Flava_of_bravery

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(2nd post, continuing 1st) After Dr. Hill described the 4 procedures he does - he then did a Q&A session -  A few people asked pertinent Questions, I asked 2 questions 

1) Q: I have spinal stenosis and have pain management issues. I take a high dose of Ibuprofen every day - I know you're not supposed to have NSAIDs after the surgery- What should I do?
A; The sleeve can actually help with that - you can take a lot of medications with the sleeve. Q: I also have bad GERD though A: We'll review you individual case by case and figure which is the best surgery for you (I think he's leaning toward sleeve)

2) Q: I have been diagnosed with an eating disorder, binge eating disorder specifically. How can that be handled? 

A: Eating disorders are extremely rare, but if you do have one - we'll help you find a counselor that can help you heal that. 

 

 

Two great answers  - so happy that finally found someone whose willing to work with me...

THE NEXT STEPS

- I have to finish filling out a packet for medical history

- I have to schedule an Initial Consultation

- I have to call my insurance company AGAIN (finally got the CDP codes they *had to have* to answer my question) and see if Fidelis covers surgery with Dr. Hill. 

- " " " go to my My Primary Care Physician (main medical doctor) for another letter of support and needed medical records

 

 

And then it continues the process. I'm so looking forward to this. I met people at the info session that lost 120 - 200 lbs. in like - a year - 

Amazing! and just what my back needs, as well as my other health conditions... So excited to get this processes going. 

I went to the informational session with my fiance (whose also a big guy) and my CNA. It was a great session, one of the best I've attended of those functions. I'm so glad I went I finally felt hope in the process for the first time in a long time. It was on par with Graber's info sessions and way above Albany Med's. I feel I've gone to the right place finally. 

It was a cold snowy January day when we pulled up to the slushy main entrance to Adirondack Medical Center ie the small hospital in Saranac Lake NY. I had to stand and pivot on slush which was terrifying but I was determined and I eventually succeeded. Being in a wheelchair it's terrifying sometimes in the winter. Coming from Plattsburgh in the snow and ice we were 10 minutes late to the meeting but luckily some nice ladies sprung into action and let me share the table and gave me a packet.

Dr. Hill was conducting the info session marvelously. He went through what obesity is and what it does before we got there but we did see the 4 surgeries he performs there and he also answered questions. I asked 2 questions LOL (If you knew me, you'd know I would lol).  He went over the lap band/relize band (which he said were the exact same thing), the sleeve, the RNY, and the switch. will write more later - it was a great session :) 

Hi, I've decided I wanted to update with something inspiring - because why not really? There are too many depressing things in this world - including worries which I wrote about last time, just to get them down in written form and out of my brain (sorry) .... I've decided to list the reasons why I'm going through this surgery, WLS. Y'all know why now (mobliity etc.)... but why go through this drastic change in a personal sense. so anywho... My QUICK MOTIVATIONAL SURVEY - (add your own, subtract etc.) 

What do I consider a conservative goal weight?: For me 199 lbs. 

When I reach goal, the first thing I'm going to do is: Go to a water park - I loved water slides before and when I can do them again I will 

When I reach goal - I believe I will feel:  Healthier, more energetic, more mobile, less pain, less tired, and more satisfied with my place in society (although I'll always be emotionally/physically disabled)

When I reach goal - The first outfit/store I will buy from: Banana Republic - always wanted something from there LOL 

When I reach goal - the first big vacation I'll go on: I want to go on an airplane in 1 seat, to somewhere romantic and beautiful - doesn't have to be far but I'd love to go somewhere exotic if possible 

When I reach goal - I think I will be: Satisfied and happy at a job well done, it's not magic - it won't fix everything, but it'll be a big hurdle that I accomplished. 

When I reach goal - something(s) negative I believe may happen will be (and how to deal): Relationships - I believe they will change Friends for the better (which makes me a little worried) family will be odd,                                                                                                                                         but they always are... romantically I'm not sure, I hope it goes well but we shall see (my fiance is my weight right                                                                                                                                           now, and can be insecure - although supportive of the surgery). 

When I reach goal - Will I look back: On this journey I will always remember and see how strong the human spirit is, especially in all the friends I've made 

When I reach goal  - What will my exercise routine look like: 1 hour a day in pool/resistance / walking? (hey I can dream - you never know ) 

When I reach goal - What will my meals look like: 3 meals a day (or 6 small) and much much healthier (Goal - no maladaptive eating) 

When I reach goal - What will my personality be like: Over the Top as always probably more so with more self  confidence - I've always been outgoing however 

When I reach goal - What will I style be like: I want to go back to my natural blonde as I'm going through the surgery/after process. I already have 3 months grown out so I'm happy about the inch of natural                                                                      hair LOL... as for the rest, we'll see 

When I reach goal - Will I keep moving forward?: To maintain and as always yes

                                                                        - I believe in life long self improvement/ life long learning so def. 

 

Needing to remind myself of this today (after yesterday, and 6 IV needles that were blown.... I wouldn't have had to have them if I was a smaller size). That's one thing I won't miss. I'm glad I'm moving forward with my life for once in like several years it feels almost... Sometimes you need to be reminded of the goal - and maintaining afterward

 

 

THOUGHTS FOR TODAY: At least there is a light at the end of this tunnel, it's not perfect but it's a lot better than where I've been

BMI about 60/ Weight about 370 lbs. 

Due to Spinal Fusion, 17 years post surgery, and my current weight, my nerves/sciatica are causing me not to be able to walk without a lot of assistance - for the past 3 weeks. If it's not one thing it's another *sigh*

I had a ct-scan to see if I have spinal stenosis (narrowing of the spine) due to the scoliosis/spinal fusion/ or weight gain ... I'm starting physical therapy tomorrow and trying to see about aquatic therapy in the local YMCA. Their lift for those in a wheelchair that want to use the pool is 450 lbs. which is a blessing. I'm currently using a walker for short distances, and a wheelchair for long (I need someone with me 100% of the time)

I couldn't finish the binge eating disorder clinic because of my mobility disability. But I am still thinking of things I *can* do like online and phone meetings of Overeaters Anonymous. I hope things go well for me... my back doctor basically told me if I don't lose weight I won't be walking at all and might die. Also he would never be able to do a surgery on me at this weight - I would die on the operating table or I would have 90% chance of complications at this weight.

That's scary - I'm still on a waiting list for either Albany Medical Center Albany NY (Ellis isn't sure they'll accept someone with binge eating disorder into the WLS program) or Dr. Graber Utica NY. I have an appointment with AMC on July 3rd... hopefully I can start the process but they want me to lose 10% of my body weight first... I can understand why and all but I can't walk, I hope the nutritionist can help me out with that.... Dr Graber has a 9 month waiting list for medicaid (which I'm on since I'm disabled, because of my weight mostly at the moment) 

Still my fiance and family have been very supportive while I'm immobile - my family has taken me in and my uncle says he'll help if I need to go to Albany Med the 2 months I need to heal (well critically...) I hope things go well, my fiance is a binge eater as well so that's going to be complicated, even though he is supportive and wants to get healthy  - he doesn't have the health problems I do, no where near them. So hopefully it'll be enough to change (?) Because I have to change, there is no: if's, and's, or but's... about it - I have to change something. 

 

 ~ Getting ready to do what I can ~

I had to put my WLS surgery on hold again, because I discovered I have an eating disorder. It is not the two you think of when you think "Eating Disorder" it's closer to Binge Eating Disorder. That is characterized as episodes of emotional overeating, past the point of fullness. ..  I'm currently undergoing treatment at  Centre Syracuse for my binge eating disorder.

 

I still know I need WLS but I also know from my research that, having an eating disorder, makes me a very poor candidate for that surgery. That doesn't mean I can't get Binge eating under control, it just might be a little - longer? Which isn't a happy prospect for me as I'm barely walking as it is now with my weight and spinal fusion. I'm in a 6 week program that will supposedly help me decrease my bingeing and focus on the reasons behind why I binge eat emotionally - while teaching me to see food not as comfort or fun or helpful emotionally (subconsciously what I've been thinking) - but as a prescription or medicine I need to keep my body healthy. How to eat in a healthy way while combating what it was that caused me not to eat healthy.

This does NOT mean it will help me lose weight. I've maintained my weight the 3 weeks I've been there. The dietitians /therapists/ psychologists in the program taught me what it was like to "diet" from an evolutionary standpoint - the body doesn't 'get it", doesn't understand that it's supposed to stay at a lower weight. It's made for saving fat not getting rid of it, and they believe that it's normal to binge after periods of intense dieting because that's what your body craves. They also taught me 52% of people do not only not lose weight on diets but gain it back AND THEN SOME. This is something docs dont' want you to know - you really have no alternative if you get to a certain "set point" weight (and your brain can arbitrarily make new "set points" if your weight goes up... but not down unfortunately). WLS is one of the only ways proven in some cases to help you lose weight and keep it off

 

- this doesn't mean it works for everyone (my research from both sides of the argument -  shows about 60% of people do well with weight loss surgery long term) but for me that's a big enough number and 20% (for those that experience serious complications over their lifetime from WLS) is a small enough number for me to do the surgery. I'm not being naiive about it, I know there are serious risks and I could end up gaining all the weight back (and then some)... I saw both sides of the argument for and against WLS and with my health problems they are risks I'm willing to take. I went on websites for WLS (like this one) and many that are against. One of my good friend's mother just died from WLS a couple of months ago. I'm fairly sure she helped contribute to her problems but was it the WLS that did ultimatlely kill her? Yes. I know many who are in the hospital from WLS complications. But then I know those that did great with WLS long term as well. It's a gamble and the sad truth of it is that while there are factors under our control, it's a gamble who will do well and who won't. There just isn't the research into the long term effects yet. But people are still dying every day of obesity related illnesses. So the WLS becomes a necessity for our current epidemic. 

 

Again it's a risk I'm willing to take. But back to Binge Eating Disorder. 

 

I've found through 3 weeks of intense therapy that the causes of an eating disorder are very multifaceted. Some of them for me personally, was my traumatic upbringing, past abuse, the fact I had to "nurture" myself since a young age, and physical concerns (hormones, genetics, back and ankle surgery - physical limitations to exercise), And the program went into the 'addiction' to food caused by increased dopamine in the brain some brains react with high calorie foods. I happened to be that lucky individual in a group that does react that way. I also happen to be part of the 52% of people that actually gain all their weight back AND THEN SOME when I traditional diet (by binge eating - see description above). There's actually has a lot of medical  or scientifically based reasons why it feels like I'm "Addicted" to overeating... of course there are ways to treat it. It involves intense emotional therapy, PTSD therapy, and trauma work. It also involves body image work, and individualized talk therapy with different techniques. And a new prespective about how we view food ... no more 'celebrating' with food (hey good job, want a cookie - type thing) etc. 

 

None of this will help me lose weight, it will just help me maintain my weight before and help me to not regain the weight after surgery. WLS is the only thing that is going to actually help me lose the weight - it's up to me to keep it off. Which is why I've enlisted help professionally with my eating disorder. Binge eating disorder is actually more common than Anorexia and Bulimia HOWEVER it is the least treated or talked about because of stigma surrounding it. I think that's very sad. 

 

Trying to 'get it right' the first time, and hopefully only time I need WLS.  

 

3 more weeks in program *whew* I'm ready. Today out sick because of Obesity related issues, Urinary Tract Infection, and Diabetic Skin Rashes. But tomorrow is a new day, and going back to program.

Just saw my PCP on Wednesday the 9th of January and he gave the okay for the surgery. He said it was time, and he said I really should look into it with the way my back is. I'm getting an MRI done tomorrow to figure out why and how my arms and legs are always falling asleep and I have complete and total incontinance (at times). I think it has to do with my original scolisis when I was 10 (a 90 and 70 degree turns in opposite directions - my spine looked like an S) and the harrington rod/ spinal fusion surgery that year

 

- plus all this weight on top of that - I'm worried I'll be in a wheelchair sooner rather than later and all this pain is here to stay. I'm now 359 and have a bmi of almost 58. I'm frightened but I know I'm headed on the way to do the right thing. So here goes... Orientation the 24th and then we'll see where we're at. 

Just found out my insurance will probably be fine with the lump sum coming in. I called up both insurances (Fidelis and my local DSS Medicaid) since my insurance depends on my SSI, which would go into non payment status as of I believe February with a small lump sum I'm getting from an inheritance. FIdelis is based on Medicaid and has a fairly good repatoir with bariatric surgery (just need a few letters they said from PCP, and surgeon) of course that could be because my BMI is so high as well. AND Medicaid is not going away for 3 months after the lump sum - so if I expend the resource (spend the $$$$) in that amount of time I can keep my medicaid!  Very happy about this meaning I can keep both insurances and they aren't going to be (possibly too much of ) a problem to get the surgery it seems. Very happy about this :-D

My orientation is the 24th of Janyuary with Dr. Hill in Saranac Lake, NY - he's the only doctor around here that will do the DS or duodenum switch - which is one reason he's at the top of my list. Hopefully all goes well *praying* but it looks like this is a really good move to be healthier overall. 

I'm sick - like having the flu sick. I was going to go to Dr. Hill's orientation tomorrow but being honest - I'm sick and it's -35 degrees out. I feel like add your own expletive. And it's also a -35 windchill at the moment that's supposed to last till Saturday. So I'm rescheduling the orientation, because of the flu and I don't want my car to die half way there (I doubt it will but just in case, it is cold). Still going to reschedule, and schedule with the other docs. I usually have the world's worst immune system almost need to be in a bubble I swear to God. So it'll probably be in a week or two. Still going just not tomorrow. 

Places I'm looking into to have the surgery done:

Dr. Hill Saranac Lake.

 - Heard good things

- liked his website (although one computer said it was hacked).

- takes my  insurance

- Close to where I live (50 miles) 

- Liked the online orientation session

- Does Duodendum Switch (DS) only in area except for NYC, which is too far away. 

- Going to Orientation Session in person This Friday at noon in Saranac Lake, NY

 

Dr. Graber - Utica

- Doesn't take insurance 

- Not that close, have to stay with family 

- Is good at what he does - RNY

- I like the pre/post op program, seems stricter but not overly strict 

- Had several consults with him over the years while I was trying to decide, good report 

- Would have to sign up a few weeks in advance for paid orientation / consult for $$$ so for Dr. Graber specifically

 

Dr. Baranov - Saratoga

- Seems very professional, well educated - the best schools

- located close to family, not that far away

- Doesnt' take my insurance I don't think

- Accessible free orientations every Tuesday 

 

Dr. Clarke - Ellis - Schenectady NY

- Free info session Feb 6th (a ways out)

- 6 weeks to 8 weeks to get the surgery booked if all goes well

- busiest in Capital district clinic

- Does take insurance

- Right near family in Albany

 

Dr. Signh Albany Med 

- $50 2 session orientation, must attend both, non refundable. Tuesday/Thursday every other week

- Very Strict Pre Op, Detailed Post Op

- 3 -6 months before surgery can be preformed

- Right near family, best hospital in area (teaching hospital) 

- Must lose 10% of weight on own, for me about 36 lbs.  before surgery can be done

 

Dr. Forigon Fletcher Allen - Burlington VT

- Takes Insurance

- only need 5% loss (15 lbs or so) before surgery

- comprehensive and patient friendly program / website 

- semi close to where I live in Plattsburgh... not sure if I want to go on the lake champlain ferry that sick but it's an option. 

- Very good hospital 

 

 

Thinking of looking into Rochester HOWEVER - it'd be a hike even for my family in Utica area. I've heard excellent things about them however from several sources. 

I'm having insurance problems this year it seems. I'm on medicaid and fidelis but I should be getting at some point in 2014 a lump sum that wouldn't be enough to pay for surgery but WOULD be enough to mess up my medicaid *ugh* just when I really had the motivation to have the WLS too.

I'm not being deterred though, I will get it done it just might have to be pushed back a few months. I still plan on attending the session in Saranac Lake next Friday the 3rd with Dr. Hill. There is no fee for that and I can at least get some questions answered, like which surgery is right for me, how long the pre op process is, what it costs, what I need before the surgery, and what I should do before during and after surgery. I'm a little scared they'll be like "Well why don't you just come back when you can pay for it" I hope they understand I'm trying to at least plan how to do this, and get the ball semi rolling. I guess it depends on the clinic, hopefully they'll be understanding.