Monthly Archives: March 2021

More words about food

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So the deal with this tiny stomach is that the first couple of months are about healing and learning to eat again. The first week is clear liquids, then after about a week you can add liquids that are not clear (cream soups, runny mashed potatoes, etc) but are low in fiber and easy on your stomach. Slowly you progress through the stages of soft foods until you reach regular foods like anybody can eat, albeit in small tiny bites that you chew forever.

Right now, a little over two weeks out, my diet mainly consists of protein shakes made into smoothies via the Ninja blender. Protein shakes on their own have a weird texture, kind of slippery and just unnatural, and I’m not up for that. Like, at all.

One time when I was high school I was given Maalox for an upset stomach and the texture alone was enough to make me vomit. I stayed home from school that day and have never taken Maalox since. Then when the kids were little one of them picked up pinworms at the germ farm elementary school. The whole family had to take banana flavored medicine that turned out to also have the slippery texture. We stood in a circle of Family Solidarity when we took it, all at once like we were doing shots at a sports bar, and I almost didn’t get it down and the children almost ended up wearing my little cup of yellow anthelmintic. We were supposed to take a second dose a week or two later, but after nearly throwing up from the first one I decided I’d rather take my chances with the pinworms. (I’m happy to report that I dodged that bullet).

Anyway, I’m not a huge fan of the protein shakes largely because of this, so imagine my delight when I tried throwing half a banana, a few frozen blueberries, and some ice cubes into the Ninja with one and the result was halfway palatable!

This morning I tried a caramel shake with some PB2 peanut butter powder and it wasn’t bad. I think I’m on to something here! Which is great because on our pre-op quest to find protein shakes that I could stand, we tried a bunch of different brands and flavors and still have a shitload of them in the pantry fridge. Smoothie fodder for weeks!

In other news, the five fun new scabs on my belly itch like hell. I’m not tempted to scratch them because I don’t need an infection but dear God, I can’t wait for this part to end.

Home again

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So the deal is that you spend a night at the hotel, then move to the hospital for two nights, then spend two nights in the hotel (where a nurse is on duty all day) before heading home.

When we arrived back at the hotel we were told that when we showered we should peel the bandages off in the shower, get soap on our hands, and wash our bellies with “just the bobbles”. Then we were to contact the nurse who would come bandage us back up. The nurse used giant swathes of paper medical tape which have left adhesive residue all over my belly. My new hobby is peeling it off when I’m on hold. I work alone in my home office so this is somewhat less repellant than it may sound.

There’s another puncture directly behind the phone

The last day in Tijuana we went to a salon belonging to the practice owner’s brother and had our nails done.

Beautification has occurred

The Lovely Rhonda and Joni had massages — they can do a modified version that doesn’t involve laying on your stomach for post surgical patients — while I opted for a facial.

I’ve never had a facial before. I think I might have enjoyed it more if the tiny woman who gave me the facial had not had extremely cold minuscule doll-like hands, but it was still enjoyable and I gotta say, my face was extra smooth for days. I didn’t even know it was so crenelated until it was relieved of all of its crömsty bits.

Also: I am lotion-impaired. I hate the smell and texture of nearly all unguents and resist using them unless absolutely necessary, so this involved possibly more goopy products being smeared on my visage than has ever cumulatively been smeared on it in all my considerable years.

Once we were all oiled up etc we were delivered back to the hotel and, after another broth meal at the restaurant across the street, spent the rest of the evening crocheting and watching Despicable Me 2 because it was either that or a crime show about murders. There isn’t a lot in English on Mexican TV so I was thrilled to find something than wasn’t a crime show.

In the morning we crossed the border in the program’s minibus (still no horse and cart, more’s the pity) where we were constantly implored to purchase genuine Mexican knickknacks from the many street vendors as we inched forward in a long line of vehicles. It took about an hour of waiting in the van and then thirty seconds of having our passports scrutinized to actually cross, then we were driven to the airport where we had missed our flight due to a misunderstanding about what time we were to be in the program office at the hotel vs. what time we would actually be departing for the border crossing. We got onto another flight and finally arrived home around 6pm.

It was the last flight we’ll ever need seatbelt extenders. Which is funny because we only just gave in and bought them earlier this year, right before we decided to get the surgery.

Nurse Ratched

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So we were allowed to take a companion to Mexico for this ordeal surgery. The deal is that the companion stays in your hotel room and unless you pay extra to keep the room, stays with you in the hospital as well. Technically we could bring a companion each, but we really didn’t need two people to witness this spectacle.

We chose our friend Joni, a stalwart friend from nursing school who was present the night The Lovely Rhonda and I met at an informative dinner about leukemia and lymphoma. (Ah, romance!) Joni was happy to get out of town for a bit and we were more than happy to pay airfare so it was an agreeable arrangement all the way around.

Joni basically got me started crocheting a few years back so it is to her that I owe my enjoyment of this hobby that now consumes a fairly comprehensive amount of my living space. She also is the reason it takes up so much of my living space, what with the giant boxes of yarn that she brought us recently. I’m not complaining but gosh darn it, it’s a lot of yarn. And yarn is hard to store.

At any rate, Joni spent two glorious days in the hospital with us, making us get up and shuffle the zombie walk up and down the corridors, nagging us to do our inventive spirometers, fluffing our pillows, handing us things. Rhonda was sick once or twice and it’s a true friend who handles that for you. The sleeping arrangements for the companion consists of a blocky hospital chair that, by way of a cunningly incomprehensible mechanism, becomes flat. Despite these Spartan accommodations she appeared to sleep well. This just attests to the durable sort of woman that she is.

It wasn’t all toil and tribulation. She accompanied us on the shopping excursion and the shop keepers plied her with the tequila that we couldn’t drink, and she had some quite nice meals. She bought the most enormous purple bag to tote yarn around in. This may have compensated a bit for the heavy lifting she had to do periodically, as we are unable to lift more than twenty pounds for the next six weeks. Luckily we have rolling suitcases so we were able to handle our own bags most of the time but when it came time to lift those bags the six inches onto the scale at the airport check in, Joni was there for us.

So here’s to Joni, without whom the experience would have been far less comfortable. A true friend and most excellent traveling companion!

Tijuana Hijinks

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So the next morning, dear reader(s), we were sprung from the joint. We put on Real Clothes, packed up the suitcases, and got our IVs taken out in preparation for the full day ahead of us: back to the hotel, a shower because we were getting pretty ripe by now, and a trip to the farmacia and city tour.

In Mexico you can buy pharmaceuticals over the counter that are not available here without a prescription, and in some cases are controlled substances. Our purpose for going to the Interestingly Lax Mexican Drug Laws Drugstore was, alas, none of the more exciting options such as Xanax, Viagra, or Toradol. We were there for omeprazole. We will have to take 20mg twice a day for months, or possibly forever, and it’s much cheaper in Mexico. As an example, at Walmart you can buy omeprazole 20mg in a multi-pack of 42 tablets for about 15 bucks. In Tijuana we bought bottles of 200 capsules (same diff) for about ten dollars.

But if it’s medically necessary, you may wonder, won’t your insurance maybe cover it?

Oh honey, that is just so cute. Our insurance won’t cover anything related to bariatric surgery. We have to be careful to have our medical providers to code things such as follow up labs for other (equally valid and correct) reasons unrelated to having had bariatric surgery or it’ll get rejected and we’ll be on the hook for the costs. As an example, I will set up a follow up appointment for medication adjustments related to the weight loss I’m already experiencing from pre-op and the surgery itself, and I could be paying full price for the appointment if my provider isn’t willing to work with me about it. She’s pretty cool so I’m hopeful that I won’t have to find a new provider.

Anyway, a shitload of omeprazole and vitamin B-12 shots later we boarded the bus for a touristy shopping area where we made a few purchases. The Lovely Rhonda relishes the bargaining whereas I find it stressful, so she generally handles this part. As we left the shops we stopped at a restaurant where we enjoyed delicious broth (it being the Broth Tour of Tijuana, after all) and the highlight of the day, pineapple agua fresca — basically fresh pineapple juice and water with ice, so refreshing! It took me all the rest of the evening to drink a 16oz glass.

Some realities about post surgical life with a gastric sleeve – there’s not that much pain, just soreness from the procedure. They poke you full of holes and inflate your belly so they have room to work, then use clever little long-handled tools to reach inside, cut about 2/3 of your stomach away, and sew what’s left into a little banana-shaped sleeve. Needless to say, your belly is not a huge fan of this process. We got pain medication, anti nausea medications, and antibiotics in our IVs in the hospital and were sent home with some oral medications as well. One week later I am able to do most typical household type things without much discomfort, like do laundry and get in and out of the car, and bend over to pick something up off the ground or get out of a chair, but my belly is covered with bruises and adhesive leftover from all the tape they plastered on me each time they bandaged up the little holes. I have five cunning little laparoscopic incisions, including the one from the drain. I’m fortunate in that my lowest puncture is above my belly button and my highest is below the bra area, so my clothes don’t really rub on them. I ended up with dermabond on my incisions which was interesting in that we are instructed to bring it with us if we want to have it applied to our wounds and I didn’t bring any. The nurse later told me sometimes people bring extra and it doesn’t go home with them, so they may just end up using it on random patients. I still put band-aids on them because they are rough and catch my shirt and it’s unpleasant.

Gas becomes the enemy after a sleeve procedure. Who knew that my ability to belch like a longshoreman would become my superpower! I mean, you give it up from both ends, but it’s the gas in what’s left of your tiny little stomach that causes the most distress. The Mating Call of the Redheaded Lesbian serves me well to this day.

At this point I’ve lost about thirty pounds, twenty from the pre-op diet and another ten since leaving for Tijuana. My jeans, which were recently getting pretty snug, are fitting better and even starting to get baggy by the end of the day.

The Aftermath

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So the next thing I recall clearly was being back in the room. I don’t remember getting there and I hadn’t seen Rhonda being brought back in so I am personally unsure of the methods used therein. Here is the lore according to the wife:

TLR recalls that they wheeled me in in a wheelchair, stopped it by my bed, and just told me to get into bed. She is very protective of me and was so disturbed that they weren’t helping me that she got up from a dead sleep, got out of her own bed, and coached me into bed (“Grab the rail honey! Go toward the light!” Etc) at which point they started assisting me. I am told that once I was safely in bed I immediately conked out, which I find entirely believable since I don’t remember anything until a while later and nothing at all about the process of returning to the room.

The first day was pretty much a blur, lots of sleeping and having vitals taken and IVs swapped out. We were forced to march the halls twice by our friend/nursemaid Joni because she is mean. And didn’t want us to get pneumonia. Whatever.

At some point we were told we could have a Popsicle, which was incorrect, and this made TLR sick.

This is the Bad, Forbidden, Much Too Soon Otter Pop, and also my incentive spirometer and kitty cat pajama pants.

I had some nausea at one point and definitely some wicked bad heartburn, but otherwise felt just sleepy. As long as I didn’t move any part of my body, it was as though nothing had happened. I slept that night like a dead body thanks to the anesthesia drugs that were still working their way out of my body.

In the morning we were given a very small amount, perhaps an ounce, of very dark purple beverage and told to sip it down. (They encourage sipping, not gulping, with the new tiny stomach situation.) If any purple color appeared in the surgical drain dangling at my left side, this would indicate a leak in my stomach. I studiously avoided looking at my surgical drain at all times so I have no way of knowing myself whether any purple appeared there, but one assumes that it was noted by the nurse who emptied the drain. No news is good news, amirite?

A bit later that morning we were taken to have a fluoroscope of our stomachs which was taken standing as we consumed a bit of contrast medium. This was the more definitive leak test which we both passed. Cleared for popsicles for real this time!

This is the Legit Allowed Otter Pop of Awesomeness

Passing the leak test also means you get your drain out. If you’ve never had a surgical drain, they aren’t especially nice. They don’t really hurt, per se, but they don’t feel nice. Getting them taken out is quick and also not especially nice. Imagine a small tube bumping up against your tender organs as it is yanked away. Or maybe don’t imagine it, if you’re squeamish. TLR said a Bad Word when hers was removed which prepared me for the fun times ahead. I did not say a swear but I wanted to.

The remainder of the day passed in a slow motion blur of shuffling up and down the halls, failing to use the incentive spirometer quite enough, and learning how a swollen, healing brand-newly-tiny stomach responds to minute sips of various liquids. The answer: it twitches, and gurgles, and lurches strangely. Then if you’re lucky you’ll burp up a gas bubble and things will settle down, until the next time. Which should be every few minutes in order to get enough fluids into us.

Operation

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So the next morning bright and/or early we presented to the hotel lobby bearing all of our luggage and for the last time we with our entire stomachs took a minibus ride across Tijuana.

Once at the hospital we were brought into a room, made to strip down and don voluminous navy blue backless gowns, and had IV lines placed, whereupon boredom set in. We killed the time by having quiet internal panic attacks, as one does.

TLR IS DEFINITELY NOT PANICKING INTERNALLY
I AM SUPER NOT FREAKING OUT

Soon enough The Lovely Rhonda was taken back for the procedure. We locked eyes as she was taken out in a giant bariatric patient wheelchair. Was this the end??

I remained calm, very calmly calming there in my adjustable hospital bed, certainly not reconsidering the fact that I was willingly submitting to having about two thirds of my precious beautiful stomach mercilessly hacked off and discarded in Mexico and was this really a good idea? I mean was it?

Alas, we’ll never know if keeping it was the right thing to do because suddenly it was my turn to climb into the roomy wheelchair and be ferried to the abattoir, I mean operating room. The adorable nurse who pushed me along the gleaming hallways spoke enough English to complain about one corner that was especially difficult to maneuver around.

Presently I was settled into yet another hospital bed in a strangely dim waiting area that shared space, interestingly, with the scrub sink they used to clean the roughly hundred and fifty instruments (I could be exaggerating) used in this procedure. The clattering of long metal items being dumped into the sink and the loud hiss of the sprayer used to clean them made the whole experience a touch jarring. The companionable chattering of the nurses and techs and the familiar music (Journey’s Open Arms, inexplicably) took the edge off a bit. I felt drastically unprepared for this escapade. I wondered if any patient had ever stood up off the gurney and just noped out of there. I wondered if maybe the first one would be me.

Further jarring was when they wheeled my lovely, groaning bride from the OR. I told them that TLR was my wife and asked how it went; they were very kind and let me see her briefly although this was a bit wasted on me since I am hella nearsighted and I was made to leave my glasses in our room. From what I could gather through my Mr. Magoo squinting, she was propped up and out cold. Nonetheless they assured me she was doing well and the operation was uncomplicated.

By and by the surgeon, a distinguished older gentleman, came by to make small talk and assure me that everything would begin soon and I’d be fine.

My turn! They indicated that I was to walk to the operating table and climb aboard. It was rather high and I am springing-impaired (see: missing hamstring, arthritic joints, strictly decorative inflexible non weight bearing feet) so they dragged over a little step stool for me.

Operating tables, even for the Traditionally Built patient, are incredibly skinny, I remember thinking. Also: they won’t even see my amusing Star Wars tattoos because they made me wear these dumb support stockings. And: this is all happening too quickly.

The very nice anesthetist gave me my “shot of tequila” and I was off into the darkness.

The Thing Which We Are Doing

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So now we’re on the World’s Smallest Airplane flying to an Undisclosed Mexican Location (actually Tijuana) to commence the next phase of our multifaceted lives.

I hate to fly and there is turbulence and this is a small plane so you can imagine how much fun I’m currently having. All the other passengers are blithely staring at their devices as if these are merely Air Potholes and not Potentially Crash Inducing Weather Anomalies.

IT’S OKAY, EVERYONE, I’LL JUST FOCUS ALL MY PSYCHIC ENERGY ON KEEPING THIS BE-WINGED ALTOIDS TIN IN THE AIR, YOU ALL JUST RELAX NOW

Anyway, from here we’ll land in San Diego for the arduous trek into Mexico. By which I mean that our assigned shuttle driver Arthur will pick us up in a conveyance (hoping for a horse and buggy, but it’s most likely a minibus) and ferry us across the border. I have already had several text messages from Arthur. We are practically engaged now.

Starting yesterday morning we began the clear liquids only diet. I have learned some things about myself and Rhonda during this phase of the process. Namely: one of us gets hangry and one of us does not. I’ll leave it up to the reader to figure out which of us is which. (Hint: it’s not me)

This morning was a little hectic and we only managed to suck down a little sugar free jello for breakfast. As we passed through the airport we spotted a Vietnamese restaurant in the food court and bought some pho broth from them which turned out to be very tasty. Bear in mind that I haven’t eaten real food in close to 48 hours at this point so you could probably pour cold hot dog water out of an old boot and I’d drink it.

The air hostess has just issued some helpful tips for those passengers who are not fans of “our little rollercoaster ride” so now I know where to find the air sickness bag to hurl my airport Vietnamese restaurant broth into should that become necessary. I am strangely not super comforted by this announcement.

We’ve landed and are currently having chest CT scans to make sure we don’t have the ‘rona. The cost: a princely 79 bucks each. This place is interesting.

The room where it happens
Random hyperbaric chamber. Deadpool, where are you?

Now we’re at the Baja Hospital, where we’ll actually have surgery tomorrow, for bloodwork and EKGs. This place is squeaky clean and the floors are shiny and probably slippery as hell when wet. Having sacrificed a significant portion of my left hamstring to the Slippery Floor Gods, I am hyper aware of these things.

The nurse was tickled by my Star Wars themed tattoos and admitted, as she emphatically jabbed my arm to extract blood, that she wanted a tattoo but was afraid of the pain.

Then it’s on to the hotel where there is, according to bariatric patient lore, AMAZING BROTH at the restaurant across the street.

Update: the restaurant, Fonda Argentina, did have decent broth. I don’t know that I’d call it AMAZING, but it was pretty good. You know what looked pretty amazing though? The filet mignon that our traveling companion/nursemaid Joni had, and the little basket of bread rolls, and the little cup of garlic olive oil pesto kind of stuff. And the little sandwiches she made out of the leftovers to have tomorrow. THAT looked amazing.

After our broth dinner, during which I also drank a full-sugar Coca Cola that made me almost giddy, we made our way back to the hotel with two more servings of broth to go. There we ordered a few of what they call our “benefits,” which is a special menu of broth, popsicles, and apple juice just for us Traditionally Built ladies and gents to enjoy before and after surgery. (Rumor has it that the hotel broth isn’t as good as the restaurant broth so now we’re snobby about it.) After consuming our broth and a couple of popsicles, as well as the Coke with dinner-broth, I am well assured that I’ll be getting up at least once in the all too brief night.

This hotel is pretty nice and has a lot more amenities on the bathroom counter than I’m used to seeing at US hotels these days. For example, behold the dental care kit and, my favorite, the SHEWING KIT.

In case you get a rip in your TROUSHERS

Now we’re tucked into bed, at 9pm, because our assigned time to be picked up to go to the hospital is FOUR FORTY-FIVE A.M. in the actual MORNING. Joni reminded us gleefully that we’ll lose an hour tonight so there’s that too.

Are we really doing this?

Taste explosions

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One thing I’m noticing about not eating carbs and sugar is that when I eat fresh food, it tastes AMAZING.

Like, I had some stir fried shramps* the other day and they were FUCKING INCREDIBLE. Like, I’m still thinking about them.

Maybe it was the marinade: so easy. A couple tablespoons of soy sauce, some ginger out of a tube, some fresh garlic run through the nifty 4-in-1 garlic press/nutcracker/bottle opener/cherry pitter that I picked up in Soviet Russia lo these many years ago, and a dash of rice wine vinegar. Stir fry that up with them dang shramps, some veg and GOOD LORD Y’ALL, DIG IN!

Buuuuuut like so many things, it turns out we aren’t supposed to have anything fried AT ALL. Not even responsibly sautéed in a little bit of olive oil. So I’m going to have to rethink that. Maybe a dash of olive oil pan spray? Is that loopholery? I don’t know. It feels like it’s not because it doesn’t really add any oil to the dish…

Similarly, we can eat all the non starchy vegetables we want, so salads are a huge part of my life. A salad made with tons of chopped up bell peppers (esp red or orange), radishes, tomatoes, and with the kind of dressing we can have (low or no fat, no sugar) — MY GOD, GET IN MY BOCA RIGHT NOW!

This is all pre-op. Post op, once you have gotten through the healing process and relearned how to eat, the rules are looser. But pre-op they are Not Screwing Around. You have your orders.

Do I miss cookies and cake and chips and all the things? Yes, yes I do, sometimes. But I’m trying not to focus on that because therein lies madness. I just try to turn that part of my brain off. (Like a light switch… you go “click”…)

*re: shramps — went to the meat/seafood counter of the store and bellied up to the case, told the guy I needed to buy some shramps. He said, “Some shramps? Sure!” and I was unreasonably excited by this. My life is good.

Protein shakes make me want to hurl

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So it turns out that so far 3/3 protein shakes that I’ve tried have been barftastic.

It’s not that I don’t WANT to like them, because they often smell delicious, and I want to do this and do it right — but the mere thought of drinking one just gives me the willies and not in a good way. Something about the texture? The weird aftertaste? They way they make my stomach churn?

I’m trying the third variety now, they are definitely variations on a theme but eventually I hope to find one that doesn’t actually made me gag.

Meanwhile the sugar and carb cravings can get intense but today I feel much clearer in my brain (no more “brain fog”) and kind of more energetic and able to focus than I was last week, and somewhat less nauseated over the course of the day. So far, anyway…