Year One!

One year without a stomach! First thought this morning was I wouldn’t be here without the support of friends and family. Every visit, voice, text, thought and prayer helped me get here. I am also grateful for the doctors, nurses, assistants, and staff that were there to help me through the worst of it. I have thought of them often this past year. When I started getting out of bed and walking the floor, I had a nurse who did not like to see me walk alone and would join me. At first I thought it was because I was listed as a “fall risk”. Later in the week, when she was no longer assigned to my care, she would see me walking and join me. It was just her nature. I had another nurse from the neurology floor. She was moved to the surgical floor because they were short handed and the supplies in my room and on the floor were arranged differently. She probably worked the hardest to make sure I was comfortable and laughed with me when things did not go as planned. The certified nurse assistant had to wake me several times a day to take my vitals, and made me laugh every day. I think about the 7 roommates I had during my 10 day stay and hope they are well. Most of them were not surgical patients. They cycled through my room while waiting for a bed to open on another floor. The first was admitted around 3:00 AM the morning after my surgery. I woke when they turned on all the lights to prepare his bed. The staff did not realize I was in the room. The patient was hard of hearing so I got his whole history as the doctors shouted at him. (There was no HIPPA in my room.) His wife was bringing his hearing aids in the morning. I asked about all his coughing and was assured he was not infectious. Turns out they moved him the next day because he was infectious! Initially, I was amazed by the patient who had surgery for pancreatic cancer. He was up and about working his insurance business on the phone the next day. Turns out the secret to all his energy was his hypertension. He was not being released until his blood pressure was under control and once they brought it down is energy and working disappeared. The patient who kept asking to be discharged because he had nurses visiting his house everyday to take care of him told me I should also ask to be discharged and get some home nurses. One of my favorites was the guy who came to the ER because his foot was infected. It was still healing from a severe burn (down to the bone) that occurred 4 months earlier. It wasn’t his first infection. He was telling the doctors that their treatment plan had not worked in the past and he was pleading for what he was sure would. He asked for specific antibiotics and wrapped his own wound. The doctors were trying to get in touch with the person treated him previously to confirm what he was saying. That guy should teach others how to advocate for themselves. I hope they are all doing well. To all who visited the hospital and visited me home, thank you! The only visit that concerned me was from a co-worker who told me stories and had me laughing so hard, I thought I might tear a suture. I am also lucky to work with many amazing students. They reached out to offer support and encouragement. I was gifted many protein bars, some good, some bad, all appreciated. To everyone who has been part of my life this past year, I cannot adequately express how grateful I am. THANK YOU!

I do not focus on the negative experiences, but it is important not to forget. I have described previously most of the challenges in detail and will not recap them today. While one year later, I have no complaints, it was a long year. Hours and days went by slowly. For the most part, my pain was managed well. The earliest days and weeks were not easy. There were plenty of struggles and I missed the time lines I set for most of my recovery goals. The good news is that I got here. It is important for those who will go through a similar experience to understand that recovery and learning a new life style will be challenging. Patience and perseverance are the key.

What is life like one year later? My morning routine does not vary much. I take a probiotic and multivitamin every morning. I take a liquid B-12 supplement under my tongue to prevent anemia. Five hundred milligram calcium supplement 3 times a day because my risk for osteoporosis is now around 40%. I have an ensure high protein shake for breakfast and a protein bar later. The focus on protein is to try and maintain muscle mass and some of my strength. Occasionally, I will cook some eggs, maybe a slice of bacon or sausage. Pancakes are out. Even without syrup, a single pancake can cause hypoglycemia, so unless I want to take a nap after breakfast I avoid them. I still have trouble drinking straight water. It leaves a heavy feeling in my abdomen. Like I just drank a large, thick milkshake. I often add various flavors of crystal light to my water. I stopped drinking coffee a few months before surgery and have not gone back. Crystal light adds caffeine to some of their powders so I still have that option to help on those rough mornings. RXBars are my go to protein bar. I can manage foods with less than 20 grams of protein. Anything higher in protein makes me nauseous. I often graze on something during my drive to work, peanut butter crackers or nuts. At work I teach in a 3 hour lab that is scheduled 2 or 3 days a week. Early on when I was still loosing weight, that was a long time to go without eating. It is not the hunger, I still have none, I can go days without eating. It boils down to how much I can eat in a day and trying to get enough calories to keep my weight stable. I usually eat to fulfill whatever craving I have for lunch. Often lunch is finished a few hours later as an afternoon snack. Dinners are similar. I have a few favorites because I know what is easy on my digestive system. I do not have trouble with chicken or ground beef. The family benefits when I crave steak because fillets are the easiest on my digestion. Steamed vegetables are good, but I do have occasional cravings for raw vegetables. Mashed potatoes and apple sauce are comfort foods. I usually pass on dessert. When I crave sugar, my limit is one cookie. Try to have another snack after dinner. Eating has become a routine. For the most part, I eat all the time which would mask any hunger I might have if that part of my physiology has changed. One of the more popular questions I get asked is, can I drink alcohol? The answer is “yes”. While I do not drink often, when I want to join the adults around me, I know beer makes me uncomfortable. Wine and other options are okay. Without a stomach, my intestines absorb alcohol quickly. I try to stick to one or even a half a glass of wine. On one occasion I had 2 glasses of wine which lowered my inhibitions. No, you do not get a story of me falling down drunk. You get the uninhibited consumption of cookies which I paid for later. How many people do you know who have to watch how much they drink because it might lead to eating sugar? Many of my memories from this past year revolve around food. Some bad: like plugging the first time I ate out at a restaurant and learning how to throw up without a stomach; some good: Like how happy I felt to eat a single slice of Sam’s pizza with my mom in Wildwood eight weeks after surgery. My diet one year later is fairly normal. I need to focus on high protein and low sugar. I need small portions multiple times a day. For the most part, eating has become routine. It seems ironic that much of my life without a stomach centers around food.

At 157 lbs my BMI is about 22 which is in the normal range. I know most people would be happier to see a skinnier version of themselves in the mirror, but it took me time to realize that the slighter version of me is healthy. I remember how a walk around the nurses station would tire me out and lead to the need for a nap. At home, I started with a walks in the yard or to the end of the block which also required a nap afterwards. During this “stay at home” period, most days I walk about 4 miles for exercise. The muscle mass I lost has made me weaker. I walk slower. This was most noticeable during college tours with Kiley. I was often lagging behind the group as we walked campuses. Kiley would drift back to keep me company and managed to make me laugh about it. Basic tasks around the house also remind me that I am weaker. Weight lifting is part of my exercise to maintain strength and bone mass. I go to the gym at work with colleagues. Be warned. If you join us and are not working hard enough, you will be accused of lifting “Mike weight”. I tried going back to training karate around 12 weeks into recovery. After about one month of training, I took another 8 weeks off. I could manage getting through a class but was exhausted and was losing more weight from the calories burned. Eventually, I realized that I could not put weight back on when I was not training and accepted going back to the dojo and a few less pounds. I had not thought about or planned for the change that 40 lbs would make training karate. Karate is not about strength so that should not be an issue. Being noticeably weaker meant I needed to work more on speed and focus, which were not that good to begin with. I also learned at my center of gravity has changed. Suddenly, I find myself off balance from turns and moves I have done hundreds of times. All is good because those who instruct and train with me have always been part of my support and I will continue to “seek perfection of character”. My original goal was to get myself back to where I was prior to surgery. I am not sure that goal is something I will ever achieve. For now, the new goal is to keep improving and be the best I can be.

There are so many things to reflect on from this past year, so many things to be grateful for, so many people to thank. That list will grow as I embrace Year Two!