The plan at this point is that I will drive to Texas on September 1 and pick my Dad up and bring him back on September 3. Then I can do the prep for the surgery on the 4th and have the surgery on the 5th. We will see how this is going to work out.

August 30, 2006

The pre-op lab visit was uneventful. The people were very nice, suppotive and encouraging. I really enjoyed the time I spent with them. Everything went smoothly and with real competency on their part.

My visit with Dr. Miles was surreal. I am not sure that I really understand exactly what happened yet. He came in and had a rather formal manner in which he asked if I had read the material. I said yes. He looked through my record and then out of the blue told me if I wasn't going to exercise that I may as well walk out of his office right now. I simply didn't answer, because the only thing going through my head at the moment was that he was such an arrogrant jerk. Then he followed it up with all the statistic about how I could die. I said that I had had 18 nmonths to back out, I didn't think I would be backing out in the next few days. I had been active in Genesis group in Tuscaloosa, which he did not know who that was....and that I knew what I was up against. My only concern was....and he iinterupted me and told me that he wasn't through. I was not sure which one of us was having a bad day, but he was certainly being brisk and about as warm as a hedgehog.
While I have confidence in him as a surgeon, he does seem to have the God complex that many surgeons do have. He also called me "Miss" Carmichael throughout the time, which I prefer Karla or Dr. Carmichael. It was not a pleasant visit, but I felt that it would all be over much quicker if I just kept my mouth shut and let him go on and try to intimidate me with his "superior" attitude.

September 1, 2006
I have driven to Texas today to get my dad, so he can come back with me and be with me during the surgery. I am rather amused that he started out just going to stay a week or so. That plan has stretched out to be a month ....and most recently, to two months. He is going to take care of me; and then, I am going to take care of him while he has a finger that is triggering repaired and major work done on his siniuses done.

I am not feeling any better about Dr. MIles. I think what happened is that he read something in the chart written by his psychologist that set him off. My experience with the psychologist was that we almost had a knock down drag out in his office. Unfortunate, I teach testing and I know the limitations of the instruments that he gives. The way I could be describe him is that he is not very competent to be doing evaluations, if the point was not to clear everyone who came through is office. And the psychologist does not know the limits of his abilities. He acted like a real jerk! Then accused me of having anger issues....well, I do with him. He did tick me off with his incompetence and over stepping his professional line of competence.

I vent my spleen about this. The psychologist told me that I shoudl be walking daily. I have an artificial knee. My surgeon for my knee has told me exactly how much exercise and the type that I can do. Walking long distances on hard surfaces is not acceptable for my particular problem. I can walk on a cushioned track or do exercises in water, etc. The psychologist asked me about my exercise program and I told him that my physician had told me that I would not be able to walk in the neighborhood. He then started into a some lecture about how I had to make a committment to exercise, etc. I sat there wondering what in the h was going on with him. I started to explain that my specialist (actually a nationally recognized specialist in the field, Dr. William Clancy, who does the same surgery for international hockey and soccer players at Alabama Sports Medicine) did not want me to walk any further than necessary on hard surfaces, as an artificial knee is a time limited feature. He proceeded to call a doctor...or pretended to call....a orthoped, he claimed to be his friend, and then tell me that his friend said that was ridiculous. I did not jump down his throat at that moment, but I did start reading his diplomas on the wall, and noticed that his degree was from an insitutition of dubious reputation. I did not share with him what my observation of his credientials were. I did how ever simply as, "Does this mean that you are not recommending me for surgery?" He said no, but I have noticed that you have problems with anger. My internal thinking was no, if I had problems controlling my anger, I would have you by the throat at the moment and be shouting what an incompetent jerk you are and that you should not be allowed to treat people like this. Instead, I just smiled and let him go.

What I think upset me was that he never let me complete the statements about exercise. My mother was a physical education major and a coach. I have danced all of my life until my rheumatoid arthritis got so bad that I could not. I have located a suspended track to walk on that is condusive to my condition. I have a hot tub to do water ballet in. I tried to ride an adult tricycle, but I could not exert enough pressure on the artificial knee to pedal and the knew is not flexible enough to allow me the full range of motion. I cannot do steps easily. I do exercise, but I was never allowed to describe what I do and how often I do it. Could I do more, of course. I had to have 2 full years of physical therapy because of my knee, which is unusual, it usually only takes a few weeks. I am well aware of what I can and cannot do. And I deeply resented his not listening to me, and realizing that I was not saying that I would not exercise, but rather that I could not exercise in the way most people would. I also deeply resented him calling someone totally unfamilar with my case and making a phone diagnosis. It was the most unprofessional experience that I have had.

Am I confident in Dr. Miles? Yes, he has a good record as a surgeon and is considered to be very competent. I have no reason to believe that he will be anything but an excellent surgeon. Do I believe that we have gotten off on the wrong foot? Yes. Am I going to try to straighten it out? Probably not. I don't beleive that our relationship will be long enough to warrant the trouble. I just want him to do the job that he is qualified to do, and I will do what I need to do to make this a success....and personalities aside, that is the bottom line.



September 4, 2006
This is the day before surgery. I have this really awful stuff that I hve to drink later in the day. I have a house to clean, beds to change, groceries to buy, and my living will to find. I just made a whirlwind trip to and from Texas getting in about 7 PM last night. My back is hurting and I am not feeling all that well. I am tired, very. However, all the activity may keep me from worrying too much about the surgery tomorrow. I don't like to be cut on. However, the focus has to be on the outcome, not on the first few days of pain and discomfort. I am not really scared, but I am anxious. I just don't want to hurt. Of course, I hurt most of the time with arthritis, so I am pretty sure it cannot be much worse. Lots of things could go wrong, but generally, I am not one of those people who has things go wrong. Other than being fat, and that is not phat, I am pretty healthy at this point. However, if I don't lose this weight, I am not going to be healthy and will have organ damage....that is the reason for the surgery in the first place. The second place for having it is that I will look better and that may improve my career and social life. I am aiming for a svelte, brunette bombshell look, but will be satisfied with a healthy graying look. I want to be comfortable in my clothes and look good in professional suits. Right now, I cannot do that. I want to stop taking a so much medicine to control all the blood pressure, diabetes, etc. I want to be les tired all of the time. But I have never undergone major surgery that was elective before....but then, again, I am not so sure that it really is elective in any health sense.

September 8, 2006
The surgery was perfect and uneventful. I was not sick a minute. Imade them let me get up and walk on the day of my surgery. I had minimal discomfort. I have had worse stomaches with food poisoning. The nursing staff was excellent. The stay was most pleasant. I worked hard at being a good patient and they worked hard at being good nurses. The food was bad to awful. Broth has never been my favorite and I hate orange anything. They seemed to only have orange jello. Hate that stuff. I have never really liked jello since I was 10 and had my tonsils out. The surgery was on September 5 and I came home at 1 PM on September 7. The ride home was very tiring. I was so thirsty. I should have brought a bottle of water. I came in took the antiacid that they gave me and had cheese grits and scrambled egg for lunch. The propel water that I bought so much of is a little tiring to drink all day. I want to buy some just plain bottled water. I am going to use bottled water because I read that e coli is pretty common in our Tuscaloosa water supply. I would like to avoid all the extra bacteria that I can for a while in my stomach.

The first bowel movement for those who might be curious was not painful or unpleasant. My bowels are very loose. Cannot put off going to the bathroom when the notion strikes.

Food is not painful when going down. I am not uncomfortable. I am eating probably about 4 oz. of liquid food per meal. That is not much, but it satisfys me.

The water is also not a problem, because I am thirsty all of the time.

Getting my prescriptions filled is being a problem. I waited until I came home to fill them at my local drug store and they are having a hard time getting my insulin. My blood sugar has not dropped as anticipated. It is hovering between 150 and 200. It is not really all that high, but that is very high for me.

I was not told that I could not take metaformin after surgery. That was kind of a surprise. All my other medications were taken away also. I can take the altace, which is a small...very small capsule. I asked twice about it being a capsule, and was reassured that the size of it would be fine.

What I am going to save on meds and food each month will soon have this surgery paid for.

September 8, 2006
The idea behind this surgery was to eliminate having to take medication for diabetes and high blood pressure. My blood pressure is higher than it has ever been in my life and my blood sugar is out of control. I certainly hope that all of this settles down soon, or I have gone through a lot of inconvenience, pain, money, and irritation for naught. Even th4e nurses in the hospital were surprised that I was having to take insulin. Which, since I have to travel a lot, that is really a pip!!!!

September 12, 2006
It has become evident that I definitely need to have medication. I was about to go into a rage today, but quickly went by the drug store and asked the druggist how I could get the prozac that I needed. I normally take 20 mg daily, but have not since surgery. I am most likely bipolar, it runs in my family. Anyway, he said that I could take it by openning the capsule and mixing it with applesauce, but to get the liquid that I needed, I would have to have a prescription. I came home open a capsule, dumped it on the applesauce and immediately the rage began to subside. It is so embarrassing to be that out of control, know you are out of control and yet not able to do anything about it other than take your meds. Anyway, I told my PCP and he immediately got on the phone and faxed over a prescription and the liquid should be here very soon. Prozac is made in a liquid form. He laughs at the way I describe these episodes, but he knows that they really are serious for me. It takes very little to control it...20mg. of prozac is not a lot of meds. I have taken the same amount for over 10 years. When I don't have it, I fly into rages over simple things and say things that are best kept to myself...I have what the psychologist said were "anger issues."...actually, I just want scream and be hysterical for about 20 minutes. While I do have a genuine irritation, my response to it is way over the top. The manic or happy state is not a problem for anyone. I am a lot of fun then....but the depressive state is the pits for us all. The rages precede the depression. This surgery will most likely not do a thing about the bipolar stuff, but it will perhaps make it easier to control. This is one of those conditions that are inherited and I have it on both sides of my parents...it is a seratonin imbalance. However, my physician understands it better than anyone, because I know enough about it and he has observed me enough to trust what I tell him. I am lucky that I actually know about this stuff.

Otherwise. I have no pain. I am enjoying my meals that I eat. I find it amusing that I can eat so little and feel good about it. I am having problems remembering to take the vitamins and calcium...this could be a potential problem.



May 25, 2007
UPDATE

I weigh 175 pounds most days now. I am still losing at about a pound a week. I cannot seem to keep a pair of jeans that actually fit. I buy some that fit or are a little snug and then in a week or so they are baggy. I still have problems with eating too fast and drinking too big of gulps. I am impatient, which is why I probably got to be so large in the first place.

I will be going to my 40th high school class reunion in a few weeks. I am wanting to be down another 5 pounds by then. I am going to wear black jeans to the bbq, but with the rapid changes I am experiencing in clothning sizes, I am going to wait until the last minute to buy anything to wear.

I have been tricking myself into exercise. There are so many projects that I want to get done, and it requires a lot of shopping and physical labor. So when shopping, I park as far away from the store as possible and walk throughout the store, even if I know where the item is that I want to buy. I set goals for some kind of manual labor everyday that will require me to do something that is strength building...like hauling mulch for the flower beds or digging out weeds. That seems to work best for me. I find walking a track way too boring.
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