Buffalo Springfield -- For What It's Worth -- 1967
It's Sunday, June 28th. 2:30 pm est.
I am still in the hospital. My 14th day since admission.
I may be able to go home Tuesday.
I have spent much of my time here very, very sick. Vomiting for over 24 hours at a time. Weeping while vomiting. Moaning while vomiting. Regretting my decisions while vomiting. Crying softly in pain. Praying for this all to be over.
Knowing that I would never allow one of my animals to suffer the way I have in the past 2 weeks. I would have opted for euthanasia.
But now I am optimistically better. Before my Surgeon left for the weekend on Friday, as an afterthought--------completely out of any other medically viable, legal and non-mystical options, he said "maybe we should try a short course of high dose steroids to see if the intestinal swelling will respond at all"
Within 1 hour of the first dose, the vomiting that had persisted unrelenting for 23 hours had stopped. The excruciating trapped gas pains that had been splitting my skeleton in half were gone, the weeping had ceased.
That was Friday afternoon. I have had 2 days of feeling good since then as the steroids have continued.
I am very cautiously optimistic that we have passed the worst, but the steroid doses end today, although I have been assured that they remain active in the body for several more days. That high a dose is simply too dangerous to continue safely.
I still have had NOTHING by mouth for almost 2 weeks. Not even an ice chip. Today is the first day I have experienced thirst and the remotest interest in the far-off possibility of eating something, anything, someday in the next millennium. A Chili's commercial actually caught and sustained my attention for a few seconds.
I am scared. Scared that I will lose ground and go back to those very dark days where, truth be told, I was begging to die rather than endure the agony any longer.
I am scared because even if I don't backslide, I have so much to learn before I can return home and work on becoming healthy again. I have this PICC line now, and will need to be taught how to care for it at home Because of the PICC line and subsequent nutrition, and the high dose steroids, my blood sugars have been temporarily waylaid, so I need to learn to check my sugars 3 times daily and inject myself with maintenance doses of insulin. The PICC line care is HIGHLY sterile, so I will need to be trained by VA nurses, the enteric formula and supplies will be delivered to my home and monitored,I will need weekly blood draws and sterile dressing changes and IV poles and, and, and...........
I am completely overwhelmed.
But I'm still here, euthanasia needle gleaming far, far in the background.
In the meantime, I am working on a new post to talk all about the positive changes for the Princess. Life has pointed it's good luck arrow in her direction and she is having a blast.
Sunday, June 28, 2009
Thursday, June 18, 2009
Can't predict the future, can't forget the past, feels like every moment could be the last
Robbie Robertson -- Showdown At Big Sky -- 1987
Writing from the hospital. Day 4. Admitted again.
Nausea, profound weakness, inability to take ANYTHING in. Weight loss - 8 lbs in 7 days. Not well.
Test results.
Acute gastritis. Probable H Pylori.
A large and unexplained Fistula at the site of the new surgical connection.
My Magnesium and Potassium levels are dangerously low due to starvation.
My doctor doesn't yet know what he is going to do to treat all of this.
I just sit here and cry.
Weight loss to date - 40 lbs.
Writing from the hospital. Day 4. Admitted again.
Nausea, profound weakness, inability to take ANYTHING in. Weight loss - 8 lbs in 7 days. Not well.
Test results.
Acute gastritis. Probable H Pylori.
A large and unexplained Fistula at the site of the new surgical connection.
My Magnesium and Potassium levels are dangerously low due to starvation.
My doctor doesn't yet know what he is going to do to treat all of this.
I just sit here and cry.
Weight loss to date - 40 lbs.
Tuesday, June 09, 2009
I'm on my way, I'm making it
Big Time -- Peter Gabriel -- 1986
First post-op doctor's appointment yesterday.
Prognosis: Doing well.
Advice: Keep doing well.
Weight loss:
17 lbs since leaving hospital 8 days prior.
32 lbs total since beginning my journey with the Surgeon.
Outlook: Bright.
First post-op doctor's appointment yesterday.
Prognosis: Doing well.
Advice: Keep doing well.
Weight loss:
17 lbs since leaving hospital 8 days prior.
32 lbs total since beginning my journey with the Surgeon.
Outlook: Bright.
Thursday, June 04, 2009
Turn off your mind, relax and float down stream, it is not dying
The Beatles -- Tomorrow Never Knows -- 1966
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.
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:
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.
Monday, May 04, 2009
What's all these crazy questions you're askin' me?
Three Dog Night -- Mama Told Me Not To Come -- 1970
I simply can't do this regular Blogging thing. It hurts my head.
I have too many things to think about. To much to get done. Too many deadlines.
And I only have 21 days left to get it all done.
21 days. Because on day 22, I will be comfortably numb in a room that looks similar to this:
I simply can't do this regular Blogging thing. It hurts my head.
I have too many things to think about. To much to get done. Too many deadlines.
And I only have 21 days left to get it all done.
21 days. Because on day 22, I will be comfortably numb in a room that looks similar to this:
My surgeon is the dark-haired one on the right. He's better looking in person. And taller. And his thumbs are opposable which is an important attribute for a surgeon.
That must be an old photo.
I am having my surgery on May 26. They determined that I was not significantly psychotic/narcissistic/ambidextrous/loquacious/multilingual/bi cultural or fantastical to disqualify me.
And now I have a LOT of work to get done before the operation. I will probably be out of work until July 6, so I have to do all of the planning for the time I am recuperating, and then plan the work events until August because we always plan 6 to 8 weeks ahead. I am obsessively making detailed lists for my coworkers to completely ignore so they can foul up my cleverly masterminded and highly effective systems.
I can feel my fontanel aching.
I also have to create tomes of directions for my Mother. Because my dogs will explode into hairy shards if I leave her to her own devices. She will feed them until they spew like overdue geysers. There are meds to be given, eye boogers to be cleaned and sleeping arrangements to be adhered to. There are sounds machines and snacks and Kongs and pee schedules and color coordinated food bowls and leashes and collars and...........................................
Oh sweet Jebus my follicles are bleeding.
And then there is the packing. The necessities. The things that I will NEED. The list mocks me. I work in the same facility where I am having my surgery. I used to be in charge of lost and found when I was a Patient Advocate.....or as it was aptly coined.......LOST and LOST. So I know from lost items that are NEVER seen again. But there are things that I NEED.
I NEED my I-POD. I simply cannot breath without music (operating room nurse please take note)
Ear plugs because my trusty sound machine will be lulling the puppies into a deep slumber at home.
A good book because my brain cells are atrophying as I type. They must be saved.
Chapstick because I will be allowed NOTHING by mouth for a few days and the peeling-lizard lip skin does nothing for my self-image.
New Adidas sandals. Any excuse for a new pair. I lurvs me some of those.
Gas-Ex strips. Fairly self-explanatory.
Purell almond scented, moisturizing anti-bacterial hand wash. Because some staff still don't get the 2-decade old hand washing initiative.
Clothes. Meh.
Lotion.
I WANT MY LAPTOP!!! But missing/stolen/lost laptop while in an unconscious stupor will result in murderous /psychotic rage when awakened.
And at this point of the list, my head simply blows apart into smithereens because it is
ALL. TOO. MUCH.
And then there is the worry over the general well-being of the Princess who met a guy, dated the guy, dated the guy again, got her hopes in a twizzle and the guy petered out. And not below the waist.
So she is in a funk about her LOST and LOST love life.
And my mother. Well, she is in a tizzy about what I will eat after I come home. Our conversations follow this path on a regular basis:
Her " can you eat meat ever again?"
Me " eventually, but probably not for a few months"
Her "oh. OK. Then what are we going to do about meals?"
Me " Ma. Don't worry. I know what I can have and what I can't. It'll be fine. You don't have to worry about it. I have the detailed list. Remember? The one I made a copy of so you could read it."
Her " so if we wanted a steak, you could have it? How about pork? Could I make a salad to go with it, or can't you ever have that again? I don't know how I am going to deal with all of this. This is an awful drastic change, doncha' think?"
Me-------------
In a dead faint on the floor from exploding head.
I have to clean my house from top to bottom, finish all of my outdoor projects that normally take me all spring and into the summer, groom my dogs, do eighty seventrillion loads of laundry, unsub from multiple e-mail lists, shop for post-bariatric surgery protein powders and vitamins and sugar-free foods and pureed soups and Greek yogurt and vitamins and............................................................
Me--------------------------------
Dead on the floor.
Surgery - unnecessary.
Problems - solved.
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