Monday, August 8, 2011

Gastric Bypass

Gastric Bypass Surgery

I was crapping myself (almost literally), but mostly from the excitement of it. I'd worked so hard to get there and I was relieved that it was finally going to happen for me. I woke up at the crack of dawn and Dave and Carol drove me to Sutter Roseville hospital, which was about an hour away from where we lived in Davis. The hospital was beautiful. It seemed more like a Hilton than a hospital (of course I didn't have to try any of the food, though!) Dave stayed by my side I honestly never got scared or shed a single tear until the nurses came to wheel me into the operating room and I had to say goodbye to Dave. That, I’ll admit, was pretty hard.

WHAT THEY DID TO MY GUTS: THE ROUX-EN-Y SURGERY ITSELF
The specific surgery I underwent is called Laparoscopic Roux-en-y surgery. Here is a pretty picture of what RNY surgery sometimes looks like:
Rny_surgery
(Photo courtesy of Robyn Anderson)

See those two lines of staples? Well surgeons have different ways of approaching this, but my understanding is that in my case, my stomach is now completely separate from that little pouch. I wanted it that way because I’ve heard horror stories about people busting their staples loose by overeating and basically undoing their surgeries. Once those staples are gone or stretched open, you would basically be back where you started and you would easily be able to gain back any weight you had lost. In my case, that’s not possible because my pouch is completely separate from my old stomach, like this:
Rny_surgery_separate_stomach
(Illustration courtesy of Melting Mama)

Contrary to popular belief, I still have all the guts I was born with. With the exception of my gallbladder and its lovely stones, absolutely NOTHING was removed during the surgery. It was all just rearranged. I would never want to, but I suppose if it was necessary, they could somehow reconnect my guts in the future because everything is still there. I've never heard of it, but people have definitely asked me if I would have it reversed after I lost all my weight, which is ridiculous. If I did that, I'd get fat again. Duh.

Technically, there are a bunch of different types of weight loss surgery. Some rearrange the stomach differently; some purposely bypass additional length of intestines to increase malabsorption. Gastric banding is becoming more popular as insurance companies are beginning to cover the procedure more often. It’s very different, less invasive and almost impossible to die from. Basically the death risk with RNY surgery is that they accidentally perforate your bowel and you end up with bacteria floating around inside of you causing all kinds of nasty, horrible, deathy trouble. It really is a scary surgery, but statistically, it’s also the most successful.

That said, my surgery, including my gallbladder removal, took the doctors a whopping 50 minutes. It’s a quick and easy surgery, particularly if you chose a surgeon who does a lot of them. (Did I mention yet how important it is to CHOOSE A SURGEON WHO SPECIALIZES IN OBESITY SURGERY?!)

THE HOSPITAL STAY
This was the first time I'd ever had general anesthesia in my life, so I was surprised to wake up and feel like literally ZERO time had passed. I remembered the freezing cold operating room and the giant metal cross I was laying on when the anesthesiologist asked me to count backwards from 100 and then BAM, I was awake again. Being medically knocked out is totally different from sleeping. Your brain loses the time and you wake up in a weird, hazy time warp. I think a lot of people, myself included, wake up thinking, OH NO, SOMETHING HAPPENED AND THEY DIDN'T DO THE SURGERY. But then I looked around and realized I was already in the recovery room. All was well.

They got Dave as soon as I started to wake up and I was super happy to see him again. Fortunately, the pain was never all that bad and I didn't get nauseated from the anesthesia. All I had to do was ask and the morphine was right there.

Unfortunately, there was a bit of a snafu with my IV after I got moved to my room. I had very specifically indicated that I was allergic to NSAIDS (Aspirin, Advil, Motrin, Aleve, etc). They make my stomach BURN LIKE IT'S ON FIRE. By the time Dr. Waldrep came in to visit me, maybe three hours after I woke up, he asked me how my pain level was and I told him the truth: that my stomach was on fire. He was totally surprised because the pain from the surgery is never, EVER burny. It's supposed to be achy, but not burny. I told him about my allergy and he checked the IV bag only to find that one of the drugs being pumped through me was technically an NSAID. He immediately had the nurse change the bag and I started to feel better after a couple hours and with a little help from Dr. Morphine. Having my own private hospital room and bathroom didn't hurt.

Your mileage may vary, but I did not find this surgery to be painful at all. If natural childbirth is a ten (and we all know it is), then the post-surgical pain from gastric bypass surgery is a two, if that. It was easy to manage and mostly amounted to post-operative soreness near my port sites. It only took me about three days to get my energy back and I don't remember spending any of that time popping pain pills. The most painful part is that they have to fill your abdomen with air during the surgery and that air then loves to travel all around your insides and wreak havoc for literally WEEKS after your surgery. It feels like gas pain, but it happens in the weirdest places. I remember a particularly painful bubble that manifested itself in my right shoulder and lasted for several days.

THE DRAIN
My surgeon left a drain in my largest port hole, the one underneath my ribs on the left side or my belly, the one through which they'd removed my gallbladder. He did this to make sure that there weren't any leaks in my plumbing. Some surgeons do it this way and monitor the outflow from the drain for several days; other surgeons do a barium test before they let you leave the hospital. Either way it's the least fun part of the surgery. And it's really yucky. You have to clean it with alcohol pads and seriously, you don't have the stomach for it (har har har). I actually went home with the drain on day three and then had to come back a few days later to have it yanked out. The yanking-outage was NOT pleasant. After that, I healed up almost immediately. There are no stitches with laparoscopic surgery, just a little surgical tape. It's been five years now and my scars show less than my old stretch marks do.

COMPLICATIONS
I had none, so I'm not much of a resource there. Suffice it to say that I dodged some pretty nasty bullets and I personally met people who spent MONTHS, almost YEARS in the hospital after their surgeries because of leaky staples, drainage problems and a variety of other crap. For the first few surgeries my doctor performed (way back when), he had a faulty stapler and a handful of his patients had horrible complications, from which he learned A LOT about the surgery. I'm just glad I was his 350th patient and not his first.



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