Tuesday, December 7, 2010

Another post-surgical report

(NOTE: If you are seeing this on Facebook, please click below to see the entire post or go to my blog itself. I don't always make my point in the first paragraph, which is all that shows up on my Facebook page. I mean, if you actually want to see it all :).)

I have now completed day 5 successfully. There is still a LOT of pain, and now itching and burning also: the binder that I had to wear around my middle caused not only a massive rash that looks the worst sunburn ever around my middle, but the skin is raw as well. I spent my last night in the hospital (Sunday night/Monday morning) sleeping very well, though, on IV Benadryl - they could've done another surgery and I don't think I would have known - and ice packs.

I guess I will have a bit of a recovery - a full year according to my doctor's partner, who I saw on Sunday, but the first 100 days will be the most important. I am slowly adding soft foods. I will never again be able to have carbonated beverages (or anything containing them such as slushies or punch or boston coolers) but a small price to pay...nor can I drink from straws again. Raw vegetables and bread, perhaps way off in the future, perhaps never. For now my diet is very restricted and I can count on 2 hands what I've had to eat in the last 6 days. But since I can only eat a few bites at a time (will have to eat up to 12 times a day, depending on which doctor I'm talking to, but the minimum seems to be 6), that's not an issue.

For the moment, I can't have anything with shells (like peas) or seeds, no "gassy" or fibrous vegetables (like cabbage family, most root veggies), no nuts, citrous, caffeine, tomato, chocolate...meat must be ground very fine, and moistened, and my doc recommends chicken and fish for their easier digestibility for the time being.

Everybody seems to be real curious as to what I had done. Actually I had 3 procedures in one: a hiatal hernia repair, a nissen fundoplication, and an umbilical hernial repair. The fundoplication is often done concurrently with the hiatal hernia repair these days, often enough that the line between the 2 procedures is becoming blurred, but you can have the HH repair without the NF certainly, or the other way around. But the issues that bring about the need for one or the other are often the same, and therefore they are often done together.

My stomach was in my chest. This caused not only my severe digestive issues and pain, but shortness of breath that made all but the shortest walks or simplest tasks impossible. My doctor first brought that back down into place, then repaired the "larger-than-expected" hole in my diaphragm. Then he pulled the fundus (top part of my stomach) around the lower end of my esophagus, wrapping it around like a hot dog bun around a wiener, and stitched it permanantly into place. This supports the damaged (when I was pregnant, 20 years ago) lower esophageal sphincter, or LES, and also recreated the angle that had been pulled out of place due to the hiatal hernia, that should have existed where the stomach met the esophagus. And lastly he repaired the umbilical hernia, stitching in the standard mesh to support the area.

This isn't a weight loss surgery, although my doctor had discussed doing a lap band at the same time - something I didn't want to do, for several reasons - but I will lose weight as a result, at least at first. First, my diet is quite limited and the foods that I am eating - scrambled egg, yogurt, cottage cheese - are pretty low carb. I won't be eating sweets and grains for a while yet, although cream of wheat or cream of rice is allowed, and I had one "meal" of it in the hospital. I don't think the carbs in the 2Tbsp that I can eat has enough carb to worry about :). I also had applesauce today - again, 2 Tbsp won't add weight, and my options are so limited that my main concern right now is just getting adequate nourishment from the minute amount of food that I'm able to consume. Still, I exist mostly on yogurt, cottage cheese, and just yesterday added scrambled egg.

As I am able to start adding more foods, and eat larger portions, I will of course continue on the same low carb path as I have followed the last 6-1/2 years. The plan is to not stretch or stress the new stomach area, obviously not returning to the large portions of my past. Combined with low carb eating, I expect that weight loss may continue. I hadn't wanted to lose more weight even though I'm still quite overweight (for reasons of my own) but in the interest of having the best possible outcome from this whole thing I will do so.

There is a LOT more pain than I had expected. Due to the diaphragm repair, every movement has been inhibited, although that is starting to get easier. You don't realize how important that muscle is until you have pain every time you use it! I have 6 holes in my belly (looks like I've been stabbed multiple times in a bar fight!) but the pain from those is minimal and I'm thankful he didn't have to revert to the open surgery.

The first 2 days are pretty much a blur, as I was on high amounts of pain killers and was either saying silly things (according to others) or sleeping. The next 3 days were just pain and weakness, now with the pneumonia added to the mix. But according to my sister, who stayed at the hospital 24/7 with me, she saw continuous improvements - and yes, I can see them also, in hindsight. Those 5 days in the hospital I went from not being able to sit up by myself, to getting out of bed and walking with only my walker for help, taking my own shower with minimal help, sitting in a chair, etc. So yes, those were great improvements given the extent of the surgery and the added issue of the pneumonia.

So I am now settled at my sister's for a week to continue getting stronger and learning how to eat and resting, exercising, and recovering. I'm homesick like crazy so I try not to think about it. I miss my husband more than I can even say, and can't wait to see him again next week. We have Skype at least :).

I will continue to write about my recovery and also diet changes, as so many people aren't familiar with the procedure (which is somewhat controversial due to its high failure rate and numbers of pretty awful side effects, but that's another post) - even many of the staff in the hospital I had to educate. Good thing I was so thorough in my research beforehand, eh? :)

Lastly I just want to say that the care I got from the staff at MidMichigan Midland hospital was EXCEPTIONAL! They really worked hard to control my pain and help me to recover and get "home" as quickly as possible. I was truly amazed, this was head and shoulders above any other hospital experience I have had. Everyone was so great!

So I will try to get back to sleep now, and write more when I am thus inspired. Thanks for reading :).

No comments:

Post a Comment