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.

Title-less

It's January 1st and here I sit at my computer.  I have no "resolutions."  I don't care.  Maybe because it's the fact that I'm stuck in an incredibly deep depression and my marriage is a mess.  Maybe it's because I'm super cynical find resolutions to be ridiculous.  I mean whatever we say today is usually broken by the end of the week or the month.  Very few of us actually do those things we resolve to do.  Whatever it is, I don't make them.

Ok, I got that out of the way.  I want to share that I've seen a bariatric surgeon.  He believes I'm a good candidate for a gastric sleeve.  Here is some information about the sleeve, but the site also includes oodles of information about bariatric surgery, including an hour-long webinar which offers a lot of information.  It's basically a doctor talking while you stare at Power Point slides.  It's not the most interesting of things, but it gets the job done, plus I had to watch it before my appointment.  It's not anything that's inserted, nor do they re-route any part of your digestive system.  They simply staple off part of your stomach.  This both makes your stomach smaller, but releases your body from experiencing the hormone that makes us feel hungry.

The doctor was wonderful.  He spent nearly an hour with me!  I recorded it so that I can refer back to it.  The city where the doctor will perform the surgery is in the city.  I saw him at a local office (30 mins, which is local for this area) and during the course of the appointment, told him that I don't drive in the city and he is totally willing to work with me.  There are a number of tests and evaluations necessary for the surgery to be performed.  One is a sleep study - already had one done and I use the C-Pap; one is a psych eval - since I've seen my psychologist for nearly 16 years, he will take a statement from him (who is the one who brought it up in the first place).  They also need an endoscopy.  I had one several months ago, but despite me telling them that I vomit with Propofol (they said it is the med of choice for those who do experience nausea and/or vomiting after a procedure), they gave it to me and the doctor couldn't finish the procedure because - guess what (?) - I vomited in the middle of it.  The bariatric doc wants to be in the room so he can watch the screen and know what to expect if there are anything which would interfere with the surgery, since my upper GI tract is involved.  Additionally I need a cardiac eval and he is comfortable with me seeing one locally.  I saw one many years ago and know that he's in the same practice as my husbands doc, but may wind up seeing whoever has an appointment available.  There is also a consult with a nurse practitioner and a nutritionist/dietitian, but he said those can be done over the phone.  I love this guy!  It doesn't hurt that he is the husband of one of the docs in the practice where my Mom (an RN) works.  It makes trusting him easier.

When we talked about the psych eval and my doc, he said that I understand the procedure and have done my research (I have a very full binder with tons of info, using page protectors, of course!).  He also said that I was asking all the right questions, so he feels comfortable with my psychologist covering that end of things.  Oh, and I have my entire medical history and a bunch of other things typed up since I'll never remember it all - it's too long and complicated, plus I'm on so many meds there's no way I'd know them all, especially if they want dosage and times!  He can see that I am "together" mentally, especially after seeing my OCD paperwork.

I asked how long it usually takes from the initial appointment.  I expected him to say 6+ months, especially after all of the testing.  Granted some of my testing is already "taken care of" but his answer was 6-8 WEEKS!  Ahhhhhhh!  That's soon.  While I'm excited, I'm also terrified.  This is an enormous lifestyle change and I guess it feels like that's a fast time to prepare mentally.  On the other hand, the sooner the better, right?

In other news, I became a consultant for Thirty-One.  My timing is pretty terrible as I'm dealing with the surgical stuff, but hopefully I can get something out of it, even if it's just a good group of Christian women supporting each other... and hopefully there are some close to me.

Well, "life" calls, so I have to say good-bye for now.  I'll try to write again sooner next time - I know I say that every time, but if I'm going to be down for a couple of weeks I expect to be online more.  So, happy new year!  I wish you all the best.