6/22/05         I have tried for a few decades various diets, gyms, exercise equipment etc. Nothing has resulted in permanent weight loss. I am thinking seriously about bariatric surgery as a way to force myself to make the necessary cognitive-behavioral changes. My BMI is above 40- I have hypertension, arthritis pain, mild sleep apnea, hypothyroidism, GERD, some family history of diabetes, etc. Portion control has always been a HUGE challenge for me. I am tired of being labelled/ limited as a fat person by society (and all the negative connotations that go with it). I am so much more than my morbid obesity- and I want to showcase all of ME without my fat defining me completely. I plan to go to an info session on surgical options within the next few months. My significant other and I enable each other's more "negative" eating habits so well now - we figure we can do the same with a "positive" twist- VERY WELL post-op :-) even though he is not ready to elect WLS for himself. We do however have to find new hobbies and lifestyles as so much of what we do is centered around food/meals. My journey is just beginning...

9/17/05          I attended an information session last week and already have my first consult with Dr. VR scheduled early next month. The only little surprise I have found so far is the $300 mandatory fee for the COMP Comprehensive Obesity Management Program. While my insurance is pretty comprehensive- supposedly some insurances do not pay for nutritional consult and lifelong follow-up after the surgery. I have never been able to afford the fees of Jenny Craig, LA weight loss etc but somehow I will pull together the fee amount for COMP. I know I have spent thousands of dollars on weight loss products and quick fix schemes historically---just never a large lump sum at one time. If for some odd reason I do not medically qualify for the surgery---I would hope to get a $300 refund.

10/2/05          I am excited about my first surgical consult tomorrow--but maybe a bit fearful of the unexpected too. I hope I do not have to go thru another sleep study. I had one about three years ago and the primary diagnosis was insomnia! I have heard my co-workers did not need 6 mos. of documented physician supervised weight loss (same insurance) so it should be the same for me. My thought now is to schedule the surgery as soon as it can be---given whatever pre-op tests are needed. I am not going to ask for a 2006 surgery date unless of course that is the only option. Hopefully my employer/supervisor will not throw any wrenches into whatever surgery date I am given if it occurs around the December holidays.

10/7/05          Well the intial consult is over. That was pretty simple. I hope they have clarified with my insurance co. that they require either 6mos of consec. physician sup. wt. loss OR weight loss attempts. I got an echo done today and have labwork and psych eval next week. So my thought is the next appointment at surgeon's office in early November--I will have all priliminary needs done and the info can be sent to the insurance co. The low cal low fat diet info provided me at the initial consult is somewhat disappointing given I have been on that sort of "diet" in the past as my history reflects and it is one of deprivation and constant hunger pangs. I have been on a low carb diet for so long I do not see much sense in following the other. I will try to reduce some of the fat though. I do not plan on increasing my carbs/starches as much. I got loads of protein drink samples in the mail I am trying out. So far the taste has been pretty good and tolerance (bodily reaction) is fine. Hopefully my tolerance of the ones I like now doesn't change post-op. I probably will be going to the monthly support group this month--it's on my birthday!

11/12/05          The support group at my surgeon's office last month was predictable--I went with a co-worker who is about one year post-op. It did give me the feeling of some AA groups I attended in graduate school when I was taking courses on addictions treatment. It was set up like a seminar---chairs in rows. I got a sore neck turning around to see others when they spoke. They had some former fat guy jock as the guest speaker but his results were not typical and he seemed a bit OCD with his gym routine. But hey---it works for him---swopping one addiction for another. The rest of the time was pretty unstructured and IMO not faciliated well. It was primarily lead by the surgeon which is good so he can directly respond to questions rather than thru his team members who may have differing opinions on what is best. Perhaps I will make some suggestions on facilitating the support group after I attend a few more and feel more like a member.
All my pre-op tests are done except the EKG which I get next Friday at PCP's office. I didn't need the abdominal ultraound with no gallbladder. The upper GI series found another co-morbidity--- I do not keep liquids down if I drink in a lying down position--which can be caused by obesity. I never eat or drink when lying down on my stomach or back---but this test required such. That radioactive glow-in-the -dark potion they required me to drink has wrecked havok on my bowels ever since. I was told to expect constipation but the white chalky liquid was running out my lower end within 3-4 hours. (perhaps the joys of IBS). The arterial blood gas test was a breeze for me. I have gotten needles in the wrist many times for blood draws and one cortizone shot so perhaps I was prepared. I actually got more anxious during the pulmonary function tests. I did not feel in control with the tube in my mouth and the breathing gases being regulated. ( I was thinking---"so this is what its like being on a ventilator?"). I am not sure if it was the anxiety but one of the breathing tests I had to take twice (seven minutes each) as my lungs would not "wash out". I am still not sure if that issue is a serious one or not. The technician stated I may have a small perforation in an eardrum that caused the results as the test showed no obvious leaks. I don't sense I have any major breathing problems so I am trying not to worry about that test. I am nervous about the WLS but NEVER imagined I would get insomnia and my stomach twisted in knots over some of this seemingly easy pre-op testing. I believe I have some element of claustaphobia. I have gotten very anxious in an OPEN MRI in the past and the breathing machines can bring out these symtoms the technician said. I can easily get in an elevator with no fear but any tight environment I am placed (reminiscent of near death or a coffin...) is freaking me out. Most of my anxiety is internal (not obvious to anyone else). My face was twitching and quivering during the lung tests. My only way to cope with the procedure was to close my eyes and meditate by concentrating on the breathing only---not all the devices hooked up or the lack of control I felt. Maybe all fat people are claustraphobic as some level or another. Even going to an event or establishment---I am always asking myself ---will there be enough space in the seat, can I fit thru the turnstyle or gate opening, etc. Does being fat make a person anxious about space in general or does the existance of too many tight, unaccomodating spaces make the fat person anxious? Sounds like a chicken or egg came first debate.
I am holding my breath waiting for my surgery date to be confirmed. My surgeon's office submitted my paperwork this week. This waiting game is weighing heavily on my mind. It's akin to torture in some respects. My anxiety or obsession about it is probably a bit overinflated. It's as if I was having CABG surgery---which is a very aggressive and risky surgery when your ribcage is cracked open (like a Maryland blue crab freshly steamed) to get to your most vital organ- the heart and re-route its connections. My dad had CABG surgery twice in 20 years so these descriptors come from him. Bringing up my Dad got me off my own issues which is a comforting diversion. I have to limit my time spent on these egocentric thoughts and feelings I am having lately. Does WLS make you more selfish? Perhaps its just the pre-op gitters and its normal and everyone has them. OK times up on the "me" talk for now. Signing off...


Circa 11/20/05                  I'm on my way to becoming Mini Me The Meaning of Mini Me: For me, this meaning goes beyond simply weight loss or reaching a goal weight. It also means to continue being all the wonderful things I am and more regardless of my body size. I want to maintain a balance of: self interest but not selfishness, considerate but not contantly comparing, ego aware but not egocentric, spiritually open but not spiritually void or defeated, assertive but not aggressive, focused and opinionated but not militant, reality based but not deluded by fantasy, calm but in no way still or sedentary, generous but not easily taken advantage, knowledgeable and informed but not a know-it-all, understanding, compassionate, and fair but able to employ tough love when necessary, forgiving but rarely forgetful as history is important in guiding my future. To be continued as i travel this journey....

11/27/05          I have decided recently to simplify my profile to cut down on the downlaod time for viewers. Today I also decided to stop changing the beginning "theme" of my profile. Given my themes have changed a few times already in these few months---I decided to add the "theme" chronologically as it will probably reflect the paths I choose during my WL journey. (otherwise my themes and evolvement will not be captured in my profile as I change it repeatedly.) So---from this point forward---my user name is the real me and I will not edit what I have written in my profile previously (unless its a typo). In some ways I like the "mini me" theme still but it might give viewers and myself the wrong impression. I had a "serene" theme before that one and I deleted it as it included too many pics and fancy fonts which took a while for the dial up viewers to see (including my home computer).
I have also taken a calmer, more no-nonsense approach to this waiting period for WLS approval. The anxiety was at the very least distracting and at the worst it was creating insomnia and strained relationships for me. I am still asserting myself strongly to get the decision/approval but I am taking a gentler approach on myself which will inevitably be kinder for those around me too. For the most part I have been reluctantly following a number of the dietary guidelines the dietician has given me. Fundamentally though I am against this type of "diet" as its track record I have proven over and over again historically as not successful for me. The goals I have set for myself---although probably small according to RDLD are the secrets for me in making permanent changes in lifestyle. Going on "cold turkey" diets (Sorry...no Thanksgiving leftover pun intended...) have not worked for me. I have to gradually change my habits and behaviors---making sudden and drastic changes makes me feel punished and deprived. I have been exercising (ie structured program) on average about 3x a week for several weeks now but I find this rather difficult to maintain. I have to do this routine daily at home in order for it to become a habit. It's still painful for me to follow this program 3x a week but I know if done 6-7 days a week it will become much easier and pain-free. I know this firsthand as I have had many months of consecutive structured exercise daily and I felt GREAT- physically, emotionaly etc! (that is an understatement). So I know what I am missing but its been quite challenging to cross over to the other side this time. Even though I have made many healthier changes---I have yet to see the effects on the scale. My weight is the same as it was 2 months ago---before the changes. I think I would have gained 5-10 pounds though if I did not make the changes so ---in the end I really have lost weight---simply by maintaining my weight. Routine calorie counts have me burning more calories than I ingest--- but its not showing on the scale. I guess this is just another reason why exploring alternative WL options is necessary. I understand its very common for patients not to lose weight on "physician supervised weight loss programs". It seems I am among the majority!! :-) So far during this journey---I have become more cognizant of eating behaviors and obesity issues---when I had thought I knew just about everything in these areas given my three decades of experience with Morbid Obesity (MO). I am becoming more conscious what and when I eat if that makes any sense. I may not change my behavior right away or consistently when I notice the connections--- but it has changed the eating experience for me altogether. I am already finding less pleasure in eating than I used to. Plus I am experiencing the positive benefits of not overeating---I don't have the horrific IBS/GI symptoms I did when I ate too much. This is a real reward for me---and for some reason in the past I did not accept that my eating behaviors contributed greatly to these horrible symptoms. I thought that a human body should be able to do the job ---and that somehow something was medically wrong or deficient with my organs/digestion and that alone created the horrible GI symptoms. I now know that I was in reality inflicting much hardship upon my own body by overeating---no organ/body can withstand that sort of abuse for years and decades without eventually developing medical problems. OK....I am long winded by nature so I will limit myself---and say enough said for tonight.

11/28/05          Some progress on the pre-auth! YES! I called FutureHealth this morning for an update on the pre-auth status and got more info on what they still needed for the approval. Reportedly they need "evidence" of 6 months supervised weight loss program---any sort of program like Weight Watchers that takes attendance...or physician notes. I asked if they got any of my PCP notes and was told no. I advised them my PCP notes are typically illegible and asked if the PCP could type a summary letter of the weight loss structure and strategies I have discussed with her over the last 3 years. I was told that was acceptable!! Wish I had this info sooner---but moving forward... I immediately sent notice to my PCP about the need for this detailed letter and I made some suggestions on what to include in it. Ironically, I had a visit with my PCP on 11/23/05 and she asked if she could write a letter to speed up the approval process. I told her then I haven't heard that was needed....but I did hear it today. The FutureHealth nurse told me my surgeon's office should have told me about this requirement. I happen to agree but I want to move forward. I have found emailing the surgeon's office gets a quick response whereas voicemails are not so reliable. Whatever works, right? Persistence pays off---although some may view me as a nuisance caller---I take this issue seriously and my sense of urgency to get an approval is high. Given my experiences so far, my thought is my surgeon's office needs more assistance in the business end to develop an organized pre-auth process so it speeds up the process rather than delays it. I will have to make some of these suggestions once my pre-auth and surgery is completed. No news is bad news until I get approved. Thankfully my actions resulted in some progress today!

12/4/05          Went to DVR's open house holiday get together yesterday afternoon. It was nice plus a little support group all rolled into one. He has a new physician in his program now---one I know NOTHING about---called "Moen"---like the faucets.... I will have to make it crystal clear that I enrolled in the COMP program to be surgically altered by DVR only! PERIOD. I researched his info and got some personal recommendations. I would give the newbie a chance post-op at a medical follow up appointment---but I am not confident with a new person's complication rates and #'s of surgeries I am sure are not as good as DVRs. BTW---Anyone reading this that wants the no bake cheesecake recipe ---just email me.
BTWx2, I got the letter from my PCP on Friday and promptly faxed it to DVR and insurance company. Not sure it has enough details to be sufficient for the 6 months supervised WL program but I am sure my PCP would give more details if needed----she claims this sort of summary letter has worked 100% of the time for her other patients getting WLS approval. Worst case scenerio---I have to continue for about 3 more months with DVR and his RDLD to have sufficient "evidence". Wouldn't ya think a few 8x10 glossies of me in my skibbies sent to the insurance company would be "evidence" enough?? I guess we all are just a piece of paper with varying co-morbidities in documentation. Geez---just imagining myself allowing such pics to be taken---that would be a huge step for me. I usually avoid the camera whenever possible. I do have to get some offical "before" pics though so I will have to take the plunge soon anyway.
DVR's party was way cool! Actually it was somewhat ordinary but since my fiance' came---it was extraordinary. It's just one tiny step towards getting him to understand WLS and my goals-which can only strengthen our relationship. I think he found he too could relate to the folks attending---as some men were there---thank God! I think the man's emotional and social experience with MO varies greatly from the woman's experience. I hope he continues feeling some sort of connection. Perhaps if they had a partner's/spouse's group---he might attend it---although I doubt it---maybe an online forum for partner's he might do. Okie Dokie then---its about 3am here---just finished two cups of regular coffee--- had a headache since midnight so got up for some java. I usually only have 1-2 cups each weekday morning but when I don't have it on Saturday---Oh man---the headache I can get on Sunday morning---Advil and Tylenol won't even touch it. And I make my coffee on the weaker side-- it has flavor just doesn't taste so strong like the bottom of an ashtray. I am going to try switching to decaf coffee ---I am not sure if its the caffeine or some other ingredient in the coffee that helps with my occasional headaches. Teas and sodas do not relieve the headaches and they got caffeine too---even the Dr. Pepper/Mt Dew with higher levels of caffeine do not do the trick. And---believe it or not---I have NEVER had a Starbuck's coffee---perhaps I am one of the few remaining citizens of the industrialized world in such a circumstance. Given the SB's coffee has lots more caffeine than the average coffee---I have always wanted to avoid it. (not to mention its probably 5 bucks a cup). I think they lace it with coke powder or something too--because those lines at that place are just freakin' unreal---surreal even.... and it makes me wonder???~~~what are they really selling in those cups?!?!....
OK---I better think about getting to bed---my cats are going bezzerk wondering why I am up at the computer at this hour. Of course they go nuts about most things anyway so it's no good reason really. >^..^< >^..^<