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A different kind of leak...



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Hi all! I'm new here so I'll just tell ya'll what's transpired since last June! (Some of this is copied & pasted) Sorry it?s so long, but it helped to type it all out! Some background ? I go to school full-time and work full-time. In addition, my dad has alzheimers and I help my mom with him plus my husband is having health issues so I was dismayed and depressed as my tale unfolds?..

June 2008 - went to the weight loss seminar sponsored by the hospital where my husband works. This really well-spoken surgeon spoke about the different options: band, bypass & VSG. Afterwards, having never heard of the VSG, I started researching and found info on PubMed (medical research), most of the articles I found were from overseas, but I thought that it sounded like the right fit for me! Nothing left in inside (band & port) and no malabsorption (bypass) were huge pluses in my view. I've taken care of several patients who have had problems with these surgeries and didn't want to run into complications in the future (I'm a surgical/shock/trauma ICU RN). A big plus at this time was that the insurance would pay for the surgery!

July 2008 - Called surgeon's office and scheduled appt with him and with all other specialists (their psychologist, nutritionist, internist) for evaluations and tests. Told surgeon's office I was shooting for surgery in October.

October 2008 - No surgery yet - the therapist at the psych ofc wrote a good letter but ended it with the statement that I would benefit from more therapy before surgery - and the insurance company turned me down! She recommended a year! Later found out that she did the same for other people too. Spoke with school counselor (yes I'm still in school - grad school!) and she (PhD in psychology) and the psychiatrist both wrote wonderful letters stating that I was ready! Surgery rescheduled tentively for mid-December - just waiting on insurance reapproval.

December 2008 - insurance company hasn't met to reapprove and now rescheduled for early January.

January 2009 - the )&_^^*(&(*& insurance company still hasn't met to re-preapprove. I can't afford the surgery without insurance!

*Finally got approval in mid-January and surgery scheduled for March 10th!

February 18 - Well, just got a call from the surgeon's office - he can't do my surgery on March 10th - he's going to be in Saudi training surgeons there! I'm so disappointed, I've worked so hard to lose the 20lbs before surgery and was so excited that the date was only 3 wks away & now because of school & work I'll have to wait until May. This is the 3rd time it's been moved... Oh, the nurse says that the trip might get canceled, but they won't know until March 2 or even until the 5th. My husband took off work to be with me and I took off work, now I have to try to get time off in May - the busiest month for vacations...I just want to be done!

March 1 - Great news everybody - my surgeon couldn't get his visa from the Saudi govt in time for his trip, so my surgery is on for the 9th!! I'm so exited! And just a tiny bit nervous - I've already paid my out-of-pocket expenses and have requested the anesthetist I want. (I'm an RN in the shock/trauma ICU at the hospital where I will have my surgery and since I know most of the surgeons & anesthetists, I wanted one who would go the extra mile in insuring my privacy - I don't want all my coworkers to see me naked!)

March 5 - Ok, I had my preop yesterday and am now on a liquid diet until surgery on (drum roll please!) Monday, 3/9 at 0730! Weight ? 235.5 ? already down 17lbs! I AM SO EXCITED! Last night the hubby and I went out for my 'last supper' and our anniversary (1 week early) and I was so excited that I could barely eat! I have to work all weekend so being on the liquid diet won't be too hard since we hardly get enough time to go to bathroom much less eat! The surgeon & I discussed going back to school & work afterwards and he said school is no problem as long as I use my wheeled bag and not the backpack, but that I may have to wait a while for work especially since ICU nursing is so physical.

March 9 ? slept really well and managed to get to hospital at 530am (I only live 10 minutes away); didn?t have to wait long for them to call my name to go back to preop. Got stripped down and into gown. RN in to start antibiotic by iv and get all the vital signs down. Several of my friends dropped by to wish me luck (they?re all nurses too!). Then read a little and watched some of Good Morning America while waiting. Anesthesiologist finally appeared at about 7 and we?re off! Down the hall to OR, where as soon as we entered they gave me the midazolam and I was off to lala land. (gotta love sedation!) Don?t remember much after that until they were moving me to the bed in my room on the bariatric floor. Husband, mom, dad, & daughter were all waiting for me. Made some stupid jokes and fell back to sleep for an hour. Woke up and decided that I had been in bed long enough (a whole 6 hours), talked the nurse into letting me up and I was off & running. Managed to walk around most of the afternoon ? very boring laps. Still nothing to drink until after barium swallow in am.

March 10 ? slept well again except when they woke me up for labs! Up and walking again, husband came and brought his Breakfast to eat with me ? mind you I still haven?t had anything to eat or drink yet! He ate waffles, bacon, sausage, fruit & toast ? yes, he needs to diet too! Smell of food actually made me feel nauseous. Went down for barium swallow, MD says looks good, but won?t discharge me until my surgeon comes back in am.

March 11 ? home with follow-up visit on 3/18. Surgeon said swallow looked good with no leaks. Once home, it?s hard to keep up with liquids, but keep plugging away at it.

March 18 ? go in for follow-up visit ? weight 212 ? on my way down. Feeling okay, but still having problems with keeping up with fluids, running about 8-10 ozs behind goal.

March 26 ? starting to feel like I have the flu, just feel sluggish and achey. Go to work that night and just keep sweating ? of course the plastic gowns we have to wear into patient rooms don?t help.

March 27 ? go to work again and spend all night wondering why I just don?t feel well. No fever, no pain, just not hungry and sweaty.

March 28 ? go to work and really feeling bad around 1am. Feel like I can?t catch my breath, have coworkers and MD on unit listen to lungs and one said that my left lower lung sounds ?wet? but others said it sounded clear.

March 29 ? slept, only got up to drink Water or go to bathroom. Running 103.5 temp.

March 30 ? go to school and went to back to bed when I got home. Ole? tattletale that I married called the surgeon?s office and spoke to nurse practitioner, told her what was going on, she suggested I take an antibiotic that I had on hand and if not better by Wednesday to call back to come in. Still running fever.

April 1 ? not a good April Fools Day ? still feeling crappy, so call Dr ofc to make appt; tell Dr I think I have pneumonia, have fever of 102.9. Dr wants to admit to hospital. Get to hospital with father and husband in tow, go thru admission and on up to bariatric floor. Greet the wonderful (truly!) nurses that I had during surgery and enter room to find no TV or phone. Nurse and friend try 6 times to start IV, but am so dehydrated that it?s near impossible ? they finally get one in in the bend of my elbow (AC for you nurses!). so I can?t bend my arm. Dr orders xray of chest & abdomen, CT of chest & abdomen, blood cultures and IV antibiotics to start ASAP. Two hours later moved to new room with TV & phone.

April 2 ? Xray & CT show a leak ? not into my abdomen but into an air bubble that has gotten big enough to rub and irritate the diaphragm and cause the pneumonia. The bubble is close the very top of the staple line, but Surgeon and his partner want me to decide on conservative or risky ? DUH ? conservative! Will be getting a PICC line (long-term IV) with TPN (IV nutrition) for about 2 weeks ? nothing to eat or drink for 2 weeks except my medications. SIGH!!!!

April 3 ? nurses give me my antibiotics by mouth and I promptly throw them up. Dr decides that I need to stay over the weekend to get more IV antibiotics since I can?t swallow them. The PICC team comes in to start my line in the right upper arm and it HURT! But now I can bend my other arm and I don?t have to be stuck for labs anymore! End result of day ? don?t even get water to take with meds.

April 6 ? go home and wait for home health nurse and delivery of TPN. Have to show nurse how to set up IV pump and how to mix the TPN ? SIGH ? I can?t tolerate incompetence. She can?t even take my blood pressure right! For 150 a visit, I think I can expect some competence, right?

April 7 ? May 4 ? on TPN for 5 weeks ? had a repeat CT after 2 weeks ? leak still there and dr wants me to go for 2 more weeks. Still nothing to eat or drink ? eating is not a problem but my mouth is so dry! Go for 2nd CT and then have to wait for Dr appt on 5/5. Went back to work around mid April with the IV line just can?t take of infectious patients and have to wear long sleeves.

May 5 - 5 ? leak is smaller than ? of my pinkie nail and, joy!, I get to start all over with clears to pureed to soft ! Dr says I?m averaging 5 pounds a week and he expects it to keep up. So I?ll be skinny in time for my 30th high school reunion in August. Plus I get to start exercising again!

May 18 ? never knew babyfood could taste so good ? all it needed was salt & pepper! Can only finish a 2 oz jar but it?s so good to eat. Have a co-worker take out PICC line (MD said we could) and wow it feels great to get rid of it!

May 29 ? go to wedding ? try a bit of cheese and strawberry and I?m full! (Bride was absolutely gorgeous) Bought a new dress to wear ? size 16 down 4 sizes!

June 2 ? not having any problems hydrating but still can?t manage more than 2-3 ozs ? but I?m down to 189! Hooray!!!!!! If I had to do it all again ? I would still have the surgery, even with everything that has happened ? I?m doing well now & losing weight, my scars are almost gone, I?m passing all my classes and while Dad & husband aren?t getting any better ? they?re not worse either! So life is gooooood!!!!

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You certainly went through a lot but I'm glad to hear you came through it. Why is it RNs always treat themselves last? LOL. Congratulations on your loss. I'm sure you'll wow them at the reunion!

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