So yesterday I met with a nurse, nutritionist and dietician. I didn’t realize it at the time, but yesterday’s appointment was also the first of the six sessions I have to do over the course of six months. Cool! One more step completed.
So, the appointment. I was weighed (321 lbs., eek!), had my height measured (5’7”), went over some basics of the surgery, and was given a patient handbook and several to-do’s.
The to-do’s:
- Meet with an exercise physiologist to go over fitness abilities and eventual goals
- Have my PCP do some blood work
- Have a psychological evaluation done
Along with my patient handbook I was given instructions to keep a daily food log, to not skip meals (I have a tendency to skip breakfast), to cut down on fried food, breads and starches, and to try to stick to a 2200/day calorie plan.
Things have definitely picked up in speed since yesterday morning! I made an appointment with the surgical weight loss center’s exercise program center for tomorrow at 6am. I know, that is a brutal hour to have to arrive at a center that is an hour’s drive from my house, but it was either that or wait until September, since everyonee lse passed up the 6am appointment in favor of more tolerable times.
I called my PCP this afternoon, and my blood work appointment is set for July 24th at 9:40am.
I also made an appointment with a local psychologist, and my evaluation will be on July 21st at 7pm.
I’m then in the clear until August 27th, which is my next (second!) session. Until then I just need to take care of the exercise eval, blood work and psych eval, do some reading, fill out a homework sheet, and log my daily food intake.
Yay! 
Finally, after a few phone calls, including one to the director of the surgical weight loss program herself, and picking up paperwork from my doctor and faxing it to her directly, I’m moving on to the next step: meeting with the nutritionist!
My appointment is… today! In seven hours!
I’ll definitely update when I get back!
I have been a very bad blogger. My excuse? I work. A lot. I have been overwhelmed with work from all directions since early April. There have been other things going on as well. Nothing bad, nothing extraordinary. Just things that take up my time, and a lot of it.
I last left off with the seminar, I believe, so I’ll continue with what has happened since then (it isn’t much).
On April 22nd, 2008, I had an appointment with my mother’s family doctor, Dr. R. I decided to have him do my medical evaluation, because he knows my mother’s medical history (obesity, diabetes, hypertension, risk of heart attack, etc.) inside and out, and subsequently knows my maternal grandmother’s and maternal grandfather’s medical histories. He approved her choice for lapband surgery with no questions asked, so I hoped he would do the same for me.
And he did. I spoke with him for all of fifteen minutes, had my weight done (315.8, ergh), did a quick BMI check (“Oh yes, you more than qualify!”), and I showed him a thorough and detailed list I had created, which showed all of the health problems that are on both sides of the family, starting with my mother and father and working on up to my great-grandparents (all four sets of them). Time and time again, obesity, high blood pressure, diabetes, heart attack, stroke. He made a copy of my list, listened to me recite all of my research to him and reasons for choosing the surgery, as well as my failed attempts at weight loss going back to 2002.
At the end of the fifteen minutes, he gathered up the paperwork I brought in and the medical history/letter/approval form, and promised to have it and my mother’s form completed and sent in to the weight loss center within two weeks time.
On April 9th, 2008, I called the weight loss center to check on the status of my form, and that of my mother’s. So far part of my mother’s form had been processed, and mine hadn’t yet been processed. They requested that I give them until June 1st, and if I hadn’t heard from them by then, to call back.
So, I’m counting down the days until June 1st. I feel like I’ve been stagnant for far too long. I want to get moving!
Has it really been almost a month? My apologies! Life has been getting in the way, kicking ass and taking names, and then some! I promise to update with a blog entry within the next twenty-four hours. For now, goodnight!
For the last few weeks, my husband has been suddenly cracking fat jokes. Last week, for example, we were talking about nicknames, and one of his nicknames for me – Angel. He then made some comment about this angel (me) being too fat to fly.
Tonight I asked him about how to raise the height on his desk chair. He cracked something about it not going up with my ass in it.
I’m not hurt by these comments… yet. But will I be? Is this suppressed ew-you’re-such-a-fatass rage coming through, after being held in check after all these years? Has anyone else had a significant other or family member who kind of let go of their self-restraint once they found out that you were having weight loss surgery?
Getting on treadmills is the best option. This is the only fitness equipment with guaranteed results. Another good idea would be to invest in a trampoline.
Fat girl thighs plus jeans that kept sliding off my ass last night which contributed to a droopy crotch area (the JEANS, not ME!) equals very sore, painful chafing on my thighs. I’m currently sitting on a towel, with my legs spread as wide as the chair comfortably allows, with a thick coating of baby diaper rash cream and vaseline smeared on my thighs.
Pray that my husband does not read this blog entry.
Or, pray that if he does read it, he chooses to leave me the few shreds of dignity I have left and NOT make a comment, either here, or to me directly.
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:
- Attend the hour and a half information session (which is what that was!)
- Have a medical evaluation done by my family doctor, or by their nurse practitioner (I’m going to talk about this more later)
- 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.
- 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.
- 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.
- Pre-admission testing.
- SURGERY!
- 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!
