Jeanette_S.

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I would like to start off by saying that I have not cheated ONCE. This is definitely something to be proud of. There has been more than once that I have been seriously tempted. I literally have had to slap my hand away.

I had read a lot of other posts and blogs about the hell of the pre-op liquid diet. But nothing can really prepare you for what that really means.

I am convinced this diet was NOT created to shrink your liver or whatever. The doctors have collaborated with satan and created this torture device. It was created in order to test your will power. To break your spirit and your addiction to food.

My doctor allows me to have Slim-Fast, SF Carnation Instant Breakfast, and things like Boost and Ensure. Some broths, but no real soup like tomato or anything. So 10 days of chocolate, vanilla or strawberry flavored milk and occasional chicken flavored water. Don't forget about the SF Jello ("Slimy, yet satisfying") or SF Popsicles. What a treat.

Yup that half-gallon plus of milk in two days was really wonderful. I had heard the warnings of liquid in = liquid out. But nothing - was - coming - out. Nothing. My stomach hurt so bad!I never wanted to fart or poop so bad in my life. I went and bought the $4.50 a half-gallon of the lactose-free milk. Today I was never so happy to poop!! Too bad I will have to buy that crap almost every other day just so I have sustenance.

And the cravings...Oh....mah......gawd....I want to eat EVERYTHING and ANYTHING. I have had to ban myself from watching food porn. And I love me some food porn. All these damn foods keep popping into my twisted little head. I go drink my shake and play head games with myself. "It's not that much longer." "I will be able to have it again later (just smaller)" "It's not that bad." It's all bull shit and I know it. I am allowed to have as many shakes as I want. If I am hungry I can have another shake. Yay. Another friggin shake.

I know that the end result is worth it. I know that even as much as it sucks that I have to stick with it. I am sooo afraid of getting all the way through it and they post-pone my surgery and have to do it all over again. I am terrified that it will be canceled all together because I was not able to follow this simple diet.

I know I can do it. I HAVE to do it.

So many people that I have told what I am doing say that they are proud of me. That it must be hard and I am a strong person for going through this. All of this is really surprising to hear, but it's also really good to hear. It makes it a little easier to "keep on keeping on"

But they are the same people who get to eat real food. And cook real food which smells really, really good. And talk about food. DAMN IT THEY SUCK DONKEY BALLS!

Will be my band birthday. I have 10 days to go. Which means I start the liquid diet tomorrow.

Last week I had the pre-op band education appointment with one of the nurses. And then I met with Dr. Jones and got scheduled for 1:30 on November 14Th.

At the pre-op education we went over "the band bible" with all the guidelines and the rules of living with the band. She told me about the process of surgery day, what to expect, etc. A lot of good information. Then we (my husband and I) met with Dr. Jones. He seems like a very nice and caring surgeon. He was cautiously optimistic about the results I could have. I don't think he could say I will absolutely do fantastic, but he did said that I was a good candidate. Then we looked at his calendar and he was debating between the 21st and the 14Th. He had to bump another guy on the 14Th, for some reason or another, but I got the last spot on the 14Th! This actually for me worked better, obviously I get it done sooner, but also my cousin is getting married on the 22ND, and I would like to go.

Last Friday, I had my last appointment with the nutritionist to go over the pre-op and post-op diets. For 10 days before surgery I can have sugar free Carnation Instant Breakfast, Ensure, Boost, Slim Fast, SF Popsicles and SF Jello. Then after surgery I will be on clear liquids such as see through juice and broth for about a week. Then progress to full liquids for 3 days, then pureed foods, then mashed foods, then soft foods, and on to regular foods. Each stage has new proteins to add, and in the "band bible" each stage has menu plans to follow. It will definitely be a long process but well worth it.

My last dietician appointment was on 9/30, and then my sugeon's office submitted my paperwork to the insurance company for the pre-authorization.

Today (10/22) I got word from the surgeon's office that I had been approved!!!!I had to set up 3 MORE appointments. On 10/29 I go for the pre-op education with the nurse, and then meet with the surgeon for the consult. On the 31st I will have my appointment with the nutritionist again to go over the high protien liquid pre-op diet and the post-op diet. I think (and hope) that I will be scheduled for the acutal surgery.

Somehow, it still doesn't seem real. From what I read this may be normal. I felt like I was waiting for such a LOOOONG time for this approval, and I am so excited that it came through. But I don't know that it still feels real yet. I have all the common feelings of being excited and scared as hell all at the same time.

One of the bennefits though, is that since I KNOW I am going to miss a week or more at work, I need to make sure all my shit is caught up on as much as possible. I have this complex where I don't believe any of my work will get done when I am gone and it will be hell to come back to try to catch up on all that crap. I especially freak out because there is no way my work will be done the way I do it. So I know I still will have to fix it all when I go back. Very frustrating cycle, but I know it is another thing for me to work on.

I had my 3 dietician appointments on 7/28, 8/28 and 9/30, as required by my insurance co.

These were pretty much the same as the first one. At each one we had talked about what I had been working on since my last appointment and what to work on for next time.

My appointment with the physical therapist was on July 23. I really did not know what to expect with this one!

I had to go to the hospital's heart and vascular center, so I was really freaked! I thought for sure they were going to make me do a cardiac stress test or something like that. But that couldn't be farther from the truth.

I showed up in my workout clothes, tee-shirt, sweats and sneakers. They had advised me to wear comfortable clothes and walking shoes. I probably went a little overboard, but I had to go to work afterwords so I did not want to wear my work clothes in case they did make me run on a treadmill.

We sat in her office for a while talikning about what I am currently doing for excersice and things like that. Then she has me stand up and do some warm-up with my arms. They are pretty easy to do. But my darling husband called them oompa-loompa excercises, so I am a little self-concious doing them. They do look a little ridiculous, but hopefully they are effective. Since they are easy to do, I will probably stick with them.

After the monkey excercises, she hooks a heart-monitor to my finger and explains we are just going to walk around the track for 6 minutes. OK! I can definitely do that! While we are walking we are talking about differrent things I can do to get excercise in and things like that. Before I know it we are done, and she says that is the level of activity I need to do about 3-4 times a week to start out. Then gradually increase as I go along. Get the heart rate elevated, but not too much. I should be able to talk. Start at 20 minutes and increase that as well. This is definitely do-able!

We go back to her office and she has me do some streches with my legs. She said it is good to strech after exercising when your muscles are warm so you get more strech and increased flexability. I am not very well balanced so I feel like I am going to fall on my ass somethimes, but they are still very easy.

People always have told me to excercise, but nobody had ever told me HOW! Does that sound ridiclous or what? But it's true, I would have thought that it would have been much more difficult. It's good to know that right now, I don't have to do 8 hours of hard-core cardio. Maybe I can work up to it .

(I am tired as hell, but unfortunately I have terrible insomnia. Since it's Friday I decided not to fight it and continue my story about my journey).

On June 23rd, I had 3 appointments scheduled. I could have had 4 but there was a huge project going down July 1 at work. So it was a crazy time and I felt guilty missing too much work at any given time. (Another thing for me to work on).

I was scheduled at 9 for my first appointment with the registered dietitian. Or are they nutritionists? I am sure there is a difference, but I am not sure what right now and I am too lazy to go look it up. Then at 10 I was scheduled to meet with the Bariatric Physician, which is different from the surgeon. Before these appointments, I am told to go over to the Heart and Vascular Center for my EKG.

I go to the EKG not knowing what to really expect. I have never had a reason to have one before. So I am thinking it will be this long ordeal. I go into a curtained room (kinda reminded me of a trip to the ER) and the tech attaches the sensors to me. I don't even think I had to put a gown on or anything. I think there were 3 or 4 that were glued to my chest, some on my ankles and I think the finger thingy, too. The tech had me lay down on the table. I don't remember if she had me breathe deeply or normally. I laid there for about 30 seconds and that was it! I was shocked it was so painless and easy.

When that 's all done I head over for my NUT appointment. I had to bring along a 3 day food journal. This I thought I pretty much knew what to expect. When I was a teenager my doc sent me to meet with one. This time I felt it was a more positive experience. Maybe it was because I was there under my own power. Maybe it was because I wasn't chastised about my food choices. Who knows? But it was a lot better than what I had in my mind. At first we talked about all these eating habits to change before surgery. I had a whole list of things written down, and honestly, I was a little overwhelmed. And then she almost knocked my off my chair when she said to pick 3 of these to work on over the next month!! What a relief that it wasn't all or nothing! Baby steps. I could definitely handle WORKING ON mindful eating, thorough chewing and getting more protein. I will have 3 more NUT appointments as required by the insurance company, and more baby steps along the way.

After the NUT I had the appointment with the Bariatric Physician. Basically she did a physical, and looked over my labs, EKG, etc. She didn't have my sleep study results yet, as it was Monday morning and had just did the sleep study the previous Friday. There are a few minor things she wants me to follow up with my PCP. But she pretty much cleared me for surgery as well!

Problem is that I have been using my gyno as the PCP, since I really didn't think I had a reason to see another doctor regularly. I guess that's not really the way things are supposed to work. I still haven't found a PCP, I guess I don't know what to say. "Uh...yeah...I need to find a PCP...but...uh....I guess there are some things the Bariatric Surgeon's office wants you to check out but I really can't remember what she said...and by the way can you check out my elbow/wrist pain, and my knee pain because I fell and didn't see a doc then and it's still bothering me" I feel like kinda a dumbass showing up for an appointment but nothing is really 'wrong' with me. I guess it would be similar to a physical, but still, kinda embarrassing that I haven't done this earlier. Not to mention that if one more doctor writes off my problems because I am 'morbidly obese' I am going to go ballistic. HELLO!!! Not EVERYTHING wrong with me is because I am fat! If it is then why does everybody I see at the bariatric program say I am in pretty good health except for the fact that I am 'morbidly obese'??

Anyway...I am going to go try to find this thing I keep hearing about "Sleep." Maybe my eyes will be tired from staring at the computer screen and they will shut and tell my mind to shut off too!

Well in my packet of paperwork there was this "Epworth Sleepiness Scale"
www.stanford.edu/~dement/epworth.html. I fill it out thinking this was showing how much energy I don't have because of my obesity.

WRONG!

Turns out since I am ALWAYS tired and can fall asleep while reading, watching TV or on a long drive, I might have apnea. .

So the nurse at the consultation sets me up for a sleep study. It was on June 20Th. I was told to arrive at 7:30. So I go there with as much of a positive attitude as I can.

The very nice tech shows me around and shows me my room and tells me to fill out the paperwork and change in to my pj's. Not so bad so far. The worst part of this was walking through the halls sans bra. I am way too self-conscious for that!!

So after a while she takes me to the prep room so she can start attaching PART OF the 7000 wires to me. There are about 300 glued to my head, another 300 to my face, wires down my pants, things strapped around my chest. I feel like friggin Frankenstein.

OK. Back to my room. I think this is where she showed me the CPAP machine and even showed me how it worked. It kinda freaked me out!! I suppose a person could (or would have to) get used to it, but she told me to breathe normally, but it was like trying to breathe on the windiest day where you can't catch your breath. How in the HELL are you supposed to breathe normally when there is air constantly blowing in your face????

Now just chill out and relax and watch TV, use the phone, read, whatever. And then call the nurse when I am starting to fall asleep and she will hook up the remaining 7000 wires and attach them to the monitoring system. I MIGHT have been OK with the first 7000 wires but these last ones were killer. Two tubes (like oxygen tubes) in your nose and one of them is really hard.

I think I had called her in about 11:00 ish because I was bored with TV, forgot my book and had talked to everyone I wanted to talk to. Plus she had said that is about when they hope to start the study.

Oh yeah...I forgot to mention that I can fall asleep anywhere I AM COMFORTABLE!! Even though I can sleep on MY couch in MY home and in MY husband's car, I CAN'T fall asleep when I am not home. Not ever since I was little. I was always the last one to fall asleep at slumber parties. I would lay there and listen to the coo-coo clock (no joke). On vacations when I am dogged tired I lay in the hotel room staring at the ceiling while my hubby is sawing logs next to me. Even at home I will be awake for 30-45 minutes after I go to bed.

Needless to say, I could not fall asleep for the life of me. I tried every trick in my book, and it's a big book. PLUS with all the crap strapped to you, it is nearly impossible to sleep on your stomach or side. Guess how I always sleep...stomach or side! 

So I FINALLY fell asleep. They didn't have an alarm clock in the room but I know it was well after 1. But then one of the sensors on the back of my head starts to freak out because it's too hot. So the nurse comes in to check it and have me put a towel over my pillow Once again, it takes me a long time to fall back asleep. Once again, one of the breathing monitors is reading that I stopped breathing and in she comes to adjust it (all other breathing sensors were fine). Back to sleep. Again. Now I manage to yank one of the other sensors out of the machine. Back to sleep again.

She's in promptly at 7 to wake me for the last time. (can't blame her, I would want to go home too). She tells me that once I fell asleep I seemed to have no problems. Gee, ya think? She actually can't tell me but somebody will call me with my results in a week or two.

Turns out I don't have apnea. Thank God!! I just need to go to bed earlier, with a routine so my mind/body can start to shut down. STILL not very good about this. But I think I have come to kinda accept being tired. Any my vitamins seemed to have helped a little bit.

On May 23, I had my blood work drawn (holy blood tubes batman ) They took 14 vials! I was seriously worried that I was going to blackout, since that what happened when I gave blood and of course it was while fasting. Turns out that isn't that much blood. Props to the lab tech though - he found my sneaky little vein on the first shot and I didn't even get a little bruise!!! After the lab, I had the appt with the shrink to go over the results of my psych eval. This was not as bad as I thought it was going to be. She was a very nice and understanding lady and we talked for an hour or so. Then she told me that she didn't see anything that would stop me from having surgery. WOO HOO! One more hoop down!!

My first appointment was on May 9Th for the psychological exam and the nurse consultation. I was really nervous for this appointment. I felt like this was the point of no return, I'm in it so I am going to stick with it. Looking back, this was obviously not the point of no return. But I was going for a psych eval...what if they found something "wrong" with me that would prevent me from having the surgery. I answered the test as honestly as I could. I figured if there was something "wrong" with me at least it would be found out and I would get "fixed." The nurse consultation was OK. I don't think I connected with him too well.  Maybe I was nervous. But I felt like he was pushing Roux-en Y rather than the band. Up until this point I was OK with all of the this if I was getting a band. For some reason, I could not make my self believe the bypass was the right option for ME. I was worried about malnutrition, especially if I was going to have babies later on. I like the fact that with the band it is adjustable. That it's not all or nothing. That it can be made right for ME. The nurse also said that I should do a sleep study because I am always tired (based on those 5 questions about how likely I was to fall asleep doing things like riding in a car for more than an hour or watching TV or reading a book.) I am convinced that they pose those questions so almost everybody 'needs' a sleep study. One appointment down, about 30 to go .

It was actually my husband that made my decision to have sugery a lot easier to make. The person I was most afraid of disapointing was actually encouraging me! At first I was a little put off by this. Shouldn't he love me as I am? But then I begin to understand that he knows how unhappy I am with my weight and he wants me to be healthy. Also I have been told that if I can avoid getting pregnant I should because there are so many more risks involved when I am so far overweight. So if we want to have babies, I need to lose the weight. I am not getting any younger (almost 30) and I can hear the clock ticking. I know that there are a lot of people who have babies when they are older or weigh more, but I am chosing not to be one of those people.

So I called my insurance company just to see how much would be covered. If we were going to go through with this, it would be nice to know how much we would have to come up with out of pocket. As long as I went through a bariatric center of exccellence, it would be covered 100% as an in-patient surgery. I am really lucky to have such great insurance!! On the days I am really hating my job, I just have to think of my bennefits, and it at least seems tolerable. 

Off to the information session we go. I went to the session August 21, 2007. I mailed my information packet in April 2008. I really procrastinated on this one. I guess I wanted to make sure that I really wanted to go through with this. And I wanted to see if I could try one more time to lose the weight. Plus I had to get my referral letter from my PCP and my annual checkup was in February.