Sunday, October 30, 2016

Post-Op Part One: How are you?

Hello from the other side! 

{Adele sings that way better than I do. 
But, now I'm humming it in my head, and you probably are too!}

I am 2 weeks post-op from my Sleeve Gastrectomy.  What a ride! I am so thankful for the ways the program had prepared me for this portion of the journey.  Multiple classes and sessions are dedicated to what to expect, what to do and what to avoid in this stage of the game.  I also had great emotional preparation for the post-op period as well. I wanted to share a little update. Y'all have been so kind and supportive. 

"So how was your surgery?  How are you doing? How can we support you and your family?"  These are the most frequently asked questions so far.  I will share my experience from my perspective as well as I can.  I will answer each question with a separate post.  

Here is my story in response to this first question: How was your surgery?

We arrived at the hospital a little early. They had called from the hospital saying they were running a little behind with the surgery schedule, and we could report later.  Smitty and I ambled over there, but I was ready to get there and get this next step behind us.  We were greeted by my parents and our pastor, Emily.  We found the surgical waiting room to be really full, so we found a little conference room to gather for a prayer. These very special 3, circled around me, laying their hands on me, invited the Lord do a good work that day.  {Actually, there were 5 of us in that circle, aside from anything spiritual, Emily was great with child. That sweet child was blessing us before he even made his entrance into the world!}

I was called back to the pre-op surgery area, and I hugged, kissed and waved "Love you, see you in a bit!" Smitty was assured he would be able to join me in pre-op as soon as my IV was placed.  And then an hour and a half went by. 

They began wondering if I had actually gone into surgery, and they hadn't come to get Smitty.  Thankfully, Tom, the gentleman at the desk in the waiting room, was so kind to come by, check on me, and give my folks an update.  

So what was taking so long?  I was so dehydrated from the surgery day of being NPO, and the day prior to surgery of only clear liquids, that it took 9 sticks, 4 nurses, a CRNA and an anesthesiologist with an infrared vein locator and ultrasound machine to find a vein for my IV.  

{Let's just all sit with that for a second.}  

Y'all, I started feeling so sad.  My attitude all morning had been a cheerful, let's do this!  With each passing attempt at the IV, I would get tearful.  They asked if I needed a break.  Nope! Let's get this done.  But my tears were telling the truth of my anxiety: what happens if I'm too dry to start an IV? Then what?  I've worked so hard to get to this day; I can't go home.

I give thanks for that kind and gentle anesthesiologist.  He took great care to make sure that process was as painless as possible. He kept injecting hope into my heart when he'd say, "we aren't giving up. We know we'll find it." He would say "ok, well, onto plan B.  Then plan C.  But we weren't giving up."  

{Amen. Me either, man.} 

The next thing I knew, I heard the sweetest words all morning: "I've got it!" Then, quickly heard that the OR was ready for me. Smitty was able to see me for a hot minute as they roll me towards the OR. I recall all of the next bit: I hadn't had time to receive my "sleepy" medicine.  The CRNA is assuring me that just as soon as we are in place in the OR, they will give me a little something to help me relax. And literally about 26 seconds later, I feel so much less anxious about it all.  Then I'm breathing deeply in the mask.  Then I'm waking up in Recovery.  

"When are they going to get started?" The nurse replies, "darlin you're already finished! You did great!" 

Well, how about that?  I did it.  I already, very sleepily, feel proud of me.  That part is behind me. Whew.  {Aaaannd then right back to sleep.} 

That first day, hours after surgery were not at all pleasant. I don't want to say awful because I was never in any pain. After being warned about the possibility of nausea, I was prepared for this but never experienced it.  However, I was terribly uncomfortable after being pumped with gas in my abdomen for the laparoscopic procedure.  I had been prepared for this discomfort; and they (literally everyone) weren't lying. After surgery and after a short time in recovery, once settled in my room, the nurses got me up and want me to start walking.  {Walking helps to eliminate gas.  I'm good at that, I think. Ahem.} I was still so sleepy from the anesthesia but nothing was keeping me from working that gas out.  

Smitty, my sleepy self and my IV pole shuffled around the floor of the hospital.  I began what I would come to love as laps around the "track!" A few times those first few trips around I almost fell asleep while walking.  {Be careful about that.}  Thank God I had Smitty there to catch and wake me! I felt more and more relieved with each lap we took. We met a new patient with each turn that were also out getting their laps in.  We were easily recognizable: patient in hospital gown, rolling our IV poles with a look of grit and determination in our eyes. {Or maybe that was gas?}

This pattern continued throughout the afternoon and evening of that first day. I had a really hard time sleeping because the pressure had moved into my shoulders and back. The nurses do all they can to help relieve this discomfort, but when they say walking is the only way... it's true. Throughout the night, the nurses kept saying, you are going to feel totally different tomorrow.  I rested a little more with that hope.

Once again, they were right!  Of course, the morning brought more alertness after having anesthesia and less pressure from the gas.  I kept walking.  More laps around that track.  Each time my support people and I rounded a lap, I would accumulate more patients to walk with us. Stopping at their room door, I'd call "come on! it's time to walk!" If we were feeling extra motivated and sassy, we found a "long way" around the track that gave us a few more steps. {A friend said, of course you were creating community even in the hospital!} 

We were quite the squad, cheering one another on when we felt like staying in the bed, stopping when one needed to rest for a moment, and celebrating small victories with one another along the way! At times we made a bit of scene, either laughing or clogging up the hallways.  Well, why not? It's a party: we all have a new lease on life! Worth celebrating together! Together, we will walk along side each other in our support groups.  I was thankful for each of them and the journey that had led each to that space.

Aside from working the belly discomfort out, I was wildly thirsty.  They are pumping fluids in my IV, so I know I'm not dehydrated.  My mouth was just parched.  But Day 2 brought word that I could try drinking my first liquids since surgery.  I know that for this phase of the process, I am only doing clear liquids.  I couldn't wait for a sip of something... anything.  

I got a tray from the cafeteria a few minutes later with a Gatorade G2, a sugar-free popsicle, some broth and some jello.  Friends, my new stomach will hold about 4-6 ounces at a time, but lawsamercy, I wanted to gulp that Gatorade.  I knew to take sips of whatever I tried first. Here goes. I literally took a 1 ounce medicine cup, filled it with that glorious nectar and sipped it over the next hour.  {It might have been the best thing I've ever had to drink.}

I tolerated that fairly well.  But my mouth was still feeling dry. Popsicles!  They have been so perfect for this first phase. I cannot take much volume at a time, but I can suck on a frozen treat for a while! So far, I was tolerating all the liquids well.  Very slowly.

And this is how it went. Walk. Sip. Rest. Walk. Sip. Rest. 

My post-op hospital stay was, gratefully, without event.  Everything went as expected and I was discharged home after a 2 night stay

I am so grateful for my support system, my docs and nurses, and the care I received through the Novant Medical Center. I am also so thankful to be home.  

Stay tuned for Part Two!

Thursday, October 20, 2016

A Tool for the Journey

{I wrote this post a couple weeks ago as I prepared for the next step for me.  I have not been sure of when to publish it, but now the surgery is behind me. So, here goes. This is part of my story, the next piece of the lifelong journey.  Be kind and gentle as you read and absorb.  As you read this, may you be encouraged, may you spurred on to make a next step in your own life, may you be moved to pray for me and others in a similar physical, emotional and spiritual journey for health, strength and body image. I am 3 days post-op and doing really well!}

I have made a decision.  A really important decision.  One that is for my health and the very best me. One that I have been pretty private and guarded in conversation about until now. And it is exactly the opposite of my expectations.  I was so very ignorant and misinformed about my choice, skeptical at best. So what is it?

I am having bariatric surgery, a sleeve gastrectomy, specifically.

Allow me to share my story.  I have been seeing the weight loss clinic at Novant Health in Kernersville*.  The support staff has been amazing.  I began my journey with this group in May this year. I have been a life-long dieter and thought I knew all there was to know about healthy eating options, successful diet and exercise plans, and general good nutrition.  I had tried so many diets in the past, with lots of will-power and enthusiasm, only to get discouraged and quit.  So in the Spring when I reached my highest weight, I began praying for a solution.  I had been diagnosed with hypertension, gastroesophageal reflux, obstructive sleep apnea and was morbidly obese.

Not only did I feel terrible most of the time, I also carried around a load of shame.  How could I have allowed myself to get here?
"I know better."
"I'm just a quitter anyway."
"Why try again, you'll fail."
"I'll never be able to..."

The shame I carried seemed to weigh me down more than anything.  At one point, my own body insecurities were all I could see.  I began examining these feelings head-on with a wonderful counselor.  She helped me see what my family and friends have tried to tell me along: that I am worthy of self-care.  I live my life with arms wide open ready and willing to be available and of service.  It was time to make sure that I am also make it onto the list of folks that I care for!

Also, my eyes were opened to the startling truth that I AM NOT A FAILURE.  I have failed some diets before.  I have failed at other things before, too. We all have. We can't win them all! Somewhere along the way, I made the rules for success and failure much more stringent for myself than anyone else.  I am quick to offer grace to everyone around me, and now I am offering it to myself too.

I am already doing the important thing about falling down: I get back up and get out in the arena of life again. I am not listening to the voice of shame in my life any longer. Period.

As I allowed these truths of grace to sink in deeply, I reached out for help with my health.  Additionally, I wanted help with my weight loss.  As a Physician Assistant, I know the realities of comorbidities associated with obesity.  My family history includes diabetes, hypertension, and other cardiac issues, like heart attack and congestive heart failure, and as my diagnoses list grew, I knew I had better get serious about my own health.

The help I sought needed to be a wholistic approach.  I desired to work with physicians, nutritionists and a behavioral therapist.  Having seen and read so much about the Kernersville Bariatric Clinic they were my first call and where I landed.  I have been so thankful for this group of folks that are so supportive and helpful.  I have already mentioned some of the ways they have supported me in my journey.  I wanted to know all the tools and options that are available to me in this program.  Even though I immediately answered "no" when asked if I was interested in bariatric surgery, months later I was encouraged to just go and hear what they have to say.

We did.  And we haven't looked back.  Smitty, as my support person, and I went to a surgical seminar that is lead by the bariatric surgeons of the group.  There we learned about all the different types of bariatric surgery, and the ones that are performed at this facility. They are very frank about surgery risks, side effects both short and long term, and managing expectations of bariatric surgery.

Apparently I had formed a really negative opinion about bariatric surgery somewhere along the way. The myths in my mind were dispelled by hearing the truth straight from the surgeon.  Even being someone in the primary care medical community, I recognized my own misconceptions. There is still so much education needed around this life giving procedure.

So what did we learn?

Bariatric surgery is not the easy way out.  This was the biggest emotional/mental obstacle I had to overcome because of the shame I have associated with failed attempts at weight loss. My desire is to be strong and healthy, not just "successful" at weight loss.  There is so much hard work done prior to surgery to prepare your body for this change.  The real work begins after the surgery is complete.  Lifestyle changes are made months in advance to prepare for the surgery and are necessary for the rest of your life after surgery.  Commitment to a vigorous cardio and strength training exercise program is required.  This investment in the process and the commitment to lifestyle change and exercise must be demonstrated prior to scheduling the surgery.

Bariatric surgery is successful at curing and reversing many comorbidities caused by obesity, so much that it is being recommended as first-line treatment in obese diabetic patients.  A return to health and quality of life is a side effect of these surgeries.  My hypertension and sleep apnea have an 80% cure rate within 6 months of surgery.

Bariatric surgery is much less invasive than it has been.  The surgeries performed at this facility are laparoscopic.  5 very small incisions in the belly, so the risks of bleeding and infection are significantly reduced. You spend a couple days in the hospital.

Bariatric surgery, specifically sleeve gastrectomy, does not have post-operative malnutrition associated with it.  The main concern after this surgery is staying hydrated and keep moving. My food intake will look very different from most for several months after surgery.  I begin with liquids for a few weeks and slowly introduce solid food.  Think, introducing a baby to new foods: slow and steady.  That will be me!

Bariatric surgery with the Novant group comes with a beautiful support system after surgery too.  I expect to have good and bad days, as anyone does after a big life event. My team of surgeons, nurse navigators, nutritionists, and psychologists are with me for the long haul.  In fact, I have signed a contract committing to all of my post-op care, including annual follow-up for the rest of my life.  They truly want me to be successful in my quest for health and are walking with me every step of the way.

Bariatric surgery requires more than just the support of the staff; I need support from my community.
I share this story with you, my people, because I would very much appreciate your prayerful support and encouraging words. As we have prayed through each of these decisions, we have been affirmed in our decisions.  As the doors continue to open, we continue to walk through them with more knowledge, confidence and peace.

I am laying down my shame about my weight and taking hold of my own strength. The surgery is a tool among many to help me reach my goals.  My hope is to be free of some of my medical diagnoses, and be much stronger before my 40th birthday! Thats about 20 months from now.  I am ready! Let's do this!

{I would love to share more of my story if you have questions.  I would appreciate at this point in my journey if you have an "aunt's cousin's girlfriend's terrible bariatric surgery story," that you would not share that story with me or my family.  As with anything in life, there are so many varying experiences.  My physicians and support team have thoroughly evaluated my current all-around health and have given me a stamp of approval for this specific surgery.  Thank you for understanding these boundaries I need in place for my head and heart right now.}

*Disclaimer: No one at Novant Health Bariatric Clinic is paying me to comment on their practice or services.  I am sharing this because I am truly thankful.  I hope sharing my experience will encourage even one more person to take the next step towards health.