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Today marks 4 weeks from my surgery date. My incisions are largely healed, and the surgical glue/scabs have fallen off. There is clearly more healing happening inside, where I can't see. My surgeon calls this 'surgical stuff'. The spot just under my left ribs is particularly tender. Is it my stomach? My hiatal hernia repair? It doesn't pain me too much.

My weight loss slowed down a bit the last 2 weeks, with the addition of purees. I've enjoyed things I never thought I would ever eat, such a dish I'm fondly calling 'tuna pudding'. Buffalo chicken dip with canned chicken is amazing. Surprisingly, ricotta bake was meh. Yogurt is still a staple. I've started experimenting with decaf tea. I would LOVE a cup of coffee, but no word yet on when I can have it. Soft foods are just around the corner, and all I can think of is tender, flaky white fish. And some soft asparagus. 

I haven't had a ton of energy. I have to sit a lot and my walks are short and slow. I'm hopeful that when I can eat a little more I'll feel more athletically inclined. Next week, I'll try the commute to my office two days a week, which involves a lot of walking, stairs, and carrying my laptop. We'll see how that goes.

I had an overnight trip this past week, and packed a small cooler with my pureed foods. It was hard to be around others eating delicious things while I slowly spooned down curry chicken salad puree. Fun fact, not drinking while you eat curry chicken salad puree is a fun game. Play with your friends. I resorted to serving it with a bit of greek yogurt on the side to cool my mouth down. Driving multiple hours without caffeine or road snacks is also a new thing. 

I've tried on some old shorts and work pants, to see if they fit yet. Some do, and some very nearly do, which is exciting. At least I won't need to source smaller clothes for a while. I'd saved all my favorite things down to about a size 14. Hopefully they are all still in style.

A little more than one week post-op update:

Pain - My incision pain decreased enough for me to feel comfortable most of the day on Tuesday, Day 6. As of today, Friday, Day 9, I can get in and out of chairs without feeling my incision pulling and needing to put pressure on it. I was able to drive my teen to work in the next town, with the support of a seatbelt pillow. I stopped by the local rail trail and had a short walk in the greenery yesterday. I'm planning to up my walking now that I don't have so much pain, but I want to take it slow so I don't overexert myself. My legs are starting to cramp from inactivity.

I've been building up to my hydration and protein goals daily, and worked up to 4 oz of liquid intake every 30 minutes. I didn't really have a schedule until I woke up on Wednesday, Day 7, feeling absolutely ravenous. The day before I had concentrated on hydration and come up a little shorter on my protein goals. So I made a spreadsheet, to plan out my protein and hydration intake according to what my stomach was capable of now, and discovered I could get a bit more in if I paid more attention to things. Yesterday, I made 72 g protein and 64 oz hydration/36 of which was clear liquids.

I have medications/vitamins to take 4 times a day, and I had been following the 30 min before/after for them, just in case, because I wanted to make sure they were absorbed. However, my dietician told me this morning that I didn't need to do that. So that clears up significantly more time for clear liquid hydration!

I weighed myself yesterday, and discovered that in the first week since surgery, I've lost 23 lbs. Part of me thinks that is a worryingly large number, but also probably a great deal of it is water weight. I did some measurements, and it appears that most of the weight has come from my arms and bust (of course). My clothes don't appear to fit differently yet, but I haven't worn most of them yet. I did notice while putting my face serums and creams on that my cheekbones and jawline seem more prominent.

One of my first NSVs is that my left ankle used to swell after sitting all day. Recently, despite sitting most of the day during recovery, my ankles have matched in size and slenderness. It's very exciting!

The best news of all is that I met with my dietician this morning and been cleared for advancing to more foods. Our program has weeks 1-3 set aside for full liquid diet, so that is what I was prepared for. My dietician said that starting today, I can start making protein shakes with fruit, and I can also have fully blended soups of any type. So that expands my diet significantly! Also, I am permitted to move to stage 3, purees, next wednesday.

Day 6, and I finally feel well enough to sit at my desk to type up my surgery experience.

My surgery was the first of the day, with a hospital arrival time of 5:30 am. My father and son came with me to the hospital. I was taken back to prep immediately and received my IV, anti-nausea patch, antibiotic shot, and all the instructions I needed to understand what would happen that morning. The pre-op area was hopping, with a party atmosphere, with surgical staff and patients pouring in, while I waited for the surgeon to arrive for my 7:30 am surgery. After the surgeon arrived, I was wheeled down to the operating room, and I got one glance of it before I was apparently sedated.

My next recollection was the recovery area, and I was in a tremendous amount of pain in my abdomen. It never improved, as apparently my surgeon only allowed IV tylenol after surgery, which I didn't know until that morning. I knew he didn't send his patients home with narcotics, but I thought I would at least have pain relief in the hospital. I was still in a large amount of pain when they wheeled me to my room, and transferred me to my bed in front of my horrified father and son. They wanted me to get up and walk, but I was so shaky from the anesthesia and beside myself with pain that I couldn't get out of the bed. Every time I tried, I felt a burning in my abdomen, which I would later find out was the largest incision. My family advocated for me, and they added Toredal to my pain relief, which is IV ibuprofen. Once that kicked in, I had a small nap, and woke up that evening with much steadier legs. At this point, my other child had joined us, and my 3 family members escorted me on my first walk down the hall. 

I knew I had to walk to get rid of the gas, which was uncomfortable under my sternum, but the only time I was able to get out of bed to walk was after the Toradol took effect, and I got that every six hours. I made the most of the moments when I felt ok to walk until I felt shaky. The gas never spread anywhere else in my body, and by the end of Day 2, I really didn't feel any extra pressure from it at all. My pain was mostly this big incision, which continues even today.

I had trouble getting comfortable in the hospital. My body is shaped wrong to sleep flat on my back, even propped up. I usually sleep on my side, which just wasn't possible. I finally got the night tech to understand my issue, and he adjusted my bed so that my butt was lowered and my legs propped up, and that put a lot less pressure on my abdomen. The morning after my surgery, I was very concerned about my pain levels without the Toradol. The surgeon visited and told me he had done a hiatal hernia repair and if the pain was too bad, when I got home, I could crush 3 motrin and take them with applesauce. I was discharged with haste, by 11 am, I was dressed, in a wheelchair and being pushed out to my father's car.

The drive home was comfortable. I had two small pillows to cushion the seatbelt and prop my side up on, and the 30 minutes home wasn't bad. I was able to climb the stairs to my 3rd floor apartment, slowly but without issue. I tried managing the incision pain with liquid tylenol, but it only ever took the edge off. Before I went to bed, I crushed the 3 motrin, which makes a LOT of powder, and I took it with several small teaspoons of applesauce. I have a wedge/body pillow set up to sleep with, and that worked very well to sleep. One of my children is a night owl, and stayed up to help with my 1 am pain relief, and the other is a capable early riser, and they got up early to help with morning pain relief and everyone hovered a bit to make sure I had the items I needed, since I still wasn't too steady on my feet. 

By Day 4, I discontinued the tylenol, because it just wasn't worth it. It wasn't making a dent in the pain, and it meant I had to stop taking in liquids for a while, to make sure it digested. I've been managing my pain with cold packs mainly. I never took a second dose of the ibuprofen because it was so uncomfortable to take it, it also didn't seem worth it. I've been taking my omeprazole and blood thinners, and this morning I started my ADEK vitamins.

I've seen a steady rise in my ability to get down clear liquids and I am able to get down 4 oz of premier protein shake in 30 minutes, which is what my dietician wants me to do, every 3 hours. I would like to have more clear liquids in a day, but I can't seem to find the time to get them in. Between medications and meals, and having to stop for 30 minutes before and afterwards, there just isn't math that equals to me being able to drink the 64 oz of clear liquids PLUS 80 grams of protein a day. I need a much bigger capacity to do that. My urine is the right color, so I'm not dehydrated at least, but I am thirsty.

Big flavors aren't as appealing as they had been before surgery. I prefer plain water, herbal tea, and watered-down broth to full flavor anything. I am drinking some gatorade zero every day, for the electrolytes. Nausea hasn't been a problem yet, though I do get a lot of stomach gurgling when I take my medications with applesauce. I definitely feel pressure and get a hiccup when I am full, but it's not uncomfortable.

Energy-wise, I am able to walk around the apartment and take a few strolls around every day. Around 4 pm every afternoon, I usually take a nap for about an hour and a half, and I'm no longer waking up in the middle of the night. The incision pain isn't as raw as it was at the start, but it does pull when I get up and down from my seat. The cold packs help a lot. I'm really looking forward to being free of that pain.

I'm looking for a little more diversity in my full liquid diet, which I'm on for 15 more days (unless by some miracle, I'm cleared early). I did step on the scale yesterday and was a little alarmed that I'd lost 20 lbs since surgery. That seems like a LOT in five days. Perhaps I was retaining a lot of water?

Initial consult with the surgeon later today. I'm excited and anxious. Taking my list of questions, and a great many deep breaths. Wish me luck!