On June 6, 2011, after a long journey of soul searching and medical tests to get surgical clearance, I had gastric sleeve (or sleeve gastrectomy) surgery.
WHAT IS GASTRIC SLEEVE SURGERY?
"The primary means by which the gastric sleeve operation works is by removing the storage capacity of the stomach. Because of this, the patient has a subjective feeling of fullness with a much smaller amount of food. This means that he/she can more easily control his/her hunger and stop eating sooner. The new capacity of the narrower stomach is hard to measure but likely is between 4 and 8 ounces. One intestinal hormone shown to be favorably affected by the gastric sleeve operation is Ghrelin. This is produced in the part of the stomach that is removed, and therefore, drops to a low level in the bloodstream after the operation. Ghrelin is important for how the brain perceives hunger, and low levels cause the patient to be less hungry – turning down the drive to take in too many calories. Because of a combination of the above factors the gastric sleeve operation has demonstrated excellent weight loss for almost all patients. Its ability to produce very good weight loss – as good or better than the LapBand – with no implantation of a foreign body, and the ability to avoid some of the complications related to the rearrangement of the intestinal tract as seen with the gastric bypass makes the gastric sleeve a very attractive option for weight loss surgery for the future." From the website of my surgeon, Dr. Robert Marvin.
It's called a gastric sleeve because about 75% to 90% of the stomach is removed surgically, the open edges are stapled and the remaining portion of the stomach looks like a "sleeve." or a tube. The procedure permanently reduces the size of the stomach and is irreversible.
MY ROAD TO SURGERY
I initially went to the surgery orientation with the thought that I was going to have adjustable lap band surgery but, after hearing all of the short term and long term complications of the band as well as the bypass, I decided the sleeve was the right surgery for me.
After the orientation, I thought I would have the surgery in about 2 or 3 weeks but it took much longer to get all my medical clearances. Dr. Marvin was extremely thorough to make sure that all my operative risks were as low as possible. I had to go to the cardiologist for a stress test and an echocardiogram. All my cardiac tests were great (in fact, the doctor said I had no evidence of mitro-valve prolapse or disease which I had been diagnosed with many years ago). I had blood work done (6 vials) and, when the results came back, I was told all my blood work was good except that one test (the clotting test) came back abnormal so I needed some additional blood work. I went for the additional blood work (5 more vials) and then waited for the results. If they came back normal, surgery could be scheduled. If they came back abnormal, I would have to be referred to a hematologist. I called the doctor's office and was told all my blood work was normal and we scheduled my surgery for Monday, June 6th, with my final pre-op appointment with Dr. Marvin scheduled for the Wednesday before. When I went to my final pre-op appointment, Dr. Marvin told me that, in actuality, I did have a clotting disorder [Factor V Leiden heterozygous disorder] and I could not have surgery until a hematologist checked me out. This disorder in essence means that my blood clots too quickly making me at a 5% to 10% elevated risk for blood clots. The hematologist said that I didn't need any daily regimen for the disorder and that I am at greatest risk for a blood clot following trauma, surgery or broken bones. He also indicated I should take aspirin a few days before and after long flights to help avoid DVT. Fortunately, the hematologist cleared me for surgery and spoke to Dr. Marvin about the surgical regime of blood thinners before and after the surgery (those damn shots hurt and gave me huge bruises!).
On Monday, June 6, 2011, I went for the surgery at University General Hospital. Here's a picture of me at the house just as we were leaving for the hospital.
The surgery was performed laparoscopically with 5 small incisions to perform the surgery. Because of the post-op risks for any patient, and my blood clotting issue as well, I had to spend one night in the hospital. The doctor told me to be at the hospital at 6:30 a.m. but, when I got to the hospital, my surgery wasn't until 10:30 a.m. So, Joe and I had to sit around for longer than I would have liked. I was nervous, anxious, excited, stressed out and emotional. I was definitely ready to get the show on the road! I went back to get prepped for surgery, had the Lovonax (blood thinner) shot and then, before I knew it, the surgery was over and I was in recovery. Waking up from anesthesia is such a strange feeling. Of course, I was also full of morphine - thank goodness! The surgery was a bit rougher than I anticipated but I was up and walking within 4 hours of being brought back to my room. I had to get up and walk a lot and, at first, I could hardly walk very far. My surgical incisions (particularly the one where the muscle was cut in order to remove my stomach) was extremely painful and moving was difficult. In fact, that was my only real pain from the surgery. Originally I didn't think anyone needed to stay the night with me but, after seeing how difficult and painful it was for me to move and get out of bed, sweet Joe stayed the night with me and helped me up when I needed to use the restroom and walk. I made myself walk every time I could and every time the nurses came into my room (which was a lot) because I was so afraid of blood clots. I was released from the hospital by 10:30 a.m. the next morning with instructions to walk and stay hydrated.
First day home
I took a week off from work and I am so glad I did. I just rested, walked and tried to drink as much as possible but I just could hardly get anything down. Not surprising since about 90% of my stomach was removed. The first few weeks I was paranoid with each and every pain in my body that I was getting a clot. Poor Joe had to make sure my limbs weren't swollen, red or hot so many times. He was so patient with me. Initially my blood pressure was quite high and I ran a bit of a temperature which had to be watched (a spike to 101 or greater could indicate an infection or a leak in the staples). After 2 days, my blood pressure was back to normal as was my temperature.
For the first 9 days, I was on a liquid diet - sugar free jello, sugar free popsicles, water, crystal light and broth. My first week I lost 22.5 pounds!! I only took pain medicine the first night I was home to help me sleep and then I didn't feel like I needed it again even though I did have incision pain. I had no nausea or any other major side effects from the surgery. In fact, the only issue I had at all was the one incision pain. I was so lucky! I went back to work after a week and was on "light" duty meaning I couldn't lift our 25 pound boxes for court. I tired easily at first but I am now cleared and have no physical restrictions as related to the surgery.
I am now 5 weeks post-op and have lost 43 pounds. Just Friday (after a month of a soft, mushy food diet), I am now cleared to eat "normal" food as tolerated. Of course, I should avoid high fat, high sugar and fried foods and what I can eat should be nutritionally valuable. I cannot eat much at all but am trying to get my protein in at each meal. It's not easy. So far, the 2 main foods that people complain about (bread and red meat) I have eaten in small portions and had no issues. I am adding foods back a little at time and I am determined that I will be able to eat what I want. Of course, I am working on adjusting what I eat so that it is nutritious and healthful but, knowing that every now and then if I want a bite of something I can have it, will make it much easier to eat healthfully the majority of the time. My incisions are healing nicely even though I will have 2 pretty good scars.
My only issue at this point is the chewable vitamins which make me nauseous and the PA said I could not take pill vitamins because they don't absorb well enough. Joe bought me some liquid vitamins which look like seaweed sludge and the smell also makes me gag. I thought I was so smart by buying Flintstones but the PA told me that they don't have enough of what I need and no amino acids like the bariatric vitamins. I got some vitamin crystals so we'll see if those are any better - keep your fingers crossed! I go back to the doctor September 16th and will have blood work done prior to going to make sure I am not mineral or vitamin deficient.
I have already gone through my closet with my mom and sorted all the clothes that didn't fit because they were too big (6 garbage bags full). I weigh less than I did when I got married 8 years ago and so many of my clothes that were way too tight are now fitting again. It has been so nice the last week to open my closet and know that everything in front of me fits. It certainly makes getting ready in the morning much less stressful.
One thing that is so odd to me is that I have no hunger at all and get full so quickly. My eyes and my brain will have to adjust to how much food is realistic for me to eat in one sitting. This is going to be a definite adjustment process in so many ways - physically, mentally, psychologically. Food has been a source of great comfort to me for many years and its relationship with me is now forever altered.
I have been enormously blessed with amazing family and friends who have been so loving and supportive in my decision and the early days of the journey. I look forward to living a long, healthy and happier life.
I told Joe that for 10 years he has had a very low maintenance wife because I haven't cared much about clothes, shoes, fashion, beauty products, makeup. However, he's been forewarned that when I can wear any clothes in any store, he better watch out because I might become just a bit of a high maintenance skinny bitch! :)
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