Wednesday, December 04, 2013
The hernia is fixed!!!
I was really worried about how bad this surgery was going to be, which turned out to be a waste of my time: it was by far the easiest of the abdominal surgeries so far. I think I hit the right combination of having a great surgeon, going in to the surgery in relatively good shape, and knowing my body and how it reacts to anaesthesia and painkillers.
The surgery started at 7:30, and I was in the recovery room by 11:00, and in to the ward around noon. I did my first few laps of the ward before 1:00 --- really slowly, but at least I was moving. They put in a local across my whole abdomen that lasted for about 6 hours, and had me on a morphine pump that I could use for 1 mg of morphine every 6 minutes as required --- I only used 12 shots of that total, with the last being around 3 in the morning. Other than that, the only painkillers I have needed are extra-strength Tylenol and ibuprofen, spaced every 6 hours.
There definitely was a fair amount of nausea to deal with, but eating small amounts every couple of hours and taking Gravol made that totally tolerable.
The docs made sure that I had stronger pain relief available if I needed it (there were orders written up for morphine, percocets, and oxycontin), but I know that those cause me major constipation, which is just NOT a thing I was willing to risk after this surgery! Same situation with the anti-nausea drugs: they had stematil and Ondansetron both on order if I wanted them, but I stuck with plain old Gravol since it doesn’t bung me up. I much prefer dealing with a low level of pain and nausea to having to deal with all of the additional pain and nausea caused by constipation (not to mention the risk to the incision if I were to be so foolish as to strain trying to empty).
The incision for the hernia repair is vertical, from pubis to the base of the sternum, while the panniculectomy incision is horizontal from hip to hip. I’ve got 99 staples in there that I know of (although there may be another one or two tucked in to the belly-button that I can’t see yet). There is some bruising, but not too bad. The worst looking spots are where the 3 drains came out of the belly – they were pulled out after a week, and are going to heal a bit more slowly since I was back on the blood-thinners by then.
I will be wearing an abdominal binder for support for at least a month, will be attempting to sleep on my back for about the same amount of time, have lifting restrictions (10lbs) for at least 8 weeks, and was strongly encouraged to walk as much as I can (but to listen to my body when it wants me to stop). I wasn’t able to sit properly when I had the drains in (it hurt too much when they kinked as I bent), but can move pretty freely now that they’re out.
One of my nurses had worked for a plastic surgeon who specialized in bariatric surgery and reconstruction, and was really shocked that I had chosen my colo-rectal surgeon to do this for me. She happened to be on duty when he came in to rip off the dressings for the first time, and had a look of total shock on her face when she first saw the incisions --- she came back after the surgeon had left to rave about how good it looked: the plastic surgeon she worked for apparently always had some skin puckering at the ends of the incisions and at the navel, and I have none of that.
Even with the drains, there is a massive amount of fluid and swelling that will be around for a while. I literally put on 10lbs from the morning of the surgery to the morning of the day after. I still have 5lbs of that on, and it’ll be anywhere from 2 to 6 months before the swelling goes away entirely. It’s also kind of funny to have areas where all feeling is gone --- I can see it being touched and not feel a thing. The nerves get cut during the surgery, and may or may not grow back over the course of a few years. Pretty small price to pay to get back my ability to move without fear of the hernia, in my opinion…
The Man and I both have had to laugh at ourselves, and how much our lifestyle really has changed over this year. He was trying to deal with fast food and cafeteria food while I was in the hospital, while I was doing my best with the hospital food, and both of us just could not wait to get me home so that we could eat REAL food again! We both headed straight for the veggies when I got home, and, even though I had declared it a non-tracking week, he automatically weighed and measured out all of my portions (yup – he’s a keeper – he took over the cooking and serving for the first few days). Who knew that asparagus and brussels sprouts could be “comfort foods”?!?
We’re settled back down in to our routine, I’m back to tracking (although staying in maintenance ranges and not looking at losing for a while), and the staples should start coming out next week. There is still a fair bit of pain, but not too much worse than I had from the hernia itself, and that’s fading day by day. All told, I’m thrilled to be at this point, and am looking forward to getting the all-clear to start working out again.
Thank you so much to my Spark buddies who sent me so many strong thoughts and support – you brought me many, many smiles. I hope that none of you ever have to go through this, but if you do, please remember that it really is not too bad at all!
Hope you all have a great week!
Thursday, November 14, 2013
Well, I do have some things to update from my long whine of a while ago…
The eyeball thing is still up in the air. The “top of the line” retinal surgeon I was referred to turned out to be one of those “I am a surgeon-god --- don’t ask me questions” types, who wasted a ridiculous amount of my time either not telling me anything or lying to me. He did, apparently, refer me to an ocular oncologist to get the thing checked out, but left with a “don’t you worry about it – leave the worrying to us – enjoy your Christmas”… and a follow-up appointment in January. The Man was with me, and neither of us have a clue what that appointment is for --- it could be for a biopsy, it could be for surgery, or it could be so that the twit could just waste more of my time. This dude may be awesome dealing with unconscious patients on the operating table, but he is obviously incapable of communicating with someone conscious.
Ummm. No. That’s not how things work in my world. In my world, I get copies of test reports, discuss them with the doctor, and make the decisions about my own care.
So – I am in the process of going around him, and have my oncologist from the colon cancer arranging to get me in to his preferred ocular oncologist. It will likely be a few weeks before I can get in, which will work out well with my schedule.
The other update is that my hernia repair surgery is confirmed for November 25. I had my final pre-surgery meeting with the surgeon on Tuesday, and the surgery itself has now changed: instead of a simple hernia repair, it is now a complete abdominal reconstruction combined with a panniculectomy (removal of the pannus, or “apron” of skin and fat below the navel).
Both my surgeon and I are dedicated to doing whatever we can to make this a permanent fix, with the lowest chances of complications and of future re-herniation. This was the reason behind me losing weight, and he was thrilled that I had done so well.
I am extremely grateful for some folks who have blogged here about their thoughts and discussions with their surgeons about hernia repairs combined with either panniculectomy or abdominoplasty. Those blogs spurred me in to doing the research, so that I was prepared when my surgeon wanted to discuss the same thing. The studies that I found showed that there were fewer complications with repairing a hernia by stitching the muscle together instead of using mesh. I also found studies showing that there were less complications and less chance of a new hernia if a panniculectomy were done at the same time.
Since I am so obviously dedicated to doing whatever I can to make this work, my surgeon wants to do the same. If I hadn’t done what I had, then the repair would not have happened. Due to allergies, I can’t have the “standard” “stitch in some mesh and hope that it holds”. Instead, it will be a much longer surgery, with the skin and fat separated from the muscle, the muscle pulled together and stitched, and the excess skin and fat removed. There will be a full horizontal incision from hip to hip, and a full vertical one from pubis to sternum.
He’s not a plastic surgeon, but I have incredible trust in him (since he did a great job with me on the original cancer surgery), so the new incisions will be stapled shut and I’ll have some new “railroad tracks” to go with my old ones. We’re definitely not talking about “bikini ready” here!
What I’ve found really interesting about this is that I have discovered that I apparently have a lot more vanity than I had realized. I’ve always been comfortable with myself nude (even at 290ish pounds), am quite fond of my current sets of railroad tracks, and even have a somewhat bittersweet fondness for the “flap of flab” that I had thought would be my permanent reminder of what size I used to be.
Yet still, when I found out that there were definite health benefits to the removal of that “flap”, I discovered that I was quite happy about losing it. I went searching on Dr. Google for pics of similar surgeries, and discovered that I am actually quite adamant that the results turn out to look at least remotely human, and not like the end of a 3-year-old’s day playing Dr. Frankenstein with the office supplies on their teddy bear. I’m quite fine with scars, but had my surgeon laughing when I firmly reminded him that straight lines and even curves are wonderful things, and that I would be more than happy to supply a straight-edge and a compass if they were required…
He, in turn, reminded me that I’m not allowed to start back with even the simplest strength training until he tells me it’s ok (he figures at least 3 months with the extent of this surgery), so I guess I’ll focus on being a bit excited to see what my “new” body will look like for a while, before I’m allowed to focus on what it can do! I’ve had the Man shaking his head and laughing at (with) me as I pose in front of the mirror and try to push/pull the old belly in to what I think it might end up like…(ok – I’m a goof – I’m good with that!). I have absolutely no mental image for myself post-surgery, so I’m hoping for a pleasant surprise!
Many, many thanks to those of you reading this, and to my Spark-buddies for their amazing support. I’ve had a few bumps in the road lately, and you all have done so much to keep me focused on finding the good stuff in each and every day.
Now, the question is: do I record the weight of the removed pannus as weight “lost” on my ticker?!? Or is that cheating?!?
Saturday, October 26, 2013
Best grab a fresh cup of coffee first if you choose to read on...
This is for me --- to get my thoughts out of the swirl in my head and clearly in front of me. They can get too big to deal with when they’re building up in there, so need to be cut down to facts…
So – I’ve never been totally what you could call “healthy”. I’ve dealt with an auto-immune disorder and IBS for my entire life. Those gave me some limits, but I learned to work around them and enjoy life.
I spent most of my life obese, but fit and active. I loved heavy lifting, and used my strength daily at work.
A few years ago, when my Dad was dying, I had an extreme sciatica attack (due to degenerative disc disease) that necessitated basically re-learning how to walk (I was a shoe-in as the winner of the Ministry of Silly Walks), quit lifting and working out (since activity just made everything worse), but still enjoyed life. The Man and I just made some adaptations to our activities, and it was ok.
Then, I got sick. I was increasingly dizzy, and disoriented, and confused. I was always nauseated, had extreme pain at the base of my sternum, and couldn’t follow a simple “how was your day” conversation. I was unable to work – heck, I was unable to sit upright without being supported by the arm of the couch and some cushions. Multiple scans didn’t show anything, but some great docs stayed with it and found that I had colon cancer. I had surgery to remove half my colon, and then 8 months of chemo.
During the chemo, I ended up with a pulmonary embolism. I was put on injections of blood-thinners, but still ended up with two more as chemo went on. The final post-chemo scan showed some trouble spots in my lungs and the PET scan to see if they were dangerous or scarring showed up some scary activity around my uterus and ovaries. So, I had a full hysterectomy.
I seemed to be recovering, but 3 weeks after the second surgery, I started to randomly faint. It started as once every few days, and progressed over the months until I was dropping 3 to 5 times per day, every day. We still managed to enjoy life, just made some more adaptations to accommodate my “strategic naps”.
I started the rounds of every medical specialty to try to figure out what was going on. I started tracking every bite in case it was caused by nutritional deficiencies. We got a treadmill so that I could safely start to get my strength back, and I hesitantly started working out again. Yay for me – this caused a massive hernia on my incisions. The doc informed me that my excess weight was one of the major causes of the hernia, and that he couldn’t attempt a fix unless I was almost at “normal” weight, and that he couldn’t see it being a permanent fix unless I maintained “normal” for the rest of my life.
Fine. So – I started restricting my calories while still maintaining the nutrition. I started learning to cook, so that there would still be as much pleasure as possible in eating. We made still more adaptations so that we could still have fun.
It actually was a relief to me that there was something that I could control that would have a positive impact. I kept seeing docs and trying meds to get the fainting under control (it’s improved, but not gone), but could at least work with the surgeon about getting the hernia fixed. A date for surgery was set, I’m almost where the doc wants me weight-wise, we really enjoy how we eat now, and – even with all of the adaptations – life was good.
Two weeks ago was the first time in a couple of years that I felt safe and comfortable enough with my level of health that I said to the Man that I actually believed that it was possible that he might have to put up with more for a few more years.
Then I had this bright idea that it was time to get some new glasses and contacts. My vision seemed to have settled down after being all over the place during chemo, so it was time for a new prescription. Saw the eye doc, and got a “hmmmm – I’m sending you to a specialist”.
There is a spot on the back of my right eye that has been there for years – according to the last specialists it is simply that the opening in the back of my cornea where the blood vessels come through is slightly smaller on that side, making the vessels squeeze together and look like a lump. Nothing to worry about, but this time the eye doc said that it looked more “raised” and wasn’t happy about it.
Off to the retinal surgeon, who was quite inordinately happy while shining bright lights in to my dilated pupil: “Oh – this is cool. You are an interesting patient.”
Damn – I HATE being interesting!
Apparently, there’s something there besides the clumped-together blood vessels. It could be a cyst, it could be scarring from a bleed (I’ve been on blood thinners for a long time), it could be a benign granuloma from my auto-immune disease, or it could be a metastasis from the colon cancer.
My brain hates me, and has been focusing on that last one. I’m not having an easy time keeping myself from spiralling down in to fear. Logic tells me that the odds of it being cancer are miniscule, but it comes down to this:
REALLY?!? FREAKIN’ REALLY?!? AFTER EVERYTHING ELSE, I CAN’T EVEN GET FREAKIN’ GLASSES WITHOUT THERE BEING SOMETHING TERRIFYING?!?
So, right now I’m scared. And whiny. Really, really whiny. And starting to get more than a bit PO’d.
The Man is working crazy OT right now, so he’s not around to logic and laugh me out of it, so I need to do that myself…
So – here I am. Writing this all out, so that I can SEE that it’s not as big and scary and threatening as it seems when it’s swirling around in the dark recesses of my mind. And really, it ISN’T so bad…
Week after next, I will have a quick hospital visit for them to scan the cornea and retina, and I’ll KNOW what I have to deal with. Knowledge is power – the power to deal with whatever it is. There’s nothing I can do about it until then, and, regardless of what it is – LIFE IS GOOD.
The Man and I will make more adaptations if we have to, but we’ll find a way to keep having fun. We always have, and we always will.
The hernia will get fixed. Hopefully, we’ll get the fainting fixed, but we’ll be fine even if it stays how it is now (we’re awfully good at dealing with it, and it’s a great source of dark comedy when we’re out), and the eyeball will … well, it will be whatever. None of that is ultimately important. What IS important is that we’ll deal with it, and have a lot of love and laughter along the way…
Hmmmm – there might be something to this writing thing. There definitely is power in the “spin”…
So, those who were silly enough to read this --- thank you for your time, thank you for being here, and please: take a few minutes to clarify what is important in your life, and “spin” your perspective to focus on that…
Right here, right now, life is good.
Thursday, October 17, 2013
I’ve been doing some pondering over the last few days, and have concluded that I don’t have a clue…
Here’s the background:
- I was happy and active when I was obese (basically maintained the same weight for decades), and only chose to lose weight so that I get the best possible chance for a permanently successful repair on the massive incisional hernia that appeared last January (I can’t get back to my adored ST until the hernia is fixed)
- My surgeon wants me at 170 lbs or lower for the surgery at the end of November, and wants me to drop in to the “healthy BMI” range for the rest of my life to lessen the chances of a recurrence, but can’t / won’t give me an absolute number
- Healthy BMI for my height is 119-162 lbs
- I am currently at 173 lbs, which is the lowest weight I’ve been since I was 12
- I have no concept at all of *me* at a “normal” weight: the jeans that fit me right now look insanely small when I lay them on the bed, and I had to look at the sleeves of my favourite fleece sweater now hanging 6” below my fingertips to realize that I no longer have the shoulders of a pro linebacker
- I am loving the whole cooking thing, and have to consciously make changes to add calories since I learned to cook and plan my meals based on calorie-restriction to lose weight (I automatically eat within range unless I pre-plan going over)
- I will be going in to “maintenance” range for the 4-6 weeks after my surgery (mostly additional protein) at my surgeon’s recommendation, but he wants me to continue to lose after that
- I loathe shopping (and am quite disconcerted that the “normal size” stores around here seem to assume that everyone is either a teenager or wants to dress like one), so want to avoid replacing my wardrobe until I am at the size that I am going to stay
So, where I get lost is that I have absolutely no idea where I should be “aiming” for. I still look like *me* in the mirror, there’s still lots of flab hanging around (but I lost my booty *sob* --- can’t wait to get back to squats), and I just don’t know what I should be planning for. I originally kind of had 150ish in my head, then I randomly chose 140 (cuz it’s in the middle), then I had a brain-fart and started contemplating 130ish (which earned me a playful smack from the Man), but I quite simply have no clue.
Please help me out here: how did you choose your “goal”, and how will you *know* that the weight-loss phase of the journey is over and it’s time to move to maintenance? At what point do you say “this is it – I’m happy, I’m healthy, I’m enjoying my life and my body, and this is as small as I’m going to be”?
Thanks in advance!
Monday, September 09, 2013
Good morning, Sparksters!
This is gonna be long, but I’m goin’ all girly and gushing and happy dancin’ this morning. The Man is already tired of hearing it, so I’m just gonna throw it all out there with you all…
Let me start with pointing out that I loathe shopping… It doesn’t really matter what for, the problem is that shopping involves stores, and stores involve crowds of people (especially on weekends), and, well, just not my thing, ya know?
The other thing I want to mention is that I have never in my life been the same size or smaller than my partner. I've always been obese (well, overweight now), but have always been with slim and fit men.
Now, I’m currently on disability and don’t go out much, so have been just wearing the clothes that I’ve had for years. I had gone through the closet and gave away everything that fell off as I put it on, so I’m down to just a few basics. These are also too big, but I can at least keep them on with a belt. Since I’m not having to present a professional appearance (the trees really don’t care what I look like when I’m tramping the back-country), I’ve been going with the idea that I could wait ‘til January or so before I would absolutely have to pick up a couple of more basics to get me through until I get down to the weight I want to stay at (somewhere in the healthy range – we’ll see when I get there). I’ve got some vague idea in my head that I should get there some time next summer or so. My plan is to avoid shopping as long as humanly possible.
Besides, I look in the mirror and don’t look all THAT much smaller. Sure, the clothes are a bit big on me, but no big deal, right? If I wash everything in hot, and put in the dryer on high, then surely I can shrink them down that little bit…
So, last week the Man decided that it was time to go in search of new dinnerware. A plate broke and another bowl chipped on my 30-year-old stoneware, and he decreed that it was time to replace them. We spent a few days searching on line, but since the feel is important to both of us, it is required to actually set foot in some stores and check them out in person.
Well, I put on my freshly dried 36 waist jeans on Saturday (with belt to hold them on), and off we went to hit some stores for dinnerware. While we were out, I discovered to my horror that I wouldn’t be able to wait ‘til January for new pants, since even with the belt, I was still pretty much having to hold the jeans on. The Man also wears a 36 waist jeans (he likes to have enough room inside to park a moving truck in with him if required), but mentioned that he had some 34’s at home that he doesn’t like to wear (there’s only enough extra room for a pick-up truck --- apparently that’s not practical for him). Well – no luck on finding dinnerware, but we got home and I tried on his 34’s – JACKPOT! I now have jeans to wear at least until January! Not only that, but I was actually wearing pants a size smaller than my partner! (I'm just going to ignore the fact that he could fit in to a 32 - but they wouldn't be baggy enough to keep him happy.)
So, Sunday comes along and we’re off to check out even more stores for dinnerware. Naturally, all of the stores are in huge, busy malls, which is enough to give me the screaming horrors. Oooh, but the Man knows me well… We’d hit a couple of stores with no luck, and I was starting to lose it because of the crowds, so he aimed me to the one place he knew I’d be happy: the leather store. OK, I admit it: I have a HUGE thing for leather. I could just stand in there and smell it all day. The store we were in only goes up to XL in their jackets, and their women’s jackets are all fitted, so I naturally gravitated to the purses and boots since there’s never been anything in there that I could wear. They do have other locations that have a minor selection of larger sizes, but not in this particular store. The Man, however, navigated me over to the jackets, knowing what style would catch my eye (we have the same taste in clothing for me), and started shuffling through the sizes. He pulled out the largest, which was a Large (not even an XL), grabbed my purse, and raised an eyebrow at me… Well, I can’t argue with the eyebrow, so I tried it on…
Not a squeeze, no sucking in the belly to do it up, could easily move my arms, no pulling in the shoulders. It. Just. FIT.
And hot damn – did I look good in it!
I've always been able to pull off "statuesque" (tall and hourglass). I easily could do "professional". I could even pull off "elegant". What I could NEVER pull off is "cute". This jacket --- I looked CUTE! I didn't think that could EVER be a possibility for me!
No – I didn’t buy it. There’s no way that I could justify spending that kind of cash on something that I will hopefully be too small for in a couple of months. It did, however, leave me so happily astounded (It FIT) that I just sailed through the rest of the day in the mall. I was in so much shock that it didn't even bother me that we didn't find any dinnerware and that I'll have to go in even more stores this week.
The Man ROCKS! We got in the truck to leave the mall, and he looked over at me and said “Did ya hear?! The Large fits! Next time it’ll be the Medium, you know…”
So – I’m girly, and gushing, and astonished that there has been far more of a change to my body than I was seeing. I can’t say that I’m looking forward to the rest of the clothes shopping, but you all KNOW that I’ll be in that leather store next spring before I go anywhere else!
Wishing you all happy surprises when you hit the stores!
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