Post Operative Expectations

It seems that a lot of people have questions or even fears about the changes that they will see in their lives post op. As did I.

There are certain things that many of us are simply unable to do. My own surgeon was excellent about preparing me for the possibility that I couldn't tolerate some foods afterward, as well as advising me against certain foods (to contribute to the long-term success of my wrap).

The things he specifically warned me against were anything that would cause certain changes within my system, such as caffeine and alcohol. He also told me that I should never again drink carbonated beverages due to the amount of pressure the ingested gases would put on my wrap, or drink through a straw because of the amount of air that is ingested with the beverage.

The foods that he told me to prepare myself for being unable to ingest afterward were bread, raw vegetables, and "gassy" cooked vegetables. He advised that I could start trying them after 6 months, but to understand I probably wouldn't be able to stand them, and if they did cause pain from pressure that I was to avoid them completely.

Other things that people seem to have long-term difficulty with are pork and rice. I had trouble with pork for a fairly long time. As a low-carber rice isn't something I eat regularly (although when I'm going to splurge it is one of my favorite splurge-foods - with LOTS of butter!), but I didn't have difficulty with it. Maybe because of all the butter :).

He also told me that the majority of people who have this done will not be able to burp or vomit afterward - this should be considered a given. If you are one of those who are able to get air back up through your LES after your NF, you are in the minority. (NOTE: with time, some wraps will loosen somewhat and allow air to escape upwards; however, this means that stomach contents - acid - can also escape upwards, and this is not ideal obviously.) Remember, the intent of the Nissen wrap is to prevent the LES from allowing ANYTHING to go back up into/through the esophagus. That is the whole point of the procedure, after all.

For those who do find themselves able to burp, many are able to enjoy beer or sodas. (Definitely consider this the exception rather than the rule, however.) Whether this has any long-term effect on the integrity of the wrap, I don't know. I do know that with the fairly high failure rate - or shorter lifespan - of so many of these, my own choice has been to avoid anything that might contribute to an eventual failure. But some surgeons advise their patients that they may resume all normal activity and dietary regimens after complete healing. I'm just one to err on the side of caution with my own wrap :).

I've only mentioned the more common adjustments that most have to make after NF. Everyone has different results afterward and what is true for one will not necessarily be true for another. It may be wise to go into it accepting that we probably won't be able to drink carbonation or eat bread or raw veggies or caffeine or whatever...and then accept it as a wonderful gift if we find that we are indeed able to do so after we have healed.

Some Health Thoughts, and Other Miscellany

I'm sorry, I can't wrap my head around the "muscle pull" diagnosis that I came home from the hospital with. It makes no sense to me whatsoever. I couldn't BREATHE for heaven's sake! Pressure around my ribs...anyway, none of it makes sense. It has been suggested that perhaps my muscles are being used so differently due to the rearranging of my guts and how I move and hold my body since the pain and bloating are gone, compared to before with the constant pain. This may hold a little more water, but there is another theory - not put forth by the doctor - that makes more sense.

My friend Connie suggested this could be part of a detox, something that doctors don't acknowledge or discuss. I have been losing weight quickly, releasing toxins stored in body fat, plus I gave up caffeine cold turkey the day before my surgery on December 1st, plus I was on so many heavy-duty painkillers through much of December that were trying to get out of my system...this makes a lot of sense also, that getting rid of all of the effects and toxins from caffeine and drugs and whatever is being left as the fat is going - well, wherever fat goes.

Since I have been out of the hospital, the dyspnea has been improving. However, my chest still feels pressure, and tight inside, like I can't take a deep breath. I can, but it feels like I can't, and there is tightness when I do. And I have to push and force out the last of the air. And I am fatigued. And I have pain around my ribs.

Today I had a fundoplication-related issue. Drank some chocolate milk, and the pain was horrible! My stomach wanted to sent it back but since the surgery nothing can come back up. I was near tears, and there's nothing to do. I took a Zofran but how can I tell if it helped? It didn't give me relief, but maybe kept it from being even worse...but that was one miserable half-hour.

And today I started with a UTI as well. I'm drinking tons of water (and a little decaf tea)...taking cranberry (3000 mg every few hours)...taking OTC phenazopyridine hydrochloride tablets...but it has been miserable, as only those who have suffered from these can understand.

Between all of the above, I just feel like a sick person. I thought by this time, over 5 weeks post op, I would be feeling better than I have in years, not like a sick person. But I want to go to bed and sleep until it is all fixed and better and I can feel and act and BE healthy...

The black depression seems to have started lifting. It started to lift, oddly enough, in the hospital. I have some theories as to why, but they're probably wrong anyway. I have felt, for the last few days, merely "blue" which is an improvement over "black". I even played my keyboard today, the first time I have actually wanted to play, or felt inspired to play, in weeks. And I'm starting to feel I want to get back to cooking and creating in my kitchen. I have a ways to go to get back to joy, but it will come, if this path continues. God is hearing the prayers of those who are interceding for me, and my own.

And now I'm going to make another post, about Sleepee...

Dec.1 - Jan. 1 - The First Month

(NOTE: If you are seeing this on Facebook, please go to my blog - http://chiachatter.blogspot.com - to see my whole post. I don't make my points in the first paragraph, which is all that shows up on my Facebook page :).)

I've already written a lot here almost every day so there isn't much to write about, I just have 2 things, really.

First, I'm about 1/3 of the way through the 100 days. (The surgeon told me it will take a full year to recover completely, but the first 100 days will be "critical" and that I need to go easy on myself during this time. I interpret "go easy" as to rest when I get tired, don't push it when something causes pain, eat what is comfortable in my stomach and no more, and things like that.) I have periods of time when I feel almost normal and go about doing housewifely things and then suddenly I can't do one more thing and have to stop. Right then and there. I simply cannot continue whether or not I want to, or even need to. I'm anticipating that these next couple of months will find me gradually able to do more and more until that doesn't happen anymore.

And I have to once more bring up this depression. I described it to my husband yesterday like this: Yes, I can laugh at a joke, I can carry on a normal conversation, I can put smileys in my emails and FB updates (though I don't feel them these days, they are more like punctuation), I can make myself act and talk normally. I can feel happy about something - such as Pete's new job after all these months of unemployment - but underneath there is a blackness that doesn't go away. It is like a shiny red boat racing across the waves, the sun is shining brightly, the boat is bouncing happily across the lake...but underneath it the water is dark, black even, and icy cold. The boat may be bright and bouncy, but it is surrounded and supported wholly by something dark and cold and ready to devour it at any minute. That is how it is. Exactly.

I talk about my food choices and adapting and how this surgery has changed my diet in my other blog. Between what I've been posting here and there, I think I've given a pretty complete picture of how life has been as it pertains to the nissen fundoplication surgery, and hopefully it will be helpful to someone else who needs this surgery, or has had it and just wants to compare notes.

Day 30 - A Whole Bunch of (Unrelated?) Stuff

(NOTE: If you are seeing this on Facebook, please go to my blog - chiachatter.blogspot.com - to see my whole post. I don't make my points in the first paragraph, which is all that shows up on my Facebook page :).)

Yeah, I've talked about the depression with which I am struggling, that popped up and caught me unaware...or maybe creeped up...but which I really started noticing about a week ago. I wouldn't have thought this would have been related to my surgery but it apparently is...and there are other things that are different.

(NOTE: Parts of this are personal so if you are squeamish stop here. I just want an honest story of my fundoplication experience for others who may be considering this procedure, or who may experience the same thing(s), plus maybe someone can help me understand all of this who has been there done that.)

My skin: I am itchy. Not just where the skin is STILL dry after that awful mess under the binders, but nearly everywhere. I could spend my entire day scratching. I'm using a wonderful cream that works wonders on my hands but the itching isn't necessarily related to dryness of my skin, and some of the itching feels like it is way beneath the skin, where I can't scratch hard enough to reach it.

My hair is limp and has no body, no life, no nothing. Like when I was a teenager and it was always oily and only looked nice for about an hour after I washed it - only I don't even get that hour, now. It is dead.

My personal scents, just the smell of my skin, my breath, etc. are all different. I don't recognize these various "natural" scents that are so unnatural now, that aren't me...

I have areas on my skin where it is turning to thick, textured elephant skin. Seriously. In several places. It is hard, it is thick, and it has a definite rough, hide-like texture. Where is THAT coming from??

As do many fat women, I struggle with candida in the folds of my skin, but have been able to control it for years with a routine that has kept it in check: daily showering followed by towel drying followed by air drying with a blow dryer set on cool and high followed by a liberal dusting of Caldosene Powder, which has no corn starch (yeast loves to feed on corn starch!) but has 15% zinc oxide which I've never found in any other powder. But now it is out of control, and acting differently than it ever did. The skin is splitting open and bleeding and very VERY painful in several areas, and there are other changes as well that might be too graphic for this blog. But it is worse, and it is different.

I now have fingernails for the first time in my life - literally - since I have bitten them since I was a toddler. I never ever had nails. But after the surgery I didn't want to ingest fingernails and cause pain so I stopped biting them. They are making me nuts, I hate the feeling of them, the tapping on my keyboard and the mistakes they are causing...but see paragraph 4 above: They are great for scratching so they get to stay although I will keep them very very short.

There is also some pain, not enough that it gets more than a passing notice, but it is frequent, across my chest/rib cage, and into my shoulders. I read that this is quite common, having something to do with nerves and diaphragm repair and whatever. It isn't a big deal..but it is one more thing that is so different...

Looking back I see that most of these changes are skin-related, but why? I don't get it, and it all only serves to make me even less of who I was before. There is almost nothing about me that I recognize anymore. I'm more puzzling than whining, no matter how the text reads, but I'm fairly certain that all of this strangeness isn't helping my feelings of detachment and strangeness in my own skin.

But I'll work it all out, one way or another. I have a lot of years to enjoy the intended results of this surgery, that I am already enjoying, the ability to eat without reflux and pain and all the rest of it. I still can't believe I haven't had these things in a month, when it had all been part of my life for so many years...I'm so so so thankful for the opportunity to have this done, and am sure I'll get excited about it again once I get my head fixed.