Friday, July 26, 2013

Food Additions

T has managed to advance to eating mashed potatoes and Cream of Wheat cereal.  This is exciting stuff, and it is happening a bit ahead of the projections by the doctor.  Mind you, she is eating a couple of spoonfuls...  But still...

Progress :-)

swan

Tuesday, July 23, 2013

Beginnings...

The beginning of learning to eat again with a brand new, post Roux en Y stomach pouch, is a diet composed mainly of clear liquids.  That means that, except for "milkshakes" made up in a blender with unsweetened , vanilla flavored Almond Milk, fat free/no sugar added ice cream, and Unjury Protein powder, she is limited to clear broth, reduced sugar, clear fruit juice without any pulp, sugar free popsicles, and sugar free jello.  It will be 4 or 5 more days before she can step up to what is termed "full" liquids including dairy, puddings, yogurt, creamed soups and thin cooked cereals.

I have made up a batch of homemade applesauce that will be good when she can tolerate it.  She took a chance and had a small spoonful today.  Even that challenges the new stomach pouch, but she enjoyed, and it seems to have done no real harm.  So...  t.his is the beginning.

swan

Monday, July 22, 2013

Home!

We brought T home from the hospital this afternoon, arriving here at about 4 PM.

She is well, although very, very tired.

We are all just very glad to have her here.  Our old man cat, Pranzer, her special feline buddy, is glued to her side.  Tom and I have done our level best to spend lots of time with him, but there is no replacement for his "mommy."

Now, we begin the long journey through post surgical weight loss, and the slow return to what will become the "normal" eating patterns for her.  For the next few days, that will be mostly clear liquids, and the protein supplement that is recommended for bariatric patients.  Slowly, over the next few weeks, she will advance through stages:  full liquids, soft foods, and then eventually, solids.

There is time for all of that now.  For today, it is just enough to have her back with us.

swan

Friday, July 19, 2013

Better Today

Today, T is much better.  The x-rays today showed that the contrast medium is moving down into the large intestine, and the nurses are beginning to be able to hear bowel sounds.  She is having much less pain, and there has been no nausea.  At about 2:00 this afternoon, they clamped the naso-gastric tube and allowed her to start sipping water and eating ice chips.  That all seemed to go fine this afternoon.  If she continues to do well for 12 hours, they will remove the N-g tube and allow her to start on clear liquids.  A couple of days on clear liquids, and she will probably be able to come home (assuming all goes well).

So, maybe we will be able to bring her home on Sunday or Monday.

Today is definitely better than yesterday.

swan

Thursday, July 18, 2013

Not as Easy as it Looked

We were thrilled with the outcome of T's surgery on Tuesday.  She seemed to breeze right through, and when we left the hospital on Tuesday evening, we were imagining she might be home today sometime.  Wednesday started out well, and things were looking promising, but by afternoon, it began to appear that there were problems developing.

The doctor had ordered a "routine" x-ray with contrast that was meant to show that all the new connections were intact.  That was done at about 9:00 Wednesday morning, and in theory, once it was read by the radiologist, she would be allowed to start taking clear liquids.  We waited.  And waited...  And waited.  As the morning turned to afternoon, and then as the afternoon wore on, we began to worry.  Too, she began to feel nauseous and her abdomen was distended and felt warm to the touch.  She began to complain of pain -- inside, and it kept getting worse and worse.  By about 6 PM, we got word that there was NOTHING moving through the stomach; absolutely nothing passing through the stomach and into the intestine.  We were told that it might be edema that was causing swelling and preventing the contrast media from moving through the new pouch.  It might also be an ileus.  We are familiar with ileus -- Tom had trouble with ileus after His roux en y, and again after His bowel obstruction.  Or, worst case, maybe it was a kink in the intestine -- which would necessitate further surgery to correct it. 

We were at the hospital until about 9:00 last night, and when we headed home, we were very concerned that there would be more surgery today.  We tried to get to bed early and got up at 3:45 AM so we could be back at the hospital by 6 AM to see her surgeon.  When we arrived, it turned out that a series of additional x-rays were being ordered to try and evaluate the situation. 

We spent about 13 hours today, waiting for some word, watching poor Teresa hurt, helpless to alleviate her pain and nausea.  It was a long, miserable day for her.  At the end of it all, it appears that there is significant swelling which is impeding the flow of liquids through the stomach.  There will be more x-rays tomorrow, but unless the docs see something else, this is going to be mostly a matter of some days to allow the swelling to resolve. 

At least tonight, she seems to be feeling better.  Hopefully, she'll be able to sleep tonight.  Hopefully, we will do likewise.  Tomorrow, we'll be back at the hospital with her, and we'll see where we go from here. 

swan

Tuesday, July 16, 2013

Out of Surgery

T is out of surgery as of 11:00 our time.  Everything went very, very well.  The surgeon was able to do it all via laprascope, so much less difficult than we feared.  She will be a couple of hours in recovery, and then may be home in 2-3 days.  To say we are relieved is a huge understatement.  Thrilled!!! 

Thank you all for the good energies.

swan

Today is the Day

We are off to the hospital.

See you all again when we can.

swan

Sunday, July 14, 2013

The Weekend Before

We have spent the weekend together.  Trying to take it easy ahead of Tuesday's surgery.  T has been limited to a liquid, pre-surgical diet that is meant to enhance her recovery.  It is pretty awful stuff, and she has not been feeling terrific as a result.  Too, she has needed to take it pretty easy so as not to disturb the pic line in her arm.

We have "entertained" ourselves by seeing silly movies:  World War Z and White House Down.  Neither one is recommended if you are after heady, intellectual fare.  These are action packed and pretty light stuff.  Good diversions for this last weekend before surgery. 

We are coping with our stresses.  Hoping for the very best possible outcome.  T is determined that we will all be home together next Sunday.  If she's up for that, then Tom and I am right there with her.

Wish us luck, friends.

swan

Friday, July 12, 2013

Looking Toward the Future

This morning, T and I headed for the hospital where her surgery is to be performed.  She had a pic line installed in her right arm.  It was the final hurdle in this run up to Tuesday -- the actual date of the surgery.

Now, there is nothing to do but wait, and try and cheer her on as she lives through the just awful, liquid diet that is required for these last five days. 

We are, each in our own way, anxious -- this is a very big deal surgery with some very real and scary risks.  We have done everything we know to do to give our T the very best shot at having this be successful.  The surgeon is one of the best in the area.  She has been cleared by our cardiologist, after some very thorough testing. 

We will, most likely, spend a quiet weekend here together.  There are some movies that we want to see together, and we will find some time to do that.  It is probably going to be a good long while before we are ready to go see movies together again. 

Tuesday morning will start very early.  We are to be at the hospital very early.  The surgeon estimates that the actual surgery will last between two and five hours.  Figure another hour or two in the recovery room, and we should have her back in her room, with us, by about 2:00 in the afternoon.

Once she is through surgery and on her way to recovering, we'll get her home as soon as we can.  We'll tuck her in nice and comfy in her favorite chair, and get to work helping her through the beginning days of post surgical eating.  The digestive system shifts that the surgery creates are monumental, and it is a very slow process to reintroduce foods.  In fact, it really seems that Himself has only begun to eat pretty much normally in the last 4 -- 6 months, and His surgery was over four years ago. 

I am working hard to be positive and hopeful and upbeat about this.  We are so aware of what can go wrong with this surgery, but I also know how much can go "right," and I am focusing on that.  This will be good, and my sister-heart will come through with flying colors.  By this time next year, we'll be hanging out at the pool together so she can show off her new cute, little self.

swan

Monday, July 8, 2013

Converting a Gastric Sleeve

The BIG event of our summer is that T plans to have a revision to her gastric sleeve on July 16.  The original surgery, done four years ago, was deemed to be less invasive and less dangerous for her in light of her previous surgical history.  The sleeve gastrectomy was a relatively new procedure at the time, and seemed very promising.  However, it has proven to be less than optimal for most (if not all) gastric bypass patients, and our T is no exception.  She did very well in the beginning, losing about 90 pounds.  However, as time has gone on, she has gained all of that weight back.  That does seem to be the story for most people who have had the gastric sleeve surgery.  T is a woman of small stature, standing just 5'-2", and she carries way too much weight for her health and comfort.  We have decided it is time to try and address it before it becomes a major health crisis.  So...  back to the surgeon (Dr. K.) for a revision of the sleeve to a Roux en Y.  It is a big deal, and we are nervous, but also determined to see her through this one, and on the path to a long and healthy life.  She is in the lead up phase of preparation for that surgery, and on a very limited dietary regimen.  She is, however, calm and determined, and really doing wonderfully.  Keep her, and all of us, in your thoughts as we get ready for this big hurdle.