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| Body Transformed 
Pre-op testing went well, but it was a LONG day. My husband and I drove to the hotel the night before since it's a 400 mile drive. We got there at about 1 a.m., so we were exhausted. After a fitful five hours of sleep I woke up feeling drained but unable to go back to sleep. Leaving Ed at the hotel to catch some extra ZZZs, I drove to the weight loss center for a session with a nutritionist. I knew where I was going, having been there before for the initial consultation. As always, the staff was wonderful. One other woman attended the nutrition class with me. We chatted for a bit about the surgery and its impact on our lives. There's a common bond between people who have decided to take this drastic, irreversible step to become healthy. First, a nurse described what the day of surgery will be like for us. We are to arrive two hours prior to surgery. Preparation will include having an IV, nasal-gastric tubing, and bladder catheter inserted. Fortunately, the tube and catheter will be done after anesthesia knocks me out cold. The surgery itself is expected to take about 90 minutes. During this procedure my stomach will be divided into two sections. The smaller section, connected to the esophagus at the top, will be about size of an egg and will be connected to the small intestine via a narrow stoma (tube) about 5 feet further down the digestive tract than before. The larger section of stomach, still connected to the digestive tract, will remain in place, continuing to produce stomach acids necessary for digestion. These stomach acids will drain down, meeting up with the food passed through the stoma from the newly created "pouch," aiding in the passage of the food through the digestive tract. Because about 25% of the small intestine is bypassed due to the procedure, both nutrients and calories are reduced. During the surgery, which involves a vertical incision from breastbone to bellybutton ranging from 5-10 inches depending on the patient, a tube is placed in the abdomen to allow any post-op fluids to drain out. The purpose of this drain is twofold: to release pressure from fluid and to allow medical staff to visually observe any leaks from the newly created stomach pouch. After surgery, I should spend about an hour in recovery and then will be spending three to four days in the hospital. I'll have a PCA pump for on-demand IV morphine to help with the pain. The catheter will stay in for about 48 hours, the nasal gastric tube for 24. Within 24 hours of surgery, I will be allowed to begin to sip water, just a little bit at a time. Within 48 hours, broth and juice will be added. This liquid diet will be my only source of nutrients for a couple of weeks. Patients are expected to get out of bed and try walking a few steps within eight hours of surgery. Moving is essential to prevent deep vein thrombosis (DVT), the most common cause of postoperative death for abdominal surgery patients. Walking, which prevents blood clots from forming in the legs, combined with leg exercises done in bed an inflatable hose designed to push blood through the legs, are important factors in recovery. About 48 hours after surgery a test called a barium swallow is done. The patient drinks a small amount of a white, chalky substance known as barium while having an X-ray done. The purpose of this test is to observe the barium flowing through the digestive system, from mouth to pouch to small intestine. The technician performing the test looks for any leakage of the barium product. It is essential that the new system be completely stable and leak proof before the patient leaves the hospital. My surgery is scheduled for a Monday. If all goes well, I should be on the road home by Friday. The session with the nutritionist was interesting. She went over the post-op diet with us: only liquids for two weeks, avoiding sugary drinks, trying to get in as much protein as possible by using protein powders and prepared protein drinks. Since the pouch only holds about 2 ounces, I'll be sipping, rather than gulping, for the rest of my life. Drinking about an ounce of water every 15 minutes or so should keep me from getting dehydrated. My husband has offered up a shot glass for me to use as a guide! After the meeting with the nutritionist I drove back to the hotel to pick up my dedicated husband. He was ready to go to the hospital for the clinical part of our visit. Thankfully, he brought along a book, because the wait was a long one. Shortly after checking in at preadmissions testing, I was called in for an EKG. That took about five minutes and was completely painless. Back to the waiting room. After about an hour, I was called to provide a urine sample. Back to the waiting room. Another hour passed and I was led to the lab to have eight vials of blood drawn. Back to the waiting room. (Are you seeing a pattern here?) After another hour I had to do a breathing test. Back to the waiting room. This time it was only about 20 minutes before I was led to an exam room. A nurse interviewed me and went over a patient history form that I had filled out at home prior to the appointment. She said that the doctor would come in to do a physical examination and then I'd be done. What a relief! I was really tired after the long drive and poor sleep the night before. The doctor came in shortly and did a very thorough exam, surprising me by informing me that I have a slight heart murmur that no other doctor had ever mentioned. He said it wasn't an impediment to surgery but suggested that an echocardiogram be performed about six months after surgery. We discussed my sleep apnea and he predicted that I won't need to sleep with a CPAP device after about six months, so he advised a follow-up sleep study to check that out. I cannot even imagine the freedom of being able to sleep without my CPAP blowing air down my breathing passages all night long! It's an incredible thought. We talked about the emotional changes that I will go through following surgery, both the immediate and the long-term adjustments.
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Pre-op Testing