My God. I feel like a door that slammed in my face just came open. When I walked out of the doctor’s office this morning, I was almost weeping with relief.
Here’s what: After the surgery to relieve the bowel obstruction that I enjoyed at the end of June (the sixth major surgery in 12 months), it took a little time to recover. After about two months, the Mayo called me back for a “follow-up.”
Instead of seeing a doc for this appointment, I met with the surgeon’s P.A. And by the time I walked away from that woman, I was utterly terrorized. She said…
• The adhesions will (not “may”) return.
• They could return within a few weeks or months, or it could be as long as ten years.
• When that happens I’ll have to go through the whole horrible thing again: another five days in the hospital in agony with tubes stuck down my throat; another abdominal surgery; another God knows how long to recover.
• There’s a limit to the number of times they can do this surgery. After two or three procedures, they can’t do them again.
• And at that point, you’re pretty much done for.
• I must eat an extremely low-fiber diet. That means…
….No fresh veggies, properly cooked or raw
….No fruit unless it’s stewed or canned
….No salad greens
• All meats must be stewed or boiled: no grilled meat, no broiled meat, no fried meat, no roast meat
• No whole-grain cereals
….No oatmeal
….No whole-grain breads
….No polenta
….No brown rice
….No barley…and on and on and on
Holy shit. Basically she was saying that my life as I knew it was ended, and that 70 years worth of vibrant health was effectively ruined.
Needless to say, I’ve been in quite the blue funk these past few weeks.
I actively dislike soggy, mushy food. Some of it, I’ll eat, but it’s not something I would seek out, or that I look forward to eating. So, since I spoke with this woman, I haven’t had much to eat. Certainly not much I enjoy.
But I’ve gained ten pounds!
Part of the reason for the weight gain is that in the absence of anything appetizing to eat, I’ve been scarfing down ice cream. I don’t much like ice cream, but as a practical matter it seemed like about the only thing worth eating that didn’t threaten to send me back to the O.R. Part of the reason has been that I’ve been too depressed to crawl out from behind the computer. And part of the reason is that things like pasta and boiled potatoes tend to pack the pounds on. I can gain two or three pounds just from eating a hearty helping of spaghetti.
I’ve only gained ten pounds because I’m hardly eating anything.
Saved a lot on groceries, though. 😉
Then the GERD symptoms came back. I’ve had a lump in my throat for weeks and weeks.
At first I thought it was probably trauma from all the tubes they stuck down my throat — they had me intubated for three or four days, and the surgery (during which they stuff God knows what down your throat) took three hours. Thought it would go away over time.
But it didn’t. Instead more GERD symptoms joined it: burping and queasy and heartburn that wakes you up at three in the morning.
So I thought…I need to see a gastroenterologist, NOT a surgeon. And thanks to Young Dr. Kildare, I happen to know one.
The last time I was enjoying GERD manifestations, he wanted me to go to a specialist. Well, I don’t think much of the specialists who reside at John C. Lincoln, so I tracked this lady down through Angie’s List and managed to wriggle in to see her.
At the time she told me I did not need to have anything stuck down my throat to diagnose what was obviously gastric reflux and that if I kept taking the omeprazole YDK had prescribed, in a few weeks it would settle down. If not, they had other strategies.
She was right. Within a couple of weeks, it went away.
That was in 2012. It didn’t bother me again until after the most recent Adventure in Medical Science: three years later.
So I asked her if the GERD-like symptoms could have been kicked up by the surgery.
Yep.
And was the throat lump thing from acid reflux or from the various gadgetry shoved down my gullet?
Probably both. Keep taking the omeprazole. It’ll get better in a few weeks.
Is it true that this is going to come back and I’ll have to have repeated surgeries but after a couple more there won’t be anything more they can do for me and then I’ll be pretty much a goner?
SNORT! She said that?
Yesh.
No! I have one patient who’s had eight surgeries for adhesions. And it’s not a foregone conclusion that the adhesions will cause another blockage that requires surgery. I have one patient who went FORTY YEARS without a recurrence. She’s 80 years old.
Is it true that henceforth I must eat baby food? I’ve gained ten pounds on this stuff! I have to lay down flat on my back to zip my jeans.
Gaining weight is what causes the GERD to kick up. Come to think of it, tight pants aggravate GERD, too. Go back to your healthy diet and lose the tight jeans until you can fit back into them.
Can I eat salad greens?
Yes. Have a Cobb salad for lunch today.
*** woooHOOOOOO! ***
So it was straight to Whole Foods from her office! Got a package of crunchy tempura sushi and a box of mâche for lunch. Have been afraid to eat sushi because of the seaweed wraps, and tempura and greens were verboten.
Also got a package of CARROTS (not allowed) and a bunch of RED CHARD (on sale on sale on sale!) and a cantaloupe and four juicy-looking peaches and some of those wonderful salty dried black olives (so bad for you!) and another head of garlic and some little green onions and a $4.99 bottle of wine. And some made-in-America chew toys for the dawgs.
Happy Dappy Day.
I figure at two pounds a week, it’ll take five weeks to lose the starch-and-ice-cream-induced avoirdupois.
Fortunately, the weather is cooling off enough that I can walk and bicycle during the day. So, in addition to getting back to the low-starch, low-sugar, low-salt fresh veggie and fruit diet, I figure I can walk an extra mile in the morning after the doggie-walk and then set the alarm to get off my duff in the afternoon and go for a three- or four-mile bike ride.
So with any luck at all, after about a month the fat will be gone and so will the GERD.
Happy Day indeed! I don’t know what a surgeon’s P.A. is, but I hope I never have to deal with one if they’re that ignorant. Or vicious.
This reminds me of what my G.P. and his nurse said when I was diagnosed with Type II Diabetes. Nearly everything they told me was wrong! The nurse was especially scary. I took a diabetes education class (recommended by my G.P.) and learned how and what I could eat. Thank Goodness!
A “P.A.” is a physician’s assistant. This is a relatively new type of health worker who takes up the slack for the doctor by talking to patients over the phone when they call in with problems or questions and by conducting follow-up conversations with them. And the like. A P.A. has a master’s degree in medical science. And they’re by and large very bright and capable people.
The thing is, NO doctor knows all that much about another doc’s specialty. GPs as a rule don’t have a specialist’s expertise & insight about any specific ailment: they know enough to know when to refer you (we hope…) to a specialist and when to tell you to take an aspirin and call back in the morning.
A surgeon knows how to do surgery. Does she know why to do it? Of course. Does she know the risks? Absolutely. Does she have a good feel for what’s likely to happen in the aftermath of surgery for a given condition? Yup. But she may not be a expert on the condition itself. She’s an expert on treating the condition with surgery, but very possibly not on the latest research about what causes the condition and how to treat it over the long run.
Vivat! Fresh fruits and veggies for the win!
It frightens me sometimes how ignorant some medical professionals can be about anything that falls outside their narrow specialization. (And sometimes, things that fall within it.)
Glad to hear you’re feeling so much better.
Wow, what a bunch of crap you’ve had to deal with. I have no idea how one deals with adhesions in the gut, but having been through some gastro issues myself I can relate. Two bouts of diverticulitis in 4 months really set back my own healthy eating and exercise schedule that was helping me lose weight. Like you, I was forced to eat “low residue” foods like white rice, noodles, and pasta, and to skip things like raw or high fiber veggies and fruits. I was miserable, and I gained back some of the weight I had lost. (Like you, I pack on the pounds when I eat a lot of starchy stuff.)
I went to see a gastroenterologist, too, to get his opinion and guidance on what I should do because of recurrences (I’ve actually had three bouts of diverticulitis now in two years). He said I may have more occurrences in the future and advised me to avoid seeds and nuts and to not take ibuprofen. Except, I can’t do either of those things. Ibuprofen is the only pain reliever that actually works for me on things like muscle aches and pains, and while I don’t take it a lot, there are times when I do need to take it several times over the course of a day or two. As for seeds and nuts, those are considered high fiber foods which are actually *good* to keep diverticulitis away (once one is fully healed and able to eat high fiber again), and that advice is also decades old and pretty much outdated. I saw the gynecologist this week and in my general health update I told her about these recommendations and she agreed, especially on that point about nuts and seeds. (I love this gyno; she is so great as a doctor in general and I wish I could have her as my general doc.)
So I’m enjoying my high fiber diet again and eating lots of veggies (both raw and cooked), fruit, and lots of nuts and seeds. I make a smoothie nearly every day with fruit, fiber, some Bio-K probiotic (’cause I’m trying to get my gut flora back after taking heavy duty antibiotics for so long), and a special mix my guy made up that includes flax and chia seeds, among other things. As long as get the fiber and probiotic in my system every day, everything seems to work OK. Now if I can just stay consistent with my exercise routine I should be able to start dropping weight again. 🙂
Yah…I hear you!! Part of the problem with doctors’ advice is that the science keeps zig-zagging back and forth. Remember when we were all told to eat margarine, not butter? My mother took us off butter and served up icky-tasting corn-oil margarine — which was the least icky-tasting of the bunch. All hydrogenated fat…now said to be desperately bad for you. One day it’s this, the next day it’s the exact opposite.
Where food is concerned, I think as a general rule you should eat what you like and quit worrying about what experts say.
But then there are the special rules… When one has a specific condition that causes pain, discomfort, illness and even possible risk to life, one pretty much has to at least LISTEN to the quacks. But here, too: contradictory advice! I incline to believe an experienced gastroenterologist more than a surgeon’s PA, so I’m buying what the gastro doc said…not just because I like what she says better but because I think she probably is better informed. I hope.
Man-o-man, the starchy stuff REALLY packs on the pounds. That’s why my DIY diet dumped the pasta and the potatoes as well as the sugar & the unnecessary salt…and it worked. Not working as well now because I’m not getting exercise…simply am too overloaded with work to take an hour or two off, plus it’s been too darned hot to move. But at least now that the healthier food is back, I feel a LOT better and I’m not actively gaining weight anymore.
Always get a second opinion! (And after that, some fresh raspberries.)