If you missed the first two installations – see:
So, as I was saying before I got distracted by Spring Break, a sick kid, feeling better and having WAY more energy, and then having a little bit of a setback…
Dr. Zelko was making noises along the lines that I would possibly get to go home from the hospital! We both agreed that the hospital was the last place a person with an open wound needed to be! So – in order to get sprung I had to accomplish several things… one of which was get my lab values to improve significantly – and the only way to do that was to utilize the feeding tube that went through my abdominal wall to the jejunum.
Given all of my allergies, it took a while to find a product that would work for me – but with the help of an excellent nutritionist we found Peptamin AF – a predigested form of nutrition that would deliver all of the nutrients I would need to dig me out of the nutritionally compromised pit I’d been in for months on end by this point in time.
As a DS’er – my albumin level should ideally be at at least 4.5 g/dL. My nearly daily labs in the hospital showed my albumin level at 1.5. In essence, Dr. Zelko explained, I didn’t have enough protein stores in my body to begin to heal from my surgeries, the wound infection, much less regain my strength.
So tube feedings it would be – 24/7 for the coming 6 weeks.
So – even though I was about a weak as a newborn kitten, I was discharged on Friday, February 12th. Woo Hoo!
Little did I realize how taxing the 15 minute drive home would be. That pretty much was the end of my energy for that day, and so I went home and essentially zonked out.
My only outings for the next month would be doctor’s visits. And those involved debriding the wound – so I’d come home ready to whimper, whine, and then nap!
After only two weeks of tube feedings my albumin level had increased to 3.0. Woo Hoo!
However, my weight dropped down to 120 lbs. I think in part it was because I was finally off of IV’s and was slowly attempting to adjust to what eating was all about with my new configuration. I looked pretty awful at 120 lbs. In fact, it scared me a little – was too reminiscent of my Mom before she died – she lost so much weight in her last weeks of life. So, after a pep talk from the nurses, the doctor, and some strategizing with John, I determined to get really disciplined about making sure I was getting in more calories daily.
At my next doctor’s appointment, Dr. Halpin told me that if I could get my weight up a few pounds, she’d consider stepping me down to 18 hour a day tube feedings. So, that was the goal – and I was able to do it!
After a week of 18 hour a day feedings, I was able to discontinue tube feedings. The deal was that if I could keep my weight within 5 pounds of where I was at the date of discontinuation, then the feeding tube would be removed.
I’ll admit it – I freaked out a bit. Not only was I able to keep my weight steady – I was able to increase it – at a rate of 3 pounds a week for three weeks.
Confession: Serious freak out.
At the rate of 3 pounds a week I would quickly be in scary weight territory. Yeah, I needed the extra 9 pounds. But not much more than that! See – here’s the thing that everyone has warned me about my new configuration – it will be MUCH easier to gain weight. Like too much weight.
HELLO! Remember me? The girl who started with a BMI of 66? 365 pounds? Wheelchair bound?
If there’s one thing my body knows how to do is gain – and hold onto – weight!
They say that if you have four family members in four generations who are morbidly obese, then you may have a genetic predisposition to obesity. I’ve got NINETEEN in four generations.
This scares the snot out of me.
So – maybe I should explain this new configuration – ’cause I haven’t really yet. I wish I had a copy of that x-ray they did a couple of days after surgery. It was an upper GI and I got to see the films at the conclusion – it really helped me to grasp what was going on – as did the radiologist’s excellent explanation of what was being seen.
Essentially – I have:
- 1 inch of buffer stomach material between the esophagus and small intestine. (They’ve learned that small intestine sutured directly to esophagus does not fare well – hence, they try to salvage some stomach material to buffer the two. When they are able to do this, there is a reduced risk of leak.)
- Small intestine
My intestinal configuration has been changed now so that the alimentary limb, biliopancreatic limb, and common channel are now all 100 cms in length. (Previously my alimentary limb was 285 cm, and my common channel was 65 cm.), and biliopancreatic limb was the balance.
So – no more stomach, of course, and no more pylorus. No pylorus means no sensation of full any more. That is then combined with no sensation of hungry (although I can and do get a blood sugar drop out if I go too long without eating) because of the removal of the stomach and nearly all of the ghrelin production.
Pylorus – just for basic understanding – is kind of like getting a shut door at the base of your stomach – giving you the signal that you’ve had enough – you don’t need any more.
That’s a scary thing to have gone.
Especially when you see my x-rays and see that I’m just a big up and down tube from esophagus to small intestine.
It is absolutely frightening how much I can eat now. And things that I have avoided a lot during the season of my DS – like rice and pasta, the amazing ever expanding foods – ’cause honestly, they were a waste of valuable real estate – are SO easy to eat now.
So – my new life as the Gutless Wonder will entail a lot of calorie counting, a lot of dieting, and – likely – a lot of freaking out about the scale.
I’m not loving that so much.
Cause I gotta be honest. I loved having a BMI of 22. Yeah, I know – that was when I was too thin.
I won’t lie – I loved wearing size 6. I know – the size on the tag has nothing to do with real life. But it’s an easy place to get comfortable.
Okay – so I know if you’ve been in the WLS community any length of time you’ve heard this more than once: “They didn’t do brain surgery!” Yeah, well duh! If only it were that easy!
Okay – this is getting long and has taken me far too long to put together, so I’ll close out this chapter and finish the balance tomorrow, okay?