Two weeks!

Two weeks from right now, I will be groggy but probably awake and the surgery will be complete. Wow. I most definitely am starting to get nervous, which was significantly compounded by my pre-op appointments yesterday in Eugene.

Keith and I showed up at the clinic office at 7:45 yesterday for what turned out to be 5 hours of pre-operative appointments, discussions, consents, and test. We had a brief class with other patients having surgery in the next week where we reviewed pre-operative procedures (don't eat, don't drink, scrub your belly...) and post-operative expectations and care (you will hurt and be grumpy). I got weighed again and they were super happy with my progress. On their scales I lost over 34 pounds, which is WAY over the 20 pounds I was required to lose. We met with the surgeon for quite a while and got to ask lots more questions. My surgery will be conducted with robotic assistance. Seems weird, but it is far more precise and so far has fewer complication rates. I had to read the insanely depressing and terrifying consent forms and sign my acknowledgement that I might die in 2 weeks. The surgeon gave me a quick physical - everything looked awesome and she said my liver is "nice and flat" - which will make for a safer surgery too! I did ask her that if she had to choose one thing about my case, what causes her the most concern. She did not hesitate to say it would be the possibility of a pulmonary embolism (PE). If you get a PE you don't automatically die, but you can. They are hard to predict and are more common in obese patients. It is not a complication that is exclusive to this surgery - far from it! Healthy people can get them at any time, but they are more common in obese patients after surgery. The fact that I just lost weight from 52 down to 45 BMI (and probably less by surgery day) reduces my risks quite a bit, plus I'm young and otherwise healthy, so my personal risks are low. But they are not zero. We also discussed the pain medications I will receive. Because of some concerns about my history with vomiting codeine and percoset family drugs, I'll be put on dilaudid which is apparently 4 times more potent than morphine.

The four other patients that were there were interesting characters. I had met them all before at either a support group meeting or at a nutrition class. All were at least 10 years older than me and two of them were significantly heavier. One man said he has 9 children at home - ages 1 to 19! Another man was their with his partner who had undergone the surgery a year ago. Everyone was a bit nervous, as was evident by their incessant chatter even when the nurse was giving us instruction. I learned later in the day that at least one of those other patients had her surgery cancelled when the doctor did his physical exam. He found an infected cyst on the woman's neck - best to wait until the infection is gone before getting your gut cut open.

After we finished with the surgeon's office we headed over to anesthesiology. We met with a nurse who reviewed a million things about my medical history. They took some blood, did a quick EKG, checked my BP, pulse, and temp, and deemed I was in good shape. Then an anesthesiologist came in a we talked about anti-nausea meds (normal, but I'll be put on a super-dose because of family and personal history) and what is like to be under general anesthesia. At least I'll be asleep when the catheter goes in. She gave me final instructions for prep during the final days before surgery (scrub the belly with special antiseptic pads, no food or water) and we were done. 

Oh, and I recently had a meeting with my general physician, and because of my weight loss and what is to come, she took me off metformin. One less med. Yay!

So now I have another week when I can eat normally, and then I start the pre-op diet. I will be very busy this week though, because I'm teaching an intensive summer class that meets all day next week. My final normal meal with be Thursday night, June 27th. After that it is 5 days of protein shakes for breakfast and lunch, and then a 300-400 calorie protein-rich dinner. The last 2 days before surgery are clear liquids only, combined with bowel prep.  Yeah, so I should be real chipper that last week. But it will be worth it in the end if I can find and keep a healthier me.