post-op anxiety

Question
Hi Karla:

I am a 56 year old man and I am 3 days post-op for the vertical sleeve gastrectomy.  I had my sursery bacause dear friends and family members were concened about by weight - I had a BMI of 43. While I have been blessed with relatively good health, even my personal physician said that loosing the weight was the "lynch-pin" to resolving all my remaining health care issues.  Intelectually, I believe that I was well prepared for my surgery.  Emotionally, well that's been a surprising concern.

I think that because the surgery was never my idea, I never made peace with the idea.  Now every little twinge, every unfamiliar ache, I seem to fixate on this as a dire concern - thus initiating an anxiety response.

Is it typical to be so skiddish following the surgery?  How long should I expect it to take before I can drink more than a few onuces of liquid faster than over an hour's time?  Any tricks for getting down those few medications that don't come in a chewable or liquid format?

My surgeon assured me that everything went just fine, but I just keep dwelling on what an enormous change this is in my life.

Any words of encouragement?

Stressed out in Ohio

Answer
Hi Michael:

If it at all helps, what you're going through is completely normal! A lot of people find themselves thinking, "What on earth did I just do to myself?" right after surgery.  It doesn't help that the immediate post-op period is the most uncomfortable, either.  The good news is that you're through the worst (and the riskiest bit...the surgery itself)--and that each day you should feel exponentially better.

It is completely normal that you can only drink a few ounces over an hour or so at this stage.  You just need to view drinking as your job right now, as unpleasant as that might seem.  What I found worked best for me was to take a large (32 oz.) bottle of Propel and tell myself that I had to drink one by Noon and another by dinner-time.  That ensured that I got enough liquid in.  Please watch your urine output and color as you really need to watch out for dehydration at this stage.  I know quite a few people who've ended up in the ER for IV fluids due to dehydration.  So, if you're urine gets a little dark in color, be extra vigilant in getting your liquids in.  If you have any doubts or think you might be dehydrated.. dark urine, low output, headaches, low energy... call your surgeon.  Right now, water is more important than anything.

Most people find that the swelling goes down in their sleeves pretty quickly, and I think that you'll probably find drinking a lot easier in a week or two.

As for non-liquid meds, just crush them with a shot glass or spoon on a piece of paper.  You can either swallow them "whole"... or put the powder on a spoonful of applesauce or yogurt (assuming you're on full liquids).  If you're still on clear liquids, just mix it into a bit of juice.

As you progress through your post-op diet, you'll begin to feel more normal... especially once you make it to solids.  Just follow your surgeons recommendations which are usually clear liquids either in the hospital or the first week... full liquids for the next phase (1-3 weeks usually)... purees/mushies for another two weeks...and then solids.  The reasoning is not only to allow your stomach heal, but to also avoid any complications like having a bit of food stuck in your staple line while it heals.  So although it seems counterintuitive to weight loss, you're much better off drinking a milkshake than eating a piece of celery in the first few weeks.  Of course, a protein shake is better than a milkshake ;) (Oh...as an aside, you might want to try Lactaid Brand milk immediately post-op as many Sleeve Gastrectomy patients find that they are lactose-intolerant from the surgery.)

In terms of quality of life post-op, you've picked the best surgery.  Once your stomach has healed and you're on solids, you will feel normal.  You shouldn't have to worry about dumping as with the RNY, or foods getting stuck with the Band.  You should be able to go out with friends and eat normal foods... just smaller portions.  So, really, the changes won't be as enormous as you fear.  You should choose protein first, followed by fruits/veggies, and then whole grain carbs for maximum weight loss... but there are people who also ensure that they get their 60-70 grams of protein and eat pretty much whatever they want and still end up losing 50% of their excess weight or so.  It's what you make of it, really.

In terms of pain and healing, most people find that their largest incision where the stomach was removed bothers them the most in the immediate post-op phase.  It usually feels normal at around 2-3 weeks, though... so really, you shouldn't have much more discomfort to deal with.

As for dealing with the change of surgery, it's normal to mourn your old life.  It can be really tough to lose everything that was familiar in terms of food, coping mechanisms, habits.. and feel like you're being forced to do something different.  The good thing is that as some experiences die off, you'll find new things that replace them.  As the weight comes off, you'll feel better about yourself, have more energy, etc... and this may cause you to try new things or do things that you haven't done in a long-time.  Your surgeon may have a support group or therapist on-staff that you can talk to about these changes--because really, every single bariatric patient faces them.  You are not alone... and what you're feeling is completely normal.

You might also want to hook up with some other VSGers online, such as through ObesityHelp.com  or the Sleeve Gastrectomy Yahoo! Group if you're not comfortable at your surgeon's support group.  Although most of the post-ops are women, there are still quite a few men floating about...and I can think of 10 or so who are well past 1-2 years post-op.

Let me know if there's anything else I can do to help.

Happy New Year!

Karla  

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