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Surgeon Testimonial

Rafael F. Capella M.D.
**last edited June 3, 2007**rnJan '07 Found the names of Drs. Capella and Iannace by searching on obesityhelp.com. rnFeb 6, 2007 – Attended “Informational meeting” - very disorganized. No one told us what do. Took a clipboard and completed a stack of papers. Then stood on a line to make an appointment for a consult. This was before we were given info. I was told I would see Dr. Rafael Capella because his name was under my insurance. We then saw a powerpoint presentation that boasted of all their successes and experience. They described all possible procedures, and the after weight loss surgery that Dr Capella Junior does. Lots of information about risks, complications, etc. At the end of the presentation they took questions. Overall, it was an informative meeting but I had the distinct feeling they wanted the open RNY for all patients. rnFeb 13, 2007 consultationrnI arrived early for my 3:00 appointment. It didn't take long for the nurse to call me to get weighed and have some pictures taken. There was a huge issue with my insurance coverage. Had consult and exam and was told they'd be in touch. Meanwhile, they still hadn't followed up with my insurance company so I called and got the information I needed. I got everything I needed together, and faxed it to them.. followed up 2 days later and was told that they hadn't sent it yet because they were trying to determine what they needed to send... grrr.. explained I did that and to please send it. Next communication was a form letter telling me when to go for pre-surgical testing and what my surgery date was. About 2 weeks pre-op a nurse called me to say that I had to come in to pick up prescriptions I had to fill. No contact with anyone else in the office. rnDay of surgery - Dr. Capella said hello and he'd be back soon.. Dr. Iannace was late and they were trying to call him. Then I was out. Post-op -- day 1 both dr's stopped in for about 45 seconds to say hi. Rest of the time, Dr. Iannace stopped in. He was very late on the day of my discharge - I had to wait at the hospital 4 hours longer than I planned. I was told to schedule next appointment in 4 weeks. rn1 month post surgery visit-rnSaw Dr. Capella for about 7 minutes for my 1 month appointment. I lost 25 pounds in 28 days and he was very disappointed saying that he would have expected me to lose 30 pounds.. then he tried to reverse himself because I was only 28 days out and had another 2 days to lose the rest.. I told him point blank that I'm not in a contest and that I was very happy with my progress. rnOverall, I think as a surgeon he is top notch and would recommend him for that part.. but bedside manner, realistic expectations, aftercare, etc.. all are way below what I'd want. I don't care to be treated as a statistic. rnrn
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When it rains, it floods.. if you turn off your sump...
on April 29, 2007 6:27 pm
Last week, in preparation for a predicted rain storm, I lowered my sump pump and fixed a leak in the outake pipe.  As a result, the pump ran continuously (on purpose) since I didn't want my cave/basement to flood.  Thursday night, after looking quickly at the local forecast, I unplugged it because I was going to raise it up Saturday so it wouldn't run all the time.  Slight problem to this well intentioned idea was that it rained overnight after I unplugged it.  Woke up Friday morning and hopped in the shower.  Afterwards, I was sitting at my desk wearing a towel and my feet felt wet - really wet.  I realized water was flowing in from the laundry room (where the pump is).  I ran in, turned on the pump - but the water was already seeping through my carpet. I was very angry because it was my fault. I decided to go to work and if pharmacy wasn't too busy - I'd leave early.  Meanwhile, I began having excruciating period cramps (no NSAIDs poor me) and wondered if during the RNY they could remove my uterus as a bonus.  Took 1 Vicoden and 3 arthritis strength tylenols.  Made it bearable.  Meanwhile, my fingers and hands hurt now also (hehe I'm a mess!) but  I'll be fine. I left work a few hours early - and spent Friday night vaccuuming up water.  Also had the dehumidifier going and used a heavy duty blower to circulate air.  (I have lots of flood experience).  Saturday, my brother and niece came down to visit pre-surgery.  I tried valiantly to explain to my almost 4 year old niece about the surgery - she was stuck on what exactly was broken in my tummy.  Then when I said I'd be getting smaller every time she saw me she wanted to know if someday I'd be her size..  it was cute.  My cramps soon returned and I was tired from the night before so I went home for a nap.... only to find that a cap from laundry detergent had fallen into the sump pump pit and jammed the float so the pump stopped pumping... AND ALL OF THE @*)*#&&)!!@@ WATER WAS BACK on my carpet.  BLAH!  I don't know if I mentioned that I live here rent free because I take care of the house (usually doing a much better job then this) - so when a crisis happens its generally up to me to fix it - or call someone else to do so which means I have to pay for something that I normally can do.  I have had the most crappy weekend ever. This being my last before surgery weekend, I had lots planned.... instead i'm rewashing clothes, vacuuming up water and trying to stop the smell/mildow/mold.  
The worst is I know why this happened -  I had decided that I was going to come home from my parents after a day.  Upon discharge from the hospital I'm going there. (It's 2 blocks away) But stubborn me wants to just rest at home... apparently the spirits that be... don't agree... and now I'm looking forward to being away from here for a few days...

4 days to go.. I'm going to be happy to gone for about a week or so.  Thankfully I'll have all the comforts of home... dad's computer..
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April 26
on April 26, 2007 8:04 pm
I now know how well Celebrex and other NSAIDs I took helped me! I'm feeling it strangely though.  The parts that hurt the most are the backs of my thighs and backs of my calfs. It feels more like I've overstretched them than anything else.  My feet (both) hurt normally (which is bad) and my left knee hurts normally (bad) and my right knee is pretty good - it's just achy. Took me a long time this morning to get myself moving. I'm not used to that.  Got my dot today so maybe I'll be punctuation free for the surgery and right afterwards! I hope so. I'll be prepared with pads either way.

 I'm getting conflicting instructions about eating post-surgery. Surgeon's office gave me a printout saying clear fluids only for 2 weeks then pureed for 4 weeks.   The nutritionists printout says clear fluids for 10 days, introduce liquids (with protein supplements) starting on Day 11 and up the protein every day to get to 60 grams and start vitamin supplements. After 5 days, introduce mushies/pureed foods. That continues for 4 weeks.   I think I'll just keep both options open and see how I'm feeling at that point.  I think the sooner I begin protein, the better. Tonight I'm going to order SF syrups from Davinchi - that way I can get creative for tasting options.

I also decided that I'm absolutely not going to rush back to work.  I'll hurry a little, but won't rush.. I can't believe it's less than a week now.  This weekend I have to pack for the hospital and for the pleasant stay at my parents house afterwards.  Honestly - I can't wait to just have it done with.  

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9 days to go
on April 24, 2007 5:27 am
April 24, 2007
Dear Me:
There is just one week to go before I find myself in an operating room where I will voluntarily allow my body to be cut open and have my internal organs rearranged.  I want to remind me that the road that led me here was a very long one.  There was a very long and thought out process that extended over several years.  Had there been a better way - I would have gone that route.  This surgery is the best way. 
I want to remind me that I'm not doing this to become better looking.  I look just fine as long as I'm still me.  I'm not doing this to lose XXX pounds but every pound I do lose is a better chance for a healthier and less painful life.  I want to make sure I remember the pain so at no point will I allow me to slip up and regain what I've tried so hard to lose.  I may never reach whatever goal weight I set, or I may go below whatever goal weight I set - it will all depend on what my body tells me - by reducing the arthritic pain, by reducing tendonitis, by reducing inflammation.  Most of all - by telling me that I can exercise and I can walk and I can go to Walt Disney World without renting a scooter for 24 hrs a day.
Good luck me!
Me.

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T minus 12 and counting
on April 21, 2007 6:05 pm
What a day! Got a lot of outside work done! I feel like I'm in a race to get the most done.  I have tomorrow (sunday) and then next weekend - if it's nice out. (forecast now says cloudy - but it's a week away.. ) First project of the day was to mulch around a medium sized maple tree - and then hand carry slightly heavy rocks to make a border around the mulch.  I bought a new mulch (as in one I've never used) that has spectracide weed killer in it. Didn't have to use weed preventer (which never works for me).  Then mulched under and around the wide Japanese maple - lots of trying to squeeze under branches. Took a really long time for this.  Then installed a 10 foot perimeter border around the outside so I could pile the mulch up . Moved lots of rocks.  Used all 10 bags of mulch.. so headed back to home depot - and somehow managed to buy 7 bags of mini-marble stone for the walkway I'm making in between all the gardens. The stupid bags are over 100 pounds - actually I think they are 80 pounds.. but whatever.. they're heavy.  Came back with them and laid landscape fabric on the first section.  Put down 4 of the bags and so far it's looking really good.  Also did some grass seed patching.  My feet hurt.. but not because of being used - instead because the stupid plastic shoes I decided to wear rubbed off my skin. And where it didn't rub off - there's blisters.  Idiot me didn't want to waste precious outside time changing my shoes.  At the moment, they're too stiff to hurt.  I keep thinking that I should come up with foods that I want to eat before surgery - but I'm not coming up with much.  I really just want it to get here already! I'm ready!  
I think I will rub smelly menthol on my feet ..
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stupid feet
on April 20, 2007 5:29 pm
ok so today was the first day without Celebrex and no anti-inflamatory meds.. It isn't a happy moment for my feet.  Despite taking Extra-Strength Arthritis Tylenol (that is extended release so I can't even keep taking that) my feet reminded me how bad they are.  The only pain thing besides that is Gabapentin - but thats more for nerve pain - not achy my bones don't want to be part of me anymore pain.  Staying off my feet doesn't help, staying on them doesn't help.  they're so tender right now I can't even touch the middle part of my foot (the doctor wanted to fuse the joints but I'm waiting to see if losing weight helps)  Meanwhile, I'm not very happy with this.  I can't even take a stronger pain pill because I didn't fill the Vicoden yet (without nsaids)... 

I did go to home depot and I bought 10 bags of mulch to use to clean up a small area (I have lots of small gardens around the front parts of the house) and I need to get it done tomorrow - so if my feet still hurt I'm just going to ignore it. I see a nice long session tonight in my bathtub with the jets on full force.   I want to get lots of stuff done this weekend. Can't let feet interfere. 
13 days to go..

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2 weeks to go..
on April 18, 2007 9:54 pm
I'm sitting here taking a good look at what will soon be my former body. Tomorrow is the last day I can take my celebrex or any other NSAID and at this point I'm more worried about arthritis/horrible foot pain than anything else. I can take Tylenol - which hopefully will help a little.  I have Vicoprofin - but that obviously has Ibuprofin and is an NSAID.    I really hope that losing weight will help my feet behave better.

I've been getting the strangest reactions as it gets closer.  My dentist - who was initially very positive when I first told him a few months ago - told me yesterday that he was thinking that maybe if I tried just one more diet I could "do it this time".. I told him there's no more maybe this times left. 

I got all the results of my pre-op testing and I'm in pretty good shape. My liver is very mildly enlarged (that was about the only thing they noted) and I am told not to worry about that. Just to verify everything I spoke to my cousin (she's a medical doctor - despite my belief that she was just recently born) and she assured me everything was better than she would have expected.   I'm actually thinking about eventually purchasing a scale --  I swore I'd never own one again... but I'm changing my mind..
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15 days to go!
on April 17, 2007 10:05 pm
I really can't believe it's getting so close. The results of my presurgical testing were sent to my PCP today.. but I forgot.. and when I got home from the dentist tonight, I saw they had called twice.  I purposely wrote on my information sheet to call me at work (they are a doctors office in the same mall as the pharmacy I work in -not sure what part of call me at work wasn't clear)  Anyway I will call them tomorrow. I'm figuring that there isn't anything wrong. 
So 15 days to go. So much to do! I really hope it's a nice weekend coming up and the next one because I'd like to lay stone in one of my new gardens. There's no way I can do this right after surgery. The bags of stone are quite heavy - and I'll have to crawl under a very low to the ground Japanese maple. I already laid landscaping fabric over part of the area. I'll be happy if it's just that area I can get done. I have lots of garden work planned this summer...  15 days to go...
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April 12, 2007 - T minus 21 days
on April 12, 2007 1:25 pm
Today I finished the first step - had my pre-surgical testing done.  Left home at 6:15am and drove through blinding windswept rain and got there a little before 7am. Hackensack University Medical Center is a huge and massive place. Very easy to get lost.  In fact twice I took an elevator to the same place I already was at.  My first appointment was at 7am - and thankfully I just went from one thing to next and it didn't matter what time I was scheduled for - I was taken immediately to a little admissions room where I was asked a few questions and gave my ID and insurance to be copied.  Then someone rolled a cart in for the EKG. Then she took out a tray for blood taking (I have one colorful reminder in my inner elbow).  She left and I had to give urine. Came back and someone was waiting to take me to the chest x-ray room.  That was in the same building, but on the other side.  From there I had to walk to another building and another floor for the gallbladder sonogram - but it wasn't really another floor...  the floors in different buildings had different names.. Lobby may be Ground.. I don't know.. LOL it was funny though -- from my gallbladder (which was slightly uncomfortable when she pushed really hard) I went for the venous doppler - another sonogram - this time of the legs to record blood flow.. again it was slightly uncomfortable at times when they pushed in hard - but nothing bad at all.  I was done by 9am.  I left there and drove in more blinding rain to Dr. Capella's office. Met with the nurse to go over regular stuff and got prescriptions for Lovenox (injection), Percocet, and prevacid.  I'm pretty sure I'll need Prior Authorizations for the prevacid and lovenox.  The lovenox injections are for 10 days once I'm home, Prevacid for 2 months, and the Percocet is as needed.  I know that will totally knock me out - so I probably won't take that beyond a few days. Actually - since I'm being forced to stay at my parent's house upon discharge for a few days -- the thought of being knocked out isn't so bad.  It amazes me that even at close to 45 years old I'm being told I have to go there and have no choice..
  Oh well. I guess I can lose my stubborn independence for a few days.
Anyway, the best part of today is that I took the day off and now I'm going to have another nap session. 
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April 8, 2007 - -25 days
on April 8, 2007 7:30 am
Wow. 25 days to go! I'm currently focusing on trying to clean up my cave (I live in a full sized basement that looks like a hurricane, tornado, and slob have moved in).  There's lots of stuff I need to get rid of - because I want to move things around this summer...  cleaning up after myself has never been a strong point - I'm finding all sorts of old clothes that I may be able to use as I start to drop weight.  So far I've found clothes ranging from size 22 to 28.. The 28's are too big but I'm wearing them so I can feel as though I've lost already :)  I also found a box I put away of clothes that were the right size when I bought them, but ended up too small... when I say clothes I'm actually talking about khaki pants and red shirts for work... I have plenty of other clothes that I can wear even if I need to tie a rope on to keep them up.  Several team members at work have volunteered to loan/give me Target shirts as I lose weight.
Funny part of that is that the shirts are not a problem.. red t-shirts are everywhere.. it's the pants I'm worried about.. but whatever!  When I am able to buy off a rack it'll be much easier. In the past I've bought the same pants in different sizes so I'd have them if I lost or gained.  
I've been figuring out my post-surgery feeding schedule.. errr.. meal schedule based on input from the nurses at my surgeon's office and things I've read.  At this point, I don't really feel like  paying a nutritionist/dietitian unless I'm really not able to follow the standard diet plan. I can see one through the surgeon's office - but it's a required 3 visits at $125 each time.  The 3rd visit is when you make a post surgery plan.. I don't see a purpose in doing a food diary NOW... and having in analyzed.. my concern is post-surgery.  I don't intend to carry over my present eating habits.
They did (the nurses) tell me that they suggest 2 weeks of clear liquids and then move to liquids with some purees if tolerated.   My plan is to do 2 weeks of clear liquids followed by 2 weeks of liquids with 60 g's of protein supplement daily. Week 5 I will introduce purees and do that over the next 2 weeks and see how I tolerate it.
I'm in no rush to get to full solids.
Anyway, this week is my pre-surgical testing.  I can't believe I'm looking forward to this.. heheh

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April 2, 2007 - Time to start blog
on April 2, 2007 7:59 pm
I have about a month to go before surgery day (May 3 if it doesn't change) and so far I'm very proud of myself.  I stopped smoking 3 weeks ago (March 12) because I promised myself I would do so 1 month before pre-op testing. Little did I know I'd get the date for that so soon... but I stuck to my promise.  Overall, it wasn't as bad as I feared it would be. I wore the "patch" for about a week and then decided it wasn't helping and the little square marks it left annoyed me. I thought I was doing very well - but I've been told by co-workers that I'm more tense and that I seem troubled. LOL Probably because I'm focusing so much energy on not yelling at everyone to leave me alone because despite the happy exterior I just want a cigarette. However, I'll be fine.  
Surprisingly, I had almost no wait for approval from insurance.  They sent me a letter right away.  I am still waiting to hear from the surgeon's office - but I guess they have nothing to say to me until after the pre-op testing or if they change the dates.  I prefer to be in some sort of contact with the office - but I guess they prefer to schedule as many surgeries as they can rather than focus on any individual patient.  Can't say I blame them.  I just want to know that things are still going as planned - and I guess unless I hear otherwise.. they are.
As it gets closer, I have been making a concerted effort to increase my liquid intake.  I have been steadily weaning myself off Diet Coke... something that I have been absolutely addicted to since it was introduced in 1982.  I began my day with bottle or can as soon as I woke up and continued to when I went to bed.  I finally made the switch to coffee first thing a few months ago.  Now I'm down to less than 16 - 20 ounces  and sometimes none at all.   I have been drinking a lot of water (mostly flavored with crystal light blends I mix)  I'm continuing to increase the water.
And I'm trying to learn to not drink with meals. Small things - but it helps me realize what I'm working towards.
I've been taking time to explain to co-workers about what I'm going to be doing.  I'm still planning on staying out for about 2 weeks... we'll see how possible that is.  Since I can sit if needed, or walk around if needed, or basically do whatever is needed - as long as I have the energy, there's no reason why I can't go back.  I may not be able to last a full day.. at first.. but we'll see what happens.  I have a lot of stuff that has to get done monthly (I'm a pharmacy technician) plus the faster I get back to work, the faster I'll feel better.  So we'll see what happens..



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