I know, I know, I should have started this before surgery, but instead I'm staring it 3 weeks after surgery, so let's see if my memory will let me get caught up.  

Background: 

I've lost and regained all of my excess weight the old-fashioned way a few times, but I had been resistant to bariatric surgery until I heard about and researched VSG because I was concerned about malabsorption and dumping syndrome.  The last thing an aspie with life-long IBS needs is dumping syndrome.  Even after reading up on VSG, I was leery to try it because I didn't want to lose the enjoyment I have from cooking for my wife and exploring the culinary world.  We talked about it a lot.  Finally, we decided that the benefits would outweigh the struggles in the long term when I became very unsettled by no longer recognizing myself in mirrors.  (That's not to say that pain and fatigue weren't an element, or wanting to be there for my family long term, or wanting to avoid the severe loss of quality of life my mom suffered after 50... But those were already there.)

Pre-approval classes: 

Before surgery with Kaiser So. Cal, I had to go through their Options class.   What I learned from the class is that if one instructor seems to have unreasonable demands and/or rubs you the wrong way, there's usually another with a different approach.  My first instructor was a "tough love" type, and if you know anyone on the Autism Spectrum (like me), you know that tough love doesn't work with us, especially when we're trying to meet you half way, but need more information to do so.   Long story short, first instructor operated by goading the class, and some people need that.  Some people do better hearing "don't ask - just do" while others need to know how they can tailor a plan to their other medical problems.   This instructor insisted on 60 min, minimum, of moderately strenuous exercise per day, and all that did was destroy the little cartilage I had left in my knee.  I could have really used that cartilage post weight loss! 

It got so bad, I almost quit entirely, when I found out that I could finish the class with another instructor, and what a fantastic instructor she was!  She answered questions, explained the whys of everything, and she was honest that each post-surgical plan will be unique to the individual.  I finished the course within a couple of weeks then, and I had my clearance to request an appointment with the surgeon by Feb 13.  She also helped out by telling me which hospital tended to have the shortest wait. 

Approval: 

I had my appointment with Dr. Zane on March 10, and all of my labs were good.  No sign of diabetes.  Weight loss of 25lbs the old fashioned way.  Blood pressure a little elevated but not too bad.  Fibromyalgia? Bad.  Joints and back? Crazy painful. Dr. Zane agreed that I was in a great place for VSG, and when he asked when I'd like to do the surgery, I told him "I'll take the first opening you've got."   As it turns out, he had one last opening available for March 27, and I took it without a moment's hesitation. 

Pre-op & Surgery Day: 

To get ready for the surgery, I had to observe a clear liquid diet for the two days leading up.  That, alone, made it tough for me to eat.  Looking back at my logs, I was lucky to make 600 calories a day those two days, and that was only by virtue of being able to chug protein water.   No chugging after surgery, though! 

Surgery day, my wife, MiL, and the service dogs all trundled down to the hospital.  We arrived only to discover that we had a two hour wait before check in time!  So the lucky dogs got a nice long walk around the new hospital complex with all of the flowers in bloom, and I think everyone felt better for that.  

Once I checked in, I was given a robe to change into and a pair of disposable hospital underpants that were made of the most uncomfortable material ever invented.  They had a texture a bit like stretched out gauze, and (TMI alert!) my butt is STILL healing a patch of chafing from them 3 weeks later.  Just so you know, part of the surgery involves you being sat up in the OR, so if you have mysterious butt bruises or soreness, it's probably that.  I had no idea. 

Okay, so, hospital, gown, TMI, and now I met the surgical team.  Two anesthesiologists, both of whom were incredibly cool.  Don't be shy about telling these guys if you have nausea issues. Everyone kept me WELL drugged to avoid any vomiting.  They also made adjustments for my long-term use of extended release morphine, so make sure you tell the docs about that, too.  I remember being wheeled into the OR and my doctor making a joke.  I was just alert enough to respond to the joke and then they knocked me out. I went out while being transferred from the gurney onto the operating table, which was so bizarrely narrow. 

After surgery, I woke up on the most comfortable hospital bed I have ever been fortunate enough to experience.  I guess it's because it's the bariatric ward and the beds have to be comfortable enough for people significantly heavier than me, but it's the first time ever in hospital that I wasn't squirming in discomfort because of the mattress.  Aside from that, I woke up thirsty and in zero pain.  I think I only used the pain pump 4 times during my 24 hours in the hospital.

I also want to mention that I woke up feeling incredibly positive, motivated, and ready for the future.  For someone who's suffered major depression most of her life, that was kind of amazing. Endorphins, maybe?  

I slept and dreamed of cooking delicious things and serving my wife and MiL afternoon tea on our deck, enjoying the process of creative cooking without needing to eat it.  I still want to do that.  (But I'll probably join in, at least for the tea...) 

Shortly after napping, I felt well enough to walk around the floor, and I fell into a routine of getting up to pee and then going for a walk.  No catheter involved.  Kaiser also had a set up for bariatric patients of single rooms with fold out chairs that allow a family member to stay with you overnight, and that was invaluable.  I don't think I slept much after the time immediately post-op, and my will to exercise was a lot greater than my stamina.  I was also incredibly grateful to the suggestion I read somewhere to bring your own pajamas and robe, etc.  I'm sure that helped with morale. 

Food, or "food" rather, was diet Ocean Spray cranberry juice (ugh), chicken broth that tasted exactly like KFC fried chicken (still don't know what's going on with that one), jello (didn't touch it), and ice chips.  I found the salty broth and the ice chips the easiest to eat, but I also discovered I had a bad case of water nausea.  That's only just starting to go away, and I'm a person who LOVES drinking water. 

So, thanks to the soup, I met my Dr's expectations, and when he came in the next morning in between surgeries, I was bright eyed and bushy tailed and ready to go home.  He warned me that I had one stitch "to remind me I had surgery," and said my healing looked good to him.  Don't scrub the surgical glue or get it too wet, and then Discharge ahoy! Dr. Zane released me onto a full liquids diet and out the door I shortly went.  I was also told that I'd had heparin shots (one last for the rode before I left the hospital) and a LOT of IV antibiotics. 

It was an absolute dream to slip into my own clothes, but if I had thought it through more, I would have brought something other than comfortable jeans.  Even though they sat well below my incisions, they pushed up on the incisions just enough to cause a case of the ouchies and enormous relief upon arriving home.  Having a pillow to hug to my stomach helped a lot on that car ride and on car rides for the next week and a half or so.

First week post-op:  

I have 5 incisions, and the "big bad" where my stomach was extracted is just to the left of my belly button, about an inch long with almost no bruising at all in spite of the heparin.  Dr. Zane assures me this is because my surgeon is just that awesome.  I love him for his modesty. 

That one stitch he mentioned was a tiny slice of hell for the first week and a half.  Rolling over or sitting up were painful enough to make me see spots and yelp, but that did go away as the sutures began to dissolve.  So if you're in that kind of pain, know it does go away, and it's just whatever stitches you have being evil.  In fact, they were so evil that on the first and second night home (where the IV pain meds had worn off), I was in so much pain, I spent most of the night wandering back and forth across the dining room and kitchen with a pillow clutched to my stomach.  The third night, I managed to sleep all the way through, and then some. 

Taking my medicine for the first week was probably the hardest part.  One pill at a time with only enough water to wash it down.  Did I say water? I meant water with a splash of juice.  I couldn't tolerate plain water or artificial sweeteners at all.  And I did try.  Unfortunately, my sensitivity to artificial sweeteners has only gotten worse post-op, which made it increasingly difficult to get my protein in.  

My salvation?  The discovery that milk is still not only delicious but that I did not develop an intolerance to dairy!  Granted, I always drink lactose-free milk, but I also have no problems with cheeses or yogurt. So, fat free lactose free milk kept me going when the going was rough.  It took the best part of an hour, at this point, to get down a 12 oz glass of liquid.  I spent a lot of time sitting at the dining room table staring resentfully at a glass half full.  It did gradually get easier as the first 10 days progressed, and the evening before my follow up with the surgeon, I had a delicious dinner of Tom Kha Kai (broth only) from my favorite Thai place, and the spice was deliciously soothing.  YMMV on that part, but I was raised on salsa. 

The other discovery I made the first week is that walking was suddenly easier.  I wanted to walk.  I felt like I could just keep walking forever.  That's a feeling I haven't had in a long time.  

By the time I went to my follow up, the majority of those struggles were in the past.  And one was in my future: thrush.   

Follow up appt & the 2nd & 3rd week: 

At the appointment, my Dr. asked me how I was feeling, how I was healing, and how I was doing at keeping things down with the full liquid diet.  It was all going well there, with 20lbs lost since surgery, so he cautioned me that everyone has a 2 week stall about 2 weeks out, and he moved me right along to soft foods.  I asked him what's the difference between soft foods and mushies, and he answered "they're the same."  After asking a few questions, it became clear that he combines those two groups and emphasizes that the food has to be soft even before you put it in your mouth.  No chewing chips until they go mushy.  I have no problem with this at all.  

He also diagnosed me with thrush.  Ugh!  The mouthwash treatment was intolerable, the tablet treatment, slightly tolerable, and the pill, completely tolerable.  What a pain in the behind to deal with while learning to eat again!  Especially with soft, mushy food.   It did put me off eating for a few days, but things got better once the medicine kicked in.   So make sure you can find a yogurt to take in during that first week after the IV antibiotics! 

Other than that, the Dr. said I'll be on this soft/mushy stage until my next follow up with his nurse, the beginning of may, so here's how I'm allowed to eat now: 

• 4 tablespoons of food per meal, max.  (I've only managed the full 4 a couple of times.  More often, my meals are closer to 2T, and I feel full) 
• 4-6 meals per day 
• No water or drinks for 30 minutes after eating.
• All food must be soft and moist. 

On the way home, my wife and I celebrated by swinging through Taco Bell to split a Pintos & Cheese.  It takes me about 30 minutes to eat 2.5T of it, one tiny mouthful at a time.  We're talking Barbie spoon size for that first meal!  I also had to wait another 30 minutes for the nausea to go away before doing anything else. 

Since then, I've been living primarily on beans, soft cheese (queso fresco is a favorite!), yogurt (plain with cinnamon), the occasional tuna salad, and lactose free fat free milk, still 1-2.5T for most meals before I feel that sensation that the next bite will not be appreciated in my stomach.  That feeling really does seem to be different for everyone.  For me, it's a subtle hiccup-like sensation in the back of my throat.  I have missed the signal a couple of times, and yes, I did throw up.  Throwing up itself is an interesting experience post-op.  It's not the same "oh my god I'm turning inside out!" feeling I remember from before.  With the exception of my body rejecting a vitamin it did NOT like, throwing up since the surgery has been non-painful and over quickly with very little bile involved. 

My birthday happened during this time, and I had a treat of curry rice in Little Tokyo for lunch, cheese enchilada and beans for dinner out with family (shared the dish with my wife, who ate most of it), followed by a birthday flan the table shared, and then at home, a bit of ice cream birthday cake and some out of this world raspberry sorbet from Fosselman's, a local family-owned ice cream parlor that's been dishing out the good stuff since 1914! 

Some of you are probably wondering if the carbs on that day set me back at all.  The answer is: nope.  Remember, this is only one day, and each serving was 4T or less.  I had a great time downtown on my birthday and got in a lot of walking with my family while we explored Little Tokyo together.  

And then I crashed into bed and slept for 36 hours.  No joke!

During this stage, I also had my first post-op experience with stairs, and my heart would race like crazy by the time I got to the top.  It turns out, that's a sign of dehydration.  Once I got to the point where I was getting in my full hydration, the racing heart issue stopped.  

Now, I seem to be evening out a bit as I get the hang of things.  I still eat with the family when there's a family meal, and I focus on the soft foods that I can eat, protein first. When they have tostadas, I have beans, queso fresco, crema, and salsa. When they have Eggs Benedict, I have egg and avocado with a teaspoon of hollandaise.  When they have spaghetti and meat sauce, I have meat sauce.  My travel food is low fat string cheese, or in a pinch, Taco Bell Pintos & Cheese.  My wife and I split a lot of meals.  My most recent meal was beans, salsa, and requeson from the middle of her burrito.

Working out a plan to share meals with your SO has been a great way for us to keep eating together and enjoying food as a shared experience while keeping me within my requirements after VSG.  

I've also been pleasantly surprised with HOW the weight is coming off me.  It seems to be coming off from the areas that were deforming my shape first.  I used to be one of those larger people who stays perfectly in proportion, just large.  I'm moving quickly back in that direction, and that alone is heartening.  I do suspect that part of the reason my waist went down as dramatically as it did is due to the actual removal of 85% or so of my stomach.  Considering how much I could eat in a sitting before without feeling full, I would imagine my stomach was on the large side. 

I'll have to ask about that during the follow up.  

What else?  I'm on the verge of crossing down from Obesity III to Obesity II, which feels like a great landmark to pass.  I'm wearing clothes I haven't been able to wear since a major injury pushed me from "hanging in there" to "nope" back in 2014 by severely curtailing my physical activity. My clothes are fitting better even when they're loose (except my damn bra, which is too big around the ribs now and a collection of underwear that think they're thongs).  My vintage-style dresses no longer REQUIRE a petticoat to hang correctly over my hips, although petticoats are always cute, and I suddenly have more leggings and tank tops that are actually comfortable to wear again. 

It's like shopping in your own packed wardrobe and the opposite of all of those miserable shopping trips where nothing fit right. I'm glad I never gave up hope that I would be able to wear these things again.  I really am.  Hopefully by summer, I'll be able to fit into my favorite size 17 capris. 

#GOALS