Miscellaneous Gastric FAQ

I’ve had a lot of disparate questions come up, so here is a collection!

Q: What was your health before surgery?
A: Other than being fat, I’m in excellent health. All my lab work pre surgery proved that. I take no medications other than my daily supplements. I am also at the bottom end of qualifying for the sleeve. My weight is relatively low for a sleeve patient (250) and my BMI was just one tick above the minimum 40. I think this contributes greatly to my speedy recovery and success so far. As they say, your mileage may vary (YMMV).

Q: Why did you go to Mexico?
A: Coupla reasons. The first is cost. Sleeve is $4k in Mexico rather than $10-20k that you’ll pay here. Second is my complete lack of confidence in the medical industry here. If you want exemplary care, the US is not the place to look for it. I also feel that RNY is still pushed in the US as the “superior” gastric surgery, and I disagree wholeheartedly with that. I think the US healthcare system is mired in status quo rather than looking at what is BEST for the patient.

I went to Tijuana, Mexico and Dr Mario Camelo did the surgery at Florence Hospital. If you’d like a recommendation, I’m happy to hook you up with the coordinator, Veronica, who works with Americans who need bariatric, dental and other medical stuff done. Please email me for contact info: misangela at gmail.

Q: What is the timeline from surgery to real food?
A: The standard answer for gastric sleeve is 2 months. For poor RNY people, it’s like 3-4 months. MY timeline is this:
Liquids until May 30
Purées until June 13
Soft foods until July 11 (aiming to be off these sooner than a month) **As of Jun 22, I am on track with this timeline.

Furthermore, once I hit the soft food mark, I’ll be incorporating soft whole proteins, mainly fish. Fish is the softest protein and a great place to transition. For more on this, pick up the book Ultimate Gastric Sleeve Success.

Q: How did you get that surgical tape residue off?
A: I tried Goo Gone, alcohol, acetone and oil. Nothing. Then I read about liquid eye makeup remover. THAT worked better that the others. I saturated the goo with EMR, rubbed with rough gauze to loosen, then got into a hot shower and literally rolled up the goo into balls and picked it off. Time consuming, but it worked.

Q: When can you take pills, capsules, etc.?
A: Official answer from my Dr: 2 months. Which makes sense. At the beginning, I opened up the prilosec and cephalexin (smells and tastes like FEET) and I waited to start gummies until week three. As of June 22 (wk 5): I take prilosec caps whole and selenium caps whole. I take Vit B12 sublingual tabs, calcium chews and gummy vitamins (and vegan iron chews every other day). When the gummies run out, I’ll go back to my regular capsule regimen.

Q: OMG! You drank coffee and tea! Won’t your stomach explode?!!??
A: Obviously NO. The party line is to avoid all coffee, tea and caffeine for the full 2 months. But if you think about this logically, that’s just a one size fits all answer, like most things from Drs. I drink coffee and tea, yes, BUT it is 50% or less of the beverage! I’m really drinking cafe au lait, which has little coffee in it. I don’t think I’d dump in plain coffee, it’s too acidic. I did drink some plain tea and it was fine – tea has less acid than coffee. My logic is that with so much Silk (or whatever your mixer), the acidity is near zero. I’ve had no issues. I would say to use caution if your pouchie has been bitchy with you. Mine doesn’t seem to care what I drink so far. YMMV

Q: Why are you documenting all this stuff?
A: I think the more info out there about living with sleeve (or Pouchie as I call mine. YES I named it. What?) the better. I found lots of “official” info that was just copied over from RNY (bypass) and that is not really applicable, IMO. I think sleeve offers a faster recovery, faster transition to whole foods and is overall less harsh on the body than RNY. If you’ve not found it already, I also post video updates on my youtube channel.

Q: Did you get pix or video from your surgery?
A: Why YES! Yes, I did. I’m weird that way. I got a pic of my excised stomach from the doc. Stomachs are HUGE, dude! I also have a clip of my actual surgery on the youtube channel if you’re curious. Another great thing about Mexico is that you get ALL your files. X-Rays, EKG, blood work, barium leak test, EVERYTHING. Unlike the US, where your medical files belong to everyone else BUT you. I love having all my medical files at hand so I can compare my follow up blood work and have records of my overall health.

Q: Is your Dr doing follow up?
A: Well, if I had a great Dr, my answer would be a strong yes, but my crazy Indian Dr is CRAZY, so the best I can say is maybe. From the get-go I’ve handled all my own arrangements and planning, so my follow up is the same. I’ll have blood work done in six months to see what’s changed and if I am doing OK with my supplements. As for physical healing, my incisions (FIVE!!) are healing up nicely and starting to itch – which is a good sign. Speaking of incisions, there are no sutures on the outside, they are sealed with Dermabond! The drain hole heals itself from the inside out. **NOTE June 22: One incision became deshisced, which means it opened up. At week 5, I’m still dealing with it. It is not infected, but it is still open. I think it did not have enough dermabond on it, so it popped open. In any case, it is aggravating, but not life threatening. Hopefully it will close up on its own, without having to see a wound clinic, which is PRICEY. ::fingers crossed::

Q: Can you help me with my planning and recovery?
A: Yes. I am available for consulting, menu planning, travel arrangements, etc. I’m a professional organizer and I’m ALWAYS for hire. Hit me up if you’d like some help. I can also put you in contact with the organizers in Mexico. Shoot me an email: misangela at gmail.

Intake Day Six

Sun 5/22/16
10oz tea+silk
anti/prilosec 9:20am
smoothie 2 cups (16oz)
1.5 Tbl yogurt, 1 Tbl pnut butter, 6 oz silk, 2oz water, 1 sc vanilla protein 11gm (about 20 TL)
vit b12 sublingual tab 1000mcg
1 cup chix, 1.5 tbl broccoli puree, 1 sc plain protein – DO NOT MICROWAVE PROTEIN POWDER! It poofs up and coagulates! 18gm
10 oz vit water
1 cup broth
thai smoothie 10 oz
1 tbl greek yogurt, 2 tbl natural creamy pnut butter, 1 tbl shroom puree, 1oz coconut milk, 1 tsp miso, 1/2 cup chix, 1 sc plain protein, 1 squirt sriracha. heat on stove. 30gm –>> Only ate half, too rich! 15gm

first bowel movement 6:45pm!! Yay!!
20 oz water
5 oz vit water
Protein: about 60 gm
fluids: 82 oz

ANSWER to surgical tape goo removal: liquid eye makeup remover. Saturate the goo, then rub on it with rough gauze or a washcloth. Get into a hot shower and just roll up the goo into balls and pull off. I got about 80% of it today.

I highly recommend Quick Dots sublingual Vit B 12 1000mcg from Vitacost.com! Yummy cherry flavour!

Day Five intake log

Sat 5/21 intake
low grade fever remains 99f
2 oz vitamin water
1.5 oz coffee + 2.5 oz silk (shhh don’t tell the Dr I drank coffee!)
1 oz more silk
2 oz vitamin water
tylenol/anti/prilosec 9:30am
8 oz miso+broth+shroom
6oz vit water
10 oz broth+soy
temp 97.4
10 vit
10 broth+carrot
53 oz
2 oz water
10 broth+shroom
one hershey dark chocolate square (licked it ALL!)
anti/prilosec 8:30pm
10 vit
TL 75oz

Today (Sunday) I’ll begin adding protein powder to my liquids. I think the fever has worked itself out. My biggest issue? Dang sticky stuff from all the tape! ARGH! I’ll also be doing a video today.

Day Four intake log

The goal is 64 oz of fluids a day. Since you’re limited to a 5oz pouch, I divide all mine into 4 oz servings, about one per hour, finishing in about 15 mins. If it’s more than 4 oz, I sip it for a longer period. I am happy to report that my veg purees are serving their purpose well. Using them for flavour in your liquids is helpful to stave off going crazy from ONLY LIQUIDS. Blech. Here is everything I took in on Day Four, give or take an ounce.

Friday 5/20 intake
omeprazole and cephalexin, first round
4 oz gatorade
4 oz silk
2 oz tea + 2 oz silk
2 oz tea + 2 oz silk
2 oz tea
6 oz miso over 45 mins
6 oz miso over 45 mins
2 oz water
4 oz silk+tea
4 oz silk+tea
6 oz miso+chix broth
4 oz silk+tea
low grade fever 99f
acetamenophen/anti/prilosec
1.25 cup 2 Tbl carrot puree, 2 Tbl miso, 1 oz pedialyte, top with chix broth
5 oz vitamin water
TL: 65 oz

NOTE: Any time you see something that’s more than 4 oz, assume that it took a half hour or more to consume. I’m very careful not to overload my little pouchie. :)

Sleeve Gastrectomy timeline

Well, it’s done. I do, occasionally, think that I must be crazy, but it’s a done deal now, so, ONWARD!

Ok, flew into San Diego on Sunday. Got picked up and taken to the Grand Hotel in Tijuana. Had soup for dinner, got to bed early. Being on Eastern time is very handy since they like to get started early.

Monday, head to Hospital Florence. It looks a little skeevy on the outside, but it’s fine on the inside. Meet the patient coordinator ladies, get settled in the room. They bring you compression hosiery to put on. Then here come the vampires for your blood. Y’all know how wound up I get about needles. The girl that did it was AMAZING. It didn’t even BLEED. I didn’t even bruise! That is a first!

So then they do the EKG. Interesting experience! They put these clamps on your wrists and ankles along with the electrodes. It takes 5 minutes. Fun!

Then there’s the chest x-ray done by a little old man named Miguel Angel. Very sweet.

Then they come to get your IV going. UGH. Of course they are bound and determined to use my left hand rather than my arm. Fine. It took two nurses and a vein finder (very much like a stud finder for the wall!) to finally get a vein. Not too painful, either. Too bad it didn’t work and my hand swelled up. So now this poor kid Luis comes and tries to find a vein. He as looking literally everywhere: wrist, forearm top & bottom… I finally said, honey, please go get someone to help you! So here comes two more nurses with the vein finder. They stick me in the middle of my left forearm. Nothing – except a huge bruise. I’d been telling them all along that they’ll end up using this one vein that I know is a good one and guess what? That is the one they used, which is in the bend of my left arm. What I told them TO BEGIN WITH. Why do people not listen?

Then the parade of Drs comes in: the internist, Camelo the surgeon (cute!) and Reyna the floor Dr (VERY cute!). I could look at Dr Reyna allll day. ;)

Then they haul me off to surgery. It took about 45 mins then about 45 mins recovery. I felt amazingly well right after surgery. I figured I’d pay for that, and I have. :P

Day two, Tuesday, I’m sore, of course, and don’t do much other than sleep and be prodded by nurses. I did have the leak test where you drink barium. Again, administered by the sweet old man Miguel Angel. I never had too much gas pain. I burped some, but not too much gas. Mainly it’s just SORENESS, which makes sense. Expect to feel like you’ve been beaten with a baseball bat.

Day three, Wednesday, we go back to Grand Central hotel rather than the Hilton SD because I don’t feel well enough to be that far from the hospital. I threw up a lot on Wednesday. Throwing up is actually much less of a production w/out much of a stomach. It’s like BLECH, VOILA! No pain, at least. Hilton refused to cancel my reservation and charged me for the room. Letters will be written to those fuckheads. That would have never happened with Hampton Inn, but sadly, I’m foregoing all Hilton properties because of this treatment, so I guess I’m a Marriott girl now. [update: Hilton did rescind the charges AND gave me a shit ton of points that will cover a one night stay.]

Thursday we come back to SD for the flight home. I am very sore and moving slowly, so Nick gets me a wheelchair. This apparently pisses off the TSA to no end. I didn’t do the nudie scan because a) it violates my rights and b) I couldn’t raise my hands anyway. Therefore I had to get a pat down, which is fine, as long as the agent is not a midget with an attitude. I told her exactly where all the incisions were, even SHOWED her and she manhandled me like I was meat. She SLAPPED my incisions in the pat down! When she hurt me, I grabbed her hand by reflex and she freaked out because I touched her. Fucking cunt. There were FIVE TSA agents called over, so I yanked up my shirt and said WHAT PART OF FIVE INCISIONS DO YOU NOT UNDERSTAND? I was also dizzy from dramamine and percocet, but they make me stand anyway. So they bring another bitch over who also manhandles me then they all walk away. ?? Letters will be written, but since they conveniently separated me from my husband and my phone, I have no pix. FUCK THE TSA. [update: I wrote an email of complaint and got a response. Then: nothing. It’s been almost two months, so I doubt anything else will happen. Time to write the politicians!]

So, that’s it. It goes by extremely quick! The coordinators Veronica and Azalia are amazing! The hospital liaison Rosa is very sweet, too. Really, everyone there is awesome and the care is top notch. Just a coupla caveats: the hospital had no hot water in the rooms one day and the wifi is fairly useless. The Hotel is NOT quiet, so don’t expect it. It’s loud with slamming doors and our last night there was a party at the pool right below us. At least the music was good! Photos of the hotel and hospital:
IMG_2170

IMG_2171

IMG_2173

IMG_0449

IMG_0448

They send you home with a bag of meds: prilosec, pain meds, antibiotics, mylanta type stuff, dramamine, dressings and antibiotics for your incisions and whatever else you need. At this point you have to open up the capsules and take the powder or bbs, which sucks ass. Cephalexin smells like feet. Prilosec is little bbs that have a weird taste. Learn how to hold liquid in your mouth and toss in the meds. You don’t want to taste that. Ick.

I’m now on day 4, Friday, and I’m up early. Didn’t sleep much. I am having Nick pick up a bed wedge for me today, I think that will help. Since there is a drain hole on the left, I have to sleep only on my right, so my neck is jacked up from that. ALSO: make sure to practice your deep breathing! Anaesthesia is very hard on the lungs. The bed wedge will make it easier to sleep on your back and help clear out your lungs.

Today I woke up extremely dehydrated, so my main task today is to follow the 4 oz every half hour rule. So far, so good. I’ve had gatorade, Silk Vanilla and some weak tea + Silk.

Just checked my weight. Pre-surgery it was 239.8; today it’s 242.2. ? Anyhoo, it won’t be that for long. :)