Sunday, April 27, 2014

You want to put that where?

The first day that you wake up they bring you apple juice and a sports drink. After hearing about how small your pouch is supposed to be and the little amounts you are able to take I was very hesitant about drinking anything. Ally was only able to take a few sips because anything she ingested would make her very nauseous and then the night before we were to be taken back to the hotel she got even worse. She was throwing up constantly and there was nothing in her to throw up but she managed to find something. Once done with what little she had managed to drink up till then, there was stomach acid and bile along with other substances I was unwilling to try and identify.

As the hours wore on she continued to throw up anything and everything. She was constantly nauseous and in pain. The more time went on the less energy she had and the only thing she was able to focus on was me. Later she told me that her only goal was to get me home from Mexico before she “dropped dead”. At this point she was getting so weak I was worried she was going to end up with permanent damage. The nurses were no help at all just coming in and emptying our drains and getting her a new container to throw up in.

The next conversation had to take place thru the language barrier between us and the nurses. When I asked to see the doctor they just told us that they weren’t in and we would have to wait for the surgeon. They didn’t even have a definite time on when the surgeon would be in just that she would be there “in the late afternoon.”  Finally asking to see the doctor on call they told me that there was no one, I couldn’t believe that they wouldn’t have a doctor present at a hospital at all times.

While this was going on there was a man nearby who heard what was going on. He came in and after introducing himself (I think he said he was the head of the hospital’s board of directors but I am not positive) offered to help translate and find a solution. During the conversation with the nurses they said that there was nothing else that they could do for her except give her more anti-nausea medication. This had already been tried twice earlier and consisted of a very large needle injected into her butt. The look on her face when she saw the needle was priceless and only got better when they told her where it was going.

When he asked what we wanted them to do I said that we just needed her well enough to fly home. This confused him and he asked what that would accomplish. I said that I just needed her well enough for me to get her home where we would take her to a Canadian hospital. This seemed to light a fire under all of their asses. I guess that leaving Mexico sick to go to a hospital in Canada to get better wasn’t what they had in mind.

After he found a doctor they said that there was nothing they could do without putting the IV back in. Because she was unable to keep anything down an IV would be the only way to keep her hydrated and the most effective way to deliver needed medications. We agreed and it took them another four tries to get it situated, at one point they even tried to put it in her armpit, which is something they DO NOT do in Canada. They also didn’t want her to try and drink anything else for the next twenty-four hours.

It wasn’t a good night. She had to continually call the nurses to come empty her drain (which would fill at a rate of about four times for every one of mine) and get her an empty pan to throw up in. Twice she accidentally threw up on nurses during particularly violent episodes. To say we were exasperated by the time the surgeon showed up in the afternoon is an understatement. The Surgeon decided to send her for another scan to see if there were any leaks or blockages they hadn’t discovered before.

This time the Surgeon went with her to have the test and she started by going thru the same process as before, standing in the machine and drinking the contrast. It didn’t work like they wanted though and after a few minutes of maneuvering her around and trying to get the contrast to move they decided to send her back to the room to wait fifteen minutes. When she went back the second time the surgeon’s assistant was there and the contrast still had not moved.

After reviewing the results the doctor came back and said that there were no leaks but her tract was so swollen and inflamed that nothing was able to move on passed the pouch and so she was throwing up anything she ingested. To me this only made sense as far as what she was drinking, but where was all the extra stuff coming from? An extra night’s stay was ordered to keep an eye on her and she was told not to drink anything until he came back the next day. Until then he was going to order the anti-nausea medication be upped.

Having gone thru all of this and worrying that if she is still throwing up they might not let her on the plane we requested that they issues us both a “Safe to fly” letter. He said that he would talk to our coordinator and have it ready when we were discharged.

At this point with how well everything has been going I am skeptical, but we will see.

XOXO, Evie & Ally

Sunday, April 20, 2014

They Did What?

Sometime early in the morning they came for the stretcher, I summoned all the energy I could and in a series of movements scooted myself over onto my bed. I woke up and was in and out a few times during the night, not that I remember any of it. The nurses came in a couple times during the night to change our IV bags and give us medications thru the IV and empty our surgery drains. They give you a series of medications including a pain killer and an antibiotic.

For the first day after surgery I was on oxygen because my levels kept dropping. They have a clip on your finger that measures your oxygen level and mine kept dropping whenever I would move causing the machine to let out a loud continuous beeping sound. Although I wasn’t concerned because I never felt faint or out of breath, Ally nearly had a heart attack each time it happened so I just tried to stay as still as possible.

That first day after surgery they had to redo our IV’s because they had punctured the veins. Mine they got on the second try and Ally’s they had to do about four before they got it and by now her arms are so bruised she looks like a junky.

The Surgeon comes to see us and I am not happy with what they say. Ally had a hernia when she went in that we already knew about and discussed with our patient coordinator and noted in the paperwork along the way. She told them that she didn’t want it fixed because she didn’t have the money and in an email they told us no problem they would just leave it. This was obviously not discussed with the doctors themselves because when they came in after surgery to talk to us they told us that they had fixed it and we could settle with the patient liaison before we left. She acted like she had done Ally some huge favor by finding and fixing the hernia, then after we pointed out that we knew about it and hadn’t wanted it fixed she changed it to “it had to be fixed to do the surgery.” Ally and I just let the subject drop for right then and we would discuss it when we were alone later.

When they got to talking about me I was very worried with what they told me. They said that when they went in my liver was too big and they had to do a mini-gastric bypass instead of the original gastric bypass that I wanted. At the time they told me this I had no idea what a mini gastric bypass was and they just said that it’s the same thing just with less of the intestines bypassed. I was confused but at the time there was nothing I could do from my hospital bed. If there was the possibility of this happening I should have been told, after the hundreds of surgery’s they have done I can't have been the first one with this problem. Had I know that this could happen I would have asked them to do a sleeve should this situation arise.

Example of our Drain
A leak test is performed when you are finished with your surgery and still under anesthetic. How they managed to get mine in me is still a mystery to me as when I woke up Ally pointed out that there was blue stains on the side of my face and neck. The idea of the dye is that when you drink it if you have a leak it will leak into you abdominal cavity and then out into the drain they put in you. If there is blue in the bulb of the drain with the other fluid then you have a leak. When you wake up in your hospital room the first day they have you drink more blue dye to test it again. Ally still swears to this day that she saw blue dye in her drain, but when she pointed it out to the nurses they just shook it and said that no everything was normal.

After you are awake and mobile they perform anther leak test, this one involving contrast and a large piece of machinery. We were less than impressed when they did this test as they didn’t have us stand there long enough to have the contrast go all the way past the pouch. I stood in the arm of the machine less than one minute and that is counting the time that I was swallowing the nasty tasting liquid.

The next morning a nurse came in and told us to take a shower, when we asked if there was a shower chair she said that no there wasn’t one. For not only a hospital with surgery patients, but one that has overweight patients not to have a shower chair was unbelievable. When I tried to stand I had a huge knot on the right side of my back and hip, because of this I was unable to walk for more than a few steps and standing for long enough to take a shower was impossible. At this point I was wonder what they actually did to me when I was out that I am now unable to use my left arm because of pain in my shoulder and unable to walk because of pain in my back. Ally had a quick shower first and after managing to push a chair into the bathroom I managed to give myself a version of a sponge bath.

When my IV slipped for the second time I decided to just have them take it out and not put it back in. I was not in any pain from the surgery sites just from my arm and back and the pain medication was not helping with that. Ally had the same idea when hers slipped, and they began giving us our medications orally. We had been having some weird reactions, muscle twitches and hallucinations which we later attributed to the pain medication. I asked them to stop giving me the pain medications and actually had to insist on stopping when they were hesitant and told me that I wasn’t in pain because I was on the meds.

There were a few things missing in our room including a remote for the television and a call button for the nurses. Another patient that had surgery the same day as we did gave us her call button as she had her husband there for help and wasn’t having any problems. Unfortunately when you pressed the button it would call out the room number (loudly) at the nurse’s station, which led to a few mix ups until they all remembered that we had the button now.

Up next will be how things started to go wrong for Ally

 XOXO, Evie & Ally

Monday, April 7, 2014

Surgery!

The night before surgery we packed our bags and made sure we had everything ready for the next day. We were so worried that we would sleep in that we set an alarm on the iPod and the bed side clock, along with a wakeup call from the hotel. In the morning we got up and took our bags downstairs to the lobby to wait for Raul to show up. There was a woman we talked to who was going to be having surgery that same day we were.
 
It was a little confusing in the lobby because they had more than one driver showing up for people going with the different companies that use the hotel and hospital. The staff kept asking us who we were waiting for and trying to get us into the wrong cars. Eventually everyone was where they were supposed to be when the right van showed up. There were two or three other patients going with Ally and me, all of them were women.
 
When we got to the hospital we were met by one of the coordinators who escorted us to a room to wait to get blood work done. For a hospital that does a lot of weight loss surgeries I will say that the chairs need to be bigger. They called my name first to get my blood work done and things went downhill from there. Whenever I get blood drawn they have a really had time and if they don’t get it right away I tend to get faint.  The chair that they have you sit in has a table attached for your arm to rest on, unfortunately there was not enough room to lower the table so they had be rest my arm on the armrest. After I warned her about my veins she proceeded to poke and prod my arm looking for something and when she thought she found one she went in. She stayed in there poking around and moving the needle for a very long time until I was beginning to wobble in my chair. They got Ally for me and another patient fluent in Spanish translated for us, she said that they decided not to try again and that they would just get it from the IV later. Bringing up a wheelchair they insisted I get in and they wouldn’t let me out again until we got to our room, I think they were afraid that I was going to keel over on our way there. Ally had no problems getting her blood drawn so I was the only one sitting in a wheelchair feeling ridiculous.

In our room there were two beds, a small safe, a television, a complete en suit bathroom, and air conditioner. Once showed to our rooms we were left to get situated and Ally and I unpacked what we needed to into the safe. A little later they came back and gave us both IV’s with fluid to make sure that we were hydrated. They managed to get mine with the first poke this time but she did have to dig for it a little, Ally’s had to be done twice as the first time it didn’t go in so they switched hands. Leaving us again they told us that the surgeon would be in to see us soon.
 
The surgeon, Dr. Jacqueline Osuna, came in with another Dr. that she didn’t introduce but I learned later his name was Dr. Ramirez. She went over the form that we had filled out the night before with us, but from the questions she asked and the things we had to remind her of, we got the feeling that she didn’t read the more comprehensive forms that we filled in and sent while we were still in Canada. After everything had been covered we then waited for the anesthesiologist to come and talk with us. Ally has had surgery in the past and had complications from anesthetic so when we talked and told the anesthesiologist this she decided to give her a different dose and giver her longer to wake up.
 
We had specifically requested to be the first surgeries of the day so when asked who wanted to go first Ally got in before me and volunteered (we had both wanted to go first when we talked about it previously and hadn’t come to an agreement.) Having us sign a few final forms they said that surgery would take about three hours and wheeled Ally out of there in a wheelchair.
 
(Side Note: Both of us decided that we wanted to be the first surgeries of the day because we figured the surgeon would be fresher at the beginning of a new day and if someone was going to have any complications our surgery wouldn’t be pushed back.)
 
Four hours later I was still waiting for news on Ally but when I asked they said they didn’t know how long it was going to be. I had expected her to only be three or four hours so by then I was really worried. It was at least twice the expected time before they came to get me for me for my surgery. As they wheeled me into the operating room we passed Ally asleep in the recovery section. After that I remember getting on to the operating table, while trying not to flash anyone, and then nothing.
 
Ally remembers waking up in recovery and asking about me but they didn’t answer her. After a bit they took her to our room. They wheeled her stretcher right up to the bedside and then had her scoot herself over onto the bed. When they brought her in they took her to the bed closest to the door and realizing that I was still going to have to come in she took herself to the bathroom and then switched beds. She was kind of in and out after that trying to stay awake to see me.
 
I don’t remember nearly as much as Ally, only that when I woke up I was screaming about my arm. They must have given me something because the next thing I was aware of was them telling me to move myself onto the bed in our room. At that time I wasn’t able to move and they decided to just leave me on the stretcher beside the bed for the night.
 
Notes:
1. To avoid problems with them finding veins make sure you are hydrated.
2. Be sure to keep an eye on your IV line and prompt them to change it before it gets to the end or you can have blood back up into the line. When this happens and it gets coagulated in there they just flush it back in.

XOXO, Evie & Ally

Tuesday, April 1, 2014

Tijuana Marriott Hotel

Pulling up to the Tijuana Marriott Hotel was an experience unto itself. Instantly there were a bunch of porters swarming the car, getting luggage, helping us out and escorting us into the hotel. They placed our bags on a luggage cart and waited with it while we checked in. We have never had so many people try to help us at once, if you have never stayed at a hotel like this (we never had) then it is going to be a nice experience for you. 

At the check in desk you have to sign some papers and give them a credit card, even though everything is paid for they still want the card for incidentals. You also have to sign agreeing to a $250 charge if you smoke in the room. They gave us a paper listing all the things that are included with the room because we are surgery patients. This includes, free wi-fi, two bottles of water a day, three cups of broth a day, and popsicles.

After finishing up with the front desk we were escorted up to our
room by a porter with our bags. We were on the fourth floor and in order for you to activate the elevator you have to have a room key (this would be an inconvenience for us later). Arriving at our room the porter showed us around, told us that in order for the lights to work we had to have the room key in a little box on the wall, and set the air conditioner as cold as it would go. He unloaded our luggage and we tipped him three dollars before he left.

Finally alone we were exhausted so we just stripped off and hopped into our beds for a nap. Sometime during the afternoon Raul called, we were still half asleep but the gist of the conversation was that he would call us around noon the next day. We had managed a four hour nap and the sun had set by the time we got ourselves motivated to do anything. Ally decided she wanted to go in the pool so she changed and we went to hunt for it.

Going down to the main level we looked for any indication of a pool and had no luck. Asking someone was fun because the people we asked didn’t speak English and we don’t speak Spanish. After some pantomime we finally figured out that you have to walk through the restaurant and down a ways. It was uncomfortable walking into the restaurant, especially for Ally in her swimsuit and cover-up, while people are eating and it was worse coming back when she was wet.
 

The pool itself while small was really pretty and blue. There were palm trees, large umbrellas and lounge chairs around the pool. I brought a book with me to read while Ally was in the pool although the lighting wasn’t very good so I could barely read. Ally went in and soon discovered that the pool wasn’t heated and was very cold. She didn’t last in there very long and we were soon on our way back to our room.



At our room we decided that we needed to start drinking more and make sure to get in the chicken broth we are supposed to, so we go out our sports drinks and broth. Looking up the location of the ice machine Ally left to go got some for our drinks and returned quickly having discovered that our room key would only activate our floor and the lobby in the elevator and there was no way to get to the other floors that had ice on them. When we called the front desk to inquire about getting to the other floors they just said that they would have some ice sent up to our room and twenty minutes later it was delivered.

Since we were using chicken broth we brought with us we had to heat it up ourselves. There are no microwaves in the room and we couldn’t ask the hotel to heat it for us because they have a “no outside food” rule. We ended up using the hotels in room coffee maker to heat it up. Washing out the pot we poured in the broth, placed it on the heating element and turned it on. It took a while but we got it heated and into mugs to drink. We both had a mug of chicken broth and half a bottle of green sports drink each.

Surfing the television channels we were able to find about two that had some English programing on and we watched Criminal Minds and CSI:NY before calling it a night and going to sleep.

The next morning Ally insisted that we be up and dressed early because housekeeping would be coming to do the rooms. We were up and dressed by ten and she was in a panic because she thinks we should have been ready by eight. They didn’t show up until half past two although they were very fast and through. I requested that they put an extra comforter under my sheets (Ally’s bed already had one) because the bed was as hard as a rock. It only took two of them twenty minutes to do the complete room and we tipped them four dollars.

By this time we were wondering what was going on as Raul still hadn’t phoned like he was supposed to at noon and we had no idea how to get a hold of anyone (Note: if you are going to a foreign country to do your surgery make sure you have multiple contact numbers for people in the country). We decided to email our patient coordinator Cathy (she is in the states) and requested that she get a hold of Raul and tell him to contact us. She texted him and he called us ten minutes later.

When he phoned he didn’t tell us why he didn’t phone when he told us he would. He just said that there is paperwork that we need to get and fill out for tomorrow and he would get someone to drop it off to us later. After we asked what time he was going to pick us up he had to phone someone and ask what time we needed to be there (this is something I think they should have already had figured out. They didn’t seem very organised to me.), and then phoned us back to tell us to meet him in the lobby at quarter to seven in the morning.

We then went to the pool and when we came back the paperwork had been slipped under our door with instructions to fill our and bring with us to the hospital.

Television and Mini Fridge
 
Vanity and Bathroom Area
In room Safe
 
 
 
 
 
 
 
 
 
 
 
 
 
XOXO, Evie & Ally