Gastric Sleeve Surgery as Experienced by a Nurse

Generally speaking, I consider myself a model patient. Not every nurse is, but I am an exception. Except for the fact that I never ask for help when I get out of bed after surgery. I don't take my pain meds and complain about the taste of the meds I do take. Then there's the jello. Why is it always green? I hate green jello... OK. I'm not the sweetest patient in the world.

I started off pretty well. On the day of my surgery I arrived at the hospital only slightly late. I'd fasted and done what I was told; no jewelry or other valuables were with me. I'd gone to all of my pre-op classes and learned nothing new about getting up with abdominal incisions, coughing and deep breathing, or ambulation and position changes. I already knew all that stuff. I was ready.

Hospital gown; otherwise I was naked. Immediately I felt vulnerable. My bravado wavered. I was on home turf, though. This was the hospital I worked in. Every face was familiar. Friends began popping their heads in through the door to see me where I reclined on the gurney; cheerful hellos and wishes for luck, then reassurances that I wouldn't need luck, I'd be fine. I'd hand picked my anesthesia team; a privilege of working within an OR environment. An IV was inserted and my CRNA gave me "something nice" through it. After that, I remember nothing, but I'm told I held a pleasant conversation with my team before I became unconscious.

Groggy. Pain. PAIN... it wasn't where I expected it to be. 80% of my stomach had been removed laparoscopically. There were five small incisions on my belly, held together with staples and covered by bandaids. But this was in my chest. I couldn't breathe. My nurse was beside me in a moment. Pain meds, blood tests, EKG were done. I wandered in and out of consciousness. The pain improved. My anesthesiologist explained that I would have a sore throat of some sort, and we came to the conclusion that the pain was in my esophagus. It had been stretched and was possibly in spasm. My anxiety lessened, and with it the pain lessened too.

I spent several hours in PACU. I have sleep apnea, and all patients with apnea are kept for about three hours. I didn't mind. I'm what they called a "lightweight" or a "cheap date". One small dose of pain med and I was out for the count. My caregivers told me I continued to be pleasant, and told no deep, dark secrets. I still can't help but wonder if that was true or not.

At last they found me a room on a floor with telemetry monitoring. Again, this is a precaution for sleep apnea patients. I had a PCA pump, a system by which I could administer up to ten milligrams of morphine to myself over the course of an hour should I need it. Just one milligram and I slept until the pain woke me up again. Or the nurses did. Vital signs every two hours, antibiotics, and they replaced my low potassium level with an IV solution. Fortunately I had a Foley catheter, so I wasn't up to the bathroom constantly.

Time began to blur. I remember getting up to go for a walk. This is entirely necessary to improve circulation and breathing post op for any procedure. A nurse came in to let me know it was time to get up. I swung my legs over the side of the bed and pushed myself up, just as a second nurse came in with a walker. "That won't be necessary," I said. Placing a hand on my IV pole I stood while my nurses flanked me, prepared to keep me safe should I get dizzy. It hurt, but I was fine. We did a lap around the unit, and I felt so much better. After that I'd get up and walk between naps. I took deep breaths and used my incentive spirometer, kept my compression boots on my legs while in bed, pointed and flexed my toes. Did everything I was supposed to. I wanted no complications.

In spite of all that it took an extra day before my stomach started to gurgle and I was allowed to drink or eat anything. The first thing I was allowed to sip was gastrografin, a thick substance that coated the inside of my new stomach so it would be visible by fluoroscopy. In order to fully display my stomach and make sure it wasn't leaking I had to take a large gulp. Now, I warned my technician that what went down would more than likely come up if I drank it fast. She was unyielding. I was fascinated by the images of the liquid outlining my little stomach. Until I threw up. But the gastrografin stayed down long enough to confirm that there were no leaks. I could start eating.

I wasn't hungry. Tiny sips of water had a strangely sweet taste, made my esophagus spasm, and sat like lead. Lime jello came next. As if I wasn't in enough pain... sheesh. Soon I had taken in enough liquids half teaspoon full at a time for them to remove the IV and catheter. There was no possibility of staying in bed too much without the catheter. Finally thick, milky liquids stayed down. It was time to go home.