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Michael Jay Nusbaum
'Dr. Nusbaum gives the impression that he is completely confident and will be in absolute control from the first steps all the way through for as long as you need him. He describes the procedure fairly matter of fact
Latest Surgery Support Comments
I am finally embarking on the journey!
I have played this over in my mind so many times, read so much information on it, and studied so many profiles, I could probably perform the surgery on myself if there was a way to do it awake!
5/8/2006 I met with Dr. Michael Nusbaum. He was informative, personable, and seems to really know his stuff. I like that he is my age - it means he's old enough not to still be "in training" and young enough to still be learning.
Wanda, who is the coordinator, will be phoning my insurance company to see what hoops they will require me to jump through in order to have the procedure done. When I hear back from her, I also have to schedule an EGD (upper endoscopy) and a test to see if I have DVT (deep vein thrombosis). I think I have pretty good looking legs on the outside - I hope they find the same on the inside.
My family doctor is probably going to be my biggest obstacle. He is not a fan of gastric bypass. I love him to pieces, but I am going to have to figure out a way to get him to cooperate with me on this.
I had not heard from Wanda, so I phoned expecting bad news. She said she phoned my insurance company and they told her they will send a form for her to fill out. They did not indicate to her what they required except filling out the form. She is hoping the form doesn't ask for a bunch of test results that we will then have to start working on, but according to my phone call with them, they just need proof of a life style changing diet. I hope that means WW receipts.
I got a phone call today from the office asking if I have had my psych consult done. I did not know I needed one. Apparently, it is not a requirement of my insurance company, but of the doctor, so I quickly asked for help on the SJBSS list and had an appointment scheduled by the end of the day. I meet with the therapist on Monday afternoon.
On my way to my middle daughter's preschool graduation, my cell phone rang. I AM APPROVED!! I don't know what to do or when to do it, and I feel so overwhelmed right now with the stuff that has to be scheduled. I hope something helps me get organized!
Another phone call from the doctor's office. This time, it's Wanda, and she gives me my date - August 1st :-) She makes me feel much more comfortable when she tells me she will send me a letter with everything I need to know in it - prescriptions, orders for tests, everything I have to do will be all spelled out. Thank goodness.
I told my two moms (my mom and my stepmom) today that I got approved. My stepmom immediately volunteered to keep my two youngest kids for a week. My mom was less helpful. Hopefully, when the time comes, she'll be able to pitch in.
I had my appointment today for the psychological evaluation. The therapist was Louisa Latela from Haddonfield, and boy, did I like her. She was so nice and so helpful, and I really thought she was someone you would like to be friends with. She just had a sweet and gentle way about her and she seemed very new age-y. I hope I passed the audtion and she clears me on her end for surgery. I didn't come across too nuts!
I met today with my primary doctor, Gary Heck. I love this man to death, but he has always been very negative about gastric bypass surgery. I went in prepared for an argument, and instead, I got what I hope everyone pursuing this gets - a doctor who said he would work with me, help me with whatever I needed, wished me well, promised me he would not allow me to have this surgery if he finds anything in any of my tests that would make me less than an ideal candidate, and sent me on my merry way with phone numbers of people he recommended I see to have the tests done. He is such a wonderful, caring doctor. He also told me I must be the smallest person seeking WLS - I can't believe that. Feeling as fat as I do most days, that was the kindest thing anyone could say to me. He said he was surprised I qualified at my weight. If he wasn't married, I'd marry him. Of course, Jim might have a problem with that, but I'm sure if Dr. Heck shared in the yard work, a deal could be arranged.
I had a mammogram today! It was my first ever, and it was MUCH easier than I thought it would be. It was a test added on by Dr. Heck, and I was lucky that the radiology center had a cancellation for today, or else I was going to have to wait until August, which meant I might have to change my surgery date. In the coming weeks, I have an EKG and EGD scheduled, as well as the doppler study. I have a dental cleaning, and I have to get in for a chest x-ray and some blood work. I see Dr. Heck again on July 17th to go over everything I've had done, and then he will send his final report to Dr. Nusbaum. I also got very lucky with the EGD. When I called the doctor that Dr. Heck recommended, the secretary told me no way was I getting in in time for my surgery. She asked who my doctor was, I told her Dr. Heck, and she told me to hold on. Suddenly, they had time to squeeze me in for a consult on July 3rd, and the EGD on July 5th. That's the test I am most dreading. I used to work for a GI doctor, and I know they are not fun. The thing I am most dreading next? The Fleets kit!
I went today for my venous doppler study, and I have no blood clots in my big fat legs. The test was painful at times, which I did not expect. I thought it was an ultrasound kinda thing - which it is - but in a few areas, she had to press pretty hard to get the image she needed, and especially in the groin area, that hurt!!
If I had done a better job in the timing of things, I could have waited and scheduled this on the same day, same place as my chest x-ray and would have only had to go once. I don't know if I can do my EKG and chest x-ray on the same day, but I expect I can. I am going for a marathon testing day if I can - all of my blood work, my EKG and the chest x-ray all at the same time.
My EGD is coming up next week - little worried about that, but I have to get it done.
My kids are all pretty well arranged for. My oldest daughter, who was going to be going away that week, is now not going until the following week. I think I can leave her here with my two younger daughters the day of the surgery, and have my husband just come home that night with the girls. My stepmom has also offered to help out, so I think we'll be able to work it all out.
It is just over a month away now! I can't believe after all these years of putting it off, I'm that close to it.
My first big hurdle :-( I got a call today from the gastroenterologist's office to confirm my consultation for Monday, July 3rd. I confirm, then ask if there are instructions for the EGD on Wednesday. They do not have me scheduled :-( They are booked for Wednesday and she doesn't know if they can fit me in before my surgery. Now when I made the appointment, I made it perfectly clear how important it was to get this done in time. They told me I can ask the doctor on Monday if there is anyway he can squeeze me in, but they made no apologies or any concessions for the error on their part. I even asked if I should bother to keep the appointment on Monday, because if they can't squeeze me in, I have to find someone else. She said that was up to me. What a bitch.
I'm not posting the name of the office until after I see the doctor on Monday, but if they've jerked me around and wasted 2 weeks when I could have gotten an appointment with someone else, I will be one pissed fat chick. I phoned 3 other offices after I got off the phone with them, and there wasn't anyone who had an appointment available in time for my surgery. UGH.
I had my appointment with the Gastroenterologist today. His name is Dr. Alloy, and he was so nice! When I told him my only concern was getting on the schedule, he marched right to the receptionist with me and made sure she added me. I just got a call from the endo center and I am to be there at 12:30 on Wednesday for my test!
He was very nice about my weight. He said he didn't think I was big enough for the surgery. That's nice to hear, but at almost 300 pounds, I don't know how much bigger I'd need to be! He told me to make sure I understood all of the risks, and he said he wasn't trying to scare me, because most of the time, everything works out fine, but he did want me to be aware of what could go wrong.
The only other thing I want to do before the surgery is to make an appointment with a lawyer to get a living will (I had one, but don't know where it is) and to update my will. I haven't done it since 1991, and now with three kids, I should make an effort to do something just in case. I am not thinking of something bad happening, but if something bad happens, I want all of my ducks in a row.
Okay, so relief is setting in, now that I am a go for my EGD, and the rest of the stuff will fall into place!
Yesterday was my EGD. I was supposed to be at the center at 12:30, and all the arrangements were made for my kids. Well, at 8:50, the center called to say they were running early and could I be there at 9:45. I was still in my nightgown, one of my kids was still asleep, and I'm about 25 minutes from where I need to be. I tell them I can be there at 10, and then make a mad dash to the shower, leaving my poor hubby with two kids to get ready.
The center - The Endo Center in Voorhees - is VERY nice. Everyone was very friendly. Within a few minutes, they escort me back into the changing area, and they tell me to just take off everything from the waist up. They give me two gowns to put on, one front ways and one backwards, and then they have me sit and wait in a room with two antique magazines.
After a few minutes, they bring me back and put me on a gurney. I was interviewed by a nurse, and then the anesthesiologist comes over and talks to me. I have let the nurse know that I am scared to death of the IV, because they usually don't go well for me, but she has it in so fast, I barely know I've been touched. I mention to the anestheiologist some prior complications I've had with anesthesia - including terrible nausea after my last c-section - and she assures me that the meds they use will put me out and make me feel like I am having the best nap of my life.
At just after 11:00, I am wheeled into the OR for the procedure. They put a bite blocker thing in between your teeth so that you can't bite down in your sleep on the stuff going into your throat. The next thing I know, it is 11:25, and I am awake in the recovery room.
The doctor says everything is fine and wishes me good luck. The nurse is telling me about her three friends who've had the surgery and done well. They are checking my vital signs, and by 11:40, I am taken into the room where they sit you in a chair and make you drink something. In this room, I am sitting next to two women who have had colonoscopies, and there seems to be a fart competition. I lose my appetite for crackers, and when the nurse tells me to let them know when I am ready to get dressed, I tell her I am ready now.
They phoned Jim while I was in the recovery room, and I have to wait for him to come and get me. I go back to the changing room to put my clothes on, and this time, they send a nurse with me to make sure I can function.
Okay, here's where it gets gross. I am taking the hospital gowns off, and I feel chilly, like an air conditioner is blowing on my butt. I reach behind me, and my shorts and underpants are damp. This is not a damp like I have sweated and it has run down the crack of my butt, but it is also not a soaking wet like I just peed myself. But, during the procedure, I may have wet myself!! Why they would not tell you that, I don't know. So now, I'm in this dressing room, and I'm thinking "Do I tell the nurse I peed my pants or do I just let it go?" I decide to let it go, but I tell her I'm stopping in the bathroom.
Once I am in the bathroom, I check my panties more thoroughly. I do not smell urine, but they are definitely damp. I am now praying that Jim gets there quickly so I can get home and change.
When I come out of the bathroom, they take me to a row of chairs to wait for Jim. I am chatting with a woman who also knows someone who had WLS and is doing well. It's nice to hear the good stories, because family and friends are way to willing to tell you the bad stuff. She leaves, and almost right after she leaves, Jim arrives and I am on my way.
They told me I would feel a bit tipsy, as if I had a glass or two of wine for the rest of the day. I don't drink, but I don't think this is what a glass or two of wine does. I was SOOOO tired. If that was the best nap of my life, I needed it to be a bit longer. I come home, and Jim bring lunch, which takes a long time to eat because my throat hurts. After lunch, I fall asleep for a while, and then go sit downstairs with everyone else. I sound a bit raspy, but by the next morning, it was gone.
I am still a bit tired today, but I can blame that on being awoken this morning just before 6 when my 5 year old fell out of bed. My husband had the brilliant idea to bring her into our bed, which is already crowded with two fat arses and a 1 year old. So I am balanced on the edge of the bed until 6:30, when I finally just go downstairs.
So, tomorrow, I am going to try for the EKG, the chest x-ray and the blood work. Wish me luck, because I also have to see the lawyer and get the kids to an 11:40 movie!!
Well, obviously, I did have my EKG, chest x-ray and blood work done, and went today for my follow up with my PCP to get my medical clearance. He said he'll give it to me, but I have to repeat the blood sugar and hgA1C tomorrow and go back and see him on Tuesday. I need him to get the approval to Dr. Nusbaum by the 28th - which is Friday of next week. I hope he doesn't mess around with it and not get it done.
My blood sugars were up today - back in diabetic range. He said he wants to consult with Dr. Nusbaum to see if I need to be put on glucophage or another diabetes medication prior to the surgery, or wait and have the sugars repeated after surgery. I'm hoping they just repeat the sugars after surgery. I've done pretty well, and they aren't "THAT" high - 144. So, we'll see what happens on Tuesday. Either way, he said he would give the medical clearance.
As a side note, I joined a gym and have gone three times and on the scale today, I'm down a pound. Yay.
The day before surgery, we had the kids packed up and took them to my mom's. We were supposed to get a call from the hospital between 4 and 8 PM to tell me where to go and what to do. By 8:30, I had no phone call. Dr. Nusbaum's office has not been very communicative, so I was worried. I phoned the office and got the answering service, who paged Dr. Bilof, Dr. Nusbaum's partner. They told me if he didn't call back in 20 minutes, I could call them and they would page him again.
By just after 9, I still had not heard, so I phoned the answering service, and they called him again. He was clueless. He didn't know what time to tell me to be anywhere or what I needed to do. He suggested I phone the hospital, which is what I thought I should do from the beginning, but Jim told me to call the office. There are reasons why I don't listen to Jim.
Finally, I got through to the hospital, and they found a nurse who told me that they had my phone number wrong, but they had been trying to reach me. I got my details, and was told I had to be at the hospital for 6 AM - and the hospital is an hour and a half away. Yay - just where I want to be at 4:30 in the morning - the turnpike!
We got to the hospital with no problems, and everyone was very nice. I didn't wait too long before they were calling me back to be prepped for surgery. The anesthesiologist came in and talked to me, and I mentioned to him that I had to be stuck a bunch of times for my c-section with Granuaile. He had a line in with no pain in just a few seconds.
Pretty soon, I was back in the pre-op area, waiting to be taken into surgery. Dr. Nusbaum, who had met me in the room where I got my gown and stuff, came out to let me know that the room that was reserved for me was being used for an emergency, so we had to wait. I am not sure how long I waited, and I honestly don't remember a whole lot from the point where Dr. Nusbaum came. I know I was waiting a while on the table, and I may have fallen asleep. The anesthesiologist came out and gave me a sedative through my IV to take the edge off the anxiety while I was waiting, and I think that knocked me out. I don't remember being wheeled into surgery, seeing the operating room, nothing. I wish they had given me that before I left home. I cried all the way to the hospital, worried about whether or not I made the right decision.
Next thing I know, I was in recovery, with the doctors and nurses telling me to take deep breaths as they removed my breathing tube. By 3:30 or so, I was in a room, but in a bit of pain. They had a morphine pump there that I could hit the button on every 10 minutes to get a dose, and I know I hit it a few times. I spent most of the rest of the day sleeping, and since I was unable to eat or drink anything, I didn't have to go to the bathroom until much later in the day. That's when they told me I had to use the bedpan :-( UGH. I wasn't happy about that and asked when I would be allowed up. When they told me the next morning, I knew I could hold it all night long, but what an awful, humiliating experience. I'm glad that's over.
Wednesday, I spent most of the day without the pain meds and started walking around the halls. I felt a little uncomfortable, and they gave me a shot, since I had told them they could disconnect the morphine. It made me nauseous, and I really felt like I was past the point of needing pain meds. The shot made me really drowsy, and I'm afraid I slept most of the time Jim was there visiting. I was able to drink one ounce of fluid an hour, and I did pretty good getting it in. I couldn't believe that tiny little bit of fluid was taking so long to get down.
We are in the middle of a terrible heat wave - temps over 100 degrees - and my room at the hospital must have been the epicenter of the heat wave. I spent the whole time sweating and uncomfortable. They let me take a shower on Thursday, but by the time I got dressed, I was sweating again. Dr. Bilof came in to see me, and I asked him about going home. He told me Friday morning. I pushed as to why I wasn't going home that day, and he said with the heat wave, I ran a greater risk of being dehydrated, so unless I could get 4 ounces of fluid into me in an hour, I wasn't going to be able to leave. He said if I consistently got 4 ounces an hour in, the nurxe could call him in the afternoon and he would let me go home.
Let me tell you, I drank my heart out - and I still think I came up short some hours - but at 3, the nurse finally called him and he said I could go home. When I stepped outside, waiting for Jim to bring the car around, I thought I had made a huge mistake. It was sooooooo hot out. But soon, the air in the car kicked in and we were making our way back home, and I felt better.
Thursday night, I slept like a log. I barely moved, and I know I slept pretty much from about 10 until 7 this morning. And then at 7, I only got up to use the bathroom, and then went back to sleep until 9:15. It was so nice to have that luxury, but better not to have a nurse over you every hour all night long with some test or some piece of information they needed.
I know I have a long way to go, but as of today, I am off the pain meds entirely and have no pain except a stiff neck. I am down 13 pounds since I went into the hospital, so I feel pretty darn good about that. I pray, and hope you will continue to pray as well, that I have no complications. The first few days have been mostly a breeze - I would hate to think that it's going to get bad from here.
I had my one month post-op check up yesterday, and I am now down 40 pounds! I am absolutely thrilled with the weight loss, although I still have a couple of things I'm struggling with. I feel good, and with the exception of one incision that is being stubborn about closing, the others have healed very nicely.
I am still struggling to get the protein drinks in. They just don't taste good. I did get a recipe from a friend that was tasty, so now I'm just waiting for that protein to come in the mail.
I am also dealing seriously with head hunger. Every time the family has something that seems like it would be really good - pizza especially - I just start craving it. I know I am not hungry for it "for real", but I just WANT it. Fortunately, the fear of dumping is keeping me from having it.
Things that I thought might be easy to eat, like ground beef, are not so easy. It seems to get stuck and not go down well no matter how much I chew it. It definitely is a whole learning process, but I am finding that seafood - fish and crabmeat especially - are easiest to eat. We're going to try chicken tonight.
I feel good - physically and mentally - and now that I am cleared to go back to the gym, I should be getting stronger and leaner and feeling much better in the weeks and months to come.
I cannot believe the journey, as short as it has been, has taken me so far already! I am now 2 months post-op and have lost an amazing 61 pounds. My goal is to lose 130 pounds total, so I am 46.9% towards reaching my goal - in only 60 days.
I won't say it's easy. I miss food so badly, I can't even begin to tell you. I would sell one of my kids for a bite of pizza or a piece of cake. I do best with light, flaky fish and tuna; and I seem to eat a good bit of soup. The problem with soup is that I keep looking for something low fat with a good bit of protein, and seem to be stuck on black bean. Used to love it, now I think it would be a good road surface material.
But having people tell me I look good is an amazing feeling. Getting compliments from people is really nice. Wearing clothes I haven't been able to for a long time is really nice, too.
The good far outweighs the bad so far. It's a learning process. I think I say that a lot. But it really is. And when you're learning, sometimes you fall. I'm not falling much, but there are definitely stumbles. It's worth it though. I'll take a scraped knee here and there for a 61 pound weight loss