More Like Used As A Punching Bag

This past week has exceeded my expectations for recovery.

I'll start with Tuesday itself.  I did per-admittance check-in on Monday so that all I'd have to do on Tuesday was show up and pay.  They ran me through the procedure, what to expect, and what I needed to do before arriving.  E and I showed up at the surgery center around 10, paid, and set up in my own private room.  Within the hour I was IV'd up, debriefed, and good to go.

I was set for a 12:45pm surgery time, but due to some delays didn't get wheeled out until 1:20pm or so.  At no point were we left in the dark about delays.  The nurses were friendly, funny, informative, and very helpful. Both the surgeon and anesthesiologist stopped by to see me and explained what would happen next.  It was downright enjoyable, and the way the staff treated me went a long way towards alleviating any anxiety I had.

When my time came I was drugged up and wheeled into surgery.  I'm not sure when I went to sleep, but I was in the middle of talking to the nurse and anesthesiologist about their favorite types of history and the next thing I remember I was waking up in recovery.  It's weird, but there was something comforting about being in the operating room with all its technology surrounded by a staff with years of training and experience.  Far from feeling sterile it felt safe.

It took me about 20 minutes from regaining consciousness to being wheeled to my room by a volunteer who was going to school for Bio-Mechanics.  My throat hurt from the breathing tube and my mouth was like a foamy desert, but other than that I don't remember being in much pain.  I was thirsty, but had to wait until I went to get x-rays done to see if everything was working correctly.  E said the surgery lasted a little less than an hour and that the surgeon came about immediately to tell them when it was over.  Apparently my insides are in excellent condition.

In radiology I had to drink about 4 teaspoons of a foul substance whose name I can't remember.  Drinking that was by far the worst thing that happened to me that day, and I'm glad I asked for the anti-nausea meds before taking it.

After that ordeal I was finally given a glass of water and went back to my room to rest for awhile.  By 5:30pm or thereabouts I was released and on my way home.

I was in bed by 7 and slept for most of the night.  I think I woke up around 3am to walk around for a bit and get a drink, but I was back in bed before too long.  I slept for most of Wednesday as well.

So far yesterday and today have been really good.  I've felt a little sore, but my incisions don't hurt that much so long as I move slowly and deliberately.  I feel less like I've been stabbed and more like I was used as a punching bag.  I don't have stitches and the incisions themselves aren't near as big as I thought they'd be.   They're held together with a type of tape that should fall off within the next week.

I had real bad gas for most of Wednesday, but its seems to have gone away.  At least now I can tell the difference between pain in my incisions, uncomfortableness because of gas, and being full or hungry.  I find about 8-12oz of fluids are enough to fill me up and keep me satisfied for about 2 hours before I need another glass.  I'm drinking mostly juice, almond milk, skim milk, and meal supplements and so far I don't feel deprived, but it is only three days out.  I imagine as the weeks progress my appetite will return and I'll have to put my techniques to the test.

I'm very much aware of the band.  Unless I'm sitting up straight I can feel a tightness in my stomach that wasn't there before.  This is good and bad as it's easier to tell when I'm full, but also something that's just slightly uncomfortable.

My energy levels are returning to normal.  E and went out this afternoon for about 2 hours to visit a local museum.  It was nice to get out of the house, but after about an hour or so I started to get fatigued.  

I know this wasn't a terribly exciting or insightful update.  I'll have some more thoughts on my new life soon enough, but for now I'm focused on relaxing and recuperating.  

Post-Op

This will be a short one.

I'll go in to more detail on my hospital experience later, but for now let me just say that I'm doing fine.  The pain from the incisions themselves is the same sort of constant ache that you get after a ridiculous abdominal workout.  It's easy to forget how much you use those muscles.  The worst pain so far is internal.  As a part of the procedure, the operating team pumped me full of air so they could navigate my inner organs more easily.  Over the next few days my body will absorb the air, but now now I'm very gassy. 

The pain is only really bad when I burp, hiccup, or cough.  I warned E not to make me laugh and so far she's only slipped up once.  I don't feel like I've been stabbed fives times so much as I feel like someone's used my stomach as punching bag.  That said, I'm not in near as much pain as I thought I'd be and most of what I have is due to soreness.  Sitting straight up hurts the worst because it puts pressure on my lower abdomen/spine and causes all of the gas they pumped into me to gather near my shoulders.

I'm still on clear liquids through tomorrow, but I'm in no hurry to move on to pureed or semi-solid just yet.  Roughly 12oz of liquid is enough to fill me up right now.  I'm not talking 'that was a nice meal' full, I'm talking 'WHY DID YOU LET ME DO THIS!?' full.  Twelve fluid ounces - that's a cup of jello and half a cup of juice.  It sticks too.  I had that jello and juice at roughly 5:45 and even now at 8:25 I'm still a little full.  The last thing on my mind is solid food.

At the moment I'm off for a small walk and a drive just to get out of the house. 

"Like You've Been Stabbed Five Times"

I met with my surgeon last Thursday for the last time before my surgery.  We went over the specifics of the procedure and what my recovery will be like.  It's a laparoscopic surgery so I'll only have five small incisions about an inch or so in length in my abdomen.  He didn't really say how long it will take, it should be between 20min to an hour.  Of course there's a whole host of complications that could come up (and they made me sign a waiver detailing all of the various complications, including death), but I'm trying to focus more on the fact that this particular surgeons group has a perfect record.

This will be the second time I've been under general anesthesia (the first time being for tonsils which I don't remember), and I've got to say I'm a little nervous about it.  Part of the nervousness comes from reading all of the ways in which general anesthesia can mess with me.  I'd say the other part isn't nervousness based on fear but rather nervousness at starting a radical new period of my life. 

I've been preparing for this for nearly 8 months, but it's still daunting to think about.  I've got all of my technical information down, but it's learning how to put it into practice that I'm nervous about.  After Tuesday the way I live will be totally different that what I'm used to.  It's exciting, nerve-wracking, scary, and hopeful all at the same time.  I'm looking forward to so much.

I usually do well with change in my life.  Whether it's moving, starting a new job, or going back to school it usually doesn't take me too long to adapt.  Getting into a healthy routine is essential for my success, and having a month or so to gradually get used to eating differently will help with that.  It'd be much more difficult if there were no transition period to separate my old life from my new one.

I'm trying not to anticipate difficulties.  It might sound like a recipe for failure, but I find I do better when I focus on the specifics of my goals in small increments.  I'm making a huge life change that will require lots of change on my part as well as E's.  However, my decisions to life healthy are a day to day, moment to moment decision.  Long term achievements with daily goals.  Can I walk by those cookies someone brought to work?  Can I resist the spontaneous urge to drink a Coke.  Will I be able to control myself?  I'd like to say absolutely yes to each one, but I won't know until they come up.  I've been working for two years now on making sure I'm aware of when I'm making a decision and the motivations for why I choose what I choose.

In three days a skilled, experienced surgeon surgeon will cut small holes in me, insert long metal tools into my abdominal cavity, and, with the aid of a camera, place an inflatable silicone ring around the upper portion of stomach.  What a tremendous thing.     

By This Time Next Week...

...my surgery will be done with and I'll probably be resting.  Apparently I'll feel okay by the next day, but I haven't ever had this type of surgery before and I've got no idea how long it will take to recover. 

This is my last week to enjoy solid foods until early September.  For 1-2 weeks after surgery I'll be on a liquid diet (the first two days clear liquids only), and the following week I'll be on a puree diet.  I've got specific goals I have to meet each week before I can move on to the next stage.  For the first stage I need to consistently drink 64oz of fluids per day.  For my pureed diet it's being able to eat 3 meals per day, for my semi-solid diet it's chewing my bites 30 times, and once I'm back on solids it's resting between each bite.  Each stage is designed to help me get used to my new stomach, or 'pouch', without hurting myself.  Hopefully by the time my birthday hits I'll be able to eat regularly and I might even be able to enjoy a literal (small) bite of cake.  It will be glorious.

For the moment I'm slogging through the high-protein/low-carb meals.  I've got a good system going on now, but this is definitely not the diet for me.

I've given a lot of thought to how I want to eat once I'm back on solid food.  I've never been a fan of the 'fad' diet, but I do think there is some good that can come out of having a limited set of daily foods to build a healthy diet around. I'll have to wait and see what works for me once I'm adjusted to the band.

Last Meal: Estancia Churrascaria.
E decided that for my penultimate last meal we should eat at this delicious restaurant.  For those who are unfamiliar with Brazilian steakhouses let me paint you a picture.  After your waiter takes your drink order you're directed to a large salad bar with a variety of tasty (so I'm told) vegetables, cheeses, and cured meats.  Once you've had your fill of roughage, your waiter brings out a clean plate and the feast truly begins. 

Each diner has a card that is red on one side and green on the other.  As you flip your card over to green you're swarmed by servers with long skewers of smoking, steaming, glistening, and aromatic meats.  Bacon wrapped filet mignon, pork tenderloin covered in parmesan, pork sausage, garlic sirloin, beef ribs, leg of lamb, juicy chicken breast...yum.  This all you can (m)eat extravaganza continues until you turn your card over.  At this point you tuck in, but the wise take their time and eat each cut slowly so as to savor the meat and pace themselves for more.

We invited two friends along, A and J, who both appreciate the finer qualities of the churrascaria.  We first ate there of A's birthday a few months ago, and after stuffing myself full of beef, chicken, and pork I wondered where these restaurants had been all my life.

Obviously a place that serves mostly meat (they also have mashed potatoes, polenta, fried bananas, and cheese rolls - foods meant to fill you up) was a perfect choice for me given my current dietary restrictions.  Estancia is a thing of beauty and I've developed a fine method for eating as much meat as possible (hint: eat light before hand, pace yourself, avoid the filler, only get 2-3 meats at a time.)

As amazing as Estancia was on Sunday I learned a good lesson that I need to keep in mind over the coming months.  I ate a lot of food.  Too much.  For the rest of the day I felt sluggish and had the meat sweats.  After working on ways to control my portions and pay attention to when I'm actually getting full, eating a meal without observing those techniques really wasn't a good idea.  I ignored them intentionally because I knew that this would be the last time I could eat that amount of food in one sitting.  While I was uncomfortable I don't regret eating that much.  It made me reflect on how not so long ago I would eat like that daily.  I appreciated one last face-stuffing, but I'm glad to say that I could do without that again. 

Who knows? Maybe by Thanksgiving I'll be able to eat a whole 6" diameter plate's worth of food! 

10 Days To Go

Okay.

If you'd have told me a few years ago that I'd be on a diet that consisted mostly of various meats and cheeses I'd have called shenanigans on you.  When I first heard of the high protein/low carb diet I thought it was too good to be true so I never looked into it.  I thought, "there's no way that someone made a diet plan that called for eating two of my favorite food groups in abundance while justifying my lack of fruits and vegetables as healthy."  I imagined it as a heaven full of steaks, fajitas, beef jerky, and barbeque sausage.

How wrong I was.

Since last Tuesday I've been on what's functionally an Atkin's Diet and I hate it.  You see over the last few months I've grown accustomed to eating lots of fruit as a substitute for unhealthy snacks.  It's worked tremendously well because if I snack slowly I remain full and have the satisfaction of knowing I'm taking care of myself.  On this two week pre-op diet I'm limited to one piece of medium fruit per day.  In this case I've chosen to have about 1/3 cup of watermelon.  Sweet, delicious, juicy watermelon.

Now, I understand the basics behind the diet and why it's important for me to be on it before surgery but that doesn't make it any easier.  These last few days have been hell.  I'm pretty much always hungry and my stomach hurts most of the day.* I went walking with the dog last Wednesday and when I came home all sweaty E commented that something smelled like meat.  While she first thought it was the pup we both came to the revolting conclusion that it was me.  I smelled like a butcher's shop.

Two eggs with Turkey breakfast sausage.  Small portion of watermelon.  Roasted and lightly salted peanuts.  Cocoa almonds.  Low-fat cheese.  Turkey lunchmeat.  Roasted Chicken.  Small bag of carrots and celery with almond butter.  Baked chicken with melted cheddar (actually really good.)

By the time I get home I'm craving vegetables which is something I never thought I'd experience.  I finish off the day with broccoli,green beans, salad, peppered cashews, and pistachios.  That part isn't so bad as I find it's best to have my last meals be light so that I don't feel sluggish by the time I go to bed.  Also, eating a bunch of fiber at work is a bad idea.

I've only got ten more days until the surgery.  I had a talk with a co-worker, J, about surgery as she's had quite a few recently.  I'll talk more about my thoughts on being cut open and having a virtual stranger root around in my insides later, but suffice to say I'm feeling a mix of excited, impatient, and anxious about the whole thing. 

*WARNING - Honest Talk About Crapping*
For those who care not to read about the bowel movements of a 313lb (still!) man then skip this part.

For most of my adult life I assumed I had Irritable Bowel Syndrome because, to paraphrase Louis CK, every time I had to crap it was an emergency.  For whatever bizarre reason, I never linked eating fast food almost exclusively with alternating constipation and diarrhea.  Odd isn't it?  When I once told E that I went #2 she was shocked and told me that something was wrong.  I assumed she was weird or something. 

The thing is once I started eating healthy I started having regular BMs.  This may be too intimate a confession, but it is wonderful.  I can now go out to eat in public without worrying that at any moment I might need to take a dump RIGHT NOW.  I now longer need to carry Immodium with me everywhere.  It's one of the benefits of eating healthy that I think should be mentioned more.

Two Weeks!

Last Week's Last Meal: Omlettry Pancakes.  I've been craving some good pancakes for weeks now and had the opportunity to indulge myself this past Sunday on some of the lightest, fluffiest, and most delicious pancakes in town.  I ordered the Eggonomical breakfast, but in hindsight I should have just gotten a short stack.  Unlike sandwiches, eggs are best when you prepare them yourself, and despite their name the Omlettry's eggs are meh.  Their pancakes though..oh man.  I went all out with butter and syrup, and gave it my best shot.  After I carved the soft, syrup soaked center out of a pancakes larger than most dinner plates I sat back and marveled in my indulgence.  Tummy full and sweet tooth sated I'm glad to say I chose wisely for my Last Meal Breakfast.

In two weeks I'm getting bariatric surgery.  It didn't really hit until this afternoon when I was considering how I'm going to approach the next two weeks on my pre-op diet.  Of all the difficult things I'm going to tackle over the coming months this virtual Atkin's diet is turning out to be the hardest.  I've grown accustom to using fruit as my go to snack food, and having to limit myself 1 medium piece of fruit a day is annoying.

What's really bothering me though is the realization that I still have powerful snack impulses when I'm at work.  Over the last year I've taken steps to reduce the amount of time I spend doing nothing at home.  So long as I stay busy with some task then I don't feel the need to snack.  Work is another matter though.  Eight hours of soul-crushing monotony can drive any person to find ways to alleviate the boredom.  Some people take hourly smoke breaks, some people snack, some chat constantly, and some just don't do any work.  Myself, I snack. 

In past years I might chow down on chips, crackers, cookies, donuts, or candy.  As I've talked about before, this usually leads to a nasty cycle of self-hatred and emotional eating that's only reinforced by being at a meaningless job.  This year I've tried to make sure to bring my snacks from home so that I have a healthy choice at arms length.  When I bring all my food from home I set myself up for success by making the healthy choice before I get in a situation where my instinct is to go for the unhealthy food. 

Without a big bowl of fruit I can snack at throughout the work-day I'm at a loss as to what to do.  Naturally the alternative is to bring carrots and/or celery to snack on, but without hummus I just don't have it in me.  I've done exceptionally well over the last few years in expanding the number of vegetables I eat, but I still haven't reached the point where I like them in and of themselves.  I've had the same bag of carrots prepared for the last week that I don't get around to eating with my lunch.

Of course all of my problems with snacking tie into larger issues as well.  There's nothing stressful about my job.  In fact it's anti-stressful.  It's so non-stressful it blows past boring and heads straight into mind numbing.  I'm not joking at all when I say that I like jobs with a moderate degree of stress - it makes the day fly by.  The job itself isn't so bad, but the fact that it's a filler job, a temporary way to make some money while working on my Master's, means that I'm constantly reminded of how much I'd rather be doing something else.  I know it's bad when the first thing I think on Monday morning is 39 hours and 59 minutes left to go.

Snacking was (and still is to some degree) my way of dealing with unhappiness.  Emotional health is directly tied to physical health, and developing ways to deal with unhappiness has been a large focus of the last year of my life.  I've largely succeeded, but being at work is like placing myself in temptation central.

I know I can do this, but the next two weeks are going to be hell.  On a more positive note, two weeks is nothing and after they're done I get a full week off from work!