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Tuesday, March 13, 2012

So much information...How do I remember it all?

I've read through my "education manual" now.  There. is. so. much. information. SOOOOO much!  I'm feeling a little overwhelmed by it all, and to be perfectly honest a little bit intimidated by it.

That may seem silly to some of you, but there is just so much to take in and so much to remember.  I know the manual is there for my reference, but I want to "know" it.  I want to be able to not really have to think about it - because when I stop to think about it, I realize that the surgery is really only a tool.  Another tool to help me lose weight.  Tools have failed me in past.  Tools have broken.  Tools have gotten lost in the shuffle of life.  So yes, it's a bit scary and a bit intimidating.  That being said, I'm still excited.  I'm still encouraged by how God is giving me the strength and courage to face the surgery.  I'm looking forward to my appointment on Wednesday to see if MD is ready to recommend the surgery to the insurance company!!

Thoughts on all I've read...

I want to be careful not to post too much information here.  I don't want anyone to think that they can (or should) try to follow certain "eating" plans without being under supervision of a physician.  Our bodies are intricate machines...designed by God to function as He planned.  We should really be very careful in how we treat it.  Years of abusing our bodies really takes its toll.  So make sure before you start repairing the damage you've done to consult a physician or health professional.

So... what's in the manual?  Glad you asked!  I'm going to highlight things that stuck out to me as I went through the manual.  To keep this entry from getting WAY too long (it's long enough as it is!), I'm going to tackle one section of the manual per post.

Section 1
Two Weeks Prior to Surgery
  • Begin walking.  (Common theme throughout this section.)
  • Reduce caffeine by 1/2 - it stimulates the appetite.
  • Drink six 8-ounce glasses of water per day.
  • Take chewable multivitamins.  (started this already)
  • Take calcium twice per day.  (going to ask about this one)
  • Start eating 3 meals per day.  Do not worry about the calories, just work on the habit for now.  (I do okay with this...most days.)
  • Avoid binge eating or having the "Last Supper"  (hahahaha!  I've had a lot of "lasts suppers" over the course of my weight loss journeys... the "what is the one thing that I want to eat before I can never eat again" meal!)

Ten Days Before Surgery
  • Choose protein-rich foods.
  • Start eliminating sweets and carbs.
  • Reduce by another half or eliminate completely the caffeine I drink.

One Week Before Surgery
  • Stock the pantry with foods for the first few weeks after surgery.  Be sure to have a variety of "Free Foods", the foods allowed on Phase II, Phase III, and Phase IV.  Remember I will only be eating small quantities...don't buy these in bulk!
  • Read the nutrition information in the manual again.
  • Make sure to take all vitamins daily.

Day Before Surgery
  • Relax!!!  (great advice...you try relaxing before surgery!)
  • Ask your doctor for medication to help you sleep the night before surgery.
  • Read your education manual.  (again?!)
  • Write in your weight-loss journal.
  • Call a friend who is supportive of your decision.
  • Reread your commitment statement and the reasons you chose to have surgery.
  • Starting at 6am the day prior to surgery, begin clear liquids only - NO CAFFEINE (caps added for my benefit!): Beef or chicken broth; jell-o; Sprite or 7-up, crystal light, clear juices.
  • Walk as much as possible.
  • No nail polish.  (No problem)
  • Medications - list of what not to take and what's ok to take
  • Shower with CHG soap (night before and morning of surgery) - given specific instructions on how to shower, how long to shower, how long to rinse, etc.  (What?!  I hope CVS has it!) 

Day of Surgery
  • Arrive two hours before scheduled surgery.
  • Meet with the anesthesiologist.  (I'm sure CME will make reference to him/her about how I breathe funny when trying to come out from under anesthesia.)
  • The operation time can vary - but in some case it can be up to 2-3 hours  (Glad I'll be out of it during that time!) and approximately an hour in recovery.
  • I'll be given Heparin or Lovenox right before surgery to lesson my chance of forming blood clots.

Hospital Stay
  • Length of stay is 2-4 days (including day of surgery)
  • Must take comfortable slippers because I'll be up and out of bed walking quickly.  I'm not sure if my sock-monkey slippers will be "safe" to walk in right after surgery.  I may need new slippers.
  • Walking after surgery is EXPECTED.  If you do not agree to walk, then you will not have the surgery. 
  • Why is walking after surgery important?  It helps prevent blood clots, improves healing, relives post-op indigestion and gas, promotes deep breathing, decreases the chance of developing pneumonia, helps control pain and improves emotional outlook.
  • Bring my education manual with me to the hospital!

  • The size of the incision(s) varies and depends on whether surgery is open or laparoscopic.  (I'm hoping for the 5-6 smaller [1cm] incisions over the incision from the bottom of my breastbone to my above my navel!)

  • Each person's pain tolerance is different (my words), expect some level of pain in the first couple of days after surgery.  Usually mild to moderate abdominal soreness but not severe abdominal pain.
  • IV pain meds will be given and I'll be taught how to use it effectively to control the pain.
  • I may experience nausea and indigestion but I can let the nurse know so she can give me the appropriate medications.
  • I'll have pain meds to take when I am released.  (I hope to not have to take those - I really dislike taking medication...for anything.)

  • I will begin with clear liquids for 24 hours before surgery and resume with clear liquids for three meals after surgery.
  • I will progress to "full liquids" on day four.
  • I will be monitored closely while in the hospital to make sure I am getting adequate nutrition.
  • My RD will visit me.  :)
  • I may struggle to get in all the liquids required the first few days after surgery.  IT'S NORMAL.
  • I will not be able to drink and eat at the same time.  My stomach will not have enough room and it will make me vomit.  (Ewww!  I hate vomiting!)

Drains, Catheters, Tubes and Other Devices
I'll save you the graphic details - you can thank me later.

How to Prepare
  • Walking is the single most important activity you can do to improve your health and prevent blood clots after surgery!  (this is really a good thing to remember even if you're not having surgery!  W.A.L.K.)
  • Start walking now.
  • Walking improves circulation and lung function and develops a habit of exercise.  (Note to self - tackle the exercise topic soon!)

Range of Emotions
  • The first few days/weeks may be very difficult emotionally.
  • My hormones may be disrupted after surgery (watch out world!)
  • Sadness - because I have lost a "friend" (food)
  • Anger - that I can't change my mind and go back to my old life.
  • Hurt - life and people do not magically change once I lose weight.
  • Resentment - of others who can eat like I would like to...but can't.
  • Fear - of others noticing me more...or of regaining weight.
  • Vulnerable - having to face old hurts that have been hidden beneath the layers of fat and are now exposed.  (I put an * next to this one.)
  • Happiness - with myself, life, others
  • Joy - at experiencing what I have wanted so badly
  • Pride - in myself and what I've accomplished (side note - please pray that I never become prideful, but continue to focus on God's work in my that allowed me to accomplish these goals!)
  • Relief - from the medical conditions I lived with.  
  • Freedom - to move, to breath, to live life to the fullest!!

Facts to Remember About My Digestive System
Again, I'll save you a lot of the details...here are the most important in my mind:
  • Nausea may be frequent int he first few weeks after surgery.  There are medications to help!
  • My new stomach pouch will only hold a maximum of 2-3 ounces at one time right after surgery.
  • STOP EATING WHEN YOU FEEL FULL.  If you over eat, you will vomit.
  • You must eat three meals per day in order for my pouch to stretch normally.  
  • I will be taking Vitamin B12 for the rest of my life.  (Much better than taking medications for heart disease, diabetes, etc!)
  • I should carry some form of identification on me that will inform healthcare workers of my altered digestive system - in case of emergency.  (I'll ask my paramedic hubby what he thinks would be good for this part!)

So there is a glimpse of the first section of my manual.  I'll end this post with one other sentence that caught my attention and a word of good advice regardless of where you are in your own journey:

Your weight won't defeat you, but your negative thoughts will.
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

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