Post-Op, Days 1-2

Well, it's over. I remember going to the seminar in early June and thinking that six months of testing and nutritional counseling would go by slowly and really, it flew by. I also realized how grateful I am that I had six months to mentally prepare myself. Once I made the decision to go through with weight-loss surgery, I was ready to jump in and get it over with. However, after going through the entire process, I am happy that I was able to prepare my body physically and mentally. There is definitely a method to the madness of the insurance companies and bariatric programs here in the United States. If I could make a recommendation to anyone considering having a weight loss surgical procedure, I would say to do at least six months of preparation even if you have the choice to just do it. In the long run, it will help you be successful.
Day of Surgery: Tuesday, 12/8
I had to check in at the hospital at 5:45 am (yuck...). I had to shower the night before and the morning of, cleansing with an antibacterial soap like Dial. Of course, I didn't sleep well the night before because I was nervous, excited, scared, happy...and so many other emotions that I can not possibly explain. After checking in, I was taken into what I call a "pre" pre-op area where I changed into a gown, reviewed my medical history, had some labs drawn and was asked to wipe myself down with chlorahexadine wipes. During this time, my husband was able to sit with me, which was a relief because I was so nervous. At around 6:45 am, I was moved into the pre-op area which meant I was now alone and without my husband. Luckily, the pre-op staff was amazing and nice. The nurse put in my IV and gave me some pre-op medications (Lovenox, which is a blood thinner and zofran, which is to control nausea). The anesthesiologist and the surgeon both came to speak with me and gave me a chance to ask questions. After I signed consents and spoke with the doctors, the nurse gave me some Versed (a benzo to help control anxiety and relax me before going into the operating room).

Me, in the "pre" pre-op area - scared and nervous!

The Versed must have knocked my ass out good, because the next thing I remember is being moved into the OR and moving myself onto the operating table. Next, a mask with oxygen was put over my face. Then suddenly, I am being woken up. My first memory is feeling like I had swallowed something and I was not able to cough it back up. I am guessing this memory occurred when they woke me up while I was intubated, which they do to make sure that I will be able to maintain my airway. 
After this, I remember waking up and being able to thank the OR staff for taking care of me. I think I also mumbled some weird things to the CRNA, but I can't be sure that this happened or if I was imagining it. Once I was done in the OR, I was taken to the post-op area when the nursing staff monitored my vital signs and made sure I was stable enough to go to my room. Once I was stable and I had a room assigned, I was moved into a private suite which is where I stayed until yesterday afternoon. 
The day of surgery is pretty much a blur. When I came out of surgery, I was able to move myself from the OR stretcher to the bed...I remember the nurse calling me a "rockstar" because I was able and willing to do the moving by myself. I had terrible epigastric pain, which I was told is from the gas they used to inflate my abdominal cavity to see during surgery. I was quickly hooked up to a pain pump (PCA) which gave me a dose of Dilaudid every 10 minutes if I needed it. Basically, when I needed pain medicine, I could push a button and the machine would administer it to me. Not going to lie - I pushed that button every 10 minutes. I am happy I did because the pain never truly went away, but the medication made it way more tolerable. So, my second piece of advice - stay on top of that pain medication because once it is out of control, it takes longer to get it back down to a tolerable level.
I came out of surgery with a Foley catheter, which is tube that was in my bladder and drained my urine into a collection bag. This allowed the nurses to watch my urine output and ensure that my kidney's were functioning properly. It also let me rest in bed without having to get up to pee, which would have been often because they gave me quite a few fluids during the procedure. I also had a Jackson-Pratt (JP) drain in place, which allowed the staff to watch for any stomach content leaking, which is a potential complication of the Roux-en-Y surgery. The JP drain is a small tube that was by my stomach and came across my epigastric area (internally) and exited around my right mid abdominal area. I was also hooked up to IV fluids and the pain pump. On my legs, I had white TED hose and SCD's, which helped make sure that my blood continuously flowed to help prevent blood clots from forming.  My husband and parents spent most of the afternoon with me, which was awesome especially since I was pretty much in and out of sleep the entire time. I walked a couple times the first day, which was painful and I got a little nauseated, however it was necessary to get the healing process going as soon as possible. Ambulating helps prevent many surgical complications like blood clots, pneumonia and it helps get the gas moving.
Other than the fact that I had just had surgery and I had drains and tubes, plus 5-7 small incisions on my abdomen, I didn't feel like anything had changed inside. It sounds weird...I'm not entirely sure what I expected to feel. But I felt like nothing had changed. Of course, the day of surgery, I was kept NPO which meant nothing by mouth so I wasn't able to actually test out the new pouch and re-routed intestines. It was just weird to think about the fact that my stomach was now the size of the tops of my two thumbs and my intestines were moved around. 
Post-Op, Day One: Wednesday, 12/9
Early in the morning on the day after surgery, I was able to have the Foley catheter removed. I admit, I was pretty concerned about having a catheter in the first place because I know all about catheter associated infections and other complications associated with having a catheter. However, it was nice to be able to rest all night and not have to worry about getting up to pee 100 times...because that's exactly what would have happened. After the catheter was removed, I went for a couple of walks, up and down the hallway to keep the CO2 gas moving out (which was put in during surgery and causes quite a bit of pain when it just sits in your belly). That's my third piece of advice - walk, walk, walk...because that gas pain does hurt!
At about 8am, I was taken down to have an upper GI performed to check again for leaks. The upper GI is an x-ray. I had to drink 60 mL's of contrast and have multiple x-rays done to see if there was any leaking at the internal suture lines. That test was all good, so I was given the green light to start drinking fluids. I had to drink 30 mL's over an hour, for six hours. Once I was able to do that without feeling pain or nausea, I could move onto clear liquids which was 30 mL's every 15 minutes. I have been very lucky, because I have not had any nausea since the day of surgery, which is likely from the anesthesia and pain meds. I was able to take in some sips of water and some sips of chicken broth. Fortunately, I was able to tolerate this without any issues as well. After lunch time, the PCA pump was turned off and I was started on oral pain medications.
Later that night, I developed a low grade fever. This had me somewhat freaked out. The nurse reassured me that this is often normal after abdominal surgery and I needed to cough and deep breathe more often. I did just that and by the morning, my fever was gone. Bob came and stayed the night with me, which was awesome because I was scared I was going to have a complication and not do as well.  
Post-Op, Day Two: Thursday, 12/10
Discharge day - yay! I had 3 requirements to meet: pain control on oral medications, pass gas and be able to hold down fluids. I passed all the tests and was able to be discharged late afternoon. Prior to discharge, I had to have the JP drain removed. Talk about a weird feeling - I seriously felt the drain pull across my abdomen and out. I had some chest pain immediately after and for a couple of minutes. It was the weirdest feeling. Luckily, the sensation went away pretty quickly and I got to go home!
Whew, this was a long entry and I am exhausted, so more on the post-op experience to come... :) Thank you everyone for our love and support. The amount of messages, visitors, texts and phone calls from everyone has been overwhelming and so appreciated.