068 Another Hospital Stay

On Friday afternoon we went to a follow up appointment with Dr. Hornbostel because of Jimmy's trip to the ER the night before. Jimmy was still feeling very miserable from everything that he was going through. When Dr. H came into the room he told Jimmy he was admitting him to the hospital.

We were shocked. We knew Jimmy was sick but we didn't expect a hospital stay. Dr. H says it is because Jimmy is very dehydrated from the diarrhea and you can't really catch up because it is so soon after surgery and he can't drink large amounts. Number two it's because they need to keep a close eye on him and get his bowel, vitamins, and eating situations back on track.

So we went straight over to admitting.

They got him to a room quickly but had lots of trouble with his IV (he ended up having a pick line after two different IVs infiltrated) and labs. Finally after using the sonogram (not sonar like Jimmy thought) they got him all situated and started on his fluids and vitamins. Not surprisingly, his blood work said he was dangerously low on potassium so they have been working to bring that up the last two days.

They have also done some other tests, xrays, and listened to his bowels. After Jimmy pucked up the Barium they were attempting to use for one test, his bowels finally startedmoving. So I guess 20 minutes of pucking and dry heaving helped move things along in the bathroom department. One positive to come out of a failed test attempt.

After all the results were in, Dr. H came back yesterday afternoon to tell us the verdict. As the xrays from the ER and the fact Jimmy's bowels finally started moving proved there wasn't blockage or obstruction. Hornbostel believes Jimmy caught a very aggressive flu bug which caused the diarrhea and was complicated by the fact he was already constipated.

These things combined curbed his appetite (dropping his vitamins), caused diarrhea (lowering his potassium levels, and caused dehydration (which he couldn't combat because of the limited amounts he can drink in one sitting). That's why he ended up in the hospital. Just one big whammy. The good news was if he could keep stuff down and get his potassium up then he could go home on Saturday.

So here we are, waiting to see what his fate will be. Will we go home or harbor another night at Heartland? Only Dr. H knows.

* Thanks to everyone who came by to visit or bring us stuff. You are very appreciated and you made our stay that much easier! *

067 The Constipation Saga Continues

Last night was another long night. We are still dealing with Jimmy not feeling well. I guess last night it was just the last straw so we ended up in the emergency room.

Because of the pain Jimmy was having they first thought that he might have a fecal impaction so they did abdominal x-rays to check for blockage and one of the doctors stuck his finger up Jimmy's bum (T.M.I. I know!) to see if their was any hard blockage near the entrance of the rectum.

The Verdict
Jimmy does not have blockage.
Jimmy does not have a fecal impaction.
Jimmy did not have a septic bowel movement.
JIMMY IS CONSTIPATED.

Evidently constipation can cause diarrhea because the other poo is forced around the harder stuff in an effort to leave the rectum. In Jimmy's case, the frequent trips to the bathroom have aggravated his hemorrhoids and the wiping has made his bottom very raw and tender. This has resulted in all the pain and discomfort Jimmy is experiencing.

Because Jimmy went to the ER they also called Dr. Hornbostel. Dr. H says that Jimmy is supposed to call him today and he has to go back to the Liquid Diet until further notice. So I will keep you posted.

For now, I am going to try to focus on work through my haze of tiredness and this too shall pass (no pun intended). Hope your day is better than ours was yesterday.

054 Gastric Sleeve Diet Stage 3

Today marks four weeks out from Jimmy's gastric sleeve weight loss surgery! We are so excited because he is doing really, really well AND he gets to start his Stage 3 Diet on Sunday! He won't have his month appointment for a couple more weeks (due to the holidays) but when he does we will let you know what Dr. Hornbostel and everyone else had to say. So I know that everyone really seems to love and be fascinated by what Jimmy is allowed to eat and what he is not. I am including his whole Stage 3 diet below. Be aware that some of the foods Jimmy was allowed to eat before are being phased out for healthier options now that he is allowed a wider variety of foods. Don't miss that because I guarantee Jimmy won't! I realize this diet may be different than the one prescribed by your surgeon. All bariatric surgical programs are different. Talk to your surgeon before changing your diet or exercise program. This diet was prescribed to Jimmy by his surgeon (Dr. H) and nutritionist (Krystal).

Jimmy's Post-Op Stage 3 Gastric Sleeve Surgery Diet
What is the Stage 3 bariatric diet?
It is a soft diet that consists of foods high in protein with no added sugar and minimal fat

Recommended Foods:
Meats/Eggs/Cheese/Dairy/Legumes - These foods are high in protein, consume them first at meals. Meat should be lean, moist, tender and must be chopped or ground. Make sure your body can tolerate fish and poultry before trying to eat beef and/or pork.

• Skinless chicken or turkey
• Baked or grilled fish and shellfish
• Lean ground beef or pork (if tolerating poultry and fish well)
• Thinly sliced deli meats such as chicken, turkey, roast beef, or ham (these should be purchased at the deli counter so they will be lower in salt and preservatives)
• Meat, tuna, or egg salad prepared with light mayonnaise
• Meatless burger (vegetable, bean or soy based)
• Well cooked beans: black, garbanzo, kidney, lima, navy, pinto (including low fat refried beans), etc.
• Cheese (reduced fat)
• Eggs
• Creamy peanut butter (less than 5g of Sugar per serving & may be used in small amounts to add protein to foods such as oatmeal, yogurt, and/or protein drinks)
• Skim, 1% Milk, or soy milk (containing no more than 20g Carbs per serving)
• Yogurt - Low fat or Fat free (must be no sugar added and have less than 20g Carbohydrates per serving)

Protein Supplements - It is still very important that you consume between 40g to 60g of protein a day. This requirement will never go away.

• High Protein nutritional drinks as allowed on Stage 1 and Stage 2 diets (must have a minimum of 15g Protein per serving and less than 20g Carbs per serving)
• Powdered protein drinks may still be used
• Protein bars (containing at least 15g protein per serving and no more than 20g of Carbs per serving)

Vegetables - Vegetables MUST BE COOKED until very soft and prepared with minimal fat. Do not eat skins.

• Asparagus
• Beets, Broccoli, Cauliflower
• Celery, Carrots
• Eggplant, okra
• Lentils, beans as listed above
• Mushrooms, onions, peppers
• Spinach, sugar snap peas
• Squash, any kind
• Turnips
• Green beans or wax beans
• Tomatoes, no skin
• Potatoes, white or sweet (no skins, no fried potatoes)

Fruits - All fruits must be canned or frozen (except ripe Bananas). Do not eat skins or peels. Canned fruits must be packed in its own juice. Frozen fruit should have no sugar added.

• Apricots, peaches, pears, crushed pineapple
• Applesauce (no sugar added), mandarin oranges, fruit cocktail
• Frozen honeydew melon, cantaloupe, seedless watermelon
• Canned or frozen mango, papaya, cherries

Starches/Oils/Misc. Foods

• Oatmeal or Cream of Wheat (no sugar added)
• Cold Cereals (containing no more than 5g. of Sugar per serving)
• Fat Free or Low Fat Soup
• Whole Wheat Crackers (Triscuits - updated 12/17/12 as of Jimmy's meeting with Krystal)
• Whole Wheat toast, melba toast
• Sugar Free Pudding
• Sugar free ice cream or frozen yogurt. Avoid sherbet.
• Oils - olive, canola, soybean
• Margarine (trans fat free), butter, sugar free jelly
• Herbs, Spices, Salt, & Pepper

Foods to Avoid

• Soft bread (it can make a dough ball that could plug up your stomach)
• Rice
• Spaghetti and other pastas
• Macaroni and Cheese
• Raisins, prunes, and other dried fruit (these are too sweet)
• Granola and other Cereals with nuts
• Raw fruits and vegetables, salad
• Nuts and Popcorn
• Chips and crackers (other than whole wheat crackers)
• Tough or chewy meat
• Whole pieces of corn or whole peas (puree before eating)
• High fat foods (butter, margarine, oil, regular mayonnaise, sour cream, cream cheese, salad dressing, whole milk, half and half, ice cream, cakes, cookies, pies, other desserts, bacon, and sausage)

Serving Size: 1/4c. - 1/2c. (2 - 4oz) of food, 3 - 4 times a day. NO MORE THAN 1/2c AT A TIME! Focus on eating foods containing protein first. Avoid drinking with meals and for at least 30 minutes after meals. Drinking with meal or directly after meals can cause Dumping Syndrome. Continue to drink a minimum of 6c. of fluid daily (see Stage 1). Avoid Fruit Juice or limit it to a maximum 4oz. per day (100% juice with no sugar added). 

Duration: Follow this diet for Weeks 5, 6, 7, & 8 following the surgery or until your doctor advises differently (this diet begins 1 month after your surgery)

053 A Not so Regular Doctor's Appointment

It's almost been four weeks since Jimmy's surgery. He has done amazing! Plus he has lost over 85 lbs since starting his liquid diet on Nov. 2nd! However, your body starts to go through some major changes when you lose that weight so Jimmy really needed to go see his primary care doctor.

Yesterday was the first time in the six and a half years that we have been married that I haven't been able to go to the doctor with Jimmy. He was a real trooper and decided to tough it out and go on his own even though he really, really hates going to the doctor's office. Anyway, so he goes in to talk about why he isn't sleeping well, why he is having dizziness when he is active, and why he is having cramping in his legs and knees when he tries to sleep.

Well...

He calls me two hours after his appointment was supposed to have started to tell me that he has just gotten in and that they are going to draw blood to check his potassium levels but that Dr. Weiderholt is concerned about his blood pressure because it is very low.

An hour later...

His blood pressure is fine when he is at rest but it drops after being active (like standing up or sitting down) so she is going to keep him a little longer to monitor him and she won't draw blood until his blood pressure comes up.

An hour later...

Jimmy calls to tell me that I need to come and pick him up because Dr. Weiderholt is sending him to the ER and doesn't want him to drive himself! Yeah I was more than a little surprised. So I leave work, drive across town to the doctor's office, pick him up, and drive him back across town to the ER.

We got right into the ER. What a blessing! The doctor got in to see us pretty quickly. He talked to Jimmy and determined that they needed to draw blood for labs and they would give him an IV for fluids and the ER doctor would call "Dr. Hornbuckle" (I am sure Dr. H would have been thrilled to know a colleague was totally murdering his name!) and talk to him about everything.

At this point Jimmy is pretty dehydrated from being the in doctor's office all day so they have a lot of trouble getting the IV in and have to bring in the vein ultrasound machine. They draw labs and get the IV going and give him two bags of IV fluid to make sure he is well hydrated. By the time the second bag was half empty they had the results of Jimmy's labs.

His potassium is low which is causing several of his symptoms. So they gave him two potassium pills in the hospital and prescribed a potassium pill for daily use at home over the next week. The doctors also decided to take Jimmy off his blood pressure medicine. Evidently his blood pressure has dramatically begun to improve due to the weight loss and the meds were making his blood pressure too low. Go figure! They also told us that the dehydration was making a mess of his blood pressure as well.

About three hours later...

Once the second bag of fluids was finished, we were free to go although Jimmy will have to go in to have labs again on Friday as well as a follow up with Dr. H. Thankfully, my friend Dana was able to give me a ride to back to my car so I didn't have to leave it at the Dr. Weiderholt's office overnight. Then when I got home we settled down and snuggled in and watched Survivor and ate dinner.

It was a really long evening, but I wanted to say "Thank You" to all of you who offered up thoughts and prayers on our behalf. You are greatly appreciated! And Thank You to Dana for going out of her way to pick me up and take me back to my car. You are a lifesaver!

040 Post-Op Week One Update!

Jimmy and Krystal at Jimmy's first Post-Op
Appointment on November 21, 2012.

I can't believe it's already been over a week since Jimmy's gastric sleeve WLS! Can you?! I mean seriously, where does the time go!

Anyway, life has been hectic around here with the surgery and Thanksgiving and family. So I feel like I am running a little behind. So let's take two seconds to catch up a little...

Jimmy's surgery was on Friday, November 16th. He came home from the hospital on Saturday, November 17th. His first post-op appointment was a little early because of the Thanksgiving holiday so it was on Wednesday, November 21st. At this appointment he met with the lovely Krystal (Nutritionist) and Dr. Hornbostel. They cleared him to move on to his stage two diet. Which meant that Jimmy was able to have mashed potatoes for his Thanksgiving dinner on Thursday, November 22nd. *Whew* Now I think we are up to speed.

Today, I am sharing with you Jimmy's Post-Op Week One vlog so he can tell you what's going on in his own words. I am also posting the really short video he recorded the day after his surgery because I forgot to post it earlier (sorry about that).

Hope you have fun watching this update!

Grace and Peace,

037 Jimmy's Surgery Day in Pictures

Hello, everybody. How do you do? My name's.... Oh wait I think I just ripped that off a song. Oops :) Anyway, today Jimmy is going in for his first post-op appointment. We are really excited that Dr. Hornbostel wanted to see him on Wednesday (because of the Thanksgiving holiday) instead of making him wait until the following Monday. Friday will be one week since Jimmy's surgery. Obviously I don't have any information about his appointment yet so I wanted as this point so I thought I would share all the surgery day pics with  you instead. I hope you enjoy Jimmy's surgery day in pictures.

             

035 Jimmy's Surgery Day

Jimmy right after he checked into the hospital
for his surgery. 44 lbs lost on the pre-op diet!

If you didn't know, Friday was the day! Jimmy and I went to Heartland bright and early for his gastric sleeve WLS. Everything went amazing and they were even able to take Jimmy back for surgery about an hour early. I have a clip for you today and we recorded around 12 hours post-op. I did the narrating for this clip because Jimmy's throat was dry and a little sore from surgery. I hope you enjoy it anyway :)

Also, today's picture was taken directly after Jimmy checked in for his WLS. We also found out that Jimmy has lost 7 more pounds on the pre-op liquid diet between when he weighed on Wednesday and when they were prepping him for surgery on Friday. So that was really exciting news and a great way to start the day!

023 Pre-Op Liquid Diet (2 Weeks)

Good morning, everyone! Tomorrow Jimmy will be starting his Pre-Op Liquid Diet. Before I get into all the specifics of what Jimmy is going to be doing, I want to remind you that every WLS program is different. This is the liquid diet that was given to Jimmy by his surgeon and it may differ from the diet either you or someone you know were asked to follow. Also, please remember that you should always consult your personal doctor before trying a new dietary program.

Ok, now that all the technical items are out of the way we can get down to business!

As I said, tomorrow Jimmy will be starting his 2 Week Pre-Op Liquid Diet as perscribed by Dr. Hornbostel. The purpose of the liquid diet is to help Jimmy drop a few pounds before the surgery, prepare his body for smaller amounts of food intake, and to cleanse his system before undergoing operation.

Heartland Bariatric Center has designed specialized diets for men and women for each type of surgery they offer. They even offer two different options for men undergoing the gastric sleeve! Through some discussion about taste, amount of food allowed, and cost of supplies this is the option that Jimmy and I decided upon for him:

DAILY

• Five Cups (40oz.) of 2% milk, each with No-Sugar added Carnation Instant Breakfast
• One Cup (8oz.) of 100% fruit juice
• At least 48-64oz. of other liquids (from the allowed liquids list) daily

ALLOWED LIQUIDS

• Water
• Diet V-8 Splash, V-8 juice or Tomato Juice (Not a chance Jimmy will try these)
• Sugar-Free Jell-O
• Sugar-Free Popsicles (Less than 15 calories per serving)
• Fruit 2-O
• Crystal Light (Jimmy was really excited about this one!)
• Diet Snapple (Not a Chance)
• Up to 2 Cups of broth (unlikely)
• Decaf coffee, tea (Not a Chance--I know he's weird, right?)
• Powerade Zero/Gatorade Zero

Now that you know what Jimmy is in for I really ask that you will keep him in your prayers. Other people have said that they have experience hunger, irritability, and fatigue during the first few days of their liquid diets. So I am sure that things are going to be really fun at our house!

Also, pray for us as we continue to make Post-Op Preparations too.

Grace and Peace,