rumpole6

Send Message

Block

Add Friend

And I am incredibly psyched. I am feeling so good about this whole thing right now.  My Dr. told me there is a very very good possibility I will be leaving the hospital not needing any diabetes medicine. Woo hoo!!!!. Next, the NUT told me to be sure and schedule a follow up visit  to my Primary Dr  after two weeks to see about adjusting my blood pressure medicine. I was shocked. So Soon? This would be a fabulous thing. The quick resolution of blood sugar is kind of expected, that is what got me interested in the procedure in the  first place. I am so excited to start this journey  i can't wait.

Of course, I have to get through the pre-op diet first. Now, this has got me a little scared, because it is so spartan. With my surgeon, I am on a plan where I have two shakes a day and two Lean Cuisines. Sure, I could cook  two low cal meals but lean cuisine sounds easier.  The daily food needs to come in between 950 and 1050 cals/day. I imagine I will  need to go to sleep to keep from eating. Its a tried and true strategy  for me; I know it works but I hate that I need to become a hermit in order to lose weight. I also hope that I will be able to keep from eating at night with the sleeve and I think the immediate consequences of that will help me.

Well......

Long time no hear. After waiting a whole month t,o receive my surgery date, I called the hospital. They told me they didn't have everything yet, specifically the clearance from my cardiologist and the weight history from my primary. These things were available back in March. So when I went to track these things down. It turns out the primary already had the info sitting in his file, they just had to fax it in to the hospital. But the cardiac clearance letter had never been written. So they had to write the letter and fax it over to the hospital.  This was good enough for the insurance company, but I have to get that clearance updated before they cut.

So it took two more weeks, but I finally have the insurance approval and I have a date scheduled. Oct 13, 2014. The first day of the rest of my life.

It is so nice to be writing about something other than CPAP. I got my final medical clearance yesterday and now we go to insurance. I should hear from them within the next two weeks. I am scared and thrilled at the same time. If I had gotten delayed again yesterday, I am quite certain I would have chucked it all for this year. It has been 8 months since I started this process.

So I need 30 days of compliance. Compliance means 30 days where I wear the mask at least 5 hours. I only did 3 hours last night. I would have stuck it out longer but I couldn't see the clock. We were having thunderstorms and I was having dreams and it was my first night with the machine, so I don't know what the issue actually was, but I felt hot a claustrophobic. They techs told me to expect some problems right out of the gate. So I am not too concerned  that I did. But had I known it was only 3 hours I would have tried to go longer.

The neat thing about the machine is that its on a wireless network so they are monitoring my compliance and I guess I they will inform the Dr how I am doing at my next appt.

So All I have left to do is hopefully one more weight management session. Hopefully then we can submit to insurance.

Finally, after many misunderstandings  of what what going to happen when. I finally have an appointment at the place (where they promise) they will fit me out with my CPAP machine. Apparently what happens is its a rental to buy after a year so I get to  maybe get a different machine if the one they  give me at first  is not to my liking.

The one thing I am worried about is whether there are versions with extra filtering since I had a heck of a sinus headache the next day and it seems like my nasal passages where extra inflamed.  I'll let you know how it comes about.

I had appointments for both of these yesterday and I expected  to be  on cruise control, just trying to lose some weight and make some changes before my final weight management appointment.  No such luck.

In terms of psych, the therapist told me that it wasn't her job to clear me, just to provide a report  to the medical team and that report wouldn't be available for another week. At that point,  the medical team and the insurance company would decide. In terms of preliminary results, she told me that I needed some therapy in order to deal with the binge eating issues and in order to make sure I get enough support for the surgery as the normal support meetings provided by the programs is not going to be sufficient.

Surprisingly, I am not bothered by this state of affairs because i was considering therapy anyway because what I feel was missing from previous weight loss attempts was head work.

So we should know in maybe a week or two if getting therapy will be required for insurance clearance, pre-op, or post-op or up to me. The therapist said any of those outcomes in possible. However, if it is an insurance requirement, I don't know what that means.

Now, with CPAP, I was told (although I have to admit I don't remember who told me) that I would leave this latest sleep study with the  CPAP machine, properly programmed and adjusted, and I could begin  my 30 days of compliance.  No such luck.

The sleep tech told me that I did better with the CPAP, but it required a higher setting than he figured. But he said I would not get the machine until the sleep study was scored, reviewed, and approved by the Drs. That could also take 3-5 days. He was not sure whether I would need another appointment or not to actually get my machine, but if I another visit was required it would not be a sleep study.

But here is the thing: The machine in the sleep study seems to really aggravate my allergies. When I first put the machine on, I was really  aware of how inflamed my my nasal passages were to start with. The force of the air blowing  on the membranes was something I felt  and was pretty annoying. I might even call it painful. And some time during the night my nose completely clogged up and I couldn't even breathe through my nose. If you don't know, the machine makes quite a lot of noise when you open your mouth to breathe. But by the morning things had subsided enough. I still feel like I have a rock in my nose and sinus pain on that side. So I guess I will need to aquire some good HEPA filtering on my CPAP, because I am in a rock vs a hard place on this CPAP. I must be compliant. But the pain must be dealt with. Maybe a need a trip to the allergist?

Hi,

I just came back from the meeting with the Behavioral Health people and she said that she felt I was a fair candidate for the surgery, but she did recommend (and that she would recommend to the rest of the medical team) that I get therapy to deal with the  binge eating issues as well as to provide an extra level of support. After she writes her letter I will know the exact wording of what she said. It will be up to the surgical team  and the insurance company whether getting that in place will be a requirement for surgery or not. I am kind of happy with the recommendation  (except if it could block surgery) because I kind of felt that there was some kind of  psychological issue and it is nice to have a professional opinion  stating that. 

So, in a week, i should know a little more on this front. I was hoping it would be resolved today. I mean clearance, I didn't expect my binge issues  to be resolved.

So, tonight is the sleep study where they fit the CPAP machine. I am already really tired because I had to get up a little early to make the appointment. I don't know if that is good thing or a bad thing to be extra tired. Oh, well, I don't want to obsess over it.

Had a rough night last night. I am so looking forward to getting treatment for the sleep apnea. One more week to make it through before the fitting of the CPAP machine and I cannot wait! I hope this solves it.  Otherwise, I need to investigate other avenues for the tiredness. It is hard to consider anything else if I'm not feeling better.

So on the pre-op diet changes department. I have been replacing breakfasts with a protein shake. It has been pretty successful. Now I can see that I can do this and I was very concerned about this. Sometimes, when I had these tiny meals and snacks it wouldn't have done a thing for me.  But the only thing I miss is feeling really full all morning. Its not like I am hungry, but I was feeling really full after eating a bagel, and that fullness helped me limit my intake at lunch. Now I feel pretty hungry at lunch time. And for me dinner is pretty far after lunch 6-7 hours. I know, i should have a snack in the mid afternoon, which I have tried, but It doesn't enable me to reduce my intake at dinner,  so I just consider a snack as extra calories. But with the sleeve this should be better, I hope.

I had what I thought would be my last medical weight management session yesterday, but Nope that is not the case. I met with the Nutritionist and the  NP and the verdict is that i need another session. I have not demonstrated sufficient changes in my life to indicate that I will be a successful candidate and worse in their eyes at least is that I gained a little bit of weight since the last one. Well, regarding changes. I wasn't really aware that I had to. They made their suggestions seem like just that, suggestions. and not that if I didn't take the suggestions if would affect my ability to receive clearance. So.... It does and if I still want the surgery I am going to have to take some of the changes and lose some weight.

Oh another thing. They completely discounted how tired I am since it seems to be a psycho somatic reaction to finding out I have sleep apnea. The NP said i've had it for years and coped fine I should be able to last the two weeks until the scheduled fitting of the CPAP machine. So my coping pattern  for the next two weeks is nap where I can (not likely, I hope to get some napping in on the weekend but I have to work on Saturday), take ibuprofen early before the headaches get unmanageable. and get by without thinking too much.

But back to weight management. One of the "suggestions" is that I replace one meal a day with an appropriate protein shake: One that  is under 200 calories, has at least 15 grams of protien and there is one more requirement for the drink but I forget what. Low sugar? maybe:  I need to look it up. So I am going to try that by replacing my beloved bagel in the morning with the shake and see how I do. I am not sure of  what the definition of "do" is.

Fast food. It is "suggested" that I do away with fast food. this may be difficult because I tend to do it 3-4 times a week, mostly because it is east but also because it make meal times happier with picky children around. But the good new is that my DW is supporting this but we haven't determined what to replace fast food with. I am having trouble getting my mind around this one. See "Tired" above.

We also discussed exercise. I am to add between 30 minutes to an hour of additional exercise to my day.  See tired above. But I did discuss with DW and she proposed getting treadmill and I can add some walking in the evening in front of the TV. We'll see. Usually I sit on the couch in the evening trying to stay awake long enough to go to sleep at a reasonable adult hour. Seems like a huge jump. 

So Next Medical Weight Management is End of July, so no surgery until August I guess.

Today, I am wondering if getting this surgery is going to be worth the effort. I am prepared that I will not be getting a lot of support from the immediate family and I know that a lot of the sabotages they do will just not work against the sleeve, but it would be so much easier to know that the sabotages can be expected to stop.  I read a post yesterday about a spouse who is going on the diet along with the patient. Wow that is supportive, this is not an easy diet to do especially in the early days. The support I am hoping for involves only keeping healthy foods in the house without constant complaining that there is nothing in the house to eat. There is stuff, you just don't want to eat it. But there is no reason to expect that to change.

 So, I need to be sure. I an still post op, basically I need the psych eval, the sleep study with fitting for the CPAP machine, followed by 30 days of compliance, and one more monthly weight management session.