Day 3 of my liquid diet Wednesday, Dec 26 2012

Today is day 3 of my presurgical liquid diet. Day 1 terrified me to be honest. I thought “how the hell am I going to do this?!” Well, it has gone pretty well, but I think the main reason for that is that my habit is to not eat. For the past year and half, my weight loss doctor has worked hard to get me to bring up my intake on the weekends. During the week I don’t have a problem because I am working and my days are fairly structured, but on the weekends I am pretty much all over the place. I tend to get busy with stuff and forgetting to eat or I just don’t feel like eating. So the 2 days of the weekend were the days that were the ones that caused me the most issues. So, I think that is why this liquid diet hasn’t been too bad…well…except for the fact that I am missing chewing my food! lol It gets easier each day though. So my freak out on day 1 has changed to acceptance by day 3. I am seeing that I will really have to focus on my protein though. I am still logging my intake and my protein has really gone down without some of my go to foods. So, I am doing some adjusting and experimenting with the protein powder.

So, Wednesday is the day. My Christmas present is coming a day late. I am nervous, excited, worried, hopeful, and so very ready to start this journey. I have tried to stock up on the things I will need those first weeks. Although I am ready for this, I am also a little disappointed. My husband works swing shift and he is on midnight shift right now. Well, he was going to take Christmas night and the night of my surgery off to be there for me and to take my son to the oral surgeon on the 27th to get his wisdom teeth out. Not a pay issue since he could take it under FMLA and get paid for it. But, he procrastinated and didn’t complete the paperwork, so he will get home around 7:30 the morning of my surgery and then have to take me to the hospital for 11 a.m. Needless to say, he won’t get much sleep…he plans on sleeping in the waiting room which I hate the idea of! He snores so loud! And then without much sleep will go to work the night of my surgery and then come home to get my son to the oral surgeon for 9 am. So, I am going to ask him to leave after I get checked in and go home so he can go to bed. My son will stay for any problems if I ask him to.

I never posted this so guess I will now. 🙂

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Happy re-birthday Wednesday, Dec 26 2012

The day is finally here. I am laying in my hospital bed waiting to be taken to surgery. 5 days of my liquid diet yielded a 10 lb weight loss so now I am heading into this at 274 lbs. I am both nervous and excited that today is finally here. 🙂 I got this!!! See ya on the other side of this!

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The countdown begins Friday, Dec 14 2012

I got the call yesterday. The date has been set. December 26th I will be having my surgery. Yesterday I was so nervous and excited at the same time. 🙂

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Next step Thursday, Dec 6 2012

So, I have been a little absent from here lately.  I was very disappointed that my psych report didn’t come in when the Doctor told me it would.  I called and checked on it to find out they were out of the office yet again.  Grr.  It should have helped to know that the clinic actually had a list of reports they were waiting for from this Doctor so I wasn’t alone, but I could only think how many were like me and ready to get the show on the road.  So, in the mean time, I have been continuing to work on the things that I need to do.  Logging my food for the nutritionist, trying hard to get 120g of protein daily, maintain a minimum of 1500 caloric intake daily (suppose to be 1800 but she will be happy if I am just at a consistent 1500 each day), increase water intake from 32 oz to 48+ oz daily, and switching over my vitamins.  I am trying to get ahead on my work to be prepared too.  The end of the year and start of the new year is a busy one for me in my field (accounting) so I will have to do some real prep work to be off work for the minimum 2 weeks that the clinic told me to plan for.  So, while I have been concentrating on all of this, I haven’t been overly impatient.  Then I get the phone call this morning.  My report has been received and faxed to my insurance for pre-authorization!  As soon as it comes back they will call to schedule my final appointments before surgery.  Let me tell you, my stomach did a back flip!!  And now I have all these things popping into my head that I need to get done RIGHT AWAY because of that burst of adrenaline that I just got. LOL  I do have things I want to get done before surgery, but it isn’t like it will be tomorrow or even next week, so I have time.  I just don’t need to be wasting time and not doing it.  I wish I could take some extended time off of work….like the week before surgery and then, say, 3 weeks after surgery??  I will have to wait and see.

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Review tomorrow Tuesday, Nov 20 2012

I will admit that I am nervous about my appointment tomorrow. 😦  What is my tests didn’t come out like I hope?  What if I am told I am not a candidate?  What if…what if….

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Psych appt Sunday, Nov 18 2012

So Wednesday was my psych appt.  I completed all the paperwork, the various releases, the 32 page questionnaire, the 165 page computer test and finally, the actual sit down with the doctor.  Some of the questions of the initial 32 page form were tough…I have no clue what my weight was at 10 years old?!!  Of course there were the questions about food, but there were the other questions that are meant to delve deeper into the psyche of the test takers.  Abuse…yes….emotional…yes….sexual…yes…physical…witness to, yes…. So, of course, I complete it all with total honesty since I don’t believe in hiding my past, and I wait for it to come up doing the actual session with the doctor.  And it does, of course.  Now, I have to admit that I felt extremely at ease with this guy and very very relaxed!  I think we had a pretty good repore going. 🙂  Of course, it was November 14th, which is the day before opening day of rifle deer season here in Michigan and we are both hunters so we instantly bonded over that. 🙂

So, he asked me about my husband and kids, about my family growing up, and different things in my life and he took notes, scribbling this down and that down.   Asked me each sibling name, sex, age, health issues, and so on and so forth.  See my last post to see why this was just a tad difficult for me. 😉  I answered to the best of my abilities and he seemed ok with the answers he got.  Then came the abuse questions. I had prepared myself for them and for the possibility that he would dig a little deeper with them.  I also had this small fear of “what if he thinks I am just too screwed up from this to actually think I am ready for surgery?’  Well, I answered the questions honestly and sometimes my answer led to another question based on my reply, but when it was all said and done, he didn’t spend any more time on the subject than he did on any others.  I am curious to see what his report comes back saying. lol

So, we come to the end of the appointment and he asked when my next appt was with my doctor.  So I told him that Wednesday the 21st I have my first Review appt (see prior post on steps in process) to go over my lab tests etc.  He then asked me if my insurance needed a Summary Report or a Full Report for preauthorization.  It needs a Full Report.  So, then we discuss how he is going hunting and then has some other professional commitments that won’t allow him to get my Full Report done before my appt on the 21st, but he can get it done the following week.  Even though I am hoping to have the surgery before the end of the year (best time for me to take off work), I am ok with this time frame and let him know that I don’t have a problem with that. 🙂  I am also encouraged by the fact that he is asking what my insurance company needs for the preauthorization.  I am sure if I wasn’t a candidate in his eyes, he wouldn’t have asked this, right?

So, now I have done all the pre-requisites.  Wednesday I will find out if there are any more medical tests that I need and what the results of the ones I did have are.  I will also have another meeting with the nutritionist to go over stuff she gave me during my last appt and undoubtedly, she will give me more information.  I should also find out a “tentative” time frame for surgery. I have not talked to work yet about time off.  I don’t really know if I will even tell them what surgery I am having.  Once I get a time frame I will be able to start preparing some of the final things though. 🙂  Wow, it is getting close.

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My support staff Sunday, Nov 18 2012

A week ago today I got a phone call from my sister.  I have two, but this is the only one I ever talk to.  I come from a family of 5, 3 girls and 2 boys, which have a span of 14 years from oldest to youngest.  Of course, I am the youngest. 🙂  The dynamics of our family is what it is.  For the most part, we are not close for a variety of reasons.  In many ways this bothers me, but in other ways it is just less drama.  Regardless, my sister K is the one that I do talk to.  We tend to have a little more in common thru the years regardless of the 10 year age difference.  Both of us married, our husbands joined the Army, and we moved away from home and didn’t move back.  We both live in the areas where our husbands were last stationed and have made that home for our children.  We also have both struggled with out weight as we got older.

Well, now and then we text back and forth or we chat on Facebook, and even though I am not sure how it came up, I told her that I was thinking of having gastric bypass surgery.  She seemed very concerned about this and told me that she would be calling me on Sunday, which seemed to be the only day that we both had spare moments to sit down for a phone call.  As I waited for Sunday to arrive, I did some thinking and put some pieces of a mental puzzle together and arrived at a picture that I can’t believe I didn’t see before.  1st piece – in 2005 we got all 5 of us together for the first time since 1987 (Holy Crap! I know) and while my oldest sister and I were still battling our weight, K was skinny!  She looked absolutely wonderful and I was so happy for her.  I didn’t think much of it and didn’t really ask since I knew she had been having some medical issues and chalked it up to those.  2nd piece – in 2011 my husband and I flew down south  to spend a long weekend with K and her husband.  While there we got on the discussion of vitamins and how I chew gummy multi vitamins because I hate taking the big ol pills all the time.  She commented on Iron issues and chewable vitamins versus pill form.  I also saw in her cabinet and wow did she have the collection.  Part of me was pretty concerned that she was sick and wasn’t telling anyone.  3rd piece – she has been having all kinds of medical issues lately.  Severe anemia, B12 shots….and several other things.  So, there are my puzzle pieces, just sitting there on the table waiting to be snapped into place.  As I waited for Sunday to come, all the research I have done regarding the positives and the negatives of WLS collided with my puzzle pieces and “AH HA!”.   Maybe somewhere in my head they had all snapped together and I just hadn’t realized it so that is why I told K about my looking into having WLS.  Up until then, my husband was the only person to know what I was planning.

So, Sunday arrived and with it my phone call.  We talked for over an hour…and I hate talking on the phone! lol  It took a little while before she admitted to me that she had WLS (4 months before that family gathering in 2005).  She asked me a bunch of questions: How I came to deciding WLS was the route to take? Who suggested it? What process does my Dr have for this? Does insurance cover it? Does insurance cover excess skin removal? Do I have a support system? Was I telling our Mom or any other family? Is there support groups in the area?  All very legitimate questions and all ones that I have researched or thought about and was able to answer pretty quickly.  Then she told me that she wished she was as well informed when she had her surgery.  Hers wasn’t a well thought out choice, it was “well, I am going in for this other surgery, why not have them do that too” and her doctor was all for it and 2 weeks later it was done.  She was not trying to talk me out of the surgery, like I originally thought she would, she was just making sure that her baby sister had done her homework.  And through talking with her, I realized that I really had done my homework.  I had been obsessing with reading everything I could find and wondering if I really had enough information to make the decision.  After talking to K, I realized that I do know the risks, I have done my research, I have thought it out and am not making a rash decision, and that I am ready for this new healthier direction even though it will be a tough journey.  I think I set her mind at ease and she told me I would do wonderfully.  She also gave me some pointers for along the way and told me that she was there 100% to support me. 🙂  She also agreed with my decision to NOT tell our mom or the rest of the family.  We discussed the stigma that comes with WLS and misconceptions that people have that it is an “easy” fix to being overweight.  Hell, I haven’t even had it and I KNOW it isn’t an easy fix!  In the end, this phone call was just what I needed to stop doubting myself and trust that I was making the right choice for ME.  So, thank you K for being you and allowing me to be me. 🙂

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Required steps Friday, Nov 9 2012

I just wanted to post the steps that are required before I anyone can have bariatric surgery at the hospital/clinic I am going to.  It is a good reference for the different steps and I go back to it now and then just to have that visual of where I am in the process.  Here they are:

Step # 1      Attend Public Seminar        Cost = Free

This mandatory education session provides necessary information on the types of weight loss surgery, criteria for surgery, guidelines to follow before and after surgery, and the lifestyle changes necessary for long-term success. The program provides an opportunity to meet our physicians, and members of our multidisciplinary team. The public seminar is held every third Monday of the month

Step# 2        Obtain Primary Care Physician Referral

We work with your primary care physician (PCP) to give you optimal health care. Your PCP will also make the initial referral to our program, allowing us to coordinate your care. Your primary care   physician can assist with the necessary documentation needed to meet insurance criteria.

Insurance verification:   It is never too early to contact your insurance carrier. Insurance carriers and individual plans vary in coverage and pre-surgical requirements for surgical weight loss and related services. If you are a Blue Cross Blue Shield member you are required to have documentation from your primary care physician regarding a six consecutive month attempts at non-surgical weight loss including documentation of nutrition, exercise and diet attempts. It is important for you to contact your carrier to determine the bariatric surgery coverage, eligibility criteria and requirements specific to your plan. We do have an insurance coordinator that can assist you; however, it is ultimately YOUR responsibility to verify your coverage, criteria and eligibility.

Step # 3      Attend Consultation Day         Cost = $80.00 (Due upon registration)

New patient consultation day includes an educational class session in the morning. You will then be scheduled for 2 one hour appointments during the afternoon. You will see a provider for a thorough examination to determine if you meet criteria for bariatric surgery. In addition, you will spend an hour with a registered dietitian for an individual nutrition counseling session. If you are deemed an appropriate candidate, you will receive a list of preoperative requirements that must be completed prior to moving on to step # 5.

Step # 4      Complete Preoperative Testing/Psychological Evaluations

Based on your medical history and insurance requirements, you will complete pre-operative tests, clearances and the psychological evaluation. Once the bariatric care team receives all of the results, we will contact you to attend a Review Day for further preoperative preparation. The length of time it takes to complete this process will vary per individual. The program fee of $400.00 must be paid in full prior to scheduling Review Day.

Step # 5      Attend Review Day (First half of program fee is due $200)   

All of your preoperative test and evaluation results will be reviewed during this session. It also includes additional education and nutrition counseling. You may also receive a tentative surgery date and be scheduled for your Final Pre-op Visit at the end of this session.

Step # 6      Attend Final Pre-op Day (2^nd half of program fee is due $200.00)

This will be the final pre-op education day prior to surgery. You will receive further education and additional nutrition counseling. You will also meet one-to-one with a provider to review your informed consent and sign your consent for surgery. Final pre-op day is an afternoon class and will last approximately four hours. You will be fully prepared for your upcoming surgery.

Step # 7      Day of Surgery

Congratulations, you have made it to your day of surgery! You can anticipate your hospital stay to be about 2 days, unless you have complications. Gastric bands are performed as an outpatient and you will go home the same day. You will receive further discharge education prior to going home.

Step #8       Post-Surgical Follow-up & Support

You will be scheduled for routine follow-up appointments at the Bariatric & Metabolic Institute. Please plan to attendmonthly support groups offered through the Bariatric & Metabolic Institute.

So, I am kind of in a mix of steps right now.  I just received the call that they are beginning to get my test results in and it is time to schedule my first review appt (Step 5).  Wow that was fast!  I just had these tests done yesterday morning!!  I am still on Step 4 because my psych eval isn’t until next week.  But, that is ok.  I was still able to schedule my first review appt to keep the process moving…so November 21st I will learn the results of my tests and find out if there are any others I may need to have.  I will also have my 2nd appt with the nutritionist then.

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Intro Thursday, Nov 8 2012

This past year has been one with several changes for me.  Somewhere along the line I realized that there were parts of myself, and my life, that I just didn’t like….things that I had always wanted that I never followed thru with….and changes that just had to be made.  So, here I sit, starting a blog to document the latest change that I am embarking on.  Gastric bypass surgery.  I am a 44 year old, 5’6, 280 lb woman that is just tired of where she is in life.  After a year and half of trying to medically lose weight and actually losing 40 lbs, only to gain 32 lbs of it back…I am turning to surgical weight loss.  This is definitely not an easy decision for me to make and is a last resort measure to be honest.  Now, I am basically pretty healthy.  Although I am considered morbidly obese, I do not have any of the health issues such as sleep apnea, diabetes etc. that can go along with it.  And I guess that is one of the major factors in deciding to do this.  I DON’T WANT THESE TO DEVELOP!

It has been a month since I decided this was the path I was choosing…so far things have gone pretty quick.   My medical weight loss doctor has been very helpful, supportive, and informative with my decision.  I have gone thru the initial steps with consultations etc., have seen the nutritionist for my first appt., had my physical and today I did all my lab tests (blood work, nicotine test, EKG, chest xray, upper gi, and urine test).  Next week is my psych test and then I can schedule my review appointment.  Once these are all done, I can get pre-authorized with my insurance for the surgery.  It is feasible that I could have this surgery before the end of the year…which seems a little scary, but it would be scary no matter when it was.  It is time to break the cycle so no time like the present! 🙂

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