Nov 28, 2007 - I Get to Chew!

I was going to put off writing today, but after this morning experience, I have decided to post. As a morbidly obese person, I have never really much thought about chewing. Hell, as a 210 pound football playing stud I never much thought about chewing. Open mouth, bend elbow, insert food using food delivery vehicle, grind, mash, and swallow.

Wikipedia defines chewing as:

Mastication or chewing is the process by which food is mashed and crushed by teeth. It is the first step of digestion and it increases the surface area of foods to allow more efficient break down by enzymes. During the mastication process, the food is positioned between the teeth for grinding by the cheek and tongue. As chewing continues, the food is made softer and warmer, and the enzymes in saliva begin to break down carbohydrates in the food. After chewing, the food (now called a bolus) is swallowed. It enters the esophagus and continues on to the stomach, where the next step of digestion occurs.

Cattle and some other animals, called ruminants, chew food more than once to extract more nutrients. After the first round of chewing, this food is called cud.

Now first and foremost, I think chewing sounds much more pleasing that mastication. So for you science types, when I say chewing, you can substitute mastication. Last night I paid attention to chewing, thought about chewing. Downright enjoyed chewing. I have been on a high protein, liquid diet for 18 days, and yesterday I was released to chew. Notice I did not say, "Get real food". Did not mention purees. I GET TO CHEW! I love to chew.

My first meal was a soft scrambled egg and a piece of string cheese. A true masterpiece in the culinary world. Huevos con queso. One egg and one minuscule piece of cheese, and I asked SWMBO (She who must be obeyed) for a doggy bag. One egg and I had leftovers. That is really funny. But I was satisfied, satiated, not overfull, but very pleasantly comfortable. From this day forward, I am gonna be one cheap date. Excuse me waiter, I would like a cup of soup, a 4 oz steak and a doggy bag please. For dessert? How about one curd of cottage cheese? That did it, I am stuffed.

I had huevos con queso again for breakfast today. 2 more meals and 2 high protein snacks left today. But whatever the outcome, I get to chew.

Bon appetit!

Nov. 27, 2007 - 1st Post-Op Doctor's Appointment

Today has been a good day. A very good day. I took no pain meds last night, it has been 36 hours and I am pain free. I have been having trouble sleeping, or maybe it is better said, falling asleep. Then when I fall asleep, I am dreaming like crazy, weird dreams. Not violent, just weird and fragmented. I have been told the sleeping will return to normal and my droopy eyes say yeah, right!

Eating, or rather should I say drinking has also been pretty uneventful. I have been sticking to my protein drinks, thinned creamed soups, protein waters and vitamin waters, having no problems keeping them down. I even had some thinned cream of wheat which stayed down fine and was quite tasty. For my protein drinks I have been using a 1/2 & 1/2 mixture of Slimfast and whey protein power, skim milk, Shaklee LiqiLea multivitamin and crushed ice in the magic bullet. Tasty and healthy. I will have blood work on Thursday, so we will probably make some adjustments then.

Now for todays news. I went to see Dr White and Roxy. 11:15 AM and I step on the scale. 3 weeks ago I would have fought to avoid scales, now I cannot wait to get to it. I look down and read 410.8 I had to blink several times - 410.8. Holy Crap - 28.6 pounds lost in the last 18 days, never to return. I am amazed. 28.6 pounds. I cannot believe it and my feelings are all over the place. I feel kind of guilty. This procedure, according to many is painful and so difficult, and it has not been very painful for me. Difficult yes. I am not starving, not craving food, don't desire sweets and I can see the results so positively. I feel great and am only looking forward to the future.

28.6 pounds, I cannot believe it. I am amazed!

Thanksgiving Day 2007 - Freedom

I slept till about 6 AM today. Have not had any pain meds since about 11 PM last night and still feel pretty good. Shannon relieved the Evil Tami, who really is not so evil, but I just like calling her that, at about 7 AM. Last shot of Heparin and Pepcid. It's Thanksgiving Day 2007 and I need my Doctor to come do the final inspection and release me from the assembly line.

Waiting.

About 10:30 Dr Dervall, the Internal Medicine man, came to check me out. My blood pressure is 113/69. I have not taken blood pressure meds since Sunday. Dr Dervall wants me to wait to see my PCP until next Thursday and determine what we are doing about the BP meds. Until then, I don't take them. We will see how the BP is next Thursday. Another set of vitals and need to see my surgeon. Shannon is keeping an eye on me, doing a great job, be HE is not as nearly easy on the eyes as Karen, Jennie, the Angelic Crystal, Polly Pureheart and the Evil Tami. Sorry Shannon. I am such a guy!

Waiting.

Speaking of Nurses - I need to say this. They work way to hard for not near enough money. These folks are amazing. They have so much responsibility. They were always comforting, supportive, loving, and caring. I could not have been better cared for. They laughed with me, helped me when I need help, pushed me when I needed pushing. Everyone should hug a nurse, right this second, if you are in the vicinity. I am pretty sure I love Nurses. Even you Shannon, but but not in an creepy way. If those of you contemplating this surgery are reading this, don't be a jerk to your Nurse. They will get to you and want to help you. I loved all of mine - even the Evil Tami.

Waiting.

Dr. White's partner showed up around 1 PM or so and I am free. Well not completely. Shannon gets my paperwork, disconnects me from the IV and now is prepping to pull my drain. Now I have to say, this freaked me out. He pulls the dressing off, which shows signs of drainage, cuts a couple of small stitches and tells me to take a deep breath and blow out slowly. Now the last time I heard these words, there was an attractive blond nurse pulling about 12 inches of poly tubing out of my hoo-hoo. Definitely not a positive memory and hearing these words again just caused a minor flutter in my chest and an uncontrollable shrinking of my manhood. Maybe its the gas. I take the deep breath and start to blow, when I feel what might be the strangest feeling I have ever felt. I am sure it only lasted a second or two, but I will remember this forever. This rubber tube is being pulled out of my body and I can feel it on the inside, rubbing on organs and my innards. It was just weird.

Shannon cleans and tapes me up, I sign my release and Shannon calls me in a pain prescription and the Lovely Sandy went down to the car to meet me outside. I wish all the Nurses my Best, and Karen gingerly walks me to the front door, and I get to smell fresh air for the first time in 4 days. What an experience, simply amazing.

Thus ends the saga of my Laproscopic Roux-en-y Gastric Bypass Surgery. Now the real work begins. Watching what I eat, how I eat, the quantity of what I eat. I will continue to chronicle this journey. I will provide weekly updates for a while and updates whenever I have a Doctors visit. I hope my graphic explanation of what occurred this week, being tempered with humor, will draw you back to read. I am planning to share my complete journey with you, as I present my Life, Exhibited.

Nov 21, 2007 - Noon to Midnight - The Wind

The angelic Crystal still has care for me. I have seen several Doctors today. Dr. White, my surgeon this AM, he says I am doing great and I should be out of the hospital tomorrow. An Internist that works with Dr. White on cases where a patients PCP does not work at a specific hospital. I cannot remember his name, but he also says I am doing great and should be out of jail by tomorrow.

Roxy and Beth came to visit the afternoon. Roxy is Dr. Whites Program Administrator Nurse and Beth is the program nutritionist. Roxy seemed especially ecstatic about how well I was doing and was especially humored by the fact that I was fussing around putting some styling gel in my hair. She made my appointment to see Dr. White on next Tuesday which will include my first post hospital check out and weigh in. Beth again wanted to talk about my post-op diet. Liquids only at 4 ounces per hour until my first visit with Dr. White. Then I will move to, hold on to your hats, Puree's. Puree's for the next 2 months. I am glad I bought that Vitamix several years ago. I could puree a 57 Chevy if I needed to.

I am walking alot now, sitting in the uncomfortable chair now and increasing the time between needed pain medications. Sandy said my eyes were real bright and beautiful today (blue and quite nice), and except for the real gas pain, I feel great. The gas pain here seems to be my real nemesis today. My lower torso region is soft and kinda squishy, but my mid torso is hard as a rock and still obviously filled with Gas from the surgery. My left shoulder hurts still right under the collarbone. The gas bubbles move and cause varying degrees of pain depending upon where they are.

Sandy has been a trooper, supporting me in this quest. She herself is not sleeping well, not eating well, just worried about me. She is taking off a little early today so she and my visiting family can go out tonight for Thanksgiving Dinner. She has decided not to cook tomorrow for Thanksgiving for the first time since we have been married (29 years) so I don't have to deal with all of the aroma's of her incredible cooking. I have an incredible wife and love her completely and will continue to need her support as this holiday season will be difficult for me, I am sure. I will be on pureed foods throughout the entire season and historically the Holiday season and been the time of the year when I do my "best work" in eating copious amounts of food. I think for Christmas, I will take a half cup of turkey, mashed potatoes, peas and cranberry sauce, add some chicken stock, bend and see what happens.

It's about 4 PM now, the gas pains are horrible, and all of a sudden I feel that oh so pleasant pressure that signals impending passing of gas. This is going to be much easier than peeing.
So I waddle off to the bathroom, take a seat, get comfortable and whoooossscchhhh! The rushing wind. Those of you that have trouble with farting may want to turn the page here. But, I am going to detail this fart.

As a farting connoisseur, I have never experience a wind quite like this. It wasn't a rumble, but much more of a pop, followed by a gas release. Not odorific, well, I didn't think so. Think about a small balloon with its opening flopping open and the trapped air rushing out for a couple of seconds. It was a good start, a very good start. Another milestone met.

Again the angelic Crystal seemed truly happy at the news of the wind and continued to cheer me on. Pardon me, I farted again. The rest of the day just cruised and several imposing farts later I knew it was time for my first Bowel Movement. I will not go into detail about the milestone event. I will not gross you out with accurate explanations about the dark liquefied, gooey, nasty gas accelerated crap bomb, with what I have started to call crap shrapnel. But when it happens to you, don't be alarmed, and I hope your Crystal reacts to it a positively as my Crystal did.

The Angelic Crystal was relieved by the evil Tami around 7 PM. Had another round of vitals, Pepcid and Heparin. Pain Meds around 11 PM and I would have slept all night had it not been for the Techs taking vitals every 4 hours.

Nov. 21, 2007 Midnight to Noon - The Flow

I have determined that I am beginning to not like Tami the nurse who came on at 7. Its just after midnight and I dread the words that are about to come out of her mouth with that cute southern drawl. They have come out of her mouth several times in the last few hours. "Any Luck?" she says. Those two words would have been fine if I was fishing, or at the Blackjack table. But at this moment in time, they were dreaded. Tonight, I definitely do not like Tami.

I cannot pee.

I have stood, laid down, sat "chick" style. I have walked. Sipped. Walked some more. I have pushed, squeezed, prayed, stood, sit, and prayed again. "God, I know you are there, and it's not like I am asking you to save my life or anything. I just wanna pee." Can one say "pee" to God. Is that one of the "words" you cannot say in church, with out the wrath of the All- Seeing, Non-Peeing God coming down upon you?

Stand, shake, sit. I cannot pee.

It's now after midnight and those two words come grating across my brain receptacles, "Any Luck"? I hate Tami. My mind screams " leave me alone you southern blankity-blank, can't you see I am trying to. I am sitting, standing, squeezing, pushing, dancing, walking, LEAVE ME ALONE", but I open my mouth and all that comes out is an embarrassed whisper of a "No". She has to let my Doctor know and we may have to put the catheter back in. I instinctively curl into a fetal position. Even I, in my Loritab induced haze know that this cannot be pleasant. It was performed under general anesthesia the first time and the only reason I know that is because there it was, in all its hanging glory after I woke up. I cannot even comprehend the horror of that occurring awake. Twelve to eighteen inches of poly-tubing being shoved up my hoo-hoo. I think "My Guy" just instinctively shrunk in horror.

Stand, shake, sit. I cannot pee. This is beginning to kinda suck.

I was starting to sweat, hey does that count as peeing, when the young female tech came in the darkened room with a rolling cart. She politely states she is here for a bladder scan to see how much fluid is in my bladder. So again I have to expose my now shrunken in fear nether regions (hey does that come in adult sizes?) to this 20 something blond tech. I definitely was not in my glory, and she scanned my non-producing bladder. 259 ml's. 259 ml's, she said again. Was that good? Bad? Do I have to worry? The tech said that the bladder is not very full. Even though they have been pumping 150 ML of fluids into me every 6 hours, since Monday, maybe I really had been dehydrated as my mouth and throat had attested to.

Stand, shake, sit, dance, squeeze, walk. I cannot pee. Oh where is that golden flow? This is really beginning to suck.

It is somewhere around 2 AM when the evil Tami returns carrying the Oh My Gosh, Mount Everest, Holy Mother of God largest IV bag I have ever seen, and I watch ER alot. Doc wants me to have a "bolus" what ever that is. I come to find out it is a large (600 ml) amount of fluid through my IV injected in a short period of time. So Tami and her three large WWE assistants carrying the 600 ML IV bag hoist the bag onto the IV pole. I think I hear the pole groaning under the massive weight of the bag. Ok, so I am exaggerating a little. The evil Tami connects the IV Bolus and starts flowing away. My hand felt a little colder, that was strange, but Here comes the Bolus. I get a new blast of Loritab, and it's off to LaLa land.

5 AM comes around, Stand, shake, pray, sit, dance, squeeze, walk, pray again. I cannot pee. I am getting desperate and truly sub-consciously fearful.

This is really beginning to suck and I decide to walk again. 6 AM is rapidly approaching when the tech come in with my twice daily dose of Pepcid and Heparin. The Pepcid is to prevent any reflux and the Heparin is a blood thinner. I am going to walk again when I feel, whats that, but the slightest bit of pressure in my bladder that sends those signals to my neural receptors, telling my brain - I GOTTA GO PEE. I shuffled off to the bathroom, bending IV pole in hand and stand there urine receptacle inn hand. I stand, I dance, Praying again now, and I hear a dribble against plastic.

Dribble, dribble............and before you know it I am into continuous partial flow. Eureka. This could be the best day ever. I can pee. Its not full force, it is a darker more concentrated color, but who cares, I can pee - which means no Foley for me. What a site, a beautiful, yellow liquid 100 ml gift for the evil Tami. Maybe she is not so evil after all.

7 AM and the evil Tami is relieved by Crystal. I have never seen anyone so happy over urine as Crystal was. She kept congratulating me, telling me how great I was doing. After that nite with the evil Tami, I am sure I see the slightest forming of an angelic halo over Crystals head. Maybe its the Loritab.

Pain is lessening from all of the lap sites except the drain site and the gas pain is really starting to intensify. Gas pain in shoulder, back and chest. Starting to get hard to stay comfortable in my bed. Walking and breathing in the breathing thingy seem to help the most.

I can pee (again). I am a big boy now.

Next Milestone will be farting, something, that my wife knows, I am an expert at.

Nov. 20, 2007 - Noon to Midnight - Anticipating the Flow.

I awoke to the wonderful sight of Wheelchair Pusher Girl. I am sure they have an official title, but all I know, at that point in time, is that she will be called Wheelchair Pusher Girl and that Wheelchair Pusher Girl = the test and passing the test = water therefore, Wheelchair Pusher Girl = water in my current 4 mg of morphine one hour ago hazed mind. My high school algebra teacher would be happy. Let us review, if A=B and B=C, then A=C. On to the test.

So as best as we could, we gathered up the IV pole and machine attached to my left hand, the catheter bag attached to my, well you know where that is attached and my oxygen tank attached to my nose, and off we went to XRay. 5 floors down, to the left, or was it right, left turn again through the automatic doors, I got to push the button, and parked in the hall outside of the Swallow Test room. Oh yeah, I had my file (one large binder) in my lap also.

The swallow test, is a test infront of a GE digitized XRay machine, where I am bestowed the awesome task of drinking this Barium Sulfate concoction. Barium sulfate is radioopaque (x-ray absorbent), used in X-ray diagnostic work for obtaining images of the digestive system ("barium meals" and "barium enemas"). Thank you Mr. Wiki. Now Crystal (God love her) in her obvious brilliant wisdom has prepped me for this with another shot, that will prevent nausea, because this Barium crap is supposed to be so foul tasting, horrible, awful, save the women and children, and just downright bad. At this point I am so thirsty, I might even consider a liquefied cat crap cocktail, so I am not too fearful of this XRay drink. I have to stand infront of an XRay machine while I drink the stuff so the Dr. can watch it pass though my system. If it flows correctly to where it should, I pass. If I pass, I get water, if I don't, well, I won't even think of that right now. I was always good in high school at tests. I have always been great at drinking, and this is a drinking test. Should be a piece of cake.

Let the test begin, I am in the machine and take a normal sized swallow of this golden elixir. The muscles in my face contorted into positions that I am sure they have never been in before. How can something that looks like Golschlager taste like???? I don't even know what this tastes like. There is nothing that can explain it, and now " Dr. This Stuff tastes like reconstituted second-hand hell" wants me to drink again. All I am thinking, is water, water, cool, clear Omaha Metropolitan Utility District City tap water. So I take my second drink, again the similar facial reaction, and I hear those magic words, you passed!!!

Thunder and lightning, fireworks, I get water!!! Now where the heck is WheelChair Pusher Girl, I gets me some agua!

Back to the room and there she is, in her radiance, My Crystal, with that beautiful plastic graduated 1 ounce cup filled to the brim with cool, clear Omaha Metropolitan Utility District City tap water. Imagine my disappointment when I realized how small a portion one ounce of water was, and how quickly my disappointment returned to joy as that first tiny sip slipped past my parched throat. I was going to enjoy this slowly. Crystal brought me another prize also. Now that I could ingest orally, the pain would now be crushed by my new friend, Loritab Elixir. Basically Liquid Vicodin and Tylenol. That stuff made me Mr. Pain No More and worked awesome.

As soon as I was starting to feel the effects of the Loritab, Crystal and Polly were back, much to my chagrin, to remove my Foley Catheter. No, please do this in my sleep, I promise, I won't be mad. Nope, gonna do it now and Polly (the trainee) gets to do it. Great. After some fumbling with "My Guy" I am told to take a deep breath, and blow out slowly and away Polly pulls. I swear I just peed myself. That is what it felt like. When I realized that I hadn't I just smiled shyly, thanked them and hoped deep in my heart that I would never have to do that again. Crystal reminded me that the next milestone was passing water. Peeing. Urinating. And that would turn out to be the scariest of all.

Tami relieved Crystal and Polly. Lord, all I want to do is pee now - please?

Nov. 20, 2007 - Midnight to Noon - I am Thirsty

I am thirsty.

I could end this blog right here and that would sum this morning up. I will repeat, I am thirsty. I have had nothing to drink since 10:30 on Sunday night and it is now 0630 on Tuesday Nov 20th and my throat and mouth is so dry. Sure, I have been on an IV, I have the Foley Catheter properly installed (a story which I will elaborate upon) and I am involuntarily moving bodily fluids. But my mouth is dry and my throat hurts and I have just been told that I can have nothing to drink until my "Swallow Test" (get your minds out of the gutter right now), Which is at least 5 or 6 hours away.

The pain is still pretty severe after 2 or so hours of Karen's and now the wonderful Jennie's visits. They have been keeping on top of the pain. Today I also realized I have the On-Q Pain Buster around my neck which is providing pain meds subcutaneously to the areas of the most internal work. This morning I really started feeling the gas bubble in my torso (used to "Pump me up" so the Surgeon has room to work inside me. I am starting to have trouble differentiating the pain - is it from the cuts and mods or is it from the gas? I have a sharp pain in my left collarbone area, which I am sure is from the gas. That keeps coming back with the mid-torso pain. It will be around for a few days I am sure.

Crystal came on around 7 AM as my new nurse, she is also training Polly. Polly Pureheart! There's no need to fear, Underdog is here! Crystal and Polly will be with me for the next 12 hours or so. These nurses are amazing. They work so hard and have to take so much crap from people. I hear the nurses outside tell each other I am a great patient, so I don't want to ruin that. They really have taken care of me so well.

I am thirsty.

We were informed that my swallow test "may" occur around 10:30 AM. That is a milestone. Many things occur when you pass that test. First on my list is I get to DRINK WATER. Did I mention that I was thirsty? One ounce of water by mouth for 16 hours after I pass the swallow test. Bring on the test! At that time they will remove my catheter. Oh joy! Two attractive women, getting to see me in all my post-operative glory, removing approximately 18 inches of poly tubing strategically placed inside my lower nether regions. I am not looking forward to that part, but Bring on the test!

I have walked already a couple of times today, walking feels good and I am so "upright". I decide to sit in the uncomfortable chair in preparation for the wheelchair pusher girl to come and get me. It is 10:25 AM.

10:30 AM I am thirsty and no test. Bring on the test!

11:00 AM and no test. I am still thirsty and my back is starting to hurt. Bring on the test!

11:30 AM and no test. I am still thirsty, my back hurts, my shoulder hurts, my stomach hurts and I am getting cranky and I can no longer focus on the television. For the love of all that is good, would somebody please bring on the test!

11:45 AM and no test. I am still thirsty, my throat hurts, my lower back hurts, my left shoulder hurts, my stomach hurts freaking everywhere and I am really cranky, the TV is a blur and for the sake of all the poor little starving children in the world, Crystal - Bring on the Morphine - screw the test.

The swallow test will happen when it happens. Time for Jim to nap. The pain is gone, Crystal is my best friend, and I am still thirsty.