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I went back to the sleep lab last night for the CPAP titration. It went pretty well; it was still pretty miserable being tethered by all those wires (what a production just to roll over!) but the mask wasn't too bad. I did wake up a few times with my nose itching, and in my sleepy-logic, I was worried that I'd get in trouble for messing with it if I tried to scratch! What a goofball. The good news is that the tech told me "You slept like a rock," this morning and that I only had the CPAP set on 8. I'm scheduled to go back to the pulmonary doctor on October 12, but I'm going to try to get that appointment moved up to sometime before my appointment with Margarita on October 8. In meantime, the letter from my PCP and report from my psych eval are ready to be picked up, along with my lab results.

I had my psych eval this morning, and I passed! The psychiatrist even dictated the letter right then, while I listened. He said that I am "an ideal candidate" for WLS. I go back to the sleep lab on Wednesday for my CPAP Titration, and after that, I'll start gathering all my paper work for my next appointment.

I talked to my parents Saturday evening and gave them an update on where everything stands at this point. They seem to be supportive, so I guess they've gotten past their initial uncertainty. Oh, and my mom tells me that my brother - 5 months post-op as of yesterday - has now lost 130 lbs (plus 10 pre-op).

This is my first entry in this journal, so I'll have to do a quick recap to bring everything up to date to where I am at this point.

7/30/04 - After much thought, I finally decided that I wanted to seriously investigate my surgical options for weight loss. I told Kris (my partner) and, while concerned about the risks, she was very supportive. We saw my PCP on July 30, 2004 and I told her that I was interested in the surgery. She agreed that it was a good idea, and referred me to Hershey Medical Center. I also told her that I strongly suspected that I have sleep apnea, and she referred me to Pulmonary Associates in Chambersburg, PA.

8/19/04 - I attended a group informational meeting at Hershey on August 19, 2004. Kris was working that evening, so I went by myself, but I made her read all the handouts when I got home. The session covered a lot of information about the surgery, much of which I already knew from my research here and elsewhere, but a lot that was new to me, as well. I also learned a lot about the process involved in getting ready for the surgery. The support group was meeting in the same room afterwards, so I stuck around for that. Dr. Ku was speaking to the group, and he seemed very nice, and like someone that would be easy to work with.

8/?/04 - I had a long talk with my brother about his surgery, and his post-op experience, so far. He had an open RNY on 4/19/04 at Memorial Hospital in Houston, and although he had some pretty serious complications (leak, pancreatitis, wound infection) and spent something like 24 days in the hospital, by this point, he had lost about 100 lbs, and said that even knowing what he knew, he would definitely do it again. I was concerned about how supportive my parents would be, especially given his experience, but he felt like they would be ok with it.

8/25/04 - On August 25, Kris and I went to see Dr. Kurshid about my sleep issues. I took her along for moral support, because I'd like her to go to as many of these appointments with me as possible, and because I figured she knows alot better than I do what I sound like when I'm asleep. He asked her "Does she snore?" and she said, "Oh yeah!" I told her she didn't have to be quite so emphatic with her answer! Dr. K referred me to the sleep lab at Chambersburg Hospital for a sleep study.

8/?/04 - I told my parents about my plans to have WLS. I talked to my dad (who is a doctor) first and then my mom. I had essentially the same conversation with each of them. They weren't too positive about the idea at first, said that my brother was "a lot worse off," was having mobility issues, etc. I basically said "Me too!"

 My parents live in Texas, and since Kris and I moved from there to Pennsylvania in 1999, we only see them for a few days every six months or so. I pointed that out to them, and said that I think that, based on other things they've said at times, I think their image of me is more of the weight I was when we moved than the weight I am now. I told them what I actually weigh now (that was hard) and that it is seriously affecting what I can do, and they both agreed that, in that case, it probably was a good idea. I was pretty relieved about that.

9/8/04 - I did the sleep study on September 8, 2004. It wasn't a lot of fun, but the tech was very friendly and let me ramble on about my partner, my dog, my brother and his surgery, my job and God knows what else while she wired me up. If I'm remembering correctly, the wiring up included 2 wires (run down my pant-legs) on each calf, three on my face (chin, under one eye, beside the other eye), maybe one on my neck, one on each shoulder and I have no idea how many glued to my head. I also had a belt around my chest and one around my waist, and a pulse-ox monitor on my finger.

She hooked me up to a CPAP machine for a few minutes before I went to bed, just so I would have an idea what to expect if I were diagnosed with sleep apnea and had to go back a second time. Based on things I'd read here, I asked to try the "nasal pillows" instead of a mask. I don't know if it was because the pressure was too low and I felt like I wasn't getting enough air, or because it was hard to exhale, or just because there was something up my nose, but it was totally freaking me out. She switched me to a mask and turned the pressure up a bit and that was much more bearable. I sure was glad when it came off, though.

Then she tucked me in and I had to lie on my back, while she talked to me through the intercom and made me do various things so that she could check all my gizmos. It was a rather bizarre feeling, lying there taking instructions from this disembodied voice - I had to stare straight ahead, blink 5 times, clinch my teeth and swallow, look to the left, right, left, right, flex my feet and - this was the fun one - "simulate snoring." I think I did a better job of simulating giggling!

I watched tv for a while and finally went to sleep. It was probably one of the worst nights of sleep I've had in quite a while. The bed was hard, all the wires made it very complicated to roll over and I couldn't get the thought out of the back of my head that I was being watched. Oh yeah, she never mentioned it, but there was a camera, too. It was kind of creepy, every time I moved, I knew that they knew, and I kept worrying that I was going to pick my nose or scratch my butt or something in my sleep!

9/10/04 - That Friday, Kris and I got up way too early in the morning and drove to Middletown, PA (about an hour away) for my first nutritional counseling appointment with the dietician, Margarita. She was really nice, and I didn't even feel like I was in too much trouble when I described to her what I usually eat. She did, however, say "Well, you've got a lot of room for improvement...."

She then gave us the whole spiel about whole grain, low fat, low sugar, "strive for five" (fruits and veggies per day), etc. She also explained the process a bit more clearly and said that if I have all my various test results and referrals (letter from my PCP, lab work, sleep study, psych eval) when I go back to see her in October, and have "done what I'm supposed to" (re the diet, food journal, etc), that when I go back for my next appointment with her in early November, I'll have my first consultation with Dr. Ku the same day, and if everything looks good to him, he will set a date for my surgery at that appointment, and I could have the surgery before the end of the year. I was thinking in terms of maybe February or March, so this was very exciting - and kind of scary - to hear. Actually, I believe my response when she said that was "Holy Crap!"

When we got back to town, I went to my PCPs office and dropped off a request for her to write me a letter of referral, and a note requesting an appointment with the psychologist (or is he a psychiatrist? I don't know) for the psych eval. From there, I went up to the hospital lab and pre-registered and picked up a collection bottle for the 24-hour urine that my nephrologist wants (This is unrelated to the surgery - I had some kidney issues about 15 years ago and get checked annually to make sure it's all still working ok; much of his bloodwork overlapped with the stuff for the surgery, though, so I had it all done at once; I also want to get my nephrologist to sign off on the surgery, too, just in case.)

When I got home, there was a message on my answering machine from the sleep lab, saying that the do want me to come back for the second night, which is the CPAP titration, so I guess I've got "the apnea." (Sorry, old Mad About You joke. For those who remember the episode - Yes, I was a little annoyed that the didn't offer me a "Betsy." :-) )

I collected the 24-hour urine on Sunday 9/12 and dropped it off and had blood drawn for a billion tests on Monday morning. I've got an appointment for the psych eval for Monday 9/20 (at 8:30 am - who is sane at that hour?!?) and the 2nd night at the sleep lab on Weds 9/22. After that, I'll start bugging all those docs to give me copies of my results, so that I can take them to Margarita at my next appointment on October 8. I'm bound and determined that I will walk in there with everything I need for her to schedule me with Dr. Ku in November.

This week, I talked to the benefits person at work as asked if any changes will be made to our insurance (the policy renews on 12/1). She doesn't know, but will let me know as soon as she does. My big fear is that if we change from Blue Cross, I could end up with a new company that doesn't cover the surgery, and I don't know if we could rush it enough to have it done in November.

I also talked to one of the technicians who will be covering for me while I'm out. I've been taking off, coming in late, etc for several appointments lately, and she was getting worried about me, so she came over to my office to ask if I'm ok. I told her what's going on, but that I'm not making any big announcements at this point. (You know, because then people might figure out that I'm fat!) She's no stick herself, so she could understand that logic. I did tell her that she can tell the other tech (who is a stick, but evidently works at it, so we don't have to hate her too much) though. I'm glad I got that out of the way, because I wasn't looking forward to it, and there's a lot that I'm going to have to train them on before I can be out for that long.

I still have to talk to my boss about it, and I haven't decided yet whether I'm going to tell him exactly what I'm doing, or if I'll just leave it at some generic "I'm having surgery" thing. I have to talk to him before I see the surgeon and set a date, though. I will be getting 8 more sick days as of January 1, but we are usually pretty slow in December and then get busy in January, so it would be much better for him if I were to be out in December. I have about 2.5 weeks of sick days now, which won't be enough, so I'm thinking that I'll ask him if I can get the ones for 05 a little early and use at least some of them in December, so that I can be back before things get busy in January. We'll see how that goes.

This week (started Monday) I've also been keeping my food journal and doing my best to follow Margarita's instructions. I decided that I should take "baby steps" though, like it said on the handout she gave me, so I've been concentrating this week mostly on adding the "good stuff" that I wasn't eating before (milk, fruits/veggies), and making fairly painless substitutions, like whole grain everything (which turns out to be not so bad), low fat everything, etc., and not being too hung up on "I can't have X, Y or Z." Just getting in all that other stuff doesn't leave much time or room for X, Y and Z, though, and once I've already eaten all that good stuff, I hate to "blow it" by having something "bad."

We did go to our favorite restaurant/bar on Wednesday, and I did so-so. I ordered a turkey wrap, as usually, but got a fat-free dressing on it. We didn't order the "cheese plate" appetizer (yep, just a plate o' cheese cubes) and I had less beer than usual. I did, however, still order the mudslide (ice cream, Hershey's syrup and booze) for dessert. Still gotta work on that one! 

Kris has been making similar changes to her diet, as well, which is great. I don't know how much of that is just being supportive, or how much is figuring that it can't hurt her either, because everybody should be eating like that anyway.

Well, I guess we're all caught up to where I am now, so I'll shut up. :-)

I've always had weight issues, and I guess I come by them honestly. After all, at about 340 lbs, I'm "the skinny one" in my family! My first serious diet was Weight Watchers when I was 12 years old. I reached goal (80 lbs!) and became a lifetime member, which has probably saved me thousands of dollars in re-joining fees over the years.

I've gone back to WW a bazillion times, and been really successful (down to around 150, for a short time) twice. The first time was my sophomore year in college, and the 2nd time was right before my 10 year high school reunion, to which I wore (for the first time in my life) a mini-skirt and was named "Most Changed Girl." This is not why I've chosen to have gastric bypass surgery, but I sure do like the idea of going back to my 20 year reunion in 2006 looking a lot more like I did in '96, than like I do now - or even like I did at graduation!

Over the past year or so, my weight has hit a point where it is really limiting what I am able to do and really interfering in my life. I had never even considered WLS, though, until about a year ago when my brother decided to have it. When our father, who is a physician, was supportive of his decision, I began to realize that it was an option for me, as well.