My gastric plication journey begins.....
After doing a fair amount of research I have decided to get gastric plication. Although I am a low BMI candidate my weight just keeps on climbing and attempts to lose it just end up moving me higher on the scale. I knew from the start I did not want any cutting so my choices were narrowed down to the band and plication. As a self-pay patient the cost of both surgeries were similar. Because I do a lot of traveling for fun to remote places I decided the band could be more of a barrier to safety. From the research that is out there I was happy with the outcomes and low associated risks with plication. Initially I liked the idea that is was a reversible procedure however my surgeon was very candid that new tissue will form and is not as easily reversed as promoted. Because plication is still considered to be an experimental procedure in the US I would have to be enrolled in a study. The amount of follow up and monitoring after surgery also felt a bit comforting knowing I would be monitored closely.
Day 1 - Thursday June 20th, 2013 - Surgery
I arrived at 6:15 am and was back on my way home by 11 am. Felt pretty miserable waking up from surgery, was in pain and had a strong urge to vomit. The nurses who were very caring and attentive had me up walking immediately and I was given the max dosing allowed of Dilaudid before going home to make me as comfortable as possible. On the drive home my hunger was through the roof. I wanted a plain hamburger, bread or mac-n-cheese which my brain was telling me I would feel better if I had. My stomach felt like a pool of acid. At home I tried to take sips of water, melted popsicles and even tried a little broth. Nothing would go down without a lot of pain. By 5pm I decided to call the clinic and let them know how I was feeling. The MD suggested I come in the next day to get IV fluids if I continued to have trouble getting fluids in and she bumped up my anti-spasmodic meds from every 6 hours to ever 4 hours. I'm definitely having feelings of 'what have I done to myself' which I think are pretty normal.
Day 2 - Friday June 21st, 2013 - The nurse called in the am to check in on me. I was feeling better as long as I didn't try and take anything in. She thought it best I come in for fluids to play it safe over the weekend. While I was there they performed a fluoroscopy and the MD said everything looked fine. I was given permission to take some chewable antacids and this seemed to help a bit. I was still craving bread and between the meds, juice, broth, popsicles my stomach continued to feel like a pool of acid. I tried to stay on top of my medicine and during the four hour period had about 2 1/2-3 hours of comfort. For about 20 minutes after taking the meds I felt rotten, had some relief for 2 1/2-3 hours and then started to feel unwell again after the meds started to wear off which was about 30-40 minutes before my next dose.
Day 3 - Saturday June 22nd, 2013 -
Most testimonials online I have read indicate people are feeling better after 48 hours. It's been over 58 hours and things have yet to feel like they are letting up so I am feeling a little discouraged. I've also been fretting over the fact I will not be able to eat the same in front of people I know and they will figure out I've had weight loss surgery which I am choosing not to disclose for various reasons. Tonight is one of my friend's 40th birthday party and I am going to miss it as I don't feel up for it or want to explain why I'm not eating or drinking. I'm feeling a bit guilty and sad not to be there. My husband decided to go without me and I am somewhat amused that my friends are asking if I am pregnant suggesting that I might have morning sickness. I also have my brother's wedding coming up in 3 weeks so that will be interesting but I'm just trying to go day by day and not get to far ahead of myself. Been consuming some Jello today and that seems to be going down the best. Water feels like its just diluting the acid feel in my stomach. My incisions are itchy so I am keeping an eye of them and decided to rub a bit of antibiotic ointment over a couple that are red. I'm also monitoring my blood pressure and temp. Blood pressure is a little high but temp is normal.
Day 4 - Sunday June 23rd, 2013 -
Was able to get in 4 hours of sleep before waking with pain and discomfort. I've been taking short little naps throughout the day once my pain meds kick in and I start feeling drowsy. Went to the store and bought some coconut sorbet, chocolate pudding, yoghurt, chicken and beef soups which I had to strain, and some oatmeal, although after reading through my post-op instructions discovered I needed to wait until week three before trying. Today is my third day so I am able to progress to full liquids from clear liquids. I was elated to be able to consume about 1/4 cup of chicken soup broth using a baby spoon to help slow the intake. I took about a teaspoon of pudding and decided I wasn't ready for it. I'm able to suck on cold popsicles and take a few bites of sorbet. At first I was nervous as I read the cold can actually make the stomach feel worse and spasm, but thankfully I don't have any discomfort and the cold feels satisfying. By now I feel like I'm getting into a little routine and am learning a few tips and tricks. I am even trying to space out my meds a little more. Here's what's working for me:
- No lying completely horizontal. If I wake up and have slid down off my pillows I will have pain. I suspect I may have a bit of reflux. following my surgery.
- Stay fully upright at least 10 minutes after taking something in and move around.
- chewable tums and gas-x are my friend.
- walk or wiggle around at the slightest feeling of pressure and after taking in liquids. Taking an extra couple sips of something can also help to release the gas if it feels stuck.
- set a timer and take in a few sips of fluid every 20-30 minutes
- brush your teeth and rinse the mouth out as much as needed to get rid of the acidity and sickly medication taste.
I've been a bit cranky towards my husband today but he is remaining supportive. So thankful for him.
Day 5 - Monday June 24th, 2013:
Woohoo I slept for 6 1/2 hours straight. Got up at 6am had a Tums, Gas X, and a swig of pain killers and was able to go back to sleep after 10 minutes of upright positioning for another 4 hours. I am finally starting to feel good, so much so that I started to clean the house and did some work on the computer as I can focus on something else besides the pain and discomfort the last few days. I weighed myself this morning and I am down 4lbs. Who knows how much of this is water weight, but I am excited nonetheless. For breakfast I decided to try a protein cappuccino coffee from Pantry Selections and an hour later had a chewable vitamin. I have yet to have a bowel movement from surgery so hoping that adding the meal replacements will help but have decided to take a laxative in the evening if no luck to be on the safe side. I've noticed a few single hiccups here and there so I'm keeping up with the anti-spasmodics but am going to try and taper the pain meds and anti-nausea meds. My strategy to take something in every 30 minutes or so seems to be working. Pain and discomfort are diminishing and I have a reasonable amount of energy which I read can really be lacking status post surgery. I'm trying not to exceed 1/8-1/4 cup sips of liquid at a time or 3-4 spoonfuls of 'approved substances'. I was able to take in some yoghurt, odwalla carrot juice, jello, broth and liquid protein fruit drinks. My husband has been banished to another room when he decides to eat as my solid food cravings are high. I would love to have something savory and crunchy but keep reminding myself I can't do anything that will compromise the safety of my surgery! Blood pressure is down today! In the evening I decided to take a shower. I covered my incisions so I could just take my time. Was able to make it through the day without any pain meds and anti-nauseau pills but I plan on taking pain meds before bed to ensure I have a good nights sleep.