Final Pre-op Visit

Yesterday was long and incredibly informative and a wee bit TERRIFYING.

Lee & I arrived at Dr. Jawad’s office promptly at 9 AM. There were about 5 other pre-op patients and their spouses/partners/friends in the room, 2 of whom will have surgery on the same day as me, and 3 the following day. We were called back individually for weight, blood pressure, and temperature readings. Then we waited about 45 minutes for anything to begin, and then the Dietician walked in. She spoke for about an hour on all the dietary requirements and restrictions, and gave us a comprehensive packet of handouts to take home. The most important thing for me was a discussion of all the supplements, when to take each one, etc. I’ve gleaned information on supplements through OH and things I’ve read, but it was comforting to have it spelled out for me by someone on my surgeon’s staff. Turns out they recommend (and sell) bariatric advantage brand vitamins, so I’m good to go with that. She also recommends Biotin and Devrom and Colace… sheesh!

Then Dr. Jawad’s floor nurse came in and explained exactly what will happen the morning of surgery: where we’ll go to get prepped, what we’ll experience while we’re put to sleep, the drains and tubes we’ll wake up with, how we’ll be cared for in the recovery room, and when we’ll finally get to see our family members (not until we’re up in our 4th-floor suite). She explained that when we wake up from surgery, we’ll have a foley catheter, a nasogastric tube, two drains coming out of the abdomen (a JP drain and a G tube), and oxygen prongs in our nose. The catheter, JP drain, and ng tube will be removed the following morning. We go home with the g tube, and we’ll have a group session on how to clean the drain at the hospital. We’ll also have three “angels” drop by at some point in the day–they’re patients of Dr. Jawad’s at 1, 2, and 3 years post-op and we were warned that they LOVE to talk. We also discussed the importance of getting up and walking around immediately to “walk out” the pain and prevent blood clots. We were warned about left shoulder pain (no, it’s not a heart attack), and that it’s just from gas and pressure from surgery. I also found out that my doctor doesn’t do the barium x-ray to check for leaks. Instead, they have us drink dyed water and then monitor our drains for the dye for a few hours. Sounds good to me!

Then the physical therapist came in and explained the type of exercises we should do as we wait in the hospital. We got a handout with about 20 different movements that will help stimulate blood flow and promote pain relief. We’re supposed to go through the routine over the weekend, bring the packet to the hospital, and then continue the exercises for a month after we go home. Simple enough!

Then Dr. Jawad himself came out to speak with us. He went through the entire history of weight loss surgery, and then explained why RNY is the best procedure. He explained the techniques he uses to perform the surgery, precautions he takes that differ from other doctors, and the precise numbers of complications he’s had in his practice. I didn’t learn anything new during this time, except for the reason why he’s so adamant about the g tube staying in for five (yes, FIVE) weeks… he had a patient whose staple line blew due to pressure (which could have been prevented by the drain), and he also sees it as an easy way to get our water in if we’re not able to drink 64 ounces per day. Still, 5 weeks is a freaking long time to have a drain hanging out of my stomach!

Then the surgical nurse came in and explained a few more things about surgery, what we’ll do at the hospital this afternoon, and precisely how to clean the G tube. She repeated a lot of what everyone else had already told us (about nutrition, blood clots, etc), but her focus was on the details of the inner workings of our new GI tract and how to prevent any issues in the hospital or at home. She gave a disgustingly graphic account of what it will be like to clean the G tube (Lee had to walk outside so as not to barf), and then also explained that we’ll get sores and rashes from having it in place for so long, but that there’s absolutely no way the doctor will allow us to have it removed early. Great! She also explained that Dr. Jawad will write prescriptions for pain medicine, anti-nausea meds, and Plavix for us before we leave. We’re to open the big Plavix capsules and sprinkle them in food for two months to prevent ulcers from forming in our new pouch and stoma. She also explained that we’ll get our follow up appointment times before we’re discharged the day after surgery (usually around 4:00), and that we’ll be meeting with Dr. Jawad’s assistant for our routine follow-ups. Sounds good!

Then we were called back and Dr. Jawad met with us individually. I didn’t really have any additional questions for him, so it went pretty quickly. I did ask about when to re-start my birth control, and he said to wait a month after surgery. He signed my prescriptions, examined my abdomen, and listened to my breathing. Since this is the first time I’ve met him in person (he was out of town when I went to my first seminar), I was excited to finally meet him. He’s just like I expected… to-the-point and friendly. No qualms.

I checked out with the surgery coordinator, who gave me the prescriptions and directions to the hospital for pre-registration. She also suggested, quite seriously, that since the appointments had run over at Dr. Jawad’s office, that we not stop and eat a leisurely lunch, but “go through a drive through and eat it at the hospital.” Um, sorry, but I’m not about to go pre-register for gastric bypass surgery with a McDonald’s bag in hand. I’ve gone some pride left, you know. So Lee & I ignored those directions and ate a leisurely lunch inside Wendy’s (I had a side salad and chicken nuggets–not perfect, but not terrible either). The penalty was arriving second to last for pre-registration (just ahead of another couple I know defied the lunch instructions).

So I filled out some paperwork, paid what’s left of my max out of pocket, and waited. And waited. And waited. Finally, I was asked to come back and have some blood drawn (4 massive viles!) and pee in a cup. The phlebotomist was concerned that my check-in time is 6am on Tuesday, since they know I’ll need another round of blood tests that morning. She suggested that I check in a bit earlier to keep everything on schedule.

I went back out to the waiting area until I was called in for an EKG. Then into a nurse’s interview room where they asked me a billion questions. They did NOT think it was funny when I said my most vigorous form of exercise is sex. They explained that I need to come to the hospital with no lotion, no deodorant, no perfume, no makeup, no hair products (ahh!). That I need to drink only clear liquids the day before surgery and 2 tablespoons of milk of magnesia at 6pm the evening before. Bring loose clothes, etc.

Then, after a hectic nurse shift change, I was finally called back for a chest X-ray. I had to wear a skin-tight hospital gown that was quite tight on my boobies, so that was fun.

And then, finally, at 5:23 pm, I was done. Lee sprinted to the car and I clutched my 8 million papers, bottle of antiseptic body wash, and G tube cleaner thingy and made my way to the car as well.

Long day! This is it. Almost done.

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4 Responses

  1. Wow… that’s a much more intense program than what I went through!! I think that you’re going to do great… it sounds like you’re prepared, and ready – you can’t do much more than that.

    I’d wait on the Devrom – personally – I haven’t needed it, so why bother unless you feel like you need it when you’re off work… you know?

    In terms of the walking and pressure in your shoulder – the walking is so true – it’s the best thing you can do to move the gas that they have to pump into your body out. Since it’s not in your digestive tract – it’s air that they used to make sure that they didn’t have any organs or anything like that in their way while doing the surgery… the only way to get it out is to walk and move it out through the movement. It probably won’t be to bad overall though compaired to other things you’ve probably been through.

    I’m speechless about wearing the drain for 5 weeks – that’s a long time! I didn’t ever have one… in fact when I woke up from surgery – I didn’t have any of those tubes or catheters… interesting – hope I don’t have any of the problems that they told you about 😦

    I’m praying for you!!

  2. Um, sorry, but I’m not about to go pre-register for gastric bypass surgery with a McDonald’s bag in hand. I’ve gone some pride left, you know.

    You crack me up. That was hysterical!

    Tell ya what…I felt a little overwhelmed by everything they went over with you! And you know you will probably not remember half of it when you wake up from surgery (well, at least I don’t think I could!) but that is the reason Lee went with you. I guess him cleaning out your drain is out of the question, huh?

    Praying for you!

  3. My nurse & RD gave me a whole list of things that I wasn’t sure I would need. Turns out, it all pretty much came in handy. I did like the raspberry flavored calcium from Bariatric Advantage and I did end up needing the Devrom. I can say from experience that it works like a charm =) No complaints on either of those products. I’m still trying to find a protein that I can choke down on a regular basis. The one I take most often is the twisted cherry Nectar, but sometimes it’s just waaaaay too sweet.

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