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My PCP instructed me to drop one of my hypertension meds after I reported my waking BP as 97/58!

I started eating soft solids today.

I had a soft-boiled egg for breakfast. Nothing else. It made me full. It's as if my stomach capacity exactly equals one X-Large egg. Later, I filled up on 2 oz. of plain tofu. I can definitely eat more liquids than solids. I expect that stomach swelling will eventually go down and I'll be able to hold a little more food. I still have to rely on liquid protein supplement. Tomorrow: cottage cheese, crackers, and non-pureed soup. Pureed soup bites because it becomes aerated by the blender. Not cool. Adding foamy food to foamy stomach contents makes for an unpleasant kind of burping.

The incision in the center of my abdomen has started seeping a little bit. I think it's because I unconsciously use my tummy as a bumper. The original tape is still on solid and I cover that with a folded 3x3 gauze pad and some paper tape. The seepage is clear, so no big deal. 

I napped for three hours this afternoon. Fatigue is making it difficult to exercise regularly.

My calves have slimmed down considerably.

I used to have significant edema (swelling due to water retention) in my shins and calves, now there is very little. Weird, huh? My sister also said that my chin has changed shape. What kind of mutant am I becoming?

Just joking. I'm still happy.

I still have no appetite. I have an appointment on 4/17/07 with Dr. Saeed Zamini, gastroenterologist. He's going to follow up on the cirrhosis of my liver.

I visited my surgeon today for the first time since surgery.

The receptionist at the Weight Loss Center (WLS) weighed me. By their record, I lost 16 lbs. They seemed to be very impressed.

The nurse manager reviewed the detailed logs that I created. Got an A+ on eating, protein, and H2O intake.

Dr. Asbun invited me into his office. He examined my incisions and was pleased. He reviewed my logs and seemed happy. He asked if I had made sure to take before pictures.

He mentioned that he had taken two biopsies of my liver during surgery because it was very large. I inquired about that. The pathology report diagnosed probable cirrhosis (scar tissue). Since I'm not much of a drinker, I need to follow-up with a specialist. Cirrhosis is untreatable, but he said that the liver usually bounces back significantly in weight-loss patients.

So, I'm cleared to start eating soft solid foods starting this Sunday. I'm sleeping better because last night I discovered that I can sleep on my side without pain. What a relief.

Hm. The swelling in my stomach must be subsiding because now I can take all of my pills without getting the dry heaves. All I did was to eat a while before taking them, swallowing them 10 minutes apart, and walking upright to help them go down. This is a chore since I have to take 5 in the AM and 3 at night.

I cannot sleep straight through the night. This is frustrating, but it is getting gradually easier. Probably has to do with me turning over and getting pain from tender incision wounds. This compounds my overall recovery tiredness and makes it hard to get all of the walking in.

So that was a little bit of good/bad news. I'll take that. 

I still have no appetite. My tastes have not changed at all. And soups from the neighborhood chinese restaurant taste really great, even when pureed.

I have received a mind-boggling amount of support messages before and since surgery. Thanks to all!

Here it is, four days after surgery and I feel like I have enough energy to blog about it.

Lessons learned thusfar:

#1 Don’t Go It Alone

#2 Be Aggressive with the Nurses About All Pain/Nausea Medications

#3 Always Make Sure That The Callbox, Bed Control, and Telephone Are Always Within Reach

A few days before surgery, my best buddy Joe said that he was going to drive up from Los Angeles to be in my room when I got back from Recovery. He arrived after my surgery commenced. It was kind of him to insist, but my intention had always been to simply go it alone. Being relatively new to the area, I have few local good friends and they don’t live very close either. But then, something happened just before surgery that made me doubt my decision to go solo.

I never asked any family (remaining sister and brother) to fly out from Hawaii because I intended to tough it out alone. It’s very hard to make a living in Hawaii, so time off from work is a big deal and vacation time is valuable. It had only occurred to my sister the day before surgery that she ought to fly out to be here. I appreciated that and reassured her that it was okay. I received an e-mail with two sentences from my brother.

Since our parents passed away, I've been wishing that my brother, sister, and I could take time to forge stronger familial bonds even though we're busy with our separate lives. If we keep waiting until tomorrow to stop, share, and smell our roses, then one day we'll all wake up and find that our tomorrows are gone. Of this, I am very certain.

On surgery day, Tuesday, 3/27/07, I arrived at the hospital at 5:10 AM PDT.

The admitting clerk checked me in and made a big show of locking away my valuables. I had to sign and initial two papers. She put protective gloves on before placing my items into a manila envelope. THEN SHE LICKED THE ENVELOPE. Were the gloves for her sake or mine? I found this to be humorous.

I was then wheeled to my room. The wheelchair had a missing left calf cushion. I didn't realize that until i gouged my leg when I sat down. The orderly provided a folded towel. The room was pleasant. It was private and nicely sized. I changed into a gown, had my vitals taken, installed an IV catheter, then I was shaved.

The pre-op people were very efficient, kind, and attentive. I was gurneyed down to Recovery to wait for the anaesthesiologist and my surgeon. There was a single nurse and me. The big room was otherwise deserted but for rows of bare gurneys due to the early hour. So I waited.

The “something happened” was a realization. I could indeed go through the procedure solo, but looking up at all of the equipment and at the gurneys, I thought about the 0.25% chance of not surviving. In that instant I felt completely alone. I knew then that everybody, even the most stoic of people, should know that somebody important is waiting nearby.

#1 Don’t Go It Alone

The anaesthesiologist arrived. We talked. He gave me an injection. I don’t even remember passing out. Two hours later, I slowly awoke in the busy recovery room. I was not able to feel pain at that point. I was wheeled to my room. They ended up changing my room. It was private, but small and a bit cramped.

Joe was there. I was pretty hazy for the first couple of hours. I remember seeing a big teddy bear with balloons, but was in no condition to find out from whom. They were from my sister and niece. As I became fully aware, I realized that I was short of breath. I didn’t realize at the time that this was due to the pain of deep breathing. I complained to the nurse. She stated that my blood oxygen was good and that everything was okay. Joe got aggressive and strongly suggested a painkiller. I was too busy gasping. A little morphine did the trick. I was quickly resting comfortably. Until I and the nurses got into the correct rhythm, Joe was making sure that I asked for pain meds when I needed them and that the nurses did not delay. Once, the nurse ordered meds for nausea and pain. After minutes passed, Joe went for her. A different one showed up. She stated that the first nurse was on lunch break and must have forgotten, but the meds had been ordered. Joe made sure that the second nurse delivered the meds. Practice with the incentive spirometer further eased my breathing. I was quickly back up to my pre-op capacity.

#2 Be Aggressive with the Nurses About All Pain/Nausea Medications

My support group pal Nance had the surgery that afternoon. A kindly looking gentleman came to my room to deliver a pizza delivery box. It was from Nance. The gentleman was her father. When opened, the box revealed a single vial of liquid protein. Good joke! As recommended, I started walking the halls. I found Nance’s room. She was alert and pretty darn happy. Joe came in, followed by her dad, so we all had a nice visit for about ten minutes.

After the pain meds wore off, I found an urgent need to sit on the edge of the bed because my back was getting really sore. The bariatric bed that was issued to me was of a type that the nurses had not seen before. They were uncertain about how to work the controls and lower the guard rails. I took this to mean that I had received a non-standard model. The odd thing was that this bariatric bed was not capable of totally flattening out like a regular bed. This kept a constant pressure on my behind. The upper-body part of the bed could be flattened, but the lower part always had the legs raised to some degree, so it was difficult to get upright and sit on the uneven edge. Prior to surgery, I was told that the bed was supposed to be able to flatten and stand me upright so that I could actually walk out of bed. Somehow, I had been issued a non-standard bed that couldn’t do it. Perhaps it wasn't even a bariatric bed. Joe, a manager of a machine shop, figured out how to at least lower the bed and the guard rails after the nurses gave up. I sat on the edge anyway. What a relief.

That night, I could not sleep until I received some morphine. At about 3:00 AM my IV monitor timer went off. I reached for the nurse callbox, but it had slipped to the floor. I pulled on its cable, but the box was caught on something under my bed. I was too drowsy to get out of bed safely. I had to wait for the nurse to arrive for my hourly vitals. The rest of the night, different monitors alarmed at different times and nurses checked on me regularly, so it was impossible to get enough rest.

The next morning, no Dr. Asbun. I was waiting to see him so as to get released. The nurses could not predict when he would arrive.

I sent Joe back to my place and went to Nance’s room. As I approached the bed, I realized that the patient was not Nance. “I’m sorry,” said I. “I expected to see somebody else. How are you feeling?”  We had a nice conversation. The patient explained that Nance had already been paroled. Before me!? Good for her.

While napping, I received a call from Joe. The room was so crowded with equipment that the phone was placed out of reach behind the head of my bed. I had to get up and walk around the various equipment to reach the phone. After I fell asleep, my sister called.

#3 Always Make Sure That The Callbox, Bed Control, and Telephone Are Always Within Reach

The doctor arrived at about 7:30 PM-ish. He said that my surgery had been difficult, but entirely successful. He said that my liver was huge and that I should not worry, but get it checked out by a gastroenterologist. He said that it was probably diabetes related.

I asked Dr. Asbun what was the lifespan prognosis if I had not had surgery. He said that it was hard to quantify, but my quality of life would have dropped precipitously (infections, more co-morbidities, etc.). He released me from the hospital.

The nurse-on-duty started the paperwork and said that she would call in a prescription to my pharmacy for pain meds. She came back and stated that my pharmacy was already closed, but there was another one open until 9:00 PM. Joe piped up by saying that we’re not going to get there in time if she doesn’t accelerate my checkout. A nice nurse wheeled me out to the entrance, but I quickly realized that she used the same wheel chair with the missing cushion. Joe and I made it to the pharmacy with 5 minutes to spare!

This is my blog, I hope that some of my negative experiences don’t put off prospective patients. Things don’t always go smoothly or perfectly in all things. The post-op nurses were nice and seemed otherwise competent despite the incidences mentioned above.

Joe stayed another two days. I found that eating and drinking was not problematic. My blood pressure, temperature, and blood sugar was up. On the second day home, I started showering and taking my usual pill meds. While showering, I found an EKG lead under the fold of my left manboob. Yes, manboob is a word. 

Meds: I take five in the morning and three at night. 2 out of 3 times, I get pain and nausea because some of the pills are big. Other times, they go down, no problem. I have an appointment with my primary care physician (PCP) about this and my liver. I've not needed anti-nausea at all and I used pain meds until the second day home.

Today, my blood pressure was 130/78 (down from 170/93 when I got home), my blood sugar before breakfast was 116, and my temperature came in at 97.9. So everything is going pretty well. In the last four days since surgery, I have lost 9.5 lbs. I’m well pleased.

Now,  dear reader, I am off to Starbucks for my regularly scheduled coffee time!

Bottom Line: I’m pretty happy.

I have totally been blown away by the amount of free-flowing support and love that's being tossed around the forum like some huge pie fight. I've been seeing folks get lots of help and as I get closer to surgery time, I'm getting a growing wave of support. It's freakin' me out how good it is!

I moved to the bay area for a job. I was absolutely new to the area. Therefore, I have few local friends and intend to taxi to the hospital and recover with only my landlord to rely upon. I'm single and the only one in my family to move away from Hawaii, so I'm self-reliant.
Yesterday, my best buddy from Southern California said that he's arranged to be in town for business on surgery day. That was a nice surprise. He'll be in town for a couple of days and perhaps I won't have to taxi home after all.

This is my first ever surgery, so it was a good motivator to create my estate paperwork. I used Quicken WillMaker 2007 software. It is very good. I am also working on a short video DVD of myself to include amongst the papers.

All of my food and sundries have been laid in. I am ready to go!

I'm still experiencing no fear or anxiety about surgery. I am that sure about my choice. I admit that I had an ambivalent moment when I read and signed the acknowledgement about possible medical complications. I stumbled upon the memorial page of this website. The stories were heart-wrenching, but they did not scare me. Rather, my heart did go out to those patients and their families.

I'm going to have a nice little one-man barbecue this weekend. I'm going to make beef ribs. Mmm. Ribs. I'm not going to be able to chew things for awhile.

The only things left to do are my laundry and to leave my apartment in good order.

Supplemental: It's pretty amazing to me. Support ranks are closing together in the forum as surgery day approaches. Wow.

I visited Dr. Nachtwey for my pulmonary (lung) clearance. Smooth sailing. Next to last step: go to the hospital on Monday to get my wrist bands and blood typing/screening.
He had previously prescribed a diuretic to reduce the swelling in my legs. It worked, but was starting to cause excruciating night leg cramps. I tried bananas, B-complex vitamins, extra calcium, quinine tablets, lots of water before bedtime, and mild evening leg exercises. No success. I quite the Rx two days before this visit.

My WLS story started back in Nov. 13, 2006 when I told my doctor that the threat of surgery was not enough for me to be successful with traditional methods. 1-1/2 years earlier, she had mentioned surgery to me in a most nonchalant way. I picked up on that cue and asked her to give me some time to use it as motivation to succeed with dieting. Alas, came the time that I reached the end of the proverbial rope.

This blog picks up one week before my scheduled surgery (set for Tuesday, 3/27/07):

Went to the hospital. Drew blood. Took an EKG. Received an incentive spirometer to exercise breathing while recovering. Weighed in at 379. Previously, I was asked to lose 10-15 lbs. I actually lost 15 lbs. exactly. My prior week's upper-GI x-rays were good. I do have one little appointment tomorrow with the pulmonary specialist for his clearance.
Dr. Asbun asked if I was ready for surgery. I replied: "I was born ready."