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How am I doing?

Truth is, I’ve been battling a pretty debilitating bout of depression, topped with a heaping pile of anxiety, for over a year now. I’m struggling to find enjoyment in anything. Throw in the hospitalizations and the surgeries, and the result is I’m a hot mess, though I’d like to think I’ve done a pretty good job at hiding it. But as I’m working on my physical recovery, it’s become all too apparent that I also need to work on my mental recovery – I need to shake this depression, I need to tamp down the anxiety, and I need to get past the trauma of the surgery complications.

So I’m going to start by blogging. And what better way to jump right into it than to tell you all how I’m doing?

Let’s see. Today is July 10th. I came home from the hospital exactly one month ago. That was after a scheduled abdominal surgery that should have resulted in a 2-day hospital stay, but instead, due to a gastric leak (an uncommon but known complication of a vertical sleeve gastrectomy; in my case because I was having a revision from my 6.5 year old gastric bypass, that rate of complication jumped to 15%), I was in the hospital for 18 days. During that time I dealt with:

I don’t remember much about coming home from the hospital, other than having the brilliant idea of not telling Dan I was being discharged so that I could surprise him. That kind of backfired because the house was a mess and the bed wasn’t made, so when my mom dragged me in (I was so weak she had to practically carry me), everyone had to scramble to clear a path and get the bed made. I was dumped in the tub for a shower, which I was all too happy to have, though Dan had to help me. Then I was tucked into bed, and apparently a home nurse arrived not long after to show Dan and my mom how to administer tube feedings, hook up antibiotic bags to my midline IV pump, and clean my abdominal drain. I was pretty much asleep at that point.

And that’s really all I did for the first two weeks I was home: sleep. I begged my mom to stay with me that first week; she had been with me for 16 of the 18 days I was in the hospital. And bless her, she did. Despite just spending 16 straight days in a hospital with me, during which time she slept right next to my bed and took care of me around the clock (including assistance with toileting and bathing – that’s how sick and weak I was), without hesitation she said yes and spent at least a week (my recollection is a bit fuzzy) at our house with me. Dan slept on the couch so she could sleep beside me (my request). I remember doing a lot of sleeping, being woken up by the IV pump when it was time to switch out/end a tube feed, and watching a lot of Grey’s Anatomy (I made it through the first two seasons while in the hospital, and the other 10 once I was home #dontjudgeme).

* * *

My midline IV fell out six days after I got home, and I ignored the home nurse’s orders to go to the ER to have it replaced. At that point I had been on multiple antibiotics for 3+ weeks; instead I monitored my temperature and abdominal drain output, and agreed to go to the ER only if I spiked a fever or had some other symptom indicating that I wasn’t doing well without the antibiotics. Well, no fever ever occurred, my drain’s daily output continued to go down until it was just 10-15ccs per day, and I otherwise felt fine aside from healing pain, drain pain, and residual splenic infarction pain (that is still persisting).

On June 23rd, exactly one month after surgery, I had a post-op appointment with my bariatric surgeon. But first, I had a barium swallow test to confirm that the gastric leak had healed. Despite having the NJ tube and having a once-daily, 12-hour feeding, I was allowed to have small amounts of water, and I may or may not have sneaked in teensy bites of very soft cheeses just to have something. I was always very careful to have tiny bites, chew them well, and pay close attention to my body for any signs of problems – pain, increased drain output, fever. Quantity-wise, when I say tiny, I mean tiny: over the course of the two weeks I had the NJ tube, I probably had maybe a grand total of four ounces worth of soft cheeses.

Despite this, my anxiety had me convinced that the barium swallow test would reveal a leak, and I’d be stuck with an NJ tube or even need an upgrade to a PEG tube for months. You see, I had been busy doing what they always tell you not to do: Googling symptoms and looking up the experiences other post-ops have had with VSG leaks. Pro tip: DON’T DO THIS.

I was such a wreck I bawled during the test. The doctor broke protocol and showed me all of the images, and also assured me six ways from Sunday that I didn’t have a leak. And when I met with my surgeon a half an hour later (many thanks to Alyssa for pushing my wheelchair from one end of the hospital to another), the first thing she said when she came in the room was, “which tube do you want removed first?”

For those who may ultimately find this post via Googling, the removal of an NJ tube is uncomfortable, but not painful nor gag-inducing. The only sensation I noticed was a rubbing/burning in my sinuses. As for the accordion tube removal, once my surgeon cut the sutures holding it in place, it all but fell out – the last inch she pulled out hurt a bit, and the area was very sore and tender for the next few days, but other than that, it wasn’t bad, either. The JP drain I had last summer hurt a hell of a lot more to come out than the accordion drain did.

Since the 23rd I’ve been on a slow progression of food: a week of clears, then a week of creamy/thick soups and the like, and now I’m onto soft foods. I’m not supposed to try chicken or fish until next week, but I slipped and tried it a couple of days ago. Twice, actually. The first time it came back up. The second time was a success. I’ve had days where everything I try stays down. Then I have days where everything comes up. Other days some stuff stays and some stuff comes up. When the NJ tube was still in I had random bouts of nausea and dry-heaving as well. At this point I’m chalking it up to the healing process and my body not knowing what the fuck happened to it.

Weight-wise, I lost just about 30 pounds between May 23rd and June 10th. When I got home I weighed in at 144.2 pounds, clothes and midline IV pump included. That was four weeks ago. Now, despite adding milk, high-fat cheeses, and even fudge to my diet, I can’t get the scale to budge past 148 pounds. I’m so used to weight coming on if I’m not vigilant that I’m shocked and a bit worried that I can’t get it back on so quickly this time. My clavicles, shoulder bones/blades, ribs, and hip bones are all so disgustingly prominent. My clothes are hanging off of me. I have no ass – in fact, it hurts to sit because I no longer have any ass padding. No lie. I have a thigh gap. I’m gaunt and angular and hollow, and it just goes to further emphasize how sick I was and how weak I still am. And underweight, to top it all off. Considering I have probably a good 20 pounds worth of loose skin hanging off my body, and I’m 5’7”, I’m most definitely underweight. I never thought I’d say this, but I look forward to being able to put on another 10 to 15 pounds. 20, ideally.

* * *

Mentally, I’m not the anxious, weepy mess I was for the first few weeks. Now I’m working hard at getting to a positive place and staying there. I know just how lucky I am, and while coming close to dying (no joke; things were that bad) has been hard on my mind and I’m still struggling to get past that, I logically know I’m healing and am healthy. I’m going to do my best to continue pulling myself together. Not only do I need me, but Dan, Alyssa, and Ryan need me.


 

8 Things Every Groom Should Do Before A Wedding

It’s understandable to feel nervous before the big day. But more often than not, those nerves stem from a lack of planning, or a lack of organization.

To help you out in this regard, the following post will run down eight things every groom must do as the date approaches. You have been warned!

1. Dancing lessons

Your first dance is going to be performed in front of hundreds of people – and hundreds more in the Facebook video. As such, you can save yourself a lot of potential embarrassment by practicing repeatedly beforehand.

bride and groom dancing
Pixabay

Even if you don’t opt for lessons, at least hit up a couple of YouTube clips. Some revision is better than none!

2. Suit up

But not just any old thing, either. Your dad’s suit may hold sentimental value, but a moth-eaten look on your wedding day would not go down well.

Instead, look to make your suit tailored specifically to you. This way, it’ll be as comfortable as it can possibly be, while still maintaining a smart edge. One option is Lanieri suits, which offer you the ability to completely design your attire online.

However, you do things, make sure you shop in plenty of time to avoid last-minute rushes.

3. Hang out with your friends

The foray into married life can often mean less time for you and your partners-in-crime. That’s not by choice – it’s just the natural demands that full-time marriage brings.

April 15 Bachelor Party
photo credit: Barry Peters

But you have to remember how important your friends are, so one last hurrah would be a wise move. Keep it simple – a pint at your local, a meal, bowling – and make sure you remember it. Getting too intoxicated won’t exactly create the best of memories. In fact, it won’t create any memories. Just blurriness.

4. Use your best man

Your best man is an asset that’s crying out to be utilized. He can help take some of the workload off your shoulders and complete those annoying tasks that get on your nerves.

Best man's speech
photo credit: Katie Lips

Examples include picking up your suit from the dry cleaners and sorting the evening reception. Use them wisely! There’s a reason why they’re called best men. They’re there to make your day the best it can possibly be.

5. Get a hair trim

You want to be looking sharp on the day, but don’t get your haircut the day before. Give it a week or two to give you time to grow into it. You don’t want to be left with an uncomfortable hairstyle on your wedding day.

man receiving hair trim
photo credit: Pixabay

Unless of course you know that by trimming the day before, you’ll be fine on the day. It’s up to you. Don’t forget the beard and moustache either.

6. Prepare your things

As far in advance as possible, make sure you have everything ready that you might need. When it comes to the night before, lay out all your clothes and accessories ready for the morning.

Start by hanging your suit up, and make sure you have your tie, bow tie or cravat to go with it. Choose which underwear you’ll be wearing (it’s important!) so you aren’t scrambling the next day. Make sure your shoes are polished and laid out near your clothes so you can just slip them on.

Also, have one last phone call with your florist and caterer, just to check everything’s running smoothly. Alternatively, you can delegate this task to your best man.

7. Rehearse your vows

If you have a smartphone, use the notes functionality so you can whip them out at a moment’s notice. Jot down any ideas you might have, even if you don’t think you’ll use them. You might find that something starts to work the more you think about it.

wedding bands on bible
photo credit: Pexels

You don’t want to take out your phone to read your vows on the day, so make paper copies. Ask your best man if you can read through them together – trust me, it’s not awkward. This way, you can practice with another human instead of just a mirror.

8. Hire a cleaner

Your honeymoon will be glorious, but you do have to come back home one day. And do you want your wife to come home to a messy house? Absolutely not! This is also a great way to surprise your future wife and show her that you value your relationship and home.

So book a cleaner for when you’re away. This way, you can both come home to a sweet-smelling, tidy living space. It would be annoying if you had to come home, unpack and clean the kitchen too.


Filed under Articles
 

Baby steps, right? Baby steps.

I’m not used to not quickly bouncing back after a surgery. Here I sit, a month and three days post-op (though if you want to get technical,1 month + 3 days post-op from my first surgery, 3 weeks + 2 days post-op from the second, and 2 weeks + 4 days post-op from the third), and less than 48 hours ago I had to send my mother and Dan running for a shower chair for me to sit on before I blacked out from exhaustion while in the shower. Any other surgery, I’d be showering alone, for my normal shower duration, 2-3 days after surgery, and bugging Dan for sex within a week or two. (Needless to say, this time around we haven’t yet had sex.)

But I’m home. I’m healing. I no longer have any tubes in me. Progress is progress, amirite?


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The longest month ever (revision to VSG with complications)

Today I am exactly one-month post-op from a surgery that was estimated to take six to eight hours, and require a 2-night hospital stay.

The good news is that the surgery took “only” five hours.

The bad news is that I ran into complications, and ended up being in the hospital for 18 days, and was sent home with a midline IV, drainage tube, a feeding tube, and strict NPO orders except for liquid pain medication and very small amounts of water.

But let’s go back to the beginning – the morning of May 23rd, 2016. My arrival time was 5:30am, so Dan and I left the house at 4:45am. We got to Hershey Medical Center a few minutes past 5:30am, checked in, and then proceeded to wait over half an hour for a greeter/tour guide to take us to pre-op – which is kind of silly when you think about it, because with this being my 10th surgery (not to mention over a dozen endoscopies!), we knew exactly where to go. But, eh, procedures.

The pre-op process, which I now don’t remember the fine details of, went smoothly. I stripped, wiped down my body with these special cleansing/disinfecting wipes that leave your skin feeling sticky, put on a hospital gown and snazzy yellow hospital socks, patiently waited for an IV to be put in (just two tries, hooray), and signed the consent forms. I believe I was taken into the OR sometime between 7am and 8am (again, fine details have escaped me).

According to my surgeon, Dr. R, and Dan, the surgery itself went well. She had to deal with a decent amount of scar tissue and some adhesions, but given my surgical history (10 abdominal surgeries in six years, with the last four being in just the last year), she wasn’t surprised. But that aside, the revision from a gastric bypass with a lot of scar tissue and a nearly decimated stomach pouch (due to the three ulcer perforations – oh and the fourth that was beginning to occur the weekend prior to the surgery – Dr. R said that the perforation evident and the only thing that saved me from having to be rushed into surgery sooner was the extra layers of fat and muscle she wrapped around the ulcer during the April 2016 ulcer perforation repair surgery) to a gastric sleeve went well.

I woke up from surgery sometime later Monday afternoon, and thanks to a PCA pump (hello, Dilaudid!) my pain was manageable. I had a catheter, which was unpleasant, but at least it bought me a night in bed before I had to begin doing laps around the hallway to decrease the risk of blood clots, regain strength, and get rid of excess air.

But by Tuesday afternoon, my pain hadn’t lessened any. It was significant enough that I refused to allow the nurses to remove the catheter.

By Wednesday, I was begging for more pain medication. At this point Dan was overwhelmed and didn’t know what to do, so he and my mom switched – my mom came to the hospital with the kids so they could see me, she stayed with me, and Dan took the kids home. Dan has a lot of amazing qualities, but truthfully his anxiety gets in the way of him being able to question and speak with doctors and nurses. My mom, on the other hand, has brass balls (where do you think I got mine from?), and is an excellent patient advocate.

By the weekend (Memorial Day weekend), the low-grade fever I had been battling all week began to climb. It had been hovering in the 99.2 – 99.8 range since surgery, but was now creeping over 100 degrees. At this point the catheter was out, and despite the relentless abdominal and left shoulder pain I was continuing to walk as much as I could. I was also allowed water, chicken broth, beef broth, vegetable broth, and jello. I drank plenty of water, but didn’t have much in the way of broth because I just felt so awful.

On Monday, May 30th, I was finally taken for a CT scan, which revealed pockets of air and liquid in my abdominal cavity. It should be clear to anyone at this point that I had a leak (leaks after a vertical sleeve gastrectomy are not all that uncommon, and the risk for complicated revision patients such as myself is as much as 12 percent), yet the idiot residents dealing with me obviously didn’t report their findings and the severity of my symptoms to my surgeon, because instead of being taken back to the OR I was given a TRU-CLOSE Accordion Drain in an effort to remove the excess air and fluid in my abdomen. This was done with me awake, using Lidocaine injections for numbing. The pressure was unpleasant, but other than that it wasn’t too bad – many thanks to the nurse who used one hand to put Fentanyl and Valium in my IV and the other to hold my hand.
But while the accordion drain did help, putting a drain in a post-op patient with a gastric leak is a lot like adding more water to a bucket with a hole in it – without repairing the hole.

By Thursday, June 2nd, the pain was unbearable, my steadily-climbing fever now held steady above 103, and both my mother and Dan said I was somewhat delirious and incoherent. I don’t remember much from this week, other than pain, begging residents to do something, taking my temperature frequently, trying to walk, and asking my mom if Ryan had gone to bed yet because he had to get up for school in the morning (meanwhile, my mom was with me in the hospital – 50 miles away from Ryan!).

On Friday, June 3rd, my surgeon was finally clued in as to how bad things were, and at 4:00pm, shortly after having a midline IV placed because all of the veins in my hands and arms were completely shot from so many sticks, I was rushed to the OR for endoscopic repair. It was kind of funny, actually: one moment I’m lying in my hospital bed, miserable. The next, two old lady nurses are tearing me and the room apart in an effort to get me ready for transport and surgery as quickly as possible. They were like a geriatric tornado – but they were terrific, and they were most definitely efficient!

Here’s how bad things must have been: as soon as I got into the OR I started crying, which isn’t exactly unusual for me, a serial bawler. But my surgeon, Dr. R, came over to me and hugged me, smoothed my hair back from my face and promised she’d fix everything, and she stayed by my side and held my hand until the anesthesia was administered. My last memory is of her holding my right hand tightly, while I felt the burn of the anesthesia in my left hand.

* * * * *

When I woke up in recovery, my first realization was that the majority of the awful pain and pressure in my chest and abdomen was gone. After getting back to my hospital room (and my mom, who was worried sick at that point about me dying – and to be honest, as sick as I was, I was running out of time so I can’t blame her for being so worried, because in between my sleeping and my fever-and-sepsis-induced delirium I was worried too), Dr. R came in to let us know her findings: a significant leak in the connection in my gastric sleeve, which she and another surgeon were able to fix via the endoscopy (no lap or open surgery required). They put in sutures and clips, and sucked out more fluid and air.

I was NPO for the weekend, which sucked, but I did sneak a few ice chips here and there just to wet my mouth and throat. But I was ecstatic over the lack of severe pain, the lack of left shoulder pain, and more importantly, the lack of a fever. My blood draws were being done every 12 hours, and each one since the Friday surgery showed improvement with everything – whereas previously, everything from white blood cells to red blood cells to potassium to lactic acid were all severely out of whack.

But I was so tired and weak by this point. I still had the PCA for pain, and here’s an indicator of how weak I was: sitting in a chair for about half an hour while my mom washed my body from head to toe exhausted me so much that I told her to skip washing my hair, and I then napped for several hours.

* * * * *

On Tuesday, June 7th, 2016, Dr. R asked me how I felt about discharge. I was excited and very much on board – at this point I was feeling better, lab work showed continual improvement, and I was doing fine with water and tiny bits of chicken broth. So discharge paperwork was drawn up, prescriptions were filled at the hospital pharmacy, and… and then one of Dr. R’s residents came in with a cup of blue dye. “She just wants to make absolutely certain you’re okay”, he said. So I began taking tiny sips.

For about two minutes, all was well – all three of us (myself, my mother, and the resident) watched my drain anxiously as I took sips. Nothing. Then all of a sudden… blue dye. I should tell you at this point I lost my fucking mind and had a total breakdown – gasping sobs, inability to breathe, hysterics, the works. Blue dye in the drain meant there was still a leak, which meant no discharge, more time in the hospital, and more procedures to find and fix the leak. It was at this point that 2mg of Ativan every 8 hours was added to my chart.

The next day I was taken back to the OR for another endoscopic procedure: this time, not just an EGD to find and suture and clip the leak, but the placement of a nasojejunal feeding tube (NJ tube). I had been warned about the possibility of an NJ feeding tube the previous Friday, and was told the day before it would be necessary so my new stomach could rest for “several weeks”. I was frustrated, disgusted, and terrified. But I said yes, because what other option is there? Supplemental nutritional feedings via IV can be done, but as it was explained to me, leaving the digestive tract “dormant” is a very BAD idea because that can cause further issues down the line, even if it’s just for a short amount of time such as a few months or even a few weeks.

* * * * *

On Friday, June 10th, 18 days after my initial surgery/admission, and after one laparoscopic abdominal surgery and two endoscopic surgeries as well as a separate procedure to place the accordion drain, I was finally discharged. If memory serves me correctly I had a contrast swallow test either that morning or the day before to confirm I was leak-free. I also had nearly 48 hours worth of NJ tube feeds with no adverse effects – no nausea or vomiting or any other negative reactions that would indicate sensitivity or intolerance. And I was still fever-free, and my lab work was yet even more improved. As Dr. R put it, I was medically stable, so send me home and have home nurses come out to see me.

My mom — yes, she spent 16 days in the hospital with me, with no complaint; she literally dropped everything to come stay with me, advocate for me, and take care of me as much as she was able to (including running out to Panera Bread to get me a cheese danish because she was so desperate to see me eat something, only to get back in time for the confirmation of a leak in my stomach) — and I decided not to tell Dan I was coming home – we thought it would be a nice surprise.

And it was – overwhelming, because the house was a bit of a mess and here we come loaded down with bags and medical supplies. But it was nice. But I was exhausted. My first week home was a blur of a midline IV, NJ tube feedings, drain checking and emptying, crying, and sleeping – lots of crying and sleeping. My mom actually stayed with us for the first week because I didn’t want her to leave my side. I was terrified of being without her after having her with me for so many weeks. She was wonderful – she didn’t even balk at helping with tube feed setup/adjustments in the middle of the night, or sleeping in bed with me (and Dan didn’t balk at giving up his side of the bed so my mom could sleep with me).

* * * * *

My second week home was a little better – we even got into a better routine with the NJ tube feeds, which kept me bed-bound for 12 hours a day due to needing to stay with the IV pole (which was in the bedroom next to my side of the bed) and upright and semi-still. Needless to say, with so much literal downtime with being in bed so much I’ve been watching a lot of TV – when my mom was here, we split our TV watching between Catfish, Forensic Files, and Grey’s Anatomy (aside: Ryan is now hooked on Forensic Files, and both my mom and Dan are into Grey’s Anatomy).

But with more of a routine and feeling a bit better I was sleeping less – which gave me plenty of time to google VSG complications and VSG leaks, as well as information and statistics and horror stories about leaks, NJ tubes, and accordion drains. After I ran out of Ativan I was a hot mess, because it’s a lot harder to talk yourself down from a panic attack without any tools to help other than your own mind – the same mind that is running wild with negativity and fear.

* * * * *

Today, June 23rd, 2016, exactly one month after surgery, I had two very important appointments: a liquid contrast swallow test to check for leaks, and then a post-op appointment with Dr. R. I bugged and bugged and bugged the doctor and nurses who administered the swallow test for answers, and not surprisingly I cried a lot; but at the end of the test I was crying tears of relief and joy because the doctor assured me repeatedly that I had no leaks – he did the test twice as long with twice as much fluid as usual, and had me lying and standing in all sorts of positions so he could check for leaks from any possible angle. Nothing. And like he pointed out, the drainage tube in my abdomen remained clear – a sign that a leak simply couldn’t be happening, because if it was, there’d be glowing liquid in the tube – and there wasn’t.

Then I saw Dr. R. She came into the room beaming, and after hugging me she asked me which tube I wanted removed first. We went with the NJ tube, though like I told her, I was equal parts excited and anxious about having both removed, so it didn’t really matter. I’ve refrained from googling “NJ tube removal”, and was somewhat pleasantly surprised to find that sensation-wise, there was no coughing or retching like I expected (wouldn’t you? I mean, if there’s a tube shoved down your throat all the way to your small intestine wouldn’t you expect throat and stomach irritation when it is being removed?). Instead, there was just a lot of burning and pressure in my sinuses. Then it was out, and I was laughing in relief.

Finally, the drainage tube. Since I’ve had both a gastric feeding tube and a JP drain removed previously, I expected a tugging and burning sensation. Instead, most of the pain came from the large Tegaderm patch that my mom put on top of the drainage tube at the insertion site. But again: wrong! As soon as Dr. R cut the two sutures keeping the tube in, it began to fall out of my stomach on its own! The only discomfort came when Dr. R pulled out the last inch or so – this was from a slight “bulb” on the end to help keep the tubing in.

* * * * *

So now I’m home, healing, free of uncomfortable and gross tubes, and I’m cleared for liquids, protein shakes, and soups free of chunks (basically, broths and creams). Next week I can add chunkier soups and yogurts. The following week, mashed potatoes, hot cereals. And after that, I can very slowly work on introducing soft meats and other items – but nothing tough, and no fruits or raw vegetables for eight weeks.

This whole situation has been physically painful and exhausting, but also emotionally exhausting, frustrating, terrifying, and draining. I finally feel like I can really begin to heal myself not just physically but mentally – and I won’t lie, scheduling an appointment with a psychologist to help me cope and work through the probable PTSD caused by all of these medical crises but especially this last one is on my to-do list for tomorrow.

* * * * *

So many of you have reached out to me on social media, via email, and via PayPal and mail with financial help – I can’t thank you enough. Your words of support and love and gestures of kindness have meant so much to me, and to my family. Thank you. I will never be able to thank you enough, but I hope this will suffice. ♥


 

An earnest plea: can you help my family? They’re drowning while I’m still hospitalized.

An earnest plea: my family is sinking with my 2-day hospital stay turning into a 2-week+ hospital stay. Any donations will be used for food, gas, and utilities. Receipts will be provided to show use of funds.

Please help: my PayPal address is x@jenn.nu

And now our internet bill is off, and I rely on our internet to work.. I’m being discharged tomorrow and am now frantic about being able to get back to working to support our family. Please help. Please – I can repay some donations on July 1, and if you request, I will with yours.

Please help…any amount would mean a difference.


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