ObesityHelp

By the end of March or early April, I expect to begin the year-long process of removing an estimated 15 to 20 pounds of excess skin, with attached fat deposits, from my thighs.  That will put me very close to my "chart weight"

Prior to my Duodenal Switch, which helped me lose 245 pounds, I carried the majority of my weight in my lower body.  If you're old enough to remember  "Bertha Butt", that might give you a mental picture.  I was pretty much all butt and thighs. 

I still appear bottom heavy, thanks to the excess skin and fat, and I'm a size 8-10 dress and top, size 12-14 pants, depending on the cut.  Of course, I generally opt for the "relaxed" or "easy fit" cuts, which gives just enough room in the "problem area" for a nice fit, with the requisite capri-length body shaper.   There have even been occasions when I have been able to wear a size 4-6 top, and a size 6 dress, cut with volume at the bottom.

I want to be one size all over.  It's great that I can now walk into any store, anywhere  and find a great outfit, but I would like to be proportional for once in my adult life. That hasn't been the case since kindergarten!

Let's not even talk about the skin infections...I have folds of skin that no matter how meticulously I clean in the shower everyday, and "powder up", have the tendency towards yeast/fungal infections, which I swab down with Lotrimin cream..or whatever prescription cream I might need... to get rid of.  Fortunately for my budget, OTC Lotrimin seems to work most of the time. I picked up that little tip from another DSer with a similar issue.  I hate running to the dermo every time I have a skin issue that I've seen before.  In this instance, experience has taught me well.

So...Metamorphosis, Part Two.   Stay tuned!

(I'm doing a lot of introspection and looking back as I approach my 4th Surgiversary on February 25th, 2013.  My, how things change!  To the DS newbies: some of you will have dramatic changes in your life because of your weight loss - inside and out.  Others will not.  Dramatic weight loss from the DS can *work* magic for some people, but * do not* expect the fairy-tale happy ending to be automatic.  This is especially a danger for those of us who have been told all our lives that our weight was the only thing holding us back.  That was my experience. As you'll see from the repost below, I was full of hope after losing my first 100 pounds.  I have lost 245 pounds, my weight is stable and as for the hopes and dreams, well, they seem to have evaporated into formerly fat air.)

July 8, 2009

You may think this is about conceit.  It is not.  It’s about reclaiming what is mine.

Through the years, my self-esteem has taken innumerable hits. 

"You have such a pretty face...if you just lost some weight...."

"You're OK on the top half"

"If you lost some weight, you could do TV news" (This one from a former boss)

But, being within less than a pound of achieving my first weight loss goal of 100 pounds, my self-esteem is definitely on the rise.

Ironically, some of the comments have reversed-

"Don't let your face get too skinny"

"Don't lose too much"

"Maybe you can have that TV news career after all"
(This one was from a family member - who always wanted to see me on TV!)

The only sorrow that I feel now is for those people who never took the time to know me, love me or treat me fairly and with dignity before my body changes became apparent.

They're the real losers

The only person I see reflecting back from my mirror now is a  winner!


I love me some Jazzbabe!

 

I get very depressed this time of year.  It's not related to the DS, but due to the fact that I have few friends, therefore very little social contact. This is the first year I've been without both parents over the holidays.  My Dad passed the day before Father's Day in 1990.  My Mom passed this year in April, just four days shy of her 93rd birthday.  I usually spent this time of the year, as well as other holidays making  celebrations for her, but this year, obviously, that has all changed.

Where I live, there is very little in the way of activities that interest me.  Unfortunately, even living close to Notre Dame, I live in a cultural  and intellectual wasteland.  I spent my prime adult years living in Chicago, so I'm used to having a plethora of cultural activities at my disposal.  It also doesn't help that I'm still on disability for lupus and fibromyalgia.  Not enough, if any, disposable income to do the things I like, for instance, trips out of town to do things that we don't have where I live.  The nearest major cities are Chicago and Indianapolis, both two hour trips by car, approximately the same distance from me as my surgeon's office. Those visits, of which I have 3 left of a five-year follow, have become the highlights of my existence.  I have few friends who share the same interests as I do, and generally, the people who still live here haven't been exposed to anything else. I know that sounds a bit snobbish, but  It's basically a blue-collar/minimum wage/ work/school/church/married,/family with children-type of town.  I'm single, no kids, college educated,  widely traveled, and the majority of my peers live elsewhere.  It's tough trying to meet and engage in conversation with people without having to stop every five minutes to explain what it is I'm talking about.  Living near a major university doesn't guarantee that you will not live among a town full of not-so-bright people.

I have been seriously considering moving away from here.  I stayed only because my mother  my two uncles, her brothers, became ill, and I was their caregiver. I was on my way to another job in a different city when my family illnesses, including my own, sidetracked me.  I also took responsibility for two of her brothers. so for the past 15 years, I've been in caregiving mode, and except for the time taken to get my DS, and attend to my other medical issues, I've had no time for doing me. Eldercare has destroyed my life.  I did it because it was the right thing to do, and no one else in my family would. I own the fact that I made the choice, but had no idea it would cost me my life.  I am, in essence, a zombie.

My career choices, in an effort to get off disability are very limited, and I've gone back to school to acquire training for a different profession, which would not be as physically and mentally  taxing as what I spent my life doing. ( I used to be a radio news reporter and editor in a major city) I'm on hiatus from school now, preparing for a year of surgery to remove excess skin left from my massive weight loss. I am limited in what I can physically do in terms of work, and there are no professional opportunities for me here, or seemingly anywhere else. I have been actively looking for over five years now.  I've been out of the job market so long, no one wants me.  I'm middle-aged. Yes, there are laws against age discrimination, but employers have other ways of documenting denial so they can hide their real reason for rejection of an applicant who is too old/wrong race/disabled, etc.

Do I sound  a little bitter?  You betcha.  After undergoing the physical metamorphosis that was supposed to change everything for me, I got zilch.   People always told me that the only thing standing in my way was my excess weight.  Well, that's no longer an issue., yet the doors are still slamming in my face.

I keep trying to figure out what it is that I did to merit the kind of hellish existence I have now. 

I'm pretty much at the end of my rope, and most nights, when I close my eyes to go to sleep (when I can sleep), I wish deep down in my heart that I never wake up again.

I once had the kind of life many people would kill for.

Now, my life, if you want to call it that, is just pitiful, and totally unrecognizable. 

Don't  tell me I need a therapist, I already have one, and I have anti-depressants.   My pain is so deep, there is nothing that can touch it. 

Breathing, eating and sleeping is *not*  living.

November 4, 2012

So...I am 6 months behind schedule for LBL/thighplasty because of an insurance foul-up!

That puts me back to square one, but I'm hoping to have this re-approved and phase one - liposuction - done in January.

My situation is unique, but it may be your situation when it comes to dealing with insurance for this type of surgery.

My SMO and other issues (lupus and fibromyalgia, osteoarthritis of both knees, MCTD), made my DS surgery medically necessary, thus the insurance pre-cert went smooth as silk.

Unfortunately plastic surgery is considered cosmetic, and is not covered by most health insurance.

I have a different story.

The approximately 15 pounds of loose skin and attached uneven fat deposits have caused yeast infections and several bouts of cellulitis,  no matter how thoroughly I cleanse my skin. Ironically, I did *not* have either when I was SMO.

My insurance will cover the surgery, so long as it is medically necessary, which I have documented proof, with pictures, of the yeasties and the cellulitis.

Lesson One: Document, document, document!  Any medical issues that you have as a result of loose skin need extensive documentation.  Keep your own journal!  I've found that the composition books (school supply/stationery section), are ideal for this purpose.  I was even able to find mini comp books that will fit in my purse at the dollar store, where you may also be able to find the full-size books. Of course, your PCP will have the exact dates and diagnoses in your medical records.  If your doctor is very nice, like mine, it may not cost you anything to get a copy of your records to submit, but be prepared to pay for them.

Lesson Two: Include letters from both your PCP and yourself! A compelling story from you, as to how the excess skin adversely impacts your life, as well as a letter from your PCP including dates and treatments, and that this chronic condition has had a negative impact on your quality of life only strengthens your case for approval.

Lesson Three: Make sure your surgeon accepts your health insurance: Many plastic surgeons don't accept *any* type of health insurance.  In my case, I am on disability, and have Medicare and Medicaid.  The surgery is my ticket off of disability, and my Vocational-Rehabilitation counselor advised that I complete my surgery before continuing with my classwork (I'm studying to be a NUT (Registered Dietitian) with a specialty in bariatric surgery patients. A bit off -topic there but here's the thing - if you are blessed enough to find a surgeon who accepts insurance, make sure you have the correct plan that he/she accepts.  I'm six months behind schedule, because I was placed in the wrong plan.  It took me almost three months to get it straight, which involved me switching back to my former insurance, and executing the change myself online.  If you have to switch to get the surgeon you need, do the switch yourself!

Lesson Four:  Make sure you are nutritionally sound! The other part of my delay comes from not taking care of my nutritional needs in the six months prior to surgery.  Reason: My Mom was dying, and i got really sloppy about vites and shakes. If you read my previous posts, the issues are listed there.  If you are preparing for surgery, *now* is the time to beef up your supplements, and if you've let go of your protein shakes, get back on them! You will not heal properly with inadequate nutrition, especially protein and Vitamin K.

Lesson Five: Start saving money - *now*: As we all know, insurance doesn't cover everything, if they cover at all, for plastics. Make sure you have enough saved to pick up the slack! It's not worth the stress of going month to month, trying to figure out payment arrangements, not to mention the diversion of funds used for other necessities.

Stay tuned for updates on my plastics, and thanks for reading my blog!