Call Me Mr. Swiss (because I’m full of holes)

I had my surgery November 2. No “before” pictures, no videos to provide a male perspective on this surgery, just a great deal of wondering, “Would I recommend this process now that I’ve had surgery?deep-thought

I was continually asked, “Are you nervous?” I wasn’t until I was walking into the hospital Wednesday morning before 6AM.  I was wondering what would change when (ok, and if) I walked out in a few days. It was nothing more than the fear of the unknown. The day before had been clear liquids only, and that was a little tough. I did discover chicken broth was tasty, but also discovered that even the low-sodium version is still a lot of sodium. I thought a lot about never eating pizza or fried chicken again, but soon realized that my inability to handle the responsibility such food and my body demanded was part of the reason I was drinking clear liquids.

GRIEF FOOD
Looks like a food funeral to me…

I had a scare a week prior, when I went in for my last visit with the surgeon. It was a Friday afternoon, my sister was with me as my medical proxy (it turns out I’d divorced my other one four years prior), and I weighed in at 280.  Why is that a big deal? Because I was down to 265 and at one point went on a carbohydrates bender, which caused me to gain seven pounds in 3 weeks.  I still dispute the actual number on the surgeon’s scale, because I went home and my home scale, which I know to be a scant 4 pounds different frscaredom the scale at the clinic downstairs from the surgeon’s office, put me at 268. But my surgeon said she was flagging my chart, and if I gained even one more pound I would be over my goal weight and ineligible for surgery that day. That threw enough of a scare into me that I went totally low-cal, down to protein shakes and one meal a day, plus a minimum of 12,000 steps a day. It did the trick. I weighed in the morning of surgery at 266.

The intake nurse, Kellie, was nice. We went through what seemed like a million questions, an IV port inserted, and my temperature brought up to above 98.6 degrees. I spoke with the nurse anesthetist and a few other nurses, as well as the surgeon. I don’t really remember being wheeled into the operating room at all. I was told I’d be brought out of anesthesia in the recovery room, and when I was awake I’d be brought to my room on the surgical floor.  I don’t know about recovery, because when I woke up I was in my room on the third floor, and I was in some serious pain.  Not an uncomfortable amount of pain, but serious, PLEASE-GOD-LET-ME-DIE pain.  let-me-die

My daughter was there, her boyfriend showed up, my sister and brother-in-law were there (all of the I know because it’s what I’ve been told), I had a flower delivery I did not respond kindly to, and I was in tears, screaming for someone to help me. No one would. Apparently they had given me pain meds that were only supposed to be given every four hours, and they couldn’t give me another dose for some time. In the meantime, I felt like I had been ripped viciously apart and left to bleed. I wasn’t bleeding, but it felt like I was being ignored. While I was bleeding. swearing

I have nothing good to say about the initial wave of nurses assigned to me post-surgically. Should I not say anything? I will, because it will serve to highlight the care I received later, but the first batch was led by Nurse Ratched who would not allow the LNAs to help me do anything, groused at them and me, talked back, and couldn’t have been less helpful.  Someone eventually told her that if she wasn’t there to help me, she could leave and not come back, and she did just that. nurse-ratched

A sweet LNA named Krissy came in and started setting things right, and an RN named Laura did a fantastic job helping a very aggravated patient get squared away without losing her cool. She was calm, cool, collected and nothing but professional. The overnight nurse continued the trend and was so sweet. My daytime nurse was a guy, and I had a male LNA, Chris, as well, and it was great. I like people who speak my language, and these two did.  A bit of conversation, just being cool and getting things done, went a long, long way. I was fortunate enough to have Dustin, the RN, again on my final day. The night nurse on my last night there, Kelly, was fantastic. I was a little iffy on her at first because it seemed like she was not patient-focused, but I was wrong. She gave me her hospital direct dial so I could skip the nurse’s station, which was huge. I let slip at one point that I had never been ignored more anywhere I’d ever been. I’d call for pain meds, and despite the fact that the floor was not very busy at all, it would be a half hour before they’d call down again and ask how they could help because the call light had not been shut off. So I’d remind them, and it would be another 15 minutes to half hour. Again and again and again. Thank God I had a catheter. If I had to wait for them to come get me to take me to the bathroom, I’d have wet the bed and sat in it for an hour before anyone noticed. I was still on attended walks when I got tired of waiting, got up, unplugged everything, went to the bathroom (after the catheter had been removed), went for a walk, walked the entire floor by myself, marched right past the nurse’s station into a “Staff Only” kitchen, grabbed myself a popsicle and went back to my room, where I plugged myself back in and got back into bed. No one said a word. No one noticed. I took off the DVT leg wraps and shut the machine off because it was doing nothing but alarming out. Not a word again. That part really concerned me about my stay, but that’s different for every hospital, I’m sure. My grandmother raves about the same hospital, and what do I know from post-bariatric surgery protocol?

I’ve been home for two days. Friday night was difficult, but I slept upstairs, albeit sporadically. Yesterday I felt nauseous all day long. I was going to go to Target, Marshalls and Hobby Lobby with my daughter to get my walk in. I made it most of the way through Target before I had to go back to the car. I felt feverish, and nauseous at the combined smell of Starbucks and popcorn.  I had just had enough. I came home, took pain meds and slept most of the day.  Needless to say, I’m behind on my water intake, though I think I’m good on my protein. I’m waiting for my drain site to close so I can shower. I slept better last night. I didn’t feel like I was ripping open when I moved, I was able to move onto my right side for a few minutes to alleviate back pain, and I didn’t take any pain meds. It is still very hard to pick things up off the floor, but it’s getting easier. I’m passing more gas, which is good because my stomach is less swollen which takes pressure off the six sutures. (TMI?). I’ve felt feverish. I’ve been really cold. But would I recommend this surgery to anyone else?question-mark

Still too early to tell.

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The (Relational) Space Between Us

Hey, it’s not as bad as it sounds.  We had our third week of what I have begun to call “Fat Class.”  Week three is reserved for prospective bariatric patients and the support people.  It was a full room, and good for those people who brought someone.  There we were, the 5 or 6 of us who brought no one, in the back row looking at each other knowingly.  We live alone, some by choice, some not, and I am confident we’ll figure something out when the time comes.  I’m sure I could get a member of my family or a co-worker to come and sit with me to make sure I’m okay.  I’ll sleep downstairs to be close to everything relevant.  But this night, I was flying solo.  Come to think of it, if I were a pilot, flying solo would be a badge of honor; it’s something one has to graduate into.  Go me.

flying solo
from robynhobson.com

It was a good class, which surprised me, because it wasn’t as much about food as it was relationships.  One of my favorite sayings regarding the fairer sex comes, of all places, from Popeye: “It’s been proven through history that wimmenz a myskery.” Dr. W. was discussing the relational system, and how it needs 3 things from all involved to keep going

  1. Flexibility
  2. Adaptability
  3. Accommodation

    Feminist popeye
    The mystery is what the hell happened to her forearms.

If one of these things is missing, the system starts to break down.  To put these things into a diagram, draw a box, and write “ME” in it.  Then draw a large circle to the right of that box.  To the right of that, draw another box and write “YOU” inside.  That circle represents the relational space.  This is where things get worked out.  I pour in my thoughts, needs, hopes, and wants.  You pour in yours.  And from that we get our compromise.  We say, “When you ____, I feel ______, and what I really need is _____.”  Keep in mind, this means that we have to tell people what we want, and we have to be direct.  Now, write all the wants and needs in the circle.  Remember the Tinker Toy exercise, where we draw spokes off the circle and figure out how to get these things in the circle?  We are NEVER, EVER stuck in a problem!voodoo doll

Picture instead a fight. Arguments and fights happen when we don’t use the relational space, and instead go around it.  Draw an arrow from your box around the top or bottom of the circle directly to your partner’s box.  Admittedly, I have worn a path of fire in the area around the outside of the relational space.  Which is why I was alone on support night, let’s be honest.  Anyway, that path leads to the pyramid of escalation.  On the base, level 1 is discussion and compromise.  Level 2 is “Attack, defend, counterattack, retreat.”  Level 3 is the level reserved for goading and button pushing (you know who you are).  Level 4 is verbal abuse – demeaning, name calling ugliness.

Argument
Careful, lady.  I’ll bite that finger clean off.

And the tip of the pyramid is physical abuse.  If something comes at us from levels 2 or 3, we must always respond from Level 1.  We could say, for example, “Could you help me understand what some of your concerns are?”  It gets to what is happening in their head, not addressing the escalation.  Nothing good ever comes from anything above level 1!

Before the class  started, I was talking to a guy in the back with me.  He mentioned that he’s been doing the exercise, eating the way he is supposed to, and he still feels like he’s gaining weight.  I feel exactly the same way!  I met with the dietician Friday, and she thinks I’ve hit a temporarily plateau in my weight loss.  She thinks because I’ve been trying to stick to 1200 calories a day that my body thinks it’s starving and is slowing things down.  So we’re going to add a few hundred calories a day and see if that changes things up.  I also need to change what I eat every day for lunch to keep my body guessing.  Not the first time I’ve heard that.  So tomorrow I will spend time looking for other lunch alternatives.  I was only up a pound over a two week period, but I still see that as going in the wrong direction.  I mean, I wound up here by overlooking one pound at a time.  It eventually became 100.  As the saying goes, a nickel here, a dime there, and pretty soon you’re talking about real money.  At least I think that’s the saying.

Gain weight
Um…no.

I was approved for the in-lab sleep study two Wednesdays from now, so I’m (not) looking forward to that.  I mean, I sleep naked, so between having to wear something to bed and being in a strange bed on a weeknight, I may not sleep at all. Thing is, the in-home sleep study isn’t as comprehensive, and apparently many people end up needing the in-lab study anyway.  So no sleep, and I might get to come away from it with a stinking C-PAP machine.  And I get to go to work the next day.  Awesome.

No Sleep
Thursday’s warning to my coworkers