8/8/08: Methodist Hospital, Houston, TX
My DH and I arrived at Methodist bright and early. Too early for the valet parking guys, which we didn't need in the morning, but might have come in handy when I left. Followed the signs and only had to ask for directions once. The Houston medical center is a maze of buildings that connect. The signage design people must make a fortune off of them. We reported to the 3rd floor nurses station and they immediately put us into a room and gave me a lovely gown in which to change. Did the typical answering of the same questions 100 times that you do when you have surgery. This prep nurse was not going to win any miss congeniality contests, that's for sure. I would actually have described her as dour.
We hung out there for about an hour... I'm convinced now more than ever that the 2-hour before surgery arrival time is like the airline arrival time - not exactly to ensure you make your plane in time, but completely for their convenience. Next time, I'm coming a little late :thumbup:.
They wheeled me out to the surgical hallway, literally. There were patients lined up along the hallways waiting to go into their surgical suites. A nurse came by and asked the same questions again. Then the anesthesiologist who spoke so quickly, I'm glad I could catch up. Next was the nurse anesthesist and a nurse anesthesist who was in training. They'd be doing the anesthesiology -- the other dude is really just "supervising". Had a nice talk with them, since we were still waiting for the doctor. Oh, by the way, all of this sucked to some degree because I was not permitted to wear contacts and had to give up my glasses to my DH. I couldn't really see anyone I was talking to. Then Dr. Garth's resident and a VERY young intern (I swear he was 12....maybe 17) came over to talk. His Physician's Assistant and the surgical nurse also came by. I think there were 8 or more people in that operating room! Well, Methodist is a teaching hospital...
Finally, Dr. Garth came by. He asked if I was ready, and I asked if he was :thumbup:. Then they wheeled me in, and I don't remember really anything until the recovery area. They let DH come back and see me for awhile -- had told him I was fine and he let the folks know that I had told him to call or e-mail that I was fine. Then, they were just waiting for a room in which to move me. I heard the nurses talking about the room and the fact that the upper GI was not until the next morning! I tried to break in and tell them that I was supposed to go home today, so that could not be right. They kind of ignored me but pretended like I said something that made sense. They gave me a room assignment and sent me to the 8th floor room, which suprised me because it didn't seem so much like a day surgery thing. I was SOOOO thirsty. They gave me one of those spongy things to suck on, but, man, was I dehydrated -- probably from all of the broth.
When I got on the floor, they wouldn't give me anything, either. I had to use the restroom, but the nurse wouldn't let me because my pulse ox was too low. She put a nasal cannula in with oxygen, which finally got my O2 up enough to go pee! Getting up hurt like a @#$%&. I asked for some pain meds and got some morphine, which didn't really do much.
A couple of hours later, the VERY young intern comes by and mentions that they put the wrong orders on my file, and I was supposed to actually get my barium swallow and go back to the day surgery ward. So, we waited to get on the barium swallow schedule which took a couple of more hours. Good thing I had a magazine :thumbup:.
They took me down to radiology where they helped me get up onto the very odd rotating bed thing. She took an xray to get documentation of the location of the band. Then the very grumpy radiologist comes in and tilts the table up very quickly (ouch!). He had NO sense of humor. They made me drink several swallows of the awful fluid (the tech described it well -- like cough syrup without flavor), and then had me kind of move from side to side. I had to drink some more, and I SWORE that I had to talk my body into swallowing any more. The guy was just so unfriendly -- I wanted to watch the stuff go down and he just wanted to move on. Why are these guys so arrogant. Anyway, what I noticed is that my pouch seemed to be a lot larger than I expected it to be. I hope that's okay. My DH mentioned that there was another woman waiting for the barium swallow who had her surgery at 11. GRRRR.
They didn't have any beds on the day surgery wing, so I went back up to my old bed. The very young intern "Tanner" came a little later and told me I could leave once I drank some "bariatric fluids". He didn't know what that meant, really, as he was new to the "service". God, I was so thirsty, I could have downed bottles of stuff, but took it slow. Given how fast I had to/could drink that awful fluid for the barium swallow, god knows I could get more down. At that point, I started pushing the nurse for when I could leave. At 6pm (yes, 6pm), I finally got the young intern to spring me. The gave me a script for Lortadine Elixer and sent me on my way.
Stopped on the way home and filled the script, and then sat to watch the Olympics Opening Ceremony. Had a nice popsicle. Went to bed, but could not sleep. Actually, could not sleep all night. Actually went out and "slept" on the couch. I think that the pain meds have the exact opposite effect on me as they should -- they make me wide awake!!!
As I mentioned before, I was not expecting such an extreme diet prior to surgery. A friend of mine who had the surgery had no such restrictions (none at all that I could find), but it was a couple of years ago with Spivak. My understanding is that they want to shrink the liver and make it more pliable prior to the surgery. Who knew that the liver is the first to gain fat around it and the first to lose it?
I ordered the "Bariatric Advantage" stuff -- Vanilla, Chocolate, and Coffee. It came a couple days into when I was supposed to start, but I ate pretty conservatively until then, with one big exception of a Sunday of buffalo wings! Problem with the shakes -- I realized that I just do not like sweets that much and sweet-flavored things all day is not my thing. The shakes taste pretty good -- a little too sweet, but good texture. I ended up on most nights getting my protein in by boiling a chicken breast in broth and adding a couple of veggies for flavor. Made my own little chicken soup with about 23 grams of protein -- about the same as the shake.
I did have a "last meal" on the Saturday before surgery at Brennan's. We both ordered their Chef's dinner which is always fabulous and did not disappoint!
The day before surgery is all clear liquids - broth and jello (NO WAY for me) and popsicles. I don't think I've ever eaten that much broth in my life! I also took the magnesium sulfate stuff you can buy over the counter as a "cleanser" -- I had read that I was supposed to do it in the book that Methodist gave me, but I did not get any instructions on it from my Dr's office. Decided that cleaner is better, so went ahead. I got the cherry flavor - it didn't taste horrible and filled me up. It also WORKED -- I NEVER KNEW how much could possibly be in me. I was hoping that it could be an experiment to see how much "stuff" is in you, so I did a before/after weigh. Turns out all of that broth had me gaining 1.5 lbs in water weight, so the experiment failed. I also read sometime in the afternoon that I DID NOT HAVE TO TAKE IT UNTIL 4pm! So, I was urgently "going" all day and all night. Probably a good thing, because I might have had to go in the middle of the night otherwise. :thumbup:
I was HUNGRY and cranky all day. Good thing I stayed home from work! I was already cranky on folks at work the day before due to the lack of interesting nutrition in me. I did lose about 9 lbs, though :thumbup: (until I gained the 1.5 lbs on the broth!).
Night before surgery I slept pretty well, considering I had to be up at 5 to be there at 6am.
I don't know if this is the longest research project in history, but I started seriously looking at Lap Band in around 2001. I researched and researched and decided two things:
1) Lap Band not Gastric Bypass
and
2) Dr. Hadar Spivak was my surgeon.
So, I waited a year and changed my insurance to one I thought would cover it. Nope, only Bypass. Then I waited another year and changed to another I thought would cover it. Nope, only Bypass. In the meantime, I went to a seminar w/Dr. Spivak and was convinced. I did my checkout with him, and all was ok, but for the insurance. He did try to push towards the Bypass -- I think it's about the instant gratification weight loss -- they don't want you to be disappointed. Waited a year, changed again. Wrong again!
Finally, the one I chose (same as earlier change) had begun to cover the surgery, but, now Dr. Spivak was no longer on the list for BCBS. So, I changed surgeons to Dr. Garth Davis. Hadn't seen much on him, but went to their first seminar at Methodist hospital that year. Unfortunately, I was delayed after that by dealing with a lot of back pain issues, and finally was able to get back to the many dr's appts., evaluations, etc., that were required. Because I was taking Fortamet for "pre-diabetes", I also had to get a cardiologist evaluation which involved an echocardiogram and a stress test. I finally got all of the paperwork in! It took awhile, but then I got a letter from my insurance that I was approved for surgery on July 4, 2008. Since that's a holiday, I thought it was unusual, and called the dr's office. Turns out I hadn't been talking to the right coordinator for scheduling, but she did tell me that they just put a dummy date in there.
So, I called and got a date of August 8. I could have done it as soon as July 30, but my doctor said I had to be in a situation where I wouldn't be travelling, particularly overseas, for 3-4 weeks after surgery. This is unfortunately difficult for me to accomplish because of my job, but I did manage to find a slot where it would definitely be true, and stuck with it. Later, I found out that I could move it earlier, but never did get a response from the Dr's office when I asked.
When I went to do my pre-op, I did not realize that it would take HOURS! Fortunately, it was all within walking distance. That's also when I found out about the 2 week liquid diet prior to surgery requirement. They had previously mentioned that it was 1 week of 1000 calories/day which is quite different from the 800 calorie a day shake thing.
Struggling with my weight:
I've struggled for so many years with the classic yo-yo dieting. I remember dieting when I was 7 years old. I remember my extremes -- so afraid to eat anything bad that I would barely eat anything, but as soon as I slipped, would go to the extreme in the other way. Totally lost control of my weight at around 30 years old. Started researching lap band surgery at 33 years old.
