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My Pre-Op / Pre-Surgery Orientation Yesterday
Jul 12, 2008
So yesterday was my "pre-surgery orientation" or last mandatory class before surgery on Monday. I received a lovely blue leather binder with all the information I will need to basically help me adapt to my new lifestyle for the rest of my life, as well as a small quick reference guide to keep in my purse to help with the daily choices I need to make from now on. I also had 4 vials of blood drawn and paid my $18,475 (split between the surgeon and the hospital). I think this is a new personal spending record for me in one day!!! (Erwin tells me I'm expensive, but this is really an investment in our family's future.) I expected them to weigh me, but I guess that will happen just before surgery on Monday. I was all excited for that (for a change), because I had reached the weight loss goal I had set for myself before surgery (down 20 pounds in under 3 weeks). I already feel so much better! As of this morning, I have even lost another pound. Who knows what my final weigh-in will be after I have to drink my magnesium citrate tomorrow night, which will basically "roto rooter" my whole system...
A lot of people have been asking if I'm getting nervous. The truth is that I've tried to make myself numb to those feelings so I don't dwell on them too much. I'm just keeping busy, checking off my "to do" list and trying to stay focused. My younger brother Dan (who had his surgery in January and is already down 150 lbs) told me that around Saturday or Sunday I would start getting cold feet and questioning my decision. If this happens, I will be on the phone to him for emotional support, because there is no way I'm changing my mind. I need this tool in order to become the healthy person I want to be, no matter what the personal sacrifices along the way might be.
I fully expect to have some pain, some emotional struggles, and some major lifestyle adjustments - that's just part of the package - but I'm ready. Having had an emergency surgery to remove my gallbladder in February, I have a pretty good idea of what my recovery will be like, since that was laparoscopic as well. I have 4 tiny little incision scars from that, and will add 6 more with this surgery, so I'll get to play "connect the dots" pretty soon! 
The worst part of it was the pressure from all the gas they pump into your abdomen to make getting around in there easier for the surgeon. I walked around as much as I could, but no matter what I did, the pressure wouldn't go away. Finally, I called the nurse's station at the hospital and asked if there was anything else I could do before coming back to emergency, because the pain from that gas pressure was unbearable. They asked if I had tried putting a heating pad over my stomach, but nobody had told me about that... It worked like a charm! I guess knowing all of this, I haven't been as nervous as I might have been otherwise.
I come from a religious family, and will receive a blessing tomorrow evening from my Uncle Matt, Uncle Ray, and my husband Erwin. I appreciate that my faith and preparation will carry me through this change in my life, and I am confident in my doctor's abilities and my own personal and emotional preparation. I will also be well cared for by family and friends - I just need to let them know what I need, and they'll be there for me.
I will probably post one more entry tomorrow night, just to record how I'm feeling. I think using this site has been such a wonderful tool for me emotionally, and I will be grateful if I can help even one more person besides myself along the way.
5 Days and Counting!!!
Jul 09, 2008
Today I started training my temp replacement at work who will fill in for me while I'm on Medical Leave for my surgery. (I'm Executive Assistant to the CIO at a large health insurance company - interesting that I'm still self-pay, huh?) I will spend one more day with her tomorrow, then she's on her own... I've worked 9am to past 8pm 2 nights in a row, and I'm almost to a point where I feel comfortable with how I'm leaving things for 3 weeks. My surgeon nomally gives people 2 weeks off of work, but I asked for 3 and he said OK. I think it will be good for me to have that extra week to figure out what my body will and won't tolerate before I go back to work.
Friday, I go for my Pre-Surgery Orientation / Final Education Class / Labs at St. Mark's Hospital in Salt Lake City. I've heard nothing but wonderful things about this hospital, so I'm hoping it's as pleaseant as something like this can be!
I am down 17 pounds after 2 weeks on my 1,000 Calorie Pre-Surgery Diet with 5 more days to go, which is pretty good - more than a pound a day average... I'm hoping Dr. McKinlay feels this was a good effort on my part.
My Mom asked me the other day to cancel my surgery and just keep on this same diet, since I'm doing so well. We all know the answer to that one :) I am so ready for this, and I'm just trying to focus for these last several days on getting a few more pounds off. If I can lose a total of 20 before surgery, I will be happy with that. I took a few more pictures today to see if I could tell a difference from 2 weeks ago. I don't know that I really can, but at least you get to see my hair down. (It's a very rare occasion!)
I hope everyone out there is healthy and happy!!!
My Second Week on 1,000 Calories
Jul 03, 2008
I am feeling so good today - I can't believe it! I think my body has finally figured out that I'm making a change for the better. I really wasn't feeling that great over the past several days, until I started getting enough fiber in - things weren't "moving" like they used to, and I was feeling really bloated. Today is a very different story, thank goodness.
It is now day 10 of my pre-surgery diet, and I am officially down 15 pounds. I couldn't believe the energy I had at work today - it's been such a long time since I've really felt good. I work for a rather large company - my facility has a North and a South building with 4 floors on each. In my position, I do a lot of walking between several of the floors in both buildings. I'm still taking the elevators, rather than the stairs, but I'll work my way up to it eventually. Anyway, I noticed that I wasn't out of breath as I zipped around, and it was a great feeling. It also takes a few minutes to walk from the parking lot to the building when I come and go, and I noticed the same thing as I entered and left the building today. I just feel lighter on my feet than I did last week, and I'm loving the fact that I feel completely in control, and my body feels like it's cleaner on the inside (I don't know how else to describe it). I've noticed that my feet and ankles haven't been swollen for the last week - they usually plump up by the end of each workday, but not now!
I'm actually excited to go to my pre-op appointment next Friday and prove that I've adhered to my diet, knowing that I've done everything I could to have a safe, uneventful surgery. My online calorie counter has been such a wonderful tool throughout this process so far. I will definitely continue to keep it up to date every day - especially after surgery. I enjoy being able to look back and see every bit of nutritional information that I eat each day, so I can make adjustments and improvements as needed. I feel very accountable to myself, and very motivated to continue on in the right direction.
The countdown is on until my big day... only 11 more days to go!!!
My First Week on 1,000 Calories (Pre-Surgery Diet)
Jun 28, 2008
I had intended to start my diet 1 week early, but I didn't quite have it together (and certain cravings out of my system) on Monday, June 23rd, so I started on Tuesday (still earlier than my doctor had asked). Today is Saturday, and I've been on track for 4 full days. So far I'm down 11 pounds!!! I feel like I have such a head-start mentally and physically, even though it's only a small drop in a REALLY LARGE bucket, but I'm focused now and feeling great. I've been using an online tool called my-calorie-counter.com to keep track of all my nutritional information throughout the day, and it has been so helpful - there is no guess work anymore! I am not very good at writing down everything on paper, so this makes it more interesting, and I actually want to go there several times a day to check my progress. I highly recommend trying it out!
This is what a typical day is looking like on roughly 1,000 calories:
Breakfast: Atkins Shake - Chocolate Royale
Snack: Low Carb Yogurt or Low Fat Cottage Cheese
Lunch: Another Atkins Shake
Snack: Atkins Advantage Bar, S/F Jello, Beef Jerkey, or Low Fat String Cheese (only one of these)
Dinner: Lean Cuisine or South Beach Diet Frozen Dinner (if I don't feel like one of these, I've done taco salad with ground beef or turkey, 2 oz. cheese, tomato and lettuce)
Snack: 10 calorie Italian Ice popsicle
I'm also getting in about 70 oz. of water. When plain water gets boring, I add either an On-the-Go Sugar Free KoolAid or Crystal Light
Overall - Doing good and feeling great so far!!!
My Struggles With Insurance Coverage
Jun 22, 2008
I just realized I never mentioned anything regarding the process of getting my surgery covered (or not covered), so here goes...
About 2 years ago, after my brother Jeff had his gastric bypass surgery, I decided to seriously start looking into it for myself. I had recently been laid off from my job (along with about a fourth of the other employees at the company I worked for), so I never had a chance to see if I was covered under that plan. A girl my husband worked with had the surgery about a year prior, so I thought I had it made. WRONG!!! I guess the benefits folks had decided to make a change to their UniCare policy to exclude any kind of weight loss surgery, unless certain very specific requirements were met. I decided to see if I could get through their process anyway since I met several of those requirements, and I had my surgeon's office submit all the paperwork for approval. Of course I was denied. By the language of the policy, I thought I might still have a chance with an appeal, so I contacted the Obesity Law and Advocacy Center in Southern California to help me through this process.
Now, I'm sure that this law firm has done great things for many other clients, but let me share my experience with you. I first contacted them in January 2007 for assistance with my appeal. They were more than eager to help me when I paid my $1,100, which, according to the contract I signed, covered a full written appeal request to my insurance company within 3 days (expedited service), assistance with gathering any and all medical records, and (this is the kicker) their assistance with exhausting all avenues available, up to, and including grievance hearings - there was no limit to the number of appeals they would file, according to this contract. At the same time all of this was going on, Erwin and I were in the beginning stages of getting our home in California ready to sell, and beginning the building process of a new home in Utah.
So... the appeal process began. I was denied a second time. We gathered more records and I had a sleep study done, because I was pretty sure I had sleep apnea (which I did). I figured with this documentation in my medical record, I'd have one more co-morbidity to add to the list, making my case stronger. We submitted everything again, and the brilliant folks who review the appeals came back with another denial, and didn't even acknowledge the new information we had submitted with the sleep study. Many of you know my frustration, since each one of these appeals takes a full 30 days or more. One let-down after another was just about all I could bear. The fourth time around, I happened to mention to Kelly at The Obesity Law and Advocacy Center that we were running short on time before my husband and I would be moving out of state. BIG MISTAKE!!!!!! Never again could I get them to return a phone call or email after this. I would expect this from the insurance company, which was a joke to deal with in the first place, but not from these people who were supposed to be helping me. $1,100 is a lot of money, and I felt so stupid for ever opening my big mouth. I can't believe how unprofessional a move that was for people who are supposedly dedicated to helping someone like me. To this day, I've never had any acknowledgement or closure to my case from them. Needless to say, I would not waste my money on their services...
OK - so enough venting (can you tell I'm still mad?) I think I may still file a claim against them through the Better Business Bureau...
So Erwin and I moved into our gorgeous new home in August 2007. He started a new job right away, and I started mine in November. I found out very quickly that both of our companies had specific exclusions in their policies about weight loss surgery or any treatment of obesity. The funny thing is that I work for the largest health insurance provider in the state of Utah, and they have failed to see the benefits of offering this kind of treatment - even to their own employees. Maybe through my experience they will come to see the long term benefits some day...
I came to the conclusion that I would either have to pay for this surgery out-of-pocket, or it would never happen for me. After nearly a year of waiting for our house in CA to sell, it finally did at the end of May, and I am using a portion of that money to pay for the surgery. I know it will be money well spent... I'm 35 and don't have children yet (even though I've been married 12-1/2 years). My biological clock is just ticking away, and the sooner I have this surgery, the sooner I can look forward to starting my family. There is no more time to waste on fighting the insurance companies, and waiting for more appeals to be denied... I'm expecting great things from myself and my surgeon, and I think because I'm having to pay for it, I will work that much harder to be successful.
I hope lots of you out there have more success with the insurance companies than I did!!! Good Luck :)
Just Over 3 Weeks and Counting...
Jun 21, 2008
Today is Saturday, June 21st, and my surgery is 3 weeks from Monday. I have a small confession: I sat down with my husband last weekend and wrote down some of my favorite things I will soon have to avoid for the rest of my life. It was kind of scary to see that about 80% of that list was sweets. I don't have a desire to sit down and binge on anything, but I just wanted to have one last taste of all the things I know I'll miss. I'm actually hoping I won't miss them too much, and that eating will become more like something I have to do to live, rather than the other way around.
Just so I can look back on this later and see how things have changed, here's a sample of what I wrote down:
- See's Candy
- Almond Butter Ring (a Danish pastry that was one of Grandma's favorites from Solvang)
- My Grandma's Lemon Meringue Pie (I haven't had this in years)
- My Aunt Shelley's Strawberry Cake (white cake with cream cheese & fresh strawberries)
- Olive Garden (what can I say - I'm Italian...)
- My own Mexican food (tacos, spanish rice, and sweet corn cake)
- Ritzy Chicken and Funeral Potatoes
Now having said that, here's what I'm looking forward to as a thinner, healthier person:
- Crossing my legs
- Shopping in a "normal" size clothing store
- No swollen feet and ankles
- Having a neck again!
- Fitting in an airplane seat and not having to ask for an extender belt
- Not having to worry whether or not I will fit in a booth at a restaurant (or break a chair!)
- Being able to fit on rides at amusement parks
- Swimming in public
- Riding a bike
- Not being out of breath all the time
- Ditching my CPAP machine
I'm sure there are others I'm not thinking of at the moment, but I will be sure to write down all of my milestones as they happen.
