One month post-surgery blues

Content warning: Photo of my abdomen with surgical staples below.

It's been 4 weeks since I had gastric sleeve surgery to remove 80% of my stomach as a surgical intervention for my out of control weight. Those 4 weeks have been, in some ways, very tough, and have been undoubtedly different to what I expected.

Post-surgery blues

A couple of days before I went in for surgery, we got a new puppy, Dobby - a labrador/beagle cross.

It's pretty common after getting a new puppy to get the "puppy blues", an emotional state of feeling overwhelmed, sad, anxious and regretful. We've definitely felt that; while we had planned to get a puppy the first few weeks are the most difficult and with me recovering from major surgery, it put a lot of pressure onto my wife, Laura. While there aren't the major hormonal changes associated with postnatal depression, it's a similar - albeit less severe - condition that lots of people experience where the initial excitement gives way to the reality of the extra responsibility.

I've definitely felt something similar with my surgery. While it was something I've wanted to do for a long time, and had been seriously researching for nearly a year, the reality of a life-long permanent change is always going to be difficult, especially with the strict post-op diet. A painful, long recovery was always going to contribute to that, particularly with the sense of frustration.

Why am I not losing weight?

I should preface this by saying yes, I am absolutely losing weight.

The nagging question is, as you might expect, why aren't I losing weight faster? This is, rationally, a stupid question as losing nearly 60lb in 8 weeks is an outrageous amount of weight - 16.5% of my total body weight and 29.5% of my total excess weight (based on an Ideal Body Weight (IBW) formula from Robinson et al, 1983: 51.65kg + 1.85 kg per inch over 5 feet). However, given the eating reality post-surgery, it feels like the results don't fit with my expectations and that's tough. Rationally I know that I'm still losing weight, that if I continue to lose approximately 2lb a week for the next year I will be near my IBW, but it still feels quite helpless that I can't control this more explicitly.

Thank god the soup is over

It hasn't quite got to the point where if I never see soup again it'll be too soon - I was immensely grateful for strained clear soup post-surgery purely on the basis that it wasn't milk or yoghurt - but in the past week with the transition to stage 2 of the post-op diet I have been very grateful to be able to eat food that feels more like food.

The post-op diet is, broadly:

• Stage 1 (3 weeks) - fluids only: water, milk, slim-fast, high protein soup sieved to be completely smooth and pass through a straw
• Stage 2 (2 weeks) - pureed: soggy weetabix, porridge, pureed soup/chili con carne/bolognese/etc
• Stage 3 (2 weeks) - fork-mashable: omelette, as above with mashed potato/mashed veg etc.

Being able to eat some soggy weetabix, or some canned chili with some mash (I've been broadly mixing stage 2/3 and seeing how it goes) has been very enjoyable, but I'm definitely feeling the effects of trying to progress too quickly. I made my first mistake by eating a toddler meal that I'd prepared for Isobel of some cheesy pasta - I was feeling very "hungry" (it's not the same as previously, it's more a feeling of general weakness if I don't eat regularly) and frustrated that Isobel, who is an extremely selective eater, hadn't even touched it. I thought it would be soft/pureed enough already but I was wrong, and ended up throwing it up soon after. Every day's a school day.

Not being hungry is very strange, there's no point in a day really where I feel like I want to eat - it's mostly just apathy towards it, it feels like a chore at the moment. This has contributed to getting to the evening under-fuelled and then needing to eat based on that, which isn't particularly healthy either. Something that needs more work.

Staple removal

After two weeks post-surgery I was able to have my surgical staples removed. Given how itchy the wounds were as they healed this was definitely something I was looking forward to, but the experience was, to put it mildly, unpleasant.

I'm not sure why I expected anything more technical than a standard staple remover, but that is exactly what it was - a hook that went under the staple with some handles to squeeze to lever it out. Two weeks after this, everything has pretty much healed other than the largest of these, which needed some additional steri-strips for a week and is still taking a long time to heal in the same way as the others.

In general I think things are going well, I'm eager to start building my physical activity back up again (I was told 6 weeks post-surgery, so I'm hoping to get back to doing things post-Christmas) and equally am obviously eager to continue to start moving back to "normal" foods. In the coming week I've got two social events for the first time post-surgery, the first will be trying to find a drink that isn't carbonated (in the past I've typically opted for a lime & soda or lager if I'm drinking alcohol) and then I've got a pub meal where I've ordered a dhal with mash - we'll see how that goes when I'm not in total control of what goes into it.