DiTheHuntress

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Well I just had my mom take my 5weeks post-op plastic surgery ETT pictures Saturday morning and I've uploaded all but one of them.  So if you are a friend, check them out. Otherwise you'll have to friend me to see my plastic surgery album.  None of the pics are graphic, I just feel more comfortable having greater control over who gets to see these since I am sans undies in some of them although you can't see anything.

My period has still not shown up and I am now officially late. My last cycle was on the 13th, so I should have gotten it on the 11th so I'm 9 days overdue.  Considering my earlier PCOS concerns that is worrisome.  It will be just my luck if I do get my cycle on Christmas Day. I'm supposed to be looking at bridesmaid's dresses next Saturday too! I think that I will definetly be calling my gyno up after the holidays for a checkup.

Speaking of which (my sister's wedding) we have a jam packed 4 days while she's here from AZ looking at dresses, interviewing dj's, videographers and florists.  Plus we are getting one last family of 5 (mom, dad, 3 kids) portrait done before she gets married Sept 19,2009.  So yeah I'll be running around like a chicken with it's head cut off. Oh well.

Well I had my first WOW moment when I tried on a sz 10 corduroy pair of jeans this Saturday and they fit perfectly, and I'm still pretty swollen so maybe I'll even eventually (hopefully) end up in a sz 8! Also I went shopping for holiday dresses and was pleasantly surprised at how fabulous I looked without the usual lumps and bumps to distort the outline of the outfit not to mention wearing a size 12 instead of a size 14/16!

I'll be 5 weeks post-op this coming Tuesday and I am so damn tired of that damned binder!  I just don't get how some people get so attached to theirs that they are still happily wearing them at 6 months out! *shakes head* I plan on asking Dr Eaves when I can switch from the binder to a compression garment like Spanx (okay, okay I cheated one day and wore my Spanx over a pair of spandex panties and felt just fine) or something similar. It's way more comfortable and not as noticeable underneath one's clothes.  

I guess it just all depends on one's level of swelling. On my last visit the ps said I still would lose 8-10lbs of water weight.  I really need to increase my water intake from 4 glasses a day to 8 glasses a day. I do know that in the past it has knocked off a few pounds of water weight, I just don't know how it would affect the swelling this time around.  I also need to increase my protein levels, I have been very slack lately about getting in my 100grams. 

TMI ahead . . . .





I'm due to start my period this coming week and I am hoping it holds off until Dr Eaves appt on Tuesday.  I need to ask him about getting back on the birth control pills and if its safe to do so. Safe because the bc pills are known to cause blood clots hence the reason I was asked to be off them 2 weeks prior & 2 weeks post surgery. I'm a little nervous about going back on them and wonder if maybe I should wait another month or even two months.  The reason? I know CorinnaQ here on obesityhelp.com got a blood clot around the 4/5 week mark. And Corinna Q was moving around, didn't have any leg pains, etc.  .  . no one suspected her cough was actually a developing clot. Luckily they caught it in time but still it's pretty scary.  Blood clots can kill you.

Sadly I need to be on bc pills to regulate my cycle due to having menorrhagia (abnormally heavy and prolonged periods at regular intervals) as well as having polycystic ovarian syndrome (PCOS).  Having a period of two or three weeks is no fun let me tell you .  Jeez I'm depressed just thinking about all this, the blood clot issue and the possibility of a period longer than 5 days which it is currently.  Oh well I'll find out Tuesday what Dr Eaves thinks on the blood clot issue and I'll make an appt with my gyno for a thorough checkup because the the last three cycles have been extremely painful on the lower right side so I hope I'm not developing a cyst again.

Well it's been 3 weeks post-op for me and I have been doing splendidly. I had 11 pounds of skin removed and although I am still very swollen I look a vast improvement over my before pictures as you can tell in my album http://www.makemeheal.com/pictures/viewAlbum.php?albumid=7455. pw= thintreat I'll have to post some pictures of my scar once the durmabond and red scabbyness falls off which should be this week or next. My ps did such a great job of scar placement that you can't see it in the pictures but I have a long horizontal line in front followed by two descending lines that angle downwards towards my bottom. He did a great job in pulling up skin from my inner thighs too, getting rid of that crepey elephant skin look.

Recovery- wise I have been lucky, other than a drain that wouldn't quit (go below 30 ccc in 24hrs) which I finally got out this Tuesday I have been fine. No blood clots, (although they did give me a shot of Lovenox in hsopital before I left), no wound openings, etc. My ps doesn't believe in binders until you start to really swell so I didn't even get a binder until 2 weeks post-op. I hate that binder by the way, it's so bloody annoying!

I have felt really good pain wise as well, except for the first week when I was on Dilaudid and Methadone I've pretty much been able to manage on an occasional Ultracet since then. At two weeks I even went shopping at our Southern Christmas Show for 4 hours, naturally I used a rolling walker with a seat so I could rest but I found as long as I took it slow and easy I did just fine. Afterall my PS said I could walk as exercise so I took him at his word .

The only thing bothering me now is that I have officially entered swell hell and it SO annoying. I still can't fit into my sz 12 or 14 jeans. My waist is 4 inches biggger than when I went into surgery, although I have lost 7 lbs. It makes no sense. I can't wait until this massive swelling goes down. Eventhe ps has said I would probably lose another 8-10 lbs of water weight due to the swelling. I'm like "bring it on baby!" All told them I' m very pleased with my results and my progress. I'll try to be more faithful about updating as well.

Yes, I finally have my date, November 11, 2008. I guess I should back track a bit here and explain how that came about.

On Thursday 10/16/08 I went to see Dr Felmont Eaves of charlotteplasticsurgery.com for a seminar followed by a consult. The seminar was attended by a total of 3 patients and conducted by Dr Eaves and lasted an hour. During that hour he showed before/after photos of his patients who were gastric bypass/other massive weight loss in search of tt who had a variety of procedures performed; tummy tucks, arm lifts, breast aug, thigh lift, etc.  He also went over the different needs and risks bariatric patients face undergoing plastic surgery. There was a ton of of valuable information that he gave us in that hour. Most of my questions (I had 3 pages full) were answered then and there. After wards we were led one by one for our actual consultation.

Lucky Di (I was the first one there) I got to go first. Dr Eaves came across so very warm, friendly and caring I didn't feel at all nervous or embarrassed  standing there basically naked but for the surgical panties I was wearing. We went over my risk factors (asthmam, CFIDS, FMS, allergies to codeine, vicodin, darvocet) and discussed how each would be handled; inhaler and pre-op consult with anesthesiologist, surgical clearance from CFIDS/FMS specialist, demerol with phenegrin for pain. I mentioned how important it was to me to have my mons area taken care of and he said it's included in the extended tummy tuck that he felt was what I needed. He showed me exactly where the scar placement would be on my back.  I felt really happy with everything we discussed.

Later I met with Teresa the office coordinator who went over the fees with me. His fees are $2500 an hour so for a 3.5 hour sx it's $8700 plus the hospital charges. Sadly I had to wait until late Tuesday to get the hospital charge info; $4031.50 for a 1 night stay including anesthesiology so my total bill comes to $12781.50. I called Teresa first thing Wednesday morning to book. Unfortunately she was busy on the other line so I waited on tenterhooks all day long for her to call me back. It was about 5;50pm when to my utmost surprise I got a call from her (I thought I'd have to call back Thursday). 

Anyway after chatting abit about some questions I had, I went ahead and booked 11/11/08 at 7:30am at Presbyterian Hawthorne Ln. I have to be there 2hours early that day. Yikes, that means getting up at 3:45pm to take a shower with dial soap , take my am meds then drive to the hospital by 5:30am.
Teresa went ahead and made my preop appointment for Friday 10/24/08.

During my pre-op I met with Dr Eaves again, got to ask him some miscellaneous questions I had, discussed pain mangement and he said I might even be able to go home the same day if I did really well.  Teresa gave me the list of bloodwork I would need to get done and told me to get sx clearance from my pcp and my specialist. 

On the way home from my pre-op consult I called my PCP and made my appt for Tuesday 10/28 for the bloodwork and sx clearance letter. I also happen to be seeing my specialist on Tuesday afternoon so I can knock out that item from my agenda as well.

I called my sister Wednesday as soon as I got of the phone with Teresa and told her the good news. I'm sooo excited.  I then called my brother and talked to him since he's the one who'll be taking care of me while I'm laid up.  He wanted me to push the date back to the 17th of Nov when he has vacation but I don't want to wait another week, plus the 11th is the only date available until Dec 9th unless I want to go at the end of the day and I'd rather have Dr Eaves fresh in the am when he's doing my surgery not tacked on at the end of the day when he is tuckered out.    I finally told my mom about it on Friday and she was okay with it not too excited for me like my siblings are.  I can't wait to tell my friends about it.

I've met some great people over at the makemeheal.com forums and message boards for tummy tucks and one of them recommended Dr Hunstad. I called on Friday the 1oth and got in as a cancellation appt for Tuesday the 14th. The only truly sucky thing is that there was a huge consult charge of $200. However I figured what with getting a free consult with Dr Ferrari and getting the $75 consult fee from Dr Pratt waived I'd lucked already and since Dr H came highly recommended and had alot of experience in massive weight loss tummy tucks that I would bite the bullet and pay the money.

Well the staff was friendly, the doctor himself was great. I felt very positive about the encounter. Dr Hunstad did include the mons lift with his tt and he recommended the CTT for me. However when I met with the financial manager I was blown away to see that the quote was $10000 more  than anyone else I'd consulted. My quote with hsp stay 1night and anesthesiology, sx fees, etc was $22000.  If I'd had that much money I probably would have gone ahead and booked a surgery date but I don't.

Oh well, I still have Dr Felmont Eaves of Charlotte Plastic Surgery to see on Thursday. That will be final consult and then I will make up my mind as to which sx to go with for the tt.

Well Monday they called me about a cancelation on my consult with Dr Victor Ferrari of Premier Plastic Surgery here in Charlotte. Could I come in on Tuesday afternoon? Hell, yes! LOL!  

So Dr Ferrari was very personable and I felt calm and at ease with him. He is board certified as opposed to Dr Pratt who is going through the certification process and has many years of experience. While he has worked with some prior bariatric patients it is not his specialty as it is for Dr Pratt. Also Dr Ferrari would operate in his accreditted operating suite and have me stay overnight with a nurse. When I brought up my asthma issues during recovery he assured me that the MD Anesthesiologist stays throughout recovery period. Under Dr Pratt  I would be overnight at the hospital.  The last thing that was different was that Dr F wants to do an CTT (circumfrential tummy tuck) with the scar going all the way around.  This not only would get rid of my side fat but  would get rid of buttock sagging and slightly lift my heinie.

Cons: I'm just not sure if I want  an extended scar all the way around my front and back.  The in house surgery suite. I know the hospital is literally just across the street if something wrong happens but with my anemia (borderline) and mild asthma (however I suffer from asthma attacks coming out of anesthesia) I think I might feel safer in hospital. Recovery at home; how comfortable will I be resting, sleeping, etc with a scar all the way around? Plus how will I be able to check the back side of my scar for wound openings, infections, etc?

Pros; Dr Ferrari's got that magic piece of paper whereas I don't know why or how to aks politely how far along Dr Pratt is in qualifications for the board. I read somewhere that the entire process can take four to six years. However once someone has passed their written exams if they haven't gotten their oral exams passed within two-three years you should maybe question going to that surgeon. Also Dr Ferrari has more years of overall surgical experience. He has done some bariatric patients and I did get to view those photos (kicks self for forgetting to ask about speaking with them). Price; he is some $3000 less than Dr Pratt's quote but that's due 90% to the hospital charges.

I have one more consult I want to attend and I have high hopes for Dr Felmont Eaves. The only truly sucky thing is that he insist all his bariatric patients go through a free seminar first which isn't scheduled until the 16th of Oct, then a free consult is scheduled.

In the meantime, I'm off to collect more info on CTT as far as what recovery is like. That might help me narrow down my choices, hopefully.

Well, I didn't expect this; I called on Monday for a consult appt with Dr Pratt and they turned out to have a cancellation for Tuesday at 2pm. So that's where I was at today.

Dr Pratt said I would probably be better served with the fleur-de-lis/anchor/T-cut tummy tuck. However he advocates doing it in two stages, explaining that the intersection of the T in his experience ends up with too many occurrences of wound openings and infections. After examining me he said I might even be able to get away with being pleased with the results of lipo and horizontal incision tummy tuck.  He does throw in the Mons lift at no charge as well.  As far as my thighs go he stated the tt and lipo might do enough to where I would be satisfied, that I might not require a full inner thigh lift.  Later this week I'll post some pics in new empty plastic surgery journey album.

As far as a physician, I researched him quite a bit and was impressed when last year a doctor in another field thought enough of him to admire his work and second the recommendation that if I wanted post gastric bypass plastic surgery work then he was the go-to guy.  Most of my questions were answered during our consultation. I did think of several others though after I left the office. Ugh, isn't that always the way though?

I've gotten two other names from recommendations here. So tomorrow I will be calling Dr Broc Pratt of Metrolina Plastic Surgery, Dr Felmont Eaves and Dr Stanley Getz of Carolina Cosmetic & Plastic Surgery to hopefully shcedule a consult as soon as possible. I want to have my tt and thigh lift or thigh lipo by Nov.  I've got things to do in January and I want to be fully recovered by then. Plus it would be awful to spend Christmas in pain since I am hoping to spend it in AZ with my sister.  I just hope I can get all 3 consults done back to back so I can compare who I feel most comfortable with.  In the meantime I've got to buckle down and write my letter in Spanish to the surgeon I chose in El Salvador asking for more information and clarification on his fees. 

I got a great list of questions to ask from Willow on the ps board which I've copied here:

Have you done plastics on post-wls patients/How much experience working on post-wls patients?

What are the challenges faced by a wls patient as opposed to a non-op person?  

Do you take a staged approach to surgeries or do you feel it is safe to do a total body makeover all at once?

What are the challenges faced by a wls patient as opposed to a non-op person?  

Will you work with my insurance on the RECONSTRUCTIVE/MEDICALLY NECESSARY procedures?

What are your certifications?

Bariatric patients - How many do you / have you done?

Where are your surgeries performed?

Are you on staff at a hospital?

If it is in an outpatient surgery center, Is it an accredited facility?

Who assists you in surgery? another MD , surgery tech, resident?

Who does anesthesia? MD or CRNA? (I'd be happy with either to be honest, just like to know)

Will there be any special precautions taken due to my sleep apnea and other medical issues?

Can I get a better result with a different procedures?

Compression garment/ ace wraps?  Do you provide these or do I?

Do you have a previous bariatric patient I can talk to about their experience?

Experience with procedures I need? - How many, how often?

Follow up care- how soon, how often, how long?

Pain control? Do you use the OnQ?

How do you close incisions?

How long does this surgery take / anesthesia time

Cost of surgery? Including anesthesia and OR charges?

What has been you experience with getting approval from Tricare?

Payment plans?

Pictures before & afters of procedures I want

Preop procedure? Testing? When? where?

Pros & Cons of this surgery.

Return to exercise?

Revision policy?

Scar Care, treatment & prevention?

Do you recommend any supplements or vitamins pre-op or post op (Arnica and Bromelain for example)

Are there vitamins and supplements I should not take pre or post op?  (Vitamin E and K for example)

Stitches under skin vs. staples (if they say staples just leave, don't go back)

What can I realistically expect?

What do you think you are best at? Specialty?


It's a huge list of Q's but definetly everything you need to know to ask.


 

I just discovered the possibility of outpatient LBL or tummy tuck, thigh lift and mons pubic lift here locally in Charlotte verus doing it in Central America in hospital as I was planning to.  I had no insurance last year and so went to El Salvador for  selfpay gallbladder removal.  While there I went for two consults with plastic surgeons planning ahead for the day when I'd have money for it. Well that day has come, I finally won my social security disability case for fibromyalgia, chronic fatigue & immune defieciency syndrome (cfids) and all my back pay from 2004 till now has finally been paid to me. 

Now I am in a quandry; do I go ahead with planning to recontact Dr Zaldivar http://www.clinicazaldivar.com/  and go ahead with the 3-5day in hospital procedure, recovery & follow up of three weeks  for a total stay of 4-5 weeks with extended relatives who would be willing to nurse me, there would also be a maid to help out as well or do I opt for getting a consult with Dr Broc Pratt of Metrolina Plastic Surgery with the possibility of in an outpatient stay with home recovery and my parents to act as help for my recovery period and followup?   I wish I had some info on prices for plastic surgery procedures in Charlotte.  I do know the surgery with lipo, hospital and anesthiesa in El Salvador will be around $12500, at least that's what I was quoted a year ago.  

I plan to call Dr Pratt's off ice on Monday for a consult ($50 charge)  and I have a letter written to DrZaldivar that I need to email requesting current info and price. After that I guess we'll see.

I'm a little scared of having reconstructive surgery. I don't feel as if I am informed enough on all the risks and complications. I don't feel as if I am prepared on what to expect after surgery with drains, pressure garments, depth of scarring, swelling and bruising. Basically I just feel very illiterate about the whole process. I know part of it is due to my cognitive difficulties with the FMS/CFIDS/ME that cause problems with information assimilation and comprehension.  Somebody help and give me a crash course on what to excpect with an LBL or tt with tl and mons lift!

 After just turning 30, I suddenly realized that my weight is equivalent to two people. I knew I had gained weight because of all the medications I'm on, I just hadn't expected to pack on 25+lbs in less than a year! Once I hit and passed the 250lbs mark I thought, "That's it! Dieting and exercising isn't working." So now I hope to learn more about WLS.

Well I have an appointment with Dr. Melkonian on July 10th and I have also called Dr Wachsmuth to get an information packet. The staff at both offices seemed very friendly and professional as they set up my appt/explained about leaving my personal info to receive the info packet. I was so nervous about picking up the phone since I just started researching surgery a few days ago. I tend to procrastinate alot so I figured if I went ahead and called the doctors for an appt&info by the time the actual appointment comes up I'll be educated about the process.

More later ..............
July 1, 2003,
It's official. I have sleep apnea. My pulmonologist had even included "drastic weight loss recommended" to improve my sleep apnea as a therapy to follow. Great news to add to supporting documentation as to why insurance should pay for wls.

July3, 2003
I went to see my psychologist and finally told him about my decision to pursue wls and he was not very supportive. He felt I had not demonstrated a sufficient amount of time trying to lose weight! Hah! I should have brought him my diet history list and let him eat his words. True, since I have been seeing him I have not dieted/exercised because it is too difficult to do in my heavy gasping for breath body. Luckily I have to see my psychiatrist Dr. Vivian Campbell on Tuesday 07/08/03 and hopefully she will be more supportive. I can’t wait till next week!!!


July 10, 2003
I just had my 1st consult appt with Dr Melkonian. He is great. Thanks to all of you in CLT, NC who recommended him. I was pretty informed when I went in so I didn't have alot of questions but my mom and sister did. DR M was very patient as he explained the risks and after surgery lifestyle to them. I luckily had alot of paperwork ready to hand over to him from my sleep apnea test (I go for a second sleep study next week). Now all that's really left is to get my psych to write her letter (I saw her Tuesday and she was very supportive!) and to get my consult with the nutritionist done.
I have an appt with Jennifer Manley of Lake Norman Nutrition Assoc. 704-363-4544 scheduled for Monday 07/14/03 at 9:30am.
Last week I visited my PCP for my annual pap and physical. When I told her I had an appt with Dr. M she was very excited and supported me a 100%. My PCP Dr Karen Daniels-Mitchell (East Clt Family Care 704-567-1977) has watched me struggle throughout the past 8 years on one diet after another. She had at one point even had me try both meridia and xenical, neither worked for me. I had a complete cbc,tsh(thyroid),chloesterol bloodwork up done. I also discovered that I now also have high cholesterol which while not a great discovery, is good for my medical record to show growing medical problems because of my obesity. My pcp is sending Dr M a copy of my medical records documenting health issues related to obesity and proof of recommended dieting.

    
July 14, 2003
Well today I had my nutrition consult with Jennifer Manley of Lake Norman Nutrition in Cornelius. I was kind of scared to go to her because I had read negative things about her, but I figured there must be a reason Dr M refers his patients to her so I went. She was great. I am so glad this part of the process is over with. I was a little taken aback by the itty bitty diet that post-ops follow the first week. Jennifer explained why this was so and I immediately understood. She also gave me info about how Dr. M likes his patients to do a 2 week fast with the sugar free carnation instant breakfast. I have read about other surgeons doing this but at my consult with Dr M it wasn’t mentioned so I was glad Jennifer told me. Now I can prepare for what lies ahead.

Tomorrow I will call my psychiatrist and ask her to write her letter, I just have to fax my agreement to release my medical info to Dr M.  I was so irritated when I called my PCP’s office today. I had asked the nurse to send me my medical records and I had signed the release form, but she said they have no copy of my release form. Great! Now I have to fax that over as well. Delays, delays, delays, sigh! Dear God let this approval process go quickly and smoothly so I can be healthy again!

I am really calm (odd isn't it?) about being approved by my insurance. I guess its because I used to work for Cigna Healthcare and I know how the insurance process works. If UHC Select EPO doesn't approve me (the policy reads and I quote "weight loss programs whether or not they are under medical supervision.. . .or for medical reasons are also excluded." that sounds like optifast or something to me, NOT surgery.)Then I will appeal, second appeal and by the third appeal it will be time for open enrollment at work and I know that UHC PPO does approve wls, so I will just switch. I am determined to have this WLS done. If not this year than next for sure even if it means switching to personal health insurance and paying BCBS $180 a month which is what they charge for individual ppo coverage. I have looked into BCBS individual coverage and they do exclude obesity, but they also say that they do cover if it is "morbid obesity". My BMI of 48 is certainly within that range, dontcha think? :')

Hah! I was just looking at my plan documents again and I noticed this lovely little paragraph ". . . in certain circumstances for purposes of overall cost savings or efficiency we may in our sole discretion offer benefits for services that would otherwise not be covered health services . . ."  I can just see myself pointing that paragraph out to them in an appeal letter. Let's see diabetes, gerd, gout, high blood pressure, high cholesterol, asthma, anemia, dysmenorrhea, sleep apnea, stroke, heart problems, and arthritis.... All that runs in my family and I already suffer from six of those conditions. That can get pretty expensive to treat and I plan to be with my company for at least five more years to finish my college degree and get my masters. I am so sure UHC would love to continue to pay all that money out for those conditions for the next six or so years. < rofl >

I read this great quote on one of the message boards and I plan to memorize it for when people point out all the negatives of the surgery..."I can die of morbid obesity or I can die trying to save myself"...Personally I'd like to live life to the fullest and that means grabbing the opportunities to improve my life even if it doesn't end up exactly the way I had planned.
More later.....

    
July 16, 2003
Well this  morning I faxed off all my letters to my PCP and psychiatrist and even my orthopedist asking them for ltrs of support/med ness. I verified that all the offices received my faxes and they all told me to allow 5 business days for the doctor to write the letter. So I will even give them a little extra time and if I haven't received anything by July 29 I will be hassling them big time! lol

Last night I had to go for my second sleep study to have them try out a cpap device to help me while I sleep. My last sleep study cost something like $5000 (I paid zero). Once I start the cpap therapy I have to have a study every six months or so to check that there is not any deterioration in my treatment. Just think, UHC could be shelving out $15,000 just this year alone. I believe they will just love to keep doing that for the next several years. haha! haha!  Just think, one of the most effective treatments for sleep apnea is "losing weight".

    
July 25, 2003
I'd like to believe God is trying to help me because I have lost about 12lbs since June30th. I was at 267 and am now at 255. I have not been trying any diet or excersize routine, I have just been very conscious of what I am eating. I have discovered that I tend to eat large portions within a one hour time frame, or eat heavily at night. Since I noticed this about myself I have been making an effort to serve myself a smaller portion.Once I have eaten that portion I examine my hunger level. Am I just craving more? because it tastes good or am I full. Most times I am full and no longer have a second or third helping. Congrats to my psychologist who talked with me about being more aware of how and how much I eat. I am not keeping a food diary but probably will a little later on.

On another good front, I was checking on my insurance claims and saw that Dr. Melkonian's clm was paid. I hadn't submitted the nutrionist claim because my plan doesn't cover nutritional counseling, however I am now going to try and see if I can get reimbursed by UHC since my nutritionist did list cpt code 278.01 morbid obesity. I hope this is a precursor of more good things to come.

    

August 6, 2003

Happy dance! I got my PCP’s letter of approval on Monday and faxed it to Nancy at Dr Melkonian's office. I also asked her to call me back to let me know when she will file for predetermination since the PCP letter was the only hold-up.

Then.... today I took courage in hand and called my insurer and asked if they covered cpt code 43846 (gastric restrictive procedure with gastric bypass for morbid obesity with short limb less than 100cm, Roux-en-Y gastroenterostomy) and under what guidelines.  My heart leapt with joy when she told me that the procedure requires predetermination based on medical necessity and a review board that makes the final decision. With all my co-morbs (asthma, sleep apnea, high cholesterol, gerd, depression, anxiety, family history of diabetes, stroke, heart disease and etc....) I can't image how they could not think that this is medically necessary for my health and longevity of life.  I was so happy that the answer was not a straight "NO" because of my company's exclusion. I of course made sure to get the rep's name and employee # and marked down the date and time of the call, just in case. She also told me that once UHC receives all the necessary papers that it can take 30 to 45 days to review.

On a blue note, I tried on a pair of shoes I bought last summer and just found in my closet (what can I say? I'm messy). My poor plump foot could not get into my pretty sandals. That just brings home how much weight I have gained over the past year. I went from 221lbs to 267 in less than 8 months! Now I am holding steady at 255.


August 14,2003
This insurance processs is no fun. I called Nancy at Dr M's on Tuesday since she never called me back last week to check that their office had all the paperwork they needed from me to start the pre-approval process. Well she told me she never received my pcp's ltr. I rolled my eyes at this but just calmly told her I would fax it again. Wednesday morning she called and told me that she found the ltr but now needs supporting medical documentation of my weight for 3years and that I only sent her 2001, 2002, and 2003 records. Now, wouldn't you consider that 3years? Sigh.....Now I have to dig out my medical records from my pcp's old practice before she opened her own office. Later today I will once again fax Nancy. Also Nancy mentioned that she was still working on June appointment patients letters to the insurers but that she would notify me when she sends the letter off to United Healthcare. I have to tell you, you really have to  be your own advocate and keep in constant even annoying touch with the doctor's office. It looks like my personal estimate of November for a surgery date is looking more and more like a reality. I am so impatient to get this surgery approved and done.

August 15, 2003
Today I got my cpap machine. I laughed and told my mom that I looked like an alien while I was learning how to wear it at my home healthcare products company support center. Hopefully I will sleep good tonight.
I finally shared my decision for Lap RBY with my friend and cousin Sonia Z. We had lunch today at the Cheesecake Factory and I told her I was going to get dessert because it might be the last time I could really enjoy it. For those of you who don't know the Cheesecake Factory is a restaurant with more than 30 varieties of cheesecake as well as other fabulous desserts, and their lunch and dinner entrees are just as delicious.
Sonia immediately guessed. She asked "Are you having that surgery?" She must be a mind reader. I have never mentioned the possiblity of bariatric surgery to her before but she knew right away why I felt I would'nt get another chance to enjoy a fattening sugary delicious choco-chocolatey cake.

Sonia was really interested to hear about my decision and wanted to learn all about it. I told her about this website as well. She's worried for me, but at the same time happy and excited that I am so thrilled about the opportunity to have this surgery. It felt so good to share with her everthing I knew about Lap RNY and how I came to make my decision.

She even told me that she had kind of thought about surgery for herself but not in any serious way. Sonia's only been overweight for about 2 1/2 years. She was diagnosed with Graves disease and was  newly pregnant at the same time. She gained weight due to her medicine, miscarried her baby and gained more weight from her depression about the miscarriage. While she has since had a healthy pregnancy and beautiful baby girl, she hasn't been able to loose any of the weight she's gained over the past few years from her illness and pregnancies. I was so excited to share with her all I have learned. I don't know if surgery is an option she will persue but it felt good to have someone understand exactly what I was going through since she has been overweight as well.

August 20, 2003

On Monday I once again attended Dr.Melkonian's support group. It was a great experience. That night there were alot of post-ops so I got to learn about thier trials and tribualtions of being on the Losing side.  Also there was this one guy Michael who had lost 100lbs so he has just joined what's referred to as the Century Club. I was so excited for him. I met him at the last meeting in July and he does look alot healthier and slimmer than four weeks ago.  

I really hope that I can continue to attend the group meetings. The bad thing is that they are held on Monday nights, which is the only night I'm  contracted to work. Luckily I have been able to switch nights with someone else, but I can't expect that to last forever. I truly recommend going to support groups to anyone who has been wavering about going to one. It feels wonderful to be in a room full of people who have been or are experiencing the same situation as oneself. There is so much to learn like alot of post-ops swear that eating cheese has helped them loose weight quicker when they become stuck on a plateau. I also found out about liquid vitamins. I was dreading having to take vitamins because I have a hard time swallowing pill (chewing them is just as bad) so I was glad to find out they made such a thing. One lady there even gave me her new bottle of liquid vitamins because she has switched to a different type. So I just saved $30 in vitamins! : )

Tommorrow is my day off and I plan on spending it painting some pottery plates at the local pottery studio. I found some cut-outs of recommended portion size servings and I plan to trace those shapes onto a few plates so that when serving food I won't be oversizing portions. Of course, I will be eating alot less than normal portions after the surgery, but in the meantime this will help me get used to what a normal portion serving looks like.

Oh I posted for an angel and some wonderful people  responded. Defintely do this.

August 24,2003

Oh I am having so much fun. I am attempting to create my personal website to spotlight my journey to the losing side. So far I have the index home page up, but nothing else. It was so easy. I went to yahoo geocities and they have a program that pretty much does it all for you.

On a more somber note, I have started a rough draft of my will and am writing up an advance directive as well as final wishes should I get a surgery date and end up floating up into Heaven.
It kind of makes you take a closer look at yourself when you write a will. It gave me an eerie feeling while I was writing it.

So, to cheer myself up I did go to the Potter's Hand and had a great time painting pottery. I went with a group of friends and had lots of fun and laughs.

P.s. I now have a wondeful angel, Alberta R from California. Thanks! : )

September 15,2003
It's been awhile since I have updated but I have been fighting a re-occuring cold. I'm fine then the next 4 days I have a bad cold. I'm okay for a week and then I get the same dratted cold again! I hate that.

I also did recieve the dissapointing although not totally unexpected news on Tuesday 9/09 that I was denied. Someone from Dr. M's office called me that morning and told me that UHC denied based on written exculsion. I was like, okay, well my employer's spd doesn't specifically exclude surgery as a treatment option so I am going to appeal. Then she told me that she  was getting the same denial reason for all patients with my company. She told me to give the office a call once I recieve an approval from my plan. I thought that was kind of cold. She didn't offer to help in any way with the appeal. I really disliked her at that moment, but I really respect and want the surgery done by Dr. M.  I plan on calling and asking to speak with the office manager about any assistance on appeals. I already have my appeal letter ready because I was expecting to have to fight for myself.
 
I have spent the last few days polishing up my letter and making sure that it is tailored to address the denial reasons listed in the letter that I recieved from UHC.

I will admit that I was so down about the denial that I missed my business class on Wednesday. I was orginally supposed to work that day so I would have missed class anyway. The coworker I was covering for came back early so I could have gone to class, but I haven't been able to concentrate on anything but finishing up my appeal letter. I went home and worked on my letter. At this point my letter is ready to go along with copies of five years of weight history, diet history,letters from my pcp, orthopedist, psychiatrist and most importantly documents from goverment resources such as DHHS and NIH supporting the claims I make in my letter. I plan to send everthing registed, with reciept signature. The only thing I am debating is whether or not to ask for an expedited appeal which has them getting back to me in 72 hours. UHC was pretty quick in denying me once they got my pre-approval request from Dr. M's office back on August 28 so they might be pretty quick with a response to an appeal, although they have up to 15 days to respond. I am just so tired of waiting though.
I also know that my company is more than likely switching insurers for next year because of high premiums and I worry that if I don't get a fast response from UHC that I will have to start all over again with another insurance company.  Wish me luck!!!!!!!!!!!!


October 6,2003
I have spent the last two weeks feeling like someone I love has died. I have been so depressed and my heart feels heavy with grief.  What happened is this; I was going over my benefit plan document one last time to see if I had missed anything that I could use in my appeal. Well, come to find out I did miss something, only it wasn't anything that helps me. I ran across a one sentence exclusion on "surgery for treatment of obesity or morbid obesity". I overlooked it because the exclusion is buried on the last page of exclusions under additional items excluded, it wasn't listed with the exclusions for physical appearance etc where the weight loss program exclusion was stated. I was shocked. I was stunned. I had been basing a major part of my appeal on the grounds of the exclusion referring to weight loss programs and not mentioning surgery. Well, here was the exclusion for surgery.
At first I wasn't sure how to react. Should I revise my appeal letter; take it in the direction of currents medical problems cost versus lowered costs after surgery eliminates or improves current conditions? or should I just give up. I decided to contact Walter Lindstrom and get his advise. He emailed me a few days later and told me with the information I had given him that it was very very difficult to get that type of exclusion overturned. Mr. Lindstrom did say I might have a chance of my plan offered case management exceptions. Okay, I told myself. let's see what HR says. I emailed and called my contact in human resources. I didn't go into any details, merely saying Iw was appealing an insurance denial. Eventually I got a hold of our Benefits Administrator Eric L. He told me although not unheard of, written exclusions are so rarely overturned that he has never run across the situation where an approval has been given after a denial. I was so down when I heard his voice basically indicating that I hadn't a chance. I happened to be at work when he called me and it was all I could do not to break down and cry. I had been so confident, so sure an appeal would be successful, it was a shock to learn otherwise. While Eric went on to state that I could certainly write an appeal and send it in to UHC as well as to HR, I would basically be wasting paper. HR would not and will not support me.
I went around in a daze for about three days or so before my fighting insticts kicked in. I would send HR a letter! I decided to speak with a few other people I know who also work for my employer and are trying to have WLS to see if they would be willing to write to HR as well. Maybe many voices would be louder than just one voice. Well, I was further disappointed when T. told me he had written a 10 page letter to Eric, and a two sentence reply was all he recieved.
My hopes were crushed even more when the news that we would be staying with UHC for the next year insurance. I called UHC to see if they could tell me if there was an exclusion listed for next year. The customer service rep Glenda told me that since my employer is self-funded that they write the plan, deciding what benefits to pay or not pay. I immediatley emailed Eric asking for a copy of the plan document for next year, however he told me it is still being written. I was too embarresed to ask if WLS surgery would be covered or excluded for next year. I did ask him if they review exclusions and make changes to add benefits. According to Eric exclusions are reviewd. So here's my chance to change my employer's mind set against WLS. I have reworked my appeal to take a different stance based on medical costs savings as well as medical necessity. I hope to mail off the letter this week to both HR and UHC.
It's taken me the past two weeks to deal with the loss of confidence, and the extreme dissapointment to my hopes, that I suffered. Additionaly I have also been feeling conflicted about remaing in psychotherapy. Up until two weeks ago, I felt that I really didn't need to be going to my psychologist Dr. P. every week. 75% of the time I am searching for things to discuss, because the inital reasons (clinical depression/panic/anxiety)are no longer a part of my life and have not been for over a year. On one hand I very much appreciate all my psych has done to guide me on my journey of self discovery and renewal, there have been discussions I have taken exception to. There's also the whole WLS issue. In June I had brought alot of literature with me and gave it to Dr. P. at the end of my appointment saying I wanted to discuss the issue once he had time to reveiw. He was not at all supportive of surgery. So unsupportive in fact that I have not mentioned anything regarding surgery since the initial time I brought it up back in June. I realize it's not good when I begin evading discussing issues that impact me such as the WLS among other issues. I have come to dread going to appointments  These last few weeks have been especially difficult because I have been bombared so many conflicting emotions about the WLS and appeals status and have not been able to discuss this with him. I have come to wonder if it is beneficial for me to continue sessions with him. My psychiatrist Dr. Campbell who I see for medication management was suprised to learn that I was still in therapy. Dr. Campbell has told me that she is only keeping me on medication because she wants to make sure I feel stable in handling the emotions that rapid and drastic weight loss may evoke. She has told me repeatedly that she does not consider me depressed/anxious or panic attack prone and has not done so for the past year. I do occasionaly feel the need for an unbiased view on issues troubling me, however I no longer feel Dr. P. can help me. I have tossed around the idea of finding a new psych to see on an occassional basis. Now I'm left wondering: how do you break up with your doctor?

November 8,2003

I have been sick with the flu for the past three weeks and just found out I am anemic on top of that. This past week has been very difficult dealing with the fatigue, nausea, back sprain, and a stress fracture in my ankle. The one good thing to come out of all this is that both my insurance appeal and my letter asking for support (or at the very least educating my employer on wls) have been completed and mailed out just yesterday. I am so scared that I will be denied. Nonetheless I feel very proud of myself for fighting and not just letting the initial denial slide.

The emotional stress and physical pains and aches from my illness has caused me to become very tense and anxious these last few days. I have also felt very low and blue. I'm hoping these feelings of depression/anxiety are just a result of so many physical things hitting me at once (the back sprain, stress facture ankle, plantar faciitis, increased arthitic pain in my knee, the flu, and the anemia). While the two months have been stressful due to having to do more research and rewrite my appeal, it has been a good stress for me in that I have felt determined to find and utilize the most convincing arguments to use in my appeal letter. I have been excited about some of the scientific and economical cost of m.o. vs wls information that I have discovered. I was so happy to mail out my letters yesterday knowing that I have done my best to "fight the good fight". Even if I am denied again, I hope to obtain insurance through BCBS. I am mailing that paperwork off tommorow. Wish me luck either way!And thanks for all your kind words and support. It has meant so much to me.

November 26,2003
*************Happy Thanksgiving!*******************

**** Thank you God! Thank you! Thank you! Thank you! *******

I am very thankful for email I recieved from Eric L my hr rep that for 2004 UHC PPO Meck County, gastric bypass surgery is covered. I made my sister read the email first because I was so scared that it would be bad news, then when she told me I cried for ten minutes. I plan on calling Dr M to see if I can go ahead and schedule a date for Jan or Feb 2004. I don't know yet if there are specifics that Uhc will need to have for the pre-determination, good thing that I allready have all the info they could possibly want! I am so excited, however at the same time I'm almost scared to believe this great news until I have the actual approval in hand. Just two months to get through. God has been good and truly blessed me this Thanksgiving. May he bless everyone else here with similar good news.


December 4,2003

Well I've had my perioc for 6 weeks now (yuck):0  It has made me anemic, and neither bc pills or provera pills have worked so I went to see a specialist and he scheduled me for a D&C for tomorrow at 12:30pm. Good thing it's my day off. I hope this works because I'm tired of worrying about stains on clothes.

Tuesday, I found out that due to my recent abscences I used up all my sick leave hours. I am on a 3 month excessive abscences probationary period and if during that time if I will be out I need to have a doctor's note and go on FLMA Intermitten Leave. This news sucked! It also made me mad because I wasn't told that I could use vacation time for payment when I am out sick. There were a couple of times in August, Sept and Oct that I left early for dentist's/doctor's appointments or was sick. If I had only known I could have put down vacation pay, then I wouldn't have so many sick occurrences. Sigh. My supervisor and her supervisor even, went up to bat for me since they both knew how ill I have been, but our department hr head is a strict by-the-book type and told her to put me on the probationary period. My boss kept telling how sorry she was that she had to this and that I was very much valued at work. According to my supervisor, HR told her my probation would be up on March 2,2004.  I really don't want to wait any longer for this surgery but I guess I will have too if I don't want any negative stuff in my employee file.

If I do wait till March I will then have about 54 hours of paid time off. I could have the surgery sooner but I wouldn't be paid and my surgeon won't fill out any short term-disability insurance forms until the two week post op appointment. That's quite a while to go without pay. I am just so tired of waiting. My birthday is April 3 and I wanted to be a totally new me by that time.

Well, enough pitiful lil' ole me. I am still just so happy that my insurance will cover RNY. I talked to UHC the other day and the rep was able to give me all the information about what paperwork I would need for next year. She also told me I only have to pay my deductible and out of pocket, total $1200. and the rest is covered at 100%. Now that is good news. Whenver I get down about WAITING!!!! I just remember how lucky I am to be able to have this surgery and have UHC pay for it.

    
December 21,2003
This has not been a good month for me  :-(  
My ob/gyn said I had a polyp found during my D&C. Also he thinks that I have PCOS (polycystic ovarian syndrome)which causes menstrual irregularities along with hormone levels boomeranging in all different directions that are responsible for increased acne, infertility problems, etc. Luckily he did tell me that even a 10% decrease in weight helped tremendously in managing the symptoms and in most case restoring fertility. I was very glad to hear that because although I am single, I definetly want to be able to have children. That same day (Friday 12/18/2003)the rheumatologist I went to for pain management said the osteo-arthritis in my left knee is spreading itself around to my other knee along with the fingers of both hands. He kept repeating over and over was I aware that I had "significant deterioration of the cartilage". I was like, okay! enough allready. People always think that because I have such a "sweet innocent young for my age face" that I am somehow incredibly naive. Hah! If they only knew. I kept biting my lip to keep from telling him,I know I have OA and I'm only 30,I know I have 40 to 50 years of living ahead of me and that the OA will continue to worsen as I age. Just give me some management for the pain!

I did tell him about having RNY next year and he was supportive. He gave me some information about how to manage medications after the surgery to make sure they were absorbed properly. He was actually very informed about gastric bypass and how it changes the digestive system. I was quite pleased and am definitely sticking with him. It pays to go to a specialist. PCP's are great but if I hadn't gone to a rheumatologist I wouldn't be aware of all that can be done to manage living with arthritis besides just popping pills.

I spoke with Nita ? at Dr Melkonian's office and she wants me to call back after the first of the year to schedule my surgery date. I was like, "so will you be closed the first thorough the fifth?" LOL. I will be on the phone first thing in the morning to get my date!

I am so thankful for this site since it feels good to purge the annoyance with my health problems along my journey to the new me and leaves me free to enjoy the season and spirit of the holidays. I pray that next year the horrible insurance companies and employers will be struck with more intelligence and compassion and give approval to all those who desperately need this surgery

To all my amos buddies met and those yet to be met:

   Merry Christmas!   Happy Holidays!   Season's Blessings!


January 8, 2004
Well it wasn't until yesterday that I finally got in touch with Nita at Dr M's office. She had me fax over my new insurance info and told me it would take a few days to update my chart, write the new letter, verify new benefits, etc but that I should hear from her within the the next few weeks. I am SO excited to finally getting out of the insurance rut I've been stuck in. Now that I am finally getting to see the light at the end of the tunnel I am having a hard time containing my joy. It's like I want to share my news with everyone "I'm getting my RNY surgery done in less than three months!" I have to literaly keep my hands to my mouth to stop myself from blurting it out to my coworkers and friends at work, most of which know that I am having some type of surgery done, but don't know that its gastric bypass. I know the day I hear back from Nita I will be jumping up and down, Snoopy dancing with happiness.

February 21, 2004

Well, for the last six weeks I have been playing the insurance merry-go-round, however it has finally paid off. Nita called me Friday to let me know my surgery date is 3/16/04 a Tuesday morning. I was at work so I immediately started preparing my medical leave paperwork. I plan to take three weeks but may return at two depending on how I feel.

Lately I have been a little depressed even with having my psychiatrist up my medicine. My sister who I am very close with, has moved to California on a nursing assigment and won't return for another six months. I really miss her. Kris was always my best friend and talking on the phone is just not the same. I am also really sad that she won't be here for my surgery. My parents and brother will be here to support me but since Kris is a critical care nurse I would love to have her by my side to cut through all the medical jargon. Plus I have stayed at the same hospital before and the unit nurses have not been that responsive and attentive to patient's needs. If it hadn't been for Kris working there (but in a different unit) and able to track down my meals, blankets and Tylenol (which never came after requesting two hours ago) I would have been miserable. I just hope I'm not on that same floor for recovery!

I quit seeing my psychologist the last week of December. I am hoping to find a more receptive counselor to help me through this journey. It is so helpful to be able to talk out my concerns and fears to an impartial, caring, but not judging counselor. Any recommendations anyone?

I have to start my liquid diet March 2 and my second appointment with Dr Melkonian isn't until the end of that week. I am a little freaked out at how fast this is going now after waiting impatiently since last July. I am also pretty worried about the anesthesia and pain control both during and after the surgery. At my last surgery for a D&C I had problems breathing and talking in recovery. Since I have both asthma and sleep apnea I am worried about how this will be monitored in surgery and recovery. Not to mention most narcotics cause me extreme nausea, vomiting, and headaches. Can you tell I'm nervous? ;(

Plus there are so many things to do to prepare for my convalescence at home. Clean and rearrange my bedroom so that I can move about more easily. This is a major task, believe me. LOL. Prepay all my March-April bills so that I don't have to worry about them. Finish writing and notarizing my will, medical power of attorney, living well, funeral wishes, setting up a POD (payable on death) account at the bank, etc. Writing farewell letters (just in case) and finding out what to eat next week when I start the liquid diet. Wish me luck everyone! Till next time.....

March 30,2004

I used to wonder why pre-ops stopped posting the closer they got to thier surgery date. Now I know why. I was so busy cleaning my room, sorting out spring clothes & shoes, finalizing projects at work etc  that I felt so rushed and stretched thin the last two weeks before surgery. I was too tired at the end of the day to do anything other than flop into bed. So, I want to take this opportunity to thank everyone for all thier kind emails and calls over the last month. I am so grateful for all your advise and sharing of experiences.

Well on the day of my surgery (3/16/04) the surgeon had started the op laproscopically, however he ended having to make a six-inch incision in the middle of my tummy because he was having trouble getting the instruments and my stomach in the right posiion. So now my tummy has three little 1" cuts and the 6"incision. All the incisions are healing very nicely. It's the staple sites that are dark pink-red and slightly swollen. According to Dr M's nurse this is normal and I should only worry if the swelling, redness, ect reach 2"-4" across the incision sites. I am so happy my follow up with Dr M is this Thursday so that I can get the staples out. The staples are driving me crazy with the itchyness, and skin sensitivity. I have been going around the house in either just a bra or with a tshirt tucked into my bra because just the barest brush of clothing against my tummy's skin is very irritating. My UHC nurse care coordinator called me yesterday and told me to try Neosporin which has been working wonderfully.
While I was in the hospital I was not in much pain. Usually the only pain came from changing positions in bed or going from sitting to standing. I was so glad to go home and rest in my own bed. Sleeping has been kind of hard to accomplish because the only comfortable position that doesn't pull at my stomach muscles is with me half sitting, half laying in bed with my back propped up. The first few days at home I just slept except for short walks to the end of our driveway and back.

So far I have only lost about 10 lbs. I am kind of confused as to what to use as my base weight. On the day of surgery I weighed 242lbs, on Friday 3/19/04 when I was released I weighed 244lbs and this morning I weighed 233 lbs.  

I haven't been doing any protein which I know is BAD. I think its the lack of protein thats been hindering my weight loss but it has taken so long to find a protein drink I can stand. Everything that I was taking before surgery no longer agrees with me. I actually dry heaved over just the SMELL of one protein shake brand! I wish I wasn't lactose intolerant and could take the sugar free CIB. However I finally found ISOPURE Liquid Protein drink in a glass bottle= 20 oz with 40grams protein, 160 calories. It comes in a whole bunch of flavors like orange ice, apple-melon, alpine punch, grape, blue raspberry ect.
The protein drink has a koolaid like consistency and is very easy to get down and there is no protein smell to make me gag. The only drawback is that this drink is expensive at $3.50 per bottle. I have found out just over the weekend that my GNC store discounts 20% if you buy a case (12 bottles) plus if you are a GNC gold card member you can get an extra 20% off the first 7 days of every month. That brings the price down to $2.24 per bottle or $26.88 per case. I figure 2 cases (24 bottles) at approx $55 per month to be money well spent for a protein supplement drink that my stomach wont rebel against.

Food wise I have been on a soft foods diet eating things like a scrambled egg, cereal, chicken salad, tuna salad, etc. I have been able to get everything down okay. My main problem is remebering to serve myself a tiny portion and to eat it slowly. I have thrown up several times because I ate too fast or tried to eat a whole chicken salad croissant instead of just a forth of it.  I haven't had any dumping syndrome type reactions, thank goodness! I am doing better with rembering to eat just a tiny portion and I have come to recognize the line between the physical feelings of fullness and having eaten too fast or too much.  What's with this mucus thing though? I have too much saliva and nasty mucus in my throat and mouth which makes it hard to eat or drink anything. Yuck! My allergies are just making this worse especially with the high pollen count going around just now.

Since I endend up having part of my surgery as open, I have been worried about when I can start exercising or just stretching. I can't wait to feel that physical burn of a good workout.

Emotionally the last two weeks have been kind of weird. When I was being rolled into the operation room I remember focusing on  visual meditation and feeling relaxed and peaceful. After two weeks at home I am still pretty tired but I am bored out of my mind with lazing in bed. TV, the computer, books, etc none of which seem to soothe this restlessnes, this wildness I feel.
I was talking to my sister who's a nurse last night and she said I am feeling this way because I am so impatient to be physically active and fit. That is so true.
More later .......

June 26, 2007
Goodness it has been a long time since I last updated. Alot has been going in my life though. What with CFIDS and Fibromyalgia, Arthritis, Migraines, Depression, Anxiety, and Agoraphobia interrupting and taking over the last few years have been hell. The only thing that has comforted me has been my  new body and my new weight. I am currently 3 years and 3 months post-op and have managed to stay at 168-170 with attention to my diet ( just eating healthy small portions of good healthy nutritious food) and the occasional stretching exercises and tai-chi.  

Currently I have just recently committed myself to trying to exercise more with walking, doing some light weigh-lifting and taking tai-chi up again now that I have more energy thanks to some new wonder pain drugs and excellent vitamin.  I hope to get down to 150lb as a realistic goal. But my dream goal would be 135 lbs. LOL!   

Lately I have also started looking into having body conturing work done abroad. Most specifically by Dr  Fabio Zamprogo in Brazil.   Since I have no insurance due to the fact that I am disabled because of my many chronic illnesses and in hearing stages with Social Security, going out of the country to this particular doctor who has done over 100  body lifts operations on post-op gastric bypass patients seem s like a good idea.
I found out about him through a book called "Beauty from Afar" by Jeff Schult  http://www.beautyfromafar.com

Dr Fabio also has a yahoo group http://www.health.groups.yahoo.com/group/drfabiozamprognoplasticsurgeryinBrazil
Okay, I hope that link works, if not it's I'm really excited about the idea of losing all this flabby and folds of skin I over my belly, bottom and legs. I also  checked out mednetbrazil.com a travel company that sets everything up for you and they give you a price lisit and everything! the prices were so affordable compared to what one would pay in America. Despite my not having any money of my own (my parents give me a monthly allowance to pay doctors bill and my prescriptions) I know they would pay for this if I asked for it because they have indicated it several times.

But first I have to deal with this blasted galllstones that showed up which require surgery to get out!
As you see life is never easy but there is always something interesting
around the corner.