Day 2 Midnight to Noon - I am Thirsty

I am thirsty. I could end this blog right here and that would sum this morning up. I will repeat, I am thirsty. I have had nothing to drink since 10:30 on Sunday night and it is now 0630 on Tuesday Nov 20th and my throat and mouth is so dry. Sure, I have been on an IV, I have the Foley Catheter properly installed (a story which I will elaborate upon) and I am involuntarily moving bodily fluids. But my mouth is dry and my throat hurts and I have just been told that I can have nothing to drink until my "Swallow Test" (get your minds out of the gutter right now), Which is at least 5 or 6 hours away.

The pain is still pretty severe after 2 or so hours of Karen's and now the wonderful Jennie's visits. They have been keeping on top of the pain. Today I also realized I have the On-Q Pain Buster around my neck which is providing pain meds subcutaneously to the areas of the most internal work. This morning I really started feeling the gas bubble in my torso (used to "Pump me up" so the Surgeon has room to work inside me. I am starting to have trouble differentiating the pain - is it from the cuts and mods or is it from the gas? I have a sharp pain in my left collarbone area, which I am sure is from the gas. That keeps coming back with the mid-torso pain. It will be around for a few days I am sure.

Crystal came on around 7 AM as my new nurse, she is also training Polly. Polly Pureheart! There's no need to fear, Underdog is here! Crystal and Polly will be with me for the next 12 hours or so. These nurses are amazing. They work so hard and have to take so much crap from people. I hear the nurses outside tell each other I am a great patient, so I don't want to ruin that. They really have taken care of me so well.

I am thirsty.

We were informed that my swallow test "may" occur around 10:30 AM. That is a milestone. Many things occur when you pass that test. First on my list is I get to DRINK WATER. Did I mention that I was thirsty? One ounce of water by mouth for 16 hours after I pass the swallow test. Bring on the test! At that time they will remove my catheter. Oh joy! Two attractive women, getting to see me in all my post-operative glory, removing approximately 18 inches of poly tubing strategically placed inside my lower nether regions. I am not looking forward to that part, but Bring on the test!

I have walked already a couple of times today, walking feels good and I am so "upright". I decide to sit in the uncomfortable chair in preparation for the wheelchair pusher girl to come and get me. It is 10:25 AM.

10:30 AM I am thirsty and no test. Bring on the test!

11:00 AM and no test. I am still thirsty and my back is starting to hurt. Bring on the test!

11:30 AM and no test. I am still thirsty, my back hurts, my shoulder hurts, my stomach hurts and I am getting cranky and I can no longer focus on the television. For the love of all that is good, would somebody please bring on the test!

11:45 AM and no test. I am still thirsty, my throat hurts, my lower back hurts, my left shoulder hurts, my stomach hurts freaking everywhere and I am really cranky, the TV is a blur and for the sake of all the poor little starving children in the world, Crystal - Bring on the Morphine - screw the test.

The swallow test will happen when it happens. Time for Jim to nap. The pain is gone, Crystal is my best friend, and I am still thirsty.

Day 1

This has been an interesting day. I arrived at the hospital on time. I kept waiting to sign a paper stating I would not hold the hospital responsible if I died, but that doc was never placed in front of me. They gave my wife a restaurant thingy, You know, the one you get at the Red Lobster or the Outback when your table is ready, but instead of a table, it was the one you get when your husband is ready. I thought it was funny that I was having gastric bypass, and my wife was given a restaurant thingy.

So off to the prep room I went. They should really put some art in there. The grey walls were rather bland and non-descript. Put on my beautiful hospital gown and spent some time with Maureen - my pre-op nurse. Everyone kept asking me if I knew what surgery I was having and to explain it in my own words. I thought that strange. It occurred at least ten times. After 5 or 6 times I started answering Gender Re-assignment. I got a good look a few times, and then they realized that I was a smart-alek.

I spoke with the Dr of Anesthesiology and we ended up talking alot about my job and the Power needs of the Omaha area along with Wind Power. Maureen placed my IV and about 9:20 AM - I kissed my wife and rolled off to the OR(That's Operating Room for those of you that don't watch ER (That's Emergency Room)).

The next hour and a half is kind of hazy. I guess that is a good thing. I rolled into the OR - I wanted to remember the music that was playing, and I knew the song. But for the life of me I cannot remember the song. I slid to the operating table and they started strapping me in, arms and legs. Someone put a mask on my face and said breath deeply, i took a couple of breathes and remember thinking this is gonna take a while, I did not feel sleepy........................

.....................................................................................................and then I woke up.

That was just weird. That time of my life is just gone. It was about 11:45, I think, a major event in my life had just occurred, and I missed it. These was lots of beeping, lots of activity, bright lights, and people all around me. Someone pulled a tube out of my mouth. Crap - that hurt. Vitals, lots of questions. Vitals again, Someone said everything went very well. My buddy Dave told me you feel like a million bucks when you wake up. I really don't remember how I felt. In fact, I am not sure I accurately remember what time I was rolled into my room and when I saw Sandy and my other visitors. I was sleepy, and I realized that sometimes Drugs are good.

Now, if that is what a million bucks felt like, about three hours later, I felt like a buck-fity. This sucks. But wait, there is morphine and I don't have to wait for it. I'm gonna like Karen. Sleepy again. Hey, I am awake again. Karen is back and asks me how my pain is. I had decided that if I can can keep it below three on a scale of ten, I was going to try to live with it. Everyone is still here. Lots of hello, telling me how great I look. Yeah right, a big fat guy who just had major surgery and I look "Great". Who is lying to whom here. Pain is about a 7 - so more morphine is delivered and the pain quickly subsides. Vitals are taken, BP is great, temp is great, all is well in Whoville. I talk to my kids (I think), call some friends (Rich and Briana) to lets them know I am alive and decide it is time to sleep again. Karen keeps the pain going away. I know I am gonna like Karen.

Awake again, and it has been about 6 or 7 hours since the surgery. It is time to take my first walk. What you say? Yep, six hours after "The Event" I am taking a lap around the 5E wing. I get out of bed, that hurt, disconnect the power cord for the IV thingy machine, put on a second beautiful hospital gown, so my rear nether regions would not be exposed to the world, not that at that point I would have really cared, and strolling I went. IV thingy machine in my right hand, my sweetie in my left and the trainee nurse trailing. Sandy kept talking about how well I was doing and how upright I was. I would imagine the first upright walking Ape received the same compliments from his bride. About half way around, all I could think of was not how upright I was, but where was my friend Karen. Pain at a level is nothing I ever want to experience again and if I have my way, oh here is Karen now. Obviously the best nurse ever! Off to sleep again.

That really is the extent of my first day. Drugs, surgery, drugs, drugs, tests, drugs, walking drugs with a lot of sleep mixed in between. Let's see what tomorrow brings.

Be well all.

Ok, here we go!

This is the day. I have given it all to my Lord and Savior. Off to the Hospital and the skills of Dr. Thomas White. All is in order. Let the cutting commence. I do have a strange calm and I slept well last night.

I love my wife and children.

3 Days

Today I received a call from Trish, the nurse putting my file together for my impending surgery. I guess we would call this my pre-op consultation. She was very pleasant and asked many questions, on which I will elaborate later. It has been a busy week. All the preps are done, I am enjoying my liquid diet and I am ready to go.

First on Monday of this week I called my employers disability center. I do have 20 sick days, but if I am going to be out more that 7 straight, I must register a disability claim which is claim number 63494. This ensures I will continue to get fully paid for the 20 Personal Illness Payments. After the 20 days (if I am still convalescing) I can get 26 weeks of extended disability at 50% pay (up to 100% pay if my Manager approves, I hope I have done a good job!) I do not expect that I will need it, but it is good knowledge to have.

I then phoned my Medical Insurance Company to verify that they had all the proper approvals in place. I spoke with a very nice lady and she reviewed my record and ensured me that all approvals were in place and that they needed nothing else from me. That was way too easy and in past dealings with Insurance Companies, I hope this simpleness of this will not come back to haunt me. Getting approved seemed much to simple.

Wednesday I had my pre-op physical. Dr. Z is fantastic. He has been very supportive in this whole process. Much unlike my PCP in Albuquerque. She does not believe in this surgery and routinely spoke against it. That to me was very surprising and I still don't know what her problem with the procedure was. So I was poked (dang vampires), prodded, EKG'd and generally looked over. Oh yeah, two shots, flu vaccine and a Tetanus shot. Two days later and the Tetanus site site hurts. I am pretty sure the nurse enjoyed ripping the few hairs that I have out of my chest when removing the EKG probes. She had this evil smile on her face, and with every pull - said "take that!" I am just joking about that, but I did accuse her of enjoying that part a little too much. Dr. Z also perscribed some Ambien - I am having trouble sleeping. Probably a little stress - you think? Doc said I was ready to go, said I would do well and wished me well. I told him that I would see him in 30 pounds.

Wednesday afternoon I spoke with my good friend who is also a financial adviser. We spoke in depth about my insurance, investments, and what I wanted just in case I am not here on Tuesday. I have taken to calling that potential outcome "In case something stupid happens." The reality of this surgery is real and there is risk. Therefore, I have taken it upon myself to try to cover all aspects to ensure my wife is taken care of "if something stupid happens." Dave wrote my desires and wishes down, and we agreed to burn the document on next years vacation.

Which brings me to Friday. Three days to go before my surgery. 3 days before a major life changing event. As I wrote earlier, Trish called. She is from the hospital getting "My File" ready. She asked me lots of questions. Here are a few:

1. Can you tell me in your own words what surgery you are having? I had kind of hoped they knew what surgery they were performing on me - but I answered "The Laproscopic R-N-Y Gastric Bypass Surgery. "
2. Do you have a recent loss that you want to tell me about? That was a strange question. I told her about my dog Tucker, who died 3 years ago. She pretty much knew that I was a smart alek by this time.
   
3. Do you feel safe around your house and neighborhood? That was a really strange question, and I probed her to explain the question. She said that some people have real fears in their house with domestic violence. I am glad that is not an issue I have to deal with.
   
4. She was very surprised that I answered yes to the question, Do you have a living will? She stated that "Most" people do not have one, and that ask the question to prod folks into thinking about the need for one.
   

So now I am ready. Three Days. Lets do this.

7 Days.

I am seven days away from my surgery. 3 days into the liquid diet again, It has really helped me not think about food. I am ready paperwork wise. I have a physical on Thursday. I always associate a physical with the words "Turn your head and cough". Why did they do that when we were in school. I never understood what the Doctors were looking for when they did that. It is not worse than a prostate exam. That is definitely worse.

I am trying to assess where I am mentally with this surgery. I have been edgy this week. As one who has never experienced the joys of anesthesia or flesh parting as a scalpel finds its mark, that still seems to bother me. Also dealing with my own mortality has been a bit of a strain. Think about this, I mean really ponder it. What would you be doing if you chose to have a surgery, that you could die from. Nationally - 1 in 100 die from this surgery. What would you do? What plans would you make? Who would you talk to? Whom would you reach out to?

I called a good friend today. Dave and his wife Sherry are like family. In fact, if I could choose a brother, it would be Dave. We are already Brothers in Christ. Somehow, if I had the option, I would select Dave to be my brother. He promised to help my wife, OK, let us just say it, if I die. I asked him to. I don't think I had to ask, he would have any way. But I needed to know that someone would be there to help Sandy if something stupid happens next Monday. We are going to talk tomorrow. He is going to take notes to ensure he knows what I want for my wife, if I am not here in a month. We agreed that Sandy and I would go to Alaska next year so Dave and I can but those notes while fly fishing for monster trout, but I am glad he and I can talk about these things.

I am going to post my picture today. It will be the last photo taken prior to my surgery. One last reminder of myself in all my largeness. Let the shedding of pounds begin. I have many friends and acquaintances that I know are Praying for me. That is the most important thing to me. That will help me the most. I have a beautiful wife and am living an incredible blessed life. I am one lucky man.

Things that just don't make sense.

Sometimes, things just don't make sense. Things that just are so crazy, that there is absolutely no explanation that makes sense. Nothing that makes it understandable. I am going through that right now. Not anything that personally affects me, but something that affects ones that I love.

I see a person that I love, again start making decisions, that alone won't hurt that person, but when one steps back and looks at the big picture, crushes the heart of many around them. Sure, the heart only hurts for a while, but when it does, the pain is like none other.

Why do people continue to be self-destructive, when there are so many that love them, and want with all their hearts to see them succeed? Why do people that are so incredibly talented, continue to surround themselves with people who just want to use them rather than with those who will prop them up? Why do people that could conquer the world with their abilities, continue to have so little confidence in their abilities?

I will quote an incredily young friend of mine, whom I respect immensly. That person wrote me a note one day and quoted an incredible author, They wrote "Love is patient and kind. Love is not jealous or boastful or proud or rude. It does not demand its own way. It is not irritable and it keeps NO record of being wronged. It does not rejoice about injustice, but rejoices whenever the truth wins out. Love never gives up, never loses faith, is always hopeful, and endures through every circumstance."

That makes sense. Some other things do not.

Pre- Surgery Seminar

Monday evening my wife and I attended the Pre- Surgery Seminar. Two hours spent with Beth the Nutritionist and Roxi the Coordinator of the Program. I really like Roxi alot. The first hour was nutrition and what we will get to eat ( for the rest of our life) and more importantly pre and post surgery.

Ten Days prior to the surgery and 20 days post this will be my diet. Fasten your seat belts.

• Cream Soups (reduced fat, thinned)
• Tomato Soup (reduced fat, thinned)
• Broth (chicken or beef), Consumme or bouillon ( fancy words for broth)
• No sugar added Carnation Instant Breakfast
• Slimfast 2g Net Carbs (avoid Ensure or Boost)
• Tea or Coffee (limit amounts and decaf is best) (Not)
  
• Sugar Free Jello
• Diet Custard, sugar free low-fat puddings ( Now I am pretty much a custard expert. My All time favorite dessert is Creme Brulee. Is "Diet Custard" even custard. This one is just plain scary.)
  
• Low-fat sugar free Yogurt (without nuts, fruits or preserves) ( Probably really means without taste)
  
• Sugar free Popsicles
• Unsweetened fruit or vegetable juice (best to dilute half and half with water)
• Cream of wheat (thinned) ( Yummo!)
  
• Crystal Light, Sugar free Kool-aid
• AVOID Chocolate Milk and puddings made with whole milk
• AVOID carbonated beverages such as soda pop, club soda, sparkling water; caffeinated beverages, or alcoholic beverages.

That is one exciting menu. 30 days on liquids. Is diet custard even possible?

Roxi was next with the discussion of the surgery, schedules and what to expect. The surgery will be laproscopic so I will have 6 holes in me, one of which will be left open for a couple of days with a drain coming out to ensure no leakage from the staple sites. I should be home in three days with a one to three weeks recovery time. I was told to expect to be very tired and feel weak for a few days after surgery. Duh!

I actually was a very good meeting and I appreciate Beth and Roxi and their commitment to helping us.

Prayers for someone just like Briana.

Sometimes, when I want to test God, (I don't recommend testing God) but sometimes I do. I go to bed without setting my alarm. I pray and ask God to awaken me at a specific time. An odd specific time. Something that my body is not used to. I can honestly say, every time I have done this, God has shown Himself faithful. I always awaken 1 minute prior to the time I prayed for. One minute. I find it fascinating that God even answers our stupid little requests. Now when he answers a big request, something that one has been praying for, for a really long time. Then one gets to be blown away.

Today, I am announcing, that my son is in love. Yep, the "L" word. Smitten, head over heels in love. A father can only hope that his children grow to be productive adults and find a mate that will make his children better together, than they were alone. I have been blessed once by my Daughter finding Jonathan. Now I am doubly blessed, for Jason has found Briana, and this is where the answer to prayer part comes in.

We moved to New York in about 1995 and started going to a small country church in Burnt Hills, NY. The church had about 60-70 people. We met this family, Dale and Dixie King and his four blond daughters. I ended up as the youth (teen) pastor at this church and developed a very close relationship with this family. Briana and her sister Heather were always two of my favorites. Their inquisitiveness and desire to please God. The fact that they honored their parents and honored me as their Teacher. Heather even lived with my wife and I during a time in her life.

Here is where the prayer part comes in. From the time Briana was about 15 or 16, I prayed that my Son could find a girl or young women that was like her. Someone that was strong, smart and amazing. My son was a mess, living "La Vida Loca", but I kept praying for him and that someday he would find someone like Briana.

Fast forward 6 or 7 years and OH MY GOSH. My son has his act together, he is working like crazy, back in school and making plans for the future and he has found someone just like Briana. In fact, he found Briana. I could not be more pleased. It truly is amazing to see what God does when you go to Him humbly in prayer. Lord, I thank you for answering prayers.

Gastric Bypass Surgery from www.mayoclinic.com

Weight-loss (bariatric) surgery changes the anatomy of your digestive system to limit the amount of food you can eat and digest. The surgery aids in weight loss and lowers your risk of medical problems associated with obesity.

Gastric bypass is the favored bariatric surgery in the United States. Surgeons prefer this surgery because it's safer and has fewer complications than other available weight-loss surgeries. It can provide long-term, consistent weight loss if accompanied with ongoing behavior changes.

Gastric bypass isn't for everyone with obesity, however. It's a major procedure that poses significant risks and side effects and requires permanent changes in your lifestyle. Before deciding to go forward with the surgery, it's important to understand what's involved and what lifestyle changes you must make. In large part, the success of the surgery is up to you.


How is gastric bypass surgery done?


In gastric bypass (Roux-en-Y gastric bypass) the surgeon creates a small pouch at the top of your stomach and adds a bypass around a segment of your stomach and small intestine.
The surgeon staples your stomach across the top, sealing it off from the rest of your stomach. The resulting pouch is about the size of a walnut and can hold only about an ounce of food. The pouch is physically separated from the rest of the stomach. Then, the surgeon cuts the small intestine and sews part of it directly onto the pouch.

This connection redirects the food, bypassing most of your stomach and the first section of your small intestine, the duodenum (doo-o-DEE-num). Food enters directly into the second section of your small intestine, the jejunum (jay-JOO-num), limiting your ability to absorb calories. Even though food never enters the lower part of your stomach, the stomach stays healthy and continues to secrete digestive juices to mix with food in your small intestine.

Some surgeons perform this operation by using a laparoscope — a small, tubular instrument with a camera attached — through short incisions in the abdomen (laparoscopic gastric bypass). The tiny camera on the tip of the scope allows the surgeon to see inside your abdomen.


Compared with traditional "open" gastric bypass, the laparoscopic technique usually shortens your hospital stay and leads to a quicker recovery. Fewer wound-related problems also occur.

438

Four Hundred and Thirty Eight. 438. Quattro Tres Ocho. A number. I guess it would be ok if it were my lifetime batting average or number of home runs I hit. I maybe if it were the number of sit-ups that I did last week. I think my wife has 438 pair of shoes. But it is not one of those numbers. It is how much I weigh. Holy Crap – 438 pounds. 7008 Ounces. 199 Kilos. That doesn’t sound so bad. I don’t even know how I got here.

I don’t feel like a 400 pound man. Sure, my back hurts now and then. My ankles are swollen. I have high blood pressure. But, I don't have high cholesteral and I am not diabetic. When I look in the mirror, I don’t see a 400 pound man. I see Jim. Successful, happy, always smiling, never depressed. But there it is, on the scale. 438. So, what is to be done? Where am I going in life? How do I fix this? I am categorized as super morbidly obese. Super.

I am going to answer your obvious question now. Of course I have dieted. More than you could ever know. There was my 10 years in the Navy. I was always in “The Chub Club”. Had to exercise everyday after my work hours. Running, Sit-ups, always receiving 4.0 on my evaluations except for the Military Bearing part. That was a 3.2 because my neck wasn’t big enough. If only I could have a bigger neck. Then there was weight watchers. Lost 20, woo-hoo. Gained 30 back. How about the no dairy diet. Atkins, lost 80 there. Gained 110 back. Weight watchers again.

Ok – next was the medically monitored weight loss program. I paid $600.00, which was not covered by my insurance. Interesting that Insurance won’t pay for diet programs or smoking cessation, but gladly pay for all the side affects of Obesity and Smoking. They wanted to sell me Optifast, so I could live on liquids. Why is a medical doctor supplementing his Practice selling Optifast. I chose no to by the liquid crap, but followed a strict program with them. Lost 60 – Awesome. Gained 90 back. Bummer.

My daughter married last year and all of a sudden I was thinking about grandbabies. Thinking about the a lot. When I looked down at that scale, saw 438, I quickly realized that I wasn’t going to be around to see those grandbabies if I did not do something drastic. Sure I was relatively healthy now, but what would I be like in 10 years. Would I even be able to walk? Is that the way I want my grandkids to remember me? I think not, so I have decided to do something drastic. A major life-changing event.

I am going to have Gastric Bypass Surgery, and on top of that I am going to write about it. I am going to be open and honest, you will experience my ups and downs and hopefully I will find some comfort in these words and you can be following along in this journey. I covet your thoughts and prayers and comments as I go through this journey. I am blessed to have a great employer, with fantastic insurance. I have found a great Hot-Shot Doctor with an awesome team and I have a date. November 19, 2007 at 10:30 AM. That is the day and time. The day and time when my new life starts.

My Friend - Jenn

The Woman in the Ivory Gown

A funny thing happened on the way to church today, my little baby girl became all grown up. I mean it, it seems as if I left my home this morning, I arrived at the church, and there was this beautiful young woman dressed in an incredible Ivory Gown, and they kept telling me she was my daughter. How could this happen? I still thought of her as my little girl. Scraping her knee and coming to me crying. Bringing me her report card with the one B- and a sincere tear in her eye. There I was at the church, and they keep telling me how beautiful my daughter is, and all I want to do is go over to her and hug her, tell her I love her, fix her boo-boos. Wow, what just happened here?

I was able to control the shaking in my knees long enough to walk this picture of radiance down this plastic white runner and stumble through some words that sounded like "Her mother and I do". Oh my Gosh, I think I forgot to kiss her. Then some guy in a really nice suit said some more words about this nice young man and that beautiful woman on the stage. All I kept hearing was my baby girls little voice calling to me and her mom from her bed at night.

Why does everyone keep congratulating me?

Those two people on the stage kissed, It was a nice quick kiss. I think I was glad about that. That nice guy in the suit said something about being pleased to announce "Mr. and Mrs. Jonathan Ayoub" and everybody was clapping and yelling and screaming. Who are these people and where is my baby girl?

Dinner came, it tasted good, but was kinda cold. What a surprise. They told me I had to dance with this beautiful young lady, I hope my wife doesn't get jealous, me dancing with this incredibly beautiful young woman in the Ivory Gown. So many people were crying, why is that, I was lucky to dance with her. Why does my wife have that smile on her face?

We got to have some cake. Cake always reminds me of my Grandmother. I am not sure why, I wish she and papa were here today to see the beautiful young woman in the Ivory Gown. I think that would of made them very happy. Now someone is pulling on my coat, telling me I have to give a speech. I would like to tell you what I said.

"A funny thing happened on the way to church today, my little baby grew up. I think about blessings, real blessings that affect our lives forever. In this world, I know we should expect very few real blessings. Blessings that we and our friends remember for a lifetime. I think about the day that I was married. I had family members taking wagers if my wedding would last a year, and now 28 years and 2 weeks later I can still glance across the table and see my beautiful wife.

That day was a real blessing.

The days that my children were born - Psalm 127 reads "Behold, children are a gift of the Lord, the fruit of the womb is a reward. Like arrows in the hand of a warrior, so are the children of ones youth."

Those days were a real blessing.

Our kids then grow up and all of a sudden the kids are out of the house and then a father waits, and if the planets align, and the stars are in phase, God performs a real blessing and our children find a Godly mate. A mate that a father can have confidence in, knowing he will do the right thing in taking care of a fathers child. I believe that my daughter today, has found that man, and I can release her to him with peace and joy.

That is a real blessing.

Jonathan, you now have my daughter as your wife. Love her as you have loved nothing else before. Praise her for her strengths, teach her when she needs knowledge, learn from her when you are weak and take joy daily in her presence.

Brooke, follow his Godly lead, pray for him when he looses focus, and pray for him when he is focused. You both have my blessings and love and I pray that your life together is as much of a blessing as my life has been with your mother. I love you both.

Now lets lift our glasses, To Jonathan and Brooke - May your days together be long and joyful, May your love be visible to all and may my grandchildren be plentiful and beautiful. Cheers."

Well that is over. Why do I cry so? It is harder and harder to see that little girl in my mind anymore. That young woman in the Ivory Gown is so beautiful, and I love her so. That woman is my daughter and I now have a new son. That is a real blessing.