cherri's LAP-band surgery

[MasterDragonfly]

After various delays and setbacks, today (well, technically yesterday I suppose) cherri had LAP-band surgery.

The surgeon described her surgery after the fact as 'routine'.  Routine is good, as far as I'm concerned.

She's a little sore, which is understating it somewhat.  She had read from someone on another forum describing it as feeling as though you've done a million sit-ups, and she agrees, that's what it feels like.  That, and it felt like she'd landed on a rugby ball the wrong way, winding herself severely.

Aside from that, her throat is sore from having been intubated.  She said that at first that pain felt worse than her abs/lower chest.

We didn't mention anything before now because, well, best to be sure that it's a done deal before shouting from the rooftops, it seems.  (Corollary:  One way to turn a good opportunity into a missed opportunity is to tell your friends; the more friends you tell, the greater the chance that the opportunity vanishes.)

It's been a hectic day.  Even with all the planning, things were changing on the fly.  I'm relieved that the surgery was a non-event (although her pain would suggest otherwise).  I stayed with her until after 11pm, at which point they asked her whether she was in pain (that would be a 'yes') and whether she would like something for the pain (that would be another 'yes').  I expected the meds would mellow her out pretty quickly, and I needed to get home anyway.

First up in the morning:  Contrast swallow, check the imaging to make sure things are still good, then she can come home.  Here's hoping she sleeps better than I tonight.

[Juliekat]

Heal quickly, Cherri!

JK

[DruulEmpire]

I've been wondering a lot about this procedure.  Do keep us apprised, and all the best to her.

[homevintner]

Glad to hear all went well. All the best for a speedy recovery.

[Shara]

wish you well and get back here soon!

Shara 'or else' 1

*scary music playing*

[MasterDragonfly]

Thanks for the well wishes, folks.

This morning's contrast swallow test went well, everything checked out.  The surgeon swung by around noon, gave her his blessing, she was discharged and I brought her home.  The surgeon also told her she could drive in a few days; impressive, considering she doesn't know how to drive now (at least on the right side of the road).

Mind you, she slept like crap last night.  As in, almost not at all.  Not till 6am when they gave her IV a shot of something (hydrocodone, I believe).  That took the edge off, and she was more or less asleep when I arrived.

Since getting home, she's managed to shower, then went straight to bed.  After a bit, she brought it to my attention that she needed her script filled.  As soon as possible.    So I dashed off and did that.  Got home, fixed her up, and she was able to relax and eventually doze off again.  She's basically spent most of the day in bed, napping here and there, listening to her iPod (she downloaded some book from iTunes).

Today she's described the pain as feeling like there's a truck parked on her chest.  I've heard that sometimes boobjobs are described similarly, but I suspect this may edge out boobjobs in the pain department, considering what tender things have been poked in the process.  Check out the LAP-band surgery videos on Youtube to get an idea.

She's now managing to get out of bed on her own (albeit slowly and gingerly) and has managed to nuke some clear broth and have a half cup here and there.  As I write this, she's about 15 mins overdue on her next dose of pain meds, and she's actually up and about.  Slowly, but she's managing.

She's actually been a little surprised by the pain.  Some women over on the forum where they talk about such things didn't feel anything of the sort and were posting the same day as their surgery.  And yet, cherri's surgery was yesterday, and she's still not interested at sitting down at the computer.  She's jonesin' to stretch her arms up over her head, but is concerned that something might shift inappropriately.  Maybe I'll let her stretch on Sunday.  

Oh, one interesting twist is that they don't suture the cuts, or at least that's not what her surgeon does.  He basically paints this glue-like substance (similar to a liquid skin product) which seems to be doing an excellent job; none of the usual puckering you'd see from stitches, it's a nice straight seam.  Her longest cut is about 2 inches.

Took pics today and logged her weight.  Now we just need to remember to do this every week.  

[Shara]

we miss you cherry!

*brings on the meerkats and pancakes to lure her back to her comp*

[MasterDragonfly]

cherri was a little more mobile yesterday.  She's finding it a bit of a challenge to keep up with the volume of water she's supposed to be drinking (sipping?) over the course of the day.

Despite the pain (or perhaps with the assistance of the hydrocodone) she managed to get out a couple times yesterday.  Once was to go to the gym (I had to help her get her socks and shoes on) so she could do a half hour on the treadmill.  No running, she had it at a nice slow speed of "1.5".  (I believe that's rated in miles-per-hour, because when I set it at 4.0, it's a brisk walk for me.)

Besides the pain in the upper abdomen, she's experiencing pain in the region between her neck and left shoulder, which isn't uncommon for this surgery.  From what we were told and what I was able to find just now on Google, this has to do with the diaphragm; although the irritation is inside, the pain manifests itself as feeling like it is in/near the shoulder.  Apparently this has to do with embryological development, when the diaphragm and left shoulder share nerve pathways.  More a nuisance than anything.

She also said the pain had dropped down to about a 4 out of 10.  The day of surgery she said it was more like an 8 out of 10 (where the kidney stone she had a few years back was a 9).

Despite all the pain, she said she'd go through it again if she had to.

[pedonbio]

You're doing a fine job of keeping us posted, MD, for which I thank you. About once a year I wonder about this for myself, given the amount of attention I have to pay to my diet now.

[MasterDragonfly]

Today is of course better than yesterday.  She says the pain is about 2-3 out of 10, although she doesn't notice it while just walking around.  It's most noticeable when trying to get up from sitting down or after laying down for a while (eg, first thing in the morning), and if she has to bend over, the incision where the port is located is the most tender.

As for the type of pain, she reiterates that it's more like having done countless situps for the first time in ages and her muscles haven't recovered from the workout.

Yesterday she commented when she was making some broth that it smelled really good, the first spoonful tasted great, the 2nd spoonful was so-so, and by the 3rd spoonful she had pretty much lost interest.  She's read on the other forum that this is fairly common, and may actually be due to the anaesthesia still in one's system (needing quite some time to completely clear out).  Time will tell, I'm sure.

Two days post-op she weighed herself, and we were a little surprised that she was about 8-10 lbs over her previous weight.  We've learned that this is typical, resulting from the various fluids they pump into you at the hospital.  Today she's dropped those 10 lbs, so going forward from this point will be what to watch.

As for hunger, she really hasn't been hungry, although she's resumed watching the Food Network.  

Pedonbio, in cherri's case the original concern started a few years back, when she was diagnosed with PCOS.  It was subsequently confirmed that she had insulin resistance and high levels of free testosterone.  Earlier this year her most recent bloodwork confirmed those are under control, and as of the day of surgery her surgeon told her to discontinue the Metformin.  From all we've learned, our expectation is that the PCOS/insulin/etc concerns should become non-issues once the weight is down to something reasonable.  Neither of us want her to get down to a waifish size (eg, 115) because it would likely look all wrong on her.  She may not be tall, but she's hella strong.  

If it's something you're been considering, take another look at it.  It's reversible, it's adjustable, there's no re-routing of the plumbing.  About the only frightening thing (for me, anyway) is that they're working way up here behind the ribs, somewhat close to the heart but still separated by a wall of muscle.  If you have the constitution to watch it, there's a 10 min video on Youtube which shows what's going on; aside from cutting through the abdominal wall, it seems the remainder of the poking around is done with blunt instruments.  When you stop and think about it, it's freaking brilliant what they can do with keyhole surgery.  I'll post the link to it if anyone's interested.  There are other informational videos, including one animation which is almost too brief (for me, anyway).  Oh, and there's one surgeon who has posted numerous anti-LAP-band videos, saying they're all doomed to fail (and suggesting to come to him for his "mini-gastric bypass", whatever that is).  Seems that his opinion is somewhat unique, because there are lots of satisfied customers out there.

The surgery is no guarantee, of course.  Hell, I know someone who had the Roux-en-Y bypass, lost a chunk of weight, and has regained a chunk of weight.  I'm a little surprised that he managed to regain anything, but he did.  So part of the success will be to changing some other habits, like keeping the high glycemic index foods down to a minimum, try for moderate exercise (cherri walks everywhere), etc.  The band can almost be thought of as a behaviour modification system, in part because it regulates the intake, in part because it regulates the appetite.  And as I understand it, if you eat crap sugary foods or eat too much or too quickly, you'll get to enjoy "dumping syndrome".

That's it for today!

[notty]

Eep, I always forget to check this forum.

Nurse cherri, you'll be in my thoughts.  I hope this procedure is a great success!  I have many sexy outfits I insist you wear upon reaching your goal.  

[MasterDragonfly]

Shanks, Notty!  I read your post to her which made her smile and giggle.  

There was another thread on the BEA that I read to her tonight.  While it made me chuckle, she was experiencing a sort of pain/pleasure thing.  Put another way, it was something like, "Waahahahahaa!  Stop, it hurts!  Aahahahahahaa!  Ow!"  She laughed, she hurt, she laughed some more.  Needless to say, I continued to read it aloud.  

Laughter really is the best medicine.  

Last night she spent 30 mins on the treadmill, kicking up to a blazing 3.0 when she realized she wasn't getting that one odd pain (she says it's like getting a stitch in your side).  Breakthrough, I suppose.

She's looking forward to getting back in the swimming pool, which should be a week from today.

[ROUNDandHEAVY]

Best wishes to Cheri!  

[pedonbio]

Quote:
 When you stop and think about it, it's freaking brilliant what they can do with keyhole surgery.  

Several years ago I had a laproscopic appendectomy; I'm sold on minimally-invasive surgery. Virtually no scar, very, very little pain or healing time, compared to other methods.

[Sandy_in_RI]

Happy!  Happy!  Happy!  Happy!

Congrats!  

~Sandy

[MasterDragonfly]

Thanks R&H and Sandy!    And Pedonbio, yeah, laparoscopy is the shiznit!

So yesterday cherri went in for her post-up checkup.  Everything checked out, she got the nod to resume swimming and add mushy foods to her diet.  Scars are healing nicely, the doc said she could start using Mederma, silicone strips, vitamin E and the like.  We subsequently discovered that finding these things at the local SuperTarget is more challenging than we expected.  Lucked out on the Mederma, but not the others.  Looks like a trip to Whole Foods will be in our near future.

One curious thing is that the whole shoulder pain thing has been absent for some time now, but yesterday it hit her just before her visit.  Not unusual for it to happen this far out, but we thought it was odd that it would suddenly reappear.  Not worrisome, just odd.

She goes for her first fill in 4 weeks' time.  What's interesting is that apparently patients experience more trepidation when going for the first fill than with the original surgery.  Unnecessarily so.

As far as how noticeable the device is, she says that she really only notices the port now.  The doc said that even the firmness where the port is located will soften up somewhat.

As an aside, I've already started logging/charting her weight loss.  Rather than going the Excel route, I've written a ploticus script (using the chron prefab).  Only have 2 datapoints so far, so the bar chart isn't all that interesting yet.  

[Shara]

you and your silly linux hijinks.... good to hear cherri is okay

[pedonbio]

Ahh, she's at the baby food stage! I never thought mashed carrots could taste so good! Mmmmmm, Good!

[HamsterGal]

Wow, I fall off the face of the earth for a few minutes, and look what happens. I'm so glad to hear cherri's surgery went well, and am looking forward to hearing from her again! A member of my family had this procedure done a couple of years ago and it changed her life. (me, I deal with my weight the old-fashioned way - I whine about it. ) Best wishes!!

[MasterDragonfly]

Thanks HG, I just read your post to cherri.  

I suppose an update is in order.  Without getting into specifics, I can tell you that cherri is already about halfway to her goal.  I say 'about' because the goal may change, the closer she gets to it.

I'm still diligently charting the data and graphing it every weekend.  Oh, and taking snaps for posterity.  

[MasterDragonfly]

Time for a long overdue update.

cherri's weight's been fluctuating for the past month or two, so this past Friday she went in for another fill.

Before fill:  2.75cc
After fill:  3.00cc

Kind of amusing talking about fractions of a CC when we're used to talking about CCs in the thousands for breast implants.  

After we had a chat with the staff, they said she should have probably come in at least a month ago for a fill.  When it starts to plateau or yo-yo, that's a sign.  But she's been dealing with the other issues relating to her implants, and in so doing has had to take it easy, stop exercising, etc.

Somewhat surprising is that since yesterday she's already lost 3 lbs.  I know this is nothing to get excited about, as the weight can fluctuate.  Which is why I only mark down her weight on Saturdays.

The one notable side effect of getting a fill is that it causes her to be sensitive to consuming anything, even fluids.  In particular, there's lots of burping.  Which is a curious phenomenon.  Sip some water, burp for an hour.  

Still been recording her weight every week and charting it.  However, I've not been taking any regular pics in months now.  Well, there are the post-augmentation pics, but those have a different focus.

Oh, somewhat related:  last month she got to a weight which marks the halfway point to her goal.  

[rtpoe]

Sounds great! Good luck with the rest!

[MasterDragonfly]

Check this:

As of the day she got her most recent fill, she's lost 10 lbs!  

We both expect that to taper off soon.  Obviously that's not sustainable.  At least not if she's to keep healthy.  

[MasterDragonfly]

I just happened to notice Sloganizer come up with this gem in one of my recent posts:



Heh.  

(I seem to be having trouble embedding the imagine inline, so you may have to clicky.)

[MasterDragonfly]

Due to the various issues cherri has had with trying to eat or even drink the most basic of basics (a sip of water) or even to get a decent night's sleep without choking on her own saliva, she went back on Feb 25 to get a wee bit of saline removed from her band.

She'd lost something like 17 lbs from Feb 1 to Feb 25.

The amount removed was something like 0.125cc.

It may not seem like much, but it made a noticeable difference.

She still has the occasional moment when food triggers an unfortunate reaction.  Like this morning.  Trying to drink soup broth.  But on the whole, things are good.

[MasterDragonfly]

After going through this thread and refreshing my memory, I'm uncertain whether I've missed any updates here regarding cherri's band.

It's quite possible/probable that the last fill noted above was her last fill in a while.

Since that time (or since the last fill, if the one above isn't that one), a couple things have happened.

First, cherri's weight got into the low 170's. She never managed to break 170. Her weight has fluctuated since then.

It been a weird situation. You want to eat healthy. But healthy foods wouldn't play nicely. So you have to eat crap foods, like potato chips (known as 'sliders' in the LAP-band community, because they 'slide' on down when you eat them, unlike healthy foods), which is exactly the wrong thing to eat. But you gotta eat *something*.

On top of that, cherri would also experience poor, choking sleeps. Like about 1-3 times, every 3-6 weeks. As in, the band would be so tight that the saliva we all generate and subsequently swallow while we sleep, couldn't get past her band, so it would back up, go down her trachea, and trigger a round of coughing. And that goes on either all night or at least for a few hours until she gets up to sit at the computer till things settle down. Many times she would try to sleep on the couch, so that I would be able to get a quiet sleep. That, and the arms of the couch have just the right incline to help things drain better.

We couldn't figure out what was causing the nighttime coughing fits. The catalyst for the band holding things up, I mean. She thought that it might have been related to her period. Or maybe eating too late. Or having a late evening beer.

For some months now, I'd been pushing her to get her band drained. Completely. It's bothering me a lot that she's willing to suffer so much with this to get to where she wants to be, or perhaps more accurately, to avoid going back to where she was. We would discuss it. She would tell me how afraid she was of going back to the way things were, going back to the ravenous, insatiable hunger (which was one of her pre-surgery complaints).

Mornings she couldn't really eat (or drink) anything. Her appetite would typically come on mid-afternoon, and she would eat what she could. It might not be a whole lot, but that was pretty much it, her one full meal for the day. At least, typically. See note further below.

Recently she finally agreed to make an appointment with the LAP-band clinic to get it completely drained. When she went to her appointment, she gave them the background, and they told her she should have come in months (years) sooner. Long story short, they drained out a net volume of 0.25cc. I don't recall whether they said she was at 2.25cc and they re-filled her to 2.00cc, or she was at 2.00cc and they re-filled her to 1.75cc. I think it was the former. She's napping on the couch next to me at the moment, else I'd ask her.

She had the usual post-fill process of limiting her intake to fluids for the first bit of time. Man, I can't even remember whether it was 24 hours or 48 hours or what.

But the big thing is that she hasn't had any nightly choking fits since her last adjustment. It's been less than a month, but it's looking promising.

I'm admittedly having the "man, we should have done this a long time ago" feeling. Thing is, we both had done the thinking through of what was going on:

- one symptom was that she would have nights where she could eat ANYTHING, as if she never had the band - logical conclusion: band needs to be tightened up
- another symptom was that she would have nights where she would lose sleep, choking on her own saliva because it couldn't pass the band - logical conclusion: band needs to be loosened up

I should mention that before her latest adjustment, she also had problems most mornings drinking anything. Cold fluids were particularly bad, but things like coffee would just tend to sit there.

So what do you do when you have conflicting logic (band should be tightened vs band should be loosened)?

Calling the clinic wasn't the most approachable option. Trying to get through was always a challenge; at best you could leave a message to have someone call you back to make an appointment to a) come in for an info session, b) come in for a pre-op consult, c) come in for a band fill/drain. There was no option for anything else, such as "wtf is going on here? please advise". There was no way to know that she would get the consult she wanted, as soon as she requested they drain it completely.

Oh yeah, she was also (re)given the do's and don'ts of what to eat after a fill. It's good to have that refresher.

It's been good so far. I still think we might need to spend some time changing habits, because of the whole "sliders are easy, mmkay?" issue.

Somewhat related, but her knees have gotten worse. She got a Cortisone short recently for her 'bad' knee, and subsequently her 'good' knee popped while in a seated martial art position, and has been clicky/clunky ever since. She just recently got a Cortisone shot in that knee as well. So the treadmill/elliptical is not an option for the foreseeable future.

Side note: her fill part has pretty much blended in with the landscape. It used to bother her early on, being a bit pokey outy, but I don't think it's bothered her in quite some time now.

She's still a fab cook as far as I'm concerned. She'll take care of my need to eat, even if she's not interested for herself.

[DruulEmpire]

Serves me right for not following this for four years.  Cherry's story reminds me that those of us who do not already suffer from what I call "systemic entropy" (knees, ouch -- my father just had knee surgery) should honor the gift we have while we still have it.  In my own case, I'm forced to conclude that if it's nothing thyroidal, maybe it's something quite simple, something quite approachable so long as I don't forfeit muscle mass along the way.  My first girlfriend struggles with her body in a way that reminds me of Cherry.  Thank you for updating.  I no longer fear hunger, but hunger, it is a bitch.

[MasterDragonfly]

In all fairness, cherri's knees have had their share of abuse unrelated to any weight gain.

She used to be VERY active in sports: netball, rugby, cricket, basketball... and at least one triathlon.

She's had a few discussions regarding her knees over the past handful of years. One sports injury specialty clinic, the doctor/surgeon told her she needed to cut back on her gardening. Err, what gardening? She clarified and said she used to play a lot of sports. Mm-hmm, yeah, cut back on the gardening.

Recently got a new family doc (long overdue since the move). She discussed her knees with him. He told her her knees looked like those of a football player. Ding, we have a winner! He even broached the subject (read: tested the waters) regarding partial knee replacement surgery, and she's completely fine with that. But, that's the last step: first, Cortisone shots, then knee surgery to see what, if anything, they can clean up / repair. Finally, partial knee replacement.

We did learn from the first consult with the sports injury doc that for every pound overweight, that going up/down stairs it's like having an additional 3 (4?) pounds on the knee. So one of his early recommendations was to lose weight. All part of the "This is the House that Jack Built" linear dependency or "There's a Hole in the Bucket" circular dependency fun.

Headway has been made. But as it is with many things, there ain't no magic bananas.