From Pre Op to 10 Days Post Op

From Pre Op to 10 Days Post Op is a recap of my Duodenal Switch surgery with Marek Lutrzykowski, MD in Michigan. I traveled from Ottawa, Canada to Rochester, Michigan for surgery. As a result, once I was released from hospital I had to stay in a hotel in the area until I was 9 days post-op. My surgery was performed open, so depending how your surgery is performed your experience may be a bit different.

Wednesday, Morning of Surgery
I had to be at the hospital 2 hours before my surgery. My mom and I arrived at 5:30am. I was registered and my mom stayed in the waiting area while I went into a private pre-op room with a tv. I was asked some questions similar to, and probably confirming, what I was asked when the hospital called a week before surgery. I had my last pee and got undressed. My things were put in a plastic bag to give to my mom.

Note: My mom brought my bag in when we arrived at 5:30am and ended up taking it back to the car. Since they don't know what room you will be in until after surgery may as well leave your stuff in the car so it doesn't have to be carted around for 4-5 hours. The only things I used from all I brought were my hand cream and slippers; everything else I got at the hospital or didn't use.

The nurse put an IV line in the back of my hand; 2 types of antibiotics had to be given before surgery, which takes about an hour (and why you need to be there 2 hours before surgery). The IV did not bother me at all; I was quite comfortable and relaxed. I had been worried because I had an IV when I had my tonsils out as a teenager and it bothered my hand a lot.

The anesthesiologist stopped by to introduce himself and to ask me some questions.

Then the shave lady finally made her appearance. She checked my shaving job (she will shave your girly bits if they aren't done already) and with a "well you shaved more then I would have"... I passed. Once she left my mom was able to join me in the room while my IV was running.

The night before there was a HUGE snow storm from Detroit to Ottawa. We left 25 mins earlier from the hotel to get to the hospital on time. The road was slightly plowed which helped. My mom and I watched the early reports of the snow storm. Lots of school closures and highway spin offs. They got 13 inches of snow in Ottawa and I think about 8 inches in Detroit.

When the IV was finished I was given a shot of Heparin to help prevent clotting. I got a Heparin shot every day while in hospital. The first one stung a bit but the rest didn't because I was on pain meds.

The nurses that would be taking care of me after surgery and in recovery stopped in to say hello. Then Dr. Lutrzykowski came in to see how I was doing.

At 7:30am I was moved to the OR. Dr L had told me it would take them about 45 mins to prep me for surgery. When I got to the OR I moved onto another bed... and that's all I remember, they put me out. The central line, catheter, NG tube and breathing tube were put in while I was out.

My mom was given a pager so she could be beeped when I was out of surgery and out of recovery.

My mom was beeped just after 11:30 am. Dr L came out to talk to her and assured her everything went well with my surgery. They would page her again when I was out of recovery and being moved to a room.

Waking Up
I don't remember much from the recovery room. I do remember nurses talking in the background. It took me a while to open my eyes; I just laid there a while. When I did open them I saw a clock on the wall, it was almost 3:00 pm. The breathing tube was in but it wasn't bothering me. I was having a hard time trying to understand how I was supposed to be breathing with the tube in me, I didn't understand it's function; was it matching my breathing, it was slow then too fast... so I tried to breathe with the pumping. I ended up double breathing, taking two shorter breaths in a row, pause, then taking 2 shorter breaths again. I didn't need to... I was just so confused!

I found out later that they were a bit concerned about how deeply I was sleeping and how long it was taking me to wake up. My blood pressure was a little low and so was the oxygen level in my blood. As a precaution Dr L decided to keep the breathing tube in and monitor me for a while. Room 821-A in ICU (private) was available and that's where I went about 4:30pm.

My mom was paged and was given my room number.

The ride from recovery to ICU was painful. There were 2 small bumps we had to go over from doorways and they hurt a lot. That was probably the 2nd most painful thing I experienced while in hospital. It was short though and quickly forgotten.

My mom and Dr L came in the room shortly after I arrived from recovery. They were rechecking my blood oxygen and said if it had improved they would take out the breathing tube. It was still low.

Dr L explained to my mom why I was in ICU, why the breathing tube was still in and that they would re-evaluate my progress in the morning. My mom was very concerned, and I am sure it was quite scary for her to see me with all those tubes. I motioned for some paper and a pen and I tried to reassure her that I was ok, but it was hard when I couldn't talk.

Dr L told the nurse to give me something to put me out and let me sleep. I was ok, even with the breathing tube in, it was not bothering me at all. The hardest part of all was not being able to talk. A blood pressure cuff was put on my forearm that automatically took my blood pressure every 30 mins during the day and every hour at night. The nurses were around a lot, and they took my temperature every 4 hours.

They got my pumping boots on; they are on your feet pumping away any time you are not walking. I found them a little annoying but I was happy to have them because their job is to help prevent clotting.

Note: If your mouth is dry ask for a mouth swab.

Thursday, Day 1 Post-Op
This day was mostly a blur. I was weighed while on the bed, they watched my blood pressure and checked the oxygen in my blood. Dr L came to see me, he did rounds every day, sometimes twice, and decided my oxygen levels were still a little low and would check again the next morning.

I got some flowers from my sister. There were beautiful, white carnations, mini pink carnations, snap dragons and pink stargazer lilies. The nurses said they could smell them as soon as they came in the room.

A kind nurse got a cool face cloth and washed my face and left it on my forehead, it made me feel so much better.

Friday, Day 2 Post-Op
By far the worst day.

My blood-oxygen was checked in the morning. Dr L approved having the breathing tube and NG tube removed. Extracting wasn't too bad. It sucked but was over quick. It was nice to be able to communicate again. I saw my weight for that am. I was 8.2 lbs heaver then before surgery (which is normal, body is in shock). A room was available on 5th floor so I was moved down. I was very lucky and got a private room, 532A.

It was an exhausting day. I was in pain. I got my period /cry. The nurse got me some mesh panties and a pad. I needed a lot of help, I had very limited mobility. The nurses were great but over worked so it took a while to get a response when pressing the call button. Also, never call close to shift change time (plan ahead), your call may be forgotten. I went for 3 very short walks that evening. It was a crappy day and I was glad when it was over.

The thirst is incredible. In a matter of seconds your mouth and lips can all shrivel up making you unable to talk until you get some water. It's pretty funny. Thirst like I have never felt before. Had LOTS of ice chips.

My legs and feet were quite swollen (retaining water) making movement restricted. This is normal.

I had a terrible headache in the afternoon. It made no sense since I was on so many pain meds. I realized it was from not taking my anti-depression medication for 4 days and I was reacting to the withdrawal. It was not one they recognized in the US (it's under a different name in Canada) so I brought my own, but forgot to take it. Once I took it I felt a lot better.

Note: you are supposed to get a welcome package when you get to the hospital. It includes sock/slippers, toothbrush, toothpaste, roll on deodorant, bathing soap (that doesn't need rinsing) body cream and hand cream. I got a tube of white petroleum jelly from the nurses that I found worked better and longer moistening my lips then my chap stick. There is really nothing I needed to bring to the hospital except slippers. I wore the gowns there (they fit!) so just needed clothes to wear when I left.

One of the nurses that evening washed my back. We discovered I had a severe skin reaction to the binder. My skin was extremely red and irritated, I had some welts on my back, my breasts were splattered with red marks, hot to the touch. Very ouchy.

I started an inhaler, 2 puffs every 4 hours. I am not sure if this is standard for everyone or because of my respiration/breathing tube issue. I did this until I left the hospital. They also give you a small plastic tube like machine to breathe into to help expand your lungs and prevent pneumonia. You are supposed to do 10 breaths an hour; it's easy and takes little time.

Saturday, Day 3 Post-Op
I got up about 8am, had a little walk then sat in the recliner by the bed. I didn't go back to bed that day until about 10pm that night. I had 5 walks throughout the day and sat in the chair, visited with my mom, and watched TV. I felt pretty good all day. Dr L was THRILLED that I was out of bed and up in the chair when he arrived.

My other sister sent me wonderful flower arrangement with yellow and white daisies and yellow roses, very bright and cheery. My mom got me this life size cat door stopper. It's fabric with a heavy base. It looks a bit like my cat. She put it on the windowsill in my room and it scared the crap out of a few nurses... damn funny. Everyone loved it and thought it looked quite life like.

I went to radiology to have my stomach checked for leaks (standard procedure). They gave me something to drink. Taste was fine, easy to get down. I was surprised at how much of it I could drink at a time. I thought I'd be taking tiny sips but I got a small mouthful down. The test didn't take too long. Waited for the pictures to be developed to be sure they got what they needed, and then I went back upstairs.

I had a small "wtf have I done to myself" moment but it passed.

The catheter was removed mid-morning after Dr L was in. He said my results from radiology were good so I could start eating. And he said I would be released Sun am!

I was given a suppository to get my bowels moving.

To eat at the hospital you have a menu in your room that you can order off of, and you call down with your order about 45 mins before you want to eat. First thing I had to eat was tomato soup (I didn't order it but it arrived). It tasted like alphagetties. I had a few spoonfuls and it went down good. There must have been a mistake in my order because 10 minutes later the mashed potatoes I had ordered arrived. So I tried a spoonful. It was bland and a bit too heavy. For dinner I had pureed squash. It was terrible and in paste form; I didn't like it at all. However I also got my evening liquid with that meal and I had diluted apple juice. I was in heaven! It tasted so good.

My mom helped me try to repair the damage to my skin, got it washed and some cream on it.

Sunday, Day 4 Post-Op
I ordered orange SF Jell-O for breakfast and more diluted apple juice. Jell-O was so good. It dyed my mouth pretty bad though, lots of artificial color. It hit the spot so I ordered cherry Jell-O for lunch and more diluted apple juice.

My weight was taken in the am. I was losing and now just 6 lbs higher then pre-surgery weight.

I had a small bowel movement that morning, first since surgery.

Dr L came in about 11:15am. My mouth and lips were a BRIGHT VAMPIRE RED from the cherry Jell-O I was eating. How embarrassing! I am talking electric red. Now I know why Dr L smiled funny at me, I looked like a FREAK! He took my drainage tubes out and dressed the drainage spots with gauze pads and tape. The hospital gave us gauze and tape so we could re-dress the drainage sites at the hotel. He signed my release papers. Then a nurse came in and took the monitor wires off, the central line was removed from my neck and she took out 2-3 staples holding that in place. The IV was removed; it wasn't used but remains there in case they need it so they don't have to keep poking you. It didn't hurt at all having it in. Then I finished my lunch and got changed into street clothes.

My mom and I left the hospital at 12:30pm and headed back to the Drury Inn.

The hospital stay was short and it went by very fast. The nurses were very good but like I said on 5th floor they were very over-worked so it was hard for them to respond fast. Of course if it was an emergency they would. When they were with me, they were fantastic. I didn't get my welcome bag until the day I left. Probably because I ended up in ICU. I took it anyway because the cream and soap they gave were good for my back and sides that were still healing from the skin reaction to the binder.

Back at the Drury Inn
Even with all my paperwork I was confused about showering because I just had gauze put over the drainage holes. So I didn't shower :( It was great getting to the hotel. I walked the halls a bit and also outside to get some fresh air. It was a quiet day. I had some peach flavored SF applesauce which I wasn't a big fan of but it was soft and easy to eat. I also tried a snack pack of pears, but they were way too sweet.

I slept in the bed using 6 pillows to prop me up. I slept well and woke up on my own, usually when it was time to take another pain pill. I ate a few bites of cheerios with skim milk to not take pills on an empty stomach. There is a microwave and bar fridge in every room at the Drury so I bought 1 L of skim milk and had it handy.

I always took my temperature and recorded it when I woke up; best time to do it.

Monday, Day 5 Post-Op
I called Dr L's office nurse, Julie, in the am. I found out about showering. Took the gauze off the drainage spots, there was a bit of discharge from two of the sites. It was mainly clear but a little bit of blood. I had a long shower, felt great. My mom took the Drury shuttle to the Sommerset Mall for an outing. When she got back I went down to the evening dinner buffet with her for some company and brought my water. I ate Cheerios soaked in milk often the first few days because of how easy it was, and I liked the taste. I tried a SF orange Popsicles but the artificial flavor was just too sweet.

I spent my time watching Discovery Health and the Home Decorating channels as well as lurking on the OH forums with my dad's super slow laptop.

It was wonderful having my mom with me for company and I am grateful to her for all her help; she was a real trouper.

Tuesday, Day 6 Post-Op
The goal of the day was to go to the grocery store. I got my binder on, my mom loaded me in the car and we were off. It was a big outing and I was very tired after wards but it was good to be out and active. I got some pre-made SF Jell-O, low salt chicken soup broth, cream of potato and tomato soup. I needed a little nap after we got back.

I had more Cheerios and some cream of potato soup and I had Jell-O as a snack. I found diluted apple juice was an easy way to get my liquids in. I planned to cut that down/out (due to the sugar content) when I got home, and I did. But early out it went down easy and tasted really good. I was able to get in almost twice the recommended minimum for fluids. I am up around 45 - 50 oz a day. So fluids are going great. My protein (which helps with energy) is not going great yet. It's hard to get out here and find/try protein powders and drinks. I decided I will do what I can with the foods I had to eat and to work on protein when I get back to Ottawa.

My mom took some pictures of my incision. My back is healing up nicely. I started to feel by mobility returning and was able to get dressed by myself after showering.

Wednesday, Day 7 Post-Op
Wed morning I woke up with a full bladder. It seemed like overnight my body decided to stop retaining water and it was flowing through me. Longest pee ever!

I was down to only having a small amount of discharge from one of the 3 drainage sites. They were looking good.

I had a bite of scrambled egg from the breakfast buffet to see how it was in my tummy. I had heard egg was fine for some but too heavy for others. I just had a few bites but had no problems at all.

I had not had a second bowel movement yet. I was passing gas and didn't feel constipated so I let Julie know. She suggested I increase my fiber to help move things along, like Bran Flakes or fresh fruit. My mom took the Drury Shuttle to the Oakland Mall that afternoon but they didn't carry anything like that there. I knew that the Drury had Quaker Oatmeal at the breakfast buffet so I thought I'd get some the next day.

While my mom was out at the mall I started typing my surgery journey while it was still fresh in my head. I was still typing when she got back to the hotel 4 hours later!

Thursday, Day 8 Post-Op
I had a big jump in mobility today. Since I stopped retaining fluids my leg/feet swelling went down and I was able to move more freely. It is not hard to sit in a chair or on the toilet any more, I can sit down without maneuvering my legs all over. I am feeling a lot more self-sufficient, the only things I can't do yet are put on socks, tie up shoes and pick up things that fall on the floor.

I went down to the breakfast buffet and had about 3.5 oz of scrambled egg. They tasted great. I picked up a package of oatmeal to have for lunch.

My sister flew in to Detroit tonight to drive my mom and I home to Ottawa after I get my staples out tomorrow. If anyone plans to fly to Detroit, reception at the hotel told me all airport taxis will come out to Troy and it will cost approx $70 for the trip 1 way. It cost my sister $78.

Kim's advice to take in a bit of fat to help with my bowel movement was spot on. I had some SF pudding and sure enough this afternoon I had a healthy BM. It was soft but not liquid.

Friday, Day 9 Post-Op
Packed up the car and went to see Dr L at 9:15. He took my staples out (which didn't hurt, more like a mild pinching). I got a copy of my surgery report which indicates common channel length. He went over post-op eating again and since I was doing so well with food so far he told me I could try fish and moist chicken. I was down 3.9 lbs from pre-surgery weight but I had also gained a lot while in hospital and my body was hanging on to it.

The drive back was long due to March Break.

On the way home we saw the procession and bridge tributes to the fallen soldier that returned home Friday. It was amazing to see all the bridges filled with people and flags and it was very sad to see the police escorted procession.

I stayed at my parent's house Friday night since I needed to get some shopping done before I went home.

Saturday, Day 10 Post-Op
I got the shopping done I needed to; protein drinks to try and groceries. It was wonderful to be home! I was a bit tired from the drive back to Ottawa yesterday so I had a nap before dinner. I slept in my bed, I was able to more comfortably recline.

I had a few bleeding noses since I left hospital, this is from the blood thinner and I think the dry air from the hotel room blowing constantly.

I know that my journey through surgery and my recovery has gone better than most and I am truly grateful. I hope it continues. I will continue to stick close to the list for eating and watch for any signs of infection to catch it early. So far so good =)

What I Ate in the First 10 Days

• Tomato soup (few spoon fulls in hospital)
  
• Mashed potatoes (a spoonful in hospital, a bit heavy and bland)
  
• Purèed squash (didn't like, had in hospital)
  
• Sugar free Jell-o (best thing I had to eat in hospital)
  
• Diluted apple juice (LOVED this, had in hospital, helped me get fluids in quick)
  
• Peach apple sauce
  
• Cheerios in skim milk
  
• Special K Protein Plus in skim milk
  
• Chicken broth
  
• Cream of potato soup (with skim milk)
  
• Scrambled eggs
  
• Sugar free pudding
  
• Quaker oats (regular and cinnamon made with water)
  
• Cantaloupe
  

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