Friday, September 26, 2008

I'm a post-op!

Hey, I’m home from the hospital! And what a long, strange trip it’s been. In fact, I’m pretty sure I dreamed most of it since a lot of what I’m about to report will seem unbelievable – I don’t even believe it. But I’ll let you be the judge.

We went up to San Francisco on Tues. evening because going up from our house during morning rush hour is iffy at best. Sometimes it takes 45 min. and sometimes it takes three-four hours. Having to be there by 6:00 am would mean leaving at 4:00 am that day to be sure to get there in time and even then, we might be late.

My husband drove us up and Mini-Mac, the youngest, went with us. MacBoy is a teenager — in other words, weird — and had been nursing a cold and fighting coming with us even before that so we left him home. I knew he was worried about me, but more worried about crying in front of me or some other behavior that would seem absolutely horrible to a teenaged boy, so I didn’t push him to come up even though I knew all the things he was dreading – like seeing his mom in pain – weren't really going to happen. Plus I didn’t feel like getting sick from him.

The Cathedral Hill Hotel is very pretty. Our room was enormous. I couldn’t believe how nice it was for a downtown SF hotel under $100 a night. (Thought that is the special hospital rate. I think normal people pay more.) When we got checked in, I took my Milk of Magnesia and that meant I couldn't go over to the hospital to visit Ainjul from the ObesityHelp.com "sleeve" board as I had originally planned. I needed to stick close to the bathroom, if you know what I mean.

I think it was okay because her surgery got put off until 5:00 pm so at 8:30pm there was no way she’d be up for visitors. I know I wasn’t really up for them until about ten hours after my surgery.

I had some really weird dreams that night. Mostly about being late and everything going wrong. I got up in the middle of the night and realized that, when we flipped the switch to turn off the lights over the bed, it had turned off the clock radio! (Luckily I never trust the hotel alarm clocks and had also set an alarm on my iPhone.) I ended up giving up on sleep around 4:50 am and decided to take a shower. This is when I discovered that there was no hot water. Just freezing and lukewarm. I went for lukewarm.

So I guess Cathedral Hill is a more typical of $100 a night SF hotel room than I'd originally thought. It’s still a nice place though.

There is a shuttle from the hotel to the hospital, but the first one left about 45 min. after we were supposed to be there. So, based on the info that the hospital is six blocks from the hotel, we walked. And discovered it was more like 15-20 walking blocks and uphill almost the whole way! My daughter whined the whole time until the ground leveled out and she could use her Heelies, but I practically ran the whole way because I so excited.

We checked in and paid. Good thing my surgery was Wed., because Thurs. my bank failed. (Seriously, it’s WaMu. Failed and sold to J.P. Morgan.) They took me to different rooms and had me sign things and change into a hospital gown — which barely fit around me. This was bad because the Milk of Magnesia had really kicked in by then, so I made lots and lots of trips to the bathroom clutching my gown around my buttocks. I was surprised because I was expecting a bariatric-sized gown that would swim on me.

Between the day of clears and the MoM, I had dropped another three pounds – assuming that their scale and mine were calibrated the same.

Mr. Mac and Mini-Mac got to come with me for part of the prep, but then had to go to the lobby when I hit the “holding pen”/recovery area. I forgot to leave my glasses with my clothes so Mr. Mac took them. Being without my glasses is very disoriented to me so this increased the feeling of unreality.

While I was waiting in my little holding cell, I listened in to other patients. (I’m so nosy!) The guy next door was in for something completely unrelated, but when he listed all this previous operations, he had had a gastric bypass! Isn’t that weird how you can go for years without hearing about something but then suddenly it’s everywhere?

Most of the people talking to patients were anesthesiologists and didn’t impress me that much. I was starting to get worried – because the anesthesiologist is the one who keeps you alive. But mine came in and I really liked him. He gave me a lot of confidence.

He had a resident with him and he was explaining stuff to her and raving about my airways – both in the holding room and also, later, in the OR. Apparently my neck is an anesthesiologist’s dream. Who knew? I’ll have to tell my mom because she’s always telling me I have a pretty neck and mom’s appreciated stuff like that.

They walked me to the OR (to prevent blood clots) and I got on the table and they prepped me. At one point they said, “let’s call Dr. Awesome and make sure he’s here and not in traffic.” I was surprised he wasn’t already there. In fact, I never saw Dr. Awesome the entire time, which I thought was strange. But I did go out like a light soon after so he could have been there the entire time and I wouldn’t have known.

When I woke up in recovery, I had some pain, but not too bad. They had me hooked up to that machine where you give yourself a shot of painkiller whenever you felt like it. Here’s another weird thing – the LED panel said it was morphine. It’s not supposed to be morphine, right? But between the no glasses and feeling like I was dreaming, maybe I just misread it.

I took full advantage of whatever it was and, as a result, the next 24 hours had a very dream-like quality. But Mr. Mac says that everything I said that happened when he was there was true, so maybe I didn’t dream it all. On the other hand, if it turns out that I was dreaming the entire time, that’s totally believable too.

In the recovery room, I had to pee but I couldn’t use the bedpan. (Nothing came out.) I swear they let me walk to the bathroom because no one else was there. That seems questionable, doesn’t it? But later on they wheeled more people in and then I was stuck with the bedpan. So maybe I just had a rule-breaker looking after me.

My next memory was being in my room. It was a very tiny room. I had trouble getting my IV wheelie thing to move around with me because it kept getting caught on things. Plus it plugged into the wall. So if I went far away, I had to unplug it and it would go on battery power. Again, that doesn’t make sense and it part of why I think I dreamed the whole thing.

Anyway, the room felt a bit like a private room that had an extra bed shoved into it. Mr. Mac and Mini-Mac were there with me. Mini-Mac had read her card and really appreciated it so I’m glad she wrote it. She bought me a round stone that said courage on it in English and Chinese from the gift shop.

But I didn’t visit with them much as I kept falling asleep. Around 3:00 pm, they went home. I was unhappy to see them go, but couldn't blame them. I'm sure they were bored out of their skulls.

I walked the halls a lot, but pretty much never saw other patients there, just medical personnel. Again, that seemed strange and contributed to the dream-like quality of my experience. I expected a ton of bariatric people, but it’s an enormous hospital and we seemed to be scattered on different floors. During this time, my roommate was sleeping. At one point, Ainjul came by to visit me on her way out the door. She said she was on the fifth floor. (I was on the fourth.) Maybe I was on a non-surgery floor so all the patients weren’t supposed to be walking?

Then my roommate woke up and that’s when everything got very, very Fellini. She was making a lot of noise. Moaning and rocking back and forth and babbling incoherently and picking at herself. Her hands never stopped moving. It was distracting, but I thought the nurses were very mean to her in response and that put me on her side, whereas normally I’d be upset with the moaning.

They said she had to stop because she was disturbing the other patients, which she was, but how is yelling at a sick person who is clearly out her mind going to get her to stop? It reminded me of when I had my gallbladder out and the nurse in the recovery room was saying I was disturbing everyone with my crying and I was saying “but I can’t freaking BREATHE” until I made them give me more morphine and could breathe and calmed down. So this treatment of “Jessie” (I think that was her name) really pissed me off and I decided to adopt her.

I got some ice chips at some point and then later my first meal of clears. It had a Popsicle, some broth, some tea and some sort of Healthwise protein drink (with a little bottle of Arrowhead water to mix it up with) and jello. After I’d worked on it for a time, the nurses kept trying to take it away. But I wanted to eat/drink it all because of the protein. At one point when I wasn’t looking, they took everything but the protein drink and a pitcher of water. I was annoyed. I never even got to try the broth.

I also had trouble with the drinking. I was taking tiny, tiny sips but they still hurt. So it would be sip, okay, sip, pain, sip, pain, sip BRACK! (That last part was the belch-a big, loud one). I finally decided to use the straw from my water glass and that helped a lot. But it took forever to finish a drink and I don’t see how I’m going to get my protein in at this rate.

I also kept falling asleep while drinking and ended up spilling tea all over myself. The staff said they weren’t sure a bariatric-sized robe was available, but I told them the regular ones fit well enough. Besides, I had a robe with me to keep myself from giving the rest of the world a show.

I did eventually finish the Healthwise drink, which has a whopping 15 grams of protein. Yeah me! I would have been happier if I’d had the jello too, though.

Then I concentrated on my roommate who was still quite upset. Over the course of the evening, I pieced together her story — obviously the medical staff couldn’t tell me much because of HIPAA and she couldn’t tell me much either because she was out of it — but she was an elderly patient from a nearby nursing home and had dementia. (Though, I’m not sure if someone told me that or that was my homegrown diagnosis.) She wasn’t in for that, but I never figured out what she was in for.

Honestly, I think she was just old and everything was giving out and she didn’t much want to live either. She was on a catheter and also she never got up from her bed the entire time I was there.

She couldn’t really make herself understood to the staff either, but at some point, I got used to her special language (the Mother Skills never die and old people and toddlers have a lot in common) and could piece together what she wanted much of the time.

Mostly, it seemed to me that she was lonely because all of her friends and family her age were dead (she kept asking for various people by name and sometimes I could make out that they were an uncle or sister or something who had died and she missed them) and also, she didn't like losing her mind. I guess she still had enough of it to know what she was missing.

Several times she said something that made it seem like she wanted to die. I told the staff – because suicidal thoughts are not good – but they didn't seem to care. Of course, I was high as a kite on painkillers and kept losing my glasses, so maybe I only thought I had told them. Or maybe they didn’t take me seriously.

This is the same staff that delivered my spirometer but never really showed me how to use it. I was unimpressed with them. Note to afternoon staff on the fourth floor at CPMC: you suck.

The evening staff was much better. They showed me how to use the spirometer and were nicer to "Jessie". (I don’t think that was her name – it’s just what I ended up calling her.) They actually brought the earplugs for me that the afternoon staff said they'd get and didn’t. They said between the earplugs and my headphones listening to music, I should be okay, as that has worked for the gal in that room the night before. But I couldn't get the earplugs to work at all and it bothered me to just block “Jessie” out.

In the end, I spent a lot of time perched on the end of her bed rubbing her back and soothing her. She liked it when I held her hands too. This kept her quiet so the staff wouldn’t get on her case and it occupied me and kept her from picking at her bandages. It kept me off the Internet though so that's why I haven't checked in with anyone or answered any messages.

During this time, I kept waiting for Dr. Awesome to show up as I had questions for him. I’d hear he as “in the building” and did catch sight of him a few times, but he never came to see me. So I asked about it and the nurses said he wouldn’t necessarily come see me if there was no issues (again this seems iffy to me—maybe I just dreamed it?) so I put in a special request and around midnight he did pop in and answer my questions. Too bad I didn't take notes because my recollection of our conversation was hazy at best.

One thing I did figure out – that horrible pain I’ve been having in my middle left back off and on for years that felt often felt like a muscle tear and, at one point, I thought was related to my allergies? It was the hiatal hernia! Dr. Awesome said all my back pain at this time was because he repaired it. He apologized for it, but I was so happy to have my heartburn disappear and to not have that localized pain that I didn’t care.

Most people tell their bariatric surgeon that he saved their lives because of the weight they lose. Dr. Awesome improved my quality of life dramatically in one day just by fixing the hiatal hernia. He's my hero!

Around 2:00 am, the night nurse (Henry?) came in and gave me a shot of something called Tramadol. It was AWESOME. No pain and I felt like I could paint my house. However, I was now wide-awake. This was good though because "Jessie" was not in good shape. In fact, I ended up crawling into bed with her. Again, this makes no sense to me that the hospital staff would let me do this. Think of the liability! But I'm pretty sure I did, in fact, do it because at one point her doctor came in and pointedly asked me if I was a family member.

I scuttled back to my bed and let him draw the curtains between us so he could poke at her and ask her questions she couldn’t answer. Then as soon as he left, I scuttled back.

I did question the staff at various points about what was wrong with Jessie because I was afraid I would accidentally hurt her by sleeping with her like that. They were tight-lipped, but never did anything to stop me. I think they were so grateful that I was keeping her quiet that they didn’t want to rock the boat.

At one point, I told them it wasn't fair to Jessie not to be in a private room – that all these strange people coming and going were upsetting her. They agreed, but said every hospital bed was in use (reinforcing my idea that my room was supposed to be a single). Plus, later the rational part of me realized that old folks who’ve been left to die in nursing homes don’t get private rooms.

Then, the morning staff came back and at this point I was really wiped out from not having slept since the anesthesia wore off. So even though I was in better shape than the day before, I was more out of it.

I actually remembered some of them from the day before, which made the whole thing seem like less of a dream. They were also nice so my goal at this point was to get checked out by 11:00 am (like the sign in the room said to) before the dreaded afternoon staff came back. I felt bad abandoning Jessie, but not bad enough to stay another day.

Breakfast came and was a repeat of the day before except my Healthwise drink was orange and not red. Because of what happened with dinner, I made sure to try everything on the tray at least once.

I got a visit from Amy, the LapSF nutritionist soon after. We exchanged paperwork (medical leave forms) and then I wanted to go some stuff in the book to make sure I understood it. She was happy I was working on the protein drink and said it looked like from my breakfast tray that I was going pretty well. I forgot to tell her about the pain when I drink though.

Either she or Dr. Awesome said I shouldn’t take my blood pressure medicine any more, but that I should monitor it. Also, since the Potassium Chloride is only being taken because the HCTZ is, no more of that either. Yeah, I’m so happy! Except I can’t find that in my release notes so now I’m wondering if I made that up too.

At that point, all I had to do was get a sponge bath from my day nurse and then I could go home. But Mr. Mac hadn’t shown up yet! I was sort of annoyed, but when he did show up – with Mini-Mac, who I thought was supposed to go to school – he said traffic was horrible just as we had feared it would be if we came up on Wed. There was an accident on the bridge among other things and it took two hours to get there instead of the one it should have taken.

They got me all packed, I had my sponge bath, and then I said good-bye to “Jessie” and went home. I did make sure to get one more shot of pain killer from the blue box before they disconnected me. Also, because I still felt kind of loopy, I had them take me down to the curb in a wheelchair so I wouldn’t fall over and be sprawled all over the payment

As soon as I left the hospital, and got out in the sun, I had a massive case of dry mouth. Of course my chapstick was in my robe pocket. But, I realized, so was my iPhone! I made Mr. Mac open up my suitcase and make sure the phone really was there before I left. (The chapstick was no where to be found though and later appeared in Mr. Mac’s pocket.) Then we were off!

I kept falling asleep on the way home and at one point thought we were almost home when we were still on the Bay Bridge.

At some point, I found out that Mr. Mac hadn’t called the people on my list. My angel, Janet, called him, and he called my mom. But not my sister or my friend Michelle. So I called Michelle. At least I think I did. That might have been a dream too.

When we got home, Mr. Mac set up a station for me in the bedroom and MacBoy came in and gave me a big hug. I could tell he’d been worried about me. He hadn’t read his card though so he went off to do that and then I didn’t see him again until I went looking for him. Teenaged boys are so weird. They live most of their lives holed up in their rooms playing video games and texting their friends.

While sitting in bed catching up on Dancing with the Stars, I got a massive case of the itchies. It was my incisions. The glue on them was flaking all over. So I scratched at them and picked at it until I was sorry. I couldn’t stop though. Eventually I had Mr. Mac cover them with first aide cream and band-aids so I couldn’t scratch them any more.

Then, I decided to weigh myself to see how much water weight I’d gained in being hooked up to IVs. Remember that 191 figure they told me in the holding area? Well I was 10 pounds heavier when I got home. Ouch!

I had Mr. Mac make me another protein drink for “dinner”. Between that and breakfast, I had 50 g of protein so that’s good. But I’m supposed to have more so I tried an Isopure ready-made drink later on. I didn’t get very far with it though.

I also got a fever. You are supposed to call if it’s over 100.5. Of course mine was at 100.5 exactly. But it went down and was only 99.3 at bedtime. I took off the band-aids at that time because they were making my scabs moist.

This morning I was down to 196 pounds so I assume that water weight is going to fall right off. I’ve sure been peeing enough. I still have slight pain when I drink but nothing I can’t handle. Some slight itchiness too, mostly on the top of my breasts. I have no idea why it’s in that particular area.

My incisions look great too. Dr. Awesome used the top of my gallbladder incisions for the liver retractor and now it’s in better shape than it was to start with. The ones around my waistline do hurt occasionally especially if I stretch to get something off a top shelf. So mostly I make Mr. Mac do all my reaching.

The really great thing is that my stomach feels entirely normal. I was worried about that the most. With some of these operations, you end up with stomas and other weirdness that makes it hard to judge normal and can limit what you can eat.

My main problem at this point is that it takes forever to finish a protein drink. I’m still working on the Isopure from last night. Also, I can’t suck hard enough on my spirometer. Related to that, when I tried to go to bed last night, I couldn’t lie down and had to use too pillows to prop me up.

So today my goals are to get in at least 50 g of protein – as least as much as yesterday – and to walk around the neighborhood and also to blow on the spirometer until I can get up to the 1500 mark every time. I don’t want to get pneumonia.

Mr. Mac is home to help me and the kids have no school because it’s Native American day. It feels like Saturday, but it’s nice.

I’m sure I’ll think of something I left out later on, but for now, that’s my sleeve story.
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