Atl_Gadget_Grrl but u can call me Charlotte

To Do List

May 29, 2013

Upper abdominal ultrasound to check gallbladder and sleep study (required by surgeon to rule out apnea) are both scheduled for Monday. 

Preop diet started today.

Feeling a little more real and I am feeling confident and calm.

I can't wait to see the person I become.

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Trust

May 27, 2013

I have been hit with the enormity of trust that I will have to have in the months ahead.

Trust in...

  1. my body to be full when I have eaten a small amount
  2. my body to feel satisfied when I only have protein and veggies
  3. myself to follow the plan
  4. my surgeon to do a great job
  5. my family and friends to support me in making wise decisions
  6. myself to maintain these habits over the long term.

I know this is only a short list, and I may add more as I think of them.

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Preparing to say goodbye

May 24, 2013

I gave this URL to a group of friends I have known for nearly 16 years, so I guess I better get caught up and make it worth reading. I'm not going to go in and fill in all the backstory. Instead, I will pick up where the story does.(Hi, guys! I am glad you are reading. It will keep me accountable.)

Since the beginning of this week, I have been tracking all of my food, observing the choices I make in order to see what I need to do in preparation for the 20 gram low carb diet that starts on the 29th. If you look at my food breakdown diagrams on MFP, you'll see Monday looking awful, but then it gets better as the week goes on. (my MFP profile is laur gray if you want to friend me)

I also joined a gym and started working with a trainer on the 17th. His name is Matt and he reminds me a lot of Olly Murs, so that makes workouts enjoyable. I have two collections of leg/ab/arm exercises I can do. Tonight, I did them all by myself and was not intimidated by the guys around me pressing hundreds of pounds. I have never done this before.

Tonight at the gym, I happened to be looking at myself in the mirror. I don't even really see myself anymore. I see a hint of the person who is yet to be. And it dawned on me that in a fairly short period of time, this body will be gone. I realized that my mindset is that of saying goodbye to my former self, and oddly, I feel a certain peace about that. As I thought about it, much of my persona is in transition. It is interesting to see where I am going.

I only had two food funerals so far, and it's likely all I will have. At every step, I am seeing new behaviors to change, and things to watch for. My mindset is not that of self-loathing like it was from January until May. This feels more like a casting off. A getting lighter. A saying goodbye to those choices and behaviors that were not good for me.

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almost a sigh of relief

Dec 07, 2012

Talked to LaTonya at the doctor's office today. She has received all documentation except the psych eval but the psych had called her and verbally said he had cleared me and would be sending over the eval soon. Now the only thing left is the support group meeting next week and I know what I need to provide there.

I asked her about the challenge of getting approved while having a BMI

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Apparently I passed the psych test

Dec 05, 2012

Finished up with the psych eval today. I suppose I passed; the doc said I was knowledgeable about the procedure. He wants to see me improve my diet beforehand. 

Now, the last hurdle is the support group meeting next Thursday.

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Stuff on my mind today

Dec 02, 2012

 

Did not manage to make it to support group yesterday. I could not find it confirmed anyplace but on the sheet that the surgeon gave me. I didn't want to head across town only to find no such meeting existed. Now I think I need to wait until next week due to it being the first week of the month. I might be able to get to one on Tuesday, but again, I cannot find it confirmed anywhere. Must dig tomorrow and make calls once folks are back in the office.

Things on my mind:

  • Will my eyesight change post surgery? I hope it does for the better. It seems I need to wear my glasses more often lately.
  • Who will "tell my story" to the insurance company? I am not sure that the insurance coordinator at the doc's office will piece together all of the details from my various medical charts. Perhaps I will write a summary for her and send over.
  • What if the insurance company rejects my request?
  • I am worried I have blown out my RIGHT knee now. I am wearing a brace. It's really sore and I cannot bend it. Perhaps I will wait until WLS to have it fixed, if necessary, since my out of pocket max will be met via WLS and there won't be any copay. I just need to control pain till then.
  • How do I prove I went to a support group?

Got the EKG and physical and labs done on Friday in my PCP's office. The doc will get the lab results and send them over along with the the other results and the letter of medical necessity, which I thought another doc would be writing. That was two weeks ago, and I have not heard back from her yet. As long as somebody writes it, I don't much care.

Here is the list of stuff my surgeon's office requires, and the status of each. i am putting it here so I can track it:

  1. insurance verification: done, and covered.
  2. letter of medical necessity/clearance: coming from PCP this week
  3. pre op testing: results coming from PCP this week
  4. Non-surgical weight loss work: not required by my insurance, but important to my story as the work I did with my previous PCP is why I am at a BMI
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Stuff on my mind today

Dec 02, 2012

Did not manage to make it to support group yesterday. I could not find it confirmed anyplace but on the sheet that the surgeon gave me. I didn't want to head across town only to find no such meeting existed. Now I think I need to wait until next week due to it being the first week of the month. I might be able to get to one on Tuesday, but again, I cannot find it confirmed anywhere. Must dig tomorrow and make calls once folks are back in the office.

Things on my mind:

  • Will my eyesight change post surgery? I hope it does for the better. It seems I need to wear my glasses more often lately.
  • Who will "tell my story" to the insurance company? I am not sure that the insurance coordinator at the doc's office will piece together all of the details from my various medical charts. Perhaps I will write a summary for her and send over.
  • What if the insurance company rejects my request?
  • I am worried I have blown out my RIGHT knee now. I am wearing a brace. It's really sore and I cannot bend it. Perhaps I will wait until WLS to have it fixed, if necessary, since my out of pocket max will be met via WLS and there won't be any copay. I just need to control pain till then.
  • How do I prove I went to a support group?

Got the EKG and physical and labs done on Friday in my PCP's office. The doc will get the lab results and send them over along with the the other results and the letter of medical necessity, which I thought another doc would be writing. That was two weeks ago, and I have not heard back from her yet. As long as somebody writes it, I don't much care.

Here is the list of stuff my surgeon's office requires, and the status of each. i am putting it here so I can track it:

  1. insurance verification: done, and covered.
  2. letter of medical necessity/clearance: coming from PCP this week
  3. pre op testing: results coming from PCP this week
  4. Non-surgical weight loss work: not required by my insurance, but important to my story as the work I did with my previous PCP is why I am at a BMI
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Stuff on my mind today

Dec 02, 2012

Did not manage to make it to support group yesterday. I could not find it confirmed anyplace but on the sheet that the surgeon gave me. I didn't want to head across town only to find no such meeting existed. Now I think I need to wait until next week due to it being the first week of the month. I might be able to get to one on Tuesday, but again, I cannot find it confirmed anywhere. Must dig tomorrow and make calls once folks are back in the office.

Things on my mind:

  • Will my eyesight change post surgery? I hope it does for the better. It seems I need to wear my glasses more often lately.
  • Who will "tell my story" to the insurance company? I am not sure that the insurance coordinator at the doc's office will piece together all of the details from my various medical charts. Perhaps I will write a summary for her and send over.
  • What if the insurance company rejects my request?
  • I am worried I have blown out my RIGHT knee now. I am wearing a brace. It's really sore and I cannot bend it. Perhaps I will wait until WLS to have it fixed, if necessary, since my out of pocket max will be met via WLS and there won't be any copay. I just need to control pain till then.
  • How do I prove I went to a support group?

Got the EKG and physical and labs done on Friday in my PCP's office. The doc will get the lab results and send them over along with the the other results and the letter of medical necessity, which I thought another doc would be writing. That was two weeks ago, and I have not heard back from her yet. As long as somebody writes it, I don't much care.

Here is the list of stuff my surgeon's office requires, and the status of each. i am putting it here so I can track it:

  1. insurance verification: done, and covered.
  2. letter of medical necessity/clearance: coming from PCP this week
  3. pre op testing: results coming from PCP this week
  4. Non-surgical weight loss work: not required by my insurance, but important to my story as the work I did with my previous PCP is why I am at a BMI
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self-disclosure + defensiveness

Nov 30, 2012

The other day, the psych (I should call him by his name, Ronen) asked who I had told I was doing this. I told him nobody but my immediate family. He asked why. I explained that I generally don't talk about things until they are a sure bet e.g. I am not likely to say "I am going to buy a new car in 6 months". I will more likely say, "I am going to a dealership today to buy a new car", or, more often, "I bought a new car today." The only reason I have for this is that I just think there is not much point in sharing all these plans with folks before they're sure bets. KWIM? I guess it is something I have to work out. Anyway...

 

Today was my first "dry run" at telling people I am having the surgery (outside of my immediate family). I went in to my PCP's office to have the EKG done and remaining labs drawn. I saw a different doc than my primary. His response was polite but distant, almost curious, but pleasant nonetheless. The lady in the lab, however...She is a larger woman, probably at a BMI higher than mine. She asked me a bunch of questions and after each one would relate back to herself. Statements she made: 

  • "But you're not a BIG girl" Uh, yes I am. If I had not been working with the doc on weight loss for the past x years, my BMI would be well over 40. (it's at 37.5 today).
  • "I'm too old" to do that." Well, I have seen some folks on the lists I am on are well into their 60's when they have the surgery.
  • "I have worked in healthcare all my life and know too much about postop stuff." Oh, well, ok...

Here's the thing. I didn't say a thing about her weight, her health, or her lifestyle. I answered her questions honestly and from my perspective. But yet, she was defensive. Probably my biggest response (I am guessing) is going to be, "but you're not THAT big".  Perhaps I need to practice the response, "Thanks for your perspective that I carry it well, but I need to do this to stave off certain health problems."

I do worry about telling people at work, particularly. I think it is partially because I have long drawn a "line" across what is safe to share at work and what is too much. I very much operate by the inner sanctum principle - there are very few people who really, really know what is going on in my world. The rest receive information, but not much of consequence. I will be polite and self-disclose, but only trivial stuff, I guess. I would say all in all I am a very private person particularly when talking about myself. And, my weight and body image are such tremendously vulnerable things to discuss. I cannot image making them public. But, it does appear that I will figure out how to manage the right amount of information in this case, as well.

 

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preparation steps

Nov 29, 2012

I have been doing a lot of reading lately. Not finding too many surprises anymore. The information remains consistent. This is good, I think.

Last week: surgeon consult (selected RNY) and dietician consult (nice lady!). Began the mighty accumulation of medical records. Hopefully they'll get in to the surgeon's office quickly. My goal is to have everything ready to go to insurance by 12/15. The insurance coordinator said it can take a couple of weeks to hear back. January for surgery looks wide open and they can get me in as quickly as a week after approval. There we go. I really hope I am not denied, but I think there is a risk because my current BMI is 35 with comorbidities written into my insurance contract. Insurance coordinator and doc both assured me that generally the insurance companies follow the center of excellence recommendations and there is not a problem. And, the reality is that if I went off my metformin, my weight would head north again. It's already crept up a few pounds since stopping my phentermine.

This week: upper GI (results were OK, only a little reflux according to radiologist), Psych eval (2 hours down, 1 hour to go), EKG/labs tomorrow (with my PCP, no sweat). The only thing left will be the support group meeting which I will attempt to hit on Saturday, otherwise will need to wait a week due to December starting on a weekend. 

Psych consult was interesting. Went to the practice that family members have used in the past. This psych is their eating disorders specialist. Younger guy. I felt this eval was sort of a tryout for post-surgery work. I think it'll be important to work with him after surgery to help me adjust to life as...not me.

Key themes emerged in our conversation. 

  1. I have little to no comprehension of what I actually look like - my body self-image is so messed up. For this reason, I guess I really do have an eating disorder. I have read about dysmorphia in anorexics and bulimics, but I guess it is a real thing that happens to the obese, as well.
  2. The need for psych support after surgery because although *I* will be the same person on the inside, the world will be seeing a different person on the outside. I've gotta be ok with that and will need to learn to manage it.
  3. I think I can articulate some pre and post surgery differences for the first time. On my previous attempts, I have literally had to drag all of me along for the journey. All 200+ pounds exercising; all 200+  pounds fighting what I eat. After I hit goal, I can focus on keeping my body where it's at. To me, that is a completely different mindset. But, this is going to be work, no two ways about it.

He felt a reasonable goal for me is 180. Interesting, and I think that is a good solid goal, but I will be honest and say I would love to see what I look like at 150. As I calculate different BMI's, 180 would still put me in the "overweight" range. The Weight Watchers site says a healthy weight for my height is 135-169. So, maybe 180 is a bit high, but it is 70% of EBW, if I set my IBW to 150. That is right in line with what the surgery is supposed to provide.

I spent 2 hours talking with him, and I need to go back for another hour next week so we can finish up. I suppose I am doing well because he also wants to discuss a treatment plan that involves pre and post surgical sessions. I suppose if he felt I was not a candidate for surgery, he wouldn't be discussing postsurgical treatment, right?

All in all, I am looking forward to the potential future me. I am enjoying and admiring the stories and photos of others. I am feeling a little impatient at wanting to get all this hoop-jumping finished so I can find out whether insurance will approve me.

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About Me
Location
23.3
BMI
VSG
Surgery
06/12/2013
Surgery Date
Nov 29, 2007
Member Since

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