Complications, Heartbreak and Disappointment - Pre-Opp Assessment No. 3, 4 and 5 (Sleep Study, Ultrasound and Meeting Anesthesiologist)

Super Long Update on everything ahead......

Sleep Study-Results-Obstructive Sleep Apnea

So about two weeks ago, I did my sleep study to test the severity of my obstructive sleep apnea ("OSA").  I had to be hooked up to this machine, which we obtained privately which costed around RM 300.

The tubes go in my nose and there is a pulse thing attached to my finger. I taped them down with bandage tape so they would not fall off my face and off my finger. I would say that it was not the most comfortable sleep with all these stuff attached to you.

Anyway, so after that we got the results :

So what exactly do all these numbers mean mean? Well, for a situation like this the key thing to be aware of is the result of the AHI (Apenea Hypopnea Index). The severity of OSA is classified as follows :

• None/Minimal : AHI < 5 per hour
• Mild : AHI > 5, but < 15 per hour
• Moderate AHI >15, but < 30 per hour
• Severe : AHI > 30 per hour

My AHI is 37. Severe Obstructive Sleep Apnea. 

In addition to the above, what is also looked at is Oxygen Desaturation. Dips below 80% is usually considered severe. My lowest desaturation is 55%. Which is also a red flag. 

Just a small brief explanation of OSA:

Obstructive sleep apnea (OSA) (or apnoea) is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep, despite the effort to breathe, and is usually associated with a reduction in blood oxygen saturation.

Below is an image of what OSA actually is :

Getting back to the point,the test confirmed what I kind of already knew, because OSA can cause sleepyness during the day despite getting a full nights rest, always feeling tired, headaches here and there all of which I have had before and now I know that the reason for the above is because my body is not getting the oxygen at night that it actually needs. 

Generally, people who have severe OSA would be advised to not to any elective surgeries because the risks and complications that may arise while under general anesthesia are much higher due to the blocked airways. 

So,after hearing all this and furthermore reading up about it broke me down. I want this surgery so bad, and I am so prepared for it, and now I find out about this. I was utterly heartbroken and could not stop crying that night. I am not prepared to take such a big risk for an elective surgery. I do not want to die. 

But then I thought to myself, ok calm down, let me first go meet the Anesthesiologist, maybe there would be a way around this. 

Consultation with Anesthesiologist

So today after my ultrasound ( I have Gallstones btw) which was already scheduled as a pre-op assessment, I went to meet the Anesthesiologist with my sleep study results. And they confirmed that it would still actually be possible to go through with the surgery, but the risk of complications are a lot higher because of the blocked airways.

What they have recommended me to do , is postpone the surgery first, lose some weight and go get a Continuous Positive Airway Pressure(CPAP) Machine. They have referred me to the Institute of Respiratory Medicine to go and get a CPAP Machine on loan. These CPAP machines are really expensive to buy here and ranges from RM2,500 - RM6,000, Bottom line is that I need it tho. 

A CPAP machine is a small machine that supplies a constant and steady air pressure through a hose, and a mask or nose piece throughout the night while I sleep. It is basically a machine that will help me breath better when I sleep and get more of the oxygen that I actually need at night. 

Apparently the benefits of using this is that I will feel less sleepy and have more energy throughout the day.This could be a good thing, because then I will have more energy to be more active and exercise towards losing some weight. 

Postponement

So in light of all the above, I have decided to postpone the surgery. I am not willing to go through an invasive elective surgery with all these risks if my body is just not read yet. I need to fix my sleep apnea first. I really feel quite down about it, but I have to remember that this is just an obstacle, and my end goal should remain the same no matter what, even though it may take a little longer or I may have to take a different way of getting there, the end goal remains the same. 

Moving Forward

So next action step I have to take, set up an appointment with the Institute of Respiratory Medicine, and find a way to get a CPAP Machine.

Speak to my Surgeon who also runs a lose weight programme for obesity, see if I can sign up for it, and hopefully if I lose some weight, it could bring down my AHI.

I have to remind myself to keep moving forward.

Thank you everyone for all the support you have been giving me so far, I will continue to update my progress with everything on this blog. 

A Choking Experience - Pre-Op Assesment No. 2 : Endoscopy

Okay, so the other day I went for my Upper Endoscopy assessment. Upper Endoscopy is a medical procedure where a device tube thing with a light and camera is used to look inside the body through the mouth. For me it was to look inside my stomach, to check if I had any ulcers and other stuff before they do the surgery. It looks something like this below :

Anyways, so last Thursday I went for it and lets just say I was not prepared for it all! Because of reading the internet, I thought I was going to be sedated while the tube is stuck down my throat.

But that was not the case for this hospital, the way they do it at this hospital is that my throat is only numbed and I am awake, cos they need to ask me to swallow the tube. So when the tube went in, they asked me to breathe through my nose. At first I was doing okay, but then I started to feel the tube in me, and it felt like something foreign and alien was in my body and I started to panic, and forgot to breathe through my nose and was trying to breath through my mouth, and then I started choking,  and I felt like I was suffocating,the doctors and nurses kept telling me calm down and breathe through my nose, but my brain could not process those instructions up to a point when the doctor said "ok this has got to stop now" and he pulled the tube out of my mouth.  I felt so violated after that, and it was quite a traumatic experience, I just wanted to cry after.

Urgh, but it is true my body does have a tendency to fight back foreign things,once even though I was sedated (not GA), 4 people still had to hold me down  cos something foreign was being inserted and I was just fighting it.

So the test was done, and they said I am actually ok for the surgery. However, the doctor said that I do have some Acid Reflux, and it may be better to do the Gastric Bypass surgery instead. Which is something I am not entirely keen on because it has a lot more risks. But he said wants to see all results from all the tests first, and then we can explore further if there needs to be a change in the type of surgery.

sigh. I really hope I can just stick to the sleeve surgery.

My next test is the Sleep Study, which I will be doing tonight!!

Bitten by Dracula!! - Pre-Op Assessment No. 1 : Blood Tests

My mom calls the Pathology Department in the Hospital  "Dracula" , because they take your bloooddd~!

Anyways, today I went to "submit" my blood for testing for all kinds of things. This is part of the pre-op assessments that I need to do. I waited my number and when I got called, the guy said I have 10 test tubes to be filled for testing. 10!!

So then he took out a huge syringe,  I believe it was the size of the one of the far left below and it kinda freaked me out .

Being the smart person I am, of ALL DAYS, I decided to wear my top where the sleeves are impossible to roll up. We tried and tried, but they just could not, and blood guy could not take my blood from the usual place which is inner middle of the arm where the arm bends, he had to take them from the front of my hands. Here's a piece of advice, if you can take it from the middle of your arm, ALWAYS chose that option. Taking blood from the front hurts!! especially when you have to sit there for a while cos they need so much of it!!!

Anyway, after that he told me I had to take some powdered drink  called "Dextrose Monohydrate" and return in 2 hours time for me to take blood again. I don't actually know why I had to do this, but in the end it meant another hole in the other side of the front of my hand :(

Anyway, first pre-op assessment completed. Next up would be the sleep study, followed by the endoscope and meeting the anesthesiologist. 

Yay. I am excited. I must admit that I do sometimes get second thoughts about this whole surgery. But then I remember everything else, and I get excited to do it. 

Weight Loss Battle - A True Challenge - Life Altering Decisions

The Battle  & Challenges

I am back again. I think this blog is evidence of how losing weight and getting to your goal weight is a huge battle and a true challenge.  Reading back my old entries, I have tried so many times, the running, the low carb diet etc. I started this blog in freaking 2012!! its already 2015 and I still am not where I want to be. Its tough, it really is.

By the way, just a short recap of what I thought would be the year of "re-branding" for myself, last year. What happened with the low carb diet I was on, It nearly killed me!

All the meat and fat I was taking according to what I could eat on the "diet" shot my blood pressure way up, it was 160!! I was getting really bad migraines to a point of nearly wanting to pass out. It is NOT the healthiest way to lose weight.So even though it was showing great results in terms of weight loss,  I was told by my doctor to STOP the diet if I wanted to continue to live. So I stopped, and I took in carbs again, and omg after restricting yourself from carbs for so long those carbs just tasted so damn good, and my blood pressure went back to normal. And so I ate and ate and put on everything that I had lost.  So, that is the summary of what happened in 2014.

This weight loss thing, really is a tough battle I've been trying to fight it my entire life, since I was 12? 13? years of age. I have been overweight my entire life and I have tried so many things, and it is difficult and frustrating because while trying to get fit physically and lose weight,  there is also an internal battle you have to fight.

Anyway, I am now 27 years of age and I will be turning 28 this year. I am getting older, and I want to be at the weight I am meant to be at by 30, and I want to be a healthy happy person by the time I am 30. (Thirty, Flirty and Thriving!!!).  Losing weight will also help me with my current ailments that being my hormonal imbalance, sleep apnea and the pain from my extra bone in my foot (because less weight will be on it).

Life Altering Decisions

SO, I  decided to seek medical assistance because I feel that having tried everything already, and with a really high BMI of 45, that being morbidly obese btw,  it is just time for me to seek proper medical help. I have a long time ago overcome that first step , which is admitting I have a problem, but now its time to take proper action and I need medical assistance.

After numerous consultations with doctors, research, reading about all the pros and cons, watching numerous videos of people describing their journeys, as well as meeting with actual Gastric Sleeve patients and speaking to them about their experience, as well as going through all the possible risks in relation to the surgery,  I have made the decision to do the Gastric Sleeve surgery .

This is what it is :

It is basically a surgery where about 2/3 of the stomach is removed. The purpose of this surgery is basically to limit the amount of food you will be able to eat or take in. Usually after this surgery, just a few bites or spoonfuls will make you full and unable to eat anymore. However, because you have a small stomach, it will be very important to control what you actually do eat. This surgery, is actually a complete life altering surgery for people who have an affinity for food. You can read more about it in detail here.

I would like to state here, that this may seem to some like I am taking the "easy" way out, but I do not feel that it is, because I have been trying the alternate ways all my life, and I've struggled with all the highs and lows.  Furthermore, this surgery is not purely the answer to weight loss, but it is a tool to help assist in weight loss, as it restricts your ability to take in more food and a proper diet and proper exercise is of course required. It will help with one of the main hurdles which overweight people commonly face, which is the inner battle to put down that damn spoon. 

While doing research on the types surgeries, I came across this before and after video of a girl, who where she decided was also the same age I am now, talking about how she felt before and then how she felt after. I feel like most of the things she mentions in her before video, is how I've been feeling about weight (well maybe not to the extent of extreme depression, I did not go through that). Here is the video, please do watch it!

So, MOVING FORWARD, I have spoken to the doctor and my surgeon, and my date for surgery if I clear all the pre-operation assessments is going to be 10th June 2015. I will be doing it in HKL and it will be done by way of laproscopy, under General Anesthesia. The details of my Surgeon can be read here.

For those of you who would like to know, this surgery is going to cost from about RM 10,000 - RM13,000, because HKL does not pay or provide for the surgical instruments which are a one time use, these are obtained privately. Thankfully my parents have offered to cover these costs for me, because this type of surgery is not covered by insurance. They have been extremely supportive over the whole thing.

Pre-Op Preparations and Assessments

So before going for the surgery there are a few pre-op assessments which I will need to do which are as follows :

1. Blood Test 
2. Endoscopy - to check if there are any ulcers or any abnormalities. The scope will be inserted through my mouth. 
3. Ultra-sound 
4. Sleep Study - This is due to my obstructive sleep apnea, I will need to do a test where I am hooked up to a sleeping machine for a night, and the machine which will produce a report which is needed by the Anesthesia people
5. Meet the Anesthesiologist - who will check if everything is in order, and determine whether I will be fit and good to go for my surgery

Post-Op

So after the operation I will be kept in the hospital for recovery for about 3 days and on the 3rd day I can be discharged if there are no complications.

For the first 10 days after the operation or so, I will be on a pure liquid diet which means I will only be ingesting water and clear chicken soup. Following this, I will be able to move to soft foods, and then when ready I will be able to eat solids.

After the operation, the doctors will work close with me to teach me how to eat, and to properly plan my nutrition plan. I will have to return for follow ups every week for a bout one month, so the doctors can monitor my progress. This first one month, is basically for the purposes of training me how to eat with my new reduced in size stomach.

I need to lose a total of 63kg to be at a healthy BMI, and after this operation I intend to lose as much of that as I can within two years time. Its time to get healthy!! I want to be able to do activities I know I would really want to do, but I am limited because of the weight I have to carry around, I want to be able to easily find clothes and wear em.

Anyway, I believe this is already an extremely long post. I intend to use this blog to document my journey and progress. I think this blog is more of a journey of trying to lose weight blog rather than a running blog. But hey, if I do lose the weight, maybe I can start running again because there will be less weight on that extra bone. Oh and I definitely will be doing a before video for myself just like the video above,

The doctors said during this journey, support from family and friends are essential, as it will get tough at times, but in the end it will be worth it.