THE PERFECT STORM

Ok, so are you ready? Here we go...

SATURDAY.FEBRURARY.5.2011: Started vomiting uncontrollably after dinner. Lasted all night. This was very different than the stomach troubles I'd had and lasted far longer. I was worried and so was Josh. Something had to give.

SUNDAY.FEBRUARY.6.2011: Called GI doc's after hours line and GI doc himself called me back. He said we would set up a CT for Monday. Felt ok for the rest of the day...didn't eat, of course.

MONDAY.FEBRUARY.7.2011: CT at Rex Hospital with inconclusive results. Directed to see my surgeon ASAP. Not feeling too terrible.

TUESDAY.FEBRUARY.8.2011: Visit with my surgeon who concludes we should go in and check things out laporoscopically. Out of work for 3-5 days. Him: How about tomorrow? Me: Right. Cause I don't have two preschool open houses to attend, a birthday, Valentine's day with my own kids and kids at school, plus a field trip. How about February 21st? I wasn't feeling too bad. Of course, I wasn't eating.

FRIDAY.FEBRUARY.11.2011: My birthday. It was an early release/staff development day at school and all I could do was to make it until the kids left the building. Drove home and commenced vomiting. Or wretching, I guess is the better term. Nothing was coming up but a little bit of bile. It lasted all night.

SATURDAY.FEBRUARY 12.2011: Still wretching. The bile had turned dark during the night and I started to get scared. Josh called his parents to come and watch the kids and we left for the ER around 1:00. Triage was immediate. Being seen by a doctor was not. We waited for three hours, me in a wheelchair with a trashcan in my lap. Miserable.

5:00pm they came to get me. As usual, me feeling lame...like somehow I must be overreacting. I couldn't be that sick. I'm just vomiting. Right? Wrong. They started an IV and hit me with dilaudid and phenergan. Better. They admitted me.

9:00pm Finally took me from the ER room to have a CT, (so not comfortable laying flat when you're in pain and nauseous) and then up to my hospital room.

11:45pm My surgeon calls with the result of the CT. They can see an area of concern which may or may not be scar tissue. They put an NG tube down my nose to see if they can sop up any bile/digestive fluid. They can't get much, which means...there's a blockage. I am literally about to pop. There are several emergency cases in the OR at the moment and I will have to wait a bit. I went to sleep. Josh didn't.

SUNDAY.FEBRUARY.13.2011: 2:00am I was wheeled down to the OR for surgery.

4:40am Josh got the call that I was ok. I was back in my hospital bed at some point but I don't remember much.

Later that morning my surgeon came in an explained what had happened. Honestly, he really called it "The Perfect Storm" and said he'd never seen anything like it.

 1. My gallbladder had malfunctioned back in the fall. That may or may not have caused much of the pain I'd been having since it was removed in November and the pain continued. But still, it was probably part of the storm.

2. Due to scar tissue from previous surgeries, one portion of my intestine had adhered to another portion and had tangled. This tangle was causing an obstruction, which apparently was getting worse and worse over time. That was the main cause of the pain which was always associated with eating. Because when you eat, you make digestive fluids. They usually keep going through, mine were not.

3. The line that runs from my lap band to my port was tangled up in the whole mess. If you're not sure what a lap band looks like on the inside, here's a diagram.


Josh and I saw actual pictures from the surgery. My surgeon has promised to get me copies and I hope to add them to this blog. Pretty amazing to see your insides in a wad.

Throughout my hospital stay the doctors had a lot of trouble keeping my heart rate, blood pressure, and respiration stable. Had I come into the hospital in good condition, I could've probably had this surgery and been up and about in a week. Unfortunately, it didn't work out that way. I was just so, so sick that surgery hit my body like a brick wall at 75 mph.

I came home with what I estimate to be 60 lbs of extra fluids. About half of that is gone so far. I look and feel pregnant with the flu. PT is helping and I'm moving around a lot better. Once again, I just find myself thankful to be alive. I'm so appreciative of all the good thoughts and prayers as well as all of the support from Josh's parents and our friends and family. We were fortunate enough to have my mom come stay for a few days. Friends have brought meals.

We are blessed and I look forward to feeling better and better each day!

Censoring Myself

I haven't blogged in awhile. It isn't that I haven't had ideas, I've had tons! Even though my time is limited, it isn't that I haven't had time either. It just seems that every time I think of something good to write about, I stop and second guess myself.

Sometimes I try to organize my pre-blogging thoughts when I have a few minutes alone, such as in the shower or on the way to work. I start to flesh out what I want to say and how I want to say it and suddenly I find myself wondering if I say this...how will that sound to this person or that person? Will it be misconstrued? Will someone disagree with me so strongly that we'll no longer be friends? Will I find myself in the principals office? Literally? Could I get kicked out of church for using swear words? Is it way too gross to keep talking about my digestive system?

I've become a co-dependent blogger.

Freedom of speech is an American right. For now anyway. I know I CAN say whatever I want. But should I? Even if this is just a blog, I want what I say to reflect my values and beliefs. Is it right for this to be a place to vent? Yes. And no. What if my kids read this years from now? What if my MOTHER reads this?

I think the real problem here is that I've never worried too much about speaking my peace. So I guess at this point I'm just wondering...Am I growing up? Or am I just drinking the kool aid?

New Year's Revolution

I don't do New Year's resolutions. There's far too much guilt associated with procrastination and ultimately with failure. I do acknowledge that it is important to continually improve one's self and that I am not perfect. So I just prefer to go about this in a different way. And, good things often take more than a year to achieve. Therefore, without further adieu, here's what I plan to get started on this year:

1. Spend less time on Facebook. I know, less is subjective. It seems to me though, that I could concentrate more on my television watching if I was not on the computer. Haha, just kidding. I think it's wonderful to catch up with old and new friends and I really do enjoy Facebook. The other day I heard a study that suggested if you spend over an hour per day on Facebook, you may be addicted. I don't want to be addicted to anything.

2. Prepare more meals at home versus picking up take-out. This is for obvious reasons. Heating up frozen stuff counts as a meal prepared at home.

3. Spend more time PLAYING with my children. The day is coming all too soon when I will rate second to friends, media, and strange fads that I won't understand.

4. Find a new job. This one may be the exception to the no-time-limit rule. I need a new job this year. I spend far too much time driving to and from work and quite frankly, public education is sucking the life out of me.

5. Go out with my husband at least once a month. I think we've been doing pretty well on this one but there's always room for improvement.

6. Work on my children's baby books. I'm not sure why I put that off.

7. Grow more roses. Stop and smell them. :)

                  

You Can Do Anything.....but DON'T WASTE MY TIME!

For some reason the title of this blog keeps playing through my mind to the tune of Blue Suede Shoes. Try it. The rhythm is all messed up but you get the idea.

I had an appointment with the gastroenterologist today. More on that in a minute. As I was leaving they handed me orders to go to Lab Corp to have some bloodwork done. I thought maybe I'd try to go have the blood drawn quickly before heading home so that I wouldn't have to miss more work.

Thanks to the GPS on my Droid, I was able to find a Lab Corp close by. I arrived at 4:45 and their closing time was 5:00. The receptionist looked at my paperwork and the conversation went like this:
             
Her: Have you fasted?
Me: No, I didn't know I was supposed to.
Her: Well one of these tests is a glucose test, you're supposed to fast. (Yet she's still holding on to my paper.)
Me: Ok, well I didn't fast, nobody at the doctor's office told me I should fast. (She's still holding my paper.)
Her: (just looking at me)
Me: Do you HAVE to fast for this test or is it optional?
Her: Well, if you have the test and your glucose level is too high, you might have to come back and have it again. (Still holding my paper.)
Me: I just had a handful of M&M's in the car.
Her: (still just looking at me)
Me: I'm quite sure that my blood sugar would be high if I had that test right now. I'll come back another day. Could I please have my paper back?
Her: Oh, ok.

You may think that this is how my time was wasted today. Not so. There's more. It occurred to me that it just didn't really make much sense for a gastroenterologist to request a glucose test. So I looked at my sheet. The test the receptionist was concerned about was called a GGT. I looked it up on my trusty Droid browser. A GGT is a LIVER FUNCTION TEST!!! Come on, know your stuff! *sigh* I checked the time...5:03. Welp, so much for that.

I HATE wasting time. I'm using the word hate here. I hardly ever use that word. There are just so many truly important things to do. I make schedules and lists and agendas and lesson plans and iteneraries so that I don't waste other peoples' time. I am the organizer. I fit in what couldn't possibly fit in. I get things done! *sigh*

And then I got stuck on 440 in 5:00 traffic. Don't get me started on traffic. Sitting in traffic is at the top of my list of the worst time wasters and yet I experience it at least twice per day. It takes me way too long to get to and from work because of the traffic. It's so stressful on so many different levels.

Segue.

The gastroenterologist is leaning towards the possibility of me having an ulcer. Me? Stressed?

Here are the four possibilities he's theorizing at this point:
1. Sphincter of Oddi Dysfunction (but since it's so rare, he's doubting that one)
2. A small gallstone stuck in the bile duct. (Ultrasounds pick up gallstones that measure 5mm or greater. When I had a gallbladder/liver ultrasound no stones were seen. A stone as small as 2mm could cause a problem though. And...yes...you can still have gallstones after having your gallbladder removed. They can be made in your liver and then pushed through your bile ducts when you eat and bile is released.)
3. Intestinal Spasms (This is something similar to Irritable Bowel Syndrome - in fact he gave me meds to try because this would be the easiest to treat if that's what it is.)                          
4. An Ulcer

He also says I look anemic. That's no shocker though. I've had trouble with that ever since my first pregnancy.

So I'm having an endoscopy next Friday to check out my stomach for ulcers, strictures, a band slip, or any other kind of possible abnormality.

Yay, more bills from Rex. Another missed day of work. I'm so excited. But then again...at least I get to take a big fat nap next Friday.             

                  

Breaking the Double Century Mark...Again

It finally happened today. For the second time in my life I have crossed over from the 200's into the 100's on the scale, going in the preferred direction. I know what you're going to say...."But you don't LOOK like you weigh 200 pounds!" Well, thanks. I really do though, and the crazy thing is that I actually feel really skinny right now.

If you know me well, you know that in April of 2003 I weighed 326 pounds. I'm still not exactly sure how that happened. I made the choice to have gastric bypass surgery and over the course of the next year and a half I lost 395 pounds. That would be 145 pounds worth of me and 250 pouds worth of ex-husband. All for the best, next chapter. You can read about the first year or so of my weight loss surgery journey here: http://www.obesityhelp.com/member/denyseanderson/. Scroll down to "My Story."

I never reached my goal of 170, but hung around at 185 for some time. (Nope, never made a goal to get to my ideal weight.) After having two children I found my weight climbing again. I wasn't sure if my small stomach had stretched or what, and sought the advice of a surgeon. Through endoscopy this past February, it was discovered that I had a hiatal hernia that was probably there at the time of my gastric bypass surgery. Therefore my stomach pouch was not made as small as my original surgeon thought. Then, as I lost weight (a whole person, mind you! you can clap if you want because 145 pounds is really, really awesome!) and then gained and lost with two pregnancies, the herniated portion of my stomach relaxed and fell back through the opening in the diaphragm...giving me more room to eat. And that's exactly what I did. Fan-stinkin-tastic.

It made a lot of sense, though, because I had been having some discomfort from eating for several months. I was also really happy to know why I was gaining weight. Making the decision to have the hiatal hernia repaired was easy. The tough part was deciding how to deal with the semi-ruined gastric bypass. There were a couple of options but the one I chose was to have a lapband  placed over my gastric bypass. How the lapand has worked for me is definitely a topic for another blog alltogether because less than a week after that surgery, I started to get extremely sick. I haven't really had a chance to use the lapband much yet. I ended up back in the hospital for another week with an abdominal hernia that caused a small bowel obstruction. That required emergency surgery.

Now I feel like my blogs have gone around in circles regarding my surgeries...so let's review! Ha!

April 2003 - Gastric Bypass
May 2010 - LapBand Placement with Hiatal Hernia Repair & Lysis of Adhesions (removal of scar tissue)
May 2010 - Small Bowel Obstruction and Abdominal Hernia Repair
November 2010 - Cholecystectomy (gallbladder removal)

Ok...so...back to the point of this blog. Since the second weight loss surgery, my intention was certainly to lose weight. But the real reason for my weight loss at this point is that I have been so sick. The first 20 pounds came off directly after the surgeries in May. During the first two weeks of recovery, I had nothing but water, ice, and IV fluids. The next 15 pounds have come off as a pretty direct result of the gallbladder/possible sphincter of oddi dysfunction this fall. The nurses at my surgeon's office were actually surprised that I haven't lost more. I can tell you my secret, though. If you want to maintain your weight (or gain) just EAT CARBS. Little food demons that they are, they have kept me from wasting away too quickly. That's pretty much all I can eat right now. Foods that are high in fat, including most proteins, are just not on the happy list. I keep telling myself I should be thankful that I can at least eat something and that I have food to eat at all. Plenty of people in the world are not so lucky. Some days I really stink at being thankful but I'm working on that.

This is so bitter-sweet. I'm ultimately happy to be on the underside of 200. It's like I breathed a sigh of relief when I stood on the scale and saw a one in front of the other two numbers. In fact, I'm sure that's exactly what I did. Obesity is a life-long battle and no matter what size I am - ever - I will always have to live with struggling with my weight. Losing and maintenance are both extremely difficult but dealing with your weight has to become as much a part of your life as showering and brushing your teeth. It's similar to someone with diabetes in a lot of ways. Your life style changes, but you accept it as part of you and adjust. But in the same vein, I'm not always perfect with this life style. I sometimes make poor choices with eating and exercising, sometimes for a few days or a week, sometimes for a year. But then I get back on track. The best news is, that in order to get off track, I had to have been on track at some point. That's encouraging to me. I've done this before...so I know I can do it again.

This baffles me, but this blog has really not been about my adorably bright and cuddly children so far. With the health surprises I've had in the last few weeks, it's almost serving as a bit of creative (and free) therapy for me right now. They are, however, along with their daddy and my faith in God, what inspires me to keep going. I absolutely can get through all of this. And, being thinner, I can enjoy my time with them so much more....because neither of them is going to sit still for long and I refuse to be left behind!!

I was amazed this week to find out that I have several readers. I think I blushed yesterday when my neighbor told me she'd been reading my blog. I think that's really neat though, and I feel pretty special to have a few readers...so, thanks!! And keep reading because good things are undoubtedly ahead! :)

Sphincter of WHAT?

The gallbladder surgery did not fix me. Yes, my gallbladder was inflamed and the HIDA scan showed that my gallbladder function was too low. It was part of the problem and it needed to come out. But, two weeks later, I'm still having the exact same pain as before the surgery. Excrutiating pain. Pain that feels like I'm in labor and a baby is going to come out of the middle of my back. And then I dry heave for hours. Nothing relieves the pain, not even pain medication.

So back to the doctor I went. Long story short, he thinks it is likely a fairly rare condition called sphincter of oddi disfunction.

Technically speaking, here is the definition:

Sphincter of Od·di Pronunciation: /-ˈäd-ē/
Function: n 
a complex sphincter closing the duodenal orifice of the common bile duct

The HUH? Pictured below, it's the valve, if you will, that allows bile and pancreatic fluid to flow into the uppermost part of the intestines. It helps digest your food. Sometimes the sphincter of oddi can become too tight and it doesn't release the digestive fluids properly. The duct gets blocked since the fluids don't drain out, and...it hurts like heck.



My doctor is not 100% sure that this is the cause. It could be pancreatitis. The pancreas and bile duct work together so it can be hard to tell. I'm headed to a gastroenterologist soon to get his take on this. The treatment options vary for this condition. I can tell you one thing, though. After three surgeries in 2010, SuperMom is not ready for another one anytime soon.

Holy Choley OR Choley 101

Cholecystectomy is the scientific name for gallbladder removal surgery. And when you have your gallbladder out, all the doctors and nurses call it a "choley" (pronounced Ko-lee). In fact, they even referred to me as a choley. As in, "Doctor E, your choley is prepped and ready for the OR." Ha.

Actually, there are a lot of funny things that are said in hospitals. When you're being prepped for surgery, several different people will ask you if you know what type of surgery you are having. I can only assume that's either to keep you from accidentally having the wrong surgery or maybe it's a quick psych consult. I really, really wanted to say that I was having a vasectomy or a boob job, just to see what kind of reaction I would get.

It seems that it's a requirement nowadays to explain what will be done during your procedure. I guess that's to give you one last chance to back out. Typically, it's a very dumbed-down version. One nurse even explained my choley to me this way, "We're gonna make a few poke-holes in your belly and take your gallbladder out that way." Clearly they don't know me...I'm one of those people who comes in with a list of questions written down just in case I'm given a sedative prior to having the opportunity to ask questions.

In all seriousness I cannot say enough nice things about the staff at Rex Hospital. Throughout all three of my hospital stays this year, I have had wonderful care from the nursing staff to the radiology department to the orderlies who wheeled me all over the place for testing.

Since my choley I'm doing pretty well and honestly, this has been nothing compared to the two surgeries I had back in May. I'm still a little sore but should be as good as new in a few more days. But...here's what nobody will tell you about having your gallbladder removed: You can actually continue to have some of the same symptoms after surgery. Well, isn't that just great.

There are actually a couple of promintent websites that are quite dedicated to trying to convice people not to have a choley. The reasoning is that you can manage your gallbladder attacks by not eating things that bring them on. Simple enough. Their recommendation is changing your eating habits in a major way...consuming mainly fresh, organic foods (we already know that's a healthy thing, right?), completely staying away from high fats and fried food (ok, that wouldn't be such a bad thing), and also removing any processed foods from your diet. What?! No protein bars? No teddy grams? No frozen pizzas? Ah-haha. Not happening. As much as I would love to say that I could make that kind of commitment, it's just not realistic.

So, how can you still have gallbladder attacks with no gallbladder? Let's back up. The gallbladder's job is to store bile that's been made in your liver. When you eat, the gallbladder releases the amount of bile you'll need in order to digest the type of food you've eaten. When you have your gallbladder removed, the bile duct is then attached directly to your intestines so that you still get the benefit of digestion. So, once your gallbladder is gone, they're no longer gallbladder attacks, but an issue with the right amount of bile being released for digestion. That means that the gallbladder itsself is not always 100% of the problem. The problem can lie in faulty bile ducts that supply the bile, thus resulting in poor digestion.

I'm totally not going to explain what I mean by "poor digestion." Use your imagination. The task at hand for me though, is to now figure out what I can eat and what I can't. From what I understand from other choley patients is that it's trial and error. Also, factor in the idea that the amount of bile production can vary, dependent on which way a butterfly flaps its wings on it's way to spend the winter in Mexico.

So when you notice that I'm not enjoying a doughnut with everyone else, be proud of me for having good self control. But if you notice me running for the bathroom after eating that doughnut, please remember that I'm only human!