Gastric Bypass Surgery: Part THREE of [many]

THE DAY OF THE 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:

(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:

(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.

[Next installment: FOOD.  The immediate post-op diet.]

Comments

[Stacey]

Thank you for posting about this...it's very personal and very brave of you. I wish that this is something I could consider, but with the chance of death and having 4 kids, I just don't feel it's at all possible. Also, we have a $6000 deductible that makes it a non-issue. I'm very, very happy for you that it worked for you.

[cindy w]

That's weird, I thought that NSAID's were always supposed to be off-limits after surgery because they're blood thinners, so they can cause internal bleeding where you've just been stitched up. I can't imagine why they would've put it in your IV.

One thing that bugs me about my surgery is that I had to have it done open rather than laproscopic, because my insurance wouldn't cover it any other way. I have no idea why. And I tend to make keloid (sp?) scars, so now I have a huge scar down the center of my stomach. I was really self-conscious about it for a long time, but now that I have post-pregnancy stretch marks... eh. I hardly ever think about it. Not like I was ever going to be a bikini model anyway, right?

[Lia]

I also had gall bladder surgery. The air leaving your body hurt so bad. Ugh, just thinking about it makes me hut.

[ktjrdn]

Oh My God! The air! Apparently I had quite alot of scar tissue after my first c-section, so it took them longer to do the second one. More time = more air. I never had any problems the first time, but the second time was so painful, I was crying and I have a pretty high pain tolerance. For some reason no one ever talks about this part of surgeries.

[MM]

I wished I'd gotten photographs of my gut all blown up with air during surgery. ;x

[jenB]

It feels weird to comment since we just recently spoke on the phone about all this..., but you are my sister in PCOS, curly hair and now tiny stomach. I did have a drain with my c-section, i think i blocked it out, but none for my gastric bypass.

I also think there is total pain amnesia. After my gall bladder came out i was OUCHY then c-section which was horrible! then gastric bypass, which I remember for a couple of days being awful, but now it all seems so distant. i think this amnesia is what keeps the human race going.

i am so glad you are writing about this right now since i am 4 weeks post-op.

tonight i had scalloped potatoes!

[carrie]

It is nice to hear that 5 years out the scars from the lap sites are almost gone. My husband's look hilarious, seriously very funny, as he has already lost so much weight so quickly and everything is getting "loose"...it is hard to explain how they look when he sucks it in or whatever, I guess the only way to explain it is dimples on his belly (and not the cottage cheese made dimples either). I have never had the air, but he has, and I can attest as his spouse, that it is not pleasant. I think at times, the air pain was worse than the surgery pain. I am so glad they brought Dave back into recovery so soon. For some reason, I had to wait until Brian was up in his room which was another few hours. I was a nervous wreck, and even though the surgeon had come out to tell me everything went well, I was still on the verge of tears and crying out of sure exhaustion. What I learned from this - NEVER wait for a surgery to be finished alone.

[jesteasn]

Thank you for sharing your comments. My doctor told me yesterday that he really wants me to have this surgery. I am scared to death about it, afraid of the unknown I guess. The experiences that are shared here have helped me.
When he commented on the surgery. He told me that it would be great for me considering my health problems. He acted as if I had been given a gift and I should be happy that this could help me.
Thanks for your comments.

[Gloria Ainey]

Hi, I am 3 weeks post-op and I am very nervous. It is nice to here that people have had it and are glad they did; so many comments are negative.

[chris yaeger]

I had gastric by-pass Sep 2008/ I had lots of complications, but until yesterday never had a gas problem. I was fine until suddenly I started having pain in my abdomen from just below my heart to my lower abs and I still have it over 30 hrs later. I am assuming it is gas pain as it tends to move. I have taken gas x but no luck. I exercise regularly (in fact I was at the gym yesterday and was on the eclipical (spelled wrong) for 30 minutes.

How long does this pain last. It is so bad at times that I am double over then it lets up. I've even had several small movements, but the gas keeps coming back.I am not eating anything different or new.

Any help is extremely appreciated

[Lucy Bartlett]

Gastric bypass surgery has helped countless people around the world in their weight loss journey. This surgery is known to have a fairly high rate or complications, and some of them are life threatening. My doctor suggest me to have this surgery next month.

[Julie Thomas]

I had my gps on February 11th, 2009 and It went well until I found out that I had gallstones and my doctor had to go back in and take my gallbladder out. I have been out of work now almost 3 months because they keep finding things wrong with me that I guess I always had but was to fat to find. I have a peptic ulcer and just found out when I went to the emergency room the other night for sharp pains in my abdomen and all over my belly that I have a cyst on my overies. I am experiencing very bad pains from gas and I don't know what to do about that. I have not been able to eat much because I am nautious all the time. Does anyone have any suggestions on how to cope with the pain of gas after surgery? Thanks.

[LittleMissMaggie]

Wonderful illustrations. Very explanatory.

[hot celebrities]

What a big stomach, full of food.