Saturday 31 December 2011

Happy New Year!

It's the 1st of January 2012 and it's nearly three weeks since I had my stomach removed (total gastrectomy). I decided to start this blog because since having my surgery I have found it incredibly hard to find any helpful information about how having no stomach is going to affect my life, especially when it comes to eating. When I was in hospital I saw a dietitian who gave me a piece of paper detailing things that I should eat and how I should eat, but so far that piece of paper has proved pretty unhelpful. The info is often contradicting  saying things like avoid sugar and fat but then tells me to eat sweets and chocolate for the extra calories, and add butter to everything? Kinda confusing. The doctors also gave me some advice, and although they obviously know a lot about gastrectomies from a medical point of view, in reality none of them have ever had a gastrectomy so there is only so much they can help me with. Prior to my surgery I had the opportunity to speak to a lovely lady who has also undergone a full gastrectomy and the information she gave me proved to be invaluable. So far she has been able to tell me more than even my doctors about what living with a gastrectomy is like. So far, I have figured out that you just have to take it day by day and see what works for you. Most days I eat what ever I want, and apart from some nausea it hasn't caused me to much grief. I was so terrified the first time I ate, I wasn't sure what to expect. Would I feel the stitches joining my esophagus to my small intestines, would it hurt, would I vomit.... The first thing I ate was yogurt, 3 days post surgery and I felt nothing, I was honestly a little disappointed! Since then eating has become easier and easier. The first few weeks I would often experience quite severe pain, predominantly on the lower left hand side of my abdomen, which I later found out is where your small intestine fills up. Now that things are nearly healed as long as I eat slowly and chew my food I don't experience too much pain. Last night I ate grilled venison, salad, coleslaw and potato salad and felt fine. The one thing I do feel after eating though, is exhausted!! At the moment eating makes me very sleepy, I'm sure that will improve though once I'm healed. My would site is starting to feel tight which apparently means everything is knitting back together well. Hopefully my abdominal muscles will stop hurting soon cause, sneezing, coughing and even laughing hurt so much it feels like I'm going to rip  in half. My lack of abs also makes it rather hard to pick up my 5 month old daughter. Anyway I really hope that you find this blog useful, I wish I had a something like this to read before I had my surgery because I really had no idea what to expect and to be honest I still don't I am still taking every day as it comes.

Wednesday 28 December 2011

The Surgery...

PRE - ADMISSION
About a week before the scheduled surgery date I went to the hospital for pre-admission. Basically this is where they make sure that you are actually fit for surgery. First of all I had an ECG to make sure my heart was okay, it took all of about 5 minutes. Then I met with an anesthetist where he asked me if I had any drug allergies and if I'd undergone general anesthesia before (which I had twice; once for a broken arm and again when I got my tonsils out) Then we discussed different types anesthesia he said that an epidural was common for this kind of surgery, where they would insert a needle in my spinal cavity and make me numb from my chest to my waist. After this I had some bloodtests and they checked my blood type just in case I needed a blood transfusion, then I saw a nurse who told me what would happen on surgery day, where to go, and instructions on what I could eat the night before (no food from midnight, but I could drink water up to an hour before surgery). Finally I saw a surgeon (not my one) who explained the procedure (total gastrectomy with Roux-en-Y hip oesophagojejunostomy with Hunt Lawrence pouch) and went over the possible risks and got me to sign a consent form. It all took about two hours and I went home with a lot of pamphlets about a whole bunch of stuff that I never bothered reading.

SURGERY DAY
On surgery day I had to be at the hospital at 7am. I woke up at 6am fed my 4 month old baby had a shower packed my pajamas and went to the hospital. At this stage I don't think the enormity of the whole thing had sunk in. When I got to the hospital I was taken by an orderly to the ORDA (operation room day admissions) lounge where a nurse checked all my details and then directed me to a changing room where I put on a gown with a nice bit slit in the back and some super sexy anti embolism stockings (FYI don't shave or wax your legs before surgery because the stockings are so tight that your hair grows back under your skin!)

THE ANETHETIST
My anesthetist then came and met with me to talk about what would happen, we started talking about the anesthetic propofol (which he would use on me) I said 'oh yeah that's one that killed Michael Jackson' he laughed and said yes. He then went on to tell me a story about his friend, also an anesthetist who testified at the trial of MJ's doctor Conrad Murray. He provided some sort of evidence related to algorithms for administering anesthetic he said most of the people at the trial didn't get it (I didn't). But he said that Doctor Murray broke the most important rule when administering anesthesia to patients - NEVER leave them alone. Anyway he was a very funny guy he reminded me of Tim Allen from home improvement. After our in depth discussion about MJ we discussed the option of me getting an epidural. He basically said that a full gastrectomy is one of the most painful operations a person can have and 'you'll know about it if you don't have an epidural' he then cracked up laughing. I was sold and signed up for an epidural. I then signed some more forms and then went back to the waiting room.

THE OPERATING ROOM
It wasn't long and my surgeon and my nurse came out to tell me it was time to go. I kissed my boyfriend goodbye jumped in the wheelchair (they don't let you walk) and away I went. Once I was in the operating room it hit me that i was about to have major surgery and all of a sudden i was terrified. The room was so sterile (probably a good thing) and big but it had barely anything in it except a table for me to lie on. I thought to myself shit they are gonna cut me wide open, I'm going to be lying here with all my insides out and when or even if I wake up I am going to be missing one of my major organs, one I had grown quite accustomed to over the last 30 years. The fear I had was compounded by the fact that my anesthetist was having a lot of trouble getting needles into my veins for the IV lines. He kept saying that my veins were hiding from him, I didn't blame them considering the needles were the size of chopsticks. Because it was proving q decided that he would knock me out and then put them in cos it would be easier. Then it was time for the epidural back which carries it's on risks - what if I end up paralysed!? During all of this I couldn't hold back the tears I honestly wondered if I was going to die. I couldn't even wipe the tears away because of all the stuff attached to my arms. I lay down on the table they put a mask on my face and that's the last thing I remember. The surgery took about 4 hours.

THE RECOVERY ROOM
The next thing I remember was being wheeled down a hallway in the most excruciating pain I'd ever experienced. It really did feel like someone had cut me open and ripped out my insides, which in a round-a-bout way I guess they had. I don't remember too much but I'm pretty sure I was screaming. Someone kept saying my name, Kara, Kara, Kara over and over I guess they were trying to get me to calm down but I wasn't having a bar of it I just kept screaming. That's really all I remember, then I woke up in recovery with some nurse putting morphine into my arm. I think I drifted in and out of sleep for a while but when I finally woke up and was coherent enough to figure out where I was I wasn't in much pain and apart from all the different tubes sticking out of me I felt pretty normal. The nurse offered me water to drink but I initially said no because in my head I imagined the water squirting out of the new join around my esophagus and small intestine, however an hour or so later I did have some sips of water, I was expecting excruciating pain, or at least I was expecting to feel something, some sort of hint at what had just happened to my insides but to my surprise I felt nothing, no pain no water squirting out, it was as if nothing had happened. I then spent an hour or so just laying around waiting till they had a room for me in a ward, during this time I was probably the most coherent person in the room and I noticed that recovery is quite an odd place, full of people at their weakest being comforted by total strangers. It took two nurses to put the teeth of the old lady next to me back in and the grown man on the other side of me couldn't stop crying. When people are that wasted on drugs it's like everyone is a kid again who just need reassurance. A few hours later I was up in the ward in my very own room! YAY!