Saturday, November 10, 2018

Week 2 Post Op

Well, things are slowly getting better. I am still on a mostly liquid diet as I find that I am having a few issues.  One being my system rejecting food and the other that my stomach is not only physically smaller due to the fundoplication but also smaller from lack of real food since the 23rd of October.
It didn't seem to matter too much as I really didn't have much of an appetite but now I find I am feeling hunger just that about 1 cup of anything liquid or mushy fills me up.  As a result of this I am down 9 lbs since the day of the operation (Oct 24).  Fortunately I had put a bit of weight on over the summer so had a bit of leeway but I am feeling fairly weakened of course.

I visited the surgeon this past Tuesday for followup and he expressed concern for my weight and inability to retain sustenance.  He said to followup with him in a week if it hadn't changed or improved and then another followup in a month's time.  He removed the steristrips (I thought there were stitches under - there were but dissolving) and all but 2 are healed over.  The other 2 still have some scabbing and were the biggest of the incisions.  I also found that I had a few issues taking regular tylenol even though it was in an easy to swallow format for me the round pills stuck for a bit.  He said to try smaller or cutting them and to let him know if that continued.  Obviously there is some swelling from the surgery so fingers crossed that is all there is.

Interior I can feel discomfort and sometimes there is still pain. I have to admit when the pill stuck I freaked out a bit and worried that I would have to go to the ER but after about 15 mins it slipped the rest of the way down - phew.  I also find that I still tire very easily - almost too easily - when I try to increase my activity level.  2 hours at the shop and I'm wiped out.  So baby steps where that is concerned.  I will increase my daily activity level til hopefully it returns to somewhat normal.

So what are my feelings overall?
At this point I am still on the fence as to having had this surgery.  Yes in the long run I will be able to eat fairly normally with some things I may have to avoid or moderate - hopefully. But that first 10 days I had serious regrets.  Not just the pain which was pretty intense but also the thought that I had still 5 or so weeks of recovery. That I had done something to my body that changed my anatomy and how is that going to affect me down the road. That I truly hadn't realized just how long and difficult the recovery would be.  That almost 3 weeks later I would still be feeling not myself.  That I could seriously get sick of broth and jello and want to start eating but also afraid to because of the risks.  Slow and steady, stick to the Nissen Diet (for this type of surgery).

I have read many blogs and forums where the outcome is all over the map from some having no issues at all and are fully back to normal and others that have residual affects including still some form of restriction in their esophagus.  I am hoping that I will be in the first group.

I am getting a bit stir crazy too.  I have watched enough Netflix (Rupauls Drag Race for one) and the Heart & Home station has given me some easy watching movies that don't need too much thinking but are still enjoyable.  I think I've also read about 6 books.  I'm tired also of sleeping in a semi-upright position.  My neck, upper back and tail bone are feeling the consequence of that.  I tried sleeping flatter but the discomfort in my lower chest was unbearable.  I also find sleeping on my left side feels like my right side incision is pulling so I can't do that.  So I spend alot of time more or less prone but upright at the same time.  Again hopefully that will eventually change over the next little while.

It's also difficult letting go of the normal things that I can't do at this time.  Like lifting a bag of groceries or a basket of laundry.  Running the vaccuum.  Cleaning up the backyard.  Raking or sweeping the leaves.  Stuff that needs doing but I just cannot do it!  Frustrating.  Yes it's only been 2.5 weeks and it was major surgery but if you know me you know that I am not someone who likes just laying around day after day without doing SOMETHING productive.

Thank goodness I have amazing clientele and they are super supportive and patient at this time.  I wish I had been able to do this a few weeks earlier and be farther on the road to recovery but at least it has been done before my crunch time and I can be there when I need to be.

Insofar as eating, I have 2 different kinds of supplements (Boost Juice & Ensure), various creamed or pureed soups, apple sauce, yogurt and cream of wheat.  Ice cream and popsicles help fill the void of snacks. So for the most part still pretty liquid.  The doctor suggested I try adding a few things from the mushy part of the diet (a 4 week program) so Drew made some swedish meatballs (amazing recipe with ground turkey one of our favourites) and I enjoyed a cup of mushy noodles with sauce (no meat).  It was divine! Had that for 2 nights and tonight I'm trying some good ol macaroni and cheese made in the crockpot and hopefully the noodles will be super soft and easily swallowed.
Hard to believe that these simple things bring so much anticipation.

I am still overwhelmed by the amount of friends who make a point of touching base with me and checking on my progress.  Their support, love and prayers are so appreciated and I realize that I have so many people in my life who I love and who are there for me. <3  Thank you all from the bottom of my heart.

I'll try to touch base with you all next week.
Love ya,
Deb

Thursday, November 1, 2018

First Week Update

Warning Long Post (tale of the roommate from hell included :) )

So I had the operation last Wed 24th. I was super nervous going in and felt that I had armed myself with enough knowledge of what was planned.  It did all go as planned.  No issues with the surgery.  However, the recuperation is another thing altogether. 
First off, I felt that the nurses and care provided to me was top rate.  I have no issues at all with the way I was treated right from the moment I walked into the operating room til I left 2 days later.  Just want to say that.
What I didn't expect was the amount of pain and overall discomfort I would be in.  While the surgery was performed laparoscopically, there are 5 total incisions not to mention the incisions on the inside. The pain meds were readily available during the day, however,  the night time nurse was obviously super competent but the 2nd night she seemed really run off her feet.  It took much longer for her to return.  That is not her fault but just made things more intense for myself.
I also had the weirdest, rudest, most self centered roommate.  This made the entire stay much more difficult.  I'll talk about her later.
One of the frustrating issues I had following the surgery was the inability to void my bladder.  I pretty much slept on and off the whole day and around 3pm the nurse asked me if I needed to use the bathroom.  She helped me into a commode chair she brought into my curtained off area of the room (a ward of 4 people).  The pain that ripped through me was pretty intense and I was dizzy and disoriented.  I sat on the commode for at least 1/2 hr.  Could have been longer I am not sure.  I couldn't do it.  No matter what I did.  So when she returned she said she'd have to catheterize me and with a bladder ultrasound discovered i had over 850 ml of urine. How the hell does one wee bladder hold that much!!  With much fiddling around she managed to extract all of that (a very uncomfortable procedure) cleaned up, gave me some morphine & gravol and you would think I would fall off to sleep.  Nope.  I would doze for a few mins maybe an hour and then the roommate from hell would invade my sleep and I'd be awake again.  This went on all night.  I was on NBM (nothing by mouth) so I hadn't had anything to eat or drink since 8pm the night before.  I was allowed a sponge lollipop dipped in water to wet my whistle but that was it.  I was not hungry but really thirsty.  I was on IV saline so I was not dehydrated but my mouth, lips and throat were like the desert.
So back to my neighbour.  There are 4 people in these wards.  All recovering from a surgery. I had no way of knowing when any of them had theirs, they were there when I arrived.  Across from me were 2 older ladies.  One who had a knee replacement and the other an emergency groin hernia repair.  The one next to me - the nightmare - had had a gallstone removed.  A GALLSTONE.  ONE.  Just setting the scene lol.  She lay there moaning and grunting all day.  Speaking in what I later learned was spanish but didn't sound like any language I recognized.  She called the nurse at least every 15 mins.  In between her grunting.  I cannot even explain to you how she grunted.  It was with every breath.  Like every breath was too painful too take and came out in a sharp "unh" sound.  Non stop. Every breath. Loudly.  When the staff would come in to take vitals or do bloodwork she would curse at them.  In English and spanish.  Complaining they were hurting her (a blood pressure cuff for goddsake). And each and everyone of them were nothing but patient and determined with her.  Not once did I see them lose patience or ignore her.  However, for me, and the other ladies, it was the non-stop grunting and moaning and loud talking (to herself and at 3am on her cell leaving messages to someone) that made me finally ask her very nicely to please stop grunting (cause she could - she stopped when she got up to go to the bathroom and then would start up again when she walked back) so the others could get some sleep.  She first said to me I am in pain.  I said I know, I am in pain too and Im sure the other ladies are as well but we all need our sleep.  She said - I don't care about you I only care about myself!  I was astounded.  And then after finally getting some sleep I think, at 3am she had the gall to turn on her light and call 3 different people and leave some long convoluted message between crying and moaning and pleading to go home.  I then asked her to please not do that and turn off her light.  She told me No.
Unbelievable.
Drew had texted me earlier in the evening and I had told him about the grunting etc. and he told me to ask them to move me to a semi.  Well that never happened.  I started asking right away if there was anyway to transfer rooms.  I was told they would speak to room management in the morning.  I was hoping I would be going home the next day so I was hopeful.
During the night I had to have a second unsuccessful go at using the commode.  Again I was subjected to a scan and subsequent catheterization.  A further 700 ml was extracted.  I was getting quite upset about not being able to do this.  Being in the setting I was in was most likely a huge factor.
The next am the 2 ladies across from me were discharged.  I again started asking for a room change as I was exhausted and knew that sleep was highly unlikely. 
Thurs AM dawned early with the change of shift and the vitals being taken.  I was informed I would be going down to have the swallow test done first thing.  First off getting on and off the gurney was excruciating.  It is almost impossible to do anything like that without engaging your stomach muscles.  Even swinging your legs up onto a bed for instance uses the tummy.  I also was over dry in the mouth and extremely dizzy and nauseous.  I mentioned this to the lady in the imaging and she went out of her way to try and make the whole process less painful.  I had to ingest 2 different liquids in this swallow test.  The first was an oily gastro fluid that I was asked to hold in my mouth and swallow on command and the tech would take pictures as I swallowed.  This I did 2x and was to detect any leakage around the incisions in my esophagus and stomach (the fundaplication).  This is obviously very important!  However, this greasy stuff made my nausea much more pronounced and one warning I had received was under no circumstances am I to vomit. Apparently vomiting is always going to be problematic after this particular surgery and is discouraged for the rest of my life.  Great -  always had a super sensitive stomach.  The second liquid was the Barium swallow which I have had before.  It is a thick chalky foul tasting liquid that again you hold in your mouth and swallow while the progress is tracked by xray.  I was hesitant and was offered time to wait but I thought no lets just do it.  So I did and managed to hold it and fortunately they only asked me to do it one time.  This barium swallow showed that there was still a longer than normal time for the fluid to pass down into my stomach.  I wasn't surprised as the operation didn't repair or was expected to repair the lack of motility in my esophagus (the dysphagia) and there would no doubt be a bit of swelling from the surgery itself.  The attendant was helpful getting me off the table.  She raised the table til I was in a standing position and then I walked over and she helped me get my legs back onto the gurney.  Much better than the process of getting onto the table where I scootched over.
I saw my surgeon Dr. M in the hallway as he checked in with the xray and told me that it was all good as expected and everything had gone well and also that he wanted me to stay at least 1 more night.
Great.
As soon as I returned to my room.  I asked the nurse to help me into the washroom and with the door closed and the water running full on I successfully voided my own bladder.  It took a few mins but once I did I felt so much better and relieved.  I again asked the nurse to please please find me another room semi or private.  I had told her of the inconsideration of the roomie and she was sympathetic.  After all she was dealing with her as well
My lovely sister came down from Ottawa the day after the surgery (Thurs) and spent the afternoon with me at the hospital.  She brought me some Tim's decaf plain tea and it was like nector.  I could finally start on the clear liquids diet since I had passed the swallow test. She also went down to the pharmacy and found me some earplugs so I could try and drown out the grunting etc.  My sister in law arrived with a beautiful orchid.  We had a nice visit and by that time the bed across from me had been filled and she had her own visitor.  After both my sisters left the lady across the way had someone come in and tell her they were moving her to a private room.  She was like no I didnt ask for that.  And I piped up and said that it was me that had asked.  So they started moving me.  First my bedside table with the orchid.  Drew was now there after work and he gathered up all my stuff and prepared to follow us.  And then they stopped moving me as they saw that the name was not the right name. It was the lady across from me her daughter had called and asked for a private room for her mom.  She again refused and said to give it to me.  I kept saying to her are you sure? Cause you will not get any sleep.  She said she actually didn't sleep at night and that I needed to get some sleep.  The outcome was neither of us was moved and I had to ask the nurse to go and find my bedside table with my orchid on it!  That was the worse part of the whole time was that bit of disorganization and lack of communication that ensued. Both of us ended up spending yet another night with the grunter.  Who by the way slept ALL day. Snoring away for over 12 hours except for when she was awoken for vitals and then we had to listen to her curse out the poor nurses.  I spoke up a few times asking her not to talk that way to them and when it was my turn went out of my way to be polite, thankful and empathetic.
After Drew left around 7, a couple friends from the cottage dropped by with a beautiful floral arrangement and good cheer.  It never fails me to appreciate the love I have and receive from my cottage people.  We had a nice visit and they could tell I was wearing down so they said their goodbyes.
That night I was so exhausted and between the drugs and the earplugs managed to get a few hours of sleep here and there.  The lady across from me had it worse this time as she also had a new roommate who not only snored big time but being on blood thinners they were taking blood samples every few hours and would turn on the overhead lights!  I don't understand why as each cubby has a light source but I just put the blankets over my head and tried to drown it all out.  By 6 it was obvious nobody was sleeping so I started commiserating with my across lady.  And when I went to the washroom I checked in with the other older woman (who had had a toe amputation) and she just looked at me and pointed at my neighbour.  We were all WTH.
With shift change comes the vital check and blood work.  My neighbour again loudly refused to have this done.  She was told firmly but politely that she was in the hospital that she was sick and needed to have these tests done so they could look after her.  She said no, I am not sick I am pregnant.  Well I cannot laugh but that made me and the other roommates laugh out loud.  This woman was at least my age.  Hard to tell true but well over that age.  And this revelation came after I heard her tell the nurse earlier that she had children (when asked if she did) and she didnt know how many as she had them taken away.  Didn't know how many?  And now she was pregnant?  You have to laugh this woman was either mentally unwell or a story teller supreme.  The nurse taking the blood samples stuck her head between our curtains and she was trying so hard not to laugh and was gesturing at me to please stop laughing...well I tried.
The good news was that finally someone came in from room management and offered us both a private room.  We both did the paper work and were told if we were discharged there wouldnt be a charge as at that point we were both hopeful we could go home.  And yes of course we were both discharged.  I was so relieved to be going home to my own bed along with my sister who was here to help me over the weekend.
The weekend was long.  I mostly slept - obviously trying to catch up but also the pain meds help.  Sister made me tea and broth and jello.  Brought me my meds.  Went to the local natural medicine place and picked up some liquid vitamins for me as obviously I am not getting any real nutrition. Made sure I was OK.  Her help is immeasurable even though I wasn't good company.  She watched old movies with me and entertained our new kitten.  I was sad to see her go but she had given up 4 days to stay with me and I can't say enough about that.
Both of my sons paid me a visit as well over the weekend.  I was happy to see my son, my grandson and his girlfriend for about an hour on Saturday which was a good opportunity for my sister to meet the new baby (almost 5 months old now) and the girlfriend.  I won't be able to pick him up for at least 6 weeks though.  And my other son came at my request to change the kitty litter as I wasn't going to ask my sister to do that (no pets) and I certainly cannot.  He was glad to help and also to check on me, see his aunt and see the kitten (Buddy) we adopted through him.
Recovering is taking longer than I thought.  I am weaker than I expected but that is most likely from being only on clear fluids still.  The pamphlet given me at the hospital stated after 4 days I could attempt the next level of liquids.  Introducing milk products, pureed soups, ice cream etc.  Drew stopped and picked up a bunch of stuff for me.  I had some lobster bisque for dinner (1 cup) and that went down pretty good but felt heavy on my tummy.  The next morning (Tuesday) I thought I would try the thin cream of wheat with some milk.  That didn't go so well.  Neither did the vanilla milkshake I made myself for lunch.  Both didn't sit in my tummy very long.  I won't go into details but vomiting was not the issue.  I also felt better enough that I ventured downstairs and moved to the couch. I also decided to try going without pain meds.  By 7pm though I was starting to feel very unwell and went back upstairs and to bed.  Tuesday night was a long night with discomfort and my stomach making noises like I've never heard before!
Wednesday I awoke with a headache that refused to go away and an upset tummy. I decided that I would try my cream of wheat with some almond milk (to see if it was the milk I was having issues with).  Unfortunately it appears that it wasnt the milk.  Its semi solid food period. So for the rest of the day I returned to clear liquids, broth, tea, juice and jello. I also had what felt like severe heartburn. I tried some zantac and then later resorted to sucking on a tums which seemed to help but for a short time. This was a disappointing day and over all rough one.  Obviously I "pushed" things the day before by changing my bed for the couch and moving around more (which I should be doing) and changing up my diet.  I stayed in bed again all day Wed. and thought if I still had a headache and heartburn the next day (today) I would call my Dr.
Today I awoke feeling better than yesterday.  While Drew had breakfast I showered and changed into a clean tshirt style dress (out of nighties).  I tried again the cream of wheat (well thinned with milk) and about 1/2 way through realized that wasn't going down so good.  Back to broth for lunch.
So currently I am watching tv on the couch and while I am frustrated with my progress or lack there of I have to realize that it is only the 8th day. Well 7th post surgery.  That this is a pretty major surgery and there are things going on inside as well as outside that need healing.  That my whole digestive system may take quite a while to adjust. My goal is that hopefully I will be able to enjoy Christmas dinner.  Physically I should be recovered by then but  hopefully also my system will be able to tolerate solid food by then.
I have to say that the number of people who have responded to my previous blog post as well as privately contacting me via FB message or text message has been overwhelming.  I have had over 300 views of the blog post alone.  It makes you realize that you touch and are touched by so many people in our life and that when you need them they are there in one capacity or another. Prayers, thoughts, words of kindness are all so appreciated and overwhelming.  Thank you for being my people.
I'm heading upstairs to get some pain meds now. Love to you all.
Deb