Saturday, 24 September 2016

The deed is done! Goodbye band, Hello bypass!

I had my Roux-en-Y Gastric Bypass on 7th September 2016 in Brugge, Belgium.

I went to Brugge with DH on 28th August, the week before surgery, to have a gastroscopy to make sure that everything was ok for the band to be removed and the bypass done at the same time. The gastroscopy was great and showed nothing untoward except a teeny tiny patch of pink from indigestion/acid reflux. It must have been small as, as far as I knew I'd never had acid reflux!

I was really worried about having a gastroscopy; I'd never had one before and I was petrified of choking or something similar. I had nothing to fear. It was all totally fine, minimally annoying and after about 30 minutes, like it never happened!

We spent the rest of the day chilling in Brugge having a beer and enjoying the food. It was our anniversary weekend too which made it even nicer, so apart from the gastroscopy, it was a really lovely day out. When you consider it also cost us £1000 less to go to Belgium and have it done too, I was even more pleased!! ;-)

Then I travelled back to Brugge on 5th September and checked into the hotel ready to have all my pre-op tests and my surgery.

All my pre-ops were done on 6th: ECG, Bloods & Barium Swallow. I then had a meeting with the Dietician who gave me my post operative guidelines. Basically it would be liquid for a day and then puree for 6 weeks. Not too bad really. I then had a meeting with Dr. Dillemans who looked over all my Pre-op tests including the gastroscopy. Usually its a 95% possibility of Band to Bypass in one operation, but after reviewing my images he said that I had a 98% chance of having it in one operation as my band was in a good position and there was no erosion or slippage.

I then went in to see his secretary and handed over my bag of cash!

We went back to the hotel and chilled for a bit and then later on went out for a slap up meal in the restaurant De Carre. That was the same restaurant that I had my last meal before my band too! It was divine!






On the 7th, I had to be at the hospital early at 6:30am. I was taken to my room at about 7:30am, initial ops were all completed by 8:00am and then the first problem occurred! I had a fever.

My temperature was 38.6 oC!! This is very high, but I wasn't feeling ill at all. I had no idea how I could have been totally fine beforehand, and now had a high fever. It sent the nurse into a bit of a panic and she called a doctor. Another nurse quickly took my blood to check my CRP level and white cells. This came back clear and of no note.

Then, Dr. Dillemans, in full scrubs, came up himself and checked me over. He made me cough and stuff and felt my skin and looked at me and decided that maybe I was just hot from the room (It was BAKING!) and the fact I had got some sun the day before. With the blood results negative for inflammation or infection they were going to go ahead.

It was a huge relief! I had insurance, so if they had had to cancel my operation, then it would not have been the end of the world. It would have just meant that I would have had to wait and that would have been seriously annoying as I had psyched myself up for it.

So they prepared me for surgery. I was probably the first to go down to surgery that day I think because they finished my obs and extra blood tests and stuff all by 8:45am and Dr Dillemans had been up too… but I went down to Surgery at about 9:00am!

My room was lovely by the way: Separate sinks, toilets and everything. Such a pleasure to know you don't need to permanently carry antibacterial wipes about with you like you do here in the UK. There was also only 2 beds in the room! Much better!! So sterile.

 


I came out of surgery into recovery. The operation itself took about 50 minutes altogether, but I was in recovery for a long time though and not back in my room until about 3:30pm. I slept and was super dopey for the entire evening, although I didn't have that much pain. I had a drain in my side, but it didn't cause me too much bother at all. I was just worried about pulling it out!




I managed to take a couple of after shots. I had a massive bruise and fat lip too, which I assume is from where I was intubated or where they inserted the large bore gastric tube to make my new stomach pouch. It really hurt!

I was also super hot. Literally burning up and was spraying myself with the remaining water in the Evian atomiser can. I had a flannel too that I wet and left on my head. It was ridiculous. The temperature didn't go down until the evening on day 2! However, I had nothing wrong with me at all. I felt 100% fine at all times and I didn't get sick even later on.

I found it really difficult to focus on anything over the next couple of days, which was different to when I had the band. I also found it hard to swallow cold or room temperature water; coffee was much easier. The sensation of drinking and eating afterwards was totally different to when the band was there. There was no resistance at all, just a full sensation. I was super careful while eating my first meal on day 2.

I had been nil by mouth for the entire day of surgery, just using the atomiser of Evian to spray into my mouth to wet it. It helped a lot although my mouth tasted like butt!

The next day I was water only until about 6pm when they gave me a yoghurt to eat. I managed half before I could not eat any more. Im not sure why I couldn't manage more… I think it was just because I felt a revulsion. I feel that now, its like a "Urgh, I don't want anything else" feeling rather than a full feeling. I have not been hungry at all since my surgery.


This yoghurt was particularly gross. It was plain, set and just yuk, but I ate it. I got my parents to buy some Petite Suisse from Aldi near the hotel for when I got out as they are low in fat and high in protein. 

My breakfast on day 3 was more usual, but not what i was expecting so early on. There was some toast, coffee and a yoghurt! It was impossible to eat that much. Just looking at it made my head swell. 


The toast was like a thick Melba toast. Very dry and crispy and therefore breaks down easily. There was margarine and cheese spread or jam to have with it. I went for cheese spread as I did want to risk dumping on the jam. The coffee was amazing but it took me so long to drink that it was cold by the time I'd finished. I have to eat and drink separately, so I made sure I got my caffeine buzz first!! 

I didn't even bother with the yoghurt. It was pointless even trying. 


The nurse came into the room about midday and took my drain out as there was no more effluent from it and removed it. JEEEZ that thing is LONG!! It was causing me no bother at all, but when it came out YOWCH! Mine was about 6 inches. I hadn't been in much pain at all, and I was absolutely amazed by this and at how easily, if tentatively, I could get up and all about. It was hard to get out of bed and stuff, but it wasn't that bad once I was up. It was a massive improvement on how I felt after the Lap Band surgery for sure… so to get this crazy pain after removing the drain?... I just wasn't expecting it. Thankfully it settled down after a few minutes and it didn't bother me again. 

The nurse put these bandages on and I was to leave them for 10 days. The drain was under the one on the far right and the old port scar was under the one next to that. The biggest tool they use goes through the one on the far right too, and both of those are quite big incisions.. just over and inch each. The others in the centre were painless and they are quite small: about 1/3rd of an inch in size. The one on the left is again quite big but not as big as those on the left. Its about an inch wide and although panels for a week or so, niggles occasionally now and then. 

About 1:30 on day 3 I was released, so I got a Taxi back to the hotel. Mum and Dad were waiting for me and had been enjoying the sunshine as Belgium had been enjoying a strange and fortuitous period of late summer. It was good that there was an outdoor pool and they used it every day. 

Everything went swimmingly. We left Belgium on the 11th September and I drove home. Yes, I drove! I was in great shape and in hardly any pain. It was fabulous. 

However, things were about to change. You might have been wondering why I hadn't written about this until now…well! 

We got home Sunday night and all was great. I went to bed and stayed there, and I stayed there all Monday too. Obviously I got up to mooch about and stuff, but just tried to relax and take it easy so that I recuperated nicely. But, I had a pain in my side. 

The pain was liken a stitch. It was in my lower left back. It was really sharp sometimes, but mostly it just caught me when I burped, moved, or breathed in too far. 

The pain of this stitch got worse and worse over the course of the day, and I though "here we go, here's the gas pain.. its all been too easy", because I'd had nothing at all, and it had been such a walk in the park. I jammed a pillow under my left elbow and tried not to move too much. 

When I came to lie down that evening though, it was agony. It took me ages to get comfy and sort out my position. Obviously at that time I couldn't lie on my side, but lying on my back was really awful, so I was sort of half sitting, half laying down. During the night I was awoken several times by massively sharp pains like I had been drawn through with a sword. It was the sharpest, longest pain I have ever experienced. It took your breath away, and you couldn't even breathe in as breathing in hurt too much. 

I couldn't cough, breath in, blow my nose, sniff, take an inhaler even though I was wheezy, move much or do anything. The only relief I had was when I was standing and panting like a dog. 

At 6am Tuesday I rang my surgeon in Belgium. He did some diagnostic tests over the phone and said that he suspected I had a Pulmonary Embolism or PE for short. He said I should get to the doctor immediately and they would check me out. So that's what I did. I went to the doctor and he did few things, listened to my breathing, chest, back, sides etc… Then he made me lie down to hear my bowel sounds and I nearly died. It was the most hideous pain ever. He didn't think there was too much wrong with me, and that I would be home and tucked up in bed again by tea time. How wrong was he!

He sent me into hospital for them to double check me over, but didn't think it was anything to worry about. Considering I'd gone form a 1/10 kind of pain to a 100/10 pain within 24hours I KNEW something was wrong! 

When I got to hospital I had a barrage of tests… D-Dimmer, CRP, Chest X-ray, ECG and eventually a CT scan. The D-Dimmer was raised indicating a PE, but so was the CRP (130 when normal range is less than 10!) so indicating an infection. 

My worst nightmare about getting a leak was freaking me out. I was literally climbing the walls of my mind and praying, a lot!

They told me I had a PE, but also that I had significant fluid on the lung and my lung had collapsed. This only briefly made me feel better because fluid on my lung and a PE could still mean I had a leak. Then one of the nurses freaked me out because the treatment for a PE is blood thinning, which breaks down scabs as well, and as I'd had surgery so recently they thought I might start bleeding from my incisions… Well that had me terrified! I was not so much worried about my incisions coming apart, because they could stitch them, but my 2 new internal anastomoses where they had joined my bowel to my stomach!! I was going mad inside. 

Heres a picture of my buggered left lung:



I made a call to my surgeon who reassured me that the anastomoses were made using a circular stapler and that they were very strong. He really put my mind at ease that I wasn't going come apart inside, that I had no other symptoms of a leak - fever, chills, pain in my shoulder sickness and nausea etc, and that it was all going to be fine. So I started to calm down about that, then started to worry about the clot moving and having a stroke! Honestly I was a mess. 

After a couple of days in the hospital things started to calm down. I hadn't died and they said the clot was breaking down ok… but I now had an infection and pneumonia, so I had to start on IV antibiotics. This wasn't so bad, and I gradually started to feel less breathless, need less morphine and less oxygen. 

Things started to return to normal and after a week I was released. I am still on bed rest, but I'm able to potter about. I am feeling gradually better and better and brighter in myself. I only get breathless when I climb the stairs or do something too quickly like stand up too fast and immediately start walking. I have to stand up then wait and then crack on. Very weird! 

So now I am home, recuperating and taking things easy. I have also lost a significant amount of weight in a very short time. I am kind of worried what people are going to say because I haven't told many people about the bypass. Most people who know me know that I have a band, and they know that I've been in hospital having the band removed. I have failed to fill them in on the full details though. 

I am in 2 minds about this. I told so many people about my band that I wished I hadn't because it didn't work. I don't want to tell anyone about the bypass for similar reasons, but also for the fact that I just don't want people judging me again like they did when I had the band. I got a ton of negative comments and looks, and smugness when it didn't work but just ruined my life daily - the "I told you so" kind of thing.

But then on the other hand, if I lose a ton of weight, people are going to ask how. I have a few friends that are obese, and a few that are morbidly obese too and I don't want to say "yeah I just dieted" and then have them think "why the hell can't I stick to it too" and feel bad about themselves. I guess I'm going have to cross that bridge when I get there. 

One things for sure, everyone thinks its totally fine to comment on your weight loss or lack of it, and give you tips on how to do it. It's like a free subject for them to comment on, when in fact I think that kind of thing is more hurtful. You wouldn't comment on someones disability, or offer advice on how to rehabilitate oneself, and when you are morbidly obese like I am/was, then you are basically disabled. No amount of tips help. It just shoves your face into that pie further because someone has noticed you're fat, when you and often your nearest and dearest have been telling you for ever that no one cares and no one notices you anyway. Hmmm yeah right. 

Anyway, my surgery is done, and I have to prepare myself for the barrage of comments. 

I weighed in at 124kgs - 273lbs -19stone 7lbs on 7th September.

Today I am 115.6kgs - 255 - 18stone 3 on 24th September. 

That's 8.4kg or about 18lbs in just over 2 weeks. BRILLIANT!!

I haven't weighed this little in about 2 years I don't think :-)
  

Tuesday, 23 August 2016

Some unexpected costs...

When planning surgery abroad, directly with the hospital, one must remember that when you ask for the cost of the surgery, this is the price you will be given.

It does NOT include the costs of tests needed prior to the operation.

Yesterday I received an email with a request for a Gastroscopy to check everything was ok down my throat and to the point of my band. This needed to be completed before the operation.

As I only have 13 days until I travel to Brugge, I was suddenly sent into a blind panic!

I phoned about 7 or 8 hospitals and hospital access groups to find someone who could do a consultation (why?!) and then do the test. The worst part was not that most of them couldn't fit me in, but that the cost was between £1400 and £1800 ARGHHH!!!

I did manage to find one consultant that would see me, and I booked to have the consultation on Friday (3 days time) and the procedure on the following Tuesday. However, that was before I asked myself the question of whether I could actually get this all done in Belgium too.

I phoned Dr. Dillemans secretary this morning and asked her. The reason she didn't suggest coming all the way to Belgium for the test was that she didn't want to put me out. She thought it would be easier to have it in England. NO WAY!! So I booked it. I'm having the scope on Monday 29th August in Brugge! This happens to be a public holiday in the UK, so my hubbie can come too.

I've just booked the Eurotunnel - £190 as it is a bank holiday Monday - and the procedure itself costs 300 euro.

I mean WHAAAAAAAAT!!!!! That's £250! What the hell is England playing at man?

I can go to Belgium in my car, get it done and be home the same day, including a nice day trip out with my hubby as it's our anniversary too, for less that £500!!! That's a huge amount of difference.

So sod paying through the nose here.

Total surgery costs are below for those interested in getting a Band revision to a RNY Bypass in the leading European Obesity Centre in Brugge, Belgium:

Surgery:              7750 euro
Gastroscopie:        300 euro
Barium Swallow:  150 euro
Bloods:                  100 euro
ECG:                     100 euro

Total 8400 euro - £7220 - $9500

If you pay in cash, you get a 4% discount. So I'm going to do that.

So beware the little extras, as these are not quoted when you ask how much it costs to do a band to bypass revision.



Wednesday, 10 August 2016

I've got my Euros! €7750 of them!

So glad I have a safe!



Today I got my €uros as I have to pay up in cash when I arrive in Belgium. My original Lap Band surgery cost far less, but times have marched on. If I had changed my £ to € about 2 weeks ago, I would have about £500 extra in my pocket but the ridiculous government reduced the interest rate to 1/4 f a percent and the pound against the Euro took a nosedive. GRRRRRRR Just ridiculous.

I can't take any more chances that it will drop further, as its basically gambling with a lot of money, so I changed it up today.

Not long now!

Thursday, 4 August 2016

Planning, waiting and preparing to not be a pussy!

So, 5 weeks today!

To say I'm scared is an understatement. I just keep thinking of the things that could go wrong. Even though I know that the vast majority of these things go to plan without a hitch, I'm worrying from the smallest of wrong things to the big.

Heres my list of worries:

1.) I get to Belgium, have my barium swallow (freaked about the too, as never had one!) and they see that there is a big leak or something and I will have to wait to have my bypass.

2.) I get into surgery and THEN they find I can't have it and I wake up bandless but not bypassed

3.) I get a bleed from the surgery

4.) I get a clot

5.) I get both of these, or a big leak and it all comes undone and I end up filling my body cavity with protein shakes or some horror

6.) I get the scar tissue thing where they have to give you a scope and insert a balloon to dilate the stoma where your tubes are bypassed because you can't eat or drink.

7.) I have to have No.6.  loads of times like Kacy Quinn! (Youtube!)

8.) I suffer horrific internal bleeding like another YouTuber had from an ulcer or similar.

9.) I die in pain.

10.) IT DOESN'T WORK

Yes, the whole thing not working is worse than death!!!

So this is my list. I am actually going to ask all of these questions to my surgeon as I am worried also about the money aspect. I mean, if something goes wrong and I'm in hospital for weeks… who pays?

I'm guessing that this is factored into the fees… sort of like an insurance? Those that have no issue basically pay for those that do… that kind of thing maybe? Maybe the surgery itself is really like £5000 but £1500 of it covers any serious issues. That then builds up so even though someone hasn't paid any extra, they will be covered. I dunno I'm just rambling.

But anyway, that's my current worry focus. So, to try and get away from it, and give myself the best fighting chance, I'm just making plans. I've got my vitamins to start taking in about 2 weeks time, which will then be about 3 weeks before the surgery rather than the suggested 2.

Here's what I have so far:



The first one, Hair Skin and Nails, contains a lot of vitamins useful for building and repairing our skin. So this will be good for getting my body ready to help heal itself. I thought that was a nifty idea ;-)

The Vitamin C I have bought as melons. There has been a lot of studies conducted which suggest that those taking vitamin C after surgery heal quicker and have less side effects like by HALF!  As I won't be able to swallow pills, I bought the melt variety. You can read about it here: Vitamin C. These will be great as I can take them immediately after surgery.

Now the other ones… Grapeseed Extract and Bromelian. There is a herbal tablet about called InflammEnz. Trials suggest that people taking it heal 17% faster than those that don't, although I am always dubious with such things ( even though that's taken from WebMD). I'm guessing it can't hurt! It contains 7 different vitamins and enzymes and the following:

Vitamin C
Bromelian
Rutin
Grapeseed Extract

Infammenz is expensive though and, to be honest, looks a bit of a quack item. Packaging is proper crappy and it just looks whack. So I am going to be taking the main ingredients from it separately and at a fraction of the cost. As I'm getting ready little by little, Rutin (a bio flavonoid) is still to be purchased. A job for today!

Also, after surgery I am not eating to be throwing hundreds of pills down my throat, and whilst I was browsing in Holland and Barrett health food store, I came across this:



I can literally pump 4 squirts of this on my tongue and thats my full compliment of vitamins for the day! No water, no swallowing. Fabulous. It was also only £10 for 40 days!

So I'm doing all I can to be ready, and hopefully be in the best place to help myself heal.

On another positive note, I have had NO PORT PAIN for about a week. That means I haven't had to take tramadol, and haven't been itching myself to death either. Phew!! I have Co-Amoxiclav antibiotics real to go just incase it flares up again, but as we speak… all good. :)


Friday, 22 July 2016

Waste of time. Plan A it is!

I went to my appointment today at a big Cambridge Hospital regarding my port pain.

I have been waiting to see the chap there (Mr. H) for about 2 months, so I wasn't going to cancel even though I have already booked my bypass surgery. Which I didn't tell him about either ;)

I arrived, a nurse checked my weight and height and then I sat with about 35 other people in a swelteringly hot room with all the windows shut slowly wilting. Thankfully it was only about 45 minutes that I had to wait.

Yet another nurse took me through to the consultation room and I sat there and waited some more.

Mr H. came through and asked me why I was there (!!) so I briefly told him: Lap band 10 years ago, which was then replaced some time later as it had burst, Huntingdon hospital didn't pick that up so I had had a lot of pain for months on end etc… Then I explained that in late February '16 I felt very bad pain in my port area similar to when my band broke before, which grew and grew and on 17th March I went to A&E as I thought there was something seriously wrong. They couldn't see anything, so sent me home with codeine. Then I was referred for CT scan because I was still in pain and now having to take tramadol regularly, which I had on 17th May. Apparently there was also nothing untoward in that regard either (except for my clips had come off from where I was sterilised 15 years ago arghhh!!!!)

I showed him the progressive photos of the bruise/bleed that appeared under my scar and got gradually bigger 2 weeks ago, but has since faded. I also showed him shots of the bruise by my tummy button.

Now remember today is 22nd July 2016, and the pain began suddenly exactly 5 months ago on the 22nd February. The bruising happened only 2 weeks ago.

He then felt the port a little for about 10 seconds and said I "probably" had a low grade infection, and would need antibiotics.

5 months to get antibiotics??? For God's sake!

Anyway, I said that actually I was very worried that as the pain was so sharp maybe it had flipped? and he said, "Weeeeell…. without referring you to X-ray to see the alignment bla bla…" In my mind then that's what you should flaming well do isn't it? But anyway, I then mentioned that I knew that if the band has eroded through the stomach wall it can cause a latent infection in the port site, but he was super vague and I got nothing apart from "It's a low grade infection… take antibiotics… it will come back… if its repeatedly getting infected then the system needs to be removed… more vague stuff, more vague stuff..."

No shit sherlock. Of course the damn thing needs to be removed!

The icing on the cake was when I said that if that was indeed the case, and the infection will keep coming back, then its horrible to just be constantly in pain for months on end and he said "Well there's nothing we can really do about that."

Wow. Cheers mate. All those years of training and this is all you can come up with.

So, after £7 bus fare and 3 hours of my life I'll never get back, he is writing a letter to my GP saying that I have some antibiotics immediately, and referring me to a level 3 obesity team.

Now, lets be clear, I understand that level 1 is like "If you eat less and move more you will get thin". Level 2 is a bit more advanced and gives you suggestions like "Did you know lettuce is good and donuts are bad?" and possibly someone looking down their nose at you and tutting in the hope you are shamed into losing weight. Level 3 seems to be the one where you get help after bands or bypass, or access to those treatments, but basically he is referring me to them so that if the infections keep coming back I will have it removed.

Going by previous encounters with these so called urgent referrals, I should get an appointment to see how the antibiotics are doing around the same time as I get back from my surgery in Brugge!!!!!!

Then I can just tell them to shove their crap care and pass the patient parcel game up their supposedly educated arses.

On a brighter note, I found my Hospital Card for AZ St. Jan Hospital, so that should save me some time and effort on the other side!







Monday, 18 July 2016

Pondering portions

Pondering what a meal will be like after bypass.

Last night we had bbq steak, jacket potato with sour cream and cajun green beans.


Now, considering I still have a lap band, I was able to eat most of this. But, here's what I left of the meal:


Then, it crossed my mind that this little bit in the centre might be the actual size of a 'big' meal post bypass (obviously a long way past bypass, but still). Just struck me that my leftovers, would kind of be my meals in the future! Ha! Love it!

Saturday, 16 July 2016

T minus 52 days!

Its booked. 7th September is the day I have my conversion to Gastric Bypass.

I'm travelling to Brugge on 5th September with my Mum and Dad. I was going to just go with my Mum but she will be alone in a city for 2-3 days and although I'm sure she will be fine, I don't want to be worrying that she's lost in Belgium on her own!

So my dear old Dad is coming too. We've booked a 2 bedroom apartment which should be lovely. It's in the centre of Brugge so they can go off mooching for the day. It's close enough to the hospital that I can probably walk there for my pre op tests, and a Taxi back from the hospital isn't going to cost the earth either.

I am debating on taking the ferry or the tunnel. I think the ferry will be the cheapest, but it also takes loads of time too. like 2 & 1/2 hours :(

But I think that's easiest.

My parents live about 130 miles away away from us, and in the opposite direction from the port of Dover. because of this I am debating on collecting my parents from their home and then dropping them off afterwards, or whether my hubby and I will meet them half way, and then he can just drive home with their car and do the same on return.

Hmmm decisions decisions.

 

If I went directly to Dover from my house it would take about 2 and a half hours.

If my Mum and Dad went directly to Dover from their house it would take about 2 hours.

If I drive to man mum and Dad's house it would take about 2 and a half hours…

Adding this data together it means that I would have to drive for about 4 and a half hours each way.

Meeting definitely seems the best option then doesn't.

Cool. I'm glad we had this chat!! Now I have to convince them that this is indeed the best plan.