances, the patient was often awake, so we employed several methods to reduce the trauma. We would spray the back of the patient's throat with a numbing spray to reduce the inevitable gagging. We would also provide the patient with a large cup of ice water and a straw, so as the tube was snaking it's way down from the nostril into the back of the throat, the patient could take large sips of the water and that would allow the tube to essentially "float" with the water toward the stomach. It was still a painful, frightening and difficult experience for the conscious patient, but we made it as bearable as possible.
I was allowed none of these amenities. I was taken back down to Radiology, one day post abdominal surgery, and under the guidance of the flouroscope, I had to have the tube inserted dry. Had to swallow and swallow and swallow as I gagged and retched and cried and tried to keep from ripping the tube out as it was manually advanced. By the time it was in, I had vomited all over the radiologist, by abdomen was a ball of fire from the retching and I was certain that this surgery had been the biggest mistake of my life.
The next 48 hours were pure misery. I was constantly hooked up to the bedside suction, so I was only allowed out of bed to go to the bathroom. If I turned my head to either side, or tried to bend my neck up or down, the tube laying in the back of my throat literally caused me to begin to gag uncontrollably. The Reflux was worse than ever as nothing could drain past the tube and into my intestines. I couldn't lay down. I simply sat and watched the clock, willing the time to pass. Psychologically, it had a terrible effect on my state of mind.
Finally, on Friday afternoon they took me back to radiology, repeated the Barium procedure and watched expectantly. Slowly, the Barium drained.
The tube from hell was removed . I was still allowed nothing by mouth for the rest of Friday . By Saturday, I was allowed one ounce of water per hour, sipped s lo w l y.
On Sunday, I was advanced to a clear liquid diet. 2 ounces of Jell-o or broth per hour. When they saw that I was able to tolerate the clear liquids, I was discharged to home.
Since then, I have advanced to full liquids. My day of "eating" looks something like this:
Constant, sugar-free liquids throughout the day. Water, crystal lite, sugar free ice pops, decaf tea, ect. Trying to get at least 48 ozs in per day but failing miserably.
In between liquids, at least 3 "meals" per day with added protein. 2 oz maximum per meal as that is about all the newly created "pouch" can hold at one time. Creamed soups, protein shakes, sugar free Carnation Instant Breakfast. Again, failing miserably but doing my level best.
My ENTIRE day is focused on getting my protein and calories in. I go back to the doctor next Monday and hope to be advanced to the pureed stage which would include things like SF applesauce, baby foods, scrambled eggs, low-fat ricotta, etc. My protein shakes could be bulked up with pureed fresh fruit.
As of this point, I am still shedding water from all of the IV fluid that was pumped into me during my hospital stay. At one point, my hands were barely recognizable due to the swelling, as were my feet. I am spectacularly bruised over both arms from IV's, blood draws and clot-prevention shots. My stomach is covered with bruises, healing incisions and steri-strips.
My reflux is already improved, but finding a non-awful way to take daily meds is a challenge.
My family has been wonderful, my dogs were thrilled to see me and I was never so happy to sleep in my own bed.
I was down, but not out, and now I'm ready.
I'm not sure for what.........but I'm ready.
Friday -04/24/09
Apr 24, 2009
Well, one week ago today, I went back to the surgeon's office for a meeting with the APRN, who, coincidentally, has been a good friend of mine for over 20 years.
I had completed the nutritionists requirements, spilled abundant ketones, lost 9.5 lbs in 4 days and was not considered a psychological horror show.
I was allowed to pass "go".
I finished the assessment with the APRN and all that was left was to submit all of the necessary paperwork to my insuranc and wait for the inevitable denial.
Since my appointment was on a Friday afternoon, they submitted the paperwork on Monday morning.
And got the approval on Tuesday afternoon.
My surgery date------05/26/09.
They wanted to do it on the 12th, or the 19th, but I have some BIG work projects that require my attendance, so I had to hold them off until the 26th.
It all seems too easy, and that worries me. So far, everything has gone smoothly. I guess I should be thankful, but the cynic in me is waiting for the other shoe to drop.
And then there is Monday. On Monday, I have to tell my boss-----newly returned from her 9 day vacation------that I will be out of work for 4 - 6 weeks. I am wearing a rubber smock to work on Monday so when the top of her head explodes and her brains spray around the office, I am covered.
Wish me luck.
0 comments
I had completed the nutritionists requirements, spilled abundant ketones, lost 9.5 lbs in 4 days and was not considered a psychological horror show.
I was allowed to pass "go".
I finished the assessment with the APRN and all that was left was to submit all of the necessary paperwork to my insuranc and wait for the inevitable denial.
Since my appointment was on a Friday afternoon, they submitted the paperwork on Monday morning.
And got the approval on Tuesday afternoon.
My surgery date------05/26/09.
They wanted to do it on the 12th, or the 19th, but I have some BIG work projects that require my attendance, so I had to hold them off until the 26th.
It all seems too easy, and that worries me. So far, everything has gone smoothly. I guess I should be thankful, but the cynic in me is waiting for the other shoe to drop.
And then there is Monday. On Monday, I have to tell my boss-----newly returned from her 9 day vacation------that I will be out of work for 4 - 6 weeks. I am wearing a rubber smock to work on Monday so when the top of her head explodes and her brains spray around the office, I am covered.
Wish me luck.
Wednesday, April 01, 2009
Apr 24, 2009
Well, I went back to the LCSW for my follow up appointment. Far from being disturbed by my responses to the standardized test, he was pleased to report that I have, in his exact words, " a very healthy ego".
I could have told him that without forking over the co-pay.
So I have the green light from him to continue. He thinks the only issues I need to address are my propensity for regularly skipping meals, and the lightening-fast manner in which I consume a meal.
I also had my first meeting with the nutritionist, and she expressed the same concerns. After Gastric Bypass, if I eat my food too quickly, it will be virtually guaranteed that I will enjoy every meal twice----once going down and once again coming back up.
I will also have to learn NOT to drink with a meal. Because of the tiny pouch size, drinking at the same times as a meal causes a false sense of being full, yet the nutritional value of the food is not attained.
I promised to be on my very best behavior and to be perfect and act perfect and look perfect.
And my promises were rewarded.
I was given a 5 day Protein Sparing Modified Fast to complete.
Que? You say.
For the next 5 days, I can have NOTHING but proteins as the mainstay of my diet.
Simple! you quip.
(Let me just warn you that if you quip again, I promise to hurt you.)
It may seem simple, but here is how it breaks down:
9 ounces of LEAN protein a day, broken up over 3 meals. 3 cups of boullion a day to replace salt.
Gallons upon gallons of sugar-free beverages such as water or crystal lite. A day.
THAT IS ALL. FOR 5 DAYS!
The idea is that you are forced to make drastic, albeit temporary dietary changes that can actually be scientifically borne out at the end of the 5 days. It tests your willingness to comply with what you are told, it tests your ability to change the way you cook and eat, and at the end of the 5 days......
it tests your urine to see if you are a cheater.
If you do not spill ketones as a result of this restrictive 5 day torture test, you fail.
No ketones, no surgery.
I am only on day 1 and have already survived an acute bout of gagging over my lunch.
The next 4 days should be delightful.
Tuesday, March 24, 2009
Apr 24, 2009
Last evening, I went for my first visit with the LCSW about my potential Bariatric Surgery. To weed out those who are actually serious about wanting to change their lives with the procedures, this program requires several screening visits with the LCSW and several more with a Nutritionist.
Prior to a decision on whether or not you are acceptable to be operated on.
The LCSW was a man named Chris. He was pleasant and informative. He welcomed me warmly and then proceeded to plunk down a few folders worth of paperwork. And sharpened pencils.
Suddenly, I was transported back to grade school, sitting in a guidance counselor's office as they tried to dissect my defiant pre-teen brain with a series of purposefully vague questions on a standardized test.
The first test Chris handed me was a simple one. Only about 20 questions designed to determine my emotional state of mind.
Was I suicidal? Ummm, not at the moment. Bring my boss into the room and things could quickly disintegrate.
Did I like myself? Well, yes. Very much as a matter of fact. How about you?
Did I often feel sad? Not unless I overdosed on Animal Cops Houston on Animal Planet. Otherwise I am generally pissed off.
I guess I scored a big, fat A on that test because Chris said "I see your mood seems fine".
I was cruising along without a hitch. Feeling thinner by the moment and I think my Reflux had already been cured.
And then he pulled another sheath of stapled papers out of a file. With directions. And a verbal warning. I was to answer these questions VERY CAREFULLY.
The test was a variation of this.
A psychological assessment tool. About 175 questions to be answered by carefully penciling in the matching little circle.
I have taken many, many tests like this. Between a tentative diagnosis of Oppositional Defiant Disorder as a pre-teen to the battery of exams needed to diagnose Attention Deficit Disorder as a young adult-----I have taken them all. Sometimes more than once.
And I actually enjoy taking these types of tests. Usually.
Except when what you want to do with your life hinges on whether or not your responses are deemed appropriate. Then the stakes are a bit higher.
I sat and filled out the tiny circles. I puzzled over a few of the questions. Questions that seemed intentionally vague, possibly misleading, sometimes provocative. I finished quickly and was comfortably absorbed in my novel when Chris returned to the room.
He scanned the results page and quickly circled two of my responses. They had been purposely ridiculous questions intended to measure whether or not I was answering the test with any validity.
Again, I was a star student. I had answered those 2 perfectly. I was feeling confident.
Until I saw a look of puzzlement cross Chris' face. He was staring down at my results page and something was causing intense interest.
He looked up at me and said, as he circled the answer in pencil "Question 154. Um, you answered false to question 154. That is definitely an outlier. Less than 5 % of the population ever answer false to question 154. Especially those in the medical field. That is highly unusual". And he kept circling my answer for question 154.
I couldn't even remember what question 154 was, so I asked. It was apparently a question that insisted that I spent much of my time putting the needs of others before my own.
For me, that was patently untrue, so I answered the question honestly.
I don't know if Chris now thinks I am a complete narcissistic sociopath, or he is awed by my ability to back away from a pathological need for chronic caretaking.
Chris will have the results of my test next week when we meet and will detail a plan of action to assure the best outcome for me. If I passed. After the snafu with question 154, I'm not so certain.
If I had to, I would guess that there will be a round table of therapists and specialists to meet with me at my follow up appointment. Psychologists, psychiatrists, police officers, prison wardens, social workers, neurologists, interventionists, exorcists, Nurse Ratchett.
They will all shake their heads sadly at my answer to question 154. It will be oh-so-interesting.
I can't wait to see what happens when I meet the Nutritionist!
The first visit
Mar 17, 2009
Soooooooo, my consultation appointment.
It left me a bit stunned. I was expecting to have a long, drawn out conversation with the very nice doctor. I was going tell him the reasons why my life would improve with surgery that would finally correct my Reflux, and how the weight loss would be a nice added benefit. I would regale him with stories of how good a loser I am. How dedicated I am when I decide to take off excess weight. How great I look in 505 Levi's when my ass is uncovered from the fat pad. How I had no compunction about relinquishing my extra chin. I would tell him all of those things and more.
And then the very nice doctor would nod sympathetically at me and say " I see" He might even rub his chin as he spoke.
And that would be followed by something flowing from the doctors mouth that sounded like any combination of these word...
"except", "but", "typically", "usually", "too dangerous", "are you nuts?"...
The reality?
A Medical Assistant checked my vital signs. She was lovely. Before she left the room, she handed me some informational paperwork about the staff. Their names, the descriptions of what they do, their numbers. Information to make me feel comfortable. And then she told me that the Bariatric Resident would be in to see me next.
He was lovely. He walked into the room, introduced himself with an endearing level of confidence for one so young and proceeded to ask me why I felt I wanted Gastric Bypass since I really wasn't large enough to need it.
I had some trouble remaining on the examination table, what with the swelling of my head.
Until I realized that he was saying I might be more successful with a Gastric Banding because I don't weigh, um 900 eleventy trizillion pounds.
When I explained that I was there to see if I was even a candidate for ANY surgery due to my previous reflux procedure, he said "oh, I see". Which immediately deflated my giant ego and began my quick descent into " oh no, here comes the bad news" panic because I just knew that SOMEONE in a doctory type position of authority would nod gravely and say " I see" before I was given the signal to exit stage left.
The Resident talked some more and told me that he and the actual I-have-graduated-and-even-have-facial-hair doctor would review some of my test results and then the actual doctor would come and talk to me.
I braced myself. Which is no easy task because examination tables have no sides and unless you are laying flat, which is difficult because you can't lay down and then raise the thingie that holds up your legs unless there is someone in the room with you.......well, let's just say I didn't feel quite prepared to hear bad news while sitting 3 feet above a hard tile floor.
And then the actual doctor, Dr. Y entered the room. Again, a firm handshake, and introduction and LOTS of direct eye contact.
Which immediately put me a bit at ease. Having been a Patient Advocate for many years.....show me a doctor who will look me in the eye. When they are about to break bad news, there is typically a whole lot of foot shuffling, chart consulting and looking at their shoes.
This guy looked at me, spoke to me and LISTENED to me. He actually engaged me in conversation.
All was going well and I was feeling more confident and comfortable by the moment.
And then, Dr. Y asked what I thought about the information session I had attended. I told him that it was very informative, which was really a very well-thought out and witty answer since they are called INFORMATION SESSIONS for the express purpose of being informative.
I was certain that I would be disqualified from any surgical procedures for my entire life because I am a moron.
But Dr. y just smiled and said something that sounded like " Well (to which I had an internal groan of defeat), it seems as if you'd be a great candidate, perfect in fact for Gastric Bypass because you have no history of........blah, bleh, bloh, goo, gah............and you are young, foo, fah, klee, koo.........
I heard nothing else. My mind was in the throes of trying to process phrasing that was the EXACT OPPOSITE of what it had expected. My mind is often caught unawares and does not always respond with warp speed when confused.
I sat quietly as he spoke, thoughts racing through my bewildered cranium. "Does he realize I had a complicating procedure done already? Did anyone give him my records to review before he came in here? Does he understand that he is SUPPOSED TO BE SAYING NO?"
I was hearing his voice but not really processing his words, certain that he had not been informed of my prior surgery.
And then he directed me to a poster on the wall behind me. A graphic illustration of the GI system from esophagus to small intestine.
He pointed to the poster and stated, with great conviction " this is where your previous surgery was, and this area here is where the Bypass will be done. As you can see, with this surgery, we completely bypass the area that produces acid, so actually, after the surgery, you will be completely free of Reflux, and you can expect to lose between 65 and 75 percent of your excess weight. If not more".
I felt the room become very warm. And I realized that it was the sun peeking through a place where before, there had been no windows.
He and I talked some more and he gave me LOTS of information to read, digest and put into action.
My next step is to arrange an appointment with an associated nutritionist for a consult, and then one with a LCSW to be certain that I am not too nutty to be a surgical consideration. Then I have to do a horrific 5 day diet to see if I am able to follow directions appropriately.
That probably scares me more than anything else. Me and the directions......never a good mix.
And then we submit my info to the dreaded insurance company and see if they give the A-OK.
And then we set a date.
It is a long process with many steps, but the biggest hurdle has been passed. I jumped it, landed on the other side and didn't break anything in the process.
I spoke to my family and I have their complete support.
I am excited and apprehensive and certain and doubtful.
But no matter what, that little peek of sun keeps shining.
0 comments
It left me a bit stunned. I was expecting to have a long, drawn out conversation with the very nice doctor. I was going tell him the reasons why my life would improve with surgery that would finally correct my Reflux, and how the weight loss would be a nice added benefit. I would regale him with stories of how good a loser I am. How dedicated I am when I decide to take off excess weight. How great I look in 505 Levi's when my ass is uncovered from the fat pad. How I had no compunction about relinquishing my extra chin. I would tell him all of those things and more.
And then the very nice doctor would nod sympathetically at me and say " I see" He might even rub his chin as he spoke.
And that would be followed by something flowing from the doctors mouth that sounded like any combination of these word...
"except", "but", "typically", "usually", "too dangerous", "are you nuts?"...
The reality?
A Medical Assistant checked my vital signs. She was lovely. Before she left the room, she handed me some informational paperwork about the staff. Their names, the descriptions of what they do, their numbers. Information to make me feel comfortable. And then she told me that the Bariatric Resident would be in to see me next.
He was lovely. He walked into the room, introduced himself with an endearing level of confidence for one so young and proceeded to ask me why I felt I wanted Gastric Bypass since I really wasn't large enough to need it.
I had some trouble remaining on the examination table, what with the swelling of my head.
Until I realized that he was saying I might be more successful with a Gastric Banding because I don't weigh, um 900 eleventy trizillion pounds.
When I explained that I was there to see if I was even a candidate for ANY surgery due to my previous reflux procedure, he said "oh, I see". Which immediately deflated my giant ego and began my quick descent into " oh no, here comes the bad news" panic because I just knew that SOMEONE in a doctory type position of authority would nod gravely and say " I see" before I was given the signal to exit stage left.
The Resident talked some more and told me that he and the actual I-have-graduated-and-even-have-facial-hair doctor would review some of my test results and then the actual doctor would come and talk to me.
I braced myself. Which is no easy task because examination tables have no sides and unless you are laying flat, which is difficult because you can't lay down and then raise the thingie that holds up your legs unless there is someone in the room with you.......well, let's just say I didn't feel quite prepared to hear bad news while sitting 3 feet above a hard tile floor.
And then the actual doctor, Dr. Y entered the room. Again, a firm handshake, and introduction and LOTS of direct eye contact.
Which immediately put me a bit at ease. Having been a Patient Advocate for many years.....show me a doctor who will look me in the eye. When they are about to break bad news, there is typically a whole lot of foot shuffling, chart consulting and looking at their shoes.
This guy looked at me, spoke to me and LISTENED to me. He actually engaged me in conversation.
All was going well and I was feeling more confident and comfortable by the moment.
And then, Dr. Y asked what I thought about the information session I had attended. I told him that it was very informative, which was really a very well-thought out and witty answer since they are called INFORMATION SESSIONS for the express purpose of being informative.
I was certain that I would be disqualified from any surgical procedures for my entire life because I am a moron.
But Dr. y just smiled and said something that sounded like " Well (to which I had an internal groan of defeat), it seems as if you'd be a great candidate, perfect in fact for Gastric Bypass because you have no history of........blah, bleh, bloh, goo, gah............and you are young, foo, fah, klee, koo.........
I heard nothing else. My mind was in the throes of trying to process phrasing that was the EXACT OPPOSITE of what it had expected. My mind is often caught unawares and does not always respond with warp speed when confused.
I sat quietly as he spoke, thoughts racing through my bewildered cranium. "Does he realize I had a complicating procedure done already? Did anyone give him my records to review before he came in here? Does he understand that he is SUPPOSED TO BE SAYING NO?"
I was hearing his voice but not really processing his words, certain that he had not been informed of my prior surgery.
And then he directed me to a poster on the wall behind me. A graphic illustration of the GI system from esophagus to small intestine.
He pointed to the poster and stated, with great conviction " this is where your previous surgery was, and this area here is where the Bypass will be done. As you can see, with this surgery, we completely bypass the area that produces acid, so actually, after the surgery, you will be completely free of Reflux, and you can expect to lose between 65 and 75 percent of your excess weight. If not more".
I felt the room become very warm. And I realized that it was the sun peeking through a place where before, there had been no windows.
He and I talked some more and he gave me LOTS of information to read, digest and put into action.
My next step is to arrange an appointment with an associated nutritionist for a consult, and then one with a LCSW to be certain that I am not too nutty to be a surgical consideration. Then I have to do a horrific 5 day diet to see if I am able to follow directions appropriately.
That probably scares me more than anything else. Me and the directions......never a good mix.
And then we submit my info to the dreaded insurance company and see if they give the A-OK.
And then we set a date.
It is a long process with many steps, but the biggest hurdle has been passed. I jumped it, landed on the other side and didn't break anything in the process.
I spoke to my family and I have their complete support.
I am excited and apprehensive and certain and doubtful.
But no matter what, that little peek of sun keeps shining.
