Well that takes some gall!!

At least it took all of mine!
I just crack me up sometimes…

I’m a big believer that our bodies are fearfully and wonderfully made.
Every part – from eyebrows to appendixes to baby toe toenails – serve a purpose.
When you get into the guts of the thing, all the things in our guts are particularly designed to work in concert together. Even the appendix. It’s there, isn’t it?
I digress.
It is because of this strongly held belief that I resisted the idea of having one of my internal organs removed. It is also because I am no big fan of general anesthesia. That’s a lot of drugs pumped into a body all at once, and anything they do that has the potential to stop respiration and cardiac activity without careful (and expensive) monitoring . . . well . . . I’m just not a big fan of having that done to me.
So I bought time, I did all I could to try and remedy its faulty performance, and in the end it was painfully (literally painfully) obvious that keeping it was going to wind up doing more harm than good. So I agreed to have it removed. Technically I asked to have it removed. And it was.

warning-tmi

Still reading??

You can’t say you weren’t warned.

Proceed at your own peril.

OFFICIAL DISCLAIMER:
Before going any further let me say one thing: I am not a doctor. 
I don’t even play one on television. 
I never even played pretend doctor as a child, I preferred playing teacher or mommy. 
What I’m sharing here is based on information provided to me by my GI Doc, my Surgeon, Internet Research on life post-Cholecystectomy, seeing what my son dealt with after his Cholecystectomy four years ago, and my personal (very short-term) experience.

There are (by my estimation and, to date, experience) several levels on which the body recovers from gallbladder surgery.
The Procedural Impact
This, in my mind, largely entails overcoming the short-term effects of anesthesia combined with the longer-term (anywhere from a week to 30 days depending on individual metabolism) ‘purging’ of said anesthesia from one’s system. My body takes at least a couple weeks to fully divest itself of anesthesia. I know this because it takes me a couple weeks (minimum) after being under general anesthesia to stop feeling doped in the mornings and succumbing to sudden attacks of mind-numbing fatigue mid-afternoon, followed by fighting sleep by 7pm. But that’s just my body. Some people can be knocked out and do advanced trig three hours later. Not The Girl.

The other procedural aspect that’s a tad uncomfortable is the bloated feeling you have in your abdomen because of the carbon dioxide that’s pumped into the abdominal cavity during the procedure to give the doctor space to see (through the itty bitty ‘Innerspace’-esque camera they insert in one of the incisions) and work (with the itty bitty snipper thingy they insert in aonther of the incisions). Basically you feel like you have horrible gas from eating way too much of whatever it is that gives you horrible gas.
You do not, in fact, have gas.
And you won’t fart.
Which is, to be honest, a little disappointing. Because you get to the point where you just know that if you could just fart – I’m talkin’ a Blazing Saddles campfire scene worthy fart – you would feel soooo much better.
But you can’t.
And you won’t.
At least I didn’t.

You just have to wait for the CO2 to ooze into the fibers of your being and out the pores on the other side of your skin and into the ether of the universe.

The First Cut is NOT the Deepest
When one has one’s gallbladder removed there are three distinct sets of cuts made:
#1: Skin incisions
#2: Muscle tissue incisions
#3: Separating the gallbladder from the cystic duct cut
Let’s take the healing of these incisions one-by-one.

#1: Skin Incisions
These are the least of your concerns. Seriously. I have four of them and all together they’re not four inches long. And mine look almost exactly like theseExcept the one in my navel looks like I scratched myself with my fingernails.
The worst part of these? The itching under the bandages in the first three or four days when they begin healing.  Seriously.  I’ve had hangnails that were more painful.
There was some bruising around the incisions. Frankly in the lowest left incision (your left in the linked image), and about an inch below my navel I looked like I’d been hit by a major league pitcher’s fastball. Then again, I bruise like a dang banana.

#2: Muscle tissue incisions
Remember how itty bitty those top three incisions are? The muscle tissue incisions are essentially three times as wide. And they go, well, all the way through to your guts. This takes longer to heal.
I’d say most of that has to do with the fact that they’re deeper and wider than the itty bitty skin cuts. But some of it has to be contributed to because look where they are! In the middle of your body. The abs. Your core.
Name one thing you do – other than blinking – where your core isn’t engaged in some shape, form, or fashion.
If you’re thinking about this longer than it takes to read this sentence, have an incision in your mid-section and that answer will come a whole lot quicker.
There’s not much.
Sneeze – core engaged.
Cough – core engaged.
Laugh – core engaged.
Accidentally start to turn over in your sleep – core engaged.
Reach for something one inch past the tip of your middle finger – core engaged.
Sit comfortably and raise your leg – core engaged.
It’s the mid-section equivalent of pulling your groin. Which is also engaged with everything you do with the possible exception of blinking.
I’m currently twelve days post-op and those incisions are still tender. And because they are tender I don’t 100% trust them to be 100% knitted back together so I’m holding off on getting back to running.
I will tell you that there is a palpable indication – aside from the tenderness – as to the healing status of these: Knots. You know exactly where how big this healing incision is because you feel it. While these internal incisions are healing they feel like knots under the skin. Tender knots you don’t want to bump into.
Have you ever backed really hard into a doorknob or the corner of a table and ended up with one of those big, deep bruises that has a hard spot in the middle of it? (No? Seriously?! I get to hate you for a minute because I do this all the time. Okay, I’m over it now.) That’s what these knots feel like.

#3: Separating the gallbladder from the cystic duct cut
This is, of all of them, the one that is the biggest crapshoot as far as I’m concerned.
“Why?!” I hear you asking.
Because there are no visual or physically palpable cues as to when the closure of this particular ‘cut’ is fully healed. I’m sure they cauterize it, or do something else to make sure it’s fully closed. But it still makes me a tad nervous.

So you’ve got all these incisions healing.
Which is the short-term impact of the surgery.

Going Forward: Your New Digestive System and You
There are two spects to your post-Cholecystectomy gastro-intestional experience: Upper GI (stomach) and Lower GI (intestines). The stomach’s only relationship to the gallbladder is that its fullness and contents triggers the liver to send bile to the gallbladder which essentially meters the amount of bile secreted into the small intestine to help break down whatever it is you’ve eaten. (That’s the ‘Sally, Dick, and Jane‘ explanation I distilled down from what the GI Doc and the Surgeon told me, and from the non-med-jargon laden websites I’ve researched.)

After your gallbladder has been sent to some medical waste facililty to be turned into whatever removed organs are turned into these two aspects of the digestive system become separate, but not equal. Not literally, but it starts to feel that way.

The Stomach just becomes its own thing. Or at least mine has.
It gets fuller quicker – which could have some positive weight loss benefits.
I burp. A lot. Which I find both embarrassing and annoying.
And there’s no telling what’s going to leave me feeling all heartburn-y and queasy.
According to my son (who had his gallbladder removed four years ago) this isn’t unusual and will (mostly, or not) pass.
My experience – after all of fifteen days – is that high fat foods are The Enemy.
I learned this after succumbing to pizza. Cheese pizza. Pretty sure it was the fat from the cheese that had my stomach churning and me feeling its every step through my intestines starting at 3am the other night.

Then there’s The Rest of The GI Tract
Remember that whole “gallbladder essentially meters the amount of bile” thing up there? Yeah. Those were the days, weren’t they? The days of metered bile.
You’ll miss those days.
I miss those days.

Because what happens once Ye Olde Bladdere of Galle is no more is that the liver, absent its more rational thinking partner, just dumps bile into the small intestine all willy nilly with little regard as to what might actually be required from one meal to the next. This “just dumps bile” thing is referred to as ‘Bile Dump Syndrome’ and . . . well . . . it’s just your new normal.
What essentially happens is that you re-learn how to eat.
You learn what you can (and can’t) eat that will (or hopefully not) trigger the Bile Dump, which will send the preceding contents of your intestines on a fast-track to . . . ummm . . . well . . .
Let’s just say that an over-abundance of bile tends to “over process” whatever is in your intestines not unlike a virulent stomach bug. You get what I’m saying here?
I’m still on the short end of this particular learning curve. And I’m not pushing it. (Completely unintentional pun there, but I’m leaving it.)
From all I’ve been told and read online this curve is a good six months to a year long. Which makes sense if you think about it. It takes babies a good six months to a year to learn to eat solid food too.

My biggest concern, as a runner, is what happens when I’m able to get back to actual distance running (8+ miles) that requires the consumption of fuel during a run which might result in runs of an entirely different sort? There’s also the natural effect of running a certain distance on a consistent basis to ‘get things going’ to take into account.
I plan to do some ‘test runs’ with shorter runs on a treadmill so I’m within decent proximity to a bathroom should such a need arise. Or, more accurately, drop.

One Last Bit of Advice:
The Pain Medication Effect
Whether you have your gallbladder, your wisdom teeth, or whatever surgery you might incur you will likely wind up taking pain medication for a day or two. Whatever might find you taking prescription pain killers, allow me to give you one last piece of advice: Stool softeners.
Everytime you take a pain pill, take a stool softener. Whether your doctor prescribes it or not (unless it is contra-indicated by some other prescription medication you take).
My doctor didn’t give me this piece of advice.
My BFF’s doctor gave her this advice nearly nine years ago when she had surgery.
I should have taken better notes that day.  Among other things I should have taken.

At the end of the day, I have no regrets over having had the surgery.
I was walking around with a ticking time-bomb in my gut and the impact of a ruptured gallbladder is far worse than any of the after effects of the surgery described above.
People die from burst gallbladders. Livers get damaged. Sepsis sets in.
And even if the faulty gallbladder never bursts, a poorly or non-functioning organ takes a toll on all the others it is attached to.
And with the digestive system, well, they call it a system for a reason.
Pick a random part of your vehicle’s engine, take it out of commission on some level, and let me know how the whole thing functions.
Get it?
Got it?
Good!

And there you have it.

Before and The Beginning of After

So my surgery was a week ago Thursday.
Yes,THAT Surgery.
The Reduction Mammoplasty.
The Reverse Boob Job.
My great, courageous (so a couple people have told me it was) act of “Getting Proportional”.  (Kudos to a dear friend for that reference.)

Before I go any further and really start rambling, here are the obligatory Before and After Images.  (Unfortunately I didn’t have the presence of mind to take a true “Before” picture in something I am willing to share here on Ye Olde Worlde Wide Webe.  I mean, I like you and all, but no you don’t get to see pictures of me in my bra.  Or less.  So this is what you get.)

IMG_0404

Before: September 2012

December 9, 2012All buttons.  No safety pins.

December 9, 2012
All buttons. No safety pins.

Yeah. Tell me about it.

I’m still in the healing phase, and healing nicely.
This is not only my opinion but my surgeon’s opinion at my post-op visit.
There hasn’t been any horridly excruciating pain.  Of course the first couple days when there might have been I was doped up on Demerol and probably wouldn’t have felt it if someone had come in and lopped off one of my other appendages.  I mostly feel, and have mostly only felt, really bruised.

So far the worst parts have been: A) Having to sleep on my back; and B) The itching where the stitches are healing.  Fortunately both these issues are resolved by the same solution: Benadryl!  Oh sweet little hot pink elixirs of relief and rest!

The weirdest part was the first week when – for the first time in my life at forty-seven – I had to line my bra with maxi-pads (to protect the incisions and absorb any ‘drainage’). I actually found that quite hilarious on Friday morning when my mom and my BFF helped me change from the padding I’d left the surgery center with to the first set of maxi-pads. I am reasonably certain the Demerol weighed in on the hilarity factor of that experience.

The waterproof surgical tape he put back over the stitched up incisions (which will dissolve rather than having to be removed) comes off a week from Monday.  Christmas Eve morning. (The jokes on that one really do write themselves.  I’ll not insult your intelligence or sense of humor by overstating the obvious . . . )

In the couple weeks leading to the “Procedjah” people kept asking me “Aren’t you nervous?!” and I would pause, do one of those mental ‘system checks’, and answer (in all honesty) “No.  I’m really not.”  By the day before the Procedjah my answer had become “At this point I feel like I’m ten months pregnant and I’m just ready to have this baby!”  (Having gone 1/3 of the way to ten months pregnant twenty-four years ago, that’s an analogy I was quite comfortable making.) During the pre-op prep they checked my blood pressure.  111/74 (before they had given me any ‘calming agents’ via IV).  Seriously.  So it would appear that “nervous” was the last thing I was.  Which I think was pretty cool!

Friday morning I woke up and could already feel a difference in my shoulders.  The constant muscle tension and ‘pull’ I was used to was just GONE!  Saturday morning once I was showered and wearing something other than pajamas my first thought was “I can’t wait to take these puppies out for a run!”  Really.  I called them “puppies” in my head.

All told the doctor removed three pounds of excess ’tissue’.  Not fat.  Actual whatever-it-is tissue that boobs are made of.  The Mammogram Lady told me I had “dense tissue, not fat”.  I’m not sure why I feel the need to clarify that, but I do.  I digress . . .

So at this point I’m in something of a ‘holding pattern’ while the incisions heal, the bruising abates (there’s actually quite a rainbow of bruise coloration going on), and the stitches dissolve. I can’t run.  I can’t lift anything heavier than a pound.  I can’t run. Bending over causes discomfort. I can’t run.  Yet.  The doctor’s (somewhat flip) answer when I asked “How long after surgery until I can run?”  was “Around 30 days.  Basically it’s up to your pain levels.”  I was expecting to hear something more along the lines of “Eight to twelve weeks” so this was a relief!  A shocking relief, but a relief nonetheless.

Right now I’m still adjusting to what really is a whole new body.
Seriously there are days when I see myself in the mirror and am overwhelmed with not just the change, but the realization of the number of years I was identified – in my mind and other people’s – by one (okay technically two) disproportionate body part(s).
I can wear button front blouses without buying them two sizes bigger than necessary and still having to safety pin between the buttons.
I can wear pretty much any kind of v-neck t-shirt, sweater, or whatever else without worrying if the cleavage is going to be inappropriate or offensive.
I will – once the healing is complete and I no longer have to wear a bra 24/7 – be able to throw on a t-shirt or tank top sans brassiere and run to the store without worrying about scarring the psyches of small children or fast-tracking some unsuspecting male tween through puberty!
And.  And!  AND!  I will be able to not only wear cute running bras (and cute little strappy running tops), but I will be able to wear those cute running bras without additional padding on the straps or moleskin applied under the band to prevent wearing holes in my hide!

If you want to get a sense of the “Before” and “After” effect of this surgery, pick up a three pound bag of potatoes, divide them into two mostly equal amounts, wear them around your neck. (I suggest a king size pillow case. You’ll have to sew the open end up somehow.)  Pick your favorite shirt and wear it over them – have fun with those buttons on those blouses.  Do this all day, every day for a week or two.  Now multiply that by a good couple (or three) decades.  Have fun with that math!  I know I always did.
[I say “or three” parenthetically because I have it on good authority from one of my lifelong best friends that my ‘disproportionate proportions’ were there in high school even though it didn’t seem like it to me at the time.  But I trust her judgment.]

Monday HCRP and I are going to get back in the gym.
He can do whatever he wants.  I’ll be limited to a recumbent bike for cardio *rolls eyes* and lower body strength training.  But it’s better than nothing at all.  While we’re at my in-laws for Christmas I’m going to do Yoga as much as I can without pain.  Once we get back home we’re changing gyms to one that has a pool and both an indoor and lighted outdoor track.
We both realize the absolute requirement of cross training – strength training in particular.  The lighted outdoor track is a huge plus because of shorter winter days combined with the fact that our regular running trails close at sunset and our subdivision lacks streetlights  (like at all) and consistent sidewalks.

So that’s where things are in my middle-aged, post-op, currently not running life.

In Running News I’m weighing the pros and cons of Jeff Galloway’s and Hal Higdon’s respective Marathon Training programs and starting to plan next year’s running goals.
Running. Goals.
No more of this just running willy nilly for the sake of it for me!  I have G-O-A-L-S.
I’m notsomuch looking to break any particular times.  Okay that’s kind of a lie.
I would like to get my 5K finish time down to 30 minutes.  Less would be good too, but I’ll be good with a consistent 30 minute finish time.  Which will of course make for a nice, clean, well-rounded 60 minute 10K finish time.
I’m good with a 3 hour half-marathon time.  That allows for enjoying the venue as well as the run itself.
My first Full will be next year’s St. Jude Marathon in December.  I could be ready to do one sooner, but I don’t intend to make marathons a regular ‘thing’ so I’m reserving them for St. Jude and Ronald McDonald House supporting events.

So that’s how things are and where I’ve been.
How’s things with you?