Back to the Hospital

I came home today from a lovely 5 day stay in the hospital. Not fun at all. On Thursday, I started to get lightheaded whenever I stood up. We thought it was low blood pressure. I went to my appointment at the Coumadin Clinic and my INR was 3.8. Too thin. I was to stop the Lovenox shots and hold the Coumadin for that night. Cindy drove me to the appointment and I was in a wheelchair the whole time.  I didn't feel quite right, but I was not really feeling lightheaded.  At 3:30, I went to the bathroom, passed out and fell into the tub. Wow. I continued to pass each time I got up scaring Phillip into thinking I was dead the first time he saw it happen. Thankfully he was right there each time it happened.  He took me to the ER on Friday afternoon.  They admitted me and transferred me to Ochsner. It was determined after a CT scan that I had blood leaking into my belly. Once I received 2 units of blood and 2 of fresh frozen plasma, I started to feel much better and the passing out was gone. All of the blood work I had was a nightmare!!!!! My left arm started to retain fluid and they had trouble finding veins. Some of the blood techs were horrendous and stuck me multiple times. One lady stuck me three times, got nothing, and stormed out like it was something I was trying to do. I hope karma takes a huge chomp out of her fat butt.  My blood clotted twice before it reached the lab, so they had to come back. The doctors ordered more labs within and hour or two of previous labs. I had a breakdown this morning and started crying. I was so miserable and ready to tell them no more labs. I told the doctors about how miserable I was and a little after noon they sent in the orders to release me. I had been on Lovenox for a day and was to start adding in the Coumadin. Sweet relief! Robyn picked me up on the way home from school. Like Dorothy said, "There is no place like home."

Filter Placement

Today was the IVC filter placement.  Poor Cindy drove me across the lake and got me there for 5:30.  It went well and so far no problems.  I was given an anesthesia that relaxed me but I was aware of what was happening.  Afterward I had to lie flat for 2 hours.  Those hours slowly passed.  All of the nurses were great.  I look forward to what is next.

Pre Op Appointment

Today I saw my surgeon for me pre-op appointment.  I liked Dr. Richardson and feel he will do a great job. He quickly answered all of my questions and put Phillip and me at ease.  I received my discharge instructions and they all seem pretty straightforward.  I saw the dietitian next.  She went over what I need to do prior to surgery and from post-op up until my follow up appointment.  I have at admit I was kinda bummed that no one commented that I had lost 39 pounds from my initial appointment.  They said I needed to loose 17 pounds prior to surgery and I exceeded that.  Oh well, that is 39 pounds kicked to the curb.  Next up is my IVC filter placement and then the main event.  I am so ready for this!

Tomorrow

Tomorrow I meet the surgeon for my pre-op appointment.  I have my questions ready and I am eager for Friday to get here.  Right now I am mostly calm about it, but occasionally I have a bit of nerves.

I tried the Jay Robb chocolate protein today with water and with coconut milk.  It was good in water and with the milk.  I think it comes in second to the Syntrax though.  It is sweeter than the Syntrax and I think for now at least I prefer that.

Where Things Are For Now

It has been a while since I updated.  My liver biopsy showed no autoimmune disease, but Fatty Liver Disease.  The treatment for this is losing weight and exercise, so I am on my way with that.  My surgery scheduled for December 21st has been now postponed because I was taking too much thyroid medicine.  We switched from Tirosint back to Synthroid.  The dosage is off and Dr. C said surgery would be unsafe at the level it was.  He backed me down a bit and I will do blood work once the sun comes up.  I started on the the two week liquid diet prior to surgery and honestly the 4 days I did it, it was not that bad.  It helps that I like my protein powder.  I started stressing how I was going to work the Coumadin/Lovenox shots, getting IVF filter, and then possibly not having the surgery if my thyroid level is still off.  I don't like to mess with my Coumadin unless necessary and the stop/start for the Lovenox with the question of whether the surgery would be on 2 days before was too much for me.  I decided to postpone until the first of the year when my thyroid levels are where they need to be.  Hopefully they are back on track and I can schedule this puppy.  I am ready to go.  It kinda feels like I am walking around in a maze and someone keeps sticking their leg out and tripping me.  In the morning I have an appointment to see about the IVC filter.  I really do not want one of these and my PCP agrees with me.  I want a good explanation of why I need this.  So far I have not gotten one.

I Never Liked Liver

I remember as a child, Mom would occasionally make liver and onions.  I abhorred that stuff,  Total yuck.  My negative issues with liver continue.  Unfortunately it concerns my own liver.  It is uncooperative or maybe   it is not my liver, but my immune system.  My liver enzymes have come back elevated on the pre-op lab work.  Not once, but three times (and now four).  I was referred to a Hepatologist and saw his PA on Friday.  They took 9 more vials of blood and told me that I would possibly need a liver biopsy.  I just got the phone call that two of my tests came back positive for autoimmune and they suspect autoimmune hepatitis.  Oh joy.  What now?  This is a chronic condition that cannot be cured, but usually can be managed with steroids and another drug called Imuran.  My latest blood work showed that the liver enzymes are higher than the last.  I will need a liver biopsy for confirmation and then start on the drugs.  I still feel fine, so I am hoping that this has been caught early and no significant damage to my liver has occurred.  Surgery will likely be pushed back to get this all straightened out.  I am trying real hard not to go and eat the house and will try not to stress too much about this.

An Interesting Day and Welcome to Carb Central

Today was a humdinger as my Dad used to say.  It started off with an EKG at 7:45 and followed with blood work, a bone density scan, chest xray, and a stress test with ultrasound (stress induced by medicine in an IV not on a treadmill).  The medicine they gave in the IV had a side effect of causing a dry mouth.  Boy was that true.  I thought I "deserved" Cane's for all of that testing (I need to work on this line of thinking), so I swung by and got the Box Combo (no cole slaw, extra fries).  A carb dream.  I choked down the toast first as I usually do.  It was hard to swallow because my mouth was so dry.  I had to drink to swallow   Same with the fries that came next.  Did that stop me.  Oh no.  Then one chicken strip.  I had to stop.  It was gagging me not to be able to swallow.  It was weird and sad at the same time.  I was not enjoying it, but I still eat all that I did.  I kept the 3 remaining strips for Cara and was done.  On a positive note I lost a couple more pounds and am at 21 down.

I sent an email to the PA to see if we could schedule my surgery.  She emailed back that my liver enzymes came back very high even compared to previous lab work   Crap.  She had a call in to my PCP (her brother) to see what he thought.  She called me after talking to him and they think it could be viral.  She asked if I had been sick.  No, but Cara and Phillip had colds this week and I did all that I could to dodge that.  She asked me if I had eaten any raw seafood.  Me?  Nope.  Never.  My white blood cell count was slightly elevated too which led them to think it was viral.  She asked if I was nauseous or throwing up.  No.  I feel pretty much as usual.  I have had a headache since the stress test, but not related since  the blood work was prior to the stress test.  They want me to do repeat blood work on Tuesday and have a liver ultrasound to see if that picks up anything.  The blood work will be a hepatitis panel because it breaks down into the different types of enzymes.  Of course, while I was waiting for her to call me, I went online to see what elevated liver enzymes could mean. One possibility...cancer.  That friggin breast cancer had better not be coming back.  So now I am all worked up.  I keep telling myself that there many other causes for elevated levels, but I can't stop worrying about it.  I hate cancer.  It effs you up for live.  It is always there in your mind.  Hopefully the tests on Tuesday will show nothing amiss and the levels returning to normal.  She told me that if I feel bad over the weekend to go to the ER.  Was it really that high?  She said she would send me a copy of the report but I could not find it on My Ochsner.  Crud, but maybe I don't need to see those numbers right now.  For now the surgery is on hold until they can see what is up.

So by dinner time I was able to eat again.  We went to Cracker Barrel, where I do not make any attempt at all to eat mindfully and order the usual.  Country Fried Steak with cream gravy, mashed potatoes with cream gravy, hashbrown casserole, and macaroni and cheese.  Add in 2 biscuits with butter.  I ate 3/4 of it all.  In my head I was saying "stop eating", but the louder voice said "this day was a bitch and go ahead".  This canceled out any weight loss I had seen earlier in the day I know.

Once I get home, the Hershey's Nuggets with Almonds are calling my name.  Those buggers!  I refuse to listen.  They will not stop calling.  I decide to address this by making a Syntrax Chocolate Truffle protein drink with extra chocolate SF flavoring and some PB2 to make it like a Reeses Cup.  Score.  A serving of the nuggets is 4 at 200 calories and the drink was 258.  I still consider it a better choice because could I really have stopped at 4 nuggets?  I never have.  A handfull is a serving to me and a slippery slope cause they will be there tomorrow seeking me out because I opened that door.  Nope not gonna do that.  They are going out with the Halloween candy.  Those and Reeses Cups are my Kryptonite.  The drink filled the chocolate square and Reeses square and gave me 28 grams of protein.  Nuggets 4 grams of protein.  I need to rethink the almond milk because it had way more carbs that I thought. Tomorrow I will get back on that horse and head back toward the right direction.

Carb count for today- 173 g.  Holy Moly.

The Psyc Evaluation

On Monday, I went to Big Ochsner for the first of two visits for the pysc eval.  The first part is answering about 500 true or false questions.  Some of the questions were silly like "I think someone is trying to poison me." and others were hard like "I am/was closer to my mother than my father."  Some had absolutes like always and never.  Those are easy to me to answer.  It took about an hour and a half to complete this part of the eval.  This morning, I went back and met with the psychologist to go over the results and for her to talk to me and get a feel on how I might do with the surgery.  She told me that I seemed to be normal according to the results of my test.  Nothing stood out as concerning, like I don't seem to have an addiction to food that could be transferred to something else once I have the surgery.  The psychologist was very nice and I ended up telling her about Ravelry (we talked a little about my knitting and she crochets).  I cannot help to tell people about Ravelry.  Our talk lasted about 45 minutes and I was on my way back across the lake.

I was proud of myself in that I planned and took my protein shake with me in the car.  The more I drink the Isopure Chocolate, the less I really like it.  I hate that I cannot easily close the bag.  Buying it in the canister would fix that if I were to buy it again.  It does not blend as well as the Cellucor.  It was lumpy ad at the bottom was a huge clump that should have broken up as much as I stirred it with the spoon.  I don't want to fire up the blender every time I make a protein drink.  When I go home, one of packages of samples had come it and it was the one with the shaker bottle.  I tried the protein again with the shaker bottle and it was a lot better, but I could still see some clumps on the side.  I ended up getting another package of samples, so I will give those a try in the coming days and see how they go.

Pre-Surgery Info

From the boards-

Talk to your surgeon ask how s/he checks for the presence of a leak. Ask how s/he reinforces the staple line to safeguard from leaks.

Info on leaks and strictures

The Dietitian Visit

I saw the dietitian today and got the info on how they work the eating plan.  She wants me to lose at least 17 pounds prior to surgery.  I also will do a liquid diet 2 weeks prior to surgery.  She went over the progression of foods on the plan and they sound mostly like that I have read on the internet.  I plan to go ahead and start trying out the proteins and see what is palatable and what is not.  I am ready to get this party started in some form.

Visit with the Physicians Assistant

Today I drug myself across the lake and went to "Big Ochsner".  I really dislike going there.  It is so huge and the parking garage is a mess (although better than it used to be).  Robyn was born there, so it does hold a special place in my heart.  My appointment was for 2:40.  I was not called back for an hour.  I was not happy about that.  They had recently begun the change over to a new system of keeping patient records.  The Northshore had done this last November and it was a nightmare.  It is just now getting back to normal.  I am assuming this was causing the back up in appointment times.  Being later in the day, the extra time it took to enter and or find past patient information was compounded.  The length of my visit was scheduled to be 20 minutes.  I was in there about an hour.  My appointment with the P.A. went well.  She thinks I would be a good candidate for the sleeve.  They weighed and measured my height.  I am not 5'7" like I always thought.  I am actually 5'8".  Cool.  Better to be taller than shorted that I thought.  The P.A. went over the different tests that I would need.  Unfortunately, I will have to be self pay as our Humana policy does not cover weight loss surgery.  Individual policies usually don't.   I have appointments scheduled with the dietician, psychology (need to get psyc clearance), lab work, and an EKG.  The lab work and EKG are scheduled on the day I go to do my stuff for my 2 year checkup with Dr. B.  They will be able to use the chest x-ray I will need for oncology.  My homework is to check with Dr. C to see if the Tirosint I am on can be opened.  For approximately 3 months I will need to crush any medications.  She also wants me to check with Dr. B to see if there is a problem with possible malabsorption issues with the Tamoxifen.  All in all I was pleased with the visit.  It looks like I will be able to schedule the surgery over Thanksgiving break.  I would love to get it done ASAP, but I agree it would be better to do it when Cara is off from school and home to help me if I need it.