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Fat Steve's Archives

| Thursday, January 20, 2005

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      On Tuesday, when I came out of the OR, it was rather late.  The previous operation had taken a bit longer than expected, and I had also taken longer.  Thanks to my second motorcycle accident, back in '79, I had a lot of "adhesions" and other little problems inside the abdominal cavity, and it took longer than expected to staple the stomach.

      The procedure is called vertical banded gastroplasty (VGB), and there's a picture here, http://www.healthscout.com/imagepages/19498.htm.  In a VBG, staples are put into the stomach, and a pouch is created that severely restricts food intake.  Because the band at the bottom of the pouch exists, emptying is slow, and you feel full for a long time.

      I could have chosen the rather more involved Roux-en Y, which involves a greater re-routing of the stomach, but which highly restricts what you can eat, causes unpleasant symptoms if you eat the wrong things, and can give problems if it ever becomes necessary to pump the stomach, or check for gall stones, ulcers, or cancer.  It's only advantage I could see was an instant cure for gastric reflux, but while I have that problem, it's very mild.

      My surgeon, Dr. Buchwald, also does "biliopancreatic diversion,"
but wouldn't do one for me because of I had hepatitis at age ten. Further info on theses procedures here and here.

      From my perspective, this involves lots of tubes in the body.  I had a naso-gastric tube, which is just what it sounds like: up the nose, down the throat, and into the stomach.  The stomach just stops working after an operation like this, so drainage is necessary.

      I have a CPAP machine, or rather a BIBAP, which reduces the pressure a bit when you inhale.  As an old respiratory tech, this isn't much different that IPPB, Intermittant Positive Pressure Breathing.  The CPAP only involves a mask, thank God, but when it's not on they want me wearing an oxygen canula, which has short tubes in each nostril.  You've seen canulas on doctor shows, usually put on incorrectly.

      Then there's my IV line, started before surgery.  Since my gut isn't working, the IV delivers needed fluids, plus pain meds.  The pain meds are dispensed via a little pump that I control, which is very nice.  Push a button, and if ten minutes have passed since the last button push, the machine gives me a shot of pain killer.  Even better, it isn't demorol or morphine, which I had in '79 and hated (I came to prefer codeine to morphine).  Best of all, very little pain.  I think that the fact that the incision went through my last incision has restricted pain a bunch.

      In my abdomen, a tube to remove wound drainage.  And a foley catheter, for urine.  Bowel movements are awaited with great anticipation, but nothing is provided to catch them.

      A last touch was circulation boots.  These things squeeze the feet for a second or two, then relax.  The idea is to keep blood from pooling in the feet.  I suppose they work, but they disturbed my sleep.

      With all this, they wanted me to get up and take walks!  I begged off, both because I didn't have the energy and because my clothing has disappeared, containing my shoes and socks.  My shoes were with them, and my compression socks (I have blood pooling in the legs at the best of times).  So I spend the night sleeping lightly, with an extremely dry mouth and disturbances when people come to check my vital signs.

      As stays after major surgery go, this ain't bad at all.

      And by the way, I just found out blogger's spell check might work after all.  It hasn't at home, but that appears to be because my pop-up stopper killed it.  Live and learn.