I had my "Two Hour History and Physical" (also known as "First Medical Appointment") today at the Bariatric Surgery Center. Last week I got a call from the center asking if I had 15 minutes to do the "Intake Questionnaire". I did, so I spent 15 minutes answering a hundred questions about me, my health, and the health of every person in my family. They also wanted to know every diet I have been on the last 5 years, how long I was on the diet and how much weight I lost.
Um. Hi. I'm a fat girl and have been on or rebounding from one diet or another for every minute of the last 5 years. I wasn't surprised I was having to supply this information because at the initial weight loss seminar I was given a form that had to be filled out and brought to my History and Physical. The first thing was a chart for me to fill out answering that very question (along with about a hundred other ones).
I answered the nice lady's questions about diet history as best as I could. I also filled out the form and brought it with me to the appointment, even though the form and the phone call both covered the EXACT same questions. But I got to answer all the questions all over again when I got called back for my appointment. I met the nice lady that had called me on the phone in person and we went into a little room. She asked me a few more questions. "Are you nervous?" I was. "Is there anyone in your life that makes you feel unsafe?" There wasn't. She took my blood pressure (130/90). She weighed me 269.2 (which is EXACTLY what I weighed in at last week at my Group Nutrition appointment). And gave me my BMI (49.3). Then she got to the good stuff.
I have been wondering what "they" consider my "excess weight" to be. It's kind of an important question. because they tell you that you can expect to "lose 80% of your excess weight". On BMI charts I am considered "Healthy Weight" if I weight between 104-131 (I am 5'2"). So, I didn't know if they considered my "excess weight" to be anything over 104 or 131. She didn't know either..but the computer told us that my excess weight is 158.8 pounds. Which means they think I should weigh 110.4 pounds. So if I lose 80% of my excess weight (127 pounds is 80%) I will be down to 142.2 lbs. Wow. But that's best case scenario. After that bit of exciting news, I was told to go back to the waiting room until the PA could see me.
The PA called me back (she was super thin and pretty) and asked me (*surprise*) the SAME questions I had been asked on the phone and on the written questionnaire (which, by the way, they never even asked for). Then she checked my heart beat, had my lay on the table while she pressed on my belly. Then she was done with the exam. She printed out a check list of "All the Medical Procedures" I need to get done.
Since I already had an ultrasound of my gallbladder last week that came back perfect, and I don't have sleep apnea, all I need to get done is my psych eval and have my PCP complete a form. She also ordered some blood work. They came right in and drew my blood. It was nice I didn't have to go anywhere and I could lay on their super comfy super sized table (cuz, oh, yeah...fun fact. I'm a fainter).
The blood work is to test some stuff I forgot....but mostly my A1C cuz of my diabetes. I asked her about that because at the seminar, my surgeon said that "blood sugar and blood pressure had to be controlled". So I have been stressing about whether or not my numbers would be ok. She said that my blood pressure is ok for surgery. They would like to try to get it a bit lower though. And she said that my A1C has to be less that 7.5. She is thinking it will be. She said she "wasn't worried at all". The cool thing is that the medical network I'm going to is huge in this area. All the places I go are under the same umbrella. They have this online chart thing where you can go and see all your results from all your tests and all you images if you have any imaging done. I think my PCP will have me go get a CT for this weird pain in my belly....I hope it's nothing awful!! When I get the report, I have to send it to the Bariatric Center. But that's pretty much it.
I just have to do good on my nutrition and cross that hurdle.
Turns out my A1C was 8.8 and I need it to be 7.5 before surgery. Great. Wonderful.
Thursday, January 23, 2014
Tuesday, January 14, 2014
Pain, Pain, Go Away
I'm having this really weird pain/discomfort. It started 2 weeks ago. It's in my right mid-abdomen. It feels like a numb/tingling feeling sometimes and then other times like a pinching pain. I went to my doctor about it. She thought it was either a pulled muscle (from coughing/throwing up...cuz, oh fun thing, I have been sick with one thing or another the last two months) or my gallbladder. I didn't see any connection between eating and the pain, so I really didn't think it was my gallbladder.
I went for an ultrasound and *surprise* my gallbladder is perfect. She said my liver is enlarged and I have a fatty liver. Which I had in 2007 when I was down to 200 lb....and really, every fat person has fatty liver...on accout'a cuz they're fat. Anyways....I am seeing her again next week and will likely go get a CT.
Meanwhile, poor Gander has been having a really rough time with his back. My poor man! We are gonna get him all fixed up. He is going to physical therapy and also has a consult with a surgeon. Maybe we will be recouping together :-)
I went for an ultrasound and *surprise* my gallbladder is perfect. She said my liver is enlarged and I have a fatty liver. Which I had in 2007 when I was down to 200 lb....and really, every fat person has fatty liver...on accout'a cuz they're fat. Anyways....I am seeing her again next week and will likely go get a CT.
Meanwhile, poor Gander has been having a really rough time with his back. My poor man! We are gonna get him all fixed up. He is going to physical therapy and also has a consult with a surgeon. Maybe we will be recouping together :-)
Thursday, January 9, 2014
2nd WLS Support Group
This support group went way better than the first one. There was no "topic" or presenter. It was just an open discussion. I expressed how I was pretty freaked out and had just about talked myself out of this whole surgery business. The idea of having surgery...of having an IV put in...of being cut open...and my stomach REMOVED was just getting a bit overwhelming.
At the group there was a woman who totally related because she had actually gone through the whole process once before and CHICKENED out. She said that she is going to DO it this time. Her surgery is 1/30/14. She made a lot of sense. She said everyone she knows that has had it only regrets not doing it sooner. She is right. I have to remember that not having this surgery isnt going to prevent me from every having surgery...if I don't have this surgery I will probably end up needing 3 other ones (and more serious ones). I have a lot of health problems from my weight.
There was also this girl there who had the bypass and has lost 113 pounds. She ran her first 5k. We talked about everything. We talked about the nutritionist and what to tell people who ask about our weight loss. She is very open and tells people. I don't think I can do that.
I even got a fake Facebook page so that I could join the group's facebook page. :-)
At the group there was a woman who totally related because she had actually gone through the whole process once before and CHICKENED out. She said that she is going to DO it this time. Her surgery is 1/30/14. She made a lot of sense. She said everyone she knows that has had it only regrets not doing it sooner. She is right. I have to remember that not having this surgery isnt going to prevent me from every having surgery...if I don't have this surgery I will probably end up needing 3 other ones (and more serious ones). I have a lot of health problems from my weight.
There was also this girl there who had the bypass and has lost 113 pounds. She ran her first 5k. We talked about everything. We talked about the nutritionist and what to tell people who ask about our weight loss. She is very open and tells people. I don't think I can do that.
I even got a fake Facebook page so that I could join the group's facebook page. :-)
Monday, December 16, 2013
My First WLS Support Group
My Bariatric Surgery Center has a Weight Loss Surgery Support Group called MONARCH. It stands for something cleaver, but I can't remember what right now. It meets once a month right at the Bariatric Center. I am kinda anxious and nervous by nature so I didn't want to go alone. Gander hurt his back and wasn't feeling well, so I felt bad dragging him along (even though he assured me he wouldn't mind). My mom kindly offered to go with me instead.
There were only about 12 people or so at the meeting. It started with someone handing out the MONARCH Newsletter and some WLS-friendly holiday recipes. Then a man got up and introduced himself as one of the leaders. He had bypass in 2009 and has lost over 100 lbs. He went around the room and had us all introduce ourselves and explain where we are in this process. One lady next to me was 6 months out (bypass) and had lost 80 lb already. She was positively GLOWING. After brief intros, the guest speaker was introduced.
She was one of the Nutritionist at the Bariatric Center (the one that I have an appointment with in February....which will be my 2nd nutrition appointment, which could potentially be my LAST one if she approves me). She gave a presentation on how not to gain weight during the holidays. Honestly, it was kinda boring and stuff I already knew and read about in fitness magazines all the time: don't go starving, bring a healthy dish to pass, don't drink your calories, etc. I didn't feel like it was really directed toward the weight loss patient. But it certainly applies. That lasted about an hour. And then my mom was ready to go.
I wanted to stay and listen to the "chit-chat" part even though it was kind of annoying. A lot of the people there didn't really seem like they "got it"...some of them were actually approved for the surgery already, and were asking the oddest questions....things that they should DEFINITELY know already. Like what's the post op diet? What can you eat right after surgery? One person there had her surgery last week and she was asking things like "can you ever eat in a restaurant again?" I guess I'm being too judgmental. But there were people there whose brain I would have loved to pick. Like the lady next to me. I did have the chance to ask the leader a few questions. He seemed like a genuinely nice guy. Volunteering his time to help people accomplish what he did.
But anyways, I felt bad making my mom stay later, neither of us had eaten, it was getting late, and it was snowing bad. So, we left. I think next time I will go alone or take Gander (who is contractually obligated to hang out with me even if he is super bored....cuz we're married and stuff). Long story short, I don't think it was all that great, but I fully intend on going next month. I want to soak up any opportunity to learn anything and everything I can about this stuff!
There were only about 12 people or so at the meeting. It started with someone handing out the MONARCH Newsletter and some WLS-friendly holiday recipes. Then a man got up and introduced himself as one of the leaders. He had bypass in 2009 and has lost over 100 lbs. He went around the room and had us all introduce ourselves and explain where we are in this process. One lady next to me was 6 months out (bypass) and had lost 80 lb already. She was positively GLOWING. After brief intros, the guest speaker was introduced.
She was one of the Nutritionist at the Bariatric Center (the one that I have an appointment with in February....which will be my 2nd nutrition appointment, which could potentially be my LAST one if she approves me). She gave a presentation on how not to gain weight during the holidays. Honestly, it was kinda boring and stuff I already knew and read about in fitness magazines all the time: don't go starving, bring a healthy dish to pass, don't drink your calories, etc. I didn't feel like it was really directed toward the weight loss patient. But it certainly applies. That lasted about an hour. And then my mom was ready to go.
I wanted to stay and listen to the "chit-chat" part even though it was kind of annoying. A lot of the people there didn't really seem like they "got it"...some of them were actually approved for the surgery already, and were asking the oddest questions....things that they should DEFINITELY know already. Like what's the post op diet? What can you eat right after surgery? One person there had her surgery last week and she was asking things like "can you ever eat in a restaurant again?" I guess I'm being too judgmental. But there were people there whose brain I would have loved to pick. Like the lady next to me. I did have the chance to ask the leader a few questions. He seemed like a genuinely nice guy. Volunteering his time to help people accomplish what he did.
But anyways, I felt bad making my mom stay later, neither of us had eaten, it was getting late, and it was snowing bad. So, we left. I think next time I will go alone or take Gander (who is contractually obligated to hang out with me even if he is super bored....cuz we're married and stuff). Long story short, I don't think it was all that great, but I fully intend on going next month. I want to soak up any opportunity to learn anything and everything I can about this stuff!
Tuesday, December 10, 2013
Hoops: First Appointments Made!
OK people!! This is happening! (Well the things that have to happen so that the things that need to happen before the other thing can happen are happening.) I called to make my appointment at the Bariatric Center. I was pleased that all I had to say was, "I went to the Seminar...now what?" and the lady on the other end knew exactly what to do.
Although she wasn't exactly warm and fuzzy, she did know exactly what I needed to be scheduled for and how far apart the appointments had to be. They gave me the first appointments available...which was mid-January. Even though that's about 5 weeks away, it's ok because my insurance doesn't kick in until January 1st. Also, it gives me a little time to get in to see my Primary Care Physician and get her on board with this whole thing. Fun.
My group nutritional appointment is January 16th, 2014 and is from 8:30a-11:00am. Then I have my hour long History and Physical Appointment January 23rd, 2014. Finally, on February 11th at 9am I have my one-on-one 30 minute nutritionist appointment.
Technically only 2 nutritionist appointments are required, so in theory, this could be all I need. I really didn't expect to get all these appointments to soon! I am just anticipating to be met with so much resistance and to have to fight tooth and nail the whole way to make this happen. I am also struggling to really appreciate all the steps they have you take and view them as tools that will help me succeed post-surgery instead of obstacles I have to get around so I can get the surgery. I'm already thinking of things I should say and trying to figure out what they want to hear. Instead of that I should just work on DOING those things!
Like chewing a zillion times before swallowing. And writing in a food journal every day. And exercising. And taking my diabetes and blood pressure meds (which I have been doing). And eating high protein. And watching my portions. And cutting out junk food. And taking my vitamins.
Wow. That sounds like a lot of work. I think that between now and my appointments I need to really focus on getting my mind around this. I need to wake up out of this FOG. I need to start watching what I eat and exercising. I spend a lot of my life hiding from it. Hiding from life I mean. The thing about life, though, is that it doesn't spend a lot of time looking for you. Doesn't send a search party. Just kinda keeps going...passes you right by. I need help.
I know that I have to see a therapist of some sort to deal with my food issues. I tried that already early this year....it helped and didn't help. I couldn't open up. I didn't want to talk about things. I liked the person I was seeing, but maybe she wasn't as good a fit as I thought? I don't know.
There is a Weight Loss Surgery support group that's affiliated with the Bariatric Center. They meet once a month and it's free of charge. I am going tomorrow. Maybe hearing from people that are going through this and have gone through it will help.
Although she wasn't exactly warm and fuzzy, she did know exactly what I needed to be scheduled for and how far apart the appointments had to be. They gave me the first appointments available...which was mid-January. Even though that's about 5 weeks away, it's ok because my insurance doesn't kick in until January 1st. Also, it gives me a little time to get in to see my Primary Care Physician and get her on board with this whole thing. Fun.
My group nutritional appointment is January 16th, 2014 and is from 8:30a-11:00am. Then I have my hour long History and Physical Appointment January 23rd, 2014. Finally, on February 11th at 9am I have my one-on-one 30 minute nutritionist appointment.
Technically only 2 nutritionist appointments are required, so in theory, this could be all I need. I really didn't expect to get all these appointments to soon! I am just anticipating to be met with so much resistance and to have to fight tooth and nail the whole way to make this happen. I am also struggling to really appreciate all the steps they have you take and view them as tools that will help me succeed post-surgery instead of obstacles I have to get around so I can get the surgery. I'm already thinking of things I should say and trying to figure out what they want to hear. Instead of that I should just work on DOING those things!
Like chewing a zillion times before swallowing. And writing in a food journal every day. And exercising. And taking my diabetes and blood pressure meds (which I have been doing). And eating high protein. And watching my portions. And cutting out junk food. And taking my vitamins.
Wow. That sounds like a lot of work. I think that between now and my appointments I need to really focus on getting my mind around this. I need to wake up out of this FOG. I need to start watching what I eat and exercising. I spend a lot of my life hiding from it. Hiding from life I mean. The thing about life, though, is that it doesn't spend a lot of time looking for you. Doesn't send a search party. Just kinda keeps going...passes you right by. I need help.
I know that I have to see a therapist of some sort to deal with my food issues. I tried that already early this year....it helped and didn't help. I couldn't open up. I didn't want to talk about things. I liked the person I was seeing, but maybe she wasn't as good a fit as I thought? I don't know.
There is a Weight Loss Surgery support group that's affiliated with the Bariatric Center. They meet once a month and it's free of charge. I am going tomorrow. Maybe hearing from people that are going through this and have gone through it will help.
Friday, November 22, 2013
HOOPS: Weight Loss Seminar
So I went to the required weight loss seminar yesterday. I'm so lucky to have one of the best Bariatric Centers in the world right here.
The very first step in this process is to attend a weight loss seminar. I didn't get why but it's mostly because part of the insurance requirement to pay for surgery is to that you fully understand what weight loss surgery is (the person doing your psych eval has to sign off on this). I signed up for the seminar online. I waited for the one held by the surgeon I want (there are a few at the center but this guy is the director...and the best). I'm glad I waited a few weeks because when I got there they told us that you have to go to the seminar of the person doing your surgery.
The day after I registered for the seminar online I got a call from the receptionist. She asked me some questions to make sure I qualify for surgery. You either have to have a BMI of 40 or above....or a BMI of 35 or above with a co-morbidity (like diabetes). I have a BMI of 47 and diabetes and high blood pressure. So I was in like Flynn. The one time in my life that has worked to my advantage! The receptionist also wanted to know about my health insurance. I don't have it yet but will next month so I'm good.
The receptionist told me she would mail me a packet with info about the center. As promised it arrived a few days later (in a descreet unlabeled envelope which was nice). It had directions to the seminar and a thank you letter for signing up. It also had this packet that my PCP is supposed to fill out so I can bring it with my to my consult with the surgeon. It basically is a long long form saying what diets I have ever tried my entire life and how much weight I lost on them. It also has a bunch of questions about my general health. The only question I'm scared of is where it asks if I am "generally compliant with treatment"....hmmm...not always. I forget or just don't take my diabetes and high blood pressure meds...and go off diet a lot. Like a lot a lot. So I have a month to get back on track.
The packet said that I could bring one support person with me. This is a free seminar so space was limited. I had Gander meet me there after work. He is such a good husband! He is so supportive through all of this. We got there and got a folder full of info on WLS and their center. We also got a free pen! Which I was super excited about! Until I saw that it had "Bariatric Surgery Center" written on it...so I won't be using it ever. We had to get there at 5:30pm to register and the seminar was supposed to start at 6pm. I was sooo nervous so I got there at 5pm...then a lady got up front at 6:04 and explained what was in the packet...which I already knew because I had spent the last half hour sitting there reading the whole thing. It was really helpful information. It outlined every step in the process including attending the seminar so we could all check that off our list. Then she said the surgeon would be there shortly...which turned into a half hour. Sigh.
When he did get there he had a slide show about the center. He showed us that the waiting room chairs and exam tables and scales and OR table are all extra big and sturdy and comfy for fat people...which I was oddly comforted by. Then he showed us a bunch of statistics about the center and why it's so great (which I already kinda knew). Then he went on for way way way way tooooo long about the anatomy of the digestive system and how you get fat...you eat more calories then you burn. And how you lose weight....burn more calories than you eat. Seriously? Yeh...we know. We are considering weight loss surgery...its not usually the first thing you try. I think we all know how this stuff works. So I spent a lot of this time yawning and looking at the clock. But then it got good. Honestly the seminar could have started here and been just fine.
He went into the 3 different options in the order of most commonly performed there: Gastric Bypass, Sleeve Gastrectomy, Gastric Band. The surgeon did a great great job explaining the differences in not only what happens to your insides (with slides!) but also the differences in hospital stay, average weight loss, upkeep, size of stomach, method (restriction vs malabsorbtion), operating time, time away from work, post surgery care, post surgery diet, and more. He also went into the risks associated with the surgery.
At the end there was time to ask questions and he spent about an hour answering questions. We didn't leave til 9pm. But it was so worth it. I got all my questions answered and trust my surgeon 100%. I was surprised that (despite my vorascious web browsing and blog stalking) I learned a lot about this process that I didn't know before.
I have really been wondering how long all the pre-approval and hoop jumping is going to take. Basically (as long as your insurance covers it) it really depends on your nutritionist. You have to go to a bariatric nutritionist at the center and basically eat the way you would on maintenance after your surgery. There are two visits that are mandatory (30days apart) and after that the nutritionist decides how many more monthly appointments you need. You have to keep a food journal and stuff like that. You don't have to lose weight during this time (unless your insurance requires it) but you can't gain weight. If you're gaining they take it as a sign that you aren't willing to make the lifestyle change required to make surgery successful. Some one asked what would happen if some one has never dieted before. The answer was that they would probably have to do 6 months of nutrition. She also said the fastest some one would have the surgery is 3-4 months and the longest is a year. I get insurance in January...so best case scenario would be april...worst case would be January 2015.
I asked if he oversews--he doesn't. He says there is no need and it slows healing.
I asked how big he makes the sleeve. He said 11mm...about the size of a cigar....which is much smaller than "a small banana" which he described it as earlier. I asked if that's the same for every patient--it is.
I asked if he agrees that the sleeve truly isn't a "new" procedure. He agreed that it has been done for years as part the first part of a two part procedure for very obese patients who would eventually get the duodenal switch. But it is newer in the sense that it's being done as a stand alone procedure. This cleared up a misunderstanding I had...I thought it was the first part of a gastric bypass...but it was the first part of the duodenal switch.
I asked why, if the sleeve is the second most common surgery done at the center, why was there so little information about it in their literature and none on their website. His anwer was that since it is newer, insurance companies just started approving it in 2007. Ummmmmm seriously? You haven't updated your website and literature? That has been the only frustrating part of dealing with the center right now. The website doesn't even mention the sleeve. I wouldn't have even known it was an option if I hadn't stumbled upon it in my internet searches. Then I had to google my surgeon to see if he even did them. Not good!
The most amazing thing I learned was about stretching out the stomach. You can't. The new stomach does not stretch. He said he has seen tons of patients who come to him who say they need another surgery because another surgeon did their WLS years ago and they have gained all their weight back and insist their pouch is stretched out. Every time he does xrays and it's the exact same size. They have just learned to get around it by grazing all day on calorie dense food. All the surgery does is slow you down but you can still eat toooo much.
I also learned that the lower your BMI, the less difference there is between surgeries in the percentage of excess weight you're likely to lose. If you are around 40 BMI or less you can expect 80% loss of excess weight. Great news!!!!
Another important thing is that your best way to minimize risks is to be in the best possible shape. My blood sugar and pressure has to be in control even if its by medication. Also if I exercise and eat right my heart and lungs will be in better shape.
Well I was all excited to have all my questions answered!
The very first step in this process is to attend a weight loss seminar. I didn't get why but it's mostly because part of the insurance requirement to pay for surgery is to that you fully understand what weight loss surgery is (the person doing your psych eval has to sign off on this). I signed up for the seminar online. I waited for the one held by the surgeon I want (there are a few at the center but this guy is the director...and the best). I'm glad I waited a few weeks because when I got there they told us that you have to go to the seminar of the person doing your surgery.
The day after I registered for the seminar online I got a call from the receptionist. She asked me some questions to make sure I qualify for surgery. You either have to have a BMI of 40 or above....or a BMI of 35 or above with a co-morbidity (like diabetes). I have a BMI of 47 and diabetes and high blood pressure. So I was in like Flynn. The one time in my life that has worked to my advantage! The receptionist also wanted to know about my health insurance. I don't have it yet but will next month so I'm good.
The receptionist told me she would mail me a packet with info about the center. As promised it arrived a few days later (in a descreet unlabeled envelope which was nice). It had directions to the seminar and a thank you letter for signing up. It also had this packet that my PCP is supposed to fill out so I can bring it with my to my consult with the surgeon. It basically is a long long form saying what diets I have ever tried my entire life and how much weight I lost on them. It also has a bunch of questions about my general health. The only question I'm scared of is where it asks if I am "generally compliant with treatment"....hmmm...not always. I forget or just don't take my diabetes and high blood pressure meds...and go off diet a lot. Like a lot a lot. So I have a month to get back on track.
The packet said that I could bring one support person with me. This is a free seminar so space was limited. I had Gander meet me there after work. He is such a good husband! He is so supportive through all of this. We got there and got a folder full of info on WLS and their center. We also got a free pen! Which I was super excited about! Until I saw that it had "Bariatric Surgery Center" written on it...so I won't be using it ever. We had to get there at 5:30pm to register and the seminar was supposed to start at 6pm. I was sooo nervous so I got there at 5pm...then a lady got up front at 6:04 and explained what was in the packet...which I already knew because I had spent the last half hour sitting there reading the whole thing. It was really helpful information. It outlined every step in the process including attending the seminar so we could all check that off our list. Then she said the surgeon would be there shortly...which turned into a half hour. Sigh.
When he did get there he had a slide show about the center. He showed us that the waiting room chairs and exam tables and scales and OR table are all extra big and sturdy and comfy for fat people...which I was oddly comforted by. Then he showed us a bunch of statistics about the center and why it's so great (which I already kinda knew). Then he went on for way way way way tooooo long about the anatomy of the digestive system and how you get fat...you eat more calories then you burn. And how you lose weight....burn more calories than you eat. Seriously? Yeh...we know. We are considering weight loss surgery...its not usually the first thing you try. I think we all know how this stuff works. So I spent a lot of this time yawning and looking at the clock. But then it got good. Honestly the seminar could have started here and been just fine.
He went into the 3 different options in the order of most commonly performed there: Gastric Bypass, Sleeve Gastrectomy, Gastric Band. The surgeon did a great great job explaining the differences in not only what happens to your insides (with slides!) but also the differences in hospital stay, average weight loss, upkeep, size of stomach, method (restriction vs malabsorbtion), operating time, time away from work, post surgery care, post surgery diet, and more. He also went into the risks associated with the surgery.
At the end there was time to ask questions and he spent about an hour answering questions. We didn't leave til 9pm. But it was so worth it. I got all my questions answered and trust my surgeon 100%. I was surprised that (despite my vorascious web browsing and blog stalking) I learned a lot about this process that I didn't know before.
I have really been wondering how long all the pre-approval and hoop jumping is going to take. Basically (as long as your insurance covers it) it really depends on your nutritionist. You have to go to a bariatric nutritionist at the center and basically eat the way you would on maintenance after your surgery. There are two visits that are mandatory (30days apart) and after that the nutritionist decides how many more monthly appointments you need. You have to keep a food journal and stuff like that. You don't have to lose weight during this time (unless your insurance requires it) but you can't gain weight. If you're gaining they take it as a sign that you aren't willing to make the lifestyle change required to make surgery successful. Some one asked what would happen if some one has never dieted before. The answer was that they would probably have to do 6 months of nutrition. She also said the fastest some one would have the surgery is 3-4 months and the longest is a year. I get insurance in January...so best case scenario would be april...worst case would be January 2015.
I asked if he oversews--he doesn't. He says there is no need and it slows healing.
I asked how big he makes the sleeve. He said 11mm...about the size of a cigar....which is much smaller than "a small banana" which he described it as earlier. I asked if that's the same for every patient--it is.
I asked if he agrees that the sleeve truly isn't a "new" procedure. He agreed that it has been done for years as part the first part of a two part procedure for very obese patients who would eventually get the duodenal switch. But it is newer in the sense that it's being done as a stand alone procedure. This cleared up a misunderstanding I had...I thought it was the first part of a gastric bypass...but it was the first part of the duodenal switch.
I asked why, if the sleeve is the second most common surgery done at the center, why was there so little information about it in their literature and none on their website. His anwer was that since it is newer, insurance companies just started approving it in 2007. Ummmmmm seriously? You haven't updated your website and literature? That has been the only frustrating part of dealing with the center right now. The website doesn't even mention the sleeve. I wouldn't have even known it was an option if I hadn't stumbled upon it in my internet searches. Then I had to google my surgeon to see if he even did them. Not good!
The most amazing thing I learned was about stretching out the stomach. You can't. The new stomach does not stretch. He said he has seen tons of patients who come to him who say they need another surgery because another surgeon did their WLS years ago and they have gained all their weight back and insist their pouch is stretched out. Every time he does xrays and it's the exact same size. They have just learned to get around it by grazing all day on calorie dense food. All the surgery does is slow you down but you can still eat toooo much.
I also learned that the lower your BMI, the less difference there is between surgeries in the percentage of excess weight you're likely to lose. If you are around 40 BMI or less you can expect 80% loss of excess weight. Great news!!!!
Another important thing is that your best way to minimize risks is to be in the best possible shape. My blood sugar and pressure has to be in control even if its by medication. Also if I exercise and eat right my heart and lungs will be in better shape.
Well I was all excited to have all my questions answered!
Monday, November 18, 2013
Who Needs Sleep?
I told two people that I am having weight-loss surgery. Cart before the horse? Yes, yes, yes. But I just feel so sure about this. I told two people that are very very close to me. My aunt (who is basically a parent) and one of my oldest dearest friends. I am the kind of person who can keep a secret as long as it's not mine.
If I do have this surgery, I don't want every one to know about it. I wonder if I can get away with no one knowing about it. Can I just take a two week vacation from work and go to Jamaica or something? Let people think my shrinking and liquid diet is due to a horrible foreign virus? Or tape worm? I know I'm getting ahead of myself, but these are just things that I can't stop thinking about.
I have the weight loss seminar with my surgeon on Thursday night. I have so many questions! I have read on blogs from other people who have had VSG that sometimes surgeons "oversew" and sometimes they don't. Also, I have read that the size of the sleeve varies by surgeon's preference. I want to find out if my surgeon just does a standard size for everyone that he thinks is the best, and if so, how does it rate? Small, average, large? Or does he decide what size is best for me in particular? I know that there are support groups for people who have had WLS and I really hope that I can get some info at the seminar so I can start going to those. I would really like to hear about some real life experiences.
They say that people who have the sleeve usually lose 50-80% of their EXCESS body weight. At first this kind of bummed me out. I weigh 265 lb. My "pie-in-the-sky-it's-never-gonna-actually-happyen-but-you-can-dream" weight has always been 150 lb. So, in my book, I have 115 lb of excess weight. Best case scenario if I lost 80% of that it would be 92 lb lost. That would bring me to 173. Not bad. But I was looking up what my "ideal body weight" is considered by medical professionals. I'm 5'2" and 32 years old. I should weigh 104-130 lbs to be considered a "healthy weight".
With those numbers in mind, if 130 lb is the highest "healthy weight" for, me then my excess weight is 135 lb making 80% loss of excess weight 108 lb. That means that I could be down to 157 lb (if you go by the 104 as my ideal weight, then with an 80% loss of excess weight, I would end up losing 129 lb and be 136). HA!!! That would take more than VSG.....I'm pretty sure it would take pixie dust!
Every day that goes by convinces me more and more and more that this is the RIGHT move. This weekend was so typical and so awful. I am really embarrassed to even put this in print, but here goes. Friday at work I was just so exhausted. I spend all week just thinking "only X more days til the weekend". I spend all day at work thinking "only a few more hours and you can go home and go to sleep". I get home from work at 6:30 pm and I am asleep by 8:30 pm. I throw food together, eat dinner, lay on the couch and watch TV until I go to sleep, so that I can wake up the next day and do it again. What kind of life is that?? This week was particularly bad because on Friday we had a Baby Shower for a girl at work, which I organized. At the end of the day there was a ton of cake left. A LOT of cake. And I really did try to have other people take it home....it didn't work. It was either me take it home or throw it away. Since you already know that I'm 5'2" and weigh 265 lbs, I'm sure you already know what happened.
It did not get thrown away. I ate the rest of the cake by myself. We went to a friend's house on Saturday night, so that was "active" but the rest of the time was spent in exhaustion. Dreading taking a shower because there are no clean clothes because I have no energy to clean! All Sunday I slept. I woke up at 10am, could not stay awake so I napped from 11-1pm. Then at around 2pm I was still so tired I felt drugged. So I slept again from 2-5pm. I woke up and watched TV, went grocery shopping, came home, had some canned clam chowder for dinner and....fell asleep at 10pm watching TV.
Great life, huh? I don't care what any one says. This is because of my weight. I am too tired and too discouraged to do anything. I'm so scared of surgery because I'm terrified of anesthesia. I'm scared I won't wake up. But am I really awake right now??? This is the right decision. It will at least give me a fighting chance.
If I do have this surgery, I don't want every one to know about it. I wonder if I can get away with no one knowing about it. Can I just take a two week vacation from work and go to Jamaica or something? Let people think my shrinking and liquid diet is due to a horrible foreign virus? Or tape worm? I know I'm getting ahead of myself, but these are just things that I can't stop thinking about.
I have the weight loss seminar with my surgeon on Thursday night. I have so many questions! I have read on blogs from other people who have had VSG that sometimes surgeons "oversew" and sometimes they don't. Also, I have read that the size of the sleeve varies by surgeon's preference. I want to find out if my surgeon just does a standard size for everyone that he thinks is the best, and if so, how does it rate? Small, average, large? Or does he decide what size is best for me in particular? I know that there are support groups for people who have had WLS and I really hope that I can get some info at the seminar so I can start going to those. I would really like to hear about some real life experiences.
They say that people who have the sleeve usually lose 50-80% of their EXCESS body weight. At first this kind of bummed me out. I weigh 265 lb. My "pie-in-the-sky-it's-never-gonna-actually-happyen-but-you-can-dream" weight has always been 150 lb. So, in my book, I have 115 lb of excess weight. Best case scenario if I lost 80% of that it would be 92 lb lost. That would bring me to 173. Not bad. But I was looking up what my "ideal body weight" is considered by medical professionals. I'm 5'2" and 32 years old. I should weigh 104-130 lbs to be considered a "healthy weight".
With those numbers in mind, if 130 lb is the highest "healthy weight" for, me then my excess weight is 135 lb making 80% loss of excess weight 108 lb. That means that I could be down to 157 lb (if you go by the 104 as my ideal weight, then with an 80% loss of excess weight, I would end up losing 129 lb and be 136). HA!!! That would take more than VSG.....I'm pretty sure it would take pixie dust!
Every day that goes by convinces me more and more and more that this is the RIGHT move. This weekend was so typical and so awful. I am really embarrassed to even put this in print, but here goes. Friday at work I was just so exhausted. I spend all week just thinking "only X more days til the weekend". I spend all day at work thinking "only a few more hours and you can go home and go to sleep". I get home from work at 6:30 pm and I am asleep by 8:30 pm. I throw food together, eat dinner, lay on the couch and watch TV until I go to sleep, so that I can wake up the next day and do it again. What kind of life is that?? This week was particularly bad because on Friday we had a Baby Shower for a girl at work, which I organized. At the end of the day there was a ton of cake left. A LOT of cake. And I really did try to have other people take it home....it didn't work. It was either me take it home or throw it away. Since you already know that I'm 5'2" and weigh 265 lbs, I'm sure you already know what happened.
It did not get thrown away. I ate the rest of the cake by myself. We went to a friend's house on Saturday night, so that was "active" but the rest of the time was spent in exhaustion. Dreading taking a shower because there are no clean clothes because I have no energy to clean! All Sunday I slept. I woke up at 10am, could not stay awake so I napped from 11-1pm. Then at around 2pm I was still so tired I felt drugged. So I slept again from 2-5pm. I woke up and watched TV, went grocery shopping, came home, had some canned clam chowder for dinner and....fell asleep at 10pm watching TV.
Great life, huh? I don't care what any one says. This is because of my weight. I am too tired and too discouraged to do anything. I'm so scared of surgery because I'm terrified of anesthesia. I'm scared I won't wake up. But am I really awake right now??? This is the right decision. It will at least give me a fighting chance.
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