.comment-link {margin-left:.6em;}

Cut Steve's Blatherings

Tuesday, January 25, 2005

Psychological Hunger?

      Yesterday, I had trouble staying on my diet.

      I had 4 oz. of yogurt in the morning, skim milk later, more yogurt, four ounces applesauce, and a juiced orange, but it just wasn't enough somehow.  I kept craving solid food.  Thing is, I'm currently on a pureed diet.

      Finally, just before bed, I broke down and ate a slice of ham.  No noticable indigestion, and it did let me sleep.

      In a few minutes, more skim milk, and maybe an orange.  Maybe some water too.  Then I leave to run an errand.


Things Going Well

      So far, my recovery proceeds very well.

      Yesterday, Monday, I drove to the library by myself, with no problems.  Soon, I'm going over to the hospital, but only to pick up some books I left there during check out.

      Tomorrow, back again, to have my staples removed.

      If they weigh me, I'll let you all know if I've lost anything.


Sunday, January 23, 2005

Ambiguous with the timing, or 'Back in the cellar again!'

      In my first post on this blog, I mentioned that my modem had died just before I went into the hospital.  A long conversation with Qwest's tech support had elicited a pledge to send me a new, external modem to replace the bad one.

      So, I got home yesterday, and the new modem had arrived.  But that was small potatoes.  The big news was, K. had gone out and bought a new, Hewlett-Packard laptop!  Since the new modem was external, that meant I could use it with the laptop!  More importantly, the new modem has wireless capabilities, as does the laptop, so I could blog from anywhere in the house!  Yippie Skippie, Batman.

      Wrong.  It turns out, after much futile effort and more tech support, that the new modem is incompatible with my existing phone line.  So, I have to either send it back or ask the business office to upgrade my line.  We'll see tomorrow how that works out.

      It also turns out that the old modem has started working again.  So I'm back in the cellar, blogging away with the old standby computer.  We'll see how it goes.


Sunday: "Welcome to your new life!"

      That's what one of my physicians said to me while I was still in the hospital.  How's it going?

      It used to be, I'd pop a large, i.e. 12 inch, Freschetta┬« pizza into the oven, and when it came out I'd eat it.  By myself.

      Today, I've had a four-to-six ounce protein drink, a six ounce container of Yoplait® low-carb yogurt, a 4 oz. container of Dannon® low carb yogurt, and some water.  Eating the six ounce Yoplait was almost a chore: I had to put the more-than-half-full container back in the fridge for later attention.  Right now I'm a bit peckish, and am considering going upstairs to turn an orange into juice, then drink it.

      Otherwise, I don't feel hungry.  So I'd say, the operation is a success.

      The downside is that I'm half crippled.  After all, my guts were sliced open.  Doing anything that involves the abdominal muscles hurts a little, and is attended by great weakness.

      But all things considered, I'm wondering why I didn't do this fifteen years ago.


Saturday, January 22, 2005

Flashback: Wednesday

      On Wednesday morning, the pressure to get me up began again, which I resisted again by demanding my clothing bags.  People looked around; they called down to post-op, which had signed them out to a nurse on my floor; finally, the day nurse found them -- in my room.

      That sounds worse than it is.  Someone put them on my electric-adjustable bed, which raises/lowers, tilts/flattens, lowers/raises the foot portion, and raises/lowers the head.  They were placed under my head, and unless the head of the bed is raised, it's not obvious how much room there is under there.

      By the time they found them, K. was here, and we went walking together.  For me, more like shambling, holding a death-grip on my IV pump's pole.  I was weak and dizzy, worried I'd fall, and had the foley catheter and hemovac wound drainage bag dangling from me.  The multiple line leading to my IV line had to be managed, and my naso-gastric tube was still in place.  Somehow, they resisted the urge to have an oxygen tank dragged around after me.  I was back in bed in minutes, very tired.

      If my first walk or two was no fun, I did have a delightful encounter with a person.  My nursing assistant on Wens. and Thurs. was I. D., and marvelous Ethiopian-American lady.  We talked about her, immigrants, the U.S. in general.  She's a great patriot, pleased and grateful this country is so blessed, and that she was allowed to come here and live in freedom.  The freedom was emphasized by her.  She said her family was prosperous enough in Ethiopia, and she'd had a job as a nurse there.  But escaping oppression was worse huge amount.

      The big medical question was, when would my bowels move?  Until they did, I had to leave the naso-gastric tube in, and couldn't drink anything.  If you've never had an n-g tube, be grateful.  Every time you swallow, your palate rubs against the tube, gradually getting incredibly sore.  When you aren't swallowing, it's because your mouth is incredibly dry.  I alternated these discomforts for about a century after my motorcycle accident, though in retrospect, it was more likely a week.  The time would likely be much shorter this time.  But how long?

      I'd also noticed the computer in the room, and the fact that it had an internet connection, but Wednesday I was just too tired to attempt using it.  I also needed permission from my nurse, who technically is not supposed to grant it.  But she didn't care, as long as it wasn't needed for other things, and neither has any other nurse cared.

      Hmmm, by now I've stolen perhaps a dime's worth of electricity.  Bad patient, no biscuit.




Release Coming

      It's Saturday, about 10:00 AM, and I'll be leaving the hospital Real Soon Now.  When exactly depends on the paperwork and meds order, which should be done about noon -- 1:00PM.  Partly it depends on when K. gets here.  The storm last night left the roads thoroughly clogged.  Actually getting out of the garage and the alley will be a hardship for her.  When I talk to her on the 'phone, I make remarks about not being in any shape to shovel.

      While typing the above, a call from K.  She's paying someone to shovel the snow, and will be here about 1:00.  Then it will be "Free, Free, FREE!"


Friday, January 21, 2005

Flashback: Tuesday Evening

      On Tuesday, when I came out of the OR, it was rather late.  The previous operation had taken a bit longer than expected, and I had also taken longer.  Thanks to my second motorcycle accident, back in '79, I had a lot of "adhesions" and other little problems inside the abdominal cavity, and it took longer than expected to staple the stomach.

      The procedure is called vertical banded gastroplasty (VGB), and there's a picture here.  In a VBG, staples are put into the stomach, and a pouch is created that severely restricts food intake.  Because a band is placed at the bottom of the pouch, emptying is slow, and you feel full for a long time.

      I could have chosen the rather more involved Roux-en Y, which involves a greater re-routing of the stomach, but which highly restricts what you can eat, causes unpleasant symptoms if you eat the wrong things, and can give problems if it ever becomes necessary to pump the stomach, or check for gall stones, ulcers, or cancer.  It's only advantage I could see was an instant cure for gastric reflux, but while I have that problem, it's very mild.

      My surgeon, Dr. Buchwald, also does "biliopancreatic diversion,"
but wouldn't do one for me because of I had hepatitis at age ten. Further info on theses procedures here and here.

      From my perspective, this involves lots of tubes in the body.  I had a naso-gastric tube, which is just what it sounds like: up the nose, down the throat, and into the stomach.  The stomach just stops working after an operation like this, so drainage is necessary.

      I have a CPAP machine, or rather a BIBAP, which reduces the pressure a bit when you exhale.  As an old respiratory tech, this isn't much different that IPPB, Intermittant Positive Pressure Breathing.  The CPAP only involves a mask, thank God, but when it's not on they want me wearing an oxygen canula, which has short tubes in each nostril.  You've seen canulas on doctor shows, usually put on incorrectly.

      Then there's my IV line, started before surgery.  Since my gut isn't working, the IV delivers needed fluids, plus pain meds.  The pain meds are dispensed via a little pump that I control, which is very nice.  Push a button, and if ten minutes have passed since the last button push, the machine gives me a shot of pain killer.  Even better, it isn't demorol or morphine, which I had in '79 and hated (I came to prefer codeine to morphine).  Best of all, very little pain.  I think that the fact that the incision went through my last incision has restricted pain a bunch.

      In my abdomen, a tube to remove wound drainage.  And a foley catheter, for urine.  Bowel movements are awaited with great anticipation, but nothing is provided to catch them.

      A last touch was circulation boots.  These things squeeze the feet for a second or two, then relax.  The idea is to keep blood from pooling in the feet.  I suppose they work, but they disturbed my sleep.

      With all this, they wanted me to get up and take walks!  I begged off, both because I didn't have the energy and because my clothing has disappeared, containing my shoes and socks.  My shoes were with them, and my compression socks (I have blood pooling in the legs at the best of times).  So I spend the night sleeping lightly, with an extremely dry mouth and disturbances when people come to check my vital signs.

      As stays after major surgery go, this ain't bad at all.

      And by the way, I just found out blogger's spell check might work after all.  It hasn't at home, but that appears to be because my pop-up stopper killed it.  Live and learn.


Going Home Tommorow!

      In out latest update, it's Friday, Jan. 21st, about 3:15 PM CST, and tomorrow I go home.  Follow up appointment on Wednesday, Feb. 2, both Groundhog's day and the birthday of my idiot brother, who moved without giving me a forwarding address.

      All but one of my tubes has been removed, and I was actually allowed to drink today, a hearty meal of fruit juice and broth.  By tomorrow, I'm supposed to be on a 'pureed diet,' baby foods in other words.

      Back to a re-cap of my experiences here so far.


Thursday, January 20, 2005

The Big Day: Morning

      Because I haven't prepared well, and because I insist on letting K.'s worrying bug me (K. does the worrying for both of us in the family, I do the being laid back), and because K. insists on leaving ridiculously early for everything, I ( repeat, I) manage to forget my CPAP machine.  This is a minor nuisance.  Without CPAP, I probably wouldn't survive surgery, but the anesthesia department has its own machines.  They wouldn't use mine till I was awake and functioning anyway.

      So, we head for the hospital.  North on 35W, take the U of M turnoff, over the bridge, and past The Abomination.  The Abomination is otherwise known as the Frederick R. Weisman Art Museum.  It's been described as "an airline factory junk pile," "shiny metal in weird shapes riveted together," "a pile of turds deposited by a large monster that eats Aluminum," and "a really sick practical joke."  Still, the reality is worse. Spew alert: pictures here.  While K. drives, I write instructions for commuting between the hospital and home, for the use of Mrs. No Sense of Direction, Minnesota.

      We arrive at the hospital, and take advantage of the free valet parking.  Cool.

      Inside, the Fairview Death March, an ordeal almost as bad as London's Heathrow airport.  If I'd realized it was so long, I'd have asked for a wheel chair.  Finally, to the elevator, upstairs, then a (relatively) short walk to check in.

      Well, they do a lot of bariatric surgery here, but they don't bother to have chairs that will fit butts as wide as mine.  This is not reassuring.  Neither is it confidence building to be hear that they don't have a room designated for me.  But in time, that's taken care of.

      So, I eventually get taken to the pre-op prep room.  I lose the clothes and weigh in at 457 lbs.  Say, if you disregard that I'm not in street clothes, and lost a lot of fluid yesterday, I may be down a few pounds from three months ago, when the surgery consultation was done.  Somehow, I surpress the impulse to not have the operation.

      They take a blood test, and find a problem.  Thanks to my numerous transfusions of years ago, I have an antibody reaction.  The anesthesiologist tells me that he's never given blood during one of these operations, but because of the number of major blood vessels, they like to have it handy.  So, they have to do additional testing and sorting to make sure that the stuff they won't be giving me anyway won't kill me when they don't give it to me.

      After conversations with all the doctors and nurses, and being reminded that I may lose my gall bladder (about one of four patients with morbid obesity have gallstones), we're ready to go.

      A change from my old hospital days: they have a bed that moves easily, and a special layer between the mattress and the sheet.  This layer inflates.  They wheel the bed to the operating room, slide me to the operating table, and give me the gas.

      "Take deep breaths."  Suddenly, I'm waking in recovery.


Flashback: Monday

      On Monday, it will be recalled, I preparing for surgery by cleansing my bowels.  (Sorry, I realize you don't want to hear about bodily fluids, but they are a frequent theme in abdominal surgery).

      So, I drank a gallon of "Go LYTELY," a combination of water, laxative, and the ducky salts that let your blood circulate without killing you.

      In addition, showering with Hibiclenstm.  As you may know, in the times before anitsceptics, people frequently died of the immediate effects of a abdominal puncture.  But when they survived that, they almost always died of perotinitis, the inflamation of the lining of the guts.  Given that my surgery involved deliberately cutting open my abdomen, about an eight inch incision, I was diligent in the showering.  Two washings per shower, from chin down to feet, two showers on Monday and a third on Wednesday morning.

      Aside from that, sleep, don't eat or drink, watch TV with K., worry.  I still don't know why this surgery scared me so.  It's my sixth major one (want to buy a used, TESTED, motorcycle helmet?)

      Eventually to sleep, not having prepared enough for the morrow.


Thursday Evening

      I had some stuff ready to post this morning, but it wouldn't post.  Just a hazard of bogarting the hospital's computer time.  Wouldn't have been so bad, but I neglected to copy it.

      Rest in Peace, unposted blatherings.

      Meanwhile, I am doing well, with two tubes removed from the body and two to go.  Also, at the moment the wrapping aroung my left index finger is gone, improving my spelling.

      Given the problems I had earlier, I'll try posting in smaller chunks.  Coming up, a blast from the past!


Wednesday, January 19, 2005

Unlucky With The Timingt

      On Monday, I was bvlogging away at my other blog when the modem in my computrer died.  Now it's Wendesday, one day after surgery, and I'm sittingt in room 7-237 at Fairview University Memorial Hospital, Minneapolis, MN, with tubves in my body and a sensoer wrapped around my left index finger that sometimes causes me to hit two keys atr once when typing with it.  That's why the eccentric spelling.

      I've decided trhat to do the subjectr of my slashed-open intestines justice, they should have a whole seperatre blogt.  And here it is.

      More later, at great length, but I'm tired, I have to go for a walk befrore I sleep, and I need tro check trhe template and settings with a real post.

      But whether the subject is politics or my belly, I still think