Through Thick and Thin #9 (November 15, 2002)
(my first post-op journaling)
This Man's View From The Other Side
or
I'm Glad I've Made It Here, But The Trip Was Awful
Three weeks ago yesterday I had my Weight Loss Surgery (VBG), and my gall bladder (with stones) was removed. Today is the first day that I have felt enough strength, energy, clarity and focus to share my perspective about this transformative journey. My bottom line: I'm glad I had the surgery and this trip has been far, far more painful, agonizing and difficult than I ever imagined it would be. I seemed to have invested most of my energy in preparing for the surgery, without ever understanding how nasty a ride these first few weeks would be.
It's not like I think that the "posties" who share their experience in our email groups and on our websites are deliberately withholding the truth about their surgery and immediate post-op recovery. It appears that many of us really don't experience terrible physical or emotional ordeals or challenges in the aftermath of their surgery. My guess is that some others simply choose to accentuate the positive and push away the memory of the negatives as soon as they can. Others may be doing so inadvertently. Just like the physical agony experienced by many women who give birth seems to fade into the background pretty quickly once the treasured prize (the baby) is cuddling in their arms, so too may the prize of rapid weight loss stifle or soften the experience that produced that outcome.
All I can share is my experience. With help from my wife and partner, Kari, I recorded notes on every aspect of my pre- and post-surgical experience and hope to organize them soon into a coherent record of my experience Ñ maybe even a short book — for the information and education of others who are considering or planning bariatric surgery. This newsletter is not that product.
The first thing is want to share is that in my months of reading and participating in the various online email WLS groups, I just don't recall seeing much mention of painful or difficult post-op problems from new posties. So I really wasn't prepared for how difficult it was, and that in itself became a major problem for me. I'm aware that my "active denial screeners" may have been at work (i.e. I read what I wanted to hear), but I don't think so. My post-op reviews of the postings on email groups leave me with the same impression: an under emphasis on the yucky stuff.
My surgery went exceedingly well, and I was so committed to doing everything in my power to make this procedure work that I my doctor and his staff described me as their "model patient".
I was up and walking at least four times in the hours after my surgery. I worked that "incentive barometer" to clear my lungs on an hourly basis, and took great satisfaction in first reaching, and then consistently exceeding, the "healthy standard for a male my age". The pain was severe, but controlled with the morphine drip. The external staples used to close my wound were painful but manageable. I was doing so well, and was so motivated to get out and get home (and to save an extra night's hospitalization costs), that my doctor actually checked me out of the hospital about 60 hours after the surgery was performed.
That's when, off the intravenous feeding and that blessed morphine drip, the tough times began. My number one challenge was the nausea that accompanied the entry or exit of any liquefied substance down my throat and into my newly formed tummy. Any vomiting left me with a very sore tummy and an indescribably disgusting sensation. After trying a few different medications, and constant sipping of soothing warm tea, and resting/sleeping with my head elevated, and mostly giving my pouch another week to heal, the nausea subsided.
The number two, and most persistent challenge, has been sleep deprivation, and its associated side effects. For more than 15 years, I have been diagnosed with obstructive sleep apnea and slept with a CPAP (Continuous Positive Air Pressure) device. My doctor was very concerned that the CPAP's continuous air blowing into my newly formed stomach pouch could adversely affect the integrity and settling in of the staples used to form that pouch. Consequently, he didn't want me to use the CPAP again after the surgery. He suggested that after a reasonably short period of time, I would have lost enough weight to alleviate the excess of flabby skin in my throat and eliminate the condition. I was convinced, but have struggled now for three weeks with a debilitating lack of sleep. This has caused for me a lack of energy, focus, and attention; a dramatic increase in my frustration, impatience, irritability and depression; and an overall feeling of drifting lethargically through and "wasting" each day. Two nights ago, for the first time since returning home, I was able to spend a full night in bed with Kari, with only a few periods of interrupted sleep.
Every day I've worked my "Serenity Prayer" by doing the things I can to help myself heal. I've walked as vigorously as I could for 45 – 60 minutes, as instructed. I've been very careful with my consumption of liquids, making sure that I'm getting enough protein, taking my vitamins and supplements, and deep breathing. I can feel the weight coming off (especially with my daily hour of vigorous walking, to be supplemented, starting next week, with another daily hour of water aerobics.) So I'm finally feeling like I've turned the corner and will soon sleep again. And with enough sleep, I know that my recovery curve will shoot upward. I'm starting to believe the prediction I've heard: I will need a full week of recovery for every day I spend in the hospital (or should have).
Patience has never been one of my virtues, and I'm continuing to struggle with it now.
I want so much to feel normal again, to sleep normally again. From my first days home, I pushed myself to "at least" respond to the kind AMOS and other email group folks who sent me their best wishes. And just about every day for the last three weeks I've beat myself up because I didn't feel ready enough yet, or strong enough yet, to sit at the computer long enough to write to you. (Oh, the oppressive responsibilities and burdens of the writer!) So it feels very good to complete this journaling, and to send it out to you today. Thanks for your patience and your understanding.
Here are some of the most important things I've learned for or about myself that I want to share with you before I collapse back into my recliner and resume dreaming and scheming about "easing back into work" starting next week.
- The scale is my enemy, not my friend, and will sabotage me if I let it.
I don't have my own scale (I threw it out many years ago when I first realized that compulsive dieting and weighing were part of my weight problems). So the first time that I weighed myself after surgery was at my 10-day checkup with my doctor. I was thrilled to note a 30 lb. weight loss in those ten days. And I was so proud of myself for waiting another whole week before stopping at my doctor's office for another weigh-in. When the scale showed ZERO additional weight loss, I immediately spun off into the deepest depths of panic, despair and desperation. Why had I gone through this hell if it wasn't going to work for me?
Of course Kari, my blessed partner and angel, asked the right questions. As she always does. What was going on in my body? How often was I having bowel movements? Once I realized and articulated that I had been constipated for a week, with absolutely no bowel movements during that time; and then figured out that the combined effects of the anesthesia and my liquid pain medications were constipative; and then checked with the nurse; and then confirmed with other trusted posties; finally I began to see clearly the traps I had fallen into. The traps I am determined to avoid from now on: the traps called measuring success by where the arrow points on the scale or called comparing myself to others.
So I've done all of the right things; stopped or switched my medications; started taking daily doses of prune juice and mineral oil; sipping a different tea; increasing my moment to moment fluid sipping; etc. And I'm once again releasing my lost weight through my bowel movements and whatever other miracles that happen when I move my body with commitment and vigor for an hour or more a day.
But I will not become hostage to the terrorist scale, or worship at that false altar, or judge the validity of my WLS decision or its success by how many pounds I've lost.
- While I work toward my goal of healthful and fit longevity, comfort and happiness, I will speak my truth about WLS to those who want to know my experience and learn my perspective. And, in the process, I will make special efforts to fully disclose and describe —without minimizing in any way — the difficulties, the painful challenges, the aspects that were most terrible and awful for me (owning my own experience, and clarifying that others may differ), so that those who decide to proceed do so with full and clear expectations.
- I don't know how I could have gotten through this ordeal without my loving partner and caregiver. I can't imagine how I could have survived without Kari's loving, nurturing service, encouragement, inspiration, comforting and care these first three weeks. From the first night when she stayed in my hospital room to make sure I had whatever I needed, she's been my rock. I don't know how people without such partners do it. If it's not already in place, perhaps we need to expand the AMOS and other collaborations to assure that everyone who needs can find a live-in "angel" to help them on their passage to the other side.
I can feel myself coming back. I'm starting to have thoughts about resuming work projects. I'm planning to surprise Kari with an excursion to the movies tomorrow. I'm accepting more phone calls from concerned family and friends than I'm refusing. And this is still one of the most physically, emotionally, and spiritually difficult challenges I've ever undertaken. I'm glad I did it, but I'm even more glad that I'm finally moving out of the valleys and starting to trek toward the peaks.
Glenn
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