iPhoneTodd
16 Days Post RNY
Apr 23, 2014
I can't say it has been the easiest ride, but it has been a ride that started with my RNY on Monday, 4/7/14.
Like most I suppose I've had some ups-n-downs since my RNY. I'll beak them down below.
The Pain - Days 1-3
My doctor and the pre classes did well to prepare me on how to eat and what to expect in many ways including the whole process for checking in and how I'd be moved into the operating room - even the things I'd hear the doctors saying. What I didn't feel prepared for was the amount of pain I would be in afterwards.
Now, in no way did I expect that this would be painless or that the meds would dull it to where I wouldn't notice I had surgery - this isn't my first rodeo, I've had a few surgeries before. However, none of my other surgeries had me in this much pain upon waking up. I literally remember saying "please put me back under!" And, on the scale of 1-10 I was saying "10." My wife came in and I heard them say "he's in a lot of pain, but we're maxed out on all three meds we can give him" (I don't remember all three but I heard Morphine, Fentinal (sp?) and I think delotted (sp?)).
This pain felt like I was on fire - a line going across my chest from mid-ribs to mid-ribs at about the sternum (not from any of the incisions). My Blood Pressure was also very high, but this may have been from the pain. After getting up to my room, it did seem to die down some and after a couple hours I fell asleep for about an hour. They kept injecting me with morphine in my room all day and into the night - each time I'd sleep 30-45 minutes. I tried to get up and walk twice, unsuccessfully. There were three other surgeries, two before me and one after, one of the nurses at 10p said the one after me just took a short walk and I was the only one who hadn't. I felt awful - I'm not usually a bottom performer in anything in life. About 2a, I finally dealt through the pain and took a short walk - about 300 feet round trip. I didn't walk again until the next day.
I barely ate anything the next day, a few teaspoons of broth and a nibble of some Jell-o. They had to get approval to keep my on morphine versus oral pain meds and did (thank goodness, my pain threshold must be low). I walked about 3p and the doctor came by said everything went well and looks well and asked how I was doing. I said not so great yet, still really hard to walk / sit up on my own. He asked if I wanted to say another night and I said "yes please." They kept me there another night (I noted two others stayed too but one went home).
The next day, Wednesday, I felt 60% better. I was getting up and walking the previous night on my own and had been moved to liquid pain meds (versus the IV morphine). It was reasonably small does at 7.5mg hydrocodone per dose, but kept the pain at bay especially since I got it every 4-5 hours like clockwork. I asked for something to help me sleep but they couldn't... I still only sleeping 30-60 minutes at a time. The pain was much better, the only thing that was bothering me was the incision I call "my second belly button."
Home & The Second Bellybutton - Days 3-7
Being home was great. Luckily the ride is only 15 minutes from my house so it was really simple. Getting into the SUV was a tad of a challenge but once seated I felt good. The frustration is the deep incision that is somehow fused to my abdomen to the point that it sucks in - I've nicknamed it my "second belly button" or "twoie" for short.
Twoie gave me a lot of problems. Anytime I had to get up or move I had to deal with pain from twoie. ESPECIALLY when I had to cough stuff out of my lungs. I still don't know if that's normal or some left-overs from a pretty severe cold I had right before the surgery. I was worried we'd have to postpone as I had a lot of chest congestion the week before - but on the Friday before (during pre-op) I had no fever and barely any noise in my lungs. I found the best way to deal with twoie besides the 7.5mg Hydrocodone every 4 hours was to keep an ice-pack on it and press hard against the icepack when I coughed. It was still very painful but I could manage it much better that way.
Diet this week consisted of soup broth, protein shake and Jell-O. Exercise this week was walking, just starting to walk as much as I could and progressed to 0.5 mile walks by Friday (4 days post-op). With pain in check and mobility increased my next demon was food cravings.
Food: My Demon - Days 7-12
I have heard that I wouldn't feel hunger anymore. Well, this wasn't the case for me. Eating a liquid diet had me struggling. I had cravings all the time and my old stomach would growl at me often. The other scary thing is that I could take down cream-of-wheat; a full cup; without feeling any sense of fullness. I worried that either my pouch was too big or that the hole on my new stomach was too big. An appointment with my doctor on day 10 and some helpful replies here assured me this was normal.
I needed a way to cope with my cravings... it seemed anything I watched on TV had someone eating. I wasn't sure I would find anything that would help me - talking about it sucked, and walking any more than I was hurt too much. I found that writing my food down, a simple "chicken" or "avocado" on a virtual notepad helped. I could then know that the craving was captured and I know when I hit phase 5 (my last phase where I can try pretty much any food) that I'll go ahead and give the list a look over for what I want to try. I list the food anytime I crave it, some things are on there multiple times. My wife laughs at me when she sees me pick up my iPhone and tell Siri "Pizza - extra cheese" or "Tuna sandwich." My "Phase 3" was slated for Monday (day 14), I decided to move this up 30 hours to help.
Beans from Heaven: Days 13 - 16 (today)
I decided to move up my "phase 3" or the "baby food/puréed" phase 30 hours sooner, to Saturday night instead of Monday. I started off with 1/2 cup of refried beans. They were like heaven, like the best thing ever! I mashed them up really well and ensured I chewed them as much as possible - both to ensure digestion but also to savor them/make them last. I stopped at a couple spoonfuls and waited 15 minutes to see if anything felt off and it didn't so I finished them.
Sunday, I had them again for dinner - only, this time I added 1/4 ounce of shredded jack cheese and melted it... this was like another level of awesomeness. On Monday I went another step, I added in avocado and also put in a couple packets of Jack-n-the-box sauce. Yet another level of yumminess encountered. All of this went down well and passed through my system just fine.
On Tuesday I really went for it, my "Phase 3" allows for "baby food meat" - I changed this up and went with Vienna Sausage. Don't read the label on that food - it's VERY fat heavy. I went ahead and had a full-can of this split between lunch and dinner and with 1/4 of an avocado with each of the meals. It too went down really well. While this is not totally healthy, my daily average remains right at what I've been targeting for this phase - 750 calories a day, 50% Carbs, 35% Protein and 15% Fat. I get 65g of protein like clockwork and always have at least 64oz of fluids (mostly Special K protein water - diluted to half strength but also some protein shake and crystal light).
While I still am not feeling "full" at all, my cravings are nearly gone... I rarely pick up my iPhone and talk to Siri to add to my list. I wish I dated my cravings so I'd see the drop-off in inputs, I'm sure they're significant since I hit Phase 3.'
The "to-date" results
As of now, 16 days post surgery, I am down 16.6 pounds to 338.8 pounds.
I have no idea what to expect still in "the long run" but I'm okay with how I feel right now. And, I'm really looking forward to starting my "Phase 4" - but, I know I'm going to try a Saltine cracker and probably some toasted bread (maybe like 1/4 grilled cheese sandwich). I intend to up my calories to 1000 per day in Phase 4 and my protein to 40% with a final "phase 5" goal of 1200 calories per day and 45-50% of that from protein.
Thanks for reading, comment/suggestions always welcome!
Todd
