Digestive system v2.0

All is well so far. I haven’t found a food I can’t tolerate, and I’m losing weight quickly enough. A few remarks:

• I was seeing a lot of sagging skin a few days ago. Much of it seems to have disappeared. I’m not unhappy about that, but it is a bit weird.

• My diet right now consists of string cheese, nonfat cottage cheese, nonfat plain greek yogurt (sometimes with ranch seasoning), refried beans, black bean soup, one attempt at scrambled eggs, and broth. And protein shakes, of course. All of those do fine, though string cheese is slow to move through the stomach pouch. I can eat about 3/4 of a piece, then have to wait a bit while it moves on through.

• I’ve been eating three 2-oz meals per day, with protein shake sips scattered around the day. I do end up feeling somewhat hungry after dinner. Most of the time, I just ignore that (it’s not too intense), but one night I decided to try a snack and had one of those soft Babybel cheeses. It was wonderful.

• I’m missing the ability to eat other food. I’m not too hungry, so it’s not that I want *more* food–it’s that I want *different* food. I’ve been reading accounts of other folks who are much further along than I am, and it sounds like eventually most foods are workable, but everybody has a few things that their body no longer tolerates at all. I’ll be patient.

• My blood sugar is almost completely normal. When I get up in the morning, it’s usually 110 or so, and in the evening it’s often below 100. That’s a huge relief.

I’ve lost 20 pounds from my weight taken 3 days post-surgery, about 30 from my peak. People are starting to see it in the shape of my face.

I had a minor epiphany this evening which, as I follow up on it, is making me realize some things. A good friend of my wife and mine–one of my favorite people, actually–usually comes over on Sunday nights to catch up on a favorite TV show, or just to talk for a while. She usually brings over some delicious snacks, and tonight was no exception. However, unlike on most previous Sunday nights, tonight I was unable to eat the snacks.

I found I didn’t quite know what to do with myself. I felt at loose ends, as if there was suddenly a lot of time to fill, and I realized…I spent a good fraction of those evenings standing by the snack bowl, enjoying the delicious munchies. And now I couldn’t, and I didn’t know what else to do.

It got me to thinking, and I started to realize how huge a role food, and planning around food, has had in my life. Much of that is good and appropriate; eating together is part of how we live together, maybe one of the biggest parts. But food was also often a part of my errands and outings, often in very unhealthful ways. If I had a mid-day errand run, I’d also be thinking about how I could have a burger while I was out. I would come up with reasons why I’d need to go do something just so I could sit and read a bit while I had some buffalo pizza sticks. And a stop at 7-11 was virtually always part of leaving the house, if I was alone. Those moments were wonderfully pleasant–honestly, a source of joy. And they were undoubtedly a big part of how I got to be 300 pounds, and a drain on money we couldn’t really afford.

I’m not quite sure what to do with this. The rational part of my mind knows that I need to find something else which will fill the same place–something which will provide joy, but without the dire health and financial costs. But part of the problem is that the food was one of my only sensual joys. I’m not a very sensual person, in general; I live most of the time in a very rational headspace. I think those moments might have been one of my only places where I really engaged with a pleasure which was almost entirely sensual. I’m not sure how to fill that, but I’ll need to find something. This is a good change, I am confident of that–but it’s an interesting challenge.

I’ve made Sundays my official weighing and measuring days, and I enter those in the blog’s sidebar. I’m down 14.8 lbs over the last week, and 25.2 pounds from pre-operative weight. I can definitely see it in body shape, and running my hands over my belly feels different.

There has been one other interesting change so far, which I was not necessarily expecting. I am sleeping much better. As I mentioned, I have severe obstructive sleep apnea, so I use a CPAP at night. The CPAP I have reports on various aspects of my sleep, which I can see on an app. One of the aspects is the number of apneas/hypopneas per hour during the night. Under five is considered good. The CPAP therapy was going very well before surgery, with number of events jumping around between 1.5 to 4, as a rule.

I brought the CPAP to the hospital, an used it there. On the night after the surgery, it was just over 1 event per hour. Since then, it’s been varying between 0.3 and 1.5. On a graph, the difference is obvious; the surgery caused an immediate drop in events. I expected the surgery to help with apnea, but I assumed the effect would be weight-loss dependent. I have had a cople of nights where I have fallen asleep before putting it on, and my wife reports that I snore much less or not at all. That doesn’t make a lot of sense to me, but I’ll take it.

I’m still not hungry, though I do want food. I miss taste and feel of many of my favorites. Last night, my wife brought home Chinese food from our local cheap Chinese place for the kids, who were having an RPG meeting. It smelled wonderful, and I very much wanted to have a bite…but not out of hunger. I just missed the taste. And–to my delight–it wasn’t that hard to turn away. Knowing that someday I’ll probably be able to eat many of these things again, in small quantities, is comforting.

In terms of food, I have found that Greek yogurt and nonfat cottage cheese go down easily and stay down well. Canned refried beans also do fine, though I do need to eat them slowly. Scrambled eggs are nice, but they don’t sit quite as well; I’ll probably try them again, but slightly softer. I did find that a small digital kitchen scale with a tare feature is much more convenient for measuring out food portions than the tiny one-ounce cups from the hospital.

My energy is coming back; I’m able to take on longer walks, and if I get tired it just feels like normal tiredness, not the deep fatigue that I was feeling before. Actually, I’m feeling quite good.

I had my one week post-op checkup today. Everything looks good. I am clear to drive, and approved for soft protein foods. I still feel good. I’m still getting tired more easily than before, but Dr. Rumsey thinks it’s a combination of recovery from surgery and a body shift to a different metabolic model.

Tonight I put 2 oz of low-fat cottage cheese in a bowl, and ate very slowly. I got through about an ounce, felt the beginning of pressure under my sternum, and stopped. It has been emphasized to me that it is very important to stop eating at the very first feeling of fullness. I waited about 15 minutes, and then slowly ate the second ounce.

Everything stayed down just fine, no nausea. I did have a very brief moment of slightly sour spit just after swallowing the first bite, but it passed quickly. I’m just waiting to see if I get any dumping syndrome, but no sign of it yet.

First food, yay!

The intestinal cramping stopped yesterday. With that being gone, and no significant pain from the incisions, I’m feeling pretty good at this point. I am still getting tired more easily than I was, but I’m not too worried about that.

My first post-op appointment is tomorrow. I’m hoping Dr. Rumsey will approve me to start moving to soft foods. I’m still not hungry, but I do miss tastes and the feel of food in my mouth.

All is well so far. Cramping is decreasing, and seems to be associated with drinking fluids, so I’m going to assume it’s nothing to worry about. No significant pain at the incisions.

I did have my wife take me to the store to look at water flavorings. Turns out that the liquiod ones mostly do contain sucralose, while the powdered ones don’t (Nutrasweet or stevia). I’ve never had a problem with sucralose before, but I’m going to try the powdered ones anyway.

Blood sugar this morning was just over 100, so that’s good.

Also…today my designated “occupy myself during recovery” tool arrived…

It’s been an interesting day so far.

Good news: Blood sugar today was down to 106. Yay! I’ve also started a bit of protein shake (Premier Protein Chocolate), which hasn’t come back up yet, so that’s good.

Woke up feeling a bit fatigue-y and almost flu-like, but no fever. I’ve read that that’s not uncommon. I’m less happy about the digestive issues. Do not read further if you will be bothered by fairly graphic descriptions of toilet stuff; I’m doing this so that other folks undergoing this process have a fairly complete description, and can compare it to their own, which probably means revealing info you might not want to know.

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Had a loose bowel movement this morning along with some gas. Probably best described as a very small amount of diarrhea. However, it was very dark in color, and had a pretty unpleasant odor. No “coffee grounds” that I could see, which means I don’t think I have to worry about bleeding around the stomach or upper intestine.

A few more later in the day, along with moderate intestinal cramping (serious enough that it’s hard to think about anything else at the time, but not the “holy crud I’m about to turn inside out/I think I might rather be dead” kind.

I’ve been trying to figure out what might be causing them. A few possibilities:

1) This could be just normal adjustment, even something which had been suppressed by the Toradol they were giving me in the hospital.

2) When I got home last night, I started taking water with my own favorite calorie-free flavorings (Crystal Light black cherry). Had that off and on during the night, too. This morning, I noticed that that particular flavor is caffeinated. While I have read that caffeine is allowed, it doesn’t seem to be recommended. It is also sweetened with sucralose, which (from what I have read) is not always tolerated. I switched back to regular water; if by the end of the day the cramping hasn’t resolved, I’ll assume that’s not it. The Crystal Light in the hospital didn’t cause this, but it was a different flavor and in powder form; maybe I’ll go to the store later and see.

3) This morning I also took my first vitamins (Bariatric Advantage EA). I suppose those could be something my new digestive tract will have to adjust to.

If the cramping hasn’t significantly lessened by the end of the day, I’ll call my doctor just to ease my mind.

Am continuing walking, which seems to help.

So I definitely get to go home today. Yay! I’m peeing a lot, and my sugars are down to 127. I’m up to 3 oz fluid/hr, which my doctor says is a good point to aim for right now. More is certainly better, but I shouldn’t go above 4/hr right now.

I don’t have any significant pain. I feel slightly hot, but my vitals indicate normal temperature.

I walked 1 1/2 miles this morning, but when it was time for my next set of laps, I really didn’t feel like doing them. I skipped that set, and did a half set the next hour.

I feel significantly more tired today than I did yesterday. Not bad, just fatigued. From what I have heard, that’s pretty normal, and may come from lack of food intake. I’m prepared for a week or so of not doing much.

I’m feeling pretty good. No significant pain. My blood sugar is down to the 130-140 range, which still seems high given that I’ve had no food for something like 80 hours and several doses of insulin, but they say it’s ok. Based on the numbers, it seems to me like the insulin is having virtually no effect, but I have to trust the doctors.

I’ve been trying to walk half a mile every hour while I’m awake. I think that’s helping. It’s not particularly difficult.

This morning I’m staying out of bed as much as I can. I woke around six and moved to the chair to watch the sunrise. It’s overcast, so it was less spectacular than it might have been, but that’s ok.

I’m on 2 oz of lemon Crystal Light per hour. I have other options including popsicles, broth, and tea, but (guilty confession) I kind of like crystal light.

I’m not hungry. I do think about food (and I am astonished to notice the proportion of commercials which are either for food or weight loss products), but while I want it in my mouth, my body is not particularly interested. If someone came up with a way to give you the taste and mouthfeel of, day, a big bite of pizza without actually giving you the calories etc., they’d make a fortune.

I’m hoping they send me home today.

Slept well last night. I may have to look into a bed which tilts up. They’re letting me drink 1 oz water per hour. I’m on an IV, so they’re not worried about me dehydrating; it’s just enough to wet my mouth a bit (which is nice, as it is quite dry). When the water hits my stomach, it definitely rumbles, but there’s no pain.

Actually, there hasn’t been much pain. They add Tylenol and Toredol (sp?) every once in a while, but that’s it. I have a little bit of pain around the incisions and a tiny bit of gas pain in the abdomen and occasionally in the shoulder, but it’s not bad.

They took the catheter out this morning (yay!). I just peed on my own. Also have passed some gas, which they tell me is good.

I’m trying to get up and walk every hour. The loop corridor around the floor is conveniently marked as 1/16 of a mile; I try to do four laps each hour.

Feeling pretty good overall.