Surgery Day and Early Recovery

Today officially marks 5 days post surgery! This is the first day I felt up to sitting down and typing up a post so I have a bit of catching up to do! This post will take us through the night before surgery through my discharge at 1 day post-op.

Pre-Surgery Jitters and "Before" Pictures
The night before surgery was the first time I really started to get any nerves. I was mainly nervous about getting to the hospital, having them put me under, and then deciding not to do the surgery. It was a bit irrational in retrospect, but I was so anxious to get things underway I was really worried that something would happen to postpone the surgery or make it so that it couldn't happen. Jitters aside, I was actually able to sleep really well that night.

As I was getting ready for bed, I showered and washed with the antimicrobial wash as instructed, and I decided it was finally time to take my dreaded "before" pictures. I put them off for a long time, partly because I didn't want to see them. But truth be told, I mostly put them off because I didn't want to feel like the Kacey before surgery was any less worthy, any less loved, or any less me than the Kacey after surgery would be. So I struggled with whether or not to even take them. In the end, I decided to do it because I want to be able to see my progress along the way. I want something to look back on and see how much my body has changed...my equally loved, equally worthy, equally me body. So here I am taking a majorly vulnerable and scary step by sharing them with all of you who are reading.

Surgery Day
The morning of surgery I woke up and showered again with the antimicrobial soap as instructed. I also had to "shower and go" meaning no hair styling or makeup. And anyone who knows me well knows that meant I died a little inside! Ken and I hit the road at 7:30am to make sure we arrived at the hospital by 9:00am. We met my mom there at the front doors and walked in together up to the 5th floor for surgery check in.

Right when we got there we were shown to a room where I changed out of my clothes and into my hospital gown and socks. Shortly thereafter, they placed my IV line. I was absolutely amazed at how quickly they did it because normally everyone struggles to hit my veins. They used a vein finder and lidocaine to numb the site so it was easy peasy and pain free! They also gave me an injection of heparin and one of the medications (atenolol-chlorthalidone) that I take on a daily basis. Keep this in mind because it gets pertinent later!

We waited for probably 30 minutes after that for someone to come and wheel my bed down to the surgery waiting area. The man who came for me was named John and he was simply wonderful. He made me trade the headband I was wearing for a surgical cap and we were on our way! He joked with me and kept the conversation friendly and flowing. It went a long way to keep me, Ken, and my mom all calm and relaxed.

Once we got to the surgery waiting room, I was greeted individually by the operating room nurse, my surgeon, and the anesthesiologist. It was all a really great experience and I felt like I was in  good hands. The anesthesiologist and nurse did the most to settle my nerves. My nurse let me know she also had gastric bypass five years ago and that it was the best decision she has ever made. So that was comforting! The anesthesiologist let me know he would be responsible for monitoring my vitals the entire time. Putting a face to the person who would be responsible for something so important was really comforting. I asked him who would be in charge of making sure I stayed breathing after surgery (this was one of the fears that manifested for me that morning) and he reassured me that I would be monitored very, very well by my recovery nurse.

After the introductions, the anesthesiologist wheeled me to the operating room where I then transferred onto the operating table. I was quickly introduced to the surgical team. I remember looking to my left and smiling at the surgical staff and that was the last thing I remember. They  didn't let me know when they were ready to put me under...so one minute I was smiling and present...and then I wasn't.

Waiting to head to the surgery waiting area. IV placed and feeling excited!

The next thing I remember was waking up really, really groggy and moaning a lot. I was in pain but didn't understand why. It took me a minute to register where I was, what had happened, and that I was out of surgery. I don't remember a whole lot about being in the recovery room. I remember the nurse telling me I was ok and that they would be giving me something to help with my pain and I would get relief soon. I also remember her handing me the PCA pump that allowed me to give myself doses of Dilaudid. I do remember asking the nurse at one point "am I skinny yet?" but that's about all I really remember from the recovery room! I do remember being wheeled out of recovery into my own hospital room and seeing Ken and my mom there waiting for me. It was a big comfort to finally see their faces. All in all, the surgery itself lasted about an hour and I was in recovery for about the same amount of time, so I was comfortable in my own room at about 11:45am. By this point I was feeling great (thanks anesthesia and dilaudid!) and still coming out of anesthesia...but I thought I had it fully together. The picture below is evidence otherwise!

Right after surgery in my hospital room.

Once I was in my room, I was greeted by my care staff for the day including the CNA and nurse who would be caring for me over the next several hours. They were absolutely amazing. At about 12:30pm they started having me take small sips of water. I was allowed 1oz every hour. My mouth was really, really dry so they gave me some oral sponges to help and let me have a few ice chips as well. Drinking the water initially out of surgery didn't hurt but definitely caused a cramping discomfort when I swallowed. My throat was also sore and a little hoarse from the intubation tube. It was about this time that I also "met" my neighbor in the room next to me. She was an elderly woman who kept calling out "help me" at the top of her lungs during the times she was awake (which was a lot). It was absolutely heartbreaking and something I will remember forever.

Around 3:00pm I was feeling great and ready to get up and take my first walk. My mom was there with me and helped me do 4 laps around the nurse station. Walking is absolutely essential after surgery to help dissipate the gas that they pump you full of so I was determined to do it. On our walk, I noticed my ears started to feel like I was under water because my hearing sort of got muffled. It passed pretty quickly so I didn't mention it at all. At 7:00pm I was ready to take another walk before the nightly nursing staff change. My mom went with me again and we did 5 laps around the nursing station. I needed to pause in the middle because my head felt like I was under water again and my hearing became muffled. After stopping for a few minutes it cleared again and we walked back to my room. Things to this point had been absolutely fabulous, I felt great,  and my care team had been amazing! Oxygen was good, pulse was good, blood pressure was good, and I felt fantastic. By this time I was just ready to hit the hay and get some rest so Ken and my mom headed home and I put on a tv show to fall asleep to.

This is where things start to get a little fuzzy for me. I remember the alarm on the monitor that was checking my vitals started to beep incessantly. Every time I was just about to fall asleep it would go off again. My poor little neighbor was also having a struggle and continued to cry out for help continuously through the night. I remember looking back at the vitals monitor and seeing my oxygen level in the low 80s and my pulse rate at 46. It was at that point that I pushed the call button for the nurse and the CNA came into take my vitals. When the CNA took my blood pressure it was 90/46. I remember asking her if it was anything to be worried about and she told me no since I hadn't had any blood in my stool (?) and my drain looked fine. Through the night, my vitals continued to be really volatile. My pulse and oxygen would come back up to normal levels (Pulse 75 Oxygen 98) and then drop significantly (Pulse 40s Oxygen low 80s). A few hours later when the nurse came in to take my vitals I asked again if it was anything to worry about. She said that it was probably the dilaudid. My brain was fuzzy so I didn't push any further but I knew something was off. I was having a hard time breathing and had to concentrate on each breath in and each breath out. Because of this, I had sat myself completely upright in the hospital bed. At one point, I tried to recline it back down but it wouldn't work. Three different  people came in to look at it and couldn't fix it. I spent the rest of the night sitting upright, focusing on breathing, with my alarm going off about every 10 seconds.

At about 5:00am the next morning I had the sense to finally text my mom who immediately came up to the hospital. Before she got there, they drew a blood sample and let me know my surgeon would be coming in shortly to talk with me. My mom and the surgeon walked in at about the same time and that's when I found out that my potassium had dropped to critical levels in the night. They believed it was due to the atenolol-chlorthalidone that I had been taking prior to and the day of surgery. At this time the nursing staff changed again and I was prescribed potassium supplements to take. They were HUGE pills and really hard to swallow with my ounce of water allotment. It was extremely painful but I finally got them down. My mom made sure the new care team fixed my bed so I could finally lay down and also had them change the sensitivity on my monitor so that the alarm beeping would stop. I was finally able to get some sleep in the chair in my room. They took more blood and tested it to make sure my potassium was back in a safe range after giving me a second dose of potassium pills (4 total). About two hours after the potassium supplements my vitals began to stabilize.

Over the next several hours my mom and I just talked and worked on my water sips and breathing exercises. Things started to turn around and I was doing really well. The head nurse for the floor (I believe she was over quality control) also came in and asked me for feedback from the night. I was able to share the night's events with her and she was a great support in making sure I had everything I needed for the last several hours of my stay. At about noon my levels had stabilized and things looked good so they let me know that I could be discharged around 4pm. Just prior to discharge, my new nurse Jose came and took the staples out of 5 of my incision sites. He removed the drain from my 6th incision site. That drain was a trip. It freaked me out having it hanging out of my body. I didn't actually realize until after it was removed that it was easily 2 feet of tubing that was inside me...maybe more. Sometimes ignorance is bliss!

I was discharged at 4:00pm and still a bit shaken from the night's events so I ended up going home with my mom where I would spend two days (I'll post about this tomorrow). I don't recall much from the drive home because I slept in the car. My pain was well-managed and I was grateful to be heading to the comfort of home!