Hello, "Twoterville"

Today marks day #14 post-op from my lap-band removal and Duodenal Switch surgery.  The last two weeks haven't been a cake walk but every day is a small improvement from the day before.

Scale Victory

I am very happy to report that I weighed in this morning at 299.4 pounds!  This is the first time I have been under 300lb since I was 21 years old (11 years ago).

In the weight loss community, this milestone has been adorably named "Twoterville" -- meaning the person has gotten down to a weight that starts with the number two.  The next milestone is named "Onederland" for having a weight that starts with the number one.  For me, I have not been to Onederland since before I was 14 years old.  They better save me a spot, since I am on my way!

Food Progress

Eating post-op was more difficult than I had anticipated. I came home from the hospital and did NOT want to have any part of any of my protein options available.  The Nectar products smelled like powdered baby formula to me (including the unflavored). My oh-so-reliable Premier Protein RTD cartons that I had been living off of pre-op were now unbearably sweet.  I just couldn't drink my Optimum Nutrition option either.  I even tried Isopure again (pre-surgery I thought it was NASTY) and my feelings didn't change with my new taste buds after surgery to suddenly start liking it!

Not only were the protein options not appealing, but I also didn't want to drink anything. No interest in plain water (regardless of temperature). I didn't want crystal light (my favorite), and chicken broth (plain or Asian flavored) was unappealing.  I had become the pickiest of eaters... and that was really bad! 

How did I get past it?  This may be counter-intuitive because of the sugar content, but Lemon-Lime Gatorade helped. I watered it down to 50% potency and was able to get it down.  I forced myself to SIP SIP SIP because it was better than battling the nausea that was creeping in from not drinking. 

The next concern was that I wasn't getting in any protein!  As a DS patient, I only absorb about 60% of the protein I take in, too... so I started to get concerned that too many days without protein, I would start to become protein deficient.   Post-surgery, the general rule of thumb is the 30/60/90 rule for DS patients. 30g of protein by day 30, 60g by day 60, 90g by day 90.  For a few days, I decided to force down at least 1 serving of protein per day. I didn't like it (AT ALL) but stomach-turning and all, getting in some protein was more important than my picky taste buds.

Because protein drinks were so BLAH to me, I sought out some protein via food as well. Thankfully, Greek Yogurt tasted good!  As did cottage cheese!  I tried blending mayo with tuna (into a tuna puree) but did not enjoy the texture or flavor at all. Thankfully, my 1/2 cup of Cottage Cheese or my small package of Greek Yogurt both come in at 13g of protein. 

Another solution that I found is Unjury Chicken Soup protein powder. I have only used it a few times so far, but it does not set off my "Eww Gross Protein Powder" alarm that has been on high alert lately.  I highly recommend having this on hand after surgery just in case you're also averse to anything sweet-smelling!

Bathroom Issues

If you're grossed out by bathroom issues (or don't want any of the TMI) then stop reading! 
Let me start out with the saying pretty common in the WLS community: "Liquids In = Liquids Out". This is a very true statement!  I thankfully only had one encounter during my pre-surgery liquid diet week with the dreaded diarrhea. Other than the one time, my stools were very small little 'pebbles' basically. 

During my 3 days and 2 nights in the hospital, I only ever had the urge to urinate (due to the TON of liquids they were pumping into me) so thankfully no foul experiences while still in the hospital. Unfortunately, as soon as I got home, the bathroom issues started! 

It was about 4 or 5 days post-op before I even passed gas. It was a relief to do so, since gas pains after surgery are common. Then, a few hours later that night (in the middle of the night) I had my first round of DS diarrhea! Oh my lord was it gross.  The smell was that of raw sewage.  I had to put my shirt over my nose to try to filter the air because it made me nauseous.  Then, every few hours for the next few days, I was back in the bathroom with more diarrhea. The colors each time varied pretty significantly. The smell did not. 

I was worried that I had signed up for a lifetime of this issue, but then remembered reading that it's pretty common for new DS'ers to have bathroom issues early on before we can eat enough of the right foods to make us more regular.  This was confirmed a few days later after I added the Greek Yogurt and Cottage Cheese to my diet. I suspect it is a combination of the food having protein, as well as the calcium content that helped stave off the diarrhea. For a few days now, I have been somewhat regular!  What a stinky NSV!

Do Not Progress Diet Too Soon!

 I learned this the hard way. I was doing well with my soft dairy products and felt like I could handle some kielbasa. I figured I would chew it REALLY well and it would basically be pureed food, right?  Nope.  The sausage felt fine while I was cutting it into small pieces, chewing it excessively, then slowly swallowing.  I even felt fine hours later.  Then, about 5 hours after eating, I was hit by nausea.  Then it got more serious.  Then diarrhea while vomiting.  Nothing came of the vomiting except for liquid (my own saliva). The nausea persisted after the bathroom trip and two hours later I was vomiting again. Still just saliva.  It was an awful experience, especially with recently rearranged guts, healing incisions, and healing abdominal muscles.  The only part that I believe could have triggered it is adding the greasy sausage too early and I paid the price!

Sleep & Pain 

My biggest complaint so far about my DS Surgery is the amount of pain I had to go through. I do not blame the surgery itself, but rather that my surgeon did not adequately manage my pain.  Once released from the hospital, the pain transferred from being mostly surgery pain to being mostly body aches.  My tailbone, buttocks, and lower back were in hell from the awkward sleeping positions I tried to find on the couch and in bed. If I lie THIS way, then THAT ends up hurting.  It was not the best of times.  I made a post on BariatricFacts.org at the height of my frustration if you're interested in knowing more details (Link).

Now that I am at Day 14, I am happy to report the pain level is much more manageable -- no surgery-related pain, other than briefly while standing or sitting, or getting in and out of bed. Since about day 10, I was able to sleep in bed again, and being able to sleep on my side was a huge help.  I put a pillow under my stomach to support it (and lessen the 'pulling' feeling) and finally was able to get some restful sleep. 

What's Next?

Well, I have one more week of Disability Sick Leave left, so I plan on using this time to continue to heal and continue learning about my new set of guts!  My diet plan has me on 2 more weeks of pureed/soft foods before 'Lifestyle Maintenance' where I get to introduce more normal foods.  I plan to walk more every day, and really work hard to get in my 64oz of water every day! 
I'm excited to see where this journey takes me next!!