ObesityHelp

I am a 29-year-old work at home mom to two girls and wife. I have had weight problems all my life and am a binge eater. I want to lose this weight to make me happy, to be around to see my daughters grow up, and to prove that anything is possible. I want a life!

My consult is scheduled for 1/17 at 10:15 a.m. at Barix Clinics. I'm so excited and nervous with so many questions.


JANUARY
Well the consult went pretty good but I was nervous about the number of deaths. At first, Dr Marymor rubbed me the wrong way but we got along fabulously toward the end of the visit. He definitely doesn't sugar coat things. I found out I am 5'4", 238.5 pounds. BMI of 40.

Right now my focus is moving. Then when we get settled, I can refocus on this surgery. The fact that Aetna is being a pain and requiring 6 months of diet/exercise prescribed by a physician within the past 2 years is a pain in the butt. I literally have to find a new physician when we move, get then to prescribe me that, and do that for 6 months before I even try to get approval. But I will give it my all. If anything, it will reaffirm that I need to do this and that I have tried everything else.

MARCH 2005
Okay, well we are officially moved into our new 2BR apartment and it's great to have our own space again. New furniture, a new apartment, and a new lease on life perhaps? I have a newfound spring in my step as far as goals are concerned. I'm not even fully unpacked and I'm looking into finishing my degree online. I have an appointment with Dr. Hong Tran on 3/15 for a physical and to get on a diet and exercise plan for 6 months - hopefully very well documented! I have a cervical biopsy and colposcopy scheduled for 3/9 and I'm hoping all is well in that department since that's one thing I do not need to stress over.

I am thinking of joining Curves. I got a free trial from my sister-in-law. I bought a resistance band to do the exercises in the book at home and may ask the doctor if this is an okay thing to do for diet/exercise. My step-mother-in-law goes there.

My stress level, anxiety, and depression is really bad right now, but other than that I'm physically ok thus far.


3/10-
I didn't undergo the colpo yesterday. Funky discharge and got diagnosed with a yeast infection with more cultures to be determined. The D.O. was awesome and suggested the possibility of diabetes or at least insulin resistance, and a definite possibility of PCOS. It would explain a lot to me. I'm also going for a new job with a better insurance policy that might make it easier to get the surgery! I will undergo colposcopy and punch cervical biopsy on 4/4, along with PCOS testing.


3/18-
Made an appointment with Dr John Meilhan at Temple for a new consult. I would rather have surgery done laparoscopically and at a hospital where I'll be in safe hands. I also hear good things about him. The consult is 4/20. I hear I need to save $600 for something or other, but I'll figure that out when I see him. My weight went up when I went to Dr Tran for my physical. I'm now officially 247 but the girl at the Access Line said I was barely obese enough for surgery. I'm not sure 'barely obese' is a good thing! Getting started with the IR diet and exercise is tough, though I did walk yesterday and do strength training. In fact, I'm about to go do it again right now!

3/27-
Other than 1 can of coke and some M&Ms for easter, I've been doing really well. Eating SF Jello with FF whipped cream as I type. Whole Wheat spaghetti aint too bad! Things are looking good. Hopefully I'll start to lose weight.

3/30-
Found this on the Aetna website:

Multidisciplinary surgical preparatory regimen: Proximate to the time of surgery, member must participate in organized multidisciplinary surgical preparatory regimen of at least three months duration meeting all of the following criteria, in order to improve surgical outcomes, reduce the potential for surgical complications, and establish the member's ability to comply with post-operative medical care and dietary restrictions:

Consultation with a dietician or nutritionist; and
Reduced-calorie diet program supervised by dietician or nutritionist; and
Exercise regimen (unless contraindicated) to improve pulmonary reserve prior to surgery, supervised by exercise therapist or other qualified professional; and
Behavior modification program supervised by qualified professional; and
Documentation in the medical record of the member's participation in the multidisciplinary surgical preparatory regimen. (A physician's summary letter, without evidence of contemporaneous oversight, is not sufficient documentation. Documentation should include medical records of the physician's initial assessment of the member, and the physician's assessment of the member's progress at the completion of the multidisciplinary surgical preparatory regimen.)

I'm gonna ask Dr Meilhan about this. If there is a physician willing to help me set all of this up, I'd be so much happier!

APRIL
My baby is 1? When did that happen? We had a great birthday party for her on 4/17, even though everyone showed up late and I ate too much cake. It was nice reconciling with my in-laws, but upsetting my MIL showed up. Blah. She is finally walking too, which means more exercise for ME!

I had my consult today with Dr Meilahn. Love him. He is the best surgeon I've ever met (aside from Eric Johnson, MD in minnesota.) I trust him completely. He told me because of my age, body build, having no real problems now from my weight, and my flat upper stomach, that he could do it laparoscopically with relatively low risks. I was thrilled. I weighed in at 246.8. I have to pay the $600 fee to get the tests going, then get through the 6 months of diet and exercise through Aetna. I am going to try to join a gym or something or at least document my exercise and see if dr Tran can refer me to a nutritionist or if I can refer myself through Aetna.

I'm so psyched and absolutely ecstatic that in a year, I could be so much thinner and happier. Life will never be the same! Life will BEGIN!

It's MAY!
This month I'll turn 28. School is going well and I'm getting pretty good grades. I feel great about it. It was something I needed to do for myself and I'm proud of myself for coming through on it. Best of all, my pay will go way up after I finish school - definitely need that!

I've been doing a modified WW approach and am down to 241.5. I was 239 at one point but am back up after starting out at 248. Better than nothing but I feel hindered with it.. I feel plateaued already. I need to pump up the exercise. Thank goodness I switched to Diet Coke! It's soooo much better for me (I know this sounds ridiculous) than regular Coke. I know that sugar is better because it's natural as compared to artificial sweeteners but not for my waistline! I'm glad I can tolerate it. FINALLY! That takes off probably 600 calories a day I was drinking at least! Eating low fat and fat free with a lot of things... lots of WW meals. I found thin sliced Chicken Breast and it's awesome. It will make great sandwiches and stuff on Kaiser rolls. I'm just going through the motions with what the insurance company wants. I go back to Dr Tran on the 24th to get weighed in and discuss a nutrition referral, etc.

My goal now is to save, save, save money. I need to save or make 600 extra dollars to pay for those tests. Then, fight with the insurance company teeth and nail to pay for it.

On a side note, back on Paxil and feel like I'm floating in a freakin cloud. I hate it. I have to get off of this poison. I tried to break down to 10 mg and wean myself off and I never felt so dizzy, lightheaded, disassociated in my life. Why I went off Zoloft and back on Paxil is beyond me. I guess because Zoloft is expensive, Prozac doesn't work, and Paxil is the only other generic. Maybe try Wellbutrin or something... I'll talk to Dr Tran. But jeez... I'm tired CONSTANTLY, forget stuff when I'm talking on the phone, can't pay attention... I hate this stuff. It should be illegal.

5/23-
Marlene is having her surgery tomorrow and I am praying all goes well for her and she has a good experience. I think it will boost my morale.

I went back to regular Coke and feel stupid. My scale is off, off, off, and I can't stand it. We just bought the stupid thing and it's a lithium one.

I've been debating this surgery and scared of it. I am going to save money over the summer for tests, diet some more, and see how I feel. I hate to waste another year of life being fat. I definitely will never let myself get to 30 and be fat anymore. I can barely keep up with the baby and I want another child in the future.

5/24- Marlene had her surgery today. I hope she pulled through okay. I saw Dr Tran. She wrote me an AWESOME letter to Dr Meilhan's office for the insurance company and surgery and I had only seen her once. She is too cool. She told me I deserved this surgery and should go for it! The pep talk helped. I'm reconsidering it again! I weighed in at 241, down 5 from where I was. :\ She said she was proud of me. :D I've been sick so she gave me tons of samples of stuff for my symptoms too. Love her! she's great!

Goals: Get Surgery
Vow Renewal in slinky dress!!!
More kids
Buy a house and get a pool!
Pay off car
Finish school, better job.

I was reading in some national newspapers information about WLS through our school library. I hardly saw anything bad about it in all of the newspapers across the country. Then I read an article that stuck with me. This woman said she wanted surgery because not only did she have a daughter she wanted to keep up with but also because she never wanted to go anywhere and do anything, she was ashamed of the way she looked, there were no pictures of her, and she didn't look people in the face when she went out.

This is me. It was a revelation that hit me today and it hit hard.




Well, I think I've decided that now is not the right time to pursue this. Yes I'm 5'4 1/2" and 241 pounds but I need to try diet and exercise some more. I'm not willing to take a lot of unneeded risks and the idea of my skin hanging off my body like a freak show just doesn't appeal to me. Part of me thinks I'd rather be fat than look like that. The idea of constantly going under the knife for the rest of my life to improve my appearance isn't appealing to me. I'm not willing to give up occasional treats with my daughter, celebrating her birthday with cake, or her asking me why I can't share a snack with her.

I'm 28. Maybe in the future if I get larger or feel more uncomfortable than I do now, I will change my mind. But my cholesterol is excellent, I don't have hypertension, I just lost 6 pounds, and I need to show my daughter that I can do this on my own.

To those of you that have had this surgery and love it, kudos to you for doing what I could never do. You are truly strong.

For those of you that have decided not to have surgery, WE CAN DO IT!!!!

Love to you all.
A


100 REASONS TO LOSE 100 POUNDS
To feel good about ourselves.
To have GREAT sex! :)
So we won't think people are laughing or talking about us.
To buy clothes in a normal store and actually get clothes with some
style to them that fit correctly.
To have more energy!
To be able to tie your shoes/paint toenails.
To be able to sit on a floor and get up gracefully.
To wear a bathing suit.
To cross your legs or sit Indian style.
To fit into an airline/theatre/bus/whatever seat without spilling over
and without having to see "that look" from the person who has to sit
beside you.
So our ankles won't swell.
To fit into a booth at any restaurant.
To not need an extension to a seat belt on an airplane and to have the
tray table not balance on our bellies.
To not worry about being decapitated in our cars with our seat belts on
if we should be in an accident.
To not turn beet red after moderate exertion.
To be able to pick something up off the floor.
Panty Hose that fit!
To go to an amusement park and ride the rides.
To be able to sit in any chair without worry of breakage.
To not have to apologize when caught in a narrow aisle and have someone
need to get by.
To go dancing, sky diving, bungee jumping....
To be able to go horseback riding or ride a bike.
To not worry about rashes and sweating.
To not have to listen to "caring" people ask why you don't diet or
worse still... "gee youhave such a pretty face".
To not worry about spilling food, sauces or gravy down the front of
your blouse/dress/shirt when eating.
To not have to think up some excuse for not doing something because you
know your weight will impede you.
To not have your belly hit the steering wheel and to be able to fit
comfortably in the driver's seat.
To have a bra fit comfortably and to be able to buy underwear at
Victoria's Secret rather than at "Tubby the Underwear Guy".
To not have to worry about the weight limit of step stools, ladders,
motorcycle, exercise equipment, etc.
To not get stuck in a turn style.
To not wake up feeling achy in the back..or to have ache free legs and
feet.
So the bathroom scale won't creak and groan when you step on it.
To be able to leave the tablecloth on the table at a restaurant instead
of dragging it with you when you get up.
So you won't look the other way when you see yourself in a monitor
where they have security cameras.
To never be embarrassed about your size.
To not count tying shoes as daily exercise.
To not have to wait for the handicap stall when there are plenty of
other stalls available.
To not be more out of shape than seniors.
To not break toilet seat when leaning to one side.
To be able to put on wedding rings again.
To try to make a double chin and fail!
Buy clothing bargains to fit the next year ... and they do!
Not to have to worry about plastic zippers or having your pants bust
open.
Normal waistbands rather than elastic!
To wear knee socks correctly instead of worn like slouches!
To look good in a tee shirt!
To try on slacks or jeans and have the pant leg actually fit over leg!
To be able to get close to sink and not come away with a wet belly!
To get out of a stuffed chair GRACEFULLY and not look down to see if
the chair has come up with you!
To not worry if the hairdresser's smock will fit!
To not be self-conscious about eating in front of others!
To not be afraid to ask which hairstyle suits your face.
To not have people checking you out after looking in your grocery cart.
To not feel (and look) like a sausage in stirrup pants.
To have your friends NOT be embarrassed to be seen with you.
To get promotions/hired or close that sale.
Pants that stay up because your waist is smaller than your butt!
No more boobs! (this is for the guys!)
Wearing shorts or tank tops without fear of arrest or grossing out
others!
To not have the fear of being rejected.
To successfully flirt!
To not worry about how to get in and out of the back seat in a two door
car!
One size fits all and it fits you!
To have a lap.
To not have the car you are ride in slant in your direction.
To be able to use toilet paper as it was meant to be used and not to
have to invent ways to "get the job done".
To not have to watch TV news reports on fat people in hopes that you
haven't been caught on camera!
To be able to get between cars in a parking lot without wiping the dust
off with your belly and your butt.
No more heat rashes and chafing in the upper thighs.
So that the cloth in the thigh area doesn't wear away long before the
rest of the slacks do!
To meet a friend online and not be horrified to have to send a picture
of yourself.
To not take fat references and fat jokes personally.
To know you can go anywhere because wherever you sit you CAN be
comfortable and look at ease.
To shop at the mall and not have your back ache from lugging your huge
butt and stomach around!
To be able to stand still, carrying nothing and still look poised.
To be able to cross your arms across your chest without them resting on
your stomach!
To have your feet get smaller.
Using your mouth to taste and chew food rather than as just a route to
get the food from your lips to your stomach.
Blood pressure returns to normal.
To avoid other health complications from being overweight.
To be able to borrow a co-worker's jacket for an important meeting.
To meet someone for the first time and their eyes don't pop out of
their head with amazement...because they never knew you're fat!
To see your reflection in a mirror or store window without turning
away!
To wear a watch with a regular length watch band.
To look in the mirror when getting your hair cut without thinking you
have the biggest face in the world.
To not mind getting your picture taken.
To not avoid going to the doctor because you have to get "weighed" in.
To wake up each morning feeling energized and ready to go.
To not even worry about squeezing into small spaces.
To not have to enter an elevator and check the weight limit.
To look in your closet and have problems deciding which stylish outfit
to work since you have so many that look good and fit well.
To not have to lie perfectly still in bed at night for fear of breaking
the bed!
To buy tie shoes instead of slip ons!
To be able to walk any distance without looking for a bench to sit on.
To look forward to shopping and just trying on clothes!
To be able to drive by any fast food place without salivating!
To be able to shop at the same store for food instead of having to
remember where you shopped last night for the junk food so you can avoid
that store for a few days!
To not feel lower than low when an innocent child remarks about your
size!
To not constantly be thinking of where your next morsel of food is
coming from.
And the 100th reason to lose 100 pounds.....
I'M WORTH IT!

-- Author Of List Unknown

6/22/2005
Arguing majorly with dh... not sure our marriage is going to work. I'm very unhappy and insecure because of my weight. I can't stand being off of Paxil... I can't believe how I act and the person I become. I really have a lot of issues to work through as far as anger and depression. Ugh.

I sent a letter requesting pre-approval for the surgery to Aetna today. Praying it was the best 60 cents I spent. I got a sample letter from an WLS success story's website and tweaked it to look in my favor... I hope they are positive. I also have to send my medical records to the doctor's office but I am going to wait and do that when I sent in the 600 for the testing... unless I decide to save that money and go with Barix.

In the meantime, buying organic food for amaya... eating better myself. Weight still the same though.. what a shock! Even though I've been sick with gastroenteritis for a week, I'm still 244. Grr!

7/14 -
saw Dr Tran today who encouraged the surgery while her medical assistant said not to do it, that it was a cop-out. Grr. My weight is UP 3 pounds! Dr Tran thinks it could be the Paxil but it's really disheartening. I came home motivated to go through with surgery and came home to my Protein DeLite Very Berry waiting for me! I tried it and it was sooooo good! There were samples of lemon sugar free cookies that were DELISH! Dr Tran said that yo-yoing isn't safe and that the surgery is the safest thing, even diet pills are not as safe as the surgery she said. She said everyone's risks are individualized and that mine are pretty low. I'm psyched!


I want this stuff when I'm skinny:
7 for all mankind jeans!
True Religion Jeans!
To buy jeans at the Gap again!
To wear a bikini!
To start jogging!
To be able to buy a necklace that is 18" and have it fit around my fat neck!
To buy a ring that is a 6!

August 2, 2005
I can't believe I'm almost at my highest weight ever. I feel awful. My gut sticks out like i'm 9 months pregnant. My face is swollen and I have 3 chins. I look awful. I hate looking at myself. It's hard to roll over in bed, climb stairs, get up off the floor, do anything. I eat whatever I feel like and just act like I'm thin but I am oblivious to the fact that it will catch up with me and here I am. I'm depressed about it; I'm happiest I've ever been in terms of finances, my marriage (well, almost), and my job... it's my weight that is still hindering how I feel about the outside world.

I get my first big check from work next week; I'm sending the $ to Dr Meilahn.

let the testing begin.

8/5 - Grandma is here in Philly!!!! We are having a good time. I dread seeing her leave. :( I really want to go home to Minnesota. I miss her and miss it there. I hate Philly! :( We've been to Walmart, to Des' neighborhood, visiting and watching the baby play and be silly. Grandma taught her to say puppy and num-num! lol :)


8/14 - this really sucks shit. Des got a notice in the mail for child support hearing on that skank's baby. I can't believe this is happening to us. I don't know how to feel. It fuels me wanting to get surgery even more but it pisses me off and makes me want to leave D in ways. I knew about the situation before we got married but never dreamed she'd pop up and screw up our lives. I can't wait to confront the dog. I'm just gonna flash the diamond and roll the eyes. She can bite me. she can have D's money but she'll never get mine... HOW GHETTO CAN YOU BE? She waits 2 years until her bf that was supporting them dumps her to come out of the woodwork and she don't even know who her baby's dad is! She has to test D AND another guy! I am so depressed. I ate a whole bag of sugar-free reeses. :( At least it was SF. LOL

Waiting on my check from skool... WTF is the hold up man?! I wonder if this includes MISP? Skool sucks. I hate algebra!!!

I'm upset over all ofthis....

8/21
Well, tomorrow is the day I take my money in to Temple for my surgery preop testing. I AM REALLY DOING IT!
I have questioned and questioned and there is a little voice in my mind that won't let me rest until I do this. I am SICK OF BEING FAT. I am sick of trying to diet just to fail. I am sick of feeling ugly. I am sick of being in pain and out of breath when I climb stairs. I am sick of my dh giving me food to show me love. I am sick of not having anything to wear. I am sick of being depressed. I am sick of worrying about my weight. I am sick of not living. I am sick of worrying about what the next thing is going to be that I shove in my face. I am sick of counting points, calories, fat grams, hearing 'calories in, calories out.' I'm sick of it all. I am doing this and I'm doing it FOR MYSELF. Other people don't want me to have it done because they are afraid I might change for the better. I'm afraid of change. I'm afraid of giving up things but risks must be taken!:

The people who risk nothing, do nothing, have nothing, are nothing.
They may avoid suffering and sorrow,
but they cannot learn, feel, change, grow, love, or live.

SOOOOOOOOO TRUE!

8/24 - Sent in money for preop testing!!!!!!!! EEEEEEEEEEEEEEEEK!

8/31 - I haven't heard anything yet. The wait is killing me! I called the Access Center yesterday and corrected my phone number just in case. My knees have been bothering me. There is something wrong with my left knee; I think it's the weight. Every time I go upstairs it hurts and cracks. :( I can hardly move! It doesn't bother me too much when walking unless I try to walk after climbing the stairs. I feel crippled!!

School isn't going very well; i think I'm gonna get an F in math and have to do it over but that's ok. I couldn't concentrate well this term anyway. I think I'll do well on the NET test - especially the reading part, but I have to study for the math part for sure. I wonder what is taking those fingerprint cards so long??

9/2 - This sucks again. Des lost his job at the P cola company. I hate P cola anyway so HMPH! I'm a Coke girl. :) He applied at Coke and waiting to hear. Our benefits were so good there. Thank God I kept my benefits at HCR. Maybe Coke has even better bennies, who knows. I did get to get contacts at the eye doctor, just another step in my transformation. I am also going to dye my hair dark for the winter.

I got the fingerprint cards and the criminal background check is sent. Child abuse check is back. Studying for NET. Still waiting to hear from Temple. It's nervewracking! Can you see the small changes I'm making? Nursing school, WLS, the hair, the eyes... I'm hoping feeling better about myself will be helpful in the overall scheme of things and the way I live my life.

My highest weight ever today at 255. :(

Tropical Punch sugar-free KoolAid is yummy with lots of ice! :)

Ummm... must get sugar-free Powerade Option and Allsport.. try dollar store.

I want to order water delivery after I have surgery so that I can be sure to have no excuses about getting my water in and I won't have to lug it upstairs. :)

I donated to the Red Cross and Salvation Army and plan on getting a box of baby clothes out to them in TX somehow. I feel so sorry for the victims of Katrina. They are in my prayers.

I have been watching Paula White on TV. She did a sermon called "Have You Seen My Resume"? that really spoke to me. She has been helping me think through a lot.

We found out that the girl applied for welfare and that the DPW filed the child support case on her behalf for dh. That SHOCKED us. She has a college degree in computers and has no job and has to go on welfare? She had someone watch her baby for 4 years so she could go to college but now can't get a job or have someone watch the baby so she can find one? This is really a pain in the butt for everyone involved and will be even more so if it isn't his baby. I'll be glad when this is over. the only bright side I see is that Amaya would have a playmate in the little boy I guess since he'd be her half-brother. I want to think a lot of bad things and have this negative vibe against her but I can't do that... all I can say is "have you seen my resume?" I have been through everything there is to go through and I'm stronger than that and a better person than that. I deserve to be revered rather than stoop down to insult, so I am going to take the high road. :) Amen!

9/7:
I got this off the boards today just in case I have a plateau in the future postop:

#1 - Do this for 10 days to break a plateau



#2 - Drink 2 quarts of water a day



#3 - You must have 45 grams of protein supplement and all your vitamins/minerals
supplements each day



#4 - You may consume up to 3 oz of the following high protein foods, 5x a day




beef

pork

chicken

turkey

lamb

fish

eggs

low fat cheese

cottage cheese

plain yogurt or artificially sweetened (?)

peanut butter

beans/legumes



You may also have:



sugar free popsicles

tea or coffee

sugar free soda

sugar free jello

broths/bullion (sp?)

crystal light drinks



#5 - If it's not on the list, you can't have it for 10 days!!!!



#6 - Keep a food diary and try to get up to 30 mins of exercise daily

............still no word from Temple. GRRR!!!!!!!!!!!!!!!

9/7/05
I am going to start exercising and eating as postop if I can. I need to lose some weight preop and it will help me get into the swing of things. I will be healthier going into surgery and it will only work to my advantage to survive.

9/14/05
I finally got the letter of receipt from Dr Meilahn's office. Now I just wait a week or two for the preop testing packet! Ugh! I take Nurse Entrance Tests on Monday and I'm so nervous! This is a VERY big week. NET, Pap, Dr Tran for my knee hurting, and D goes to court. :(

9/24/05
D went to court yesterday and they scheduled a paternity test. I took the NET test on Monday and think I did pretty good but there were over 100 people there, easily for 96 slots. I guess we'll wait and see. Still waiting on the stuff from Temple. I'm anxious!

9/26/05
I finally got my appointment dates from Temple!
Labs: Complete metabolic panel, lipid panel, CBC, PT and INR, PTT, direct bili, ferritin, hgb A1C, iron % sat, TSH w/reflex free T4, complete UA, vitamin B12/folic acid, H. pylori antibodies including IgA, IGM, IGE. - complete

10/4 - sleep study - complete

10/10 psychiatric consult - complete

10/17 - preop teaching class - complete
Call and schedule nutrition consult! - complete

10/28 -
2D echocardiogram with Doppler and color flow imaging
upper GI to evaluate anatomy -complete
RUQ ultrasound that I don't need because I don't have a gallbladder! Supposedly to rule out gallstones and check for fatty liver infiltration.

11/11 - Pulmonary function tests -complete
ABGs, spirometry, lung volumes, diffusion, 6-min walk, CO2 challenge, and pharyngometry. - complete

12/13 - Pulmonary consult - complete!

I need to call and schedule a nutrition consult after preop teaching, then that's it! EEK! - complete

10/1 - I missed passing the nursing entrance test by 4 points and am disappointed. I will retest. Lots of stressful things going on right now. Nursing school and WLS are both goals that I want to accomplish in the next 365 days. I also got an F in Algebra. :(


10/5 - I signed up to retest for the NET on 10/27. I had my sleep study last night. It went well but it was hard to sleep. I feel like it wasn't really representative of how I usually sleep since I was so uncomfortable. The room was freezing cold, there weren't enough blankets, and I sat there from 7:30 p.m. and didn't get to actually go to sleep until around 11 p.m. or later because of the time it took to hook up all of the patients. I was soooo tired. I'm glad it's over. She said if I had severe sleep apnea, she would come in the room and hook me up to CPAP during the night. She told me she couldn't tell me how the test went but that she didn't have to come in, so that's good. Could it be that I'm just lazy?! lol

Next up, psych exam. I'm terrified!

10.26.05
I had my psych exam. It went pretty smoothly with the exception of knowing I'll need counseling to deal with everything (duh.) But I could have recommended myself for that. I went to the teaching class with hubby and it went well. The whole thing about never eating pasta or rice again freaked my hubby out but I could try whole wheat pasta in the future and wild rice maybe since they don't expand. The nutritionist I met with yesterday was from Madison and really cool. We talked about how I'll need 70 grams of protein for the first 4 weeks, then 55 grams and by then it should be all from food - no shakes. She said to stop trying protein shakes now because I'm just adding calories and they aren't curbing hunger, that regular protein foods would keep me going longer.

Tomorrow is my nursing retake test and I'm kinda blah about it. I am studying and praying but what is meant to be is meant to be. I won't stress over it. Also, Friday is the upper GI, echocardiogram, and abdominal ultrasound so it will be nice to get it done. All that will be left after this week is the pulmonary testing and pulm consult!!! YEEHA!

On the bad side, I weigh more than I ever have. I gained 9 pounds since my initial consult in April. :( She said that is really bad and if I gain 1 more it means trouble. So I have to really watch it over the next few weeks.

Bought an elliptical glider and will give it a shot and see how I like it before investing in a heavy duty one for winter.

Planning to go to Minnesota soon but that might be postponed because of surgery. I'd rather go postop and be slimmer anyway!!!

Ok,better go. Soda BAD!

11/16- I had my CPAP titration the other night.I have really restless legs. Waiting 2 wks for the machine. The only thing left is the pulmo consult. Marriage on the rocks. In shock over death of Jessica O already. Can't give up soda. Missing home. That's it for now.

DECEMBER
My mom died on Thanksgiving.She was 44. She died from anorexia, bulimia, and cirrhosis of the liver from alcoholism, along with kidney failure. I am just in shock and still can't believe she is gone. I went home for the funeral, so I got to see my relatives but not under good circumstances. I got home and already my 23-yr-old sister is in the hospital, needing a liver transplant from the same problems. I don't know how much more I can take. I have a counseling appt. on Monday. I hope it is the answer.

Another quarter of school is over. Eating is worse than ever. Coping with everything by eating. Started my CPAP and felt great the first night, now it feels like it's not helping. I'm adjusted to it ok.

One more appt. until everything gets submitted but at this rate I don't know if it's a good idea. Too much going on.

12/13-
Had last appt. today with pulmonologist who gave me the green light. He said 'as you know, you are smaller than most of our patients, though I'm sure that doesn't make you feel any different about surgery.' Well.. it does a little. But he said that i had a great airway and he forsees no problems with anesthesia or any of that, so I'm glad that I'd live thru it respiratory wise should I decide to go thru.

So I'm done. Most people would be on the phone with Temple, telling them it's all done. I'm not anxious to get a date. That says something, I think. I'm just going to let them take over now and in the meantime work on myself a little.

In worse news, I was my highest wt ever today. 260. I can't believe it. I hate it. I feel desperate. I actually started to think the surgery is a great idea after I saw the scale. At this rate, I'll be 300 this time next year. I can't do that. Never.

1/21-
I have gone through so much. My mom died on Thanksgiving and now my baby sister died on 1/14. She was 24. She had ARDS (a respiratory illness), liver failure, and kidney failure. She couldn't clot because of her liver and essentially bled to death. She was on a ventilator and in the ICU for quite awhile. She was doing well enough around Christmas to get out of the ICU and onto a normal floor and spend one last Christmas with her 8-year-old before she died, and talk to all of us, then she went into cardiac arrest and they brought her back (on 12/28) but she died on 1/14 and never came out of the ICU again. I am so broken hearted. I will never be the same. She was an alcoholic and drug addict and I didn't know it was as bad as it was until the week she died. I lost half of my being.

My weight is up to 262, highest ever, from all of the toll of emotional eating. I am pretty sure I'm going through with surgery. At this rate I'll be 300 soon enough and I'm not doing it. I need relief from this weight problem. IF my mom and sister can go through all the procedures and hospital crap they went through and lived another day, I can survive a lap RNY as a healthy 28-year-old.

I have a couple questions I was gonna post about protein drinks versus protein in food and about regular vs chewable/sublingual vits.

2/8 - Well this is it. Today my file was completed and the surgeons' office got everything they needed to submit to Aetna for approval. They will submit tomorrow and they say it will take 1-2 weeks to find out. If they approve it, I'll get on the surgery schedule. I'm nervous and scared but excited that all of this agony may finally be over. I'm sick of being trapped in the mind of a crazy person. I'm obsessing over food and turning my grief into worrying about my weight, dieting, the scale, and food. It's crazy. I talked to my therapist who says that "everyone who has the surgery has food issues, you are not alone" so I felt better. She supports whatever I choose. She said that if I need to, she'll see me twice a week and make Aetna pay for the therapy. So at least I am hooked up with an awesome therapist to guide me through the changes I'll experience. I think if I get approved, I'll feel like it's a sign from God, and if I get denied, I'll feel like the same - like it just wasn't meant to be. I can accept either way. i am letting God (and the board of Aetna) decide my fate. I just can't do it. But in my heart, I know that I want the surgery. I know I want to be thin and be rid of my constant worry about my next meal or next soda. I am sick of the misery of being trapped in the body of someone I am not. I want to be free to become who I was meant to be.

I am doing a massive amount of self-discovery and journaling. So much has become so clear about my childhood and growing up that I am healing everyday. I have made amends and talk to my father, who is incarcerated for drug trafficking. I am trying to learn to be mad at my mother's traits, not her as a person, and to grieve my sister for the tortured soul she was.

I think this will really change my marriage and I'm not sure it will be positive. But we will work through and have dedicated ourselves to each other and to making it work, no matter what. We are not shy of going to marital counseling if it takes it to save our marriage. I love my husband dearly and he means the world to me.

My daughter is my light and my love. Everything I do is for her. I feel like I have it all and all that is left is to be happy with myself. This is a step toward doing that. I've spent my whole life caring for others and now it's time to take care of me. My life is about to begin.

2/21/06
Denied, denied. Aetna denied. Said I didn't have 6 months of diet/exercise history from my PCP. I am going to see if they will fax more records to Dr Meilahn's office and do some appeal work myself. Nyeesha said Dr Tran should call the denying physician and talk to him so we'll see. I guess in the meantime I'm on my own and maybe will try phentermine again. I'm so upset.

2/21/06
Dr Tran's reply about Aetna: "oh my God, they are so cheap!" LOL

She is calling the denying doctor and getting them some more clinical information and hoping it helps. I wrote an appeal letter and am getting it out tomorrow by certified mail to be sure they get it. I wonder how long it will take if they overturn it before i know?

2/23/06
Sent out my appeal letter to Aetna!

2/24/06
Going to call Aetna today and see if my doctor's office ever got ahold of anyone. It's crazy but since they denied me, my desire to get surgery is higher than ever. Nobody tells me NO! LOL

2/26/06
Here is a copy of my appeal letter. I am faxing this and a letter to my PCP about the appeal and hopefully it will come together this week.

Re: Denial of coverage for laparoscopic RNY gastric bypass surgery

To Whom It May Concern:

I am writing to appeal the denial of my request for coverage of gastric bypass Roux en-Y surgery.

I am a 28-year-old female, 5’4” tall, weighing 262 pounds. Calculating my height in relationship to my weight classifies me as morbidly obese with a body mass index of 45. One of the requirements of Aetna’s Clinical Policy Bulletin on the coverage of obesity surgery includes the precursor of having a BMI of 40 or above. Clearly, I do, and I do not think there is a debate on that issue. I am thoroughly versed in your qualifications for the coverage of gastric bypass surgery and while I understand that the reason I was denied was due to your opinion that I lack six months of diet and exercise supervised by a physician, I would like to take this opportunity to again discuss my reasons behind choosing this extreme method for weight loss and my diet and exercise trials in the past.

During my preoperative testing with Dr _____ office, I was found to have obstructive sleep apnea and restless legs syndrome on a polysomnographic study at Temple University Hospital. Sleep apnea is a respiratory disease caused when an enlarged abdomen causes pressure against the diaphragm and when thickened neck and chest tissue constricts airflow in the airway. Sleep apnea can result in sudden death while sleeping and leads to profound fatigue during the day because of constant night wakening as the patient gasps for air. Since my diagnosis, I have been utilizing a CPAP machine to help me breathe at night and to supply me with adequate blood oxygen levels. It is medically proven that sleep apnea is directly correlated to morbid obesity and that weight reduction is the number one way to ‘cure’ sleep apnea and eliminate CPAP usage altogether. I currently take 0.5 mg daily of Requip to deal with restless legs syndrome.

I have also had asthma the majority of my life, which has been exacerbated by my obesity. According to the medical journal, Allergy, it has been proven that asthma is more difficult to control in patients with a higher body mass index and morbid obesity. I have been forced to undergo multiple treatment methods including steroid inhalers, rescue inhalers, nebulizer treatments, antibiotics, cough suppressants, expectorants, and nasal inhalers in order to keep my asthma symptoms under control and most of these methods have only worked for short periods of time. I have exercise-induced asthma as well and this makes me unable to participate in strenuous exercise due to breathing difficulties. It is known that as people lose weight, their asthma improves.

I have been fighting depression for many years. Currently I am seeing a therapist by the name of _____ at _____, to assist me in dealing with the behavior behind overeating and body image issues. I am currently taking 20 mg of Paxil daily, as well as BuSpar 15 mg as needed for anxiety, and Ambien 5 mg p.r.n. for sleep disturbances.

I was diagnosed in my early 20s with hypothyroidism and have struggled continuously with inability to lose weight. I take 0.5 mg of Synthroid daily and have even doubled and tripled dosages in the past in efforts to ‘speed up my metabolism’ and help with weight loss, which, of course, did not work.

Over the past two years I have been undergoing workup by Dr _____ at _____ in _____, PA, for the treatment of amenorrhea and dysmenorrhea. I have had an abnormal PAP smear showing cervical dysplasia and have had to undergo painful cervical and endometrial biopsies to test for abnormal uterine bleeding due to obesity. I have been on oral contraceptive therapy and undergone multiple progesterone challenges for the initiation of menses. I have undergone testing for polycystic ovarian syndrome due to symptoms of abnormal bleeding, acanthosis nigricans of the skin, and hirsutism.

Additional comorbidities that I have that are caused by or aggravated by morbid obesity include:

• Pain in my legs, lower back, feet, and ankles.
• Swelling of my hands and feet.
• Shortness of breath
• Profound fatigue
• Migraine headaches
• Depression and anxiety
• Seborrheic dermatitis

I have a strong family history of morbid obesity in my maternal grandmother, maternal great-grandmother, maternal aunt, and paternal aunts. My maternal grandfather had esophageal and stomach cancer, my maternal grandmother has heart disease, type II diabetes, hypertension, high cholesterol, and depression, as well as osteoporosis. My maternal great-grandmother died of heart failure. My maternal aunt died at 46 of a stroke due to hypertensive renal failure from her obesity.

I have been overweight the majority of my life. When I went to my primary care provider, Dr _____, and discussed my weight issues and idea of possibly having gastric bypass surgery, she took the time to go over my diet history, explaining to me that she thought I did indeed try everything in the past and that obesity surgery would be an excellent idea for me. Without hesitation, she supported the idea and along with Dr _____ I have received excellent advice, guidance, and care regarding my past history of weight gain and dieting/exercise. I have been on many diets including Slim Fast, a diabetic diet, Weight Watchers, eDiets, Atkins, low calorie diets, insulin resistance diets, Dr Phil, Food Addict diets, and fasts. I have tried pharmacotherapy with phentermine and Xenical. I have been engrossed in excessive exercise on many occasions, swimming, biking, using the elliptical machine, step aerobics, low impact aerobics, walking, walking videos at home, kickboxing videos, etc. to no avail. I have tried self-induced anorexia and tried to ‘talk myself into being anorexic.’ As a teen, I forced myself to throw up to lose weight and still did not lose weight. I am including a sheet with diets and efforts I have put forth on my war with obesity. My self-esteem and hope are waning in this war and it has come to the point where my obesity interferes with my ability to exercise in that it causes me pain and severe shortness of breath. I have yo-yo dieted, gaining and losing, for many years and it is well documented that this sort of abuse to the human body is dangerous and unhealthy.

It is well known that obesity surgery is the only effective long term way to treat morbid obesity and that less than 1% of people who are morbidly obese who lose weight with diet and exercise will be successful; Less than 1%. These odds are frightening to me. I have a daughter who is almost 2 that depends on me to be a mother to her with 100% effort and being trapped in a oversized body that limits my mobility and ability to care for, diaper, and hold her without pain is nothing less than tragically unfair to a child who needs 100% of a mother to be there for her. By requesting that you cover this surgery, I am doing nothing more than asking that you provide me with the chance to be the best mother I can be for my child. The fact that most people with sleep apnea who lose weight with obesity surgery are able to eliminate their CPAP machine should be a cost-effective reason enough to provide approval for this surgery.

I could sit here and quote journal after journal, document after document, and say the exact same things that are already so well publicized now and out there on the forefront of bariatric medicine but it would just waste your time and mine. I do not doubt your knowledge on the topic or your knowledge of the improvement in quality of life it provides for morbidly obese patients. What I do want to do is tell you that I’m tired of being overweight. I’m sick and tired of being sick and tired and I want to live and have a real life. I want to fit comfortably in a movie theater seat. I want to get on an elevator without it shaking. I want to fit in a booth at a restaurant without sucking in. I want to shop in normal stores and buy shoes that aren’t wide. I want to not worry about whether the seatbelt on an airplane will fit. I want to be able to get out of my car without rocking myself in momentum to get up out of the seat. I want to be able to breathe when I sleep at night and not wake up gasping for air or worrying I’ll die in my sleep of a stroke. I want to exercise and run… I’ve always wanted to be a runner… and I want to be able to do this without wheezing, gasping, or needing to stop after less than a minute. I want to be able to play with my daughter and teach her healthy habits. I want to be a role model for taking care of yourself and living a healthy lifestyle. I beg of you to give me this chance. I want to climb a flight of stairs and be able to breathe. I want to be able to carry my own groceries. I want to make it through a work day without yawning. I want a normal life!

I have done massive research on this surgery including discussing the surgery with others who have had it performed. I know the ins and outs of it. My surgeon even commented that I’ve done so much research, I could probably tell him how it’s done. I know what it has the ability to do in improving my quality of life. This is why I know I need the surgery. I know wholeheartedly about the risks involved including death, wound infection, nutritional deficiencies, the need for a vitamin regime the rest of your life, hernia, digestive system leak, and bowel obstruction possibilities. I fully recognize the risks and statistics behind these occurrences. I also understand that if left untreated, I have a 1 in 7 chance of reaching my normal life expectancy because of morbid obesity.

I hope that you will take this information, along with the newly provided medical documentation from Dr _____, and come to the decision that I know is right, which is to approve my laparoscopic gastric bypass surgery. I await your decision and reply with great hope.

Warmest Regards,

3/7/06
I started taking Phentermine again that I ordered online and have lost 6 pounds in the 5 days I have been on it. I am just not hungry at all and hardly eating. my cravings for sweets is gone. Last night I had some chest pain that scares me though so I don't know if I'll continue on it. It's definitely working though and I feel good and energetic. I may couple it with Weight Watchers. No news on my appeal yet.

3/24/06
Ok so My journey is officially at a SCREECHING halt. I found out on 3/20 that I am PREGNANT! I am pregnant with baby #2, due 11/17. It was not planned but a blessing nonetheless and my husband and I are thrilled. I also got a denial letter about my appeal, so that was discouraging. I guess it just isn't my time for this surgery and God has other plans for me right now. That's okay. I was on the fence pretty badly up until recently, and I knew I wanted more kids, so once I have this child I will feel more whole and more fully prepared for surgery should I decide that is the way to go. I am out 600 bucks at this point from preop testing but feel good. I am blessed.

5/30/06
Still pregnant. LOL I have had hyperemesis so bad and was in the hospital twice for dehydration. There was even talk of home IV therapy. It made me think, is this how I am going to feel postop? One of my good Myspace friends, Chrissy, had surgery since and is doing wonderfully. She is in DE and applied and got approval and a surgery date like nothing.

At this point, I am unsure I want to get surgery. I am considering trying WW, Phentermine, and exercise after the baby comes. If somewhere down the line I feel ready, then I may consider surgery again.

This site has changed... A LOT! I dont deal well with change :/

I got laid off my job on 5/8, which sucked, but I got a job with a more stable company so I'm happy. Dh got a new job too so hopefully everything will settle in to place soon.

Ok, better go. Smoochies :)

12/8/06
Well today would have been mom's 46th birthday, RIP. I have a one-month-old daughter, Kaia, and now weigh 246, down from a high of 262 before getting pregnant. I feel hopeful. I got gestational diabetes and had to give myself insulin during pregnancy but the eating plan helped me and I had a hard time GAINING weight during my pregnancy!! My baby doesn't have diabetes and she is a happy, healthy breastfed baby. She weighed in at 6 lbs, 13 oz., on 11-10-06. We have also since relocated from Philly back home to Minneapolis and I was able to have a VBAC (vaginal delivery after cesarean) and am so happy! It was a joy! I am battling postpartum depression right now but hopefully I can put the life changes I learned in diabetes ed together with my newfound motivation and lose this weight. My employer said there is no way around the exclusion so I'm not sure what my next step will be. I want to get the weight off for my babies, and to stay away from type 2 DM in the future.
Preop health problems:
Obstructive sleep apnea, on CPAP
Back pain, no treatment
Asthma attacks, albuterol, steroid inhaler
Amenorrhea, occasional progesterone challenge
Dysmenorrhea
Skin yeast infections
Skin boils
Severe fatigue
Moderate to severe depression
Severe anxiety
Cellulitis
Gestational diabetes requiring insulin

Weight Progress
PREOP
HIGHEST - 253 lbs.
5/05 - 241 lbs. BMI 41
7/14/05 - 244 lbs., +3
8/2/05 - 249.5 lbs., +5.5 BMI 42.74
8/22/05 - 248 lbs. - 1.5 (see the yo-yo?)
8/31/05 - 251 lbs - give me a break! This is only 2 pds away fromy my highest weight. I'm getting scared.
9/2/05 - 255 lbs? Ok, my scale must be off... or is it?
9/13/05 - 250 lbs. that's more like it!
10/24/05 - 255.5lbs. WHAT?!My highest ever. :(
11/11/05 - 253 lbs. Going down. Good.
1/13/06 - 262 - my highest weight ever. I feel awful.
3/20/06 - 254.5 - PREGNANT?!!!!!!!!!!!
12/7/06 - 246.5 - postpregnancy! Hey, at least it ain't 262.


Me
My baby isn't a baby anymore! Amaya Johari - 15 months.