Weight Loss Surgery - RNY scheduled March 1 - Getting nervous




Loodie
01-21-2006, 03:42 PM
Hi all, I have been a part of 3FC for a few years off and on--Mostly with the WW groups. Those diets just didn't work longterm for me. I started considering WLS a couple years ago, but actually took the step to get the process started last July. After many calls to insurance carriers, I have been accepted & am now scheduled for March 1. My first pre-op mtg is 2/2 & I am starting to get nervous. Mostly about what will I be able to eat 6 months after surgery--will I ever be able to eat with my family or go out for dinner? Silly thoughts maybe, but I am sure I can do the liquid, soft diet, protein thing for 6 months, but what about the next 30 years?
:?:
Then I wonder if I am too old. I am 56, 5"2 & 266#, have Rheumatoid Arthritis and take 10 pills each day (including the multi-vitamin & calcium), an additional 6 on Saturday and an injection weekly. I know the RA meds (injection, 6 Saturday pills & 1 daily) are here to stay--which is good cause they reduce the pain & swelling wonderfully. I sure would like to get off the High Blood Pressure, Acid Reflux, & osteo-arthritis meds though--and I know losing weight will do that. I also have a goal of being able to walk again for more than a block or two.

Ok now that I have put my wierd thoughts out there for everyone to see, I would sure appreciate someone sharing what was happening with them a few months & years after surgery. My hubby is a great supporter, but unfortunately our careers took us in 2 directions & during the week, we live 100 miles apart. My daughter lives in the same town, but she works the hours I am home. I'm afraid the day to day support is not going to be there--so where do I go, but to my virtual friends at 3FC.


jiffypop
01-21-2006, 09:49 PM
loodie linda.... welcome aboard!!! and relax. assuming all goes well with the surgery [and i'm figuring that it will, since you're in Indy and there are EXCELLENT doctors and facilities there], i can promise you several things at 6 months:

1. you will be eating reasonably normally [but small and a few things will work better than others [for me, it beef worked, chicken didn't, and there was no way a scrambled egg would stay down - but deviled eggs made with extra hot salsa, chili powder and hot sauce worked just fine!!!!!] [your doc isn't making you eat soft for 6 months is he??? that would be weird!]

2. you will be able to go out to dinner and to eat with your family. you won't each much, but that's not the point is it? you might share a meal, or order an appetizer, but you'll be out and about and enjoying yourself

3. assuming you start moving as soon after the surgery as your doc says, you will be able to move more than a block or two.

4. most surgeons have a support group - many of them REQUIRE attendance. there WILL be support, and believe me, from experience, it might come from places you'd never expect it! and some sources of support might dry up.

5. be aware that some relationships might change as you change your relationship with food. doesn't mean that you're a bad person, or that they're being mean. it's just hard.

6. a key point to remember: eat on YOUR schedule, not according to what others might consider a 'normal' mealtime. for me, that meant dinner at 9 or 10.

7. a lot of this is trial and error. and what works for one person might not work for another. but that's all ok. we're here to share info and experience, and to help each other figure this out.

i've decided that one of the main things that happens to us is that all the STUFF we've been swallowing along with our food [anger, sadness, etc.] comes out. we don't have a personality change, but the way we cope with life changes, and that's hard all around.

smile, honey. it'll be ok. the rheumatoid won't go away, unfortunately, but you'll be able to keep your mobility going. water aerobics for someone like you is a great idea.

looking forward to getting to know you..

:hug:

Loodie
01-22-2006, 10:00 AM
Thanks Jiffy. That was just the shot in the arm that I was looking for--info from someone who has actually gone through the process. I haven't told a lot of people about the surgery, because I am attempting to stay away from negative feedback. There are 4 people at work that know, my husband, my daughter & her roommate.

I don't intend to let my siblings, or my in-laws know or my hubby's congregation. I just don't need to hear about someone's aunt who heard from her cousin who heard from someone at work about their friend's daughter who had the "exact same surgery" and is dead or will never be able to eat again. (You get the picture). I will, however, let my cousin know as she did have the same surgery in March 2003 & is doing wonderfully and was the one who advised me to be selective in who I tell, and stay away from negativity.

As far as what my doc requires--that is part of the problem. I am a planner & like details. My 1st pre-op meeting is scheduled for 2/2 & that is when I find out what is expected after surgery. I guess this is where God is teaching me patience again and not to worry. As far as the RA, it will always be with me, but I am one of the fortunate ones. It was diagnosed in early stages & with the meds, I am doing really well & have had minimal joint damage. The weight however is doing a real number on my knees & hips.


jiffypop
01-22-2006, 11:46 AM
loodie linda!!!!!you're doing fine. does your doc or his practice group have a website? there might be additional info out there.

in general, most docs have us on liquids for few days, or up to 2 weeks. then it's a soft diet, which will include protein shakes. some docs allow mashed potatoes, but frankly, they have way too many carbs and many of us get sick on them [dumping]. i had a terrible time with all forms of yogurt [too many carbs, no matter which type i tried], but others do fine with it.

and then you gradually advance your diet as tolerated. sounds easy, doesn't it???? it's not. what went down and stayed down one day doesn't work the next. and then the weird things happen. like the fact that i was the first one my surgeon had ever seen who got sick on white onions. not red onions. and if a dish had white onions in it, even if i didn't eat them, i got sick.

it went away.

and then i threw up at least twice a day for 6 weeks. he said that some patients just have 'twitchy' stomachs, and that one day - after about a month - it would be like a light switch turned off, and it would stop. he was right.

the best advice i can give you is to take it one step at a time, one meal at a time. the rest will take care of itself.

now, about the RA. i can tell what you're taking by the med schedule. be SURE to talk with the surgeon and everyone else involved with your care about the NSAID you're taking. the injectable isn't a problem, nor is the MTX, but that NSAID on a tummy that's having surgery can be tricky. in general, we're not allowed to take them for a couple of weeks before surgery, and for a few months afterwards, and then they can be used with caution.

it's not a deal killer by any means, but it's going to have to be managed carefully.

indigo child
01-22-2006, 11:08 PM
Loodie, welcome!

hubs
01-23-2006, 10:51 AM
Hey Loodie. Your feelings and your questions are SO normal at this point. I believe two things are true. One, is deep within yourself, in the center where its the most quiet - you KNOW if this is what you need to do and if its right for you. No matter what you feel about what that knowing tells you, no matter what other thoughts and fears and wants are around it, listen to what you know and you'll be fine no matter what.

The second thing is this. If you've made the decision to have the surgery, don't plague yourself with the torture of second guessing the decision beyond what seems reasonable (and leaving room for last minute intuitions of course!) and settle into devoting yourself to the positive! Especially because of your age pre-operative preperation in terms of nutritional support can make all the difference. Indi can attest to that! You won't compromise anything by following the post op nutrional protocal before the surgery to optimize cardiovascular strength and overall healing support for your body.
There's a thread I posted in this folder with my preferred protocal as a professional in general terms you might want to check out.

Like I said elsewhere, you still have decades of living ahead of you and you are entitled to live those years in a body you feel comfortable in!

invisigoth
01-23-2006, 07:38 PM
Loodie, I'm a single person who rarely cooks for herself and goes out a lot. is possible to make healthy choices and dine out. It's just more difficult and expensive. (Although most meals I order can last me for 3 meals now.) Just make sure that you always ask how foods are prepared, avoid cream and cheese, and try getting steamed and grilled stuff.

Fear is a natural and healthy emotion to have with this surgery. I remember the day before the surgery I had to take antibiotics. I threw up after my second round and thought, what the **** am I thinking? Do I really want to throw up all the time? Do I really want to not be able to eat everything I love the same way I do now? But then I had jello with my third round and kept everything down and I calmed down. (I have only thrown up three times since my surgery now.)

It will change your life in a dramatic way, and it's not for everyone. But I think for most people here, it was the right choice. You'll be surprised at how many people will be supportive of you and your journey. You may even find a support group in your area that can help you with the every day problems that you may be facing after weight loss surgery.

Loodie
01-24-2006, 07:18 AM
Thank you everyone for your responses and support. Many of the things that I was worrying about have been put to rest. At least now I think I can make it until 2/2 for my 1st pre-op meeting when I get the "notebook". ;-) I think I'm going to like being a part of this group. I need to go through some of the other older threads though, because I'm sure that what I'm thinking has already been asked & answered. God bless you all.

jiffypop
01-24-2006, 12:05 PM
we're thrilled to have you around!!!!!

Loodie
02-03-2006, 11:35 PM
Yesterday my hubby & I went to the 1st pre-op meeting. Got my little binder with all the rules & regulations. Most of it I expected & knew something about--Thanks to you guys, my cousin, & research. The one thing that I wasn't expecting is the 2 week diet before surgery. Basically a liquid protein supplement drink for 2 meals & a reasonable normal 3rd meal. (The dietician said it was kind of like the slimfast diet.) I need to read over the stuff to see for sure what I need to do when & mark it in my calendar.

I needed to go shopping tonight, so I picked up different high-protein things to try--also some of the recommended things for after surgery at home. I still need to get the vitamins, etc. from the health food store. There is one by the Weight Loss Center that gives a discount to the patients, so I figure that is a good place to go--at least the first time.

I also would like some feedback from you guys that have had the RNY. My surgeon initially said that I probably could be back at work after 2 weeks. I took off 4 weeks to be sure. Yesterday the RN said that the usual time is at least 4 wks and usually 6 weeks. How long did it take you to go back to work. (I work at a computer, have flex hrs, can sit, stand, walk when needed--I also get 7 weeks of paid disability @ 100% so there is no need to rush back!)

All in all after the meeting yesterday, I feel much better about the whole thing. They have a support group once a month & it just happens to be on the night my daughter doesn't work, so I asked her to take me 2/15. I thought it would be good for her to hear the challenges & victories also. She also said she would come & get me & take me in March (since I won't be driving a car yet)

hubs
02-05-2006, 10:08 AM
Hi Loodie, congrats on getting to your pre-op meeting and its so nice to hear your husband was there with you! I think anticipating 4 weeks is much more sensible than trying to get back in 2 and if you need more take as much as you can. You'll have considerable adjustment to do.

As far as the 2 week liquid diet goes, in part that is intended to shrink both the stomach and also the liver so there is less in the way during the surgery. Partly its also to kind of aclimatize your body. I'm glad to hear you're taking the need for supplements seriously and I would encourage you to start now. Indigo Child followed much of the protocol I have posted in this thread before her surgery and personally I think its so, so critical to take well beyond what multi-vitamins can supply. Even with really high quality multi's.

You're very fortunate to have such strong support from both your husband and daughter.

Its a lot to get your head around to be prepared isn't it?

christineu
02-05-2006, 05:19 PM
I haven't/can't have WLS because of my GI problems, but I can help with some of the other issues, having been through way too many surgeries myself and working as medical/vocational case manager who specialized in return to work. First off, in addition to all the normal things everyone always tells you to have with, make sure you bring a really good chap stick to the hospital and give it to who ever is with that day to hold onto so you can use as soon as they are allowed back to see you. Between the dryness of air in hospitals and being intubated for the surgery, my lips are always soooooo dry and let me tell you, when the best the nurse can find is KY Jelly, you'll be surprised what you'll put on your lips. Now for me having been on a feeding tube and not being able to eat, I love having chap sticks in lots of yummy scents/flavors- I know that doesn't work for everyone because the scents/flavors can trigger cravings. But if thats not an issue, you can get double duty out of your chap stick- soft lips & sensory stimulation.

As for your return to work- a lot will depend on you and how you recover. Its hard to predict how well someone will do, but from experience, I would believe the nurses more then the doctors on this type of detail. Doctors tend to not pay attention to return to work as much and I find a lot of them tell you the very quickest you can return as if everyone is back to work at '4 weeks'. I'm not sure why, but it happens across all types of surgeons too- wishful thinking maybe? The biggest tip for returning to work is don't jump back into a 40 hour week to start- and don't start back on a Monday. They've done studies, and if you go back to work on a Wednesday, you're more likely to be successful & have less problems. Its hard enough to go back to work on a Monday after a weeks vacation- think how long that first week seems. By starting on Wednesday, you only have 2 more days before you have the weekend to recover. Also, start back at 4-6 hour days and build back up to 8 hours, as your body allows. Your body will be going through a lot of changes with WLS- its not like recovering from an orthopedic surgery were everything is stable & you just need to rehabilitate your shoulder or your knee- you are going to be rehabilitating your entire body & lifestyle. If you can do the partial days, you can usually go back to work a little sooner then if you have a job that says its a full shift or nothing.


Good luck with your surgery~

jiffypop
02-05-2006, 06:02 PM
what smart people we have around here!!! and linda, i'm in the 4-6 week camp!!! don't get me wrong, by week 2 you'll be up and around, but tired tired tired. so give your body a chance to heal. and give yourself a chance to adjust to the many changes. don't try to rush back just because you're allowed to - wait until you feel up to it. we're talking about your life, here... take it seriously.

invisigoth
02-05-2006, 09:12 PM
My doctor said that it varied for person to person, but he said that I needed at least 2 wks to heal. I scheduled 3 wks off, and hoped that I could get back in the office early. I had complications and was in the hospital for a week. I still attempted to get back to work after 3 wks, but I was completely drained and had to leave work early a lot for a few weeks. Of course, I still had my feeding tube and drain during that time. Go for the longest period of recovery, you'll be glad you did.

Loodie
02-06-2006, 06:28 AM
Thanks all. 6 weeks is sounding better & better. I have the pd. disability for 7 weeks & I just completed my 3 year project & haven't gotten deep into a new one yet. Maybe God has arranged this for me. Today is all the tests (upper GI, etc.) Yuck! As long as I don't have to do a liver biopsy, I can handle anything.

Loodie
02-08-2006, 08:39 PM
I was at the hospital from 8:30 to 3:30 getting all the tests done and seeing the doc who is taking care of my meds before the surgery. I thought I was all done with the tests & the doc ordered another x-ray. The results he could get right away were all okay. My hubby went in the exam room with me as he wants to know everything that is going on. He even got to demonstrate how I stop breathing @ night & then snore real loud. :o

We took 2 hours out at noon & had lunch & went vitamin & supplement shopping.) I now think I have everything I need to get started. Several brands & flavors of protein supplement & all the vitamins, etc. the dietician ordered. I figure I have 2 wks before the surgery to taste all the different kinds, so I'll keep a record & know what is good. Course I realize that some of my tastes will change after surgery. I got samples whenever possible--ordered some from a website. I was concerned about getting such a variety & the cost & my husband said that the cost was not the important thing, but having a variety to try to find what I do & don't like so I could be successful with this.

Tonight was my regular hair appt. I had been trying to grow my hair out. It was almost shoulder length. I decided with the probability of hair loss to get it cut short again so I wouldn't have to blow dry or put up--also got some good shampoo. I am READY TO GO & EXCITED! :cheer: (Course I'm sure that my mood will change multiple times before 3/1)

christineu
02-09-2006, 10:58 AM
He even got to demonstrate how I stop breathing @ night & then snore real loud. :o

They are having you go for a Sleep Study, aren't they? If you do have Obstructive Sleep Apnea (which it sounds like is a real possibility, given your husbands observations), do some research into autoCPAPs that adjust as you need them to through the night...and through out your weight loss as your pressure needs will usually decrease along with your weight. If you get diagnosed with the more rare form of sleep apnea called Central Sleep Apnea, where you litterally just 'forget' to breath- let me know...I've had to learn a lot since I was diagnosed with it a little over 2 years ago and its treatment can be more complecated. Also, make sure you get a comfortable mask if you end on CPAP or other form of xPAP therapy...I've been through a ton and can let you know what my favorites are...and which ones would probably not be affected by weight loss as much.

hubs
02-09-2006, 11:10 AM
Loodoe! You are just so, so positive and prepared! Your husband sounds amazing btw. I think you should look into cloning him!

The hair sounds practical if nothing else. It also sounds like you're set for the journey of a lifetime!

Big hugs!

*** And Christineu is right, I hope you're getting that sleep study done! ***

Loodie
02-09-2006, 10:05 PM
The doc said that from the hubby's description, I more than likely did have Sleep Apnea, but at this time, there would be no sleep study. He felt that the weight loss would solve that problem, & if it doesn't then the sleep study would be a good idea. He was going to be sure to have a bipap? oxygen mask on me when I was out of surgery and leave me in intensive care for the 1st night because of the oxygen. I didn't mention before that the gal who was the technologist for the EKG was 3 years post-op & had gone from 320 to 160. She was very willing to share the good & bad experiences she had. She had some post-op problems with ulcers & lots of throwing up. Said that she has never regretted (even when she was having problems) having the RNY done.

And yes, I did get the grand prize for a husband--That is not to say that he is perfect 100% of the time, but then neither am I. ;)

The being positive is good as long as the majority of my family doesn't know what is going on. The siblings (B & S) are very distant (miles & mind), so I'm waiting til the last week, then sending a letter so they won't have a chance to cal me to tell me what an idiot I am for taking the "easy way out"--that's assuming they would even care enough to call! The in-laws & step-children will get their letter with their valentines. Those could go either way, but I am planning on making it clear in the letter, that if they aren't going to make positive comments, I don't want to hear any comments at all. Good thing my hubby & daughter are strong supporters. The odd thing is that I am more comfortable telling the people I work with, than I am my own family. Go figure!!

christineu
02-11-2006, 11:00 AM
I'm not sure I understand putting off getting a sleep study done and not getting treated for it. Too many doctors still think of apnea as a inconvenience or just an annoyance, like simple snoring; instead of a potentially life threatening condition. The effects of untreated sleep apnea are not good- besides the lack of quality sleep for both your and your partner, there is high blood pressure, increased night time urination, stroke, enlargement of the heart, irregular heart beats, lack of concentration/memory, increased risk of auto/work accidents- and most importantly, it makes it harder to heal/recover and to lose weight. Losing weight can sometimes help reduce the severity of Obstructive Sleep Apnea, but it doesn't necessarily stop it- otherwise there wouldn't be anyone of normal weight with apnea...and there are plenty of people who are not overweight who have, even babies can have it. To give yourself somewhat of an idea what your body goes through during an obstructive apnea event, try holding your breath for 15 seconds. Can you do it? Did your body start to fight your and feel panicked after just a few seconds? Did you gasp for air when you finally took a breath? Imagine that happening every time your airways gets blocked- except now you're asleep and the only way to open it back up is for your body to struggle & strain so hard that you are aroused out of whatever stage of sleep you're in so you can gasp to breath.

I happen to have a much more rarer kind of called Central Sleep Apnea, where somehow the brain 'forgets' to tell me to breath or the message gets garbled along the way. No amount of weight loss is going to change that and its not uncommon to have a combination of both types. And with central apneas, there is usually no snoring or other easily noticeable noise to clue someone in that you're having a problem like there is with OSA. You mention you have RA- do you have a lot of pain from it? That can also affect your sleep quality in general and cause what they call Alpha Wave Intrusion or Alpha Delta Sleep. Its common in people with Fibromyalgia and other chronic pain conditions- mine is so severe that I literally don't get enough restorative sleep, no matter how much I sleep- even with the various medications they've tried me on.

I guess I would want to go into WLS as healthy as possible, if it was me. I would recommend using a autoCPAP, since it could adjust to your needs as you lose weight. Now there is even an autoBiPAP available, if you need it. Also, depending on the type & severity of the sleep apnea, the anesthesiologist will tailor the meds to your needs. In my case, they have an anesthesiologist & an nurse anesthetist both monitoring me, they will not give me any medications ahead of time until I'm in the OR & ready to be intubated and they wake me up in the OR as they remove the breathing tube, and the anesthesiologist stays with me until I am completely breathing on my own and my oxygen levels are high enough to go to recovery were I am assigned to 1:1 monitoring (instead of the typical 1:2 or 1:3). They don't necessarily go to that extreme with the more common, Obstructive Sleep Apnea, but they do take more precautions then they normally would, even with a morbidly obese patient. I've also heard of surgeries being canceled if the anesthesiologist thinks someone has undiagnosed/untreated apnea too- when it comes down to the actual surgery, its the anesthesiologist call in the end, not your surgeons.


At the very least, ask to have an overnight oxygen level monitoring ordered now, before the surgery. You should be able to ask your regular doctor to order it for you- its just a small little machine and one of those finger clip thingies that you would wear overnight and then they can download the information to see if your oxygen levels go below 90% and for how long over the course of the night. Its not the most accurate way to determine the severity of apnea, but at least it would let you know if the OSA is causing your oxygen levels to drop too much.

Loodie
02-26-2006, 09:00 AM
I've been a bit absent in posting the last few days--I have been sooo busy. I have been reading some though. I've been doing my pre-op diet since 2/15 and to date have lost 7# (now why wasn't it that easy before:?: ). Had my final pre-op appt on Thurs. & all is go. My tests all came out pretty normal--surprisingly. An indication of fatty liver (pretty common) but they will probably do a biopsy while I'm. under. I told the nurse that that was the only way I would ever have a liver biopsy done again. (The last doc who did one, went in 4 times before she got a sample-Very painful!)

Anyhow I report to the hospital 5:30 a.m. on Wednesday to get everything signed, etc. I really like my dietician, she listens and hears--great combination. I had been keeping a spreadsheet of the 45 different protein supplements (brands/kinds) & as I tried them rated them. She was really interested & wanted a copy to give to other patients, so I sent her an electronic copy.

I worked my last day on Friday. I'm taking 6 weeks off (since I have the paid leave time) so won't be back until 4/10. I may not need all the time recouperating, but I needed the time to de-stress myself, before I get thrown into another big project--besides that it might give me time to get my baby quilt done for the 1st grandbaby that's due in September.

I am no longer nervous--just excited!

jiffypop
02-26-2006, 06:27 PM
loodie, will there be anyone around who can tell us how you're doing? inquiring minds will want to know..

and WOW on trying 45 different protein supplements!!!! DOUBLE WOW!!!!! that's amazing!!!! what were the 'winners'????

Loodie
02-27-2006, 09:34 PM
I asked my hubby if we would sign in for me and let you all know how I did with the surgery. He agreed--he's new to forums so it should be interesting.

Yeah, I was fortunate enough to find sample packs in a few places. I would be happy to share the spreadsheet with anyone who wants it. Send me a private message with your email address & I'll send it.

Tomorrow is clear liquids for me, so I'll have to see how I hold out all day.

jiffypop
02-27-2006, 11:46 PM
ok. be brave. and we'll be nice to hubby - promise!!!!

what time are you scheduled???

the clear liquid day is boring, but you'll be ok. i was so excited it didn't matter!!!

Loodie
03-01-2006, 11:47 PM
Linda had her surgery this am. We got there at 5:20 and her surgery started at around 7:45. They had a hard time getting her IV started. Other than that it went real smooth. It took a little songer than I expected but it went well. The Doc showed us a picture of gall bladder, pouch etc. She was in pain for a while afterwards till they got her clicker set up for morphine. She had some chicken broth and jello at about 4:30, and sat up on the edge of the bed. Then she got up for a short walk at 5:00 which was ahead of scheldule. Usually they wait till the next day for the first walk. She slept most of the afternoon. She is in very good spirits.
Thanks for your support and answering questions.
Linda is so ready for this, I am very impressed with her.
blessings
Karel