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Nova Terra

~ Just another way of stalling on my other writing

Nova Terra

Tag Archives: gastric sleeve

The Day My Brain Broke

16 Saturday Apr 2022

Posted by lionsofmercy in Blog

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dehydration, delirium, friends, gastric sleeve, illness, life, love

I’m tempted to stop going on vacations.

I tried to take a couple of weeks last month because I just wanted time off to chill and make art. Instead, I had to wrestle with the fascinating experience of Abilify discontinuation syndrome. The best way I can describe that was that it was akin to being on a three-week-long emotional acid trip. I never became psychotic or delusional, although I did have a couple of major epiphanies–the Abilify, in its desire to save me from myself, had been bossing around my dopamine for over a decade, and had padded me with chemical bubble wrap to protect me from my emotions.

Very luckily, I have mad professional skills if I say so myself, and thus I did all the stuff: I was in close communication with my providers, I used my lovely support network, I journaled, and I made art. After roughly five or six weeks, I was back to normal, other than a mild case of tardive dyskinesia, which seems to be on its way out an ångström at a time.

However, after the above, I was ready to go back on vacation. Last Thursday (April 7, 2022) I was delighted to be scooped up at work by Angel and Saint, the lovely friends who live in a restored farmhouse in rural Connecticut. (A side note: I had many Zoom tours of this house, making the actual experience a tad surreal, as if I were in one of those numinous locations in a dream you just barely remember.) We chatted, I met family members, had a snack at teatime–and then as evening approached, it began: I felt a little queasy. The itty bitty tummy is a sheeping diva, and so this was nothing new. I went to bed at my usual ridiculous hour, Angel and Saint went to choir practice after teaching me where the coffee was, and I figured I’d feel better in the morning.

I didn’t. Itty bitty tummy was empty, so when the inevitable began, it was extra-awful. I was grateful that my hosts were on a different floor so I could be wretched in privacy, but at 4 a.m. some survival instinct kicked in and I tapped on their bedroom door. We ended up at an acute care place, where they did things I don’t remember (Reader, take note). And then it happened: I stopped making sense–or memories. I had severe aphasia; I am told that somehow I used the word karaoke in trying to talk to the doctors.

Angel filled me in on Friday later. I have a few dreamlike flashes here and there–realizing one of my earrings was missing, being snuggled by the fiercely protective Angel, my strong and silent daughter having hysterics at my bedside, and one long vagueness of trying to find words and gamely tossing words out in hope that somehow people would understand me. But that’s it. (Angel told the docs some important piece of information, and apparently I greeted each of the *three* repetitions with surprise.)

This was worrisome, so they did some CT scans and whatnot, and told us it was either dehydration or a mini-stroke. Have a nice day, ma’am.

Angel wasn’t having any. She got hold of my daughter, who agreed with Angel’s gut feeling that I needed a real hospital. So back north we headed–Angel’s husband Saint logged sooo many hours driving hither and yon!–and I ended up at the real hospital in my city. I was rapidly admitted, given an IV and my fifth anti-nauseant shot, and lined up for testing in the morning.

I woke up feeling perfectly fine. Maybe not ready for breakfast, but that was a moot point, as I was NPO since midnight because testing. I could talk and I remember Saturday quite normally, as opposed to the long blanknesses of Friday. After an echocardiogram (heart ultrasound), a stress test (I am quite out of shape, but not dangerously so–test was embarrassing but I passed), and a brain MRI (John Cage meets industrial meets percussion minimalism! What a LOT of different noises! The tech now thinks I’m a weirdo) the Real Hospital said, “Uh, dehydration and *maybe* a TIA? She’s fine now! Check in with your neurologist just in case!” And home I went, my vacation having been exceedingly short.

My neurologist is a mighty man of science with more compassion and work ethic than I’m used to. Instead of calling the office to talk to him in three months, I used the patient email system and he got back to me immediately.

It hadn’t been a TIA after all–the symptoms went on too long and weren’t quite right. Instead, I had been literally delirious from dehydration.

Delirium? Really?? At first I found this a relief–no stroke issues to fret over, and by golly, I had always feared I was that lady in the old movie whose aneurysm was inoperable, but now the MRI gods have proclaimed Mr. Brain to be A-OK. However, as the week progressed (and Mr. Brain finished getting back online), I figured out that delirium is kind of near the end of the dehydration journey. What the what?

On that Thursday, I had had a small beverage with lunch, and then a couple of sips of tonic water about three hours later. (In between I had the delightful social occasion of gabbing with Angel and Saint as we drove down to Connecticut, so BIG distraction.) I didn’t feel particularly thirsty. However, by the time the acute care people put in a line, I hadn’t been able to hold anything at all down for ten hours, meaning that on Thursday I had one cup of coffee and one half-bottle of tea–and then no other fluid for about 16 hours. (In case you’re wondering why the lack of peeing wasn’t a clue, I will overshare that I’m used to not needing to pee, especially at work, where there are distractions.)

Gentle Readers, this sort of thing is very bad. People go on hunger strikes, not thirst strikes, because those would be very, very short–about three days long for the average person. I keep forgetting, but Teeny Tiny Tummy means I’m no longer average: I am supposed to be working much harder on getting in the basic raw materials. Protein, yes–but water comes first.

I am guesstimating that I’ve been chronically dehydrated for weeks if not months. Not entirely sure why, but I’ve been making do with about a liter and a half per day–which is about half what it should be. Thus, between that and having lost 115 pounds of backup storage space, I hit the wall relatively quickly.

As a coda: I felt AWFUL over causing such a kerfuffle and needed the reassurance of talking to Angel *twice* before I forgave myself for having needed to be loved and cared for. It would seem that I have more to work on than just my fluid intake . . .

So check yourselves, folks. Two liters per day, or whatever it takes to pee clear. (Your urologist will also thank you for this.) Mr. Brain needs that, else he breaks. And a heads-up? If you’re lucky like me, dehydration can cause nausea and vomiting, setting up a vicious cycle which needs emergency medical care: I now have a large adhesive burn from that first IV, but that may have saved my life.

.

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My Tummy is Officially Tiny Now

17 Sunday Jun 2018

Posted by lionsofmercy in Blog

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Tags

bariatric surgery, dieting, fat, gastric sleeve, illness, life, surgery

For those of you just joining: I am a 55-year-old ciswoman of mixed racial heritage who started this journey with a BMI of 49, cardiac artery disease, type 2 diabetes, high blood pressure, and high cholesterol. My knee muscles never bounced back all the way after their replacement surgery a couple of years ago–although the titanium parts work fine, at 285 lbs they had too much to haul around. So my mobility has been limited for the last two years and I need a cane on stairs. I had a minor heart attack two years ago, and when they went to place a stent, my right coronary artery was 95% occluded–as the OR nurse said, I was one cheeseburger away from The Big One.

Being fat runs in my family, and although I whimpered in the back of my throat when I hit size 26, I actually have a healthy ego and have been a fat activist. I still support anybody’s body, although if you’re as unhealthy as I was, I suggest you . . . think things over. I will never proselytize, and there are other modalities of getting your body healthier besides the one I chose.

But then came the day my very nice, non-fat-bashy cardiologist turned to me and asked, “Have you ever considered bariatric surgery?”

Tl, dr: I’m not a skinnyism fascist, and I didn’t do this to become gorgeous, because I started that way. My kids need me, and I can’t afford to die yet.

The Surgery: After looking at the options for bariatric surgery, I chose the sleeve over the bypass for two reasons: The “connect piece A to piece Q” part of the bypass creeped me out and . . . damn it, I wanted to be able to cheat a little without an unpleasant physical reaction to simple carbs called dumping syndrome. (I was gambling, because some people dump with the sleeve anyway.)

I ended up losing 25 pounds to slim down my fatty liver, which was in the way, and every so often I would think, “Well, you’re losing weight . . .” (And then I reminded myself that we’d been to that rodeo before and it had all come back, as it does for 95% of the dieting population. True, there’s only a 56% success rate at five years with the surgery, but I know how to succeed and have been given the tools.)

For the last two weeks I was a ball of nerves, but despite an administrative glitch that postponed me a week, I showed up at Boston Medical Center last Wednesday, and the deed was done. Every single staff member (except maybe one nurse who was a tad brisk) was a complete honey and I am proud they are my co-workers.

It was rough. Probably because my surgeon had just reshaped my normal footballish tum into a small banana holding maybe 5 or 6 ounces max, I had horrible post-op nausea and retching, and the anesthesia took a long time to shake. (I’ve been induced with propofol a lot, and it never did this before.) Thus, Wednesday night flashed me back to hyperemesis with my daughter (18 weeks of non-stop “morning” sickness with 7 hospitalizations) because I haven’t had an experience like that in 30 years.

Pain, on the other hand, has been almost non-existent. I’m just on tylenol. Liquid tylenol, which isn’t as yummy as Robitussin but a lot better than the liquid bactrim I’m on as prophylaxis against my kidney stone, which of course picked this week to give me a UTI. What I am mostly is exhausted. I feel like I’ve walked through fire.

Probably the worst part is that all my meds have to be powdered. Imitrex? Kinda nasty. Metoprolol? REALLY nasty. Ranitidine? Worst of all. I know there are those of you out there who chew all your pills, and I think you’re freaks. Brave, wonderful freaks. How the hell do you do this?

I will be on a liquid diet for the next 2–3 weeks, and then graduate to very soft food. Most of my hunger-making hormones were secreted by the part of the stomach they excised, so I will have no appetite for the next half year. Right now, that’s just ducky.  It’s all I can do to stay hydrated right now–that’s the first goal; the second is high protein intake to reduce muscle wasting.

I’ve already lost 5 pounds from my pre-surgery weight. But the big news is that my diabetes has somehow gone into remission: No more insulin (I was on a high dose, too) and not even oral meds, thank all the gods, because those pills are huge and I’m sure taste awful.

So far, no regrets, other than some purely post-surgical self-pity. We’ll see how this goes. I’ll keep you posted.

 

That Bariatric Thang

20 Sunday May 2018

Posted by lionsofmercy in Blog

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Tags

bariatric surgery, diabetes, fat, fear, gastric sleeve, heart disease, life, sleep apnea

My cat knows it’s Sunday, and that hence our household runs an hour early. I am trying to let my son (the cat valet) sleep in for fifteen minutes. So Zoe is biting my legs–with great affection, I hasten to add. Unbidden, I get this flash of a post-surgical nibble. Maybe the fat helps insulate the nerves, and now it will hurt more. Maybe it would startle me into acting out on Zoe. And then maybe–

(You’ll have to excuse me. I think the most horrible things. Not just sometimes, but consistently. I suspect that this is part of why we writers are often a dour race.)

After attending group info sessions (three), visiting the dietitian (a couple of times), a shrink-person (who then needed documentation), a nutrition doctor (who put me on vitamins), my cardiologist (something of a character) and consuming hundreds of protein shakes, I was given my surgery date for my gastric sleeve this week. It is now less than three weeks away. Yipe!

I only lost ten of the sixteenish pounds I had to lose pre-surgery, so in a few days I start the no-kidding diet, which I’ll be on for the two weeks before the operation: shakes for both breakfast and lunch, and *gulp* a LeanCuisine dinner. “Couldn’t I just have another shake?” I asked the PA.

Nope, and “you’ll be hungry,” he warned. However, two weeks of this should take about eight pounds off. This is so all the instrumentation can fit around my corpulent little liver–thank mercy it’s laparoscopic “bandaid” surgery. (Yes! You too can have your stomach essentially removed through a two-inch incision!)

I don’t mind admitting that I’m freaking out. There are like all these voices in my head screaming, “What are you DOING???? Aieeee!!!” But then there are things like the looks of relief and satisfaction on the faces of all my medical personnel: When I started this project, I had a BMI of about 50; the ten pounds hasn’t done much to that. I also have “the trifecta” of diabetes, high blood pressure, and cardiac artery disease.

Plus high cholesterol, sleep apnea, and needing help to get things off the floor, not to mention not being able to easily take care of my feet–my tummy is in my way. So losing a bunch of this is only a good thing. But it’s still scary. I’m also afraid of the loose skin making me look like a shar-pei. We will have to see.

 

The Adventure Continues

02 Saturday Dec 2017

Posted by lionsofmercy in Blog

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Tags

bariatric surgery, data, fat, gastric sleeve, injustice, mental health, mental illness

Sorry to have been AWOL for so long, but between Inktober (which I didn’t do very well on) and NaNoWriMo (squeaked by), my creative energies have been sucked dry. In fact, in the interest of full disclosure, I’m making this post because all I need to do is tell what happened, not pull it Athena-like out of my forehead.

Last post: I finally decided to go for bariatric surgery, and joined the program at Beth Israel, where I had my knees replaced last year. I ended with being about to join the new patient group.

Well, no, bunkies. That didn’t happen.

Instead, I got a call a couple of days beforehand from a social worker who wanted me to come in to talk about my *chord of ominous music* Mental Health. So I get there, and am told that my diagnosis of Dissociative Identity Disorder scared the bejeebers out of their staff. My favorite line from this interview was the lady saying, “As it is, we have patients say they feel like an entirely different person afterwards.” (This sort of thing has nothing whatsoever to do with the alters experienced in DID.) In vain did I try to educate her, both about DID in general (spectrum disorder; not often as dramatic as Sybil) and my case in particular (well-controlled thanks to excellent therapy; don’t dissociate anymore). She managed somehow to combine “Sympathetic and on your side” with “Boy howdy, ain’t you the freak!” She claimed they’d never had a DID patient. (Well, if you don’t let them into your program . . .)

They kicked me out of the program. She told me (with the tiniest sneer) that there were over 30 programs in the city. I said, “Yeah, but my insurance sent me here.” She gave a cryptic little smile and suggested I call them back. Sheep you, honey.

Happily, said insurance covered the programs at the other huge local hospitals, so I steeled myself for a round of phone calls. I started out with Boston Medical Center, because I happen to work for them. I am a Certified Peer Specialist, which means I’m professionally qualified to deal with my fellow mentally ill and to be a Shining Example of Recovery. In other words, they hired me because I’m crazy, so I figured they’d have their nerve turning me down for the same reason, right?

I call and get the coordinator. I gave her the two sentence version of the BI story and said, “So BI thinks I’m too crazy to cut. What about you guys?” In an impassive voice, she replied, “We take everybody. Come on in and talk to the surgeon.”

Well now! I watch what by now is the third informational video, and pick the surgeon who seems most sympatico. I went in and talked to this very nice man, who has operated on people who were unrecovered schizophrenics. (Even really crazy people deserve medical care, folks.) The worst news I got from him is that my GERD means he sorta leans toward the RNY gastric bypass instead of the gastric sleeve, which is the procedure I want.

He had heard my story about Beth Israel and their weirdly creepy head surgeon before.

So why did this happen? Because what BI’s bariatric program is doing is called cherry-picking their data. This means that by refusing to treat people they fear may have less than picture-perfect outcomes, their end data looks amazing. They claim they’re the best program in the area, when all they are is a pack of hyenas who share the same level of accreditation with hospitals which actually (be still my overweight heart) heal the sick.

 

 

Nova Terra

just another way of stalling on my other writing

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