On December 31st I go into my local docs office in Port Charlotte to Dr. Maremaıs menu of surgical clearance tests completed. I walk into the lab, the tech examines the list and throws her hands up. ³We canıt do all these and get them to the hospital on time,² she tells me. I need to go over to Ft. Lauderdale to have the tests done. Candidly, I think they realize the tests will be expensive, the reimbursement inadequate, and they arenıt doing the surgery. Better to send me away and not lose money on a bunch of tests. I call Holy Cross and arrange to drive over on January 3rd for the tests. This is getting a little too close for me. Meanwhile, I celebrate - a big mistake. We eat three meals at Italian restaurants and I eat garlic bread as if I must finish the worldıs supply.
On Monday, January 7th we awake at 4:15, load the truck and drive to Ft. Lauderdale for the duration. I have been asked to arrive at Outpatient for pre-admission screening at 9:30 A.M. We register and Iım taken back to an office where my blue cross/blue shield information is checked again and other data taken. Irene stays by my side. This seems increasingly necessary as I seem to be getting foggier as we move toward the date. They take some more blood and let me go.
We drive out to our home for the next couple of weeks. The Homestead Suites Hotel is neither a homestead nor a suite, but it has an efficiency kitchen, which will allow Irene to prepare the foods Iıll need after I get out of the hospital. Otherwise, itıs small and not well lighted. The bathroom doesnıt even have a fan. Itıs biggest advantages are location and price. We get oriented and settle in.
On Tuesday I must attend a nursing education meeting in the evening. We lunch at the New York Hong Kong restaurant which has wonderful food, a fitting last meal. Linda, a nurse educator who works for Maremaıs practice walks us through the program book describing everything that will happen to us over the next couple of years. The program litany - "Follow the program exactly and everything will work out." - is continued through the presentation. One particularly sour black man sits next to me. He doesnıt want to have general anesthesia, he doesnıt want to shave his beard, and he doesnıt want to have his surgery on Saturday because he thinks doctors should be off playing golf on Saturday. I wonder why heıs there, but he has a scheduled date for February. Another participant, a surgeon herself, lets us all know how much she knows and asks technical questions. We must present ourselves at the hospital at 5:30 A.M. and consume nothing by mouth after midnight.
We arrive at the hospital and go to a room where I change into an extra large hospital gown and the nurse starts an IV. Soon Iım wheeled on a gurney to the holding area and Irene is left behind. Irene goes to the family waiting room to wait for me. In the holding room I lie on the gurney while other patients are wheeled in, meet with their anesthesiologists, see their surgeons, prepare. A kindly nun holds my hand and offers a prayer. My anesthesiologist comes in, asks some questions, and Iım moved to the operating room. I wake up in ICU sometime later with a ventilator down my throat. I canıt make any sound at all. Irene is sitting to my left and the anesthesiologist comes and goes saying something about not fighting the tube and having to breathe on my own. I go in and out. To my right thereıs a buzzer that goes off from time to time. Each time it buzzes, Irene reminds me to breathe for myself. I canıt keep my mind on breathing, but around eleven they pull the ventilator and I am breathing on my own. In the morning I can look out on the ICU area, open and ready for action. I donıt feel much pain or much of anything else for that matter. Around ten or eleven in the morning the wheel me to room 410 on Four North, my home to be for the next week.
I have a line of staples reaching from my sternum to below where my navel used to be. A tube comes through my side from my "old" stomach to allow excess bile and stomach acids to be let out. Ice chips then liquid diet. Cough, cough, cough while holding my sides to get out possible phlegm left from the anesthesia. Breathe, breathe, breathe into the Incentive Spirometer, a torture device sent to me by respiratory therapy to give additional help to my lungs. Drink, drink, drink to raise the levels of liquid in my system. I will have to drink 64 ounces of water a day for many months to allow the poisons from fat out of my system. Walk, walk, walk to get me on my feet and working properly. They didnıt get me out of bed as quickly as some patients because I was in intensive care, but walking is a painful and unwelcome part of the regiment. Irene is there the whole time - encouraging, pushing, reminding - never coddling. She arrives early, getting past the entrance nazis with her own combination of businesslike spunk and authoritativeness. I pump morphine, trying to bliss out, but the pain is always there.
The secret to getting out of here is moving to pureed foods and having bowel movements. Neither is easy, both are inhibited by taking pain medicine, so I give it up soon after they move me from the morphine pump to pills. Iım not interested in food, but the bring it anyway. I can manage the jello and tea all right. I still am not making any noise down below. After a day or two they bring me pureed eggs for breakfast. They go down all right, as well as the chicken for lunch. One day I make the mistake of ordering fish for dinner, vomit, and am back on IV fluid, nothing by mouth. Iım all swollen up, and the IV technician has trouble finding a good vein. They finally pull the IV and I start giving up fluids and something that gets credit for being stool.
Meanwhile, the shrink, Dr. Melodie Morehead, comes in regularly to visit and provide support. The nursing staff is terrific, working with often outdated equipment to provide excellent care. Apparently, Dr. Maremaıs practice brings so much money into the hospital that his bariatric surgical patients will soon take over a new wing in the hospital. Meanwhile, we meet and chat in the hallway as we perambulate. Everyone is sore, everyone is hopeful. Weıve made the decision, had the operation and now look forward to a new, thinner world.
An endocrinologist stops in each day to check on my blood sugars, which come down slowly with the help of insulin. With luck Iıll be off all diabetic meds in a few weeks. One of the surgeons examines me every day, too, but I get the idea that theyıre pretty well done with me. My recovery is mine. The full resources of the program are available for me to access, but since Iım an out-of-town patient, Iıll be using less of them than do locals. I wonder if they have any research on the relative progress of local and out-of-town patients over time.
South Florida has increasingly developed a Caribbean flavor over the years. Ft. Lauderdale is no longer the innocent beach resort frequented by college students it was in the sixties. The staff and patients of the hospital both reflect this. Lilting island accents abound. My night nurse, Beryl, is from Granada. Sheıs a tough old bird with a heart of gold. Many of the docs are either black or Hispanic. Patients are of all shades and colors. Altogether, a pretty nice place to be.
I begin to walk more often and further. They try me on pureed food again. I get it down and keep it down, so they release me. Back in the Hotel we settle in for a week of recuperation. Iım sitting on the side of the bed when Irene notices blood all over the front of my shirt. Itıs flowing out of the wound. We jump in the truck and rush to the emergency room holding a towel against the wound to stop the flow. Once in the ER, we sit and wait. After a while we go to an examining room where an ER doc looks at the blood, now oozing, and calls Dr. Benitez who tells him this sort of blood release is normal. He bandages me and tells me to go to Benitezı office at 9:00 the next morning.
We go to the office where Iım weighed and measured. Iıve lost almost sixteen pounds since I weighed in last November. Thereıs no telling how much of it has come off since the surgery. Benitez comes in and prods around a hole in my incision with a q-tip, bandages the wound, prescribes an antibiotic, and sends me home. No harm, no foul. We go back to the hotel and settle in for a long, and not too comfortable series of days watching tv, walking a few times a day, and eating according to the program - three tablespoons of protein three times a day and 64 ounces of liquid. I canıt drink for ninety minutes after I eat, but then I have to sip, sip, sip all day.
On Friday thereıs still some pulling around the incision and my skin is tender from more than a week in bed. Otherwise, I feel better day by day. Weıre looking forward now rather than back. Issues of what to eat and how much I can tolerate lie ahead. How my psyche will adjust to its new body is an interesting question that only time will answer. Meanwhile - life is good.