Before and After Pictures and Numbers!!

HOLY COW...Check these out!!

 This picture was taken on my birthday in January of 2013.

This picture was taken in June of 2013, about 2 weeks before the initial surgery.

This picture was taken in San Diego in October of 2013. 

This is about 3 months post-op initial surgery.

This picture was taken on New Years Eve 2013. 

This is 4 weeks post-op revision surgery!

• At my heaviest weight, I was 222 lbs. I now weigh 125 lbs. and have a BMI of 19.5. 
• A BMI of 18.5 is considered underweight. 
• I wore a size L-XL shirt and a size 16 pants.  I now wear a size XS-S shirt and a size 4 pants. 
• My feet have lost a full shoe size. None of my rings fit. I had to have all my watches re-sized!
• I have lost 97 lbs. in 7 months. I think you can tell the most in my face!

Never in my wildest dreams did I think I could be this small. It never even crossed my mind that I would battle becoming underweight once I had this surgery.We expected weight loss, but not this much and this fast. The weight loss has been a blessing but at what cost and where do you draw the line?

I guess for now, we'll enjoy the shopping for new clothes and not so much all the pain that comes with!

5 Week Post-Op-Dr. Rasmussen

I go to see Dr. Rasmussen for my 5 week follow up. Things are not going as well as we both expected. I still get sick and have severe pain any time solid food hits my stomach. I am doing much better with liquids, which is an improvement from the initial surgery. I feel like I am falling into the same pattern as before in regards to doing well and then once food was re-introduced, the pain and sickness comes back. The only difference this time around is that I actually force myself to eat since I cannot afford to lose a single more pound. If I lose one more pound, the feeding tube will be placed again.

Dr. Rasmussen thinks that this may have turned into a case of "Goldilocks". The first surgery created an opening that was too small. The second surgery created an opening that may be too big. It may become an issue of finding an opening that is just right. The only issue is that since it has only been 5 weeks, it is too soon to know if this is the case. I need to heal more and re-gain my strength. So now I have been lumped into the waiting game category to see what the opening will do.

At this point, I can no longer muster any more courage and my brave face falls to pieces.  I lose it and have an emotional break down right in front of Dr. Rasmussen. Luckily, he is very caring and doesn't seem too bothered by my tears and tries to convince me that with time, things will turn out OK. It gets harder every day to stay positive and have a good attitude, but I am really trying. I don't know if there will ever be a light at the end of this tunnel and this is now the way my life has become. I also don't know if I am prepared to live this way if that is the case. He wants to see me in 4 weeks and to keep a food journal. The reason for the journal is to see if food in general is causing me pain or food choices are causing the pain. He also wants me to see Dr. Frech to see what he thinks about the healing process and sizes of the openings as well.

The more time that goes on, the worse the symptoms are getting. The pain becomes more intense every day and it is becoming harder to eat. The hard part this time around is now I actually want to eat. I do have more energy so that has also improved from the initial surgery. I haven't passed out either. But I still throw up when I eat, which is becoming a little worrisome. But all I can do now is wait and see what happens…again! 

Post-Op Progress One Month

I see Dr. Rasmussen a week after being discharged from the hospital. At this point, things seem to be going very well. I feel like I actually have some sort of energy and that I am not going to pass out every time I stand up. I am still on a liquid diet at this point and liquids go down just fine, which is a big improvement from the previous surgery.

We go over all the typical post-op questions and he seems pleased as well. He adds some medication called Protonix to help with the burning sensations I am having in my stomach. He also wants me to use a steroid cream for the rash since it looks worse. I get to move to Stage 3 of my new diet which includes soft protein foods. He also says that if I lose any more weight, he will put the feeding tube back in. I have lost 12 more pounds this time around. I am to see him again in 3 weeks.

I see Dr. Frech the following week to follow up with him as well. He is not happy about my weight loss and is not convinced the surgery will work. But he says I look good and we are being hopeful that all will continue to go well. He agrees with Dr. Rasmussen about the feeding tube as well. He wants me to take it easy with the foods and see him in a month to address my progress.

I spend the next weeks trying to advance my diet. I am to the point I can take all my vitamins now, which is also progress. However, the more time goes on, the more pain that starts to come back.

5 weeks post-op and I can only drink liquids without pain. Eating is very painful again but I try my best because I cannot afford to lose any more weight. I am officially 100 pounds lighter.

Surgery...Round 2!

I meet with Dr. Rasmussen one more time before the scheduled surgery. We go over any final questions and what the final game plan will be. I trust him to do what’s best for me, and that’s the plan we are sticking with. He also wants me to see a Cardiologist before the surgery to make sure that the palpitations I am having are just nerves. I also meet with Dr. Frech the week before surgery and he signs off on me having the surgery again. I also have another pre-screen appointment at the hospital the day before surgery and get all my lab work done. So now I am signed off for surgery by Dr. Frech, Dr. Rasmussen, the Cardiologist, and the hospital.

I am to check into the hospital at 5:30 in the morning again. It’s a super snowy morning and its quiet that time of day. Everything seems so surreal and I really can’t believe that this is happening again. I arrive at the hospital and the usual things begin to happen. More labs done, vitals taken, and I get changed into a gown. I wait for the nurse to come in and begin the charade of finding a vein and doing the final prep before the OR staff comes in. Luckily for me, the nurse gets a vein on the first try. We go over all history information and then all that’s left to do is wait for Dr. Rasmussen and the Anesthesiologist to come in. A short while later, the OR staff begins to trickle into my room. The OR nurse comes in and introduces himself and hangs out until all the other Doctors come in. Next is the Anesthesiologist, then Dr. Rasmussen. All final questions are answered and the plan is gone over again. Dr. Rasmussen will take out the feeding tube and then is anticipating the surgery to take 4-5 hours. Dr. Rasmussen leaves and so does the Anesthesiologist. Now it’s time for the versed and to be wheeled into the OR. I am only slightly freaking out at this point. I mention to the nurse that I would only like a little versed because the last time I had surgery I felt like I was given too much. He laughs and agrees to only give me a little. This time I actually remember saying goodbye to my parents and being wheeled down the hall. I get my blue hat and into the OR we go. I am wheeled into the OR room and am moved onto the operating table and then given the rest of the versed. I remember looking all around the room and then the oxygen mask goes on my face and the world goes black.

I remember this time waking up in the recovery section of the OR known as PACU. I was in so much pain this time, something I don’t remember from last time. Once my pain is semi under control I am wheeled to my room upstairs. I am in a big room this time and my parents are there. The surgery only took 2 hours which to me seems like a good sign. I am informed that the surgery went well and they were able to do a lateral (side by side) connection from the stomach pouch to the intestine. They were able to do this without taking any more stomach. The feeding tube is gone. I have another stomach drain as well.

I spend the next few days in constant pain. I had a lot more issues with pain this time around. I do pass my leak test and am progressed to a liquid diet. All of my post-op labs are done and a lot of the numbers come back bad. My calcium, vitamin D, and iron counts are all low, just to name a few. We spend the next few days trying to stabilize some of these values. I am given iron infusions for 2 days. A few other highlights of this hospital stay included an allergic reaction to pain medicine which caused some pretty entertaining hallucinations and an allergic reaction to the glue and steri-strips which caused a massive rash which blistered over. I was in the hospital for 6 days this time around. Over the weekend, I saw the on-call surgeon who wouldn’t let me leave until Dr. Rasmussen came back on Monday morning.

Dr. Rasmussen comes in Monday morning and looks at my belly and tears off all the steri-strips due to the allergic reaction. This rash/hives/blisters bit looks nasty. He also decides to take out the drain. I am discharged later that afternoon and am to see him in a week for a follow up. Happy Day!

I really have the best family and friends. They kept me going this time around. I had several melt-downs in the hospital and being on so much pain medication probably didn't help the situation. I always heard the statement that in your time of need you find out who your true friends are but learned what that statement truly meant. All of the hospital visits and phone calls/texts can mean the world to you when you are sick!  It sucked to go through this once but to go through it twice was awful.

IV Iron Infusion

Swollen belly when rash first started

Belly with drain coming out of stomach pouch

Rash when it first started

Rash after steri-strips were removed

Rash a few days after home from hospital

My entertainment and happiness for a few days!!

Surgery Decisions...Round 2

I go in to see Dr. Rasmussen to follow up with the feeding tube and to go over the results from the Barium Swallow.

Dr. Rasmussen is now sure that the surgery will need to be re-done based off the results of the barium swallow and the pictures that were taken. He says that for as many times as the surgical connection has been dilated, it should somewhat still be open. I agree. I feel like all the dilations have been a waste of time especially since now the connection is as narrow/closed off as it was from the very first dilation. The only thing that Dr. Rasmussen is unsure of is how exactly and what exactly he is going to do in the surgery. The ideal plan is to:

• ·         Hopefully do it laparoscopically (not open)
• ·         Repair the hiatal hernia (if it’s small enough, he will leave it alone. May cause more harm repairing it then good)
• ·         Not take any more stomach
• ·         Repair the connection. This is the big “unsure” part. He will try to do a lateral (side by side) connection, but also says he will do what my anatomy will allow him to do.

The next few steps involve going through the same process as the initial surgery with a few more Dr.’s visits, pre-op hospital appointments, and to try and not have a major panic attack and back out.

The bright side of this appointment is that I get to bump my feeding tube to only feed for 12 hours instead of 24 hours. Yipee!

I am not excited for the surgery this time around. I now know too much of what is going to happen and the process and the pain and all the complications that happened last time. Dr. Rasmussen also informs me that this time the surgery will be more complicated and has more risks. I will also have to be in the hospital longer. I am absolutely TERRIFIED!! I have started developing palpitations in public settings and at work. Only when I am home do they go away and my heart relaxes a little. However, even with all these horrible “what if’s” constantly running through my mind, the only thing that keeps me going is the fact that I trust Dr. Rasmussen with my life and know that he will do what is best for me.

Two weeks and counting. 

Barium Swallow and Feeding Tube

I have to fast for this procedure. I check into Radiology in the afternoon and am taken back to the procedure room. We start the usual stuff. I get changed into a gown and the nurse explains what they are going to do. The Dr. comes in that is going to do all the testing and place the tube. I take my position near the x-ray machine and start drinking all their lovely concoctions of barium. The test is completed and it’s time for the feeding tube to be placed.

I lay on my back underneath an x-ray machine and the fun begins. The first thing that happens is they inject a lidocaine jelly into my nose and have me snort it in. This will numb the cavity and throat. He begins sliding it through and I only gag 4 times as it goes in. It takes a good 10-12 minutes before it is all the way in place. The tube gets taped to my nose and cheek. He then brings me in the room to explain what he can see is going on from the x-rays.

The first is I have either another hiatal hernia or the one that was fixed in the initial surgery has come undone. Second, I now have a lovely case of reflux. And last, the surgical anastomosis (surgical connection) appears to be pinched off and is measuring at 1 cm (10 mm). This measurement is the same as when we first started doing the dilation procedures. 

So to me and the Radiologist, some form of the surgery needs to be re-done. How much of the surgery, neither of us know.

Machine that runs the feeding tube

Feeding tube bags that hold the "food"

Staying positive. Evening of feeding tube placement.

More Appointments

My next appointment is with Dr. Rasmussen. We go over the latest and greatest which included the ER visit and partial blockage and the 4^th dilation. He also decides at this appointment that the feeding tube has become necessary and doesn't want to wait any longer to have it done. He is also leaning more towards the idea that some part of the surgery will need to be re-done but will not consider re-doing the surgery until at least 6 months post-op and until I can stabilize and maintain my weight. How much of the surgery that needs to be re-done he is not sure of and decides to order another test. Another barium swallow is ordered right before the feeding tube will be placed. I am supposed to follow up with him a week after the feeding tube is placed.

I also see Dr. Frech before the feeding tube is placed to follow up with the last dilation. He 100% agrees with placing the feeding tube. When he goes back to look at all my numbers, it is shocking to hear how much I have really lost. He is also super leery about re-doing the surgery. He thinks it will be beneficial to leave the tube in place for 6-8 weeks and then pull it out and do a steroid injection into the surgical anastomosis. This can prevent inflammation and allow that area to heal better. He also suggests doing a side by side re-connection in the surgery. This involves cutting the old connection loose and bringing the intestine side by side and cutting it open 3-4 cm and then connecting that to the stomach. He wants to see me again in 6 weeks or before that if Dr. Rasmussen decides to do surgery.

At this point, I am confused at whose plan I want to go along with.