ObesityHelp

July 25, 2005
Fourth day post-op and first full day at home. Great to sleep in my own bed. I feel good. Very little pain but I am trying to get used to my new stomach. It feels a little weird when I put something in it. I have not felt nauseated just a little weird. I am really getting tired of clear liquids because of the lack of variety. I am really not interesting in eating chicken or beef broth for a while. Tomorrow I graduate to full liquids. At least with that diet there is some variety. For now looking forward to a new diet. Before I went to for the surgery, I ordered some scales that will go high enough to weigh me from the internet. They are scheduled to be delivered tomorrow. Now I will be able to monitor my progress on my new journey. It was wonderful to get the get well cards and emails from family, friends and church family as well as the phone calls of encouragement. I have particularly enjoyed the many nice words of encouragement from all of you who have messaged me on this web site. This kind of support is great.

July 24, 2005
Well I did not get home the day after surgery. It seems that they dad a problem getting my Bi-Pap machine was not doing a adequate job of keeping my oxygen saturation level at the proper level, so I had to use one from the hospital. It seems to do the job with no problem. They did however run it at a higher pressure. At this point I was in the IMC (Intermediate Care) part of the hospital. The nurse told me that I would soon be moved to a regular floor in the hospital. Friday evening the night nurse said for some reason my heart rate had dropped to they wanted to do a CT scan, EKG and enzyme blood test to rule out a pulmonary embolism. My concern was whether the CT Scan was equipped to handle my size and sure enough they could not do it. They said that they would have to do the EKG and the enzyme tests three time eight hours apart.

It is now Saturday night and the resident says that I should be able to go home on Sunday. She instructed the nurse to remove the catheter and once I was able to void my bladder I could go home. She said that his should take about four hours. Unfortunately this did not happen until the next morning (about 10 hours later). They said if I did not go they would have to put the catheter back in and I said no way. Fortunately I was able to go. Later Sunday morning Dr. Chen (Dr. Elariny’s Associate) came in and told me that they were going to move me to a regular room today and I said, I thought that I was going home. After some discussion he agreed that I could come home that afternoon. Finally!

July 21, 2005
Today, I went into the INOVA Fairfax Hospital for my WLS. Although I was suppose to be there at 11:00am, they were running late so I did not go into the operating room until after 3:00pm. During the pre-opt time I had a number of visits from various doctors and one student who was working on a study of obesity. I was asked if I would be willing to participate in a study. I, of course, consented. In my opinion, if there is anything they can do through research to help any of us who are very obese I will offer my blood cells and information. It was explained that one thing that Dr. Elariny does routinely is a liver biopsy. He explained that often time obese people have a lot of fat in the liver as well. He also said that he would come to see my wife and brother in the waiting room as soon as the surgery was over to give them a report. If all goes well then I will be able to go home the next day

Approximately at 6:00pm Dr. Elariny came to the waiting room to tell them that all went well however there was a concern with my liver, rather than being enlarged as expected, it was quite small indicating that their might be a problem like cirrhosis of the liver. My wife told them but I did not drink alcohol and the doctor to her that it can be caused by fat as well. If there is any liver damage I will not be able to have the second part of the surgery (the gastric bypass part of the DS.

July 19, 2005
I called the surgeon’s office on Monday to find out the time that has been scheduled for my surgery. They told me to be at Fairfax Hospital in Virginia at 11:00am. Since Dr. Elariny does all his surgeries Laparoscopic, they tell me that I will only be in the hospital overnight. That seems hard to believe. Tomorrow I begin a liquid diet in prep for the surgery on Thursday when I begin my new journey to a healthier life. I must say that I am a little nervous about what to expect right after the surgery. I know in my head what I read but reading about it but living it is a different story and I am little nervous about the beginning the journey. I will check back when I am on the “other side”.

June 20, 2005
Approval cam very quickly and within a few days my surgery date was set for July 21, 2005. Now I am on a fast path to get all the pre-op testing done. Since I already had the colonoscopy, EDS and chest X-ray done when I was in the hospital, I have to get lab work done, cardiac clearance, gull bladder sonogram and psychological evaluation. All his must be done by July 11, 2005. Fortunately I was able to get it all done with a day to spare.

June 15, 2005
I met with the dietician and the PA. At the meetings with both the dietician and the PA they told me due to my high BMI, Dr. Elariny will most likely not do the DS in one surgery. He feels that it is too risky for someone with an extremely high BMI to be under anesthesia that long. Instead he will do the stomach alteration, allowing me to lose enough weight to get my BMI to a level that I could safely have the gastric bypass part of the surgery as a second stage. This was a disappointment to me but the more I thought about it, it made good sense since this would give me a opportunity to be able to adjust to my new stomach without having to deal with the bowel issues that accompany the gastric bypass portion. I really would like to have a VG but he knew that the insurance company would not approve the procedure but they would likely approve a VBG. This is the plan that we are going with and I would pay out of pocket for the removal of greater curvature of the stomach. During the second surgery, he will remove the band. With this plan in mind it was submitted to the insurance for approval.

June 14, 2005
My wife and I attended the information seminar conducted by the staff of Dr. Elariny’s office and concluded with a presentation by Dr. Elariny of all the different types of WLS procedures available and all the pros and cons of each. I really likes his approach of giving you all the information and allowing you to make up you mind which procedure would be best for you considering your goals and you own individual eating habits. Since I had already done a lot of research I came out of the meeting further convinced that a DS was the best choice for me. He also says that after careful consideration when you meet with him he will ask you to defend you decision.

May 14, 2005
I was taken to the ER at our local hospital with cellulites in my left leg, requiring me to be put on IV antibiotics. While in the hospital the blood test revealed that I was anemic so my PCP wanted me to have a colonoscopy and an EDS to locate the source of my blood loss. This procedure found that I had a bleeding ulcer probably from taking too many pain medications. On May 18, I was discharged from the hospital requiring me to cancel all my previous appointments. I rescheduled those appointments for June 14 & 15.

March 31, 2005
I went to see my PCP again he said now I would like you to consider weight loss surgery. He admitted that he was always against WLS in the past, but he has come to the conclusion that the risks of WLS far outweigh the risks that I have with my super morbid obesity and the co morbidities. He explained that my knees have already been replaced and the next thing would probably be my hips and eventually I would be confined to a wheel chair. This is NOT the way that I envisioned my retirement years; not being mobile, not being able to play with my grandson and the list goes on.

Personally I had come to the realization that my mobility was not going to improve as long as I continue to carry around the amount of weight that I do. I began to research WLS. As my research began, I found that there is not just one type of WLS but several, each with the pros and cons. I researched and I researched and finally came to the conclusion for me the best would be the BPD/DS. After making that decision then I needed to research my insurance, and the various Bariatric Surgeons in my area. Being within 50 miles of both Washington, DC and Baltimore Maryland you would think that the choices would be endless. Was I wrong! I soon learned that there are only a few surgeons in my area who do the DS surgery. In fact I found only three. There were two in the Baltimore area on one in Northern Virginia. The next issue was the insurance coverage. I knew that BCBS/FEP will cover WLS but which surgeons would take my insurance coverage. Since I have a PPO there are tree levels of coverage. They are preferred providers, participating providers and there are “out of network” providers. As it turns out each of the three surgeons fell in each of the three levels of providers. Still not sure which way to go, I wanted to expedite the process so I made an appointment with each of the three surgeons. After much research I decided to use Dr. Elariny who is not a preferred provider but he is participating with BCBS/FEP. What this means is, I will be responsible for more “out of pocket” expenses.

Dr. Elariny, as with many other surgeons required that each surgical candidate attend an informational meeting, before making appointments with the dietician, the PA and then the himself. I made an appointment for May 17th for the seminar, May 19th for the PA and Dietician and May 25th with Dr. Elariny.

Background
I have had a serious weight problem my entire life since I was about 5 years old and had my tonsils out. At times it was very difficult growing up with the cruelty that you experience from other children with whom you go to school. You always notice the staring that some people would do at you because you were so overweight. It seemed as I got older the more weight I would gain. What few times that I lost weight, I always gained it back with a premium. I am sure that this is not an uncommon story for many people who have had a weight problem for much of their life.

Now, I would like to begin my story back in April 1999 when I retired after almost 35 years of service in the Federal Government.. The last few years of my working I was still steadily gaining weight until I started to have problems with my knees. Prior to my retirement I had arthroscopic surgery on both of my knees. The orthopedic told me at that time that I would probably need knee replacements within the next five years. I began to walk with the assistance of a cane. At this point my biggest dream was to be able to walk down the aisle at my daughter’s wedding without the assistance of a cane. Although it was difficult I did managed to accomplish it on October 25, 2002. August 15, 2003 I went to see the orthopedic to see about having knee replacements. The procedure was scheduled for my right knee. I did all the pre-op testing, donated my own blood and went to my PCP for final approval and he would not give his approval because he felt that our local hospital was not adequately equipped to do a knee replacement on a person of my size.

At that time he talked to me about the possible of having some sort of gastric bypass weight loss surgery before I have my knees replaced. I resisted saying that I was in too much pain in my knees and I wanted to have knee replacements.. Reluctantly he preceded to find a location and surgeon who would do the surgery on a person as large as me. Finally he found a surgeon who would do it in Baltimore.

On October 15, 2003, I met with the new orthopedic surgeon and schedule the surgery for December 8, 2003. While I was having the pre-op testing my PCP found that I had some congestion in my right lung and he said that he would not approve the surgery until this was cleared up so the surgery was rescheduled for January 12, 2004. Again with the pre-op testing my lungs still were not fully clear so he said that he did not want me to have the surgery until I was in the best possible physical condition. Again the surgery was postponed. Meanwhile my PCP wanted me to see a cardiologist and have a sleep study since there was a high probability that I have sleep apnea with my current weight.

On May 17, 2004, I finally had the surgery on my right knee and on December 13, 2004, I had my left knee done. The recovery of my second surgery did not go as well as the first and I still have having difficulty with my mobility.