SunnyinSD

Send Message

Block

Add Friend

So it’s been 3 weeks since my VSG surgery. And can I tell you, WHAT a 3 weeks it’s been. I feel like a completely new person!!! I have energy, I willingly take my kids swimming (in a bathing suit… gasp!) and I look forward to the gym.  Now for the (impressive, if I do say so myself) weight loss stats: I have lost a total of 22 lbs in 3 weeks!! I have stalled for the last week or so, but I’ve lost inches, so I’m not super concerned.  In fact, I’ve more than 4 INCHES off of my waist in 3 weeks. So yeah, awesome to say the least!!!  And I've experienced literally ZERO hunger since surgery.  Food just isn't exciting to me anymore. Since my previous post, I did the 2 week pre-op diet, had surgery and had to modify my eating after surgery and I had to deal with my husband and other family members. I’ll go ahead and describe each of those items in a bit of detail.  First, the pre-op diet: I had a strict 3-4 protein shake menu, plus 1 small “Lean Cuisine” type meal per day. All in all, my diet is less than 1,000 calories per day. Since I had done the HMR diet in years past, which was surprisingly easy for me, I just went ahead and did that diet again – 5 shakes and 1 small pre-packaged meal. Very easy. I’m not saying that I never got hungry or had cravings, but with the volume of protein that I was ingesting, it was hard to stay hungry for long. And I had a big goal in mind – my surgery date of 8/8/11. Right after starting the pre-op diet, I attended the pre-op class. It was ALL DAY and went through blood tests, hospital check in, the post-diet surgery, the hospital stay and all post-op prescriptions. It was very thorough and thankfully they gave me a binder with all the info in it, because there was a guy in my class who (I kid you not) was the most annoying person on earth. He interrupted the doctor and nurse about every other minute with some personal concern (I knew his entire life history after this class), and he asked the same question multiple times. Now, I GET wanting to get your questions answered, but I made sure that I had asked all my personal questions ALONE with my doctor during my individual appointment. Anyway, it was hard to listen to what they were saying when that guy kept talking – I sort of stopped listening.  But when I got home, I made sure to review the binder in detail. The day before surgery, I was allowed to eat a REAL breakfast but only liquids after that.  I was too nervous to eat honestly, so I just had my normal protein shake day but I skipped the “real food” dinner that night.  I also had to shower the night before with Hibicleanse antibacterial soap, sleep on clean (washed in super hot water) sheets and PJ’s, and then take another Hibicleanse shower the next morning. They weren’t taking any chances with infections, thank goodness.  I was scheduled for surgery at 8 am the following morning and I had to arrive at the hospital at 5:30 am. I ended up having a coworker drive me to the hospital and drop me off (she’s totally awesome, like an older sister that I never had). My husband had to get our 2 little girls ready for preschool that morning, so he was going to come to the hospital when I was still in surgery. So, I arrive at the Sharp Memorial Hospital at 5:30 am and I’m called back to the “S.P.A.” area to get prepped. Basically, I took off my clothing, they made me take another pregnancy test and they hooked up my IV. Then I sat and waiting for another hour or 2. The anesthesiologist came in to talk to me. Now, the one thing I made SURE to do was to tell him that during my last (and only) other surgery, I felt awful for about a day afterward because the anesthesia had made me so nauseated. Like I couldn’t walk without barfing – think seasickness or morning sickness times a thousand. And with a surgery on my stomach, I imagined that throwing up was NOT a good thing. And thank goodness I did that – no nausea at ALL after surgery.  It was night and day different from my last surgical experience! Then my doctor came in, made sure I had no questions, and we were off to the operating room. I then moved over to the new bed in the room and the doctor told me he was giving me something to make me calm down a bit. Boy did it ever! I felt a bit drunk for about 2 minutes…. Then I woke up in recovery! Recovery: Now this was weird. I knew where I was and what was going on, I could hear everyone talking (nurses and doctors) and my brain felt like it was working OK… but I couldn’t open my eyes. Very weird! I lay like that for a few minutes before I was finally able to open my eyes. Then I got some pain medication, even though I wasn’t in pain, and fell asleep again. I woke up while being moved to my new room. And let me tell you, my room was AWESOME! Totally private and in the new wing of the hospital, and it was a corner room with ceiling to floor windows that overlooked pretty much all of San Diego. I totally lucked out with the room! My nurses were great, too. I was up and walking within an hour or so of getting to my room, and I had little to no pain. It was very surprising and, like I said before, a completely different experience from when I had my gallbladder removed 2 years prior. I had 5 very small incisions that really didn’t hurt. I was able to suck on ice chips for the first day with no problems, and then I was moved to Propel water the next day. I did manage to disconnect my IV line (there was a connection in the middle of the line from the bag to the needle in my arm) while in the bathroom. I didn’t notice until I saw blood everywhere on the floor. That was a bit scary! But the nurse came right away (like within 10 seconds) reconnected me without having to run a new IV and I was as good as new. I was discharged the next day. OK, now for the family drama. I didn’t tell anyone about the surgery with the exception of a few people – my husband, my awesome coworker, my boss and my Aunt who has gastric bypass a year ago. That was it. I didn’t tell people because of my husband’s reaction. He was 100% completely and TOTALLY against the surgery. We fought about it for over 6 months, and he went so far as to schedule a shoulder surgery the WEEK before my surgery in an attempt to get me to cancel. (A side note, he’s needed shoulder surgery for years, but he decided to do it right before mine at the very last minute). Poor guy – not only did I not cancel, but he was left taking care of 2 preschool girls with one arm in a sling. That backfired for him badly. Anyway, now that the surgery is over and I’m not dead (that was his big concern obviously) and he can now see how great I feel, how much more energy I have (especially for certain “things” that I didn’t have much interest in before.. wink, wink) and how much better that I look, he’s much better about the whole thing. He’s turned from 100% NOT supportive, to completely supportive. Thank GOD! The other family drama that I had was with my Aunt. She knew I wasn’t telling anyone – I made it a point to tell her right off the bat that I wasn’t sharing with ANYONE until I was ready- but what does she do?? She calls my SISTER and tells her. So my sister was frantically trying to reach my husband to find out what’s going on with me, how I’m doing, etc. So now the cat’s out of the bag. My sister is very supportive, and I was going to tell her, but I wanted to do so on my own time, and I kinda wanted to surprise everyone in a few months with the “new” me. Now I also have to tell my parents because they would be devastated if they found out second hand. But, whatever… nothing I can do about it now.  Anyway, that’s my story in a nutshell. I really can’t believe I’ve done it, and it was SO incredibly easy for me. I was excepting some problem, some complication or lots of pain, but I got nothing. No energy loss, pain, nausea, nothing. I was back to work a week early (after only a week) and I actually worked from home starting on the Thursday after my Monday surgery (I was bored and I’m a bit of a workaholic). This whole process has been a dream. I just wish that this DAMN 3 week stall would let up!!!

I finally received my approval for surgery.  Thank GOD!  I did end up having to complete the remaining 3 months of dieting, which sucks, but was necessary.  And honestly, it wasn't a big deal.  I did end up gaining back about 6 pounds that I had lost in the first 3 months, but I'm back on the wagon now.

So the plan now is to start the 2 week pre-op diet on July 25th, attend a mandatory all day pre-surgery class on July 27th and I'm scheduled for surgery on August 8th.  I could have scheduled surgery for earlier - mid July - but I have a business trip at the end of July.  So during my 2 week diet I will also be on a business trip that historically is one big booze/beer and food fest.  Yeah... that's going to SUCK.  But it will be worth it and I'm DETERMINED not to cheat.

Wish me luck!!!

So I have been officially denied.  This really sucks! Here is a little background.  BCBS of IL had a 3 month diet requirement, which I met.  They changed their policy on 3/15 to require a 6 month diet.  I completed the 3 months and submitted to insurance in early March, well before the 15th policy change.  BCBS of IL then denied me yesterday (3/21) because I didn't meet the new policy requirements.

According to the insurance rep, BCBS looks at the active policy requirements from the date of approval or denial, not from the date of submission, so even though I completed and submitted the 3 months of Doctor supervised visits AND I send in the paperwork before the 15th of March when they changed the policy, they are STILL making me adhere to the new policy.  I'm trying to decide if this is worth appealing or if I should just do the remaining 3 months of dieting.  What do you think? 

I'm just pissed off!  What was to stop them from holding onto my paperwork for as long as possible so that the decision hadn't been made by the time the policy changed, so that I would be automatically denied according to the terms of the new policy?  What if they decide in 2 more months to change the diet requirements to 12 months?  Like I said, I'm furious!  What would you do if you were me?

Today I finish my (hopefully) final weigh in and the doctors will submit for insurance this week. I am down another 10 pounds from last month, for a grand total of 28 pounds since beginning my journey in January. I am SO excited, nervous and scared all at once. I have never simultaneously both looked forward to and dreaded an event more. Even giving birth to my children didn’t have quite this level of mixed feelings. But I’m ready. I need to call the insurance coordinator this afternoon to ensure that they have everything that they need to submit to insurance, but hopefully this is the home stretch.

On a side note, I had an abnormal mammogram a few weeks ago. I was sent for additional testing, including an MRI. It was terrifying – not so much because of the test (although the test was not pleasant) but because of the waiting and the possibility of something being wrong. I just remember lying on my stomach in the MRI machine crying, trying not to move while the tests were being run. I was picturing leaving my 2 little girls without a mom and my husband without a wife. I remember what it was like for me losing my mom at 9 years old – I couldn’t imagine what it might be like for my 4 year old and 2 year old daughters. It was probably one of the single worst moments of my life. But, every dark cloud has a silver lining – everything was clear. And I can now move forward knowing that I have had the most sensitive test for breast cancer currently known to man and it came back clear. So no more dread in the back of my mind that I will die of the same disease, at the exact same age, that took my own mother from me. Only blue skies from here….

2/18/11 - Yesterday I was able to get in with my primary doctor to complete the final tests needed for approval for the surgery.

First, let me step back and say that I hadn’t actually talked with my doctor about doing the surgery because 1) it’s hard to get an appointment with her for anything less than an immediate medical concern and 2) because she is very gung-ho about losing weight the traditional way. I know, I know – I was being a HUGE chicken! I made my appointment with my PCP right after I had the initial consult with the surgeon, but it took over a month to get me in.

But to my surprise, when I went in with all of the pre-op paperwork my doctor was BEYOND supportive. She got teary-eyed (we go way back to when she had just joined her practice out of her residency and I was still in college. Our kids are about the same age and our kids go to the same preschool) and she was SO proud of me for taking this step. At our last appointment before starting down the VSG trail she threatened to put me on blood pressure medication (I’m borderline) and cholesterol medication (again… borderline) unless I lost the weight. That did it for me. It was one of the biggest reasons why I started this journey. I’m just SO happy to have her approval and her help going forward. It just helps me to solidify what a good decision that I’m making for myself.

All in all, the process was EASY. My doctor did the EKG in the office, she gave me a referral to get a chest X-ray and to get the blood draw for all the blood tests. I was able to run downstairs and get BOTH the blood draw and the chest X-ray completed within an hour. Cool, huh? I finally feel like I’m getting into the home stretch (or at least the 6th inning).

Now for the health scare. Last week you may remember that I had a mammogram done. I’m only 32 years old (I’ll be 33 in 2 months) but I was referred for a mammogram because my mother died at age 33 of breast cancer. My maternal grandmother also had breast cancer, albeit much later in life. So I know I have a high risk. To be proactive, my doctor had me go in for a baseline mammogram at 23 years old. My latest mammogram found an abnormality – although it is most likely benign, it scared the living $h!t out of me – for obvious reasons. I have only 2 months to go until I’m the same age my mom was when she died. So, in the midst of getting all the VSG testing done yesterday, I was sent for a breast ultrasound. Luckily everything came back looking normal, but to be proactive I have a follow-up MRI scheduled. You can’t be too careful and it’s better to err on the side of caution. I just hope that my insurance company feels the same

---

I CAN’T believe it!!!! I lost 18 flippin’ pounds this month on the pre-op diet. Can you say Holy $h!t???!!!!! I knew I lost a lot – over 10 pounds, but I didn’t think that I’d lost almost 20 pounds. Now my BMI is 39 and not the 42 it was at this time last month. My goal for the next month is to lose another 10 pounds. Woohoo!!!

I’m still worried about approval for the surgery itself with respect to timing. It occurred to me today that I will have only completed 2 months of actual “dieting” (but 3 different weigh ins and meetings with the NUT) before submitting to insurance. I’m wondering if they count that as 2 months or 3 months worth of visits? The NUT thinks it’s the number of visits, each 1 month apart, that is the defining factor not the actual time spent dieting. Well, I guess I’ll find out next month.

I also found out that the psychologist STILL hasn’t sent over the approval paperwork to my surgeon. Ugh! WHY do people lag like that? It’s been 3 weeks! So I called him and left a very nice message asking him to SEND THE D@MN PAPERWORK!!! Hopefully that will work, since I’m on such an inflexible time schedule. I guess if worst comes to worst, I’ll have to do a 6 month diet and the surgery will wait until summer.

I’m meeting with another doctor next week to do the lab work and the other various tests needed for approval. I certainly hope that it won’t take 3 weeks to send that type of result. But we’ll see. Again, worst case I’ll get surgery in June/July instead of March or April.

On a side note, I had a mammogram today (totally unrelated to VSG surgery). I’m only 32, but my mom died of breast cancer when she was 33 (and I turn 33 in 3 months) so the doctors want to be extra careful. I’m mentioning this because every time I get a cancer-type test done (PAP, mammogram, etc.) I tend to freak out for a few weeks until I get the results back. And the technician told me that since my hospital had moved the mammograms from film to digital, that there have been a lot more false positives. So, now I’m going to be stress-eating until I get the call back. Lovely…

I got an email today from the psych saying that he is in the process of writing a letter to my surgeon to approve my surgery! Woohoo, not crazy after alll. He is suggesting that maybe I have a few counseling sessions before and after surgery to make sure that I'm coping well with all the changes. At least it's another thing to check off of my list of things to do before surgery! Woohoo!

During my visit last week with the shrink, I was asked to give up all caffeine and alcohol for a week and report back with the results. So, I called in today and left a voicemail. I had a much harder time with the caffeine than I had expected. I really don't drink soda - even diet - and I have maybe a cup of coffee during the work week. And I usually don't drink the whole thing. But boy oh boy, by day 3 without caffeine, I had THE WORST headache imaginable. And it lasted all day. It was the head-in-a-vice-Tylenol-doesn’t-cut-it type of headache. Nasty business, that caffeine is. That same day I was exhausted – I literally got out of bed around 10 am (my norm is 6 or 7), tried to play with my kids, took a nap when they did except that they only slept for an hour while I was down for almost 4 hours, and then I went to bed at 8:30. So yeah, I think that I’m going to avoid caffeine from now on. I definitely don’t want to go through that again and I can’t imagine if I had actually been drinking a lot of coffee in the morning. Giving up alcohol was easy as I was already doing that for the diet from the NUT.

I also weighed myself today. I am down 10 pounds from when I was weighed at the surgeon’s office. Woohoo!!! Most of it is water weight (remember I had just started my period when I weighed in previously) and I was wearing heavier clothes the last time, but still 10 pounds in 2 weeks is nothing to laugh over, and I need all the good news that I can get.

On the husband front, things are going better. Not great, but better. Since the Big Fight (yes, it is now officially known in my house by that title) last week, we spent the better part of 3 days not speaking to each other, to slowly talking about household and kid stuff, to being able to have a nice conversation and sit in the same room together without our children. I say without our children because we have a habit of acting relatively normal toward each other in front of the kids, and then ignoring each other when we are alone and going into separate rooms. So, when I say that we progressed from not speaking to sitting in the same room talking to each other, on purpose without kids – it’s big, I tell you! Also, I noticed that my husband has been researching the surgery, the complications and the results. So, now that he’s gotten the initial knee-jerk “Hell NO!” off his chest, maybe now he’s willing to listen. I certainly hope that he will at least consider it, which is it does seem as though he’s doing – even if it is in secret. I still have 2.5 more months to go before I submit to insurance for approval, so I’m hoping that he will be onboard by then. Stay tuned….

---

Today I’m meeting with the psychologist. I think I’m more nervous about meeting with him than with the actual surgery. Let’s be honest, anyone who weighs 273 pounds is going to have SOME issues. I’ve never visited a shrink and there are some skeletons that I’d like left in my closet.

Without getting too personal about what was discussed (this IS the internet after all), we went through why I thought I had gained so much weight and did I have a good support system in place. Yes to the first question. No, to the second. Well, not NO exactly… I just hadn’t told anyone about my plans yet. And I mean NO ONE.

So, according to the shrink, my assignment was to go home and tell my husband my plans. Now, don’t get me wrong, I WAS going to tell him eventually, and yes I was going to tell him before the surgery. But I wanted to wait until I had insurance approval. I KNEW that my husband was going to be against the surgery.

So, I told him of my plans. And he was against them, as expected. Actually, “against my plans” is probably not strong enough of a description. He was FURIOUS that I was even considering the idea. And I mean FURIOUS!!! He is 100% totally and completely against it. He thinks that I am “taking the lazy way out.” That I’ve never really tried to lose weight, not really; that I’m a quitter and I could do this on my own without risking my life on a surgery that he equated with a boob-job. He threw everything negative thing at me that he could possibly think of – some valid reasons, like risking my life while I have 2 little baby girls at home, and some just plain MEAN things – to get me to change my mind. So, it ended up being a BIG fight.

Now, I know what you are thinking – WHY on EARTH would this woman’s husband be against getting a hot wife? Doesn’t he want her healthy? Doesn’t her want her to live a long time? The answer is yes. My husband loves me deeply and he’s terrified that I’m going to die on an operating table. Or that I’m going to have complications and be disabled for the rest of my life. All valid concerns, but he doesn’t express them properly, which lead to the fight. But my husband also doesn’t fully understand what it is like to be fat. He’s never been fat. In fact, he’s skinny. He is 6’8” and 210 pounds. He got the skinny gene just like his mother did. I didn’t. He thinks that if I eat less and exercise more that I’ll be skinny. And he IS partially correct. If I ate right and exercise more, I WOULD be skinny. For a time, until the diet ended and I went back to my old ways and ended up gaining more weight than I had lost. Like what happened when I did HMR. I started HMR at 242 pounds (my highest EVER until now), I dropped down to 195 pounds before life got in the way and I thought that I could do the diet on my own… and now I am sitting here 2 years later weighing in at 273 pounds.

So I’m at an impasse with my husband. He absolutely does not want this to happen, and I do. Ultimately it’s my body. I have to carry the weight around and deal with the health and social consequences. So ultimately it’s my decision. And I know I need surgery.

Now, I have to call the shrink and come up with a plan for another support system other than my husband. Wish me luck!

Let me start this post out by saying, I ADORE Dr Mueller’s staff already and I haven’t even met them yet. Yesterday, I called the office to try to get an appointment on VERY short notice (see my post from yesterday) because of pending insurance changes. And I get to speak with Leti, (aka, my own personal miracle worker), who is the coordinator with my insurance company. For the past few days, Leti has had the task of trying to confirm my benefits with my insurance company – right after the first of the year and after an insurance change. No small feat by any means. She has managed to confirm that I have surgical benefits but that she hasn’t been able to get a live person to confirm the bariatric surgery benefits. Technically, Leti isn’t supposed to let me schedule an appointment without having confirmed my benefits.

I calmly explain to Leti that my insurance has some pending legislation and that I have to be DONE with my 3 month supervised visit and all my paperwork submitted BEFORE March 15th. So that gave me all of 5 days, two of which were the weekend, so really all of 3 days to get in to the doctor and to the Nutritionist. And she hasn’t confirmed my benefits. Things aren’t looking too good for me now.

In steps Leti… she agrees to just go ahead and schedule the appointment for the Dr Mueller and the NUT. “Awesome!!!” Well, then she tells me that the doctor is booked for the next 3 weeks. Ugh… great. “Oh wait” she says, “You’re in luck. The doctor AND the NUT both have an opening tomorrow at 9:30 am. Can you make it?” Yes, I will absolutely be there! This was meant to be!

So I arrive at the doctor’s office a bit early and fill out the paperwork. I don’t have my new card yet because of the transition to the new plan, but I give them the required information. I fill out the family history, personal history, etc. I’m weighed with my clothes and shoes on, but they made my put my purse on the floor. (Side note here – I was afraid that I wouldn’t weigh enough to meet the 40 BMI criteria. The last time that I had weighed myself about 3 months earlier, I had been 254, which was about 8 pounds short of the 40 BMI needed. So I was praying that they would let me carry my purse on the scale. Well, they didn’t. But it turned out that I weighed a hell of a lot more than I thought so there was no reason to worry. This was probably the ONLY time in my life that I was hoping to have gained 8 pounds. But I was starting my period so I had water weight gain, and it was just after the holidays… so the stars were aligned).

The meeting with Dr Mueller was awesome. He was patient with my questions and by the end I was comfortable with my choice of the Sleeve Gastrectomy. He thought that the LapBand offered too many complications down the road, especially for someone of my age. He wanted either RNY or the Sleeve. Since I wasn’t comfortable with the malabsorption (even though he wasn’t worried about it) the sleeve seemed like the perfect option for me.

Next I met with the NUT to start my 3 month weight loss plan. Pretty easy actually – 1,500 calories and exercise 30 minutes per day 5-6 days per week. A lot LESS intensive than the HMR thing I did last year. And I’ve found that it’s pretty easy to follow the plan.

I leave to 2 more scheduled appointments to meet with the NUT, the last of which is on March 9th. So I should have 4 days to submit all the paperwork. My goal is to have EVERYTHING except the final weigh in down by my appointment in February, so that the only thing left to do on March 7th is to send the paperwork to insurance.

So, what do you think? Do you think I will be able to scrape by with only the 3 month weight loss, with only 4 days between submitting the paperwork and the new requirements being put into place?