One Month Post-Op Surgery Round #5...Dr. Rasmussen

I have my one month follow up with Dr. Rasmussen. Things seem to be going well so far. I seem to finally be at a stable weight. I am having a few issues right now that are a little worrisome.

1. I have absolutely no energy. I fall asleep if I sit still for more than 15 minutes. I have to keep myself moving constantly to avoid this. I have never been a nap person before and I feel like I need a nap every day to survive
2. I am having what I like to call pass-out episodes. It is happening more frequently and always in the morning. I had these start happening when I had the original surgery and it was because of low potassium. Dr. Rasmussen had my potassium checked a week ago and it was normal.
3. I have this pain that stretches across my whole upper abdomen. It feels more like a tearing/stretching sensation, not necessarily “bad” pain. I can’t lay completely flat because of this sensation. This also has made sleeping interesting.

Dr. Rasmussen has a few solutions/options to these problems. They are as follows:

1. We are going to repeat all the bariatric post-op labs that were done 6 months ago. I should be on a yearly schedule of these labs but haven’t quite hit that point. I will have these done later this week.
2. Passing out could be related to a number of things. Since it happens first thing in the morning, Dr. Rasmussen thinks it may be related to my blood sugar. He wants me to test my blood sugar when I have another one of these episodes. He also said that hypoglycemia may happen after this type of surgery. He said it could also be related to low protein intake. I should be at 60g of daily protein intake. However, on a good day, I can get anywhere from 20-30g of protein in. He wants me to swap more of my veggies and fruits for more protein rich foods and try and hit this target.
3. Dr. Rasmussen thinks the pain/sensations of tearing are related to having the surgery. Pain like this normally resolves about a month after surgery and I am right at that point. So we are going to just watch it for a few more weeks to make sure that it goes away.

Now, about this lovely feeding tube... The feeding tube has been in for 9 weeks now.9 whole weeks. Which in the grand scheme of things, seems like nothing! But, it is the 4^th one and I am tired of it and tired of the routine of having it. However, both of us feel it may be premature in pulling it. I am maintaining my weight but that’s with 1200 calories of tube feed. He is worried about what will happen when we rapidly take away the 1200 calories. So we are going to decrease the tube feeds to only 800 calories. What worries me is the passing out issue. If I am getting all this nutrition throughout the night, and still feel awful in the mornings, I am scared to see what will happen if that is taken away prematurely. I don’t want the tube anymore but I also don’t want another one placed in a couple of months. So for now, I will suck it up for a few more weeks and deal with it.

Game plan for now: I will see him again in 2 ½ weeks and we will see where things are at. If things look OK and are progressing in a more positive direction, he will pull it. If not, he wants to leave it in for 2 more weeks after that. 

3 Weeks Post-Op

I have started having dizzy/fainting spells. I can't stand for too long without getting crazy dizzy and feeling the need to faint. My heart races and I feel like it is going to jump out of my chest!

I called Dr. Rasmussen's office and we are going to check my potassium levels and glucose levels (I had this same thing happen when my potassium levels were low last year). I am also so weak and have absolutely no energy. I feel the need to sleep all day long! I am also having some funny pains in my side again.

**I got the results back from the blood draw and everything looks normal with the potassium and glucose. He wants me to drink some Gatorade to get my electrolytes up to see if that helps. I will see him in another week. I am just having a hard time understanding why I feel so weak and tired and I am getting massive amounts of nutrition from what I am eating and from the tube feeds!

I just want to feel at least semi-good for a day and not have to mentally and physically push myself to make it through a day!!

2 Week Post-Op

I had my follow up appointment with Dr. Rasmussen.

At this point in time, things are looking up. I have had some pain relief from the surgery and seem to be getting stronger. He showed me all the pictures he took and went over everything in detail of what he did.

My weight has only slightly dropped since the surgery so he decides that it will be best to continue to leave the feeding tube in and do night feeds. He is worried that if we take away the tube feeds, I will lose all the weight I gained in order to have the surgery. I am still on 1200 calories at night plus whatever I am eating during the day. We compromise and decide to have another follow up in 2 more weeks instead of a month. He will decide at that 2 week appointment what to do with the tube. I have had the tube in for 7 weeks now. I am so tired of it! Its rubbing my throat raw and continues to clog on a normal basis. But I know that this whats best for me at this time and trust Dr. Rasmussen.

So for now, I will continue to do tube feeds and eat. I see him again in 2 weeks.

Surgery Day

Surgery day is here. I have a check in time of 2:15 in the afternoon. I am Dr. Rasmussen’s last case for the day. I am not too thrilled about having to check in this late because an afternoon surgery time always means delays. I spend the morning running last minute errands and trying to get things arranged for my time off. I get a call around 11:30 from the hospital that they are changing my check in time to 1:00pm because Dr. Rasmussen is ahead of schedule.

I check in to the hospital at 1:00 and get all the usual stuff done. I get more lab work done and have all my vitals taken. I change into the lovely purple paper gown and wait. My nurse comes in it and it is one of my good friends that I worked with at the hospital, this always makes things better. She starts my IV and we do the run through of how things will go. She informs me that the OR staff should come and get me around 2:30 and hopefully no later than 3:00. I sit and wait and wait and then wait some more. Apparently things are not really ahead of schedule because I am not taken back to surgery until 3:45pm. I am taken into holding and meet with the nurses and the Anesthesiologist, Dr. Pearson. Dr. Rasmussen comes in and jokes that he is cancelling the surgery because I am one pound shy of the target weight. Not funny!

I am wheeled back into OR room #14. This is a new one for me, never been in room #14. I move over to the operating table and things are situated all around me. I wasn't given any versed at this point, which I am in favor of! I like being in control for as long as possible. Dr. Pearson proceeds to place everything on me, the BP cuff, heart monitor stickers and so on. At this point, I am pretty sure I am given something because my head starts to feel funny but it takes a while to take effect. I am still talking at this point. Dr. Pearson puts the oxygen mask on my face and I am pretty sure he gives me something else because the room starts spinning. It still takes a while to take effect because they keep telling me to take deep breaths and relax, everything will be fine. It feels like a few minutes later, and my world goes dark.

The first thing I remember is being wheeled down the hall to my room. I wake up more in my room and my family is there sharing bits of information from the surgery.

THE RESULTS: Apparently I had so much scar tissue in my upper right abdomen that Dr. Rasmussen could not even see my liver. My small intestine and stomach pouch were also attached to this scar tissue which was pulling them over to the liver. He was able to detach the pouch and intestines and free up the liver. I also have an ovarian cyst. He said he didn't remove the cyst because I don’t have lower abdominal pain. He also said there were a couple of places where the small intestine was beginning to loop over on itself which he fixed. He was able to detach the small intestine from the abdominal wall. It did not have a hole in it but he did reinforce the area with some stitches. He did some re-arranging and was able to put everything back where it belongs. Hopefully it stays there and hopefully this surgery works!!

I spend the night on the 6^th floor getting drugs and having my BP monitored. I have really low blood pressure after surgery. I see Dr. Rasmussen in the morning and I am good to go home. I eat some grapes and a bite of eggs and tell the nurse I am ready to go. I am discharged at 10:30 in the morning.

I see Dr. Rasmussen in 2 weeks for a follow up. We will watch things for the next bit to see what happens. Hopefully this feeding tube can be removed soon!!

We Have A Date...

We have a date.

I met with Dr. Rasmussen for my pre-op appointment this week and we have surgery scheduled for February 2^nd. I was actually looking forward to having this surgery for the simple reason that I would be able to have my feeding tube taken out. Little did I know that this is not going to be the case.

We went over all the usual pre-op stuff. Height, weight, blood pressure, temperature, medication list, allergies, and previous surgeries were reviewed. The scheduled plan is to do a laparoscopic lysis of adhesions and to take down the small bowel that remained attached to the abdominal wall from the previous surgery. There is a possibility that the surgery will have to be an open procedure instead of a laparoscopic procedure. There is also the possibility that the intestine will still have a hole in it from where the feeding tube was inserted in from last year. Hopefully neither one of these scenarios will take place, but knowing my luck lately it’s a possibility. There is also all the other standard surgery risk involved and the possibility that this surgery won’t relieve any of my symptoms. However, I am hoping for even a little relief. I am staying in the hospital at least one night and that may change depending on how things go.

The other super sucky piece of information is that Dr. Rasmussen will NOT remove the nasal feeding tube! When I asked him about it and he said no, I really thought he was joking. Not funny! He says that he wants to keep the feeding tube in place and use it after surgery. There will be so much trauma from the surgery and I already don’t have a good track record with eating post operatively that he thinks it will be wise to keep it in and use it. We will continue using it to stabilize my weight and then slowly decrease the feeds until I am no longer in need of it. I totally get why he wants to keep it in and he is the Dr. but I really really really REALLY wanted it taken out. I am so bummed!! I am trying to remain positive but each day that goes by, I freak out a little more and now since the tube is not being removed I am not looking forward to any of this at all!! Holy crap, here we go!

This perfectly sums me up right now, in this very moment!!

2015...A better year, right??

January 8th. I see Dr. Rasmussen for my follow up since my office visit with Dr. Smith. We are going to make a decision on what will need to be done. I am so not happy about how things have progressed and that it seems like 2015 will be another year filled with medical bills and no sign of a vacation. I would love to just sit on a beach and not in the ER or the surgery waiting area or on the 6th floor of the hospital!!

Dr. Rasmussen catches up to speed with everything that has happened in the last 3 weeks. He goes over what was done in the ER as well as the Ultrasound results to follow up with the liver pain. He says that all the ducts look normal and there are no obstructions or blood clots. He thinks it could have just been a fluke thing that happened. All the lab results are normal too. One good piece of news!

We decide to proceed with the plan that we have put off for so long. Surgery. Blah. Whether that will be open or laparoscopic will be decided on the day of surgery. He really doesn't want to do an open surgery because that will only cause more scar tissue to form. He will attempt to do it laparoscopically and if he finds a reason to do it open, then he will switch to this. The plan for now is basically to do an exploratory surgery to clean up scar tissue/adhesions and to release the small intestine that is attached to the abdominal wall. There is a high probability that this piece of intestine will still have a hole in it from the feeding tube so he may have to patch that to prevent any leakage. He also agrees that he won't do any form of surgery until I gain at least 15 pounds. I try to keep a sense of humor about this part. I tell everyone that asks why I have a feeding tube in that I am just being fattened up to prepare for slaughter day. Basically how I feel. Can you tell I am not very happy about being forced to gain weight?

Dr. Rasmussen says to call him as soon as I gain the 15 pounds and we will schedule the surgery. I am hoping for February sometime. The weight is climbing but not as fast as I would like. I make a valiant effort everyday to eat something every single hour. I have avoided water the last 2 weeks because I feel like I cant tolerate liquid and food together. And food at this point will give me the calories needed for weight gain so water goes out the window. I just add extra water to my nightly tube feeds so I am still getting it, just in different form.

So now the plan is waiting. Again. I am just focusing on putting on the weight and then we will schedule surgery. I pray with every fiber of my being that this will be the end!

Ultrasound, Labs, and Feeding Tube

I finally hear from Dr. Frech's office. An ultrasound was ordered as well as a repeat hepatic function panel. I had these done on December 31. I thought I would end the year right. Ha.

I also had the feeding tube placed the same morning. I had a very hard time with the placement of this nasal feeding tube. It felt like my sinus was punctured. Then every time he moved the tube in and out I could feel it in my stomach/intestines. Not a pleasant feeling. So for 4 days straight my nose has been a faucet. To top it off, I now have nasty looking sores at the end of my nose. A tube and sores! Man, I am a sight for sore eyes!

Check out the sores!

Feedings are going well. I have gained some weight. Still have my goal to gain 15 pounds in 2 weeks. Not realistic, I know. But wishful thinking that I can gain the weight, get the tube out, and have the surgery and be done for 2015!!

Just waiting to hear from Dr. Frech's office for results. I have an appointment to see Dr. Rasmussen this week!