History & Physical

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. 

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.