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Vonnie's Journey

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This afternoon approximately 5 hours from now I will have my long awaited Vertical Sleeve Gastrectomy (VSG)! I slept 7 hrs with some help. I started my journey in January and joined this board. I must say this forum has been invaluable to me in learning everything I could about VSG.  

 

I was a fat kid and suffered with obesity most of my life. Not fun for a girl's self esteem. My weakness is/was sweets. Of course I yo-yo dieted all of my life beginning in high school. I have done just about every diet there is, losing as much as 60lbs at a time and then gaining it all back and then some. The longest period of time I remember being a normal size was 5 or 6 years in my early 30's. I wore a size 4 or 6. Even then I always felt like a fat girl. I had thought that once I got to be a normal weight that my hunger for food would go away, but it never did! 

 

I ended up at 100 lbs overweight about 20 years ago and have been as high as 300 lbs at 5'4". About 10 years ago I got interested in weight loss surgery when I became good friends with a co-worker who had had the Duodenal Switch (DS). I found this out by asking why he had all the vitamins including Flinestone's vitamins on his desk. When he told me he was taking all the vitamins because he had had bariatric surgery. I found it hard to believe because we ate lunch together all the time and he ate lots of food and was never sick. So I started researching bariatric surgery and decided I wanted to get it.

 

I initially wanted the DS but the only doctor I would let do it was not on the insurance's approved list. At the time the VSG was offered but my insurance would not pay for it either. So I ended up letting a surgeon talking me into the bypass (RNY). I went through 4 months of a medically supervised diet and then I lost my insurance! So I lost interest and went back to the yo-yo dieting for almost another 10 years. The most success I had was on the HCG diet about 3 years ago where I lost about 60 lbs. What was great about the HCG diet is that it prepared me for the stalls when consuming less then 800 calories a day. (My solution was always to increase calories and it always worked!)

 

So here I am finally about to have surgery after a long 6 month diet required by insurance. I am nervous of course but looking forward being a normal and healthy weight! See you on the other side!

 

My song for this day - Oh Happy Day: 

 

 

 

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Good luck!!

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Best of luck in your surgery today! Remember to walk as much as possible as soon as possible to help ease the gas they pumped you full of during surgery.

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Thinking of you vonnie - have a safe trip to the losers bench.

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Sip, sip, sip

Walk, walk, walk

The more you walk, the better you will feel.

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Hope you're doing well today Vonnie.

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We have a lot of parallels in our obesity journey. Welcome to the other side. Hope to see more from you.

Best

Patricia

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Welcome and best of luck. Please keep us updated.

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Hope all is well and we will hear from you soon.

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So happy for you Vonnie that your wait finally came to an end.  It can be rough at first after surgery but I can tell you it passes and you will be so glad you did this.  :)

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I just got home. Had to stay an extra day because I was bringing everything back up. As soon as I feel well enough I will post an update! Thanks for all the well wishes and comments! I really appreciate hearing from folks here who have gone through it!

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Friday September 4, 2015

 

 I am 10 days post op. I came home 2 days after surgery instead of 1 because of nausea and vomiting.

 

Day 1 – Surgery

 

I had a laproscopic robot assisted vertical sleeve gastrectomy (VSG) on August 25th at 6pm . I was scheduled for 4:30pm so I got started late.  

 

My first recollection after surgery was being wheeled to my room. By the time I got to my room I was having extreme chest pain which terrified me because I thought I was having a heart attack. I was really confused about this because I had been told that because I had no hiatal hernia and because I was having robotic surgery laproscopically I would experience minimal pain.

 

I think I got to my room after 11 pm and my sister was there with me. I was so embarrassed for her to see me in such agony that I told her to go home at midnight. After she left I could cry without upsetting her. In retrospect I wish I had not asked her to leave. I thought I could advocate for myself as far as pain management, but I found out that was not to be true. It wasn’t until after she left that I realized that I had no pain pump. So I had to buzz the nurse for pain relief.

 

Most of the time if she responded at all she told me it was not time for my pain medicine. I continuously asked for help and asked what could be done. Once she told me she would be back in 45 minutes because that was when I was due for next pain medication. After no response for an hour I buzzed her. She ignored me for 30 minutes of buzzing her multiple times. When she finally responded I asked why she had ignored my buzzes and of course she said she hadn’t gotten them. I then asked why she hadn’t come back in 45 minutes like she had said earlier and she said she had been mistaken about when my med was due. Well! Thanks for keeping me in the loop!

 

I repeatedly told nurse I had brought in my cpap mask and was ignored. Why did they even bother to have me bring it in.

 

I suffered all night long and into the next evening. I continuously asked for relief from pain and the nurse just keep saying that I was being given what the doctors orders were. All the while I am also extremely nauseous and vomiting up blood. No explanation given for vomiting up blood. I eventually figured out that it was probably because my sleeve was inverted which puts the staple line inside stomach instead of outside. It would have been nice to expect this as a possibility.

 

Meds: Reglan, Zofran, Dilaudid

 

Day 2 – Day after Surgery

By the morning my chief complaint is nausea. The pain in chest has subsided and I just feel like I have been punched in the stomach or have done a lot of sit ups. When the shift changed I told the new nurse I was spitting up blood. She told me it wasn’t blood which made me more upset because at that point I had no idea whether spitting up blood was normal or not.

 

They take me between 9 and 10 am to do the swallow test. I dreaded this. Here I am nauseous and I have to swallow something (I am thinking that white bubbly stuff) and hold it down while xrays are taken.

 

While I am sitting in hall outside my room waiting to go to test I see the bariatric coordinator. She asks how I am and I tell her. She says I need to have a positive attitude!

 

The swallow medium turns out to be just the clear syrupy stuff which I manage to keep down long enough to do the test. Other than the trauma of trying to keep something down that I know makes me nauseous under normal circumstances, I also know that a leak test can be performed during surgery and that this leak test has a very poor track record of predicting leaks. It is totally unnecessary!

 

Since I passed the swallow test I am now brought a bucket of ice with water, crystal light packets, jello, and lemon Italian ice with instructions to drink 2 ounces a hour (yeah I know it is 1 ounce every 15 minutes). I am able to do a little of the Italian ice and some water. Later food service comes by and I ask for tea because the lemon tastes like furniture polish. The tea goes down better but like everything else it  all comes back up.

 

During the day I had 3 different patient advocate types visit me and I was honest with them about my experience with pain management. I told them I had a high tolerance for pain, had experienced natural childbirth, had experience with multiple surgeries although it had been over 20 years. (Oops I forgot I had been hospitalized about 3 years ago with painful “Sweets Syndrome” for overnight). Never had I experienced uncontrolled pain before in a hospital. They seemed genuinely horrified and promised to do whatever they could so that no one else would have this experience. I thought maybe it had to do with Bariatrics but they informed me I was not on a Bariatric ward but a regular surgical ward. So they seemed even more concerned that regular surgical patients could have this type of pain management experience.

 

In spite of this I still continued to vomit all night long particularly every 2 hours when I go to the bathroom.

 

 I ask about my lisinopril (blood pressure) and wellbutrin (anti depressant) meds. A Physicians Assistant stops by to discuss. I tell him I am concerned about my blood pressure being higher than usual and the fact that I may possibly be experiencing withdrawal from antidepressant. So he says he will order them. When the nurse comes later with xanax which she describes as my antidepressant and Hydrochlorothiazide which she describes as my blood pressure medication.  I tell her that the one they are calling an antidepressant is actually my take as needed anti-anxiety pill which I refuse to take with the pain med they are currently giving me. And the one they are calling my blood pressure pill is actually a diuretic I take on an as needed basis for blood pressure! I have not needed this diuretic since I have been on  a diet that restricts my salt and doubt I will ever need it after surgery. Sigh! I also did not think it was a good idea to take a diuretic when I am at risk for dehydration immediately after surgery.

 

Why is there confusion about this? I gave a list of medications that I was supposed to be on after surgery during pre admission on day of surgery.

 

They claimed my insurance would not fill the antidepressant because it was not due yet…….Are you kidding me???????  I have never ever heard of a patient having to bring medication to the hospital! Is that what I needed to do?

 

Another Physicians Assistant comes by. She mentions my complaints to patient advocates about pain management. Told her everything had vastly improved since first night but asked about confusion about my blood pressure and anti depressants. Also asked why I was asked to bring in CPAP. No answers!

 

I am just trying to hang on until the doctor comes. I was hoping he would get by in the morning.

 

The doctor comes by after 4pm. I ask him to please do something about the nausea and to please give me something for pain so I can get some sleep. He says he will order Transderm Scop (patch) which will last 3 days! So I patiently wait! Finally over 3 hours later after 7pm shift change I get the patch for nausea and miraculously within 10 minutes I feel nausea subsiding!

Meds: Reglan, Zofran, Dilaudid, Transderm Scop (Patch)

 

Day 3 – Went Home

I am still vomiting everytime I try to swallow medicine. Otherwise it is getting easier to get tea down.

I am feeling apprehensive about not being able to keep medicine down but at the same time wanting to get out of the Little Shop of Horrors. By now my back is aching and I miss my mattress. In the afternoon the doctor comes by and says I can go home. I ended up at home by 10:30 pm.

 

Don’t even ask how the hospital pharmacy messed up my Rx’s to take home!  I am going home with Dilaudid and Zofran. I only took Zofran once because it was so disgusting and did not help at all.

 

Days 4 – 10 At Home

 

Every day gets better. What a difference being home makes. By day 5 my 2nd day home I am no longer needing anything except pain med and I am taking fewer and fewer pills as the days go on.

 

I find that tea is all I can drink until about day 9 when I switch back to my usual crystal light flavors. I am able to get down protein shakes. I find that I can only tolerate 1 sweet shake a day at first. I mainly get protein in by mixing unjury unflavored or chicken flavored with strained SPICY Progresso Light  or Campbell’s Healthy Request Soups. If the flavor wasn’t spicy I made it spicy by adding strained Paul Newman’s mild/medium salsa.

 

I used Syntrax Nectar Chocolate Truffle and Vanilla Bean Torte as my sweet shakes. I mix Sugar free jello, puddings and preserves to flavor the vanilla.

 

I mix all with Fairlife untrafiltered fat free milk which has 13 grams of protein per cup.

 

If I drink 2 shakes a day with this milk I am getting 62 grams of protein ( I use pdcaas score for Syntrax which is 18 per day and for Unjury is 18 or 20). And yes I add milk to the soups also.

 

Had BM 1 week after surgery which I pretty much expected after doing 2 week liquid pre-op diet.

 

Meds: Dilaudid, Transderm Scop (Patch)

 

Weight

I lost about 10lbs on pre-op liquid diet.

 

Day 1 - Day of surgery:                         224

Day 3 – Day of Discharge:         224.65

Day 8 –                                    224.2

Day 9 –                                    222.2

Day 10 -                                   221.2

 

Thoughts

 

Would I do it again - Yes

 

What would I do different - Insist on better pain management.  I thought I had asked the right questions about management of pain and nausea. Still I had no idea that I would not have a pain pump or that nurse would not contact doctor for unmanaged pain. I also had no idea I would not see doctor every morning to address my concerns.

 

Things I took to hospital:

Gas –x strips

Biotin Spray

CPAP Mask

 

Note to self: get papaya enzyme tablets.

 

My 1st post op appt is in 5 days.

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Wow, sorry you had such a difficult time. But glad to hear you are feeling better and progressing. It does get better each day, but give yourself time to heal and rest. Everything else can wait.

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Geez Vonnie that is awful.  I had the nausea patch put behind my ear the minute they took me to my room, every time they asked me how I felt, I would tell them and they would tell me, it was time for my pain meds, incidentally morphine, duh? I was in morphine lala land at least 2 days.  Not by choice, that was what I was given and I was so sleepy.  On the second day I told them I was not having so much pain, it was hard getting up to walk around though and they brought me an abdominal binder as per the doctor and that helped with the walking and not having so much pain.  My doctor was there at least 2 up to 3 times a day. He is amazing.  No real nausea, no vomiting to date, TTG.  The staff was incredible, I was made to feel like the most important person on that floor. The day I was leaving one of the nurses asked me if I knew that I was on the VIP floor.  I looked at her dumbfounded and said no, I did not know that. She said their Bariatric doctors have their patients brought only to that floor and there was no other floor for them.  They indeed made me feel special all the time.  They almost hovered when I wanted to go to potty, had to have them come because there was an alarm on my bed, could not get out without their assistance.  I am so very grateful.  I hope you continue to improve and get better very soon.  Btw, I weighed 208 on my pre op visit on 8/10 and did not get weighed again until a week after surgery, I weighed 195, so I do not know what the actual weight loss is but doctors office called it 13 pounds my first follow up on 8/27 and this morning, 9/4, here at home I weigh 190.  So it is a total of 18 pounds in less than a month, I feel good and I am calling it excellent.  Feel better!!!!!

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man that sounds terrible.  so sorry you couldn't get good pain management.  and when you're post-op, or sick, you're just not in the right place mentally to advocate for yourself.  i hope by this time next month you're able to look at is as a war story and you're feeling much better.  all the best to you!xo

ps- thanks for the detailed post op notes.  this helps us pre-oppers a lot! 

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On second thought, Vonnie, if I were you I would write a letter to the hospital administration. At least that way the complaint is on file.

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I am feeling great now! It took me until today to post an update because everytime I would think about what happened I would get upset and start to cry. Lindy I expected to have your experience! Greer I may very well send this to administration in addition to posting on their patient advocate site. It was therapeutic for me to post everything that happened. I also plan to print it out and give to doctor on my 1st post op visit next week. 

 

I am so happy to be on the loser's bench look forward to the rest of my life!

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Great to see you well on your way to a new you!  The weight surgery path is not easy, but with time and some work (and some luck) you will be at your goal weight before you know it!  Hang in there and enjoy the pounds falling off (although it does mean buying new clothing).

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Vonnie, First let me say I am so sorry for your experience. I hope that you have a speedy recovery. I have a couple questions if you don't mind. 

 

What form of wellbutrin are you on? XL or SR? If you were on XL did you switch to SR after surgery due to us not being able to absorb the medicine any longer? If so are you having any side effects from it? If you are taking the SR, same question, are you having any side effects from it? 

 

Thank you, and again I hope you have a speedy recovery. 

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Vonnie, First let me say I am so sorry for your experience. I hope that you have a speedy recovery. I have a couple questions if you don't mind. 

 

What form of wellbutrin are you on? XL or SR? If you were on XL did you switch to SR after surgery due to us not being able to absorb the medicine any longer? If so are you having any side effects from it? If you are taking the SR, same question, are you having any side effects from it? 

 

Thank you, and again I hope you have a speedy recovery. 

I was on XL pre-surgery. After surgery was prescribed IR which had to be crushed. After 4 weeks I can go back to XL which is great because I had so much trouble crushing the IR that I just stopped taking it.

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Vonnie, I am SO sorry that you had such a miserable experience. I would write a note to the hospital. It's good to hear that once you've gotten home things are going better and better. I hope you continue forward with feeling better each day!

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