I have noticed some interesting things since my surgical ERCP. I was always kinda disappointed after my gastric bypass that I was an inconsistent dumper at best. I did this surgery this way because I wanted those very specific rules to help me eat right. The inconsistency allowed me to test the waters which was always a little scary.
But since the surgical ERCP - I dump like a truck. The littlest bit of sugar and I am miserable ... for hours! I talked to my bariatric surgeon about it when I had my follow up appointment with him earlier this week. He said it kind of made sense because now that they opened up the sphincter of oddi the bile, etc... is making it to the intestines much better - that would be assisting in the dumping syndrome.
Also, since the surgical ERCP my weight loss has kicked back in. I have been quite steady for at least 8 months. Now I am losing weight again. I am down to a weight my scale has never seen and only 6 pounds from my goal weight! I am more motivated than ever! Especially since I am very limited in whatever exercise I can do because of my foot. If I can't exercise I need to pay closer attention to what I'm eating.
Showing posts with label Dr. Paul Enochs. Show all posts
Showing posts with label Dr. Paul Enochs. Show all posts
Saturday, September 18, 2010
Thursday, August 26, 2010
Plan of Attack ... Finally
After being in the hospital for 4 days I have finally met with the right doctors and we have a plan of attack. I won't go into all of the details around the cluster that has been my life in the hospital. Major mass confusion on my condition and the resulting communication around it was a nightmare. The important thing is this:
The MRCP that was done did not show any stones in the bile ducts - it showed enlarged ducts - not uncommon after the gallbladder has been removed. But my blood work shows that when I have these attacks not only do my pancreatic enzymes elevate - so do my liver enzymes. This is evidence that whatever is going on is affecting my liver - almost like things are backing up there. So while the MRCP is not really showing anything definitive - the bloodwork is indicating that there is a problem.
So the next step would be an ERCP which is an endoscopic procedure (a camera down the throat) that would allow the doctor to visualize the ducts and do a sphincterectomy to relax that muscle. As I previously stated that is difficult after you have had gastric bypass surgery. So instead of it being endoscopic - it will now be done laparoscopically and surgically. They are looking to specifically go in and make a cut in the Sphincter of Oddi to allow that muscle to stop acting like a dam.
All of this will be done tomorrow afternoon whenever the GI Surgeon and Dr. Enochs can coordinate their schedules in the operating room together.
Seems pretty straightforward doesn't it? I have been in the hospital since Monday afternoon and just today at lunch was allowed clear liquids. I have to now stop because of the procedure I'm having tomorrow. This has been absolutely crazy. I'm really ready to be done with doctors and hospitals and being poked and proded. I'm ready to be done with all the pain I have had. I don't get bored easily. But I have been BORED being here the past 4 days. It looks like I will be here until at least Saturday now. Today I was told I was the most sane person on the floor - this after I unleashed the Wrath of Pam in order to get SOMEONE - ANYONE to tell me what the heck is going on. That can't be good! :)
The MRCP that was done did not show any stones in the bile ducts - it showed enlarged ducts - not uncommon after the gallbladder has been removed. But my blood work shows that when I have these attacks not only do my pancreatic enzymes elevate - so do my liver enzymes. This is evidence that whatever is going on is affecting my liver - almost like things are backing up there. So while the MRCP is not really showing anything definitive - the bloodwork is indicating that there is a problem.
So the next step would be an ERCP which is an endoscopic procedure (a camera down the throat) that would allow the doctor to visualize the ducts and do a sphincterectomy to relax that muscle. As I previously stated that is difficult after you have had gastric bypass surgery. So instead of it being endoscopic - it will now be done laparoscopically and surgically. They are looking to specifically go in and make a cut in the Sphincter of Oddi to allow that muscle to stop acting like a dam.
All of this will be done tomorrow afternoon whenever the GI Surgeon and Dr. Enochs can coordinate their schedules in the operating room together.
Seems pretty straightforward doesn't it? I have been in the hospital since Monday afternoon and just today at lunch was allowed clear liquids. I have to now stop because of the procedure I'm having tomorrow. This has been absolutely crazy. I'm really ready to be done with doctors and hospitals and being poked and proded. I'm ready to be done with all the pain I have had. I don't get bored easily. But I have been BORED being here the past 4 days. It looks like I will be here until at least Saturday now. Today I was told I was the most sane person on the floor - this after I unleashed the Wrath of Pam in order to get SOMEONE - ANYONE to tell me what the heck is going on. That can't be good! :)
Wednesday, February 10, 2010
Internal Hernia
So I posted back when I had my 1 year follow up appointment that the doctor was concerned about some intermittent pain I was having and said that one of the things it could be was an internal hernia. We talked about when enough was enough, but never really came to agreement on when that point would be.
Monday I had some achiness in my abdomen most of the day. It was occassionally enough to make me pause - not enough to deter me in my daily activities - but always there in the background. So I thought I would call the surgeon's nurse practitioner on Tuesday morning sometime and leave her a message to see what she thought.
So Tuesday morning I was woken up at 5am with excruciating pain in my abdomen. I immediately camped out in the Land of Denial - where I am the Queen. I told my husband that I was a little concerned, but I had too much to do. I would call the surgeon's office when it opened. My son had an orthodontist appointment first thing in the moring. I took him, but as I was driving to the appointment I was thinking "This was not the smartest thing you've ever done, Pam." I got him through the orthodontist appointment and I left a message with the answering service at the surgeon's office. As I was leaving the appointment with my son I called my mom to let her know what was going on. She talked me in to pulling over - that I really shouldn't be driving. So I pulled over and she and my dad came and met me where I was. My dad took Caleb to school and my mom took me to the surgeon's office.
After waiting a couple of hours to see the surgeon ( he worked me in to his schedule instead of sending me to the ER which I greatly appreciated) he felt that this was a hernia. Of course, there is no way to know for sure unless you go in surgically to look, but I was presenting with classic internal hernia symptoms. He had an opening in his schedule for the next day, but he didn't want me to wait because something like this can go south really quickly. His partner was already at the hospital and thought he could squeeze me in to his schedule in the afternoon. So we scheduled things with the scheduling nurse for later in the afternoon and headed home for a couple of hours to set some things straight.
To make a long story short we waited and waited and waited for Dr. Tyner, but he was called into a life threatening emergency surgery situation. So Dr. Enochs came back to the hospital to perform the surgery himself. Have I mentioned how much I love that man? Surgery did not start until after 9pm that night and I did not get back from recovery until after midnight. Dr. Enochs did find an internal hernia and he was able to repair it quickly. He also looked for adhesions (or scar tissue) from past surgery that might be catching things and he did an upper endoscopy while he had me under to look for an ulcer, etc... I had no adhesions and no ulcer, and they caught the hernia before my intestines were damaged.
So I spent most of the day today hanging out at the hospital waiting to be discharged, etc... Dr. Enochs was able to perform the operation laproscopically (sp?) so I was pleasantly surprised that I was not in as much pain as I had anticipated. Of course, I am convinced that they always send you home just as the really good drugs wear off so that they don't have to listen to you when the real pain hits and now that I am home I am a good deal more uncomfortable than I was in the hospital.
So an internal hernia is different than the hernia that most people think of when they hear about hernias. Most people think of umbilical hernia's (where the intestine pokes out by your belly button), or groin hernias or hiatal hernias (where part of the stomach gets stuck through the diaphragm). While this type of hernia (internal) is fairly common with gastric bypass patients it is very uncommon otherwise and most doctors won't diagnose it properly. It won't show up on ultrasound or CT or MRI very well and many "regular" doctors aren't very aware of the increase in icidents with gastric bypass patients, etc... The more common type of hernias involve the intestines poking through the abdominal wall or through the diaphragm or into the groin area. Internal hernias are different in that the intestines kind of fold in on themselves. You loose a lot of fat in the abdominal area and it leaves the intestines kind of loosey-goosey (yes that is a very technical term) and they can end up folding and going into spaces and spots that they shouldn't. This is what happened with me - and when that happened it got stuck - causing the pain. It is important to "un-stuck" it quickly so that the intestine isn't damaged or twisted or creates an obstruction or dies. I was fortunate in that my doctor could just un-tuck things and pin it down and we were good. Leaving it too long can get dangerous very quickly which is why Dr. Enochs wanted me to have surgery right away.
This is not how I expected my week to go, but I'm hoping that recovery will go well and quickly and I will be back among the land of the living here fairly quickly. Thanks to all of you who have so graciously sent well wishes and prayed for me. It is appreciated far more than you know.
Monday I had some achiness in my abdomen most of the day. It was occassionally enough to make me pause - not enough to deter me in my daily activities - but always there in the background. So I thought I would call the surgeon's nurse practitioner on Tuesday morning sometime and leave her a message to see what she thought.
So Tuesday morning I was woken up at 5am with excruciating pain in my abdomen. I immediately camped out in the Land of Denial - where I am the Queen. I told my husband that I was a little concerned, but I had too much to do. I would call the surgeon's office when it opened. My son had an orthodontist appointment first thing in the moring. I took him, but as I was driving to the appointment I was thinking "This was not the smartest thing you've ever done, Pam." I got him through the orthodontist appointment and I left a message with the answering service at the surgeon's office. As I was leaving the appointment with my son I called my mom to let her know what was going on. She talked me in to pulling over - that I really shouldn't be driving. So I pulled over and she and my dad came and met me where I was. My dad took Caleb to school and my mom took me to the surgeon's office.
After waiting a couple of hours to see the surgeon ( he worked me in to his schedule instead of sending me to the ER which I greatly appreciated) he felt that this was a hernia. Of course, there is no way to know for sure unless you go in surgically to look, but I was presenting with classic internal hernia symptoms. He had an opening in his schedule for the next day, but he didn't want me to wait because something like this can go south really quickly. His partner was already at the hospital and thought he could squeeze me in to his schedule in the afternoon. So we scheduled things with the scheduling nurse for later in the afternoon and headed home for a couple of hours to set some things straight.
To make a long story short we waited and waited and waited for Dr. Tyner, but he was called into a life threatening emergency surgery situation. So Dr. Enochs came back to the hospital to perform the surgery himself. Have I mentioned how much I love that man? Surgery did not start until after 9pm that night and I did not get back from recovery until after midnight. Dr. Enochs did find an internal hernia and he was able to repair it quickly. He also looked for adhesions (or scar tissue) from past surgery that might be catching things and he did an upper endoscopy while he had me under to look for an ulcer, etc... I had no adhesions and no ulcer, and they caught the hernia before my intestines were damaged.
So I spent most of the day today hanging out at the hospital waiting to be discharged, etc... Dr. Enochs was able to perform the operation laproscopically (sp?) so I was pleasantly surprised that I was not in as much pain as I had anticipated. Of course, I am convinced that they always send you home just as the really good drugs wear off so that they don't have to listen to you when the real pain hits and now that I am home I am a good deal more uncomfortable than I was in the hospital.
So an internal hernia is different than the hernia that most people think of when they hear about hernias. Most people think of umbilical hernia's (where the intestine pokes out by your belly button), or groin hernias or hiatal hernias (where part of the stomach gets stuck through the diaphragm). While this type of hernia (internal) is fairly common with gastric bypass patients it is very uncommon otherwise and most doctors won't diagnose it properly. It won't show up on ultrasound or CT or MRI very well and many "regular" doctors aren't very aware of the increase in icidents with gastric bypass patients, etc... The more common type of hernias involve the intestines poking through the abdominal wall or through the diaphragm or into the groin area. Internal hernias are different in that the intestines kind of fold in on themselves. You loose a lot of fat in the abdominal area and it leaves the intestines kind of loosey-goosey (yes that is a very technical term) and they can end up folding and going into spaces and spots that they shouldn't. This is what happened with me - and when that happened it got stuck - causing the pain. It is important to "un-stuck" it quickly so that the intestine isn't damaged or twisted or creates an obstruction or dies. I was fortunate in that my doctor could just un-tuck things and pin it down and we were good. Leaving it too long can get dangerous very quickly which is why Dr. Enochs wanted me to have surgery right away.
This is not how I expected my week to go, but I'm hoping that recovery will go well and quickly and I will be back among the land of the living here fairly quickly. Thanks to all of you who have so graciously sent well wishes and prayed for me. It is appreciated far more than you know.
Tuesday, February 2, 2010
Ramblings ....
So I keep thinking "I'm going to blog about that ..." and then it doesn't turn into much to talk about. So excuse me if this blog is rambling a bit - just a bunch of things going on in my head.
So I'm now 13 months out from surgery. I have been stuck playing with the same few pounds since September. I had to stop running when I had the vertigo problems and the ear surgery. It took me a while to get back into a good running routine with how cold it has been here. I have a hard time running in the cold - my old asthma rears it's ugly head then. I am now back into a good running and exercise routine in order to meet my running goals for 2010. But I am still stuck at the same weight. Frustrating.
I had my 1 year follow up appointment with my doctor. He was happy with my progress but would like to see me loose another 20 pounds. I, personally, would like to loose another 30 pounds. I have come so far - I find it hard to believe I can't loose this last 30 pounds. So I have recommitted myself to tracking my calories and my exercise on http://www.livestrong.com/ (they took over The Daily Plate). I am trying to stick to 1100-1200 net calories a day. I am easily able to eat about 1500 or so calories a day. That is really wreaking havoc with my brain. This part won't make sense to some of you. I know that is a normal amount of calories to be taking in - possibly even still pretty low. But it scares me. I'm afraid to take in too much more than that in a day. The fact that I haven't lost weight in 3 or so months scares me. I am not ready to be done and I am afraid of going in the other direction. I have actually started dreaming about it - waking up and I'm up over 200 pounds and I'm so mad and afraid and disappointed.
And there are some days I think Kanga has become made of steel - I can eat a lot of things I couldn't before - I can take in more than I could before. I don't like that. I don't want to go back to "normal". And then there are some days that she reminds me that she is still in charge and I can't get more than a couple of bites of anything or I dump on something that hasn't caused me to dump in the past.
I did get my hand slapped at my 1 year follow up with Dr. Enochs. I am not good at the vitamin regimine. And for no good reason - just not good at it. So I really need to get on top of that pretty quickly here. I am going to have some bloodwork run soon and that should give us an idea of what the impact of that truly is.
Some other things that have been rearing their ugly heads now that I am a year out: I have been having some off and on pain my abdomen. Sometimes it's breath-taking pain - sometimes it's just an ache. I talked to Dr. Enochs about it and he has a couple of different concerns that can be common after gastric bypass. One is scar tissue. I have had quite a few abdominal surgeries - 2 c-sections, an open hysterectomy, an open gallbladder removal, and some laparascopic surgeries. So I most likely have quite a bit of scar tissue - that could be catching or kind of strangulating my intestines. Something else that is common is that you can get an internal hernia once all the fat that used to hold things in place is gone. So what do we do about it? The only way to tell if the pain I'm having is one of these two things is to have surgery - there's no test that will tell them definitively if one of these things is what is happening. It's a fine line to when we decide to do something about it - right now it doesn't normally interfere with daily life, but it could happen over night and become something that needs to be taken care of immediately. So the approach we are taking right now is "watchful waiting". We shall see.
I have also started having some reactive hypoglycemia symptoms. I haven't had that officially checked out, but it looks like that is what I am dealing with - drops in blood sugar that make me weak and shaky, etc... From what I can track it appears to be reactive which means I should be able to control it with what I am eating and how often I eat. I plan on talking to my doctor about it when I see him next week.
I see my doctor next week to get fitted for orthotics for my running shoes. I seem to have developed bursitis in my left foot and I don't want anything to distract me from my goals for running this year.
Speaking of running goals - I have already raised $500 for my Polar Plunge after the 2010 Torch Run. I can't believe I have raised that much money! I am looking forward to that run and will be sure to post pictures of of the craziness that ensues.
So thanks for listening to me ramble on and on. I just had a bunch of things on my mind and no clear way to get them all out, but getting them out on this blog really is cathartic.
So I'm now 13 months out from surgery. I have been stuck playing with the same few pounds since September. I had to stop running when I had the vertigo problems and the ear surgery. It took me a while to get back into a good running routine with how cold it has been here. I have a hard time running in the cold - my old asthma rears it's ugly head then. I am now back into a good running and exercise routine in order to meet my running goals for 2010. But I am still stuck at the same weight. Frustrating.
I had my 1 year follow up appointment with my doctor. He was happy with my progress but would like to see me loose another 20 pounds. I, personally, would like to loose another 30 pounds. I have come so far - I find it hard to believe I can't loose this last 30 pounds. So I have recommitted myself to tracking my calories and my exercise on http://www.livestrong.com/ (they took over The Daily Plate). I am trying to stick to 1100-1200 net calories a day. I am easily able to eat about 1500 or so calories a day. That is really wreaking havoc with my brain. This part won't make sense to some of you. I know that is a normal amount of calories to be taking in - possibly even still pretty low. But it scares me. I'm afraid to take in too much more than that in a day. The fact that I haven't lost weight in 3 or so months scares me. I am not ready to be done and I am afraid of going in the other direction. I have actually started dreaming about it - waking up and I'm up over 200 pounds and I'm so mad and afraid and disappointed.
And there are some days I think Kanga has become made of steel - I can eat a lot of things I couldn't before - I can take in more than I could before. I don't like that. I don't want to go back to "normal". And then there are some days that she reminds me that she is still in charge and I can't get more than a couple of bites of anything or I dump on something that hasn't caused me to dump in the past.
I did get my hand slapped at my 1 year follow up with Dr. Enochs. I am not good at the vitamin regimine. And for no good reason - just not good at it. So I really need to get on top of that pretty quickly here. I am going to have some bloodwork run soon and that should give us an idea of what the impact of that truly is.
Some other things that have been rearing their ugly heads now that I am a year out: I have been having some off and on pain my abdomen. Sometimes it's breath-taking pain - sometimes it's just an ache. I talked to Dr. Enochs about it and he has a couple of different concerns that can be common after gastric bypass. One is scar tissue. I have had quite a few abdominal surgeries - 2 c-sections, an open hysterectomy, an open gallbladder removal, and some laparascopic surgeries. So I most likely have quite a bit of scar tissue - that could be catching or kind of strangulating my intestines. Something else that is common is that you can get an internal hernia once all the fat that used to hold things in place is gone. So what do we do about it? The only way to tell if the pain I'm having is one of these two things is to have surgery - there's no test that will tell them definitively if one of these things is what is happening. It's a fine line to when we decide to do something about it - right now it doesn't normally interfere with daily life, but it could happen over night and become something that needs to be taken care of immediately. So the approach we are taking right now is "watchful waiting". We shall see.
I have also started having some reactive hypoglycemia symptoms. I haven't had that officially checked out, but it looks like that is what I am dealing with - drops in blood sugar that make me weak and shaky, etc... From what I can track it appears to be reactive which means I should be able to control it with what I am eating and how often I eat. I plan on talking to my doctor about it when I see him next week.
I see my doctor next week to get fitted for orthotics for my running shoes. I seem to have developed bursitis in my left foot and I don't want anything to distract me from my goals for running this year.
Speaking of running goals - I have already raised $500 for my Polar Plunge after the 2010 Torch Run. I can't believe I have raised that much money! I am looking forward to that run and will be sure to post pictures of of the craziness that ensues.
So thanks for listening to me ramble on and on. I just had a bunch of things on my mind and no clear way to get them all out, but getting them out on this blog really is cathartic.
Saturday, February 14, 2009
The Divorce Continues
I have mentioned before that this process is really a divorce from food. I had no idea just how painful this divorce was going to be.
I am totally addicted to milk, and to me cheese makes everything better. But I think that I have become lactose intolerant since surgery.
As I have stated on this blog before - I and my surgeon have been thinking that I am suffering from a stricture. But I did have a few times that I ate and did not get ill afterwards. So it got me to thinking - what was the difference? I started going back over what I was eating and realized I was having an awful lot of dairy in my quest for soft foods. Soft cheeses, cottage cheese, milk whenever I could get it. So today I decided to test my theory and see if I could go without anything with lactose in it. I made it most of the day and I was not sick! But then at dinner tonight I decided to make my kids some heart shaped waffles. One fell apart and I took a couple of bites of that dry waffle - which was made with ... milk!!!! In about 30 minutes I spent the next 2 hours in absolute misery.
So the divorce with my favorite foods continues. Before surgery I was talking to someone I go to church with who had the same surgery - with the same surgeon about 8 months before me. He said to me "It's like learning to eat all over again." Truer words have never been spoken!!!!
I am totally addicted to milk, and to me cheese makes everything better. But I think that I have become lactose intolerant since surgery.
As I have stated on this blog before - I and my surgeon have been thinking that I am suffering from a stricture. But I did have a few times that I ate and did not get ill afterwards. So it got me to thinking - what was the difference? I started going back over what I was eating and realized I was having an awful lot of dairy in my quest for soft foods. Soft cheeses, cottage cheese, milk whenever I could get it. So today I decided to test my theory and see if I could go without anything with lactose in it. I made it most of the day and I was not sick! But then at dinner tonight I decided to make my kids some heart shaped waffles. One fell apart and I took a couple of bites of that dry waffle - which was made with ... milk!!!! In about 30 minutes I spent the next 2 hours in absolute misery.
So the divorce with my favorite foods continues. Before surgery I was talking to someone I go to church with who had the same surgery - with the same surgeon about 8 months before me. He said to me "It's like learning to eat all over again." Truer words have never been spoken!!!!
Thursday, February 12, 2009
Still ...
So I am still having problems with Kanga. She just seems to never be happy. The steroids don't seem to have worked. If I don't refund the Roo and manage to keep everything down - I have awful foamies and I am in pain for several hours afterwards - even liquids can do this to me now. It's kind of hit or miss. But I am miserable. Yesterday I was actually at -147 calories for the day because I went hiking. I am so tired because I am hardly getting any calories in. And because I am hardly taking anything in my body is holding on to every ounce of it so I haven't lost any weight this week.
So I called my surgeon today to let them know that the steroids didn't seem to work, etc... The nurse called me back and had me call the GI Doc and get in with them. I called the GI doc and they can't see me until next Friday. WWWWWAAAAAAAAHHHHHHH!!!!!!! I was assured I wouldn't die staying on liquids until then. Yes, thank you, I realize I have enough fat to sustain me for quite some time. But that is just the consult. That isn't actually correcting the problem!
SSSSSSSOOOOOOOOOOOOOO - here I sit playing Russian Roulette with my food for another 8 days.
On another note - I kinda had a WOW moment today. I had to take my daughter to the doctor for a rash she has. My whole family sees one family doctor. I love him - Dr. Bloom. He is da bomb! Anyway - he hasn't seen me since I was trying to get my paperwork together for surgery. So he walked in and he got this huge smile and said "Did you have the surgery?" Yes, 6 weeks ago. He told me he could tell and that he thought I looked great and he was very excited for me. But the best was he couldn't believe my blood pressure was already under control. He checked it and it was phenomenal as usual. Yeah Me!
So I called my surgeon today to let them know that the steroids didn't seem to work, etc... The nurse called me back and had me call the GI Doc and get in with them. I called the GI doc and they can't see me until next Friday. WWWWWAAAAAAAAHHHHHHH!!!!!!! I was assured I wouldn't die staying on liquids until then. Yes, thank you, I realize I have enough fat to sustain me for quite some time. But that is just the consult. That isn't actually correcting the problem!
SSSSSSSOOOOOOOOOOOOOO - here I sit playing Russian Roulette with my food for another 8 days.
On another note - I kinda had a WOW moment today. I had to take my daughter to the doctor for a rash she has. My whole family sees one family doctor. I love him - Dr. Bloom. He is da bomb! Anyway - he hasn't seen me since I was trying to get my paperwork together for surgery. So he walked in and he got this huge smile and said "Did you have the surgery?" Yes, 6 weeks ago. He told me he could tell and that he thought I looked great and he was very excited for me. But the best was he couldn't believe my blood pressure was already under control. He checked it and it was phenomenal as usual. Yeah Me!
Thursday, February 5, 2009
Stricture
So after a few days of misery I was able to get in to see Dr. Enochs today. Gotta tell ya - that man's smile makes it all OK. :)
Anyway - I have been having a lot of difficulty eating lately. Liquids stay down, but I am sore after I drink. Soft foods - well that is hit or miss. Sometimes Kanga refunds the Roo. When she does that has not been pretty - have had blood come up with it, etc... If the Roo stays down I am in pain for hours.
Dr. Enochs thinks that I may be working on a stricture in the area where my new stomach (a.k.a. Kanga) attaches to my intestines. Because I'm only 5 weeks out from surgery - it could just be swelling having to do with healing and not necessarily scar tissue. He wants to wait and let me heal a bit more before trying to go in there with endoscopy to fix things. He doesn't like to go in before 2 months has passed. So he gave me a script for some steroids to see if that shrinks things and makes it easier for me. I am to do the steroids for a few days and go back to liquids, and then try to advance to soft foods and see what happens. If I am still having trouble at the end of February then they will have me see the GI doc for an endoscopy. If things get worse before then they will address it. He would just like to give me a few more weeks if possible.
I hope that the steroids work. Not being able to eat and being in pain a lot of the time is getting really old.
Anyway - I have been having a lot of difficulty eating lately. Liquids stay down, but I am sore after I drink. Soft foods - well that is hit or miss. Sometimes Kanga refunds the Roo. When she does that has not been pretty - have had blood come up with it, etc... If the Roo stays down I am in pain for hours.
Dr. Enochs thinks that I may be working on a stricture in the area where my new stomach (a.k.a. Kanga) attaches to my intestines. Because I'm only 5 weeks out from surgery - it could just be swelling having to do with healing and not necessarily scar tissue. He wants to wait and let me heal a bit more before trying to go in there with endoscopy to fix things. He doesn't like to go in before 2 months has passed. So he gave me a script for some steroids to see if that shrinks things and makes it easier for me. I am to do the steroids for a few days and go back to liquids, and then try to advance to soft foods and see what happens. If I am still having trouble at the end of February then they will have me see the GI doc for an endoscopy. If things get worse before then they will address it. He would just like to give me a few more weeks if possible.
I hope that the steroids work. Not being able to eat and being in pain a lot of the time is getting really old.
Tuesday, December 23, 2008
5 More Days!
I had my pre-op appointment at the hospital today. I filled out a bunch of paperwork about my insurance, and then met with a surgical nurse to go over my medical history. I had some blood drawn for type and screen purposes and met with the anesthesiologist that will be taking such wonderful care of me during my surgery. I lovingly refer to him as The Candy Man. It turns out he is the same anesthesiologist that I had when I had my hysterectomy earlier this year. He did a fantastic job then - I had no nausea after that surgery at all. So I am glad to have him taking such good care of me this time as well.
I also got a call from Dr. Enoch's office today. There was a cancellation on the day of my surgery, so my surgery time has been moved up from 5:00pm to 1:45pm. That is good news for me since I will not be allowed to eat much of anything for a couple of days before (on a clear liquid diet) and won't even be able to drink anything on that day.
I also had a group of friends from work take me out for one last "work lunch" today. That was very nice. I feel like I need to have a few "last" things that I won't be able to have for a while. My co-worker, Lori, made these fantastic buckeyes and brought them in to work. Peanut butter and chocolate are God's little gift to me I think. I treasured the two I got in a little package from her. They were so good. But I'm also trying not to over-indulge too much - if I gain weight Dr. Enoch's could pull the plug and cancel my surgery. He has been known to do so. I was encouraged when I got on the scale at the pre-op appt. today that I had actually lost 3 pounds since my last appt. with Dr. Enochs a couple of weeks ago.
A lot of people have been asking me if I'm excited about my surgery on Monday. YES I AM! I am very excited. But today I had my first twinges of nervous-ness. That's not like me. Surgery doesn't make me nervous - I've had a lot of them over the years. But the reality of the changes I am about to endure are starting to hit me. Don't get me wrong - I'm on board - I still want this and I'm still very excited, but I'm nervous. What if I'm not good at this? What if it's hard? What if my tastes change? What if I can't find protein drinks that I like? What if I don't loose weight? What if I'm a failure? What if the recovery is more than I am anticipating?
But I am so ready for a new me. I am ready for some big changes in my life. I can do this. As my wonderful husband has said "You're Pam! Go big or stay home!" So let's do this!
I also got a call from Dr. Enoch's office today. There was a cancellation on the day of my surgery, so my surgery time has been moved up from 5:00pm to 1:45pm. That is good news for me since I will not be allowed to eat much of anything for a couple of days before (on a clear liquid diet) and won't even be able to drink anything on that day.
I also had a group of friends from work take me out for one last "work lunch" today. That was very nice. I feel like I need to have a few "last" things that I won't be able to have for a while. My co-worker, Lori, made these fantastic buckeyes and brought them in to work. Peanut butter and chocolate are God's little gift to me I think. I treasured the two I got in a little package from her. They were so good. But I'm also trying not to over-indulge too much - if I gain weight Dr. Enoch's could pull the plug and cancel my surgery. He has been known to do so. I was encouraged when I got on the scale at the pre-op appt. today that I had actually lost 3 pounds since my last appt. with Dr. Enochs a couple of weeks ago.
A lot of people have been asking me if I'm excited about my surgery on Monday. YES I AM! I am very excited. But today I had my first twinges of nervous-ness. That's not like me. Surgery doesn't make me nervous - I've had a lot of them over the years. But the reality of the changes I am about to endure are starting to hit me. Don't get me wrong - I'm on board - I still want this and I'm still very excited, but I'm nervous. What if I'm not good at this? What if it's hard? What if my tastes change? What if I can't find protein drinks that I like? What if I don't loose weight? What if I'm a failure? What if the recovery is more than I am anticipating?
But I am so ready for a new me. I am ready for some big changes in my life. I can do this. As my wonderful husband has said "You're Pam! Go big or stay home!" So let's do this!
Friday, December 12, 2008
Jumping Through Hoops
So many people don't really understand what's involved with gastric bypass surgery. I think that as much as I will be using this blog as a place for my own catharsis I will also be spending a good amount of energy educating friends and family about gastric bypass surgery - what it actually is, how it works, and how it will affect me.
So we'll start with Weight Loss Surgery, or more commonly referred to online as WLS. There are several different types of WLS. You can have gastric bypass, lap-band, duodenal switch, vertical gastric sleeve, and the list goes on and on. I chose gastric bypass surgery, or Roux-en-Y gastric bypass. Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss. I am having the surgery laparascopically. I will be in the hospital for 2 days and I plan to only take a week off of work.
I choose gastric bypass over the lap-band (which has grown in popularity a lot over the past few years) for several reasons. Lap-band can be easily cheated and I knew that if I could cheat it I would. The gastric bypass has immediate measures built into it to kind of give you a "hand-slap" when you eat wrong. If you eat too much sugar or carbs or fat you will get what is lovingly referred to as "Dumping Syndrome". I won't go into too much detail here (I may at a later time), but I think you get the idea. I also don't have a good history with having foreign object in my body. My body usually rejects foreign objects - pushing them out of my body. Don't ask me how or why I know this about my body - I just do. Also, the lap-band would require a lot of follow up visits with the surgeon to adjust the band and to do "fills". From past experience I know that I may not always have the incredibly great insurance I have now - so I can't be guaranteed that I would have the financial means to continue in that manner.
And so my official journey towards WLS began in July. I had reached the height of feeling sick of myself. I had been feeling for quite some time that I was almost ready to make some changes in my life. But now I was finally ready and I did my first ever search on weight loss surgery. I researched surgeons in my area and accepted by my insurance. I was very impressed by Dr. Paul Enochs reviews and his internet presence. So I called his office to schedule an initial consultation. I was instructed to attend one of his weekly seminars on Weight Loss Surgery and I signed up for the first available seminar. I had broached the subject with my husband (who I shall refer to on this blog as D) and asked him if he would attend the seminar with me. We went and it was very informative. Dr. Enochs' insurance specialist spoke and gave a lot of information on what the various insurance companies would require before approving the surgery. I found out that my insurance, Cigna, would require a 6 month doctor supervised weight loss program in addition to all of the other tests and sign offs from various doctors. Then Dr. Enochs did a 2 hour presentation on weight loss surgery, the various types, as well as some information on him and his experience. He was incredibly easy to listen to. His voice was soft and gentle and comforting. He was very patient and gracious. He listened and responded to every question that was posed and never made anyone feel as though their question was stupid (and believe me - some of those questions were stupid!). By the time D and I left the seminar I felt that I had a good idea of which surgery I was going to have. I remember asking D what his thoughts were on which surgery I should have and his exact words were "You're Pam! Go big or stay home!" Allrighty then!
So I quickly moved into attack mode. The insurance specialist had said that the more involved I was in the process the faster it would get done. So I scheduled an appointment with my Primary Care Physician (the astounding Dr. Bloom) and got to working on everything. To make a long story shorter here is a list of all the things I have had to ensure happen in the last 6 months so that Dr. Enochs office could submit a package to my insurance company requesting approval for my gastric bypass surgery:
So we'll start with Weight Loss Surgery, or more commonly referred to online as WLS. There are several different types of WLS. You can have gastric bypass, lap-band, duodenal switch, vertical gastric sleeve, and the list goes on and on. I chose gastric bypass surgery, or Roux-en-Y gastric bypass. Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss. I am having the surgery laparascopically. I will be in the hospital for 2 days and I plan to only take a week off of work.
I choose gastric bypass over the lap-band (which has grown in popularity a lot over the past few years) for several reasons. Lap-band can be easily cheated and I knew that if I could cheat it I would. The gastric bypass has immediate measures built into it to kind of give you a "hand-slap" when you eat wrong. If you eat too much sugar or carbs or fat you will get what is lovingly referred to as "Dumping Syndrome". I won't go into too much detail here (I may at a later time), but I think you get the idea. I also don't have a good history with having foreign object in my body. My body usually rejects foreign objects - pushing them out of my body. Don't ask me how or why I know this about my body - I just do. Also, the lap-band would require a lot of follow up visits with the surgeon to adjust the band and to do "fills". From past experience I know that I may not always have the incredibly great insurance I have now - so I can't be guaranteed that I would have the financial means to continue in that manner.
And so my official journey towards WLS began in July. I had reached the height of feeling sick of myself. I had been feeling for quite some time that I was almost ready to make some changes in my life. But now I was finally ready and I did my first ever search on weight loss surgery. I researched surgeons in my area and accepted by my insurance. I was very impressed by Dr. Paul Enochs reviews and his internet presence. So I called his office to schedule an initial consultation. I was instructed to attend one of his weekly seminars on Weight Loss Surgery and I signed up for the first available seminar. I had broached the subject with my husband (who I shall refer to on this blog as D) and asked him if he would attend the seminar with me. We went and it was very informative. Dr. Enochs' insurance specialist spoke and gave a lot of information on what the various insurance companies would require before approving the surgery. I found out that my insurance, Cigna, would require a 6 month doctor supervised weight loss program in addition to all of the other tests and sign offs from various doctors. Then Dr. Enochs did a 2 hour presentation on weight loss surgery, the various types, as well as some information on him and his experience. He was incredibly easy to listen to. His voice was soft and gentle and comforting. He was very patient and gracious. He listened and responded to every question that was posed and never made anyone feel as though their question was stupid (and believe me - some of those questions were stupid!). By the time D and I left the seminar I felt that I had a good idea of which surgery I was going to have. I remember asking D what his thoughts were on which surgery I should have and his exact words were "You're Pam! Go big or stay home!" Allrighty then!
So I quickly moved into attack mode. The insurance specialist had said that the more involved I was in the process the faster it would get done. So I scheduled an appointment with my Primary Care Physician (the astounding Dr. Bloom) and got to working on everything. To make a long story shorter here is a list of all the things I have had to ensure happen in the last 6 months so that Dr. Enochs office could submit a package to my insurance company requesting approval for my gastric bypass surgery:
- 6 month Dr. supervised weight loss program
- 5 year weight history
- Chest X-Ray
- EKG
- Upper GI
- Endoscopy
- Sign off from GI doc on my fitness for surgery
- Nutritionist appointments and approval
- Psychiatrist appointments and approval
- Labwork requiring 6 vials of blood
So after all of those doctors appointments (not all of them covered by insurance), an enrollment fee of $400 with Dr. Enochs office (to ensure that I am serious about committing to this life change and to cover a lot of the work of those in the office that can't bill insurance companies like the doctor does), and all of the poking and proding we had a package to submit to insurance requesting approval. I was approved pretty quickly and on the first try (did I mention I have great insurance right now?) and then was able to schedule my surgery. It is scheduled for Monday, December 29 at 5pm.
I will go into all of the changes that I have ahead of me immediately following surgery and beyond in another post.
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