I have three types of hernias--umbilical, incisional and epigastrica. The first two have ruptured. I'm hoping the third won't.
Things that a post op gastric bypass patient SHOULD NEVER DO: a) Eat any flour products of any kind. You WILL stretch your pouch. And if you have a lap band, ask yourself how many times do have to have that thing tightened; b) eat more than the recommended amounts of food that your surgeon and primary care physician advises for you. This is for the same reason listed in a); c)In fact, you should do everything your doctors tell you to do as if your butt's on fire and you're about to turn to cinders if you don't follow instructions; d) DO NOT, EVER IN THIS LIFE OR ANY OTHER, EAT GOMASIO AFTER ANY FORM OF WEIGHT LOSS SURGERY!
Why am I saying this? Well, first of all, many people don't know what gomasio is. Here's a formal definition from About.com's Macrobiotic Cooking section: Gomasio is sesame salt. It is made of toasted sesame seeds and sea salt, and is rich in calcium and iron. Sounds good and healthy, right? Something that a recovering food addict should have as a healthier alternative to salt, right? Yep. It is healthier, unless you have had Roux-en-Y gastric bypass surgery, which means that little pouch your surgeon made out of your stomach cannot process sesame seeds. In fact, sesame seeds tears very nasty holes in that little pouch, which is what happened to me last week. The funny thing is, the same thing happened to me around this time last year, too. It was for a different reason, but once you have an abdominal wall hernia, it's REALLY easy to have one of those holes open up in another spot. And that's what happened to me, which is what I realized as I lay in my hospital bed.
First of all, I had been breaking my abstinence, which means quite simply that I had been eating things that were NOT part of my food plan, AND I was eating amounts of food that were larger than what I had committed to my sponsor. So let's add up all the elements here--eating bread (a definite no-no for someone who's had weight loss surgery), pasta, cheese, cookies, trail mix, cashews, almonds, crackers, bagels, peanut butter, peanut butter-filled preztels, croissants...if I could have possibly lived on bread alone, I would have. Bread and cheese. That's all I wanted, all day long. I'm sure eating that stuff opened the hernia even more than the gomasio.
Here's Wikipedia's explanation of a hernia:
By far the most common hernias develop in the abdomen, when a weakness in the abdominal wall evolves into a localized hole, or "defect", through which adipose tissue, or abdominal organs covered with peritoneum, may protrude. Another common hernia involves the spinal discs and causes sciatica.
Hernias may or may not present either with pain at the site, a visible or palpable lump, or in some cases by more vague symptoms resulting from pressure on an organ which has become "stuck" in the hernia, sometimes leading to organ dysfunction. Fatty tissue usually enters a hernia first, but it may be followed by or accompanied by an organ.
Most of the time, hernias develop when pressure in the compartment of the residing organ is increased, and the boundary is weak or weakened.
* Weakening of containing membranes or muscles is usually congenital (which explains part of the tendency of hernias to run in families), and increases with age (for example, degeneration of the annulus fibrosus of the intervertebral disc), but it may be on the basis of other illnesses, such as Ehlers-Danlos syndrome or Marfan syndrome, stretching of muscles during pregnancy, losing weight in obese people, etc., or because of scars from previous surgery. (Angela's note: I had the last two conditions.)
Thank God I stayed away from doing a lot of sweets. I did some, but that dumping thing that happens to post op gastric bypass patients puts a damper on a "good" time. The splitting headaches, cold sweats, shaking, feeling faint--no thanks. Sweets, as weird as it seems considering my eating history, were things that I ate in moderation. (Hey, I said it's weird!) So,I did not go buck wild with the sweet stuff. Why not, you ask? Sensible question, considering that I was already messing myself up my weakened abdominal wall with all that pouch-swelling bread; why not go all the way? Why not spend a day at the Cheesecake Factory, or at Freeport Bakery, where they make some of Sacramento's most sumptuous pies, cookies, cakes and tarts? I have no logical answer for that one, except that in the deep recesses of my food addicted-brain, I acknowledged that what I was doing wasn't very wise, and that I was already risking another hernia rupture. The very nasty complications from eating too much sugar would have put me in my final resting place. I narrowly avoided it this time. God must have a plan for me, but I know I can't keep doing this to myself.
Now, here's the low down and dirty deal--I have been obese since age 9, morbidly obese since age 25. I'm now 51. All those years of dieting and gaining weight over and over again has stretched my abdominal wall to breaking point, or as my surgeon told me, "it has been severely compromised." I created the first hernia the night I had binged beyond human capacity, which I described here in an earlier blog.
So that umbilical cord hernia was sewn up; I went home and within months, forgot about it. Forgot that once the abdominal wall, that precious muscle tissue that keeps essential organs like the intestines, the colon, the bladder, becomes toilet paper thin after years of abusing food, there is a high risk of having another weak spot will break open. When that happens, those precious organs are displaced and sometimes burble out of that little hole in the wall. That event is known in medical circles as organ incarceration, or as I wrote in last years blog, "jailed guts". Last year, it was part of my large intestine that tried to escape through the hernia opening. This year it was a section of my colon. That was not good. Not good at all.
My surgeon, the calm, cool and collected Dr. Mortensen, informed me during our pre-op talk (actually, she did a lot more talking than I did because I was just a whisper away from shrieking in pain) that they would do some exploratory procedures first with two laproscopic cameras. If I wasn't hurting so badly, I would have geeked out and said, "Cool! Go for it!" Even now, I really think the idea of having tiny cameras inside of me taking pictures of my innards is pretty awesome.(Yes, I know I'm weird.)
"If we go in and find infection(in or around your colon), we may have to surgically remove part of it," she told me.
I didn't react to that at the time because the morphine was just beginning to kick in. But what I didn't realize was I could have been wheeled out of the operating room equipped with a brand-spanking new colostomy bag attached to me. Now, that right there is not cool. Exposing the world to the product of my elimination system is a very unflattering look, even for a fashion dud like me.
Luckily, that didn't happen. I was fitted with a synthetic mesh to keep the hernia from opening again, sewed and stapled up. I do have a drain attached at the incision site, though. That will be removed this Thursday at my follow-up appointment with the calm, cool and collected Dr. Mortensen. I have a third hernia, located much higher than the other two. It hasn't opened up yet, but the good doctor is obviously concerned that it might. We will talk about this when we meet again.
A week prior to this surgical event, I had a massive toothache. Turned out to be a very deep gum infection. I'm in need of a root canal, scheduled for May 4, 2009. And the wreckage of my addictive eating past just keeps piling up.
My problem is that I have underestimated the power of the dark side. Being a food addict means that if I'm not 100% diligent about working my recovery program, I will die way before I'm supposed to. Slow suicide, plain and simple. And I'm not ready to go, not like that. So I'm abstinent, today. And I have been since the surgery. Have I learned my lesson? I can't say. Look at what's happened to me in the course of a year. If nothing else, I've learned it doesn't matter that I very much dislike the way my food in this program tastes. I just have to endure it for one meal at a time so I can live one more day, and pray at night that I can wake up in the morning and do what I need to do to remain alive another day. That's what it is for me right now. And I refuse to think about it any other way. I'm not happy, joyous and free yet. But I'm alive, and still able to raise a little hell while I'm in this realm of existence. For today, that's enough.