Pre-Op Work-Up

Oh my word, this has been one heck of a journey so far and I'm only just starting.  It is required for all bariatric surgery candidates to have a list of clearances before surgery.  I needed a psych eval and my psychologist of nearly 16 years could provide far more information than any psychiatrist they would have me talk with for a couple of hours.  I needed a sleep study.  Well, I already use a C-Pap, so I just had the doc print out a report of recent use.  I needed some initial blood work, which I had done from my primary a few weeks prior.  I mailed all of that out to them.  Finally is my cardiac clearance.  He wanted me to have a nuclear stress test (since I can't go running on a treadmill - if I couldn't I likely wouldn't need the surgery in the first place) and an echo.  I received calls after each of these to say that the results showed no abnormalities.  I see the cardiologist on Monday and assume I will have that clearance then.  The surgeon's office also ordered a number of labs, but when I went to have them done, I found out that my insurance wasn't going to cover those tests under the diagnostic code they used, which had added up to well over $500 and they hadn't run all of them through.  I called the nurse at the surgeon's office to see if there was another code they could use (of course without committing insurance fraud).  She called the lab and there are hoops she needs to jump through.

So, the next step is an endoscopy.  The doctor is willing to allow me to do it in the hospital out here in the suburbs (usually all of this is done downtown and I don't drive downtown).  He is going to speak with my GI to coordinate something.

I'm drinking protein drinks one meal per day (at this point) and am having high protein yogurt at least once a day.  I'm testing things out and figuring out what works.  I got a special bariatric surgery cookbook and it is providing a ton of information!

We joined a gym, although my membership is suspended for now.  They offer aquatic classes and I plan on doing that.  I don't know when I'll be allowed back in the pool and right now, I'm just waiting to see when surgery is.  In the meantime I am riding my exercise bike.  I'm losing - slowly but surely, I'm losing some pounds.

I am going to see an additional therapist to deal solely with my food and eating issues.  I mean, obviously I have some, since I am a hippo.  I can't go back to eating the way that caused me to become this.... well.... fat.  I am an emotional eater and did find a book which deals with this topic, too.  Perhaps it will be a jumping off point for that therapy.  We'll see.  My OCD has had me create a binder of information, printed from the computer and in page protectors, divided by topic.  So yeah, I'm well-versed and ready to tackle this!

When's surgery?  Everyone asks and I have to explain the above process to them.  Hopefully soon I can give a solid date!  Excited and Terrified.  That's where I stand.  And I think that's normal.

Bariatric Update

Hey all!  I figured it was time for an update, so here it is :)

My psychologist has written a letter of support and approval for me to have the surgery.  When I met with the cardiologist he wanted to wait until I had a few tests before giving his ok.  I had a nuclear stress test two weeks ago and an echo last week.  I see him on the 15th and expect full go-ahead.

I've been testing some protein drinks/shakes and went through what the dietitian sent with a highlighter and pen.  I have studied my little heart out.  I'm also setting up a consult with a therapist simply for eating and food issues.  I've seen her before when my psychologist was gone and she was his student.

The next step is to have an endoscopy.  The nurse said that they typically wait until later in the process before scheduling this, when I called and asked it to schedule since it will require some coordination (using my GI doc with the surgeon in the room).  She called and said that the surgeon will be in touch with the GI doc in the next couple of weeks.

The nurse called to tell me that she received the information I sent with my C-Pap report and most recent blood work.  She expressed some concern over my triglycerides and is sending me a script for new labs (which they run anyway).  My sugar levels are elevated and there is a slight debate over if I should have a diabetes diagnosis or if I can be considered pre-diabetic assuming that my levels will decrease post-op.

After the endoscopy, I was told that the surgery is scheduled about 6 weeks out.  In the meantime, I'm having a protein shake for breakfast and working to keep my sweets and carbs in check.  The latter is HARD!  I was so cranky yesterday because I fought the urge to have some Skinny Cow chocolates.  I have to at least start to make big changes and not wait until after the operation.  I will be on a liquid diet for both the 2 weeks pre- and post-op, then 2 weeks of pureed food (I refuse to eat pureed chicken!).

My husband and I have joined a gym, at which I will use the pool - possibly taking an aquatics class.  My membership is on hold for now until I know when surgery is.  I'm sure I'll be limited after surgery and will likely not be in the pool for some time.  I did speak with the location nearest to me and she said that I can always activate my membership now and then freeze it again when I have surgery.  I loathe the thought of squeezing myself into a bathing suit, but the exercise may help me lose some weight and get into a routine.  For now, we'll see.....

I am both excited and terrified, but I have to do it.  I'll try to post more often, or at least as I have updates.