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Well, it has been a while since I have made a post to my blog.  The days just seem to be passing by so quickly.  A run-down…..

Christmas was good.  My ex-husband lives in Illinois so my daughters don’t get to see him too often.  I had made the decision that while he was here in town that the girls’ could spend the whole time with him.  My gift to him, I guess you could say.  Was it hard for me to not have them at home on Christmas day?  No.  I was just fine with it… because I had made that decision to let him have them all of the time he was here over Christmas.  That was my decision and so I was fine with them not being here with me.  They needed that time with him.  My husband, son and I spent part of Christmas day over at my in-laws.  It was a very enjoyable day and I had no problems as far as the post-surgical diet went or eating stuff that I shouldn’t have been eating. 

New Year’s was a whole different story.  It started out well, but ended rotten.  I started out feeling great on New Year’s Day, but then by noon I started feeling really, really sick.  I thought that possibly it was dumping syndrome, but I knew that it couldn’t have been that as at the moment that it started the only thing I had had was a protein shake, that I still wasn’t done drinking.  The protein shake had the only new thing in it that I hadn’t tried up to that point: egg protein powder.  The egg protein powder was actually great in making the shake itself seem light and it wasn’t bad at all, tasting wise, however I have since no desire to attempt that particular product again.

The symptoms reminded me of being in labor with my children, and that isn’t an exaggeration (unfortunately).  Vomiting wasn’t there.  Probably would be but with the little tummy food does not sit there long enough for it come back up (sorry so graphic).  Dry heaves was more the issues than anything (again, sorry so graphic but I know that there are people out there who are will want to know specifically).  After about 7 ½ hours of dealing with this and not being able to must up the desire to eat (which is a must) I was on the phone calling Carmel Surgical Specialists.  Dr. Jones was on-call for their office over the holiday.  Because of the extreme of the level of pain I was having, the nausea, the dry heaves and the probability that I was quickly becoming dehydrated she made the suggestion that I go up to Carmel St. Vincent’s ER.  I am not that far from there, 20 minutes, so that was not going to be a problem.

I will honestly say I have not been in an Emergency Room yet that is like that of St. Vincent Carmel Hospital.  Imagine walking into an ER going right up and immediately having your vitals checked out and then being taken back to one of 18 “private” ER rooms, that look just exactly like most of the private rooms when you are admitted to other hospitals, having the admittance person come right into your room to check you in, etc., etc.  I asked what they do when they have a crowd of people in the ER at once.  Where do they sit outside in the reception area?  They told me they don’t sit in the reception area that they have always had enough beds (18 rooms  plus) that they have never had to have anyone wait at all to go back.  I looked at my husband and in between a pain episode I told him, “If I ever need to go to the ER again bring me here!”  I love my PCP, he has been my Dr. for 18 years now, but I am sure he wouldn’t mind if I went to the other hospital branch that he is affiliated with.  It is the same hospital, just in different areas. 

The ER nurse had a little bit of difficulty getting an IV started in my arm.  I was dehydrated pretty badly.  It took her 5 sticks (which most nurses won’t even consider trying again after 2 or 3 sticks) to get the IV into a vein that wouldn’t roll on her.  They sent me over to have a CT scan after they gave me some Morphine for the pain.  Finished the scan, went back to the ER, and the ER nurse was rather agitated with the CT scan tech who turned off my IV fluid line.  I didn’t know she did.  I pretty much slept the whole time of the CT scan because Morphine, like most all pain meds, knocked me out.  I was lucky that I even got off the bed and on the table to do the scan, and then back into the bed after the scan… I was THAT out of it.  The scan showed that everything as far as my tummy went was just fine, in other words I didn’t have any obstruction or leaks.  They also told me that the scan showed the staple line was healing just as it should and in the right time frame that they expect them to heal.  That was good news.  :O)  BUT… It still didn’t take care of my issue.  The diagnosis was in agreement with what I figured it probably was… the stomach flu… and a NASTY flu it was too.  JUST as an FYI… the Incentive Spirometer (which I am probably misspelling) does NOT prevent you from getting the stomach flu!!! 

I was admitted and stayed in the hospital until the 3^rd of January… probably could have stayed a little longer, but I seriously got tired of staying in the hospital.  Next time I will remember to have brought up to me either my laptop or at least a book to read!  The silly IV came out of the vein at one point and I had to again go through getting stuck in order to get the line restarted.  Four nurses and 7 more sticks later it was finally in place again.  That was 12 sticks… ouch!  My arms looked like a purple pin cushion.  While I came home on the 3^rd it actually took a whole week for that stomach flu to work its course.  The pain was under control by the 3^rd and that to me meant that I was at least functional again.

Went back for my six week check up with Dr. Gupta on the 15^th (which was last Thursday), as well as for a Nutritionist visit.  Everything there went well.  Nothing out of the ordinary to tell there, except that my next check up is in another 6 weeks.

So… that pretty much does it for my update on how I am doing with this Roux-En-Y thing.  Oh… weight lost?  I guess I did forget to put that down here, didn’t I?  Sorry.  Since my last blog post I have lost 8 ½ lbs. and 16 ¼ inches over total body.  That is a good loss in my opinion.  I am satisfied with that.  I think that 10 lbs. / month is a good steady goal to shoot for with my height and weight average.  REMEMBER, those of you just starting this process or are thinking about going through with having this procedure, EVERYONE IS DIFFERENT!!! What is a healthy weight loss per month for one person is not necessarily going to be lost with another person.  Some may lose way more, some may lose the average, and some even less than the average.  As long as your Doctor is not concerned, as long as your Doctor tells you that you are on track… then that is all that matters.  ALSO… stay away from the scales except for once a week… and start measuring yourself, too.  Measuring yourself is a great way to see where you are losing weight at first, the most often, as well as to know that even if you aren’t losing a lot in pounds in a week you may be losing a great deal in inches.  FINAL THOUGHT…. STAY AWAY from anyone that you know has had this terrible stomach flu especially if you are fairly fresh out from having the surgery done!!! 

Till next time………. Go see two new movies out: Marley & Me and also Paul Blart: Mall Cop.  Awesome movies!

~Tammy~

I started a regular blog where I keep my updates on how I am doing, what my surgery was like, the process before.... etc., etc.... it is pretty detailed.  If you would like to check it out you are more than welcome to.  The address is: www.tammyinindy.wordpress.com

Tammy :O)

December 2nd at 2 pm.  Have to be there by 11.       

Well I guess the biggest news for the month is... I'VE BEEN APPROVED by UHC to have the surgery.  YEA!!!   I found out about the approval on the 16th, got their letter in on the 24th, faxed it out to Amy (along with 3 of the support group verification forms) also on the 24th, left Amy a message to call me if there was anything else that I needed to send to her at this point (didn't get a return phone call so I am assuming that means there is nothing for me to do now, except... wait), now I am just waiting for Heather to call me to schedule a surgery date.  I have started wondering if their notation of giving her ten days to make the phone call to you is ten regular days or ten "business" days.  If it is ten "business" days then I may have to stay by the phone until next Friday (November 6th)... but if they are talking about ten "regular" days then she should be calling by Monday.  I am really curious as to why it takes that long for them to schedule an appointment.  It does not take that long to check on benefits coverage one last time... I just would like to know what exactly they do during that time so that it brings understanding to others who may be going through this process.  If anyone has a clue as to what they do could you give me an idea? I will say that I think waiting for them to call for that surgery date is just as frustrating (if not more so) than waiting on the insurance company to approve the process... at least it was for me.  I think that I may feel this way because I can't put anything into my schedule and what is on there now is tentative because it is subjective to change all due to this surgery.  LOL... But watch... knowing my luck I write this and they will call today (day of all days when I am suppose to have two things to do today and I am going to have to cancel them because I have to wait near a phone so I don't miss this call.... THAT is also very frustrating). 

Okay... I'm off my complaining pedestal now.  I just had a moment. We all have them.  For other updated info go check out my blog at:  http://tammyinindy.wordpress.com 

Now... I am going to go cruise around on obesityhelp and check up on everyone and do some reading and, and, and, and.... hehehe...

TTYL!

Tammy

Well... I know I have been rather quiet lately.  Been busy with a LOT of different things. :O)  All good. 

I have started a blog.  This is my first blogging experience, outside of myspace, and it took me a bit to learn the ins and outs of it.  But, I think the biggest thing was figuring out which blog host I wanted to use.  I chose "wordpress".  I very impressed with their set ups that were offered and how informative their "help" sections were in showing one how to work a blog and so on and so forth. 

I have not really launched the blog to my close friends or family yet as I wanted to wait to tell them about it until I have gotten my insurance approval date.  But, I got it set up now to where I am very comfortable with sending out the address on here so that I can share it with all of you.  One note of thought is it is very possible that I will blog to that more than I would on here, not that I don't want to but.... well... you'll see why. 

The address is: tammyinindy.wordpress.com/

I look forward to spending the day today catching up and peeking in on all of you.  TTYL

Tammy

I don't know really how some places do their surgeon consult, but over at the hospital that I am going to be doing mine at (which is St. Vincent's Bariatric Center of Excellence), our first appointment is a informational meeting where we get the opportunity to meet with the staff of the center, the nutritionist, the individual who works on getting the insurance approval work done, and the surgeon who we chose. After the informational meeting, as I prefer to call it, if you decide you would like to proceed with the surgery (or would just like to ask more questions about the procedure to help you decide if you want to proceed) you meet one on one with the surgeon in a private consultation. If you are self-pay you would pay for the fee for that consultation (not the whole surgery just the one-on-one) at that time or you pay your co-pay if your insurance company says that is what you need to pay.

My insurance company required that I pay a $15 co-pay for the private one-on-one consultation with the surgeon, however if upon approval for the surgery, and according to my insurance company, any future payments (or co-pays) will be covered for the surgeon and any other specialist at 100%.

According to our insurance (UHC) our plan (Choice Plus) only requires that it be a medical necessity to have this surgery. But, even still if it required all the other things (40+ BMI, Co-morbidities... a word I can spell better than I can actually say.. lol, etc., etc.) I still would fall within the spectrum so their having to prove all that is fairly simple in my case. They gave me the sheet to sign to have my PCP send to me all the required paperwork that will need to be submitted to the insurance company (or at least the paperwork that they require as a center), so that should be coming before too long.

About the meeting itself. It was rather interesting. I am very glad I took my husband along. I wanted him to be there so that he could hear what they were going to say about the procedure itself, what needs to be done before hand, and what life will be like afterward. The nutritionist talked about the differences in food portions before surgery and after surgery, the vitamins and supplements that will need to be taken for the rest of ones life and their importance, how often one will come in for a re-evaluation of diet as one progresses after the surgery, and how as a WLS patient at that facility we can come in at anytime for free for the rest of our lives for nutritional counseling (insurance or no insurance). The lady who will handle the insurance stuff talked briefly about the steps that will be taken to get insurance approval, and also to those who are on Medicaid the more stringent requirement that Medicaid has for people wanting this procedure. She talked about how she couldn't specifically say how long it could take to get approval as the insurance companies are very unpredictable on how long they may take. Some may have an answer back within as little as 2 days some may not have a response back for a couple months. She also discussed how if the insurance company does deny coverage they will work with you to get that approval by submitting an appeal. She talked about how it is sometimes just a document that is needed, but sometimes it is a series of tests or 6 months of continuous physician assisted medical weight loss program. The surgeon discussed the surgery itself. She talked about the Roux-en-Y, the Lap-Band, the Vertical Banded (which she does not do the Vertical Banded), and she also talked about a new procedure that she also does... but I forget the name of at the moment... hang on... I'll go and look it up... Ahhh got it... Stomaphyx... that's it. She discussed the problems that can occur after surgery and how it is extremely important to follow the nutritional diet set up for us by them and to take the vitamin and calcium supplements every day. How if we didn't eat exactly as we were told then we could have problems with obstruction, and that certain foods and carbonated beverages can (and often do) cause heart burn and gastric reflux. She discussed how when we move into solids we must make certain that our food is cut up into very small pieces and chewed well because if not it can cause obstruction. If vitamins are not taken then the deficiency can cause major issues down the road, and not taking the calcium supplement can cause osteoporosis. She made certain that we know that if there are ANY problems what so ever that we can call at any time 24/7 and they will let us know what we need to do that no complaint is too small of a complaint. She let us know that she likes to follow her patients for life so then if we have any issue she would like to be there for us as our own personal surgeon so that we can alway guarantee that some other surgeon down the road won't botch up what we had done with this gastric bypass. Something that to me is very important and great to hear because I like consistency. My PCP has been my doctor for almost 18 years now and I prefer to have consistency when it comes to my health care team.

In the one-on-one consult the surgeon answered all my questions and gave us even more detailed information on the questions that my husband and I had on more personal matters. She made me feel very comfortable and had a wonderful bedside manner... definitely not a "Dr. House".  After insurance approval she told me about all the various different tests that will need to be ran, minus the gallbladder / gallstones test as I do not have my gallbladder so that test would be pretty useless for me. She stressed that it would be good to start walking about 15 minutes, at least, every day because that seems to have a great affect on the healing post-op if it is started pre-op. Walking is recommended anyway very soon after one is done with surgery as well. In the hospital the nurses will have us up and walking for 15 minutes every 2 hours when we are awake and we will be required to wear hose as that also helps with any possibilities of blood clotting.

All in all, I was VERY pleased with her and the staff at the center / hospital. My husband was pleased and felt more comfortable because he was able to get all his questions and concerns about how this will effect me. He is even considering going to the support group meetings with me pre-op and post-op so that he can understand more (and it was suggested). His being just as comfortable with her, the staff, the support group... the whole thing... is important to me as I want him to not worry so much and I think it will help with any of those "issues" that we hear so much occurring within relationships after this surgery.

So.. what is up next for me??? Well.. on the 9th of September we are going to our first support group meeting, on the 10th is my psych eval appointment, the paperwork from my PCP should be in sometime around then and the surgeon will have her letter of medical necessity done. As well my PCP is going to write something in support of this surgery and since he has been my PCP for almost 18 years it could have a great impact on the approval.

Soooo that is about it for now as far as an update with me. I know this is exceptionally long, but I decided to add detailed information here for those who are possibly new and have questions.   I am sure that if I have missed something here (which is very possible) Dr. Gupta can chime in and add it for me... or some of you who also use her can add it.... but I think I have written the main points.

Have a great holiday weekend, everyone!

Tammy