Stages - Part 2

In my last post, I wrote about the pre-surgery diet that must be followed. In this post, I'm going to write about the post-surgery diet stages. There are six defined post-op stages, however I am not going to go into detail on them all. I'm going to write about the ones that I have done up until now.

Stage One

Very simple. This stage includes ice chips. That's it. Tiny bits of frozen water. And not even a lot of them. As they told me in the hospital, it was pretty much only enough to keep your mouth hydrated. It wasn't nearly as bad as you'd think though. I remember after I was out of surgery and recovery room, an hour or so later I was brought a cup of ice chips. I put one in my mouth and it melted immediately. It was heavenly. A half hour later, I take another. Oh, and you should probably realize that these ice chips are smaller than the size of a dime. Anyway, I go to take my second ice chip, and it goes down okay, but not too long later, it came right back up. You cannot even imagine how painful that was. I always hurt when I vomit, but to get sick less than 5 hours out from major stomach surgery? Yeah, hope I never have to do that again. I stayed on stage one for a day before my surgeon bumped me up to stage two.

Stage Two

I was so excited to start on stage two! It still didn't mean I could eat, but I could at least have a little flavor. My surgeon approved me for stage two after I had my x-ray thing to make sure there were no leaks in my new stomach. Stage two is basically a sugar free clear liquid diet. They wanted me to get in 4 ounces of fluid every hour. Sounds easy enough right? Well it wasn't. Not when your stomach is reduced so small. The drinks allowed on this stage were drinks that I had been drinking for over a month before surgery, so it wasn't a huge change.

*Clear broth or bouillon

*Herbal or decaf tea, decaf coffee

*Sugar free gelatin

*Sugar free popsicles

*Sugar free, non-carbonated, caffeine free beverages: Crystal Light, Sugar free Kool-Aid, Sugar free lemonade, Sugar free sports drink, Diet V-8 Splash and Diet cranberry juice (both less than 7 gm of sugar per serving).

I was on stage two for about about a day until my surgeon gave me the okay for stage three.

Stage Three

This stage included everything on stage two, but with an added protein supplement. Again they want you to shoot for taking in 4 ounces of fluid an hour. This is also when you start your vitamins. They prefer you take a chewable or liquid multivitamin, calcium and iron. I have found actually that my kids Flintstone's vitamins go down pretty easy and meet all of my nutritional needs (although I do need to take an extra chewable calcium pill later in the day). Oh, you're also able to drink a little milk on this stage; skim or 1/2%. (I didn't do this as I have milk issues, but yay for more variety!) I stayed on this stage until I was two and a half weeks post-OP.

Stage Four

I am fairly new to stage four, but I am excited that I get to choose from a lot more with this stage. I will be on this stage four about SIX weeks! (Please note that gastric by-pass patients do not have to remain on this stage for that long. My surgeon recommends it to make sure that the new stomach is given plenty of time to heal before adding real foods.) This stage includes all of the previous sugar free, non-carbonated, caffeine free liquids, protein supplements, and the vitamin/mineral supplements. In addition to this, I am also able to enjoy the following things:

*sugar free pudding

*thin cooked cereals (think cream of wheat, Malto-Meal, Cocoa Wheat)

*V-8 and tomato juice

*artificially sweetened yogurt with no chunks (this is actually hard for me to find, but I did find some yogurt that is lower than most brands and the sugar in it is fructose)

*pureed fruits and vegetables (time to stock up on some Gerber baby food!)

*cream soups, made with low-fat milk and blended and/or no chunks

I can also blend unflavored protein powder into soups and cereals to help up my protein count. I am supposed to be keeping a food log to track my protein. I actually use www.myfitnesspal.com to help with this. I love that on this stage, all of these things are fluids and help contribute to my fluid goal. I should be able to take in 8 oz per hour.

Like I said before, I'm really excited to be on this stage, but since I'll be on it for so long, I'm sure the novelty will wear off soon. But still, I am pumped that I have a little more to choose from. I had some unsweetened applesauce (with a little splenda and cinnamon on top) for breakfast today (a half cup) and it took me an hour and a half to eat it, but it tasted good!

Stages

If you've read my blog posts, you've probably heard me talking about the different diet stages for both before and after surgery. Over the next few blog posts, I'm going to talk about the different stages and what all they include.

*Please note that these stages are mostly for the gastric bypass and sleeve gastrectomy. The lap-band surgery is much different, and I am not sure what all those pre and post surgery stages include. These stages will vary from surgeon to surgeon, and even patient to patient.

Tonight's blog will be all about the pre-surgery diet. There is only pre-surgery diet, and my surgeon wants the patients to start on it at least 10 days before surgery. This diet is used to shrink the liver. If the liver is too big, they won't be able to complete the surgery, which is really a shame because they don't know until you have already been cut open. While the chances of this happening are rare, it does in fact happen. I started on the diet about a month before surgery 'just in case'.

To make sure you are getting enough protein every day, you will have to do protein supplements. My surgeon and the others in the practice want you to get 40-50 protein grams a day from the supplements. You can choose pretty much any protein supplement, but you absolutely must look at the nutrition label. You should shoot for one that contains about 15 grams of protein in an 8 ounce serving, and has NO MORE than 7 grams of sugar in that same 8 oz serving.

I had a lot of issues with the protein powder, so I switched to Isopure brand, zero carb, ready to drink drinks. I ended up getting in a lot more protein that way.

Foods allowed on the pre-surgery diet include:

*4 oz. lean meat, poultry, fish, eggs or low-fat cheese daily

*Non-fat or 1/2% milk - limit to 4 cups a day

*Unlimited cooked or raw, low carbohydrate vegetables

(No corn, peas, potatoes, dry beans, winter squash, etc.) Green beans, celery, cabbage, broccoli, cauliflower, zucchini, yellow squash, beets, carrots, salad greens, spinach, cucumbers, peppers, mushrooms, onions, lettuce, tomatoes, etc, may all be used.

*Sugar free foods in unlimited quantities:

gelatin

popsicles

non-carbonated, caffeine free beverages

broth/bouillon

herbs and spices

*Include one teaspoon regular oil, margarine, mayo, or regular salad dressing daily.

Foods to avoid

*No breads, cereals, pasta, rice, etc

*No starchy vegetables: corn, peas, potatoes, dry beans, winter squash, etc

*No fruit or juice

It's so crazy because when I was doing this diet, I thought it was the hardest thing in the world. I thought, well if I can get through this, I can certainly get through the other stages! How naive I was! I was actually still able to eat and chew. I think that's what I miss the most! I just want to chew something.

I'm hoping I can write about the next stage tomorrow night. :)

Two Weeks Post-OP

This is me shortly before surgery. I was excited and nervous. I remember feeling like I wanted to puke. Although now that I think about it, it may have been because I was STARVING.

The absolute worst part before surgery was inserting the IV. I shit you not, it took at least three attempts to get the needle in me. I still have small bruises from where they tried. Hurt.Like.Hell. Oh, and then on the sites that they didn't use, I began to bleed all over. Yeah, I'm a bleeder. Thankfully my amazing husband was right by my side, trying to keep me calm. After a while it was time for them to wheel me to the OR. I remember laying on the bed being wheeled to a different part of the hospital. It got really cold. It seemed like forever before we reached the OR, but in all reality, I'm sure it was just a minute or so. At this point, I began to cry almost uncontrollably. I don't remember much from the OR besides that I was so cold.

A few hours later I woke up in this giant recovery room. I had the sweetest lady by me. She spoke with a really soft and gentle voice. Kind of reminded me of my grandma. I was so groggy and they really needed me to wake up. I would open my eyes for about 30 seconds and then fall back asleep for five minutes. Repeat for two hours. I am so glad they were updating my husband as much as they could because I'm sure he was nervous, whether he wants to admit it or not.

After two hours in recovery I was given the okay to be taken to my room. As I'm being wheeled there, I realize we are following my husband, my dad, step-mom and little sister. It was nice having them there, but honestly, I don't remember much of their visit. They brought me some magazines, a really cute cup (that I can't use yet because there's a straw in it, booo) and the most amazing chapstick ever.

My mom was watching my son that day and picked my daughter up from kindergarten that afternoon. On their way to the hospital, they stopped and picked out some flowers.

The rest of that Wednesday is kind of a blur. I remember my husband, kids and mom being there. I also remember vomiting that afternoon. Definitely don't recommend that. Can you say 'ouch'?! My brother and his wife came to visit after they got out of work and I was a tad more awake then, but still pretty out of it. Once my visitors left for the night, my nurse informed me that my oxygen was low. Not dangerously low, but I had just strained myself trying to talk to so many people at once. So I had to go back on oxygen for a while.

Totally cannot believe I'm sharing this picture. It was one thing to post it to Facebook while I was still all doped up, but I haven't been on my pain meds in a week now. Surgery makes you a hot mess.

Once my levels were stable again, I was focused on my recovery and getting the hell out of there. I know I was going to have to stay for two days after surgery, and I also knew that walking would help tremendously in my recovery. So I walked. And I walked and I walked and I walked. It felt good to be up out of bed and on my own two feet. The nurses were really impressed with how I was recovering. After I walked and walked, I went back to my room to get ready for bed. Husband and I texted quite a bit that night too. I missed him and the kids a ton.

I thought that perhaps with all the wonderful pain medicine they pumped into me that day I would sleep really well, but that was about a joke. They were in every half hour to check my blood pressure, etc. Once I finally got into bed it was about midnight (yeah, I decided to go back out and walk some more.) I laid wide awake in my bed until 1 am. Fell asleep around two, and by 4 I was wide awake then. Once my nurse came in to check my vitals and give me some more meds, I asked if I could move to the rocker chair in the corner. I actually slept for a couple hours there. I would have stayed sleeping but this damn fire alarm kept going off. For like, THREE freaking hours.

Bright and early Thursday morning the surgeon came to visit and check and on me. He was very impressed with how I was doing and said that as long as I passed my x-ray thing. Which was disgusting by the way. I got into a wheelchair and had some teenage girl wheel me to the opposite end of the hospital, hitting every bump on the way. I then had to stand up in front of a machine, and they gave me this small Dixie cup with some of the nastiest liquid I have ever tasted in my life. If you can imagine what medicated dish soap tastes like, that is what it tasted like. It was well worth it though because it showed that my stomach had no leaks and I was then upgraded to stage 2 of my post-OP diet.

I had many more visitors, phone calls and cards delivered on Thursday. It really made me happy to know that so many people love, care and support me. As wonderful as that was, it felt just as wonderful to have my IV unhooked from me, and I was able to give myself a sponge bath and put some 'real' clothes on. By real clothes, I mean stretchy maternity capris and a long sleeved t-shirt.

By Friday morning I was feeling so incredibly much better. I actually was able to get nearly 12 hours of sleep from Thursday into Friday! I felt good enough to bust out of the hospital! My husband came and got me while my mom watched my son. It felt AMAZING to be home again!

This past Wednesday marked two weeks post-surgery. I am happy to say that I am recovering very nicely. I would say I'm about 95% back to normal, or at least what normal was for me. I will admit that the first week was pretty rough, mostly due to the drain I had coming out of me, the pain from the gas they pumped into me during surgery, and I don't always do so well on pain medicine.

I'll tell you what though, as soon as that drain was removed at nearly a week out, I felt loads better. (Okay, maybe not IMMEDIATELY, but shortly after.) My mom drove me to my one week follow up appointment and after, we went and did a little clothes shopping. I found an adorable shirt I loved on clearance. Tried it on in my size, and actually needed a smaller size. I about cried!

Here's a picture of me at one weeks post-surgery. I think I look so much better!

With each passing day I am getting stronger and stronger. For the first time in a long time, I can honestly say that I am really proud of myself. This stage of the post-OP diet has proved to be incredibly difficult for me and it's only been two weeks. I should be bumped up to the next stage any day now, and fingers crossed it goes a bit better. It's just so hard to be around and preparing food for others knowing that I can't eat it. I have been so strong though. I went through, and continue to go through major body changes (not to mention the surgery cost a pretty penny) and I really don't want to screw this up.

If I told you I haven't thought this was a bad idea, I'd be lying. Especially that first week. I wasn't in a great deal of pain after surgery at all, but it was still just really difficult to be the wife and mom that I'm used to being. I couldn't (and still can't really) pick my son up. I tried playing outside with the kids, and I felt my stomach muscles in ways that were not good. I had to sleep in a recliner for over a week. I ended up with an even more sore neck and shoulders because of this.

The craving feeling totally sucks. I don't even feel hungry, and really the main thing right now is to just make sure I drink enough to stay hydrated. I know I'm not getting the protein amounts they want, but I'm slowly working on it. I bought a bag of some new protein powder tonight and I'm hoping it will help me tremendously in working towards my protein goals.

I'm very lucky that I had the surgery when I was fairly young. I hear of older people having it done, and granted by then they usually have the co-morbidities that come along with obesity, but I just could not imagine recovering this nicely from such a major surgery at an older age. I mean, less than 12 hours out of surgery I was up out of bed, holding on to my IV pole and walking the halls of the hospital.

I haven't seen the fabulous weight loss that I hear everyone talking about, but with what I lost before surgery and what I've lost since, I'm at a total of roughly 35 pounds. Still have a long way to go, but I know once I am fully healed, I can start working out, and walking, and as long as I stick to the doctor's orders, I should start shedding the extra weight in no time. I'm glad that most of the recovery (at least the physical portion) is behind me and now I can concentrate on the new and improved Amanda.

I'm Alive

Surgery went great today and so far, nothing major has gone wrong. I'm in some pain (mostly just one incision) and I was kind of pukey this afternoon, but now I'm better. I'm so excited to start my new life!

Waiting

I have been at the hospital for nearly two hours now and should be going back for surgery within a half hour or so. I'm fairly nervous. I had to be poked 3 or 4 times for my IV. I bled all over the place. I keep telling myself it will be okay and everything, but I'm so nervous that I don't know if I'm convincing myself. I will try to update as soon as I can. :)

Lucky Girl

As I sit here, the night before my surgery, I am reflecting on how I have so many amazing people in my life. My ever supportive family have gone above and beyond anything I could have expected. I have some of the most wonderful friends ever. They have said such sweet things to me these last few weeks, and I appreciate every single word. Even people I am not friends with have said such sweet things and have offered their thoughts and prayers during my surgery and recovery. A special thank you to my friends who have actually gone through the weight loss surgery and have spent so much time answering all of my annoying questions. I am so thankful that I have had the opportunity to talk to people who have been through this and tried to prepare me for the good, the bad and the ugly. It really warms my heart to see such an outpouring of love from everyone. If you are one of those amazing people, thank you. From the bottom of the heart, with every ounce in my body, thank you.

I have to say a huge thank you to my husband and children. I cannot even find the right adjectives to describe them. To say they are amazing is such an understatement. The three of them have always shown me unconditional love and their support is almost overwhelming at times. I love them all so incredibly much, and whenever I have moments of doubt and reconsider surgery, I just think that I'm doing this for them. My husband deserves a wife who will be around for the next fifty years. My children deserve a mother. I have had friends who have lost their parents at a young age, and I don't want that for my kids. I realize that there are no guarantees in life, and shit happens, but I at least have to take this chance to better all of our lives.

I love them all, with all of my heart.

24 Hours

'twenty twenty twenty four hours to go, i wanna be sedated'

Okay, not really. Have I mentioned how scared I am of being put under? I've never been put fully under (Does the 15 minutes for my endoscopy count?) My surgeon has assured me several times that I will wake up when surgery is over, and not a moment before. I'm still nervous though and will be for a couple days I am sure.

Emotional

I have been an emotional wreck lately. In an earlier post I mentioned how I'm a worrier, and that has not changed. It's only been worse. I'm pretty sure it's only going to get worse before it gets better.

I should be out of surgery in less than 24 hours!

Great News

My primary doctor signed the paper!! As long as my surgeon's office received the letter via fax I should be on for surgery Wednesday. To say I'm nervous would be an understatement.

Fingers Crossed

One of the requirements I need before I have surgery is to have my primary doctor sign a 'letter of recommendation'. This should actually be one of the first steps in the weight loss surgery process. However, since my primary doctor went on maternity leave the day after I dropped the paperwork off, I haven't been able to complete this portion. I am happy to say that after a couple months, my doctor is finally back to work today. I have an appointment today to discuss surgery and a couple of other things, and I am wishing, hoping and praying that she signs this dang paper. I do not want surgery to be delayed at all, and we are cutting it kind of close with my surgery date being just a couple days away. I have spoken with the nurses in the office over the last couple months and I guess the letter is all prepared. Literally all the doctor has to do is sign it. If you have some positive thoughts you can spare, send them my way today. I'm really nervous that the doctor won't sign the thing and I'll have to start this entire process over. If she won't sign it, I don't know what I'll do, but I'm pretty sure it will involve lots of crying in the middle of the office.

It Hit Me Tonight

This evening as I was saying goodnight to my two amazing kids and tucking them in to bed, it hit me. Although not common, there is a possibility this surgery could go horribly wrong. I am scared shit less that something terrible is going to happen. I've never really been put under, and that scares me. I have heard it is the best sleep ever, but it still doesn't help calm my worries. I am also afraid that the surgeons will nick some major vein and/or artery and I'll bleed out. The coordinator I've been dealing with throughout all this said that there's a good chance that when (if) I wake up, I'll be in the ICU. It worries me because it was in that ICU in that hospital where my grandpa passed away. Way too many bad memories associated with that place.

I spent a good portion of tonight crying into my awesome husband's absorbent shoulder. He doesn't even act like he's nervous, but I'm sure it will hit him the day of surgery. I know he's trying to be strong for me though. I've heard these feelings I'm experiencing are normal, and if I wasn't nervous, something would be wrong.

I have spent way too many hours on Google searching for 'death from weight loss surgery' and the likes. All of the websites have different numbers, but overall, they are pretty low. And it's not like I've never had surgery before; I have had two Cesarean sections. I had zero worries about them, and I'm sure the risk of dying during one of those is about the same as this surgery. Of course with those, I got to hold my sweet newborn babies right away. Also, it's not like I really wanted those. It wasn't elective surgery. This is. I know so many people think I'm insane for signing myself up for something like this.

I have so many wonderful friends that have spent a good portion of tonight trying to calm me down and assure me things will be okay. I have had friends who have done this surgery and years later they are alive and well. I know I won't die, but I still worry. I'm a worrier by nature.

I just have to keep telling myself that things will be okay. I'm going to be fine. I'm going to lose weight and be so flipping healthy. Finally. I deserve that. My husband deserves to have his wife around. My kids deserve their mom.

I have calmed down for the night, and as the clock prepares to read 1 AM, I think I'm done on here. My kids will be awake in less than six hours. Little stinkers don't know the meaning of sleeping in. Good thing they are so cute. :)

I Want To Be That Fat Again

I have always been overweight. It's never been a secret. Not like you can hide that. I remember many many years ago thinking 'Oh my god, I am SO fat.' Now I look back on those pictures and think about how much weight I have gained and how I'd do just about anything to be that 'fat' again.

spring 2001

summer 2011 (ugh)

I am rocking some pretty sweet Jack Skellington socks though.

I'm Probably Overreacting

Like most women, I tend to worry and overreact. It's just natural. Add that to being a mother, and it's taken to a whole new high. I am sooooooo nervous that something will go wrong with surgery. I don't want to die. But at the same time, if I continue down this path I'm on, it's just a matter of time before diabetes, heart disease, etc claims my life. I've weighed so many pros and cons in the last few months. I'm still convinced that weight loss surgery is the way to go to ensure the healthiest life for me. Like I said though, I'm so nervous something will go wrong with the surgery. I thought about writing letters to my kids that they can read one day just in case I don't make it out of the operating room. I told you I tend to overreact. I want them to know how much I love them, and how I'm doing this for them. They are my everything. Whenever I do anything in life, I think about how it will affect them. I love them so much. They are my world. I would die for them. I just hope it's not any time soon.

Officially

I am officially less than one week away from surgery! I'm excited and nervous and about a million other emotions. I've been doing a ton of research and part of that research included watching a video of the surgery. BIG mistake! I knew how it would work before watching, but OMG. I am officially freaked out.

The type of weight loss surgery I will be having is called a vertical sleeve gastrectomy. Basically what it does is removes most of your stomach so it's the size of a banana. There are no rerouting of the intestines or anything like that. I think, or rather, have been told, that it's a lot less complicated because of this. Here's hoping.

At my pre-OP appointment last week, my surgeon tried to put some fears to rest by telling me that he's never had a patient die on the operating table or anything like that. Hearing that was comforting for about three seconds until I blurted out "Well there's a first time for everything."

What the hell am I getting myself in to?!