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Again, so very, very tired and weary — yet so much to do.
Trudge painfully and wearily through the beautiful spring day and even the idea of making the necessary trip for groceries is too much for me, and put off to tomorrow. Now that I was unable to be successfully exfoliated, I must purchase some over the counter product that hopefully will keep my 5 o’clock shadow at bay during my hospital stay so the sight of my unkempt, mussed up plus stubbly self isn’t too much for other’s who feel compelled to visit, to bear. I must also buy soft foods like yogurt, protein drinks, etc., as instructed in my dietary manuals.
And — food for Tom while I’m away and to help him too make better choices!
I do manage to “pack” (an odd construct when it’s for the hospital; not the Bahamas) and “clean” and do 5 loads of laundry, and organize the garage; set up the porch, set the DVR (for Tuesday through Saturday); read the Sunday paper; organize paperwork, etc.
Did I mention that I am so tired?
Oh, and I crave and must eat a whopper for dinner. A whopper?! That’s my food of choice for my “last supper” (doesn’t sound like much of a religious experience to me either!). Odd since I usually don’t care for fast food and typically would have preferred some fabulous buffet or hearty Greek plate.
I think the take home whopper (poor Tom!) is part manifestation of my exhaustion and resignation — I barely care to make eating an experience any more, and the ritual of a “nice” dinner is just too tiresome today.
And I didn’t even order fries with it!
Okay - today was to be an enormously busy day on purpose to avoid the fussing, fretting and wonton anxiety that I knew would occur if left to my own devices.
The only problem is the degree of emotional and physical exhaustion I feel, so that when today arrived, all I really wanted to do was, well, nothing!
Instead, we start the day with a church rummage sale — where I buy, amongst other crap, a silver bell to ding-a-ling for Tom post surgery. Ha, ha!
Then, it’s off to facial excavation — as I’d left 2 days of stubble in preparation for this. As a dark haired woman with PCOS and Adrenal Hyperplasia and of Mediterranean descent, 2 days = Sadam Hussein for me, and any longer and I’d have to quit my job for shame about it. I was therefore shocked when Mrs. Exfoliation said she could only do my (bushy bushy) brows because my chin, mustache and side burn hair weren’t long enough! And I’ve already walked around like this (now heedlessly) for 2 days, for this!? She told me I’d have to go at least 7 (so I could look like my bearded husband?!) before there was enough to wax — ripped my eyebrows off, and sent me on my way.
Drat! Now I had to run home to frantically tweeze, shave and otherwise dehair my face before our afternoon plans, much to my husbands chagrin. I often wonder how he feels being married not just to a fat lady, but a hairy, crazy fat lady!!
Then, off we went to the Orthodox Christian Church in Lewiston that my grandfather used to be the priest of many years ago. My cousin Kenny and his wife Ann had invited us, and we’d invited friends to, this auction; bazaar; dinner event as a fundraiser for the parish.
We all enjoyed a lovely (albeit expensive) evening; caught up, laughed and otherwise kept my mind off my any minute now surgery.
Until Ann pointed out a very slender woman working the ticket table in the distance, stating that “she had the surgery last year.” Wow!
Long story short we all met up after the formalities subsided, and talked until they began turning lights out on us. She showed us (Tom; Barb and her daughter who also struggles with her weight) a picture of her 270 pounds (before); and had no shame pirouetting and raising up her shirt to show us after - including her now nearly disappeared scar and leftover ripples of flab she plans to have removed. She exuded excitement that my doctor was hers; spoke highly of his competence and manner; thought poorly of at least some of his support staff; but overall is pleased. How could she not be!
She referred often to having “made peace with food” - and although she said, I’m still not quite sure what this really means. Clearly, I have not.
Also disconcerting to me was the extreme pain she had for a few days post-operative (although she was quick to explain that she also had to have her infected stony, gallbladder out at the same time); and the barfing up of “solid” food she did that kept her on liquids for longer than the usual few weeks.
After intently listening and sharing questions with my friends and husband, I felt most insecure that I wouldn’t get it all right - especially the protein and fluid requirements and as she warned, I’d end up shriveled, bald and dead from malnutrition and stupidity.
It all seems so complicated! Exhausting yet intriguing. Worrisome yet exciting. I’m ready, but I’m not. Period.
Thank God, I got my period! Crap, I got my period! No wonder I felt so yucky yesterday.
How I’ve worried that it would come like the minute I lay down on the operating table — adding cramps and (more) blood to an already unpleasant equation. Yuk!
On the other hand, I ache so badly already without my anti-inflammatory medications and with cramps to boot — ouch! I feel like I have a headache from head to toe - and the stress at work is enormous today as I try to wind down in good graces. Distraught clients; enraged parents; overdue paperwork hold me up from my 5:00 dinner plans with Stephanie (my student) - but thank God she is patient and resilient enough to allow me the extra time I need to regain my composure and sanity through supervision, before I take her out.
At 6:00 we head to Danny’s restaurant- me unhungry (!) and with a splitting headache but determined to honor the ritual of treating outgoing interns and enjoying our final time together. She is bubbly and sweet and pleasant, as always, and eventually I warm up and settle in and manage to gather enough appetite to enjoy three bowls of soup from their salad/soup bar — including their famous chicken wing soup.
I couldn’t be more stressed, exhausted and overwrought when I finally get home after 8:00 — and my poor husband is then the sounding board for my long and stressful day while anxiety is also growing as 4/28 grows nearer.
I am soo tired though that part of me welcomes the rest and break — at least I don’t have to perform the surgery. How hard can just lying there be?
I must be exhausted!
God I’m miserable today. I feel like crap, head to toe; have little energy; and can barely hobble around (I’m still parking closer and more “illegally” at work each day!) I’ve been taken off all my arthritis and anti-inflammatory medications and I can’t even pop an aspirin.
How can I possibly feel any worse after surgery?!
Oh, why do I ask such loaded questions?
And crap, I’m not even hardly up to enjoying my “last” meals that my head has been screaming at me to savor while I still can. I’m even burning out on the whole eating thing … I guess this is good, but worry I’ll regret that I didn’t manage one last indulgence of this or that, here or there, when its “all over.”
God, please, do others think and feel like this? I feel so not on board somehow.
I swear I’m developing bipolar disorder (manic depression). I go from exhilarating highs to crashing lows of despair and doubt about everything bypass.
I was thrilled that Dr. C himself called me directly at work and had clearly read my letter and was considering my needs. Slightly funny (when he joked about transferring me to the other Doctor!) he was otherwise thoughtful and recommended I meet with Dr. P while on site today anyway - and that as he (Dr. C) was off this week but would call Dr. P ahead to discuss options. Joy! Trust restored! Hope!
I finished my ½ work day distracted and preoccupied. I then painstakingly made plans to coordinate plans with my student to treat her to dinner (as is my tradition - a vital part of closure and send off, as far as I am concerned) next Thursday - the only time we could get together before my surgery and her 5/1 departure.
At 1:30 p.m. my husband picked me up for my 2:15 consult and then 3:00 “class” at the Center. Not so ommbayahish this time, Dr. P spoke with a tone of resignation and sternness - outlined options that included substituting a subclavian line for a pic as this could be done under general anasthesia and my Vena Cava could also be installed through it. However, just as this was sounding pretty darn good to me, he suggested that there was an increased chance of infection with it, and this procedure best be done days before bariatric surgery (ie:on Thursday) to give my kidneys time to recover to decrease change of renal failure. When my knee jerk reaction was to balk at taking all of Thursday off (this whole process takes most of the day) so close to being off for likely 6 weeks (and missing my final dinner with Stephanie and numerous client sessions -ack!), he sighed wearily and indicated that I was being difficult and putting their backs to the wall. He said it might be possible to do everything the day of surgery- but I must get my blood results ASAP to see if my kidneys could tolerate this. Although both Tom and I listened carefully to everything said, somehow I (we) still left with questions and confusion - especially about which one was being planned and other than praying for success at the hospital with blood drawing tomorrow, what else I should do.
This bothered me throughout the mandatory exercise class and dietary class. The young fit man teaching us about the Center’s gym was funny and pleasant. He also did my final weight - egads - over 300! - I’ve gained 6 more pounds! He was nice enough to acknowledge that last hurrah syndrome that we both knew I was caught up in. What - no lecture! How refreshing. I liked him even better after this. And, when I splatted to the floor yelling (shit!) during a mandatory medicine ball experience, (obviously I possess no balance and no core strength); he (and others) simply laughed.
Next up was an hour class by “L” (the woman who I’ve left 2 unreturned telephone calls to, and whom I dislike based both on this and her somewhat snotty, crisp manner). Other than that it was taught by her and that she was rude when I asked about open versus laproscopic surgery, the information was valuable, although a bit overwhelming. The other annoyance factor was the music piped in overhead during our class combined with the fact that the general wait area is just feet from the café where we were listening. Can’t there be a quieter, dedicated space where overhead music and waiting room conversations don’t distract from such vital information? Plus, my husband and I met a woman who told us that her daughter had the surgery with Dr. C in November 2008 and has already lost 100 pounds (hurray!). However, she insisted that he did it laproscopically on her - causing me to feel confused enough to ask about this in class, only to be told with reprimand that he ONLY does open. Well - someone’s wrong.
In any case - feeling disgruntled and lacking closure, after class ended “early” - I reapproached apathy girl (who earlier had been holding an infant with no greater enthusiasm or emotion than when she greets patients. In fact, when my husband asked how old the squirming baby was, she blandly answered - “oh, I don’t know its Dr. C’s grandchild”). Her immediate response as I approached the window was “have a seat” (her favorite phrase, I think).
When I explained that I wondered how I would learn when/what Dr. P and Dr. C decided about how to proceed with my situation, she told me to write my questions and they’d get back to me. Okay. Except, as I was finishing it off, a nurse behind the desk indicated that something, something, something, something, something, something - at which point she said I could talk to him further if I wanted.
Yes, please! So Tom and I waited over an hour so a now very resigned and tired Dr. P could sound like “as I already said…” while I felt more confused about things than ever. Bottom line it became more clear that everything rests on the bloodwork I haven’t yet been able to produce (”If I have to I’ll cut off my arm and collect a bucketful!) to ensure “normal” kidney function. It felt as if although on one hand he was steering me to have everything done on 4/28 - when I asked about kidney risk, he clearly answered that although there is a 1% risk of renal failure with gastric bypass and 1% with the other procedures - “1 + 1 don’t equal 2 but 4 or 5″ in this case.
If, my kidney function tests aren’t entirely in the normal range, this won’t even be an option. And our glimmer of hope that I could have the first procedures done on 4/28 and then the bypass days later suddenly became impossible as he remembered that Dr. C will be off for 2 weeks after 4/28.
So - I guess we must all live with more uncertainty about when and how, and all I can do is pray for paydirt with Sister’s Hospital phlebotomists tomorrow. And if not, how I can find Venus, the Quest phlebotomist who has had success with my tiny veins in the past.
Needless to say, I ended the day on a crashing low of uncertainty and anxiety.
Oh, and I remembered on the drive home that my BUN/creatinine ratios in my last 2 blood tests were both elevated. Double shit.
Tax day and hubby’s birthday! Since we’d already gotten our meager tax money back and blew it at the casino last weekend, the only thing to celebrate today is Tom!
It’s a normal day in most regards (although I am painfully aware that of the four of us who gather for dinner, I am the only one who worked today). Tom’s childhood friend Corky and his girlfriend Phyllis — a pleasant and engaging couple, join us at one of our favorite restaurants. Danny’s is known for its ”Four Soup and Salad Bar” — all-you-can-slurp-and-eat, and I’m starving enough to try three varieties of soup and eat salad and a full meal besides. I am (once again) aware of leaving others in the dust, and when our conversation strays to my upcoming surgery I am sure it is obvious to all just how desperately I need this to provide any modicum of self control. Still, I can’t help wondering how badly, if at all, I’ll miss such days of excess afterwards. People seem to indicate that you feel satisfied and fulfilled and that mourning for lost habits and food items isn’t really an issue. I guess I’ll have to see for myself.
Compounding this recurring “worry” is increased anxiety at tomorrow’s class and Friday’s hospital pre-operative work-up.
I made the mistake of researching the pic line and pray that Dr. C. calls me back about alternatives as I am now too wigged out to imagine tolerating this while conscious. I sent him a fax outlining my fears and concerns, and desperately hope that he will be willing to address these with me.
When I asked the nurses at my job if they could fathom alternatives to give me a reference point to present to him, most were busy minimizing my phobia, (”oh, you’ll be fine” or “it doesn’t hurt much”) to be helpful. This became a free for all with secretaries and the record keeper chiming in - I so wish phobias weren’t misunderstood as silly or about pain. I tried to explain that fear of heights, elevators or spiders isn’t about pain - but apparently none of my colleagues have phobias as this seemed to fall on deaf ears. So … I largely took a gander on my own in what I wrote to Dr. C. and now sit with fingers crossed that there may be alternatives or a blow with a frying pan pre-op to render me unconsciousness so I won’t care what is done to me.
I’m so food-focused … I love (hate), LOVE (hate, hate, hate), gotta have, my favorites.
I nearly feel in a panic about the idea of “giving up” my beloved favorites (though I’m told these are not correct words as I will be able to eat anything, again, someday).
For me, this is fried foods, breads, pastas, pizza, cheeses, and potatoes. I’m not so much about sweets — I have a French fry tooth instead.
Will I really feel satisfied with smaller quantities, healthier substitutes, and better choices?
Will a healthier, more productive body and lifestyle thrill me enough to compensate for the addictive quality of a good fried clam?
These are just some of the thoughts that haunt me.
* “I So Hungy” is something funny that Homer Simpson, one of my heroes, once said.
Today was a nice break from reality and perhaps just what the doctor ordered. Tom and I along with our Compeer friend Kris who we picked up from the P.C. went to a fundraiser held by 10 Lives Cat Club, called the “Furball.” We were joined by our friends Corky and Phyllis, and Zoe and Dennis. It involved food and auctions and prizes and crafts. And food. Kris, a delightful and joyous spirit but challenged intellectually and with dual mental health conditions that can cause delusions and self talk, also enjoyed the event and social opportunities it offered. As a short statured individual who also has medical challenges, she tends to gain weight easily and can get quite pudgy at times despite a largely psych. center diet. Probably due to bureaucracys’ emphasis on her weight throughout her life of hospitalizations, foster homes and institutions, Kris can be guarded and defensive about her eating and her weight. Although probably wrong of me to laugh, she never fails to crack me up when she occasionally feels the need to inform someone, anyone within earshot, that she has lost “900 pounds!” and then gets indignant if disbelieved or questioned. Even I don’t have that many pounds to lose! Though sometimes it feels like it!
I’m so weary. I am tired and blah when Janet and Debbie visit. We order wings from the best and hottest wing place in town (Duffs), and go at it while we talk and watch shows I’ve purchased.
Shortly after they leave, Tom begins to barf his brains out — especially horrible given the nature of his dinner.
He is sick all night — now we are both weary and miserable. I guess weight loss won’t solve everything, but it’s becoming even more clear to both of us that a better diet is critical.
Please don’t call in sick, Dr. C! Even his health has become one of my worries! And what if he retired before summer?! I wonder how old he is, anyway!
Well — I’ve made out my list of medications for the appointment as asked:
- Paroxetine, 40 mg (Paxil/depression)
- Nabumetone, 500 mg (Relafen/arthritis)
- Metrotoprol, 50 mg. (Toprol/high blood pressure)
- Metformin, 850 mg. 3x a day (diabetes)
- Plus vitamins, calcium + D, cinnamon, fish oil, 81 mg. aspirin, chromium picolinate
And I’m sure I have my new insurance card, so that better not present a problem.
And, my list of questions:
- What is the area sutured with (inside and out)?
- Why “open” instead of laproscopic?
- Expectations; guidelines for recovery.
- How long is the average hospital stay?
Many issues are covered in the literature I’ve been given or information off the net, but I need to hear him say it.
Someone on a TV show about Bariatric Surgery recently said what an odd construct this surgery is. She noted that one must “risk their life to save their life” - and I see all too clearly now what this means.
What a sobering experience today’s surgical consult was!
First of all, I was underwhelmed by the bland, bored demeanor of the little young woman behind the desk that greets and processes you. Although I had called yesterday to say that I’d like to come early to tour the facility (gym, etc) and they suggested one hour and would provide me a packet of paperwork to review prior to my meeting with the Dr. - she knew nothing of this as evidenced by her monotonic “sit down, you’ll be called soon.” When I explained, she shrugged and said “okay.” I had to explain that I didn’t know what I should do or where I should head having never been there before. She then apathetically pointed me to the left, with no explanation or help.. So much for my introduction to the place I’d looked forward to visiting and touring.
Left to my own devices, I wandered an empty gym and empty snack type bar set up like a little café with a menu of health shakes and other bariatric surgery friendly concoctions. Sweet! I also read every flyer, brochure and poster I could find, before settling into the overly small wait area to go through my packet.
That’s when the creeping, skin crawling, apprehension and then “gak” set in. What serous stuff this surgery is! What strict and complex “instructions” and necessary - (pre and post-operative) information this packet held! And on the cover sheet with my name on it, a list of steps to yet be taken/appointments to attend, prior to my MAY surgery. May !! Here I’d been gearing up for likely June or maybe even July. Although, Ms. apathy explained that May is just an approximate/guess at this time, even if a little premature, it’s a sobering combination of yippee and “gak!” news.
One of my first thoughts was that now the eating with increasing frenzy will have to end early. I’d better step it up and use the really good Entertainment Book Coupons at least, ASAP. Really!
Not - oh good, one less month to wreak havoc on myself. Or - what about work or I have a lot to do to get my ducks in a row. Sure - these thoughts and more came later (in stereo!) but honestly, anticipating grief over the loss of overindulgence remains right up there!
Anyway - continuing on with my journey - next I was called by a voice I couldn’t see, as the door is around the corner from the wait area. I hurriedly grabbed my coat and purse to follow voice lady, only to find her barely visible as she ran down corridors and turned corners, not even checking to see if I was in pursuit.
C’mon lady -we’re fat here, slow it down! It reminded me of those times in busy restaurants when a waitress calls your table and then disappears into the crowd and you get stuck behind, leaving you unsure just which waitress to follow (even my analogies are food oriented!)
Anyway - Marathon lady finally stopped at a hallway scale, barked orders for me to take my shoes off and step up. Where’s the warmth I read about on the internet? The caring team approach?!
Oblivious to my windedness from the tour de Bariatric Center, she then told me to take a seat on the little chair I had just hastily dumped my coat and purse on (”excuse me - Is there somewhere else I can put these?” Shrug.), She proceeded to then take my blood pressure and pulse. She whipped out the world’s largest cuff (reminding me that I’m not at Club Med) and shock - my blood pressure and heart rate are gasp - elevated! 136/82 BP - not horrible, but do you think maybe related to my 300 pound jog to the bowels of the Center in hot pursuit of Marathon Lady? Sigh.
Next, Mrs. Efficient, but with glimmers of personality and humor nurse, briskly asks a questionnaire full of medical questions, reminding me that in addition to High Blood Pressure, Sleep Apnea and Diabetes, I also have PCOS and Adrenal Hyperplasia. I briefly tell her about these. She was humorously complimentary that she is impressed by a woman who knows here C-PAP Level (”18″), though clearly invested in the same degree of efficiency as everyone else. She left, reminding me to disrobe except underwear and bra and put on thin (paper) gown with the (paper) pad to cover up further if need be. How refreshing that for once the gown was bigger than me - but how REFRESHING that the room was like 20 degrees and I was wearing paper and sitting on a slab of paper covered plastic.
Mercifully, Dr. C. came soon- smiled and said he recognized my face (really?!) from my 10 year ago surgery with him - and was a ray of personality, warmth and humor not yet seen by others.
Unfortunately - the news he told me made my lip quiver and my eyes well up, and caused me to make Quasimodo faces at him as he shared excruciating detail about my need for a vena cava filter due to my supposed elevated risk for a blood clot. He said that he had done research and presented a lecture on the triad of increased BMI (mine’s in the 50’s); sleep apnea and fatty liver (oh year, I have this too), and the greater likelihood of lower body clots due to this. As a result the filter plus two times daily shots of heparin must be given for three weeks in my abdomen to decrease the risk! Aacchkk!
My assumption had been that “don’t most people who get gastric bariatric have all these things…I mean, why wouldn’t your liver be fat if the rest of you is too?” His immediate retort was - “9% !” You’re kidding?! So I’m in the lucky 1/11th of fat people who might be clotty and need be sent home with instructions for heparin administration AND have a pre-surgery surgery to install a vent!
Well - I wasn’t born with Arab blood for nothing. Bartering and negotiation are (also) in my blood. I told him about last years colonoscopy and my successful quest to find probably the only doctor willing to both do the procedure without an IV (no anesthesia) and locate a site that would tolerate this risk. It went swimmingly despite my oral valium wearing off long before they finally got to me, and I told Dr. C. all about it to help him understand how great my needle phobia is and how much I value doctors who are willing to consider this/other options.
After considerable discussion and compromise, ending when he said “I’m not willing to compromise anymore and put you at risk (and increase his low mortality and incident statistic(s).)
So now, here’s the plan. Rather than days before, the Vena Cava filter will be installed (in my leg/abdominal) artery while I am already under and during the main surgery. Phew - I don’t care what anyone wants to do to me once I’m under! However, I will need to have a “trap” placed in my arm days before that will act as an IV line (okay, good, I won’t need to suffer repeated sticks, I think?) and perhaps keep it in for weeks past surgery so I can have repeated blood draws to check my oral Coumadin levels regularly - a concession he was willing, but not overly thrilled to make. He said that he preferred the heparin (shots) and I still would have to have these while hospitalized - but would allow for Coumadin to replace this at home.
I forgot to ask when and how the trap then comes out. Yuck!
In any case, it was all I could do to refrain from running, screaming out of the door in my paper gown - as reality of every kind suddenly sank in. Let’s see - grosser than I imagined; riskier than I’d thought; more efficient but less “cuddly” staff than I’d hoped; need to prep and plan in more complex way than I’d considered. So what did I really think I was up for -club med?!
Later, at home, I whined my way through several telephone calls to close girlfriends, seeking reassurance, support and sympathy. Thank God for mortified friends! Perversely there is something reassuring in sharing the goriest of details with someone who truly appreciates the magnitude of yuck and doesn’t just try and placate it away.
My one bizarre telephone call was to Pete - best male friend, previous landlord and cohabitant for 20 years, and supposed-to-be sensitive gay man. Strangely, when I asked if we could set a date for him to come over so I could share some important news (I hadn’t yet told him anything) - maybe the cryptic nature of my request sounded alarming or suspicious, because his response was: “Why, what are you setting me up for?!”
So great, now when he does come over he’ll be anticipating an Intervention or blind date or something.
I guess that’s what happens when you don’t want to share sensitive information on the phone.
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April 26th, 2009 | 
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