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Surgeon: Dr. Kenneth Welker, Portland, Oregon
by Cheryl: Part 1 Surgery. I was having surgery to cure this enormous, awful disease that I have called obesity. This disease that I have endured, blamed myself for, hated and even found refuge in at times, was going end. I was on the cusp of changing my life forever. For the better. My husband Scott and I got in the motorhome and headed down to Portland, a 3 hour drive from our home in the Puget Sound area. We got a later start than we had originally planned, but it was okay. We didn't actually have to be there until the next morning. And besides, I had procrastinated at getting anything ready to go. I'm really good at procrastination. It's my way of blocking something, of not dealing with it and while it can and has gotten me in trouble in the past, I'd do it again in regards to my surgery. It kept my mind so occupied at the last minute with having to get everything together and organized that I didn't have time to get scared. I had no time to sit idle and think. The motorhome we have is an older one and perfect for a young family to go camping in. It does, however, get damp and on the way down I could tell that it was affecting my allergies. I felt my lungs start to get tight and used my inhaler. I realized that I had no business sleeping in that motorhome the night before surgery. The last thing I needed was chest congestion going into surgery. We decided to stay at a Best Western just outside of Portland that night. It was a quiet night. We didn't talk much. I watched "The World is Not Enough" and went to sleep. We left the hotel at about 9:15 the next morning. We missed the exit to OHSU on the freeway and ended up having to back track. Once we got up to OHSU, we had to find where the RV parking was. Then out of there so that he could drop me off to go up to admitting. He left to go re-park the motorhome and find his way back to where I would be. OHSU is a huge place with lots of buildings and very curvy roads and I knew that this was stressful for Scott. I went up to admitting and there was my angel, Shelley! It was 10:10am and I was 10 minutes late but it was okay as the admitting person had stepped out for a moment but would be right back. Soon I was taken back into the actual admitting area, the one with the beds, etc. And now I was concerned that Scott wouldn't be able to find me at all so I asked Shelley if she could stay out in the waiting area and watch for Scott since I realized I wasn't sure if he would know where to find me. It was at least an hour and a half before Scott ever returned. During that time I changed into a gown, got my IV and laid on the bed with the curtain closed around me. I steamed about where Scott was. I worried about what was taking him so long, about me heading to surgery before he returned. I thought about bringing Shelley in to be with me. I grumbled and vented to the nurses about where Scott could be. I chuckled with them over it. I listened to them sing and laugh together on the other side of the curtain. I relaxed some and dozed. I thought about asking Shelley to come in but then thought, no, then I will talk and end up getting scared. This way I can block it. I dozed some more. When Scott did finally walk in, my stress level deflated and I was relieved. Dr. Welker's previous surgery was taking longer so we had some time to wait. After a little bit I asked Scott to switch with Shelley. Here she was my angel and I wasn't getting to see her much! I visited with Shelley and got to know her better and then she and Scott switched places again. When Dr. Welker came in, both Scott and Shelley were with me. We discussed my options for incisions and he lifted my gown and drew all over my stomach with his pen. He drew where the transverse incision would be and explained its pros and cons and then did the same thing with the up and down incision. Then he drew lines to show where a TT would probably be and discussed that in relation to my choice of incisions that morning. I had already chosen the transverse incision as it has less chance of a hernia and is supposed to heal better. It does have the drawback of cutting the nerve on the right side so I would get some numbness on that side, but I chose it anyway. I pictured someone in the OR spraying hairspray - my same brand - on my tummy to remove the ink. I wondered what they really use to remove it. I was put on a different gurney to be taken down to the OR area. I ended up having to wait on that gurney for a while, I don't remember why. It was hard and I kept shifting positions. I felt the fear, the reality of it all start to envelop me. I felt my lips start to quiver and I kept my eyes closed and tried to block it. Tears slipped from the corners of my eyes. I knew that Scott and Shelley were right there. I did not want to lose it because I knew I could become a wreck if I let it go. I felt someone touch me, I think it was Shelley. Leaf in the stream, I told myself. Leaf in the stream. Just float. I began to calm. Someone put a sticker on my gown, right on my upper chest. I thought I would never forget what it said, but now, I can't remember. It was a big red round kid's sticker that said something like I was a good girl, or something like that. I never took that sticker off, wore it through surgery and until I was given a new gown in the hospital. I wonder if it went through the wash there and if it left the gummies on the fabric like stickers do at home... I spent about 3 hours there waiting in the admitting area. It sounds like a loooonnnggg time, but it was fine, really. After that, I was taken down a couple of floors and in to a room right outside of the OR. There were other patients in this area, also. Here is where the anesthesiologist and his (very cute) doctor in training came and talked to me. I was relieved to hear that he thought I was an excellent candidate for an epidural. He explained it all to me and then it was time to wait again. I don't remember for sure when it was that I got on the table/bed that I was on for the operation. I think it was when I first got to this room, but I'm not sure. Then it was my time to get taken into the OR... They gave me Versed, a sedative, to help me relax. I clearly remember sitting on the edge of the OR table (which was very padded and comfortable) with my arms on Carmen's shoulders. She was my support, both physically and emotionally while I was given the epidural. It took quite a while, if I had to guess I'd say half an hour. But, I could be wrong, it could have been 15 minutes, after all, I had been given the Verced and I didn't much care. I remember that I could feel some pokes around the area between my shoulder blades and that every once in a while I would jump out of reflex or say ouch. But I don't remember what the pain felt like. I do know that it wasn't very bad. I remember that as time went on during the administering of the epidural, I ended up with my arms around Carmen's waist and my head on her shoulder and hearing comments about being cuddly. I remember asking Dr. Welker if he had any kids and him telling a story about his daughter and her boyfriend. For the life of me, I can't recall many of the details. After the epidural was in, I laid back on the bed. This was it, the final seconds. I closed my eyes. I asked if any of them pray and someone said warmly that I could pray if I wanted to. I felt tears slip from the corners of my eyes once again as a prayer began to form in my head and then there was nothing. End of Part 1 First, before you read this, I want to thank everyone for all of the positive feedback I received on part 1. It's taken me almost 3 weeks to actually sit down and write about it because I knew that it would take a lot out of me to do it. Some of you have said that I should write and I really appreciate the compliment! It's so incredibly draining for me to do it, though. I shed so many tears writing the first part of my surgery story. It was more emotionally draining for me than actually being in the hospital!! I did try to write about it from the heart, to try to let you feel what I was feeling and thinking and going through at the time. Most of my emotion before surgery was so pent up and blocked. After surgery, it was such a relief to wake up in recovery, to know that I survived! I think that this 2nd part is not nearly so emotional, even though it was after surgery when I actually let some of my emotion go. Before surgery, you have to have the mental and emotional strength to physically put yourself there. After surgery, you don't have a choice, you're there and you have to deal with it. The decision was made already, it's a done deal. Hence, not so emotional. At least most of the time. Anyway, here's the end of my story, or should I say, the beginning of my new life. Part 2 The next thing I remember is feeling people lifting me and hearing voices. I was being moved to a different bed. I remember thinking that they weren't going to be able to lift me. I think I said so out loud. It's very vague. Then I remember being in pain in my middle, but worse than that was the pain in my right shoulder. They told me it was because my right arm was extended straight out during the whole surgery. I moaned and complained. I have no idea how long this lasted, it too is very vague, I just remember that my shoulder hurt worse than my tummy. In retrospect, if I had to rate the pain on a scale of 1-10 the shoulder was probably a 7 and the tummy was probably a 6. If you had asked me then, my answer may have been different. I can tell you that I'm a wimp when it comes to pain and that at the first sign of a headache, I take some Tylenol. That is all I really remember about being in recovery. I was only in there for about an hour and a half. It was 3:00 before my surgery actually started and it lasted 4.5 hours - until 7:30. It was around 9pm when I was moved to ICU. My pain was being managed well - I had the epidural plus a pca pump for extra boosts when I needed them. By 10pm I was feeling fantastic. I thought about how worried my mom was, and I told Scott that I wanted to call my mom. He dialed her number for me and handed me the phone. When my mom answered, I said "Hi Mom!" in the most clear, cheerful voice you can imagine. Mom, of course, couldn't believe it. I didn't talk long to her, but I knew that she would have peace that night. Being in ICU was really something. I had my own nurse who sat right outside of my room. I mean RIGHT outside of it, not at a central desk. She was so caring and so wonderful. I was hooked up to all kinds of wires and tubes - heart monitor, bp, IV's... Vitals were taken every hour. I don't recall for sure when I started on ice chips, I'm pretty sure it was during the night. Slowly, but boy, were they great! I was still having some pain, I'd say about a 4 (on a scale of 1-10) and so my meds were upped. I got excellent relief and for the rest of the time I was in the hospital, between the pca pump, and adjusting my meds, my pain was kept at about a 1 the whole time I was on the epidural. I really and truly expected to feel more pain than I did. I had one nurse come in to do vitals or something that night that I didn't care for. I only saw her that one time and had been sleeping when she came in. I woke up while she was there and she said something to me about whether I had tried dieting or exercise or something like that. I was too drugged to really respond with more than a yes I had tried that. If it had been later I would have given her an education. The next day I stood up for the first time. Since I was in ICU and hooked up to so many things, I could only stand at the foot of my bed. The wires prevented me from going further. As I sat further up towards the foot of the bed on my way to standing, I felt the nausea hit. All I could think of was Tamara, the DS list member who passed away after complications from aspiration following her successful surgery. The fear of vomiting was great in me. I told them I was getting too nauseated and they gave me some Nubain in my IV. That worked, but the problem with Nubain is that it makes your head swim, too. So standing at the foot of the bed for a minute or two, with help, was all that would have been possible for me to do even if I hadn't been limited by the length of all of the wires and tubes I was hooked up to. I stood one more time that day, this time asking for the Nubain before I tried standing. I was due to leave the ICU by 3pm that day but the hospital was so full that there wasn't any place else for me to go. I remained then in the ICU room for another night, I had lots and lots of ice chips during this time and thoroughly enjoyed them. I did not feel any hunger. While in the ICU I was running a low fever and while this is common, it still worried me as it was a little on the high side of what was considered a normal post-op fever. They did a blood draw on me in the evening of my first full day, a Saturday, in ICU. While I never questioned having a DS, I was incredibly scared of complications. My fears were based on what I had seen happen to a couple of people on the DS list. Thoughts of Tamara dying from complications arising from aspirating her vomit, or Tom, another list member, having a leak and an infection and spending weeks and weeks in the hospital. I would think of my two boys, ages 8 and 4. That is where all of my fears about having surgery laid. That is where my tears came from. On Sunday afternoon I was transferred to a regular room. Three teenage kids, two boys and a girl, came to transfer me. They were all chipper and laughing and cheerful. I was in a good mood. Unfortunately, they had no concept of taking it easy over bumps, around corners, etc. I asked them to go slowly over the bumps because it was really hurting me. Thank God they slowed down. Part of the journey to my new room included a ride across an 1/8th mile skybridge between the OHSU hospital and the VA hospital. OHSU rents 2 floors (or 2 areas?) of the VA hospital for overflow and that's where my room would be. The view from the skybridge is awesome. I raised the head of my bed a little in order to enjoy the view. It was a beautiful clear day and we could see Mt. St. Helens, Mt. Adams and Mt. Hood. After the skybridge, the kids transporting me continued to cut up and joke with each other and pretty soon the comments were little remarks like ugh this is heavy and how they'd have to lift weights more, etc, grunting and groaning about the how heavy it was to push and the strain of it all. I was SO pissed and humiliated and embarrassed and kept trying to tell myself that they weren't referring to me. And maybe they weren't, but it was insensitive. I closed my eyes and tried to keep those lips of mine from quivering. I kept my eyes closed and tried to block it. I wondered how many other patients in pain these kids had transferred with such abandon, carelessness and neglect for feelings. When I got to my new room I saw that it was a room for two but that it was empty! Yea! The nurses came in right away and settled me in and took care of vitals, etc. I had really excellent nursing care while in the hospital 99.9% of the time. Dr. Welker came to see me twice a day except for Tuesday when he was out of town. And even then, he came in on Wednesday morning and said that his plane had just landed and he had come straight to the hospital. He took his time on each of his visits to really talk to me and see how I was doing. He never rushed in and out and was very thorough each time. I couldn't be more pleased with his care, and really with the care I got at OHSU, also. I did have a few things that bothered me but they weren't anything like what some have gone through at some other hospitals with the feces covered linen staying in the bathroom for eons and not getting any care from the nurses, or being left to linger in pain, etc. I continued on just ice chips and sips of water until Monday. My meal consisted of red jello, chicken broth, apple juice, milk and hot tea. I ate the jello, a couple of spoonfuls of the broth, and a sip or two of the milk, juice, and tea. I kept the juice with me nursed it through the day. Lunch was the same except with lemon jello and beef broth. I hated the beef broth, it seemed too bland and greasy to me. Dinner that night was really excellent. It was a pureed vegetable beef soup, real honest-to-gosh NY style cheesecake and the usual liquids. I coated the spoon with the soup a few times and ate about 2 oz of the cheesecake. I was in heaven. Especially since it settled well. For the next two days I continued to run a fever. It was hovering around 38-38.5 degrees Celsius and I was told that anything over 38.4 was a red flag. My incision had been bothering me some and they had been keeping a close eye on it. Monday night, around 10pm, I asked if someone could check my temperature. I was feeling like it had probably risen. When the CNA looked at what my temp was she said, '39.1 Would you like to brush your teeth?' I just about died. All I heard was 39.1 degrees and instantly that fear of infection skyrocketed. Thoughts of potentially spending weeks in the hospital with my ncision open to clean out the infection, or of a leak, or both, and my poor kids, what would I do with them during this time.... And she was asking me if I wanted to brush my teeth? Holy crap, she didn't even skip a beat between announcing my temp (which equaled something like 102.x) and asking me about my teeth. Upon hearing what my temp was, I expected her to say something in reference to getting it down for me or taking care of it, not brushing it off like it was no big deal. To me, it was huge. I looked at her and said, 'Brush my teeth? Brush my teeth? Why would I want to brush my teeth? No, I don't want to brush my teeth, What about my fever?' She left the room and I didn't see her again that night. After she left I was distraught and scared. And then, to top it off, my dh thought that I had been too hard on her. I looked at him and let him have it. I told him - in my strongest harsh/angry/distraught whisper - that he was supposed to be here for ME. That he was here to be MY ADVOCATE, not to take sides with the nurses, that a temp like that could mean infection and I was scared to death of spending weeks in the hospital with it or having to be opened up again... By 10:30pm I still hadn't gotten anything for my fever. One of my machines was beeping and so we buzzed for the nurse. One came in that I had never seen before and looked at it and said that my epidural was empty. She turned off the beeping and left. I never saw her again. Half an hour later we beeped again for someone to come replace my pain meds and give me something for the fever. We were told that it was shift change and that it would be a while since they had to order up a replacement from the pharmacy. At 1am, we beeped them again as the epidural meds were starting to wear off. he nurse that came in was wonderful. She hadn't known anything about it and got on it right away. I had blood drawn to check my white blood count, a doctor came in to examine me and my incision, vitals were taken so often it was incredible. I was given almost constant care that night. During the night, my fever went down some and never did get that high again. At one point, I laid there in my bed with my hand over my incision where it was bothering me (this is the same place that needed to be drained a week after I came home) and I prayed more deeply than I have ever prayed before. I was almost trance-like as I laid there and said the Lord's Prayer, with one hand on my incision and praying for healing. The cause for my fever was never found. My incision was not infected, my lungs were incredibly clear, all of my vitals looked great, my blood work was good, it was just the fever itself that was present. I was up and walking around more now, but not enough. The problem was that both Scott and I were under the impression that I needed a nurse around first to help. Neither of us realized that I was that free, that Scott could be the one help me out of bed, to disconnect me from - oh, heck I don't remember, all that stuff was behind my head while I was in bed! When Dr. Welker told us that I could do it without the nurses, I was off and running, so to speak. The minute he left me, I was up - albeit slowly, getting in my robe and heading out the door with my IV pole in one hand and Scott nearby to catch me if needed. (Like I wouldn't flatten him...) It felt great to be so free. We walked out of the ward, passed the elevators and around the corner to a window with a great view of the water. Then we took the elevator down and I walked to the ER area of the VA. When we came back, I was pooped, but I felt good. Tuesday was the day that the epidural was to be removed. That morning the epidural meds were stopped and a few hours later I was put on oral pain meds. A doctor from pain management came in around 10am to remove the catheter. I stood up with my back to him while he began removing the tape and bandages from around the epidural site. I asked him if it would hurt and he told me no. I didn't believe him, however. I could feel the tape being removed and then he said okay. I braced myself for the epidural catheter to come out. He moved away from me and I said, what, are you done? to which he replied, yes! I never felt a thing except for the tape being removed. Amazing. It took a while after the epidural meds were stopped for the meds to actually stop working and the oral meds to take over. That afternoon, I got up out of bed and it was just awful. It hurt so bad! Here I had been able to walk all over the place with relatively little pain while on the epidural but on the oral pain meds every step was awful. I went about 10 feet out of my door and that was all I could take. I carefully made it back to my bed and for the first time since I'd gotten there for surgery, I actually cried. Before it was just a few silent tears that would slip out, enough to relieve some pressure, but this time, I sobbed. I had gotten a roommate just a few hours before that so I had Scott close the curtains for me for some privacy and I tried my best to be as quiet as a mouse about it. I think I must have cried for about 5 minutes. I just let it all go, let all of the stress, the pain, the fears, everything, I let it all go out of me with those tears. I was able to get the oral pain meds upped and that worked really well for me. Shortly after that the Foley catheter was removed. I used the bathroom to tinkle for the first time that afternoon. After that, I took a shower, the 2rd one that I had taken while in the hospital. Each time, Scott actually got in and helped me. I couldn't have done it by myself, at least I couldn't have done a complete job of it! This worked great for everyone around since there didn't end up being any water hookups there for the RV and this way, Scott was able to shower, too, and the nurses weren't tied up with helping me wash and rinse. I kind of expected the nurses to say something, but no one ever did. The next afternoon I was feeling really great. I took a ride in a wheelchair across that skybridge and over to the OHSU side to look in the gift store there. When I got back, I was still feeling so well that I decided it was time for me to go home. We had discussed whether I would go home that evening or the next day and I had been pushing for the next day. But my pain was being managed well now and I was doing great. My fever was down, my vitals looked great, I had been started on solid foods and was doing well with it. I wanted to be home. Dr. Welker was there on the floor again (the 3rd time I saw him that day) and I told him I was ready to go. We sat there in the hallway for quite a while, me in one wheelchair and he in another and my husband, Scott, standing next to us. We got out the camera, took some more pics and chatted a while about things while Dr. Welker filled out some paperwork, etc. When all was done, he hugged me and we all said good-bye. Scott made a couple of trips out to the motorhome and then brought it around to the entrance. When we left, it was really different than any other time I've been discharged from a hospital. This time, there was no escort, no wheelchair that I had to ride in. I walked out of that hospital on my own two feet and it felt really good.
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