2 days post op - and it wasn't what I was expecting!
Well, I was totally set and absolutely prepared for my gastric bypass. Researched til those wayward cows got back to their houses and then some. Considered all the angles, looked at it backwards, forwards, sideways..... all ways except for what happened. So I share my tale cause I hadn't come across this AT ALL anywhere on this wonderful web of ours. That's not to say it isn't out there, it may well be, but I hadn't found this possibility and so, I hadn't considered it.
I couldn't have a gastric bypass.
That was a curved ball if ever there was one.
Of course, it made absolute sense once I spoke with my surgeon as to why, and he gave me an alternative that we decided to go with instead and I've had a gastric sleeve. Let me explain. Back in my early 20's I had the first of a series of surgeries for various different gynae issues. The first one was a large dermoid cyst on my right ovary. It was the size of a melon, weighed 2lb and (skip past this bit if you're a tad squeamish) it had 5 teeth, hair and sweat glands. Apparently dermoid cysts are like this, a ball of genetic matter that some think may have been the incredibly early stages of a twin.... I'm not so sure about that and more recent thinking has changed that view but all the same, at the age of 20 that's what they told me. They also said my ovaries looked like bunches of grapes. I had no idea what that meant at the time but later found out that I had practically the entire book of gynae issues going on with me and after a couple more exploratory keyhole surgeries, I had a full hysterectomy at the age of 42. I had a retroverted uterus with endometriosis, adenomyosis, fibroids, endometrial cysts and a ton of adhesions from the surgery and the endo. Those grape ovaries - yep, they were polycystic, I had PCOS too. There wasn't much of a chance of any of that equipment ever working correctly so I was very glad to be rid of it back in 2014. What hadn't occurred to me is the effect of all that surgery on my intestines. I think I'd had a passing moment seeing a video where someone didn't have a long enough bowel to be pulled up to create the necessary connection for gastric bypass and wondered if I would have, but it didn't occur to me at all what the surgeon told me.
Those surgeries had left a lot of scar tissue, I'd had the first one from my belly button downwards and the hysterectomy across hip to hip. Surgery scars and endometriosis isn't the best of combinations, and I also learnt on Friday that the body sends fat cells to help with healing too and it all gets super sticky. I was told it was very unlikely that bypass was possible because it would be incredibly likely that my intestines would all be stuck together with the adhesions and scarring. It did make a lot of sense and I recalled a day case keyhole surgery I had once that lasted most of the day cause they weren't able to get through the scarring.... and that's where my bowels all sat. I understood completely but it just hadn't been on my radar at all before that discussion - after I'd had all of the pre-op tests too! We decided on a plan, going in for the bypass first and checking around with the camera if that scar tissue was there or not, if it was there, then we'd go to plan b and do a sleeve. I was very nervous of this as I suffer with reflux, my surgeon said it was very likely that I had a hiatus hernia and that he would repair that if I did.
And so it was.... my gosh, my surgeon videos the surgery and you get to see the "highlights" and that goo.... well it looked like a toffee factory inside my belly (I have the video, I may share a little of it behind a thick curtain at some point! ) Bypass was immediately off the table and he went to do the sleeve as we had agreed. I did have a hiatus hernia, to be honest I had thought I had one and was glad that it was being repaired. I was a little disappointed that the pre-op tests showed no gallstones, I was keen to have my gallbladder removed during the same surgery, but alas, it was not to be, not a single tiny speckle of stone was present in there. The other pre-op tests were very extensive. I had full bloods, ecg, lung function test, chest xray, heart scan and a full body composition scan before seeing the surgeon with the results. Turns out I have two big factors going on preventing me from losing weight by simply eating less - my vitamin D levels are less than half what they should be, which has slowed my metabolism down and I also have insulin resistance (not a surprise given the pcos) - do you know what, it was good to hear that there were reasons that I had been struggling to lose weight, I could eat practically nothing and still no weight would budge. I did feel a justification with that info, it had been a difficult path and it wasn't just because my head refused to diet for any length of time. The full reset of a liquid LRD had worked for me but boy, it was tough and certainly not sustainable over the long term. Still, it did what it needed to do and my liver looked great on the video, a smidge over 15lb gone too, not to be sniffed at by any stretch of the imagination, my best ever result from such a short time period. I'd lost that over just 20 days.
Lets talk about the surgery, I'd heard some horror stories of being strapped down to the theatre bed and indeed they did do that - but not as had been described to me. The sedation from endoscopy and incoming anaesthesia may have had an effect on the recall of what is a bit of a shock if you're not expecting it, and I've also concluded that they put the least friendly nurses into theatre cause they were very unpleasant. I had my left arm out to my side, my body was loosely strapped at the hips, which honestly felt quite comforting, I knew I wouldn't roll off the bed mid-op at the very least! The anaesthetist told me he was a doctor of medicine and his job was to put me into a lovely sleep, and as my right arm was being put out to the side I felt my lips beginning to tingle. This moved across my jaw and I figured then that sleep was coming... then I woke utterly convinced I was going to be sick (deep deep mental scars from surgery 30 odd years ago!) and asking to sit up, begging to please sit me up. I got several firm "no's" to that, probably from them nurses again. I was wheeled to recovery with my legs shaking uncontrollably. I remember a lovely man telling me to breathe deeply and it would settle down, he sat me up a little and I was so grateful. The shaking did calm and probably within a few minutes I was ok. I was keen to know the time and I know I was taken from my room to theatre at 2.30pm. I saw the clock in recovery and it was 4pm, I was back in my room before 4.30pm. It was all very quick and efficient. I remember asking if I had sleeve or bypass - I heard a distance voice shout sleeve and then yes when I asked if I had a hiatus hernia too.
And then I slept a while... one of the surgeons came to see me to explain that the adhesions had been very bad so they had done the sleeve, I think I was drifting in and out of sleep as I asked him the next day if he had been, indeed he had but the memory is more like a dream of that. So here I am, completely geared up for bypass recovery and finding I've had a sleeve instead. Not too much difference really, the recovery should be a bit faster with sleeve and any issues with malabsorbtion shouldn't be present either. I'm two days now, about to the hour too and I've been able to shower, go outside for a walk and done a bit of dancing up and down the corridor on our daily walking routine. So far, so blooming good. My care has been second to none, kind and considerate and delivered with compassion. Discharge should be tomorrow and I'm ready for a change of scene and a little bit of fresh air too. Just need this cannula out now, no more IV drugs, they're all coming by mouth now, along with a little apple juice, a small protein shake and my obligatory 5 glasses of water. Tomorrow we all get to know the routine from here with the dietitian, won't be anything remotely solid for a few weeks yet, this new tiny stomach needs time to heal.