ObesityHelp

6/10/04 Hello everyone. I have found this site very helpful to me. This is how my journey has been. I have been debating this surgery (lap bypass) for a long time. I manage a clinic so I knew the "rules" were changing in Pennsylvania. Thus, I knew that if I waited past 05/01/04, I had to wait 6 months, be on a physician supervised low calorie diet and have an array of tests. But, that is how it was. So, I was unable to get my appointment for 1 1/2 months so, I went ahead with the paperwork. I had already seen my PCP twice before my appointment with my bariatic surgeon. I did not meet the BMI criteria, but I am diabetic so I met it. I went to see him and for the first time in my life was told not to lose more than 5 lb. or I would not qualify, that sure is different. Well anyway, went to him for initial consultation as well as see the nutritionist. Then, had to go back the next month to see the shrink. It kills me that you have to pay a 20.00 co-pay, then a 50.00 administration fee. He said that was because he had so much paperwork to fill out. Well guess what, I filled 7 of the 11 pages out when I was there. He was completely done when I was finished. He really made out, I guess that is a small price to pay to be healthier. I do not need a gallbladder ultrasound because I had it removed right after my first c-section 20 years ago!!! I am real excited about what is ahead, but a little aprehensive. You kind of look at the world a little differently. For example, I was going to put my winter clothes in the atic, but then realized, I won't be wearing these next year!!! How exciting. Well gotta go. Will journal later.

06/15/04 Hi everyone. Has been almost a week since journaling. For some reason, have dreamed about surgery and have gotten a little panicky, don't know why, maybe cause it is sinking in. Had to get my medications refilled today and thought, wow, I will only have to do this for a short time and then, from what the surgeon says, should be medication free before you know it!! I can't imagine being able to wear normal size clothes and not feeling "heavy" all of the time. Well, talk to ya'all next week. I have been very lucky and met a few nice people on this site. Any feedback is so appreciated. I feel kind of alone in all of this. Have a really supportive husband, but he is not overweight!!! Only us "chubby" ones know what I am talking about.

06/22/04 Went to the Dr.'s yesterday. Lost 1 lb. The PA said everything was on target. Do not need to go back until 08/06/04. That day I will have my pre-op blood work and chest x-ray done. Then, everything should be done except the wait. I can't believe everything is so smoothe. I know my insurance does cover this surgery but it is hard to believe this has been so simple. I have read so many horror stories regarding insurance issues. I am getting a little afraid thinking about complications such as pulmonary emobli and things like that. I have had complications after surgery before but I certainly got over them. Until next time, bye bye.

06/29/04 Well, a little over 9 weeks will be the day. I met a lot of great people being on this site. I was e-mailed last night by someone from Indiana. Her friend, Sherri, died last week from complications after her surgery. She did not even know that her friend had the surgery. Ironically, she had surgery herself in April. It is not clear yet the cause of death for this young lady but I have gotta tell you, I have been sad since I found this out. I never talked to her but after I read her profile my heart broke. She has the same fears as the rest of us, leaving her family. I only pray that they will be okay. Kim, the girl from Indiana, told me Sherri's husband is a wreck which is certainly understandable. It does not really make me change my mind about the surgery. I have diabetes Type2 and I have had it for almost 8 years. Needless to say, I am starting to feel the effects from it. I have lost weight and can't get anymore off. I just feel like I "can't do it anymore - dieting" it sucks the life out of me, literally. J.

07/02/04 It just hit me, my surgery is in 2 months, or 8 weeks and 7 days. It is coming sooner. I am meeting a girl I met on this site today for lunch. It is really wierd but she lives in the same area where I work. Until next week. J.

07/12/04 A little over 7 weeks away!! I can't believe it. I am scared to death. The thoughts of a pulmonary emboli or something else freaks me out. I go to my PCP tomorrow. Just to get weighed in and have my 5th supervised diet month. This is really a bunch of bull. The insurance industry does anything they can to make physicians as well as patients jump through hoops then ultimately they end up approving it anyway. I can't believe that before you know it I am going to feel healthier, wear normal size clothes. This is unbelievable. I never thought in my whole life that I would be thin and healthy. Hallelujah!!!! J.

08/07/04 Do not know what the heck is wrong with me other than I am an emotional wreck and it is not PMS. I can't quit thinking about this surgery. I am not afraid of my life after surgery - I can handle that it is the actual surgery itself. I have had 3 c-section, my gallbladder removed (open kind it was many years ago) and kidney surgery. I am a medical professional. I think maybe I just know too much and worry about a pulmonary emboli and recovery. I hope this will pass. It is not healthy to be this crazy feeling. J.

08/12/04 Well, went to the fat Doctor yesterday. Everything seems to be in order. My lab work and chest x-ray was completed. I gave him my letter of medical necessity, my H&P as well as all my medical records for thelast 6 months of weigh-ins. Now, all I have to do is wait. I have had so much support - my mind is more at ease now. J.

08/19/04 I contacted my fat doctor's office via e-mail today to see if I was approved. Nothing yet - but not to discouraged is what the PA said. I thought "this is just the beginning of a denial." I came home, looked at my e-mail and guess what, I'M APPROVED. So far, not one single snag. I can't believe it. It is 2 weeks from today. Thank God. J.

08/25/04 8 days to go; what a 6-month journey. The time actually went pretty fast. I have now told my children and a couple of close friends as well as my sister about my upcoming surgery. I just can't believe it - my life is going to change so much. I have met some wonderful people. Erin O'brien and I have become very good friends. I have had lunch a few times with Tracee Moore who has been very helpful and supportive. I am also starting a support group for my area. I guess that there is on which is pretty rigid. Tracee and I are starting one more informal. Other than that, it will just take time. I have enclosed samples of my letters if anyone would like to use them.

SAMPLE LETTERS

PHYSICIAN PERSONALLY SUPERVISED DIET PLAN

PATIENT NAME: _______________ DOB: _________
INSURANCE ID#: _____________ SS#: __________________

Date: ___________________ Weight:__________________Height____________BMI_______

Type of Diet:___________________________________________________________________

Expected Calorie Intake: 800-1200 calories

Recommended Exercise Regimen:__________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Diet Medication: ________________________________________________________

______________________________________________________________________________

Dr.’s Assessment:_______________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Co-Morbid Conditions related to obesity: ______________________________________

______________________________________________________________________________

______________________________________________________________________________

Date of Follow-up visit:______________________

Physician Signature:______________________________


PHYSICIAN:
ADDRESS:

PHYSICIAN PHONE:
PHYSICIAN FAX:

DR. WHOEVER.
Gastric Nurse, C.R.N.P.
Suite 610
Anwhere Street
USA City, 10000
Phone ~ (555) 111-1111
Fax ~ (555) 111-2222


August 10, 2004

RE: Jane Doe Medical Necessity
DOB: 01/01/80

To Whom It May Concern:

I am writing on behalf of my patient, Mrs. Jane Doe, who has been in my care for the last 13 years. Mrs. Doe is a 41-year-old female with a long-standing history of obesity. She is currently morbidly obese at a height of 5’5 ½” and a weight of 235 lb and a Body Mass Index of 37.9. She has maintained a BMI of over 37 for the last 13 years.

Mrs. Doe suffers from hypertension, superficial phlebitis, low back pain and Type II diabetes. Mrs. Doe takes Lisinopril 5 mg once daily, Metformin 500 mg one twice daily and Glucovance 2.5/500 mg one twice daily. Mrs. Doe’s surgical history includes the following: C-section 1984, cholecystectomy 1985, c-section 1987, c-section 1989 and right pyeloplasty in February 1993.

Mrs. Doe is aware of the health risks associated with morbid obesity. As a result, she has aggressively attempted to control her weight through numerous weight loss treatment plans and exercise program. Over the past several years, she has tried Weight Watchers, TOPS, and Slim Fast, various over the counter diet and exercise plans, and most recently, the Atkins diet. Prescription weight loss medications are contra-indicative due to her hypertension. Mrs. Doe has been at my office monthly times six months to participate in my supervised weight loss with a 1200 calorie daily diet with no success. This has all been documented. Mrs. Doe needs desperately to lose her excess weight and has been unsuccessful in doing so by other means, therefore, is seeking weight loss surgery. I agree with her decision.

I feel that Mrs. Doe would be an excellent and successful candidate for the Laparoscopic/Open roux-en-Y Gastric bypass for the surgical management of her obesity, and this is the best chance for establishing a healthier life and is a necessary step in prevention of further obesity-related medical complications.

Sincerely,



Your Dr.’s name



DR. WHOEVER.
Gastric Nurse, C.R.N.P.
Suite 610
Anwhere Street
USA City, 10000
Phone ~ (555) 111-1111
Fax ~ (555) 111-2222


August 10, 2004

Your Dr.’s name, M.D.
Your Dr.’s address
Your Dr.’s address

RE: Jane Doe Medical Clearance
Current H&P
DOB: 01/01/80

Dear Dr. Whoever:

I have recently seen Mrs. Jane Doe for a physical exam in anticipation of her gastric bypass surgery which is to be performed in September. Mrs. Doe suffers from hypertension, superficial phlebitis, low back pain and Type II diabetes. Mrs. Doe takes Lisinopril 5 mg once daily, Metformin 500 mg one twice daily and Glucovance 2.5/500 mg one twice daily. Mrs. Doe’s surgical history includes the following: C-section 1984, cholecystectomy 1985, c-section 1987, c-section 1989 and right pyeloplasty in February 1993.

Mrs. Jane Doe is medically cleared for gastric bypass surgery at this time. Her physical examination was unremarkable other than her previously mentioned co-morbid conditions. Mrs. Jane Doe has tolerated surgery very well in the past and I anticipate the same outcome for gastric bypass.

I feel that Mrs. Doe would be an excellent and successful candidate for the Laparoscopic/Open roux-en-Y Gastric bypass for the surgical management of her obesity, and this is the best chance for establishing a healthier life and is a necessary step in prevention of further obesity-related medical complications.

Sincerely,



Your Dr.’s name

08/30/04 Well here it is, Monday and my surgery is Thursday. A lot of people complain about the 6-month wait with the supervised diet program. Without that 6 months, I would have not been able to do as much research nor would I have probably found this site. I have met many nice people and actually developed a close friendship with Erin Obrien. We might be miles from each other but we are close at heart. We will be holding each other's hand when we go into surgery and when we come out. J.

09/01/04 Well everyone, tomorrow morning is the day. I was suppose to have it scheduled at 7:00 a.m. but now it is 9:45; that is okay. Things happen for a reason. I will post when everything is over and I am feeling up to it. I know God will take care of me and my family. J.

09/03/04 Well, had my surgery yesterday and am home today. Not in any pain but extremely tired. This went way better than I anticipated. I hope Erin is doing fine. Scale is up 5 lb. which is to be expected with all the fluids they gave me. Also, they sent me home on Insulin; I am not thrilled but it is only for short term. J.

09/04/04 Talked to Erin today. She is very discussed. She still has her catheter in and still a drain as well as epidural port. She really wants it out and does not feel that anyone is listening to her. I wished I lived near her so I could help. She is very strong and will do wonderful. I have managed to keep everything down again today with no feelings of nausea. Will post soon. J.

09/22/04 Well, as of tomorrow I will be 3 weeks post op. Have been eating soft foods and actually doing fine. Got a little nauseated today after eating a very small tuna steak and I mean small. But the feeling passed thank God. I have never thrown up and hope it stays that way. So far so good. Thank you everyone for all the support. I did go to the fat doctor on 09/17/04 and had lost 21 lb. So, all together I have lost about 26 lb. . . . not bad for 3 weeks!!!! J.

10/02/04 Hi everyone. Was in a "no weight loss state" for about 2 weeks. I was starting to freak out a little. Kept up water, exercise and protein. Finally, poof - 5 more lb. Thank God. I know they do not call it a plateau until one month, boy did it seem like a long time. I am keeping up with my vitamins as well as taking 2 stool softeners a day - that is the only thing that helps!!! J.

11/01/04 Well, I am down almost 40 lb. It seems kind of slow but it is steady. I have thrown up 3 times, 2 out of the three times I ate fish, and one time after turkey. I don't know if I took too big of bites or not but we will see. J.

12/28/04 The Holidays are over and things are getting back to normal. Food, for the most part, was not a real issue over the Holidays. I still have not tried anything sweet and hope that I never do. I know, never say never. I feel like I am just slow with this weight loss thing. I mean, 2 years ago I wore a size 24 and now I wear a 14 so I really am not complaining. I also know not to compare yourself with others but it sometimes hard to. My friend from MASS has lost 20 more lb. than me. I am just trying to stay focused!!! Happy New Year to everyone!!! J.


04/06/05 Happy Spring everyone. Well, I am a lot thinner but the slowest loser in history. I have lost slower than anyone I can find from September and am a little discusted. However, I do exercise and went from a size 24 to a medium 12-14. I have a huge hernia, which I had before surgery, and a tummy tuck somewhere on the horizon. I feel like I am doing everything right. Unfortunately, my diabetes has come back in full force. But, medication is controlling it. I am not on as much medication but am back on it. I only have one regret, that I did not do it sooner. It is the most "out of body" experience not to shop at the "fat girls" store. I am still self concious but not like I was. Life is great with my family as it always was. My husband can even pick me up and twirl me around. I am going to Mexico next week on a family vacation and am looking forward to that. Still look crappy in a swimsuit but better than I did a year ago when I went to the Dominican Republic. Life is good but I am a little discouraged. I will keep my chin up and keep chugging along. J.

07/12/05 Hello everone. Long time no talk. I was at the plastic surgeon as well as the fat Dr. on 07/06/05. Good news and bad news - mostly bad. Unfortunately, they cannot do my hernia repair and tummy tuck at the same time. My hernia is so extensive it is just not doeable. Secondly, after much wuch watching and being careful I have to go on Insulin - not happy at all. I am feeling pretty gloomy but things will all work out. Besides, what choice do I have????????? The good news is I am having fun shopping!!!!! Take care and God Bless. J.