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2 weeks out: What I Wish I knew Then (i.e. pre-op)



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Sleeved 8/29/11. I'm 2 weeks out now and wanted to jot down some things for others who are headed this way. Most of this may be repetative, but I guess its always good to hear it different ways.

1. Surgery was just that - major surgery. Don't kid yourself and think it's anything less. There is incisional pain from the lap sites, but it's not terrible. You will have your good friend Morphine by your side. There are the inconveniences of a JP drain - which dangles from a hole in your gut, but doesn't really hurt. There is a darn foley catheter "you know where." These tubes being there doesn't hurt, it just hinders you wanting to be more mobile and get back to normal. It's the removal of these tubes that you probably want to save up a few hits of morphine for. Don't fret - it doesn't hurt terribly - its just darn unnatural to have these tubes yanked out. Painwise - after you are home you are sore. I was off pain meds (because I used it all :)) on Day 6. Didn't need it after that, or liquid tylenol did just fine. (Oh, the nighttime liquid tylenol is good if you can just nap!)

2. Weight Loss - you will GAIN weight in the hospital because they are pumping you full of liquid via IV the entire time. However, once you go home you will lose all that quickly. My admittance weight was 307. My go home weight was 313. My current weight (15 days later) is 280. You need to recognize how much of your weight is Water. Don't focus on weight loss at all during the first 2 weeks. Focus on HYDRATION. I would even say don't focus on Protein and all that crap. You can die from dehydration in a matter of days. It will take more than a month to kill yourself off by not eating. So, order of the day: DRINK. Gatorade G2, Water, Crystal Light, whatever makes you happy.

3. Eating - Sucks. This is probably the biggest challenge of this whole ordeal. In the hospital, you will be eating water. Then they give you some nasty protein to mix with the water. You will not be hungry. You must drink this protein mix with water to ensure you are capable of doing so at home. Luckily, the last thing you "eat" in the hospital is liquid pain medicine to make sure you can handle that when you get home too. Once you get home, you get to do your clear Liquid Protein thing... flavors of your choice. But remember, you will not be hungry. This is more an exercise of trying than succeeding to get your 60g of protein. Remember - this time is all about drinking fluids to hydrate. To be honest, I failed miserably at this stage and didn't get enough fluids and found myself in an infusion center at 1.5 weeks getting a few bags from a needle. Nobody said anything about my lack of protein even when I made a point of not getting nearly enough. NOW IS WHEN THE "HEAD HUNGER" SETS IN.... I didn't know what head hunger meant before. Now I know. It's watching all those damn commercials on TV for every food in the world and wanting it... in quantity. I now hate Papa John and Burger King's marketing department. I wanted to TASTE FOOD. Real food dammit. Not this liquid crap, not applesauce or yogurt or other "stretch options" outside the bounds of Clear liquids. I wanted to get in the car and drive to the chinese food place, or a fast food joint, or order a pizza. I would only be able to lick it and smell it, but I wanted it BAD. Here is how I cheated - don't try this at home.... I did get some egg drop Soup and ate a small bit in week 1. I gummed a few of those wonton thingies they give you with it. I didn't get sick. I think I ate a single noodle from a chicken noodle soup. I sucked a piece of bacon but didnt swallow it. Sad. Towards the end of week 2 the doctor told me I could start experimenting.... That is exactly what it is. You try different things. I found I could eat egg salad, but not scrambled eggs. I can eat tuna salad, but not tuna by itself. I have eaten (other than the normal greek yogurt and other good stuff): 1 whitecastle cheeseburger, 1/2 of a mexican pizza. Those are the worst things I have eaten and not thrown up. Throwing up was a huge scare for me. It's not as bad as you think it will be. You just do what you can to not repeat the experience. It is, in itself, a great learning aid. Now comes the HOW YOU EAT section.... You cannot eat too fast. you will overeat. you will be shocked at how small your stomach is. Eat a small bite, wait 2 minutes, eat another small bite, wait a bit... After 3-5 bites, stop. You will feel this sense of doom if you eat too much. Your stomach will start to hurt, you may throw up, you will feel an indigestion like feeling start creeping up your throat. Eating definitely is an experiement. Don't do it where you can't recover from it if it's not something you have experienced before. Be at home, with something to puke in if the worst happens. Don't eat and drive :) I am hoping this part gets a little easier with time. Until then, I am experimenting away. Also, listen to your head. It will tell you "hell no" to stupid ideas. The thought of a nice steak is mouth-watering, but there is NO WAY I would try that now... my head says so. I think week 3 or 4 is when I will start actually trying to hit my protein target.

4. Recovery takes time. I went back to work on day 8 (I sit all day or walk to meetings where I sit). I left feeling completely drained. I stayed home day 9, and went in day 10. This week (day 14) I am at work. I am tired. I have very little energy. Getting up in the am and showering and dressing makes me want to go back to bed. I get in about 1 hour later than usual. I take extended breaks (20 min or so) and just sit in my car with the seat reclined. Every day though is better than the last, so I do see a light at the end of the tunnel.

Overall, I am still in that "What the "F" did I just do to myself?" stage. I am lighter and skinnier, but am coming face to face with the challenges around eating and energy and drinking enough fluids. But, that does get better every day. The good thing is that I didn't overthink this too much... I didn't give in to my fears. I know this was the right thing to do. And now its just a matter of dealing with it. At this point I have no choice! So man up and do it....

Hope this helps...

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Congrats on the weight loss! It sounds like you have everything under control.

I'm still pre-op liquid stage and I already have head hunger and can't imagine it gets worse! My neighbors all bbq daily and the aroma just floats in. Very enticing.

When did you start driving? I have to start a week out and am not sure I will be able to do it.

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This is my story exactly! I was tired when I went back to work day 8. I didnt stay home on day 9 though but I probably should have. For about 2-3 weeks, I was tired after showering and had to lay down for a minute before getting dressed. I was not staying hydrated like they told me. I got a kidney stone from that. Hospital again for a week but it helped me get hydrated again and I skipped the full liquid week almost entirely! I was still weak for week 4 but it was getting better every day. Now at week 5, I feel almost brand new! I dont have to rest after my shower. I still use a chair to sit and brush my teeth, hair, etc. I dont want to push it. I am feeling so much better now. Just be aware of how important drinking is! This post is the most true to my experience as I have found. I dont think kidney stones are common but I am proof they can happen if you dont drink! Good luck to everyone and just know that this too, shall pass, and soon you will be your old self again, just a lot less of you!

I forgot to say that I struggled with head hunger for the weeks I was on liquids but that quieted down after I could eat soft food.

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So I drove for the first time on Day 6 or 7 when my power went out from a storm and evacuated to air condition at a friend's house. Driving isn't a big deal if you don't have pain meds on board. You will be fine to drive at end of week 1 as long as you aren't drinking swigs of pain meds out of the bottle and dont have to go too far.

In terms of head hunger in pre-op.... yeah, um.... I cheated a few times. Not proud of it, but it happened. And - FYI - that pre-op diet is all about shrinking the liver. Basically its like Atkins diet on steroids. I personally would have (and I am sure I did once) eat a small piece of meat without too much guilt. Not advising you to do different if your Dr. says otherwise, but I heard it from my nutritionist's mouth (she encouraged it). I didn't eat anything solid 2-3 days prior though. I ate a salad or 2 pre-op as well.

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Thank you so much for sharing this iwth us/me. I have read so many helpful posts and everyone is super transparent which is wonderful but your step by step experience is just the thing I was looking for when I logged in today. My surgery is on 9/20 and my sister and I have been talking about the day to day and right after that conversation I log on and see your post. Thank you, thank you, thank you!!! It has truly helped!

Be well and please contiue to keep us posted.

Niki

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Congrats on your success this far and for your continued success..

Let's just keep in mind that everyone's hospital experience will be different. You won't always have a catheter and you won't always have liberal access to pain drugs like that.

Just one more thing that pre-op folks should know.

That being said, I had almost NO pain post op besides tender incisions and a really tender stomach for the first 36 hours which I can more likely attribute to vomiting brought on by general anesthesia..

That's something I wish I'd known about pre-op.... your reaction to general anesthesia can vary widely. For me it was seriously unpleasant.

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I would like to add that I didnt have a drain or a catheter. My surgeon didnt use a bougie device either and I had no leak test. My surgeon used the scope and checked for leaks during the surgery so no need for a bougie or a test after. Yay me!

I was also given a medicine called emend before my surgery to prevent vomiting caused by anesthesia. I havent vomited at all since my surgery. I am careful to stop eating when I feel chest tightness.

I hope this helps someone. I could eat 3 oz of lean meat and a nonstarchy vegetable for dinner on my preop...the rest was Protein drinks and Clear Liquids.

Every doctor is different and has different reasons for having different diet plans, etc. Some use a bougie and some dont, etc...

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THIS IS REALLY GOOD! I especially agree with #3. But I would like to add that I had PAIN! Really bad PAIN!

It's so worth it though! But it's good to know the good, the bad and the ugly!

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Thank you for sharing :) As much as I love the "I am sleeved, everything went well posts" I soak up these detailed ones! I realize of course that everyone's experience is different but it really helps to read about what other people experienced, good and bad.

I am hoping to go back to work as well around day 9 or 10 but I am worried about how tired I will be. Luckily I should be able to take short shifts and only work for a few hours at a time.

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I did not have a catheter or a drain tube. I was happy about it going into it but that first night in the hospital was hell without the catheter. Being pumped full of liquid with an IV meant that I had to get up to pee every hour and a half. Hoisting myself out of bed, dealing with the gas bubbles rumbling around, having to have the nurse unhook me from everything so frequently, not getting to sleep through the night... it was awful. I wished I had a catheter at one point and seriously considered just wetting the bed. LOL I made a point to walk a lap around the hospital each time I got up though so that helped with the gas. I would also rinse my mouth out at the sink while I was up. I wasn't allowed ice chips or anything by mouth for 24 hours. They gave me a sponge to swab my mouth but that did NOT cut it.

I was lucky in that I only had two instances of nausea. The very first thing I did when I regained consciousness was throw up a little blood. It didn't hurt at all though so don't be scared! And they said the blood was normal. I was too out of it to be too concerned. haha The other time I felt nauseated was right before I left the hospital. My potassium was low so they gave me some to drink in a medicine cup. It tasted like concentrated salt Water and I immediately felt sick and it took my full concentration to hold it back. Since it was in a big medicine cup I decided to break it down to two sips. After that first one and feeling so sick, I convinced my mom to pour the other half down the drain. I obviously don't recommend that, but I don't regret doing it.

A lot of people said that they hardly take any pain medication when they get home, but I also took it for almost a week. I had to refill my prescription and started feeling a little self conscious about it, but as far as I can tell I'm healing normally. I had some pain around the one incision where they pulled my stomach out and I don't like pain so I took the meds. It wasn't excruciating or anything, just uncomfortable. I could drive once I was off the pain medication for 24 hours, but I wouldn't advise making long trips, just because you'll be really tired and your reaction times may be off.

I went back to work on day 16 and I'm glad I waited. It took me quite a while to find a Protein shake I could actually look forward to and once I started getting in more Protein my energy came back. I also got some depression after I quit taking the pain meds. It felt like PMS, like my hormones were out of whack. I cried a lot for really stupid reasons. It's totally normal and I kept telling myself that, but it doesn't help in the moment.

The only pain I have now is a little muscle soreness and I have recently started having some heartburn/reflux. Just remember that everyone's experience is a little different. Read as much as you can so that if and when something happens to you, you'll know it's normal. Your experience won't be exactly the same as anyone else's.

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Wow, this is the BEST post I've read so far! Thank you. I'm scheduled 9/29. Thank you Thank You, THANK YOU!!!!

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I had a drain for 3 days. My surgery was great no pain or gas. Only uncomfortable from the incisions. Now I am told that I did really great but another lady that had the same thing cried for 2 days because of the gas pain. I had surgery on 08/18/11 so I am still new. I took a month off work and so glad I did. I am still tired so much of the time but I do feel better each day and I also have problem getting my fluids and Proteins in daily I am down 22 lbs as of Saturday so overall I am very happy with my sleeve. And the head hunger does suck I agree burger king and other fast food ads will drive u crazy lol

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This is a good post. My experience was a little different than yours, but we all have our own little varieties. I'll share mine, so people have an idea of what can/cannot happen.

I didn't have a catheter, so I kept on going to the bathroom with the IV. I had a bruise on my left wrist for a couple weeks from the IV, and the back of my right hand is still sore from it (one month post-op).

The nausea was the worst. I threw up foamy diluted blood on the first and second days (which is normal). The barium swallow for the x-ray made me vomit. I was so afraid of ripping my staple line from all that vomiting, but I was OK in the end.

My pain was actually quite manageable, so I'm lucky in that regard. The first 2 nights I woke up from pain, but the nurses promptly treated it. The first day I was in very little pain (in fact I felt pretty good) because I was high on anesthesia; I started to feel uncomfortable on the second day (mainly from the nausea and drainage site). I asked the nurse and doctor to take out the drainage tube by then, but they had to keep it in for the leak test on day 3. TAKING OUT the drain and the stitch holding it was probably the most painful/uncomfortable part of the ordeal, but it only lasted a minute. After the nurse took it out, I was freaked out mentally by the idea that there was an open hole on my tummy that would heal from the inside-out.

In the hospital I was actually lying on my stomach by the second evening (trying to relieve the gas pain). My doctor (Dr. Aceves) came in and saw me lying on my stomach on the 3rd day and said I was the second person he ever saw lying on his/her stomach after surgery! He said it was a good sign that I was healing well and had little pain :).

I only used 2 of the pills the doctor sent me home with, and they were for things completely unrelated to the surgery. I used them for menstrual cramps, lol. I really didn't have any pain by the third day. I still have the pills and I'm just keeping them "in case". I'm not sure how to properly dispose of them (i.e. I don't want to throw them in the trash).

Gas can feel impossible to get rid of. I walked around the hospital on an hourly basis, and I still had lots of gas. It completely went away by day 4 or 5. It particularly annoyed me because I had to fly across the country (San Diego to Cleveland, OH) after the hospital discharged me. Gas-X strips helped relieve the pressure, but I still had to toot.

The head hunger IS real, especially while I was on the liquids-only phase. TV food commercials seemed evil to me, how they zoomed in on the food in slow motion. pizza was always my "drug of choice", so those commercials were the hardest to watch. I often found myself changing the channel or walking away from the TV. While on liquids I would put food in my mouth, chew it, and then spit it out. It was gross, but it gave me that little taste I desired. I did cheat once and eat a couple potato chips (that went down well). My mom always has 2-3 bags of potato chips out, and it drives me nuts.

WLS also changes your perspective on things. I'm a lot more attuned to food and the way it affects me. Another "side effect" (that I don't really like) is that I pay attention to other people and what they eat. My mom is very large, and eats a lot of crap. I want her to have WLS too, because I don't want her to die from her obesity (she already has hypertension). My dad has cancer, and I don't want my mom to be sick too! At 53 she's still young enough to make a change. But, then I remember how I would get p*ssed at people who told ME to lose weight. It's a decision she has to make for herself, but I am concerned for her. Maybe once I'm successful, she'll see that and go get WLS too.

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