Hey all, so I'm still not totally recovered, but I feel well enough to sit up at the desk for half an hour and write a quick update. Thank you all for your lovely messages of support, they've been nice to hear!
It has definitely been a much tougher recovery than I had planned for, but it's getting better day-by-day and I'm finally starting to feel normal again. I'll start from the beginning...
Surgery Day (Wednesday) - We got to the hospital for 9am and surgery was set for 11am. We checked in at 9 and were taken back to the OR prep room. At this point they made me change into a gown, put in an IV, went over my medical history again, gave me some pre-surgery meds through the IV and then I waited with my family. At about 10am the anaesthesiologist came by to introduce himself, look over my records and let me know what was going to happen. After that one of Dr. Greene's PAs came over to pretty much do the same thing and then Dr. Greene himself came by. He explained the surgery to me again and took any questions I, or my family, had. After that it was about 10:50 and I had to say goodbye to my family. Honestly, at this point I was wanting to put my clothes back on and say "Don't do it". Mainly scared and nervous of the surgery, what was going to happen, how the recovery would be, etc. Anyway, I said goodbye and they took me into the OR. They then transferred me to the operating table, strapped my arms and body down and put my feet/legs in some inflatable massage wraps. The wraps massaged every 30 seconds, to stop blood clots forming. After that they made me breath some Oxygen in for 4 minutes, then they put the anaesthesia in my IV and that's the last I remember until I woke up. I will say that while I was being strapped down and given the anaesthesia I was terrified and probably looked that way, but Dr. Greene's two PAs held my hands and talked to me through it all.
My partner tells me that surgery took about 4.5 hours, after which Dr. Greene came out to talk to my family, let them know what he did and tell them I was in recovery. I was actually in recovery for about 4 hours, sleeping. I remember waking up to them pulling a tube out of my nose and trying to give me ice chips. I was then moved up to my room on the Bariatric ward. I was slipping in and out of sleep during this whole period, so I don't remember much, just a lot of nurses coming in and out of my room, taking my blood pressure a lot, hooking me up to machines and IVs, etc.
I had the Gastric Sleeve done and also had my gallbladder removed as it had stones when they inspected it. My hernia wasn't fixed, as they said they may not, as Dr. Greene advised me that he would only be able to temporarily fix it and it would likely re-rupture within a couple of weeks, causing me more pain.
I have 5 incision sites around my abdomen, the biggest being just above my belly button area, which is where they pulled out the stomach they had cut away. The incisions are sewn on the inside, with the final layer of skin being closed with glue. The glue stays on for a week or two after surgery. It lasts through showers, etc.
That whole night I know I was in a lot of pain, more than I had expected or planned for. I had a pain pump attached to my IV, which I could press every 10 minutes and I'm pretty sure I did. You can hit it as much as you want, but it only gives out medication at 10 minute intervals. However, they use the number of times you hit it to detect how much pain you're in.
Post-op Day 1 (Thursday) - I was hoping to go home today, but that didn't happen. Because I have my hernia I was in a lot more pain than they, or I, expected. I finally got out of bed around 8am on Thursday, with a lot of pain. I was still on the pain pump and an IV. I sat in the chair for a while, until I could get the pain under some sort of control.
The nurses are very interested in how often and how much you urinate, drink and pass gas. They come in the room every hour to ask about those 3 things, which while I understand why they have to do it, it made me anxious. I was always worried that I wasn't urinating enough and they were going to put a catheter in me, which they said they may do. Anyway, around 9am I went to the bathroom and urinated a little bit. Evidently it wasn't enough for them, so they put me back in the bed and did a bladder scan, to make sure I wasn't retaining water. It was extremely painful to get back into bed and have them push on me for the scan. I wasn't retaining water and at 11am I finally urinated enough to appease the nurses. However, they still came in every hour to check how much more I had gone!
I had a bit of shoulder/back pain from the gas inside of me (this is gas they use to inflate your abdomen during surgery). They try to suck it all out before they close you up but some always gets trapped. Over 3 or 4 days it dissipated, but it does get painful occasionally.
At about 1pm they brought me a tray with a protein shake, bowl of broth, cup of hot tea, bottle of water and packet of Crystal Light. They also bring a sheet of paper so you can mark down how much you're drinking. Honestly, I saw the tray and thought "That's optimistic"! They want you to drink 1oz of liquid every 15 minutes. That's enough to hydrate you, but not too much that it will put pressure on your new stomach and burst the staples, etc. Well, that whole first day I got in about 7oz of liquid. I just couldn't get it down. My stomach felt swollen and like the liquid was getting caught up and wouldn't go down. I was still on an IV, so I wasn't dehydrated, but the problem is that they won't let you leave the hospital until you're A) urinating enough, B) drinking enough, C) walking enough and D) can manage your pain with oral medication. Well, I wasn't doing any of those things, so I wasn't going home!
I did get a little better as the day went on. I started walking around the room and then once I knew I could do that I started taking small, 2 minute walks, out of the room. I held my partner's hand the whole time as not only was I in pain and not steady on my feet yet, I was also hopped up on narcotics, which made me sleepy and dizzy.
Oh, one thing they do every day is weigh you and don't be alarmed if you put on weight. Between surgery day and post-op day 1, I had gained 8lbs! It's only fluid, surgical gas and swelling, but it can be disappointing if you're not aware that it will happen.
The rest of Thursday I slept in and out.
Post-op Day 2 (Friday) - By Friday I was doing a little better. Still in some pain, but it was improving, I was urinating more, drinking a little more and walking a lot more. I was taking 4 or 5 minute, slow walks around the hospital. The girl next door to me had her surgery 4 hours before mine, with Dr. Greene, so I would stop in her room and have a little chat with her also. I started to be able to get 1-2oz an hour down, which isn't great, but was much better than Thursday. I also stopped using the pain pump, which is the only way they would let me go home. I moved onto oral medication, which didn't control the pain as much, but enough to get me home.
Dr. Greene stopped by the room around 11am to look at my incisions to see how I was doing. After checking me over and talking to me and my family for a while he decided I could go home as long as I had IV liquids with me. He also said I could shower, which was great as I felt gross and the nurses wouldn't let me shower without his approval. I think this was because they weren't sure if the incisions could get wet, but the glue they put on them protects them from everything.
Taking a shower was interesting and somewhat painful. My partner had to come in the shower with me and basically do everything for me. Stretching is uncomfortable, it feels like you're going to pull your new stomach apart, as well as your incisions, so washing my hair was out of the question. Thankfully my partner has been an angel! She helped me shower, washed my hair and then dressed me! It may have felt like I was being pampered, had I not been in so much pain. She also stayed in the hospital with me, the whole time I was there, which helped more than I can describe. Looking back on it, I really don't think I could have gotten through those first few days without her there, she was basically like a nurse the whole time. If you can have someone stay with you, in the hospital, then I would definitely suggest you do, it makes things so much easier and you don't have to call a nurse every time you want to reach for a drink, go to the bathroom or take a small walk. My in-laws were also there the whole time, which I appreciated. I had a lot of support!
Anyway, after my shower I had to have a new IV put in, then I got dressed, my family packed up everything, I got my discharge papers and we left around 2pm that day for the 2 hour drive home. The drive home wasn't all that nice. I felt nauseated the whole time and was in pain, but I made it and then basically went to sleep!
Around 9pm on Friday, Wallgreens came by with the IV fluids Dr. Greene had ordered for me.
Notes - Everyone at the hospital was awesome! Latasha, the Bariatric co-ordinator, came by my room several times per day to check on me, order any meds I needed and to push me along with walking, drinking and urinating. The nurses were great, they were very busy but did anything they could for me. One nurse, Admire, specifically asked to look after me because I was "That girl from England". Haha! I was a mini-celebrity on the ward!
You won't get much sleep the whole time you're in hospital. The nurses come in the room every hour from 6am to midnight and every 2 hours from midnight to 6am. They wake you up to ask if you've urinated, to see how much pain you're in and to give you meds. You have to urinate into a little bucket thing, which sits over the toilet, so that they can measure your urine.
You will be nauseated quite a bit to start, but they'll give you meds for it. You also won't be able to drink as much as they want you to and they will definitely push you, but they mean well while they're doing it!
The best thing you can do is drink, drink, drink! It's annoying and you won't feel like it at all, but if you want to get out of hospital then you have to drink your 1oz every hour and walk around a lot.
While you're in hospital and for 12 days post-op (timing may vary from doctor to doctor) you will be asked to give yourself 2 shots of Lovenox, or Heparin, per day. This is a blood thinner to stop clots forming while you're not moving around so much.
Oh and you cannot laugh! Laughing hurts a lot. Your abdomen stretches, your incisions stretch and it feels like your new stomach is being pulled apart.
Post-op Days 3 and 4 (Saturday and Sunday) - One thing I forgot to mention is that I cannot sleep lying down at the moment. My abdomen feels like it stretched too much and it's painful, so I have been sleeping in a chair since surgery, with my legs raised on a foot stool. My partner has been sleeping on the sofa, next to me, so that I'm not alone!
Saturday I woke up in a lot of pain but the Oxycodone that I was prescribed was making me nauseated and stopping me from drinking. So, I called Dr. Greene on his mobile and he faxed a prescription for Vicodin through to our pharmacy, which we picked up right away. Once I started taking that the pain went away a little.
I was trying to walk around the house, 4 times per day at least, for a few minutes at a time. Apart from that I would be in my chair, hooked up to an IV and trying to drink, drink, drink. I still wasn't doing very well at drinking, getting about 2oz per hour. When I spoke to Dr. Greene he advised me to start drinking regular Gatorade (vs. G2, which is what I was using) as he needed me to get the carbs and sugar because I was drinking so little. My father-in-law went right out and bought me a few bottles. One bottle of Gatorade lasts me about 2-3 days, with some protein shake in between.
All I can drink at the moment is:
- Gatorade (regular for now, then moved to G2)
- Protein shake
- SF Jell-O
Protein shakes are hard to get down as they're so thick, so for the moment I mixing them with a little water.
Saturday afternoon a Wallgreens nurse came by the house to set up my IV. She showed us how to attach it to the IV in my arm, what to set it to and how to remove it when it's done. So, I'm on an IV of 1litre for 4 hours each day.
The rest of Saturday and Sunday was sleeping and being told when to drink!
Post-op Day 5 (Monday) - Today was my first follow-up visit with Dr. Greene. They weighed me and I have lost all of the post-surgery weight (8lbs) plus an extra 3. They went over what meds I was taking, which at this point I had moved off of narcotics and was simply on two Tylenol 3 times per day. I'm also taking a multi-vitamin twice per day and Prilosec once per day, to reduce my stomach acid.
Linda, doctor Greene's PA, did my visit today. She wasn't happy with me not drinking enough. I had one bag of IV fluid left and she said if I didn't start drinking more they would have to remove the IV and put in a PICC Line, which is a more permanent IV that they thread through your vein and sit just above your heart. Apparently that's all the threat I needed, as I started drinking 3oz per hour after that. It's funny what motivates you...
Linda ordered another 2 litres of IV fluid for me, to keep me going through Wednesday as they didn't think I was hydrated enough. She checked my incisions to make sure they were healing okay and prodded my abdomen a little, which hurt, but she said everything felt fine.
Because I wasn't hydrated she made an appointment for me to go back the next day, so they could check on me again.
When we got home I started keeping a chart of how much I was drinking and by the end of the day I had gotten up to 4oz an hour, most of the time.
I started to get really bad pain again, in my abdomen and around my hernia area, so I had to move back to the narcotic medication, which helped after about 24 hours. Apparently, because I no longer have a gallbladder, my body processes fat, carbs and protein differently. The protein I had drank (Atkins Advantage) didn't sit well with me and caused severe diarrhoea, which caused my colon to pull on my hernia, causing the pain.
Post-op Day 6 (Today)! - Today I woke up around 10am. The pain was there still, but much less and has gotten better throughout the day. It's now 9:30pm, I have a little discomfort but not too much and I haven't had any pain meds since 10am, so all in all I'm not doing too badly. I've had a headache all day, because I don't have enough calories or carbs in me, but it's getting better. I'm also sleeping a lot, but again it's because my body doesn't have much fuel for energy right now.
I went to see Dr. Greene again today and he was pleased with my progess. He weighed me again and I have lost another 4lbs, since yesterday! I'm pretty well hydrated, but he wants me to keep the IV fluid going until Wednesday. He gave me some samples of other protein shakes to try, since the Atkins is making me a little sick at the moment. We made another appointment for the 7th October, and we went home.
Today I'm much better than I have been. Pain is almost gone, I'm walking much better and it no longer hurts so much when I laugh. I'm managing to get my 4oz per hour in, but I'm not hungry at all. If I could just not drink/eat at all then I'd be happy, but apparently that's not allowed, especially when you have very cute, well-intentioned family bugging you to drink every 15 minutes! I still can't sit at a desk/table for too long without my abdomen aching a little, but it gets better every day.
While I've been at my follow-up visits in the doctor's office I've seen several people who I was either in hospital with or have chatted to at other visits. Everyone is so friendly and helpful, they all share their stories and are happy to give you advice. A lot of the new patients also ask for your advice, which is nice. It's like a mini-support group before your doctor visit, each time.
Before surgery I was told that I would regret having the surgery for the first day or two. Honestly, I thought to myself, "There's no way, I've been working towards this for a couple of years, I've researched, I've done the hard work and it's what I want". Well, that all went out of the window for the first 3 days. I was sitting there, in pain, not being able to drink or sleep and regretting ever having decided to go through with it. I was wishing I could go back in time and just walk out of the hospital before surgery. It's normal, natural and believe me, it does get better! I'm still not 100% recovered, I still have some pain, I still can't walk too far but I'm getting better day-by-day and I no longer regret having it done.
For now the schedule going forward looks like this:
- Liquids for 3 weeks post-op - 1oz every 15 minutes, never exceeding 5oz per hour
- Soft foods week 3-6 - 1 teaspoon 6 times per day for 3 days, then 1-2oz six times per day for the rest of the 3 weeks. Also having your liquids in between. Soft foods are: eggs, cottage cheese, very soft flaky fish like cod or crab and very soft, mushy vegetables
- Week 6 onwards - start introducing poultry, vegetables cooked normally, raw vegetables,etc.
- From day 90 onwards you can introduce beef, but it has to be very good cuts of beef, not hamburger.
You have to make sure you eat all of your protein first, then if you have room you can have some vegetables, salad, etc. Things vary from doctor to doctor, but specific to my doctor, I'm not allowed to have more than 50g carbs, until I get to my goal weight. So, no bread, pasta, rice, potato, fruit or starchy vegetables. Also, no drinking 15 minutes before and 45 minutes after a meal.
That's about it all covered for now. You will definitely have doubts, but if this is what you want and you feel it will make your life better, then do it! However, please make sure you have someone to support you and someone to support them. My partner has been my rock through all of this, but we definitely needed my in-laws to make sure that she slept, had food, etc.
I've included some photos of the hospital room, the food tray they bring you and my incisions. I will update in a couple of days with my progress and thank you all once again for your well wishes. I've appreciated them so much!