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Health, Post Surgery Update

Content Warning: Lots of talk about Poop and Puke.

Image from MedicalXpress article on gut bacteria.

After nearly three weeks of doing fantastic post-surgery, meeting or exceeding all my healing benchmarks… this week happened.

Some background:

In my twenties, I was lactose intolerant. I did the Lactaid and other digestive thing for a while, then did a full cut for a short period, introducing milk products back very slowly over time. It worked and since then, I’ve been able to eat milk products in moderation—including ice-cream—without any digestive issues. In fact, I found, the whole fat had less impact on me than lower fat options.

Also, my stomach has never gotten along with most artificial sweeteners, but being an at-home cook and generally preferring less-processed type foods, that hasn’t come up much with this exception: If I ever got constipated (not a common thing till perimenopause hit), I could go to Starbucks and get a skinny iced latte of some sort. Problem solved usually within the hour. Small doses didn’t bother me… like a single packet in an iced coffee or tea (as they dissolve more readily than sugar), but more than that… Hello, toilet.

Back to the current post-gastric-surgery life.

After gastric surgery, a person is on a strict, limited diet of high protein and little-to-no carbs or sugars.

And liquid for the first two or three weeks.

So, one must live on a lot of protein shakes with artificial sweeteners. Some milk-based. And broth or “strained cream soups.”

Fortunately, my husband made me a lot of bone broth, which is delicious and high protein. And while I do like many sweet things, I have gotten away from a lot of sweet over the years in my weight loss / attempts at hormone and brain chemical balancing journey. So I was splitting my required intake of liquids and protein with soups and the shakes and food / water additives.

Also, for the majority of post-gastric-surgery patients, constipation is a major concern. In fact, in our orientation preparation meetings, it came up almost as much as unplanned pregnancies (another big thing, albeit with even more significant life changes).

I had absolutely no problem with constipation. I was going easily the day I got home. In this case, artificial sweeteners FTW!  (I hadn’t even begun any dairy yet!)

The second week passed easily, except for the fact this ADHD foodie was BORED, BORED, BORED, BORED with the limited tastes and textures. And, in case you don’t know this about ADHD brains, boredom ticks off all the same chemical triggers as a dangerous situation. The hubby did his best by making me different homemade vegetable juices as were allowed on the diet, which changed some of the flavors, but it was still torture. I was mixing and matching all sorts of stuff to alleviate the dread of boring food. When the doc gave me permission to move forward to the next stage of soft foods, it came as physical relief.

The next stage of soft foods: yogurt, cottage cheese, ricotta cheese. All dairy. All low fat. Even the Greek yogurt, which was already naturally lower carb.

I was not thinking of my past food issues; I was just happy I got some change in texture and flavor.

Half a week into this phase, I was getting bored again. For anyone who’s eaten Wooldridge cooking, you absolutely understand why. We cook with flavor, texture, appearance, and diversity on the plate.

So I started mixing and matching… and my portions were going up, which was good and expected.

Then came last Friday… I started off with a little too much coffee in the morning, or so I thought, and that set me off. I had some soup and felt better. But then I had a phone appointment and would be traveling, so… Every. Other. Meal. was portable, which meant it included artificial sweeteners and / or some amount of dairy.

Yyyeeeeeeeaaaaahhhhh…

That was a bad idea.

To explain more of the science behind what was to come of all these things added up, here’s a little bit more information about gut flora. This article is more medical, as is this one, and this one is more in laymen’s terms.

In shorter blog explanation: Food sensitivities, intolerances, and allergies—as well as non-food based food allergies—are both affected by and affect the gut flora / gut biome. Long, continued exposure to the allergens or cause of sensitivity / intolerance decrease the “good”* bacteria in the gut. At all times, our body has a mix of healthy/positive/ “good” bacteria and “bad”* bacteria that, if unchecked, can bloom and make us unhealthy. Much like the Force, there needs to be a balance between the two.

Me consuming a lot of artificial sweeteners and then throwing a lot of lowfat dairy on top of that upset that balance. So the “bad” bacteria bloomed and settled in my lower GI track.

And made my life utterly miserable.

I wasn’t keeping in food or water, the two big things necessary post-surgery.  I managed to control the symptoms through two pre-recorded panels for DragonCon, but after that my body was like, “yeah, we’re done.” 

I didn’t want to go to the ER, so I tried as many of my go-to remedies as possible for if I eat bad food or if I’ve got some gastro-intestinal infection. They worked in a limited way. Adding pediatric electrolytes (with REAL sugar) in limited quantities to my water helped me keep the water in. But too much would set me off. And while I could usually keep broth in, even high-protein bone broth wasn’t enough to get me to the protein levels I needed. (60 grams a day.)  I was doing better for a while, but thank goodness a friend told me to still check in with the sugeon, which I’m glad I did then as I ended up on the phone with the surgeon’s office every other day this week….

Shortly after my first call with the surgeon’s team, I got worse and was back to barely keeping water in. But I wasn’t throwing up, so I had hope it would pass.

Well, that changed too, and I was back on the phone and got myself an appointment to give a stool sample. I’ll spare you the details.

In short, the sample confirmed an infection, so antibiotics it was.

If you remember from the last post about my journey toward this surgery, I mentioned the issue of antibiotics and the gut biome… so I was less than thrilled I had to resort to them, but I was in agony. The pain was as bad as when I was in the ER for the kidney infection while I also had the massive fibroid. Only, instead of grinding and pounding, this pain is roiling and feels like being stabbed below the belly button with giant knitting needles. I was spending long swaths of time literally sitting, rocking, and groaning in pain. Unable to do anything else.

When the nurse practitioner warned me that the first antibiotic they’d try was “not readily tolerated by many people,” I quickly learned that was code for “will be the most vile thing you’ve ever let cross your tongue.” Metallic, sour, and bitter, it was all the all the flavor sensations that make a person pucker and gag.

Puckering and gagging is not exactly what someone who’s already trying not to puke needs.

I made it through the first day, then had the Worst Night of all the symptoms. Come morning, I couldn’t finish anything and when I finally tried to take the antibiotic again, my body was like: “Oh. Fuck. No.” And, after a valiant attempt of meditation and deep breathing to fight the urge, I puked up that chalky, disgusting tablet within ten minutes.

I called my surgeon’s office back and got a new antibiotic. Pill one has been consumed and kept in, as has two cooked shrimp.

I keep reminding myself that I did get a fair amount done, and the week wasn’t totally lost: I did my DragonCon panels; I finalized the single document of Wicked Women for layout; I got invited to and submitted to an anthology; I got invited to and filled out the form to mentor on the Writer’s Track for DragonCon; and I wrote some words on my novel.

But the feeling of having lost a week in healing, the feeling of being helpless to the point of asking the Husband-of-Awesome to work from home / drive me places / do stuff I normally do, the still sick and pained feelings—those are still there. And I need to be compassionate to myself about that.

Let it be said, though, The Husband-of-Awesome has WELL earned his title for the next twenty years of marriage!

As an additional note, I have not told a lot of people how sick I’ve been. I always have a hard time doing that, especially if I don’t want to worry folks. But I’ve probably ghosted a few people or not responded because I’ve simply not had the energy. One of my good friends was talking about her daughter blaming herself when a friend ghosted her…and I know I and many of my other friends on the neurodiverse spectrum have those same worries. “What did I do? Did I accidentally hurt someone’s feelings without knowing? Are they mad at me?”

This is very much part of the issue the late, great Robin Williams spoke of when he said, “Every person you meet is fighting a battle you know nothing about. Be kind. Always.”

Be kind to others; be kind to yourselves.

Now to go, rest, and continue to heal.

* Bacteria are simple organisms without the concepts of “good” or “bad.” We classify them as such based on how they make us feel / affect our health. As cute as I can imagine the illustration, there’s no bacterium swimming around a stomach with a twirly mustache going “Mwahahaha! Ultimate pain is my ultimate goal!”

** Also, this is not the place to make a stand against artificial sweeteners or dairy products. Neither are inherently bad or good either, and I know plenty of people for whom those products have been boons to their health. Every body has a different set of needs.

Where I’ve been, What I’ve Been Through, and More Surgery

So, yeah, it’s “been a minute” (to borrow a Southern phrase I learned in said “minute”) since my last blog post. Sorry. But this one is the whole explanation why!

Back in 2017, I shared this post about surgery I had to have because of a big ole fibroid making my life super, extra, mega miserable. That’ll give you a few more background details.

Where to start…

On Monday, August 3, I went in for a vertical sleeve gastrectomy (VSG). I wanted a hysterectomy due to all the hormonal awfulness, bleeding, and other crap that had been plaguing me for… almost 30 years. My OB-GYN said no; I was too obese.

Needless to say, I was pissed.

You see, and pretty much every fat person you or I know will back me up with similar experiences, I have a bunch of other medical issues—particularly hormone related, but also ADHD—that have been causing the obesity. Yet the doctors have been treating my fatness as a cause for the issues. One of the biggest symptoms of estrogen imbalance? WEIGHT GAIN AND OBESITY.  But no, “If you just lose weight, it will fix itself.”

Those of you with more delicate sensitivities, ignore the next line.

Fuck that fucking bullshit fuckery!

Losing weight is not a means to fix existing hormone imbalances or neuroatypical issues. The weight is there because of those issues! If the issues don’t get addressed, you know what? YOU WON’T LOSE WEIGHT!

Unfortunately, added weight also exacerbates the issues.

So you get this fan-fucking-tastic cycle of a flare-up of issues causing weight gain, weight gain increasing flare-ups / symptoms, flare-ups / worse symptoms causing more weight gain.

And then there’s outside issues that exacerbate that—like stress.

Of course, having ADHD and bleeding heavily every month also increase stress…

You see where this is going, right?

So, why did I not go find a second or third opinion and a surgeon who’d do the hysterectomy anyway, which had a good chance of helping with the weight loss?

A few reasons…

1. Quite simply, I was exhausted. I was exhausted from fighting with medical professionals, I was exhausted trying to argue about yet another weight thing, and I was exhausted from all my symptoms. (Pain, hot/cold flashes, bleeding, brain fog, forgetfulness, fatigue, anxiety, depression, rage…)

2.  My OB-GYN is actually a good doctor and the conversation didn’t stop at being too obese for a hysterectomy. She gave me a bunch of resources and research on how the VSG also affects hormones and a variety of other things.  Here’s one, and another.

3.  I have a fantastic psychologist for my ADHD who I was referred to for weight loss. She is also a wealth of information and will even pull up academic and medical journal articles for me from her JSTOR account!  She also empathized with my frustrations and helped me work through those too. On top of that, she (and my also-fantastic integrative doctor my PCP referred me to) introduced me to the studies about gut flora and how that affects obesity, and how the VSG also does the equivalent of a hard reset on gut flora.  (More on that shortly!)

4.  I have some amazing and supportive friends who have also had gastric surgery who helped me through the anger and societally-programmed guilt of needing surgery for weight issues. Who also have access to lots of research and information on top of their personal experience.

So here’s another fun Trish fact that most people don’t know (I swear this is related!): When I was a baby, I nearly died of salmonella shortly after birth, so my system was flushed with a massive broad spectrum antibiotic. And then I spent a fair amount of my childhood sick, getting prescribed antibiotics, and getting fat. Part of the illness was undiagnosed allergies and asthma… and as I got older, got my first period, I got a lot of UTIs… leading me to need the Kill All The Things antibiotics whenever I got sick because your regular run-of-the-mills wouldn’t work… and I was allergic to penicillin.

Now… y’know what they do to animals to make sure they’re fat and have a high fat content throughout their muscles?

The pump them full of broad spectrum antibiotics from a few days after they’re born and onward!

You see, lots of antibiotics change the gut biome, causing obesity. And once that’s done while it’s all developing… there’s little chance of not being fat. Because it ruins a person’s (or animal’s) gut flora! (I told you’d I’d get back to this!)

Now, let me clarify something, and pay close attention:

Antibiotics! Are! Not! Evil!

Antibiotics have saved billions of lives and the world would be worse off without them. This is not going to be a rant against Big Pharma and antibiotics. (Maybe I’ll rant about Big Pharma later… but my Adderall is still working!) Had Baby Trish not gotten a big ole thing of broad spectrum antibiotics in 1978, 42-year-old Trish would not be writing this now. However, in the 70s, there wasn’t the finesse in antibiotics that there is now. Also, it was kind of a thing in the 70s, 80s, and into the 90s to prescribe antibiotics to fix everything.

And because I’m a research kind of nerd, here’s an article about early-antibiotic use and obesity, and here’s an article on antibiotics in meats and their effect on animals (and potentially humans, but that’s also not within the scope of this post.)

Over-prescription of antibiotics is a problem. But also not the main point of this post.

The main point is this:

Due to a not-uncommon mix of medical problems, many exacerbated by medical professionals treating weight like a cause rather than a symptom, three of my doctors suggested I had a three or less percent chance of losing weight on my own—if I made losing weight my full time job!

Once again, for those in the back who equate obesity with stupidity, laziness, lack of trying, a character flaw, etc:

If I made losing weight my FULL TIME JOB, I had a less than three percent (3%) chance of losing weight.

So I decided to go with the sleeve gastrectomy. All the research I’d done showed that it held significant promise to fix a lot of my ongoing issues by resetting both my hormones and gut flora. (Hysterectomy would only affect my hormones… but it’s not off the table if this doesn’t fix the hormone issues!)

I didn’t say much of anything to anyone about it because the surgery carries a stigma. “Why can’t you just lose weight on your own?” (See above research.) “Couldn’t you just try harder?” (See above research.) “Just don’t eat so many donuts!” (I had had exactly two donuts in two years prior to two days before my surgery), thank you very much! Also, see above research.) “Maybe drink fewer sugary beverages?” (I drink water, coffee, and tea… and often the coffee is with little to no sugar, as is the tea. Also, research!) “Are you sure you want to do that to your body?” (My body is doing way worse to me. Also RESEARCH!)

It’s exhausting. If you aren’t fat, you have no idea how exhausting it is already to have to deal with people ranging from wanting to be (ignorantly) helpful with (uninformed) good intentions to full-blown raging, shit-spewing assholes.

/sarcasm/ No, I’ve never tried to lose weight by adjusting my food intake, watching calories, exercising more, trying A-Z diet… Not once has it crossed my mind. Thank goodness you suggested that; you may have changed my life. /sarcasm/

Every. Damned. Day.

It was just easier to not talk about it. It was easier to just tell my family and friends who I knew would be the good kind of supportive. (As opposed to the thinking-they’re-supportive-but-actually-fat-shaming.) As I mentioned above, I was already exhausted from the symptoms of all this. I just couldn’t fathom dealing with having to talk to a bunch of non-medical persons who have no idea of my health history questioning my decision. And that exhaustion, as you all might expect, has just been ramped up to all new heights since it struck 2020!

So, I decided this, for sure, right after DragonCon last year, after chatting with one of those aforementioned fantastic friends. And thus began my odyssey of going through my hospital’s Weight Center. For the second time.  As I tried the non-surgical program back in 2012 and managed to lose 20 lbs in a year, which outside of college, had been the most I’d lost in the shortest time ever. Until I was diagnosed with ADHD, and then getting the right prescription of Adderall and getting some cognitive behavioral therapy that matched how my brain worked had me lose 25 pounds in 6 months! (See how actually treating the cause makes a fucking difference?)

Going through the program again was frustrating… I already knew how to and was tracking my food, my food triggers. I already ate 80% of my food home-cooked, mostly from scratch, with higher ratios of healthy proteins, vegetables, and fruits as opposed to processed carbs. I already averaged between 6k-10k steps a day. I had a horse and worked out with her. I spent a lot of time outside doing work. I could hike for hours. I parked in the furthest spots so long as it was safe to do so and/or I wasn’t running terribly late (the lateness being an issue that has also, in fact, decreased since the ADHD diagnosis and treatment!) I was sharing tricks about awesome things you could do with zucchini and avocado that the nutritionists hadn’t heard of; I was giving homemade salad dressing recipes that impressed the nutritionists; and I expounded on the virtues and inclusion of fermented foods and easy home ferments.

I had done this alllllllll before… but I went through it again. It wasn’t until we got into the post-surgery diet that I really started having to learn stuff, and thus my ADHD brain was sated with an onslaught of new information.

In any case, as this is getting to be a very long blog post, I went through the program…had the surgery put on hold due to COVID-19 chaos…was getting worried as Scott does have another stint of extended work travel coming up sometime…

And then finally got offered the August 3, date… with two weeks’ notice, since they did actually listen to my concerns on timing and offered me someone else’s cancellation date.

Lemmetellya… prepping for all that, rearranging my editing and writing schedule and deadlines, making sure I had the time off to heal, making sure Scott could get the time off…that was an adventure and a half.

But it happened!  And it went well!

So now I’m here on my liquid diet for the next two weeks, then a very, very slow introduction to regular foods… and I am hoping so hard that this does fix all the other (medical and health) things that are wrong with me!

All the other things that should’ve been fixed if medical professionals had listened to me and dealt with my issues (torturous periods, in particular) instead of either gaslighting me by saying “it’s normal; you’re overreacting” or assuming my fatness was a cause rather than a symptom. 

It still pisses me off that I had to have weight surgery because weight treated like a cause rather than a symptom.

I still want to scream, “IF YOU JUST LISTENED TO ME AND DIDN’T JUST SAY ‘IF YOU JUST LOST SOME WEIGHT’…”

But retroactive fury doesn’t fix anything for me. Maybe it will for others.

Keep fighting. Do your research. If you’ve got kids who get periods, treat them seriously. Don’t treat menstruation like a taboo topic. Believe them if they say they are in a lot of pain, if they think they are bleeding too much.  Be their advocates! Teach them to know their bodies and advocate for their health.

Unless more and more people start doing this, it will continue to be a problem. My mom taught me to be a good advocate; she went into every doctor’s appointment with a list and didn’t leave until every question was answered. I continue that habit. Still, it happened to me. Unless more people accept that “being fat” can be a symptom, not necessarily a cause, people with any extra weight are going to get substandard health care. Start changing that with your kids now. Start changing that with yourself now.

It will cut down on a lot of people’s suffering.

Until I manage to post again… be good to each other! ❤

Surgery Prep

It’s been over a year since my last blog post that was part of #HoldOntoTheLight…

This one probably could be too, but I just want to get it out there because I’m going into surgery tomorrow and I’ve been procrastinating on writing it for a while.

The surgery is fairly minor, though I do get anesthesia.

The short, less-icky version:

I’ve got a good-sized fibroid in my uterus that’s also on my cervix that’s been making my life miserable for a while now. They’re going to remove it via hysteriscopic surgery (i.e. no incision, using my own openings). And then they’re going to put in a IUD that’s supposed to help out with the other misery-causing issues that led to the fibroid being there in the first place.

Most urgent information… I’m going to be mostly offline / resting for the next week. I expect the procedure to be fairly easy.

The long and icky version of this is part of an ongoing medical condition that I only had doctors take seriously in 2014, though it has likely been an issue since I started having periods.

Yes, we’re getting into periods. Turn back if you’re scared; here there be woman dragons.

(I say that dripping with sarcasm, because I think everyone really ought to be educated about how half our population’s bodies work… and because I think this “ew” factor and ignorance that comes up with women’s health is a part of why I suffered as I have for over 20 some odd years…)

It took me having to go to the ER and nearly getting admitted due to a kidney infection that developed due to a bladder infection due to a uterine track infection that I neglected symptoms to because I couldn’t differentiate them from the symptoms I was already suffering due to a 6-week long period.

Short version of THAT: About six months’ worth of tests from a specialist OB-GYN and a urinary gynecologist, and I learn I produce too much estrogen, likely have produced too much estrogen my whole adolescent and adult life, because of that likely couldn’t have kids if I wanted, oh and my uterus is actually tilted and twisted (also affecting the “kid breeding potential”) and THAT contributed to my life-long war with my bladder that has led me to more embarrassment and pain than I want to get into with this blog post.

Yeah. All that.

After a few failed procedures (posted on FB and maybe I’ll do a blog post on them later… it’s almost time for The Walking Dead)… my OB-GYN gave me an arm implant that was supposed to even out my hormones and potentially make my periods go a way for almost three blessed years!

Less than a year and a half after said implant… I’m bleeding again. I was bleeding and in pain at…

Every. Single. Convention. I attended in 2017. All of them. Every month.

And it was going from five days to six days, to seven days…

And the time between periods was getting less and less and less…

It wasn’t until I spent more than half of Necon in July in my hotel room, in bed, puking and bleeding and exhausted, that I demanded another appointment with the OB-GYN.

I then had to go home and record three more months of my cycles for something to be done. (Despite the fact I had very clearly recorded the prior six months in red marker on my calendar for her to see already.)

I cheated and called her in two and a half months because I was on my third bleeding cycle. It fucked with my DragonCon.

More tests, more visits, and A REASON!

I had a fibroid.  A big one. Oh, and it was also on top of my cervix.

If you didn’t follow the link above for what a fibroid is, here is another one to the Mayo Clinic. I include that one because it has a handy list of symptoms, which I’ll copy here:

  • Heavy menstrual bleeding
  • Menstrual periods lasting more than a week
  • Pelvic pressure or pain
  • Frequent urination
  • Difficulty emptying the bladder
  • Constipation
  • Backache or leg pains

I have Every. Single. One. Oh, and also anemia. I need to sleep all the time, and I have no energy. Everything, everything I do and have been doing takes two to three times the effort.

So, add in depression, feeling like a failure, and all the emotional baggage that goes with that.

Thing is, I get most of those symptoms with my messed-up estrogen and twisty-tilty uterus anyway…  This fibroid was just exacerbating a regular level of misery I live with each month. Hopefully, this IUD will help with the hormones.

But seeing as the arm implant failed after a little over a year, I’m not all that hopeful.  I’m just glad to get the fibroid that’s making things worse out…

What I want is a full hysterectomy. Kids aren’t in the planning, and there’s always adoption and fostering if we do change our minds.  I have no need for these parts.

But I got a hard “no” on that from the doc. That’s its own blog post.

I plan on returning to blogging. I’ll talk about that as things continue.

But, for now, I’m going into surgery.

And I have a medical affirmation for at least part of my suffering, for many of the failures I’ve felt over the past year, for not being as productive and being more “flaky,” for the exhaustion and the anger and uncontrolled emotions, for the pain…

Having a name for it, having a cause does matter. Having a plan and having power over it… that’s in progress.

 

For now, I will take well wishes, hope, prayers, and whatever anyone wants to send.