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I did a lot today- had my blood work done and also had to go to the doctor for my blood pressure (it was elevated but better than it has been).  We discussed diets and exercise.  I told her that I am doing both- watching what I eat, cutting the sweets and fried food. I then went to Dr. S for my psyc evaluation.  The Dr is really nice, pleasant man.

  I had to fill out a lot of paperwork and questionnaires to make sure that I am in the right frame of mind to make decisions.  I am pretty sound and sane and have a pretty decent outlook on things.  I diagnose myself a slightly depressed because here lately, I have not wanted to do a whole lot- it has everything to do with my weight- I am uncomfortable in my clothing and refuse to keep buying bigger clothes.  I have a ton of clothes in my closet that do not fit and a selected few that fit.  I do not feel like getting out in the Houston heat and doing anything. 

This is not me--this is the fat girl that is inside of my body right now.  I need to get rid of her because she is running my life.  I am not depressed in any other aspect of my life--I am happy at home, happy in my marriage, happy to be a mother, happy to have a good job that I enjoy (most of the time) and I am especially happy to have friends and family that are there for me.  A lot of the issues or problems that I have are because I am extremely overweight and it is tiring to get out and be active.  In my mind, I want to but making my body cooperate is a different story.

  Well, such as life....  I truly believe that I will accomplish my goal weight and keep it off for life because I know what to do and have the commitment necessary.  I know the surgery will give me the tool I need to do that.  Dr. S. does not feel like I am depressed, he feels like I am normal and I have the normal worries and fears as the next person. 

He feels that once I have the surgery, I may need therapy just to talk through some of the issues that I have had with my weight and eating habits and want to make sure that I know of groups that are available.  I told him I planned to start attending the group at Cyfair hospital.  He said that is where he was going to refer me.  He also gave the card of the coordinator at memorial city hospital as they have a group too.  He is confident that I have done my research and know what I need and how to make it work for me.  I do!! 

He will write my letter of reference and cleared me for surgery.  My weight at the dr. was 240 but I think I was up today due to time of the month.  I will kick up the exercise in the next few weeks and plan to get rid of about 5-10 pounds before December.

Meeting with Nutritionist-Registered Dietician-Christina M.

Weight: 238.4 (oops)

My meeting went from 945am-1130am.  This was such a wonderful meeting and I felt good when I left.  Christina's role was to review the nutritional requirements after surgery.  We talked about everything- like friends.  We talked about exercise, diet, children, family, the surgery and of course we discussed in detail the lifestyle change that would be required after surgery. 

She said she felt like I was educated and informed about how to make good choices and said that Dr. F. was one of the best doctors out there.  She will be writing my letter of approval soon.  She said she understood why I wanted to have surgery and that I should be proud for wanting to take control of my health and my life to be there to raise my baby.  She is the same age as I am and has 2 kids- one is 1 month older that my baby.  We discussed how our bodies have changed since our 20's and even since we had children. 

We talked in detail about exercise and setting goals for my workouts.  I should plan to do something every day of the week- even if it is not a structured exercise routine-just keep moving.  We talked about our history and how it was not as important to the earlier generations to be healthy and to give and take care of themselves.  They generally took care of everyone else.  We have to break that mold and understand how taking care of ourselves will reward our families even more because the quality of our lives will be different.  She felt like I know a lot about portion control and nutrition--a lot of what I learned from being on Weight Watchers for so long. 

I am thankful for the WW program- it really did help me and teach me a lot--it just no longer works for me.  She said I should not compare my past exercise success to the present, I am different now, my body is different and it will take some changes to be successful- I may have to slow down and not try to do what I did 10-15 years ago.  She will also counsel me after surgery and I am glad of that because I truly loved her when we finished talking.  I received a packet of information but will highlight some of the things that we discussed (so I will remember):

•           Eat protein at every meal

•           Vitamins for life!! Get blood work checked regularly. Get yourself checked out if anything is out of sorts. Pain is NOT normal--do not ignore something that does not feel right.

•           Low sugar- less than 5

•           No gum

•           No straws--you take in a lot of air that you have no room for

•           Take flintstones vitamins and calcium chews

•           Ok to drink crystal light, propel, gatorade as your water, in addition to water--but all of these items count

•           When you eat out, prepare to eat very small amounts of your food

•           Stop eating when you are full

•           Dont eat and drink at the same time--sip all day; stop 30 mins before you eat and resume 30 mins after you finish eating

•           Eat about 4 times a day

•           Do not graze or snack all day, try to structure your meals so that you are not picking at snacks all day.

•           Temperature control- nothing too hot or too cold

•           When eating out--look for low fat or low carb menus and you should be ok

•           Avoid sugar- will cause dumping- watch for hidden sugar; if you are unsure, do not eat something out -if you dump, you want to be home because you will want to sit down or lay down

•           Do not drink carbonated beverages- they cause eating away at your incisions--not good

•           Clean refrigerators and cabinets so that bad food items are not there to tempt you. Clear out junk food- your kids will not notice they are gone. (young kids)

•           Dr. does not want you to trade one obsession (eating) with another. Live and eat normally, but be sensible.

•           Eat your protein and always stay hydrated

•           Keep a food journal- need to be able to spot problem areas in case of weight gain or plateau

•           Support of your household is very important

•           Make sure you eat enough-do not starve yourself or you will be counterproductive.

I feel like I am ready and know what it takes.  Like I said before, I have been conscious of my eating and exercising for a long, long time and I know what it takes to be successful.  I need this tool to help me to get and stay where I need to be!

June 8, 2006

Sleep Study

I arrived at the sleep study place at 930pm.  My study was scheduled for 10pm.  The place was very near my home.  I checked in and got to my room.  The room was soooo nice.  The bed was very comfortable and there was a recliner in the corner.  The technician hooked up the monitors, head to toe, to track REM sleep, teeth grinding, respiratory functions and oxygen saturation.  There were wires all over the place.  I went to sleep -fitfully and it took me awhile but I finally went.  I woke up about 2-3 times thru the night.  I could not fall into a deep sleep but that is normal for me lately so I was not surprised.  I woke about 615am and went home about 645am.  I found out that I have mild obstructive sleep apnea, nothing too serious that cannot be resolved with weight loss.

June 1, 2006

Appointment with Dr. Nguyen, MD

1st Appointment for 6 month supervised diet/exercise plan

Weight:  235

I met with Dr. Nguyen.  My vital signs were checked and of course the usual paperwork.  My blood pressure was sky high, even though I am now on medication.  I have returned to work because it is like a never-ending battle with blood pressure and even though I feel a lot better, it is still out of control.  All the more reason to get this taken care of.

Dr. Nguyen was pretty straight forward.  He said diets are the reason that I am overweight.  I must make lifestyle changes and stick to them throughout life.  This means diet and exercise.  I told him that I was working out about 3 times per week and he feels this should be increased, I should be doing more and watch what I eat. 

I made a commitment to cut out fried food, sweets and cut my portions.  I am already halfway there.  He said I need to come back to him every month for 6 months and we will discuss what I have done so far and he will approve me for surgery if that’s what I feel I need to do at the end of 6 months.  Sounds like a plan.  He does want to see the results of my sleep study as it might be something there that is contributing to my lack of energy.  He wants me to continue taking medication for my blood pressure.  My next appointment is July 5.

Weight 235

Appointment with Dr. Carlos Ferrari

I had been off work for about 2 weeks with headaches, dizziness, pain in my back, foot pain and just didn’t feel good.  I went to the doctor because I knew it was my blood pressure.  Sure enough it was.  I am being treated once again for blood pressure.  I had been thinking about having WLS for awhile now.  I really started thinking seriously about it after my birthday in October 2005.  My friend and coworker and I talked about it and she was going through the approval process with our insurance company.  I said, no, let me just keep doing my weight watcher thing and I will lose the weight.  Well, here it was 6-7 months later after we had the conversation and my weight is still the same.  I had been working out, and trying to eat right, I kept going to Weight Watchers week after week and my results were funny. Some weeks I would do well, others I would gain back what I lost.  WW was a wonderful program and still is, it just was no longer working for me.

Long story short, I scheduled an appointment with Dr. Carlos Ferrari.  I got weighed in and my blood pressure was checked.  I filled out a mountain of paperwork to bring.  It discussed my weight history (everything listed above) and family history.  I met with Blanca and Luly and met with Dr. Ferrari. 

Dr. Ferrari was very nice, soft spoken and I told him that he did my gallbladder surgery in 1997. That is how I chose him.  He saved my life (cuz I thought I was dying but I had gallstones).  He examined me, noted my extremely high blood pressure and discussed surgery options with me.  He feels that I am an excellent candidate because I am young and relatively healthy.  He said I can stand to lose about 100 pounds and this surgery will help with that process.  He said it is a great tool and you will lose weight in the first 9-18 months whether you want to or not. 

He said that is the time to make the most of the surgery—use that time to retrain your body and to eat right and exercise.  If you use the surgery wisely, you can lose weight and keep it off for the rest of your life.  He said that you can and probably will gain a small amount of weight back and that is ok as long as you have developed and maintained a healthy lifestyle at the start.  I am excited.  My appointment lasted about 2 hours and I watched a video.  I got a copy of the video to take home to my family and also received my list of required steps and appointments that I needed to make to meet the requirements of my insurance company.

In order to satisfy insurance requirements, I need to have:

•           6 month Dr. supervised diet and exercise program; # 1 completed 6/1/06, #2 - completed July 5, 2006 , #3- completed August 1, 2006 ,#4-completed September 1, 2006, #5-completed October 2, 2006, #6-scheduled November 2, 2006

•           Psychological evaluation and clearance; completed 6/20/06,

•           Nutritional evaluation/consultation with dietician for Gastric Bypass; completed 6/13/06

•           Blood work; completed 6/20/06

•           Echocardiogram; completed 7/11/06

•           Sleep study- due to my problems sleeping and lack of energy; completed 6/8/06

I contacted my insurance company and got an updated printout of their requirements as of May 2006.  The one my doctors office had was dated May 2005 but it was still the same, don’t want no issues. I also called my insurance company to make sure that this was covered (we have had about 25 people at my job to have the surgery over the years, so I knew what was required but I just need to know for my own self).  I have a huge support group of people here at the office as well.  My friend and coworker just had her surgery in May 2006 so I have lots of updated information and more and more people are in various stages of approval and having surgery in my office.