That Fat Chick

It’s funny how when you’re anticipating something, the weeks leading up to it seem to draaaaaaaaaag. But the last few days? They absolutely flew. Of course, part of that could be attributed to the fact that I deliberately swamped myself with online and offline projects the weekend before, and a lot of that work spilled over into Monday.

It sucked getting up at 6:00am on Tuesday morning, when I normally don’t wake up until 10:00am, if not a little later. But I put aside the fleeting thought of how good it would be to stay in bed (it was drizzling that morning, and you know how it is when it’s dark and rainy — you just want to sleep and sleep and sleep!), and dashed out of bed.

Upon arrival at the facility where the seminar was being held, the receptionist quickly sized me up and correctly assumed that I was there for the surgical weight loss seminar, and not to work out (the facility housed a gymnasium, among other things) or start job orientation. Yet again my weight speaks for me!

The seminar was led by one of the surgeons. In addition to introducing himself, the surgeon also introduced the other surgeons and surgical weight loss program team members through an informative and detailed Microsoft PowerPoint slide show presentation.

A lot of information was presented at the seminar, most of which I already knew. The information included BMI information, the definition of, causes of and problems caused by obesity, and the two surgeries most often used to treat morbid obesity after all other methods of weight loss (dieting and exercise) have been exhausted.

Benefits of weight loss, including living longer, reducing the significance of or eliminating entirely diabetes, high blood pressure and blood lipids was also touched on. He made mention of many women finding it easier to get pregnant and remain pregnant after losing significant amounts of weight.

The surgeon who was the spokesperson for the surgical program was very informative. He didn’t sugar coat, and didn’t hesitate to spell out the risks and possible side effects of both the lap band surgery and the gastric bypass. He was also very positive and upbeat, and willing to answer any and all questions we had afterward.

The surgeon went over the goals of surgical weight loss, which are:

• To induce and maintain weight loss of >50% excess body weight
• Average weight loss is about 1/3 of your pre-operative body weight
• Reduction in weight related medical problems

He also went over the surgical weight loss candidates:

• Meet the BMI criteria: BMI of at least 40, or BMI 35-39 with serious health problems
• At least 18 years old
• Overweight for more than five years
• Short-term success with other serious weight-loss attempts
• No current medical problem causing obesity
• Prepared to attend regular follow-up sessions and make lifestyle changes
• No psychiatric conditions that are being untreated and/or are out of control

Once all of the information had been presented, the surgeon went on to discuss the steps in their particular program:

1. Attend the hour and a half information session (which is what that was!)
2. Have a medical evaluation done by my family doctor, or by their nurse practitioner (I’m going to talk about this more later)
3. Enter into the six month supervised weight management program. During this program, I will be required to attend monthly two hour meetings, keep a food journal, incorporate more activity into my lifestyle, do homework as assigned at the meetings, and lose 5% of my body weight.
4. During the six month supervised weight management program, do any required testing as deemed necessary by the nurse practitioner. This can include blood work, sleep apnea testing, and will definitely include a psychological evaluation.
5. At the end of the six month supervised weight management program, assuming I have a stamp of approval and have completed the program successfully and lost 5% of my body weight, or close to it, meet with the surgeon to discuss surgery options.
6. Pre-admission testing.
7. SURGERY!
8. After surgery follow-ups

Step 1 is obviously completed, as I arrived at the seminar twenty minutes early, checked in, and turned in all of the paperwork I had received in the mail, as well as two more pages of paperwork I received at the seminar itself.

I am now awaiting a phone call from the surgical weight loss program. This will be to go over the medical evaluation: to have me turn one in, or meet with their nurse practitioner to have it done. I think I am going to have their nurse practitioner do it. This is because my family doctor really doesn’t know me, because I have been there maybe once or twice in the past five years. Also, I’m worried that my family doctor may not approve of my choice of weight loss surgery, and thus not fill out the recommendation form that I need him to complete in order to proceed with the surgical weight loss program.
My weight has been documented from 2004 onwards with my OB/GYN, and I have my own documentation of my weight loss attempts, including logs and receipts. So, that should all be enough for the nurse practitioner. Besides, he/she works with the surgical weight loss program, so as long as I meet the requirements as outlined above (which I do), he/she will be in favor of the surgery.

I also found out the insurance codes for weight loss surgeries:

Gastric bypass: 43846
Lap gastric bypass: 43644
Lap band: 43770

And those monthly meetings? If my health insurance doesn’t cover them, I’m looking at $46 - $93 per meeting.

And… I think that about covers everything. Wow, this blog entry was very long!

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