NCMTNEER13

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Okay, so I was blogging freqently before my VSG surgery and then Poof! I disappeared. So first things first. NO, I DIDNT DIE ON THE OPERARING TABLE. My procedure went very well. I only spent 1 night in the hospital. The surgeon, the PAs, and the nurses at Atrium-Mercy were great. In the 1st 24 hours I felt like crap, couldnt not get comfortable at all, was fidgtitting the whole time, and had a bit of an elevated heart rate, but other than that, the procedure was fine.

The weeks following my VSG went very well. My recovery was quick and I didn't have any major problems with eating or food. In fact, I was able to get back to a "normal" diet within 6 weeks. When I compared myself to others, I actually got concerned because I didnt have a lot of the post-surgery issues that others had. At times I even doubted they removed my stomach.

But the restriction is there, and the results speak for themself. The day of surgery I was 270 lbs, which was 50 lbs lower than my starting weight (320 lbs). I lost 30 pounds from when I had my 1st surgery consult in February 2018 through my pre-op diet which started on 11/12/18. And then once I got on my pre-op diet I lost another 20 lbs.

Between surgery (11/26/18), and April 2019, I lost another 50 lbs. That put me at the 100 lbs lost mark. My weight loss has slowed significantly since April, but as of today (7/12/19) I am down 107 lbs (at 213 lbs). Overall I'm really happy with my loss, but I still want to hit my goal of getting under 200 lbs. I'm only 13 lbs away but that seems like a lot to me. I track my food. I work out 4-5 days a week. I run and bike now. I am determined not to regain any of this lost weight.

I have been very lucky. No complications, not overly restricted, no GERD or dumping syndrome, can eat most foods I ate before. The physical part has been easy. The mental part has been the hardest. The mental part of not eating, when your body tells you you are full, but your mind is telling you to eat. The mental part of comparing yourself to other WLS patients. The mental part of worrying too much about the scale, and not how you look and feel. The mental part of WLS has been my biggest struggle.

Here are some of my NSV (non-scale victories):

• Shirt Size- Went from a XXXL to L
• Dress Shirt Size- Went from a size 20 neck to a 16.5
• Pants Size- Went from a size 44 to a size 36
• I can now wrap up in normal size towel.
• I can run 30 minutes without stopping or walking
• I can lift 120 lbs (bench press) and do 100 lb squats
• I can take spin cycle classes now

But long story short, I'm so thankful I did this. Is it easy? NO, but I knew it wouldnt be. But the things that I can do now that I couldnt do before, make it all worth it.

Yesterday I had my final WLS appointments, prior to surgery. I was at the WLS center for over 4 hours. Here is summary of each appointment:

Surgeon Visit- Found out that I'm the first surgery of the day. I have to be at the hospital at 5 AM for surgical prep. Good news is that I found out that I most likely will not have any surgical drains and will not need a catheter. I had heard from some patients here on OH that they received them, but he said it was very unlikely that I would. I will be in the hospital for at least one night. The surgeon also told me he will attempt to repair a minor hernia that I have while he is doing the VSG procedure. 2 surgerys for the price of 1. SCORE!!  My surgeon is all-business and formal, so our visit was brief and to the point. However, I have full confidence in him.

Nutrition Class- This was a class of about 20 pre-op patients (some of which where scheduled for surgery on the same day as me). The nutritionist reviewed the pre and post op diets. My pre-op diet is not super restrictive. 3-4 protein drinks daily, but I can have unlimited amounts of non-starchy vegetables and then I can have a daily allotment of 3-4 oz of grilled proteins (chicken, tuna, fish, eggs, lean meats). This will allow me to eat some of our thanksgiving meal. I was shocked at the number of people who were complaining about the dietary restrictions. Compared to the "liquid only" pre-op diets I have seen described on this site, I consider myself very lucky.

Mental Prep Class- This was a class with the same people that were in the nutrition class. I really didn't learn anything new that I hadn't already read on this site (OH) or seen in the Instagram WLS community. It focused on using support groups, setting attainable goals and accomplishments, not comparing yourself to other WLS patients, dealing with non-supportive family, setting exercise regiments, avoiding transfer addictions, and dealing with post-op reactions from family/friends/co-workers. My WLS clinic hosts a monthly support group that is held at the hospital with medical professionals. The biggest thing I took away were the number of patients in the class that hadn't done research and didn't know about post-op changes. Like there were patients that actually thought it was acceptable to start smoking again a few weeks after surgery or didn't know that they would have to take supplemental vitamins for the rest of their lives. I also heard a lot of excuses to why they couldn't do something that was recommended. I hate to judge, but from what I heard I suspect there are many in that group that will not maintain long-term success.

Next up: SURGERY- 11/26

VSG was approved today and I now have a surgery date. November 26th. I was hoping for something in late October or early November, but now that I have a date, I really don't care. I'm just thrilled to be getting it done in this calendar year. And even though I know a lot of people will cringe at the thought of having to go through the Thanksgiving holiday while on a liquid diet (4 days before my surgery), I am up for the challenge. I figure facing challenges before surgery will just help me better prepare for the challenges after surgery. Losers bench here I come!!!

In my last bog post (8/28/18) I shared that I had met all my pre-op insurance requirements and my proedure was going to be submitted to my insurance for approval. I had thought by now (9/18) that I would have a response , but no...I'm still waiting. I was told that my procedure would be submitted no later than 8/31. However the WLS office needed a simple piece of information from me (so simple that I was able to give it over the phone in 30 seconds) and yet they waited until 9/7 to even call me. So my procedure wasn't even submitted to my insurance until 9/11. And they tell me that it takes 3-4 weeks to get a respone from the insurance carrier I have. Don't get me wrong. I love my WLS clinic. The surgeon is great, and all the doctors and specialists there have been not short of amazing. But the office staff is really disappointing me.They are often making mistakes and not communicating well with me.  

I am so frustrated. I really wanted the procedure done in October as it was most convienent time for my family and my job. However, knowing that I may have another 2 weeks to wait on the approval, and that they usually schedule surgery dates 1-2 months after approval; I'm pretty sure October (and maybe even November) is out of the question. I'll get it done in December if I have to, but I really wanted to avoid that time. My wife had gastric band surgery in December and she was miserable around the holidays. But getting it done this year is the key. I will be really upset if they can't schedule it until 2019 since I've already met my insurance deductible for the year and if they do push it to 2019 then I will have to pay a lot out of pocket.

I was fine with waiting the 6 months for my weight management program and specialist visits, but this waiting now is the worst because I have no control over it and I don't know when I will get an answer.I havent handled the frustration well and have reverted to some poor diet choices and a lack of motivation to exercise. I know its up to me to change that (and I have in the past days) but the motivation isnt where it was when I was having monthly doctors visits. I'll keep pushing along but I wont lie, its been very hard the past 2 weeks.

Last Friday I had my final doctor's visit required for my 6 month weight management program. He was ready happy with my progress and felt good about me continuing on to surgery. I expected to hear him say that my case was ready to be submitted to my insurance for approval, but he told me the office still didn't have my pysch evaluation. The pysch evaluation was the only appointment with a specialist who wasn't associated with my weight management clinic. They did however recommend this pyschologist that I went to and she works with the clinic frequently. My pysch evaluation was in early July. How on earth did the WL clinic not have it by August 25th? I promptly called her office and left a message. She called back within an hour and claimed she sent the report to the clinic in late July. I called the WL clinic and let as message, but did not get a call back that day. Needless to say I was furious over the weekend.

On Monday I got an email from my WL clinic that the report had been located and that all documents were good to go. I'm hoping that means my case will be submitted to my insurance this week. The WL Clinic told me it usually takes 1-2 weeks to get an approval, but I've heard from others that is usually about a week. I really hope it happens quickly considering that my surgeron told me that they are booking surgeries about 1.5 months out now. I really want to get the surgery done in October, which is normally a slow time for me with my job and I wont have to battle my co-workers for time off.

I can't believe my six months program is finished. 6 months seemed so long when I started this journey. I've stalled with my weight loss in the past month, but overall I've lost 36 lbs since my first appointment (2/14/2018). I wanted to get under 280 by the end of my 6 months (286 now) but my doctor told me not to worry. He said I will easily hit that mark once I start the pre-surgery liquid diet phase.     

Hopefuly my next blog update will be about a insurance approval and I will have a surgery date.

Friday nigt I went to a Carolina Panthers Pre-Season NFL game. Last year when I went to an NFL game at the same stadium I could barely fit into the seat and was in pain the whole game. This time around I was 35 lbs lighter and I could fit comfortablly in my seat the entire game with no problems. So even though I am still in my pre-surgery phase, I'm going to count that as a pre-surgery NSV. WOO HOO!!

Well its been almost two months since my last blog update so here is an update.

The last blog was focused on my EGD/colonoscopy and diagnosis of sleep apnea. Nothing real exciting to report since then. I have been on my CPAP machine for almost 3 weeks now. I am still getting used to it. Of course I'm not too crazy about it but I guess I'll get used to it. Or at least use it as motivation to lose weight in the hopes (but no guarnetee) that I will eliminate my sleep apnea. So heres hoping I won't have to use the CPAP for a long time.

I had my monthly visit with my weight management program (wmp) bariatic doctor. I'm down 35 lbs since the start of the program so he was happy with my progress. Biggest suprise was that he said I only had 2 more visits with him (July and August). I must have been counting wrong as I thought we were 3 more visits left (July/August/September). This means that the office will submit my VSG request to my insurance company after my 6th and last visit to my bariatic program doctor (in late August, not September as I had previosly thought).

I also had a my 3-month visit to my surgeon's P.A. to make sure I was on track with my program. She was very pleased with my progress. Nothing really new revealed or discussed. they just want to confirm I am still interested in the surgery and am on track to meet all the pre-surgery requirments.

Today I had my physcological consult. I've never been to a conseling session before. I had to fill out a dozen or so pages of questions (took about 30 minutes) and then have an hour long conversation with the pyschologist. I guess it went okay. She was friendly, but I never felt really comfortable. I felt like she didn't believe a lot of what I was saying. I wasn't afriad to speak my mind and gave her a lot to speak to. She is going to sign off on my surgery, but recommends 1-2 sessions with her before the surgery. I get that, she wants to give as much conseling as she can, for my benefit (and of course her benefit ($) too). But it is a recommendation and not a requirment. Has anyone else done more than 1 counseling session prior to surgery?

It's been a few weeks since my last blog post and a lot has happened. here is Part 2

May 17th- I had my uper ednoscpopy (EGD)scheduled with my surgeron. Because of family history and my age, he also wanted to do a colonoscopy. A 2 or 1 is what I called it, but the nurses called it a "double". Other than having wisdom teeth removed I had never had a significant medical procedure performed. Needless to say I was very nervous. I was especuially neverous about the prep. I had MoviPrep perscribed. I fasted for 24 hours before starting the prep. The 1st  dose/container of Movi-Prep went down okay. i took the first dose as prescribed, in about 45 minutes. Within 30 minutes, it was working. 3.5 hours later I started the 2nd dose/container. This time was different. It wouldnt go down. My stomach was full and I couldnt drink it without gagging. It look me almost 2 hours to drink all of the 2nd dose. I dont care how bad the prep used to be, it is still bad. The tiolet time wasn't bad. Keeping down that 2nd dose was though. It was simply awful.

The next day everything went great. I was scheduled for 1030. I checked in at 830, was prepped by 930, and went into the procedure room at 1045. The IV didnt bother me (I was nervous because I had never had an IV put in before) and the propofol worked great. I was out within seconds once it was administed and by the time I had woken up the surgeon had already talked with my wife and I was ready to dress and leave. I found out that 1 pollup was removed and will be tested, but it looked to be benign. No issues with the EGD either. Within an hour I was eating fully again and had no lasting side effects.

May 18th- Due to poor scheduling, I had my monthly weight loss meeting the morning after my EGN/colonoscopy. It was okay becuase my wife had a surgical consult the same time. (I have a lot to say about that about that, but I will save it for another post). I was down 9 lbs since last  weight management visit, which put me at 29 lbs lost since I started. Weight management doctor was impressed with my results and made sure I was getting everything completed that would be required to get VSG surgery approved by insurance. He also shared with me the results of my sleep study, before the pulmanologist did. It turns out as no surprise that I have moderate sleep apnea. I was actually pleased that it was classified as moderate, as I thought it would be considered severe. It will also give me a co-morbidity, in addition to my BMI) that will ensure that I qualify for VSG in case my insurance will not accept my starting BMI. Starting BMI was >40, but now its less than 40 (but sill above 35).

In addition to the monthly eight loss visits (4 more to go) the last big hurdle I have is to schedule my pyschological consult. Although September still seems a long way off, it is quicker getting closer. And now that Ive had 1 medical procedure performed, I feel much more at ease about going through VSG.   

It's been a few weeks since my last blog post and a lot has happened.

May 3- Took my at-home sleep study. Picked up my equipment that morning, got a 20 minute tutorial on how to use it. I took it home and used it that night. Actually it was very easy. I didn't sleep great because I had to sleep on my back and I'm used to sleeping on my side. Otherwise it was fine. Still waiting on results, but more on that later in this blog post.

May 14th- I had my required visit to the nutritonist.Weigh-in showed I had lost 26 lbs since I started in February. Visit was very easy because most of her recommendations were things I had already been doing, many thanks to posts and blogs I read on OH. We spent most of the time talking about post-surgery diet. The funny thing was that I was neverous about this visit because I was afraid I would be lectured to about my food choices and eating habits by some super fit and skinny nutritionist. My nutritionist was nothing like that. She wasn't super fit or skinny, but she was super friendly and very supportive. No lecturing. No criticizing. She was very educational in a real world practical way. For example instead of saying "no fast food", she said limit your fast food and here are some healthier options if you have to eact fast food. She was extremely easy to talk to and being a larger woman, she was much more relatable. I didn't feel judged or looked down on because of my size.

I had my 2nd appointment with Dr. Tomcho today, who is overseeing my medically supervised 6 month pre-op weight management program. I also did a resting metabolic rate (RMR) test today. No surprise at all, but my metabolic rate is low, like very low. Like I said I am not surprised, but a bit disappointed to know it is that low. I was hoping with my recent lifestyle changes it would be higher. Although I did like hearing my doctor explain it in a way I could understand it. Also gave me calorie goals to show how I can lose weight by meeting those targets.

He was very excited to see that I had lost 15 lbs since my last visit with him. Never in my life has a doctor given me a high five. That was such a good feeling  Thats 22 lbs lost since my initial WLS consult. He also eliminated any concern about "losing too much" he said that they always use the starting weight (at initial consult) when submitting request for WLS insurance coverage. He said he only seen a few cases in his career where the weight loss has been significant enough for the clinic to NOT recommend surgery. This takes away a lot of concern and will help get me back on track. I had slowed up a bit in the past week because I didn't want to lose too much. Now I can concentrate on my diet and fitness without having that concern. I hope can lose another 5-10 lbs before my next visit.

My original weight 6 month goal was 300 lbs - ACCOMPLISHED

My adjusted 6 month goal is now 285 lbs. If I hit that, I will match my lowest weight in 10 years.