Joley

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7-29-06
I received my approval from HMSA-HPH yesterday and I am tentatively scheduled to have surgery on August 10th. Although this seems like a long process for me, I know that I am very blessed in that I received approval from my insurance on the first try. I am a 36 year old woman that has lived with obesity for over twenty years. When I started my WLS journey I was at 298 and 5'8". I started my journey when I was living in Kailua-Kona with Straub.

When I researched WLS, the doctor that I was most interested and impressed with was Dr. Cirangle. Unfortunately, my PCP refused to refer him to me because he was not in the Straub network. The only doctors he would refer me to was Dr. Huang and Dr. Balfour. Dr. Balfour, although very experienced, does not do laprascopic surgery. Although Dr. Huang does do laprascopic, she has very little experience and I think experience is vital with this surgery.

I was thinking I would have to stay with Dr. Huang and I was in the process of getting my tests performed when I had a disagreement with my PCP's office regarding insurance and payment and my PCP decided that he no longer wanted to support me in my WLS. He kindly wrote to Dr. Huang's office and they informed me of his decision to drop me as a patient. I was devastated, especially since I only had a small window to get my surgery completed and had already gone through all the tests and was just waiting for Dr. Huang to send my referral for surgery to HMSA.

Well, it all turned out to be a blessing. I had called Dr. Huang's office in search of a Dr. that was WLS friendly and every doctor that they recommended was booked and was not taking anymore patients. At that point, I decided to try Dr. Cirangle again. I called what I thought was Dr. Cirangle's office number and I got his personal phone. He was extremely helpful and recommeded a great PCP, Dr. Robert Schiff who he works with regularly.

I switched from Straub to Hawaii IPA and scheduled my appointment with Dr. Schiff. Meanwhile, I also asked for a friendly phychiatrist and ob/gyn, because I still needed to do those tests. Dr. Cirangle recommeded Heidi Kiyoto and Dr. Schiff recommeded Dr. McNally. I completed all my tests in the same week and got my referral from Dr. Schiff right away to see Dr. Cirangle.

He then sent in my request for surgery right away to HMSA and within two days, I was approved. It does need to be said that I took responsibility for my medical records and followed up after every step to ensure that everyone got what they needed and understood my situation. I was very lucky that everyone was very cooperative and things went much smoother once I switched PCP's and surgeons. I guess I should have followed my first instincts and stuck with Dr. Cirangle.

I also think it is important to note that I also decided on a different type of WLS. I have decided to go with the Verticle Sleeve Gastrectomy. I had read about it prior to deciding on the RNY, but I was under the impression that it was only a step toward the DS. After attending Dr. Cirangle's seminar at Pali Momi, I learned different and was able to talk to several of his patients, who ranged from over a year to one week post-op.

I was extremely impressed with the results and discovered that the VSG is showing the same level and better results in long term results as the RNY without all the malabsorbtion and dumping. Although VSG can have dumping, it is very unlikely and I will be able to eat relatively normal. (Keeping in mind my healthy lifestyle changes in food) The best thing about the VSG is that it removes 3/4 of the stomach and with that goes the ability to produce the hormone Gherlin, which causes the hunger sensation.

That was my biggest fear with RNY. I had read several profiles of RNYers that were struggling with their hunger and I know that would be a struggle for me and don't think dumping would deter me enough when I am hungry. So I have decided that VSG is the right option for me. I also wish more surgeons knew about it and wish it was discussed more on the main message board, so that I could have learned about this as an option sooner. With that being said, I am now in waiting mode and trying to prepare for my hospital stay.

My hospital stay will be in San Francisco, CA and I will need to travel from Oahu the day before surgery. This brings up another topic, Dr. Cirangle's fee. I have read several posts that about his fee and although $4000 is a very large amount of money for me, I believe it is worth it for me and it is a small amount to pay if I am getting his expertise and his aftercare. The program also covers the expenses for the hotel and air for myself and one caregiver. Having those expenses taken care of relieves my mind and I get the pleasure of visiting San Francisco, even if it is for a very short time. ;-)

8-7-06
The time has come. I get on the plane early tomorrow and I am headed for my new life. I will be arriving in San Francisco and will have my surgery on the 10th. Oddly enough I am not nervous at this time. It may just be that I've exhausted that energy and I am now just focusing on the minute to minute stuff. I have all my bags packed and have all my papers in order. I have also talked with the necessary family members and made sure that they know what my wishes are if something should go wrong. Not that I think it will, but it is a necessary task that needs to be done. I have weighed my options and reflected on what has brought me to this place and I have decided completely and without any doubt that this is what is best for me.

I know that I will still have demons to deal with and that I will need every bit of remaining strength that I have to deal with them, but I also know that I would rather deal with these demons than the ones that hold me back from living and keep me trapped, weighted down, and in a morbidly obese body.

I do not mean to sound so dark, but I know that this is what I feel inside and to deny it is to deny what has brought me to this place. I also know that the light will shine in a few weeks as I begin to shed my burdens. Every pound that I release will allow me to release the chains that prevent me from living. I will soon be free to be the person I was meant to be.

8/15/06
I arrived back from San Francisco last night and I am doing pretty good. I arrived in in San Francisco on Tuesday of last week and we went directly to our hotel, Cathedril Hill. I was really surprised at the condition of the hotel and felt that it needed an update and a good cleaning badly. I am not generally very picky, although I don't like to stay in slums; but considering I would be staying there after surgery did concern me.

I was also surprised that the hotel did not have any small refrigerator to store all my fluids. We had to keep filling up the ice bucket and keeping water cold that way. The beds were also worn down and I just kept visioning all the germs crawling all over it. If you can think of that commericial that has the guy jumping into bed and suspends him just above it as he sees all the slim and germs that are in it, you will have a good idea of what was going through my head. The only other thing I will say is the tv only had about 8 channels - which was frustrating when I was stuck in the hotel alone while my companion got something to eat. Okay - enough about the hotel.

We had the pleasure of arriving a day early, so we were able to go to union square and walk around. We also visited LAPSF office for my pre-op appointment. My appointment was scheduled for 3:00PM and we arrived early so I could chat with the nutritionist and get some supplies. I should know by now that it rarely pays to go early. We were stuck in the office waiting until 7:30PM that night. Actually - make that the waiting room of the hospital - the office closed and we were asked to wait in the main lobby of the hospital. Dr. Cirangle emerged from surgery and he looked beaten down. He had to do a third revision on a patient that had two lap bands (seperately). Unfortunately, the previous doctor that the patient had really screwed her up (info given by the family of patient). My heart went out to that patient - she was unable to do the VSG in the end and had to have Gastric Bypass. The thought of what she was going through just about made me want to run out the door and say forget it. But I realized who I was having surgery with and realized that if he can repair the damage that was done (hole in stomach and stomach growing into the liver), then he can surely performa simple VSG on me. I put my faith in him and it all worked out.

The next morning I went into surgery as scheduled and everything went very well. I had my surgery on 8/10 - Thursday and everything was pretty much a blur until Saturday. I really have a hard time distinguishing between reality and dreams. I guess morphine will do that to you. I do have a memory of trying to get down my first bit of jello and having a gagging fit beyond anything that I have ever felt before. I am not sure who gave me jello and why so soon after surgery. I do not even know why I would try to bite into it. Let's just say, I have not had any jello since. But, I am not ready to give up and might give it another try within the next couple of days. I want to feel like I am actually eating something.
The hospital stay was wonderful (as far as hospitals go). I did not want to go back to the hotel because we had a private room and my bed was so comfortable. I also had a wonderful nurse "Ana" that stayed an extra shift to "see me through it." She took wonderful care of me and made sure I was comfortable at all times. I was spoiled.

Right now I have had lots of protein drinks and soups. I really enjoy the Nectar teas and I like the protein soups. Some of the drinks from Healthwise are starting to taste too sweet to me.

As far as hunger goes - it is all head hunger and I know because my stomach feels full. But I kept dreaming about donuts and cake all week. And of course everywhere I turn there is some advertisement for cake.

Warning - the following paragraph may cause disturbing images and nightmares!!!!!!!!!!!

Even on a program I was watching "Twenty good years" they had this cake. Let me go into a little detail here because this is my fantasy right now - which is really sad and disturbing. It was one of the character's birthday and he was drunk. Well, he wanted to cut his cake and he decided to use his hand. All I could see was his hand sliding down the cake to the center. But I could feel the moistness of the yellow cake and the creaminess of the milk chocolate frosting. Oh my, my mouth watered so bad I think I literally drouled on myself. And of course I am on the plane coming home and can't escape this picture. I could almost taste the richness of the frosting and the delicate moist yellow cake. In my mind that was one of the best cakes I have ever seen in my life. It was a simple layered yellow cake with chocolate frosting. Did I mention that it was milk chocolate that was so creamy it was to die for. Oh - that's it - to die for - that is why I had to do this, because I am willing to die for chocolate frosting. I had to do this because I cannot control my desire for chocolate frosting. All the other pleasures in life and I am willing to die for chocolate frosting. I want to say it is not worth it - but I am still struggling - I am still wanting that bite. I want to say just one bite - but I can invision my whole face diving into the chocolate frosting and biting into that delectable moist yellow cake. What the hell is wrong with me? This cannot be normal behavior - am I that pathetic of a person. Okay - moving on from the chocolate.

Regular viewing may continue ;-)

On Sunday I was able to take a cab into union square and try to get a little more shopping in before heading home. My first stop was Macy's and while admiring all the beautiful clothes that I would one day be able to fit into and look good in - I had a moment of sickness. I felt like I was going to pass out and had to make my way to the bathroom where I sat until I recovered. After that I walked around for about another hour in a half (with lots of stopping) before heading back to the hotel.

On Monday we flew back in and the flight went pretty well. I had some discomfort, but nothing major. We came back in the evening so we went to sleep soon after arriving home.

So, here it is Tuesday and things are pretty good. As long as I keep the pain under control the better I can move around and get my blood flowing. I was able to get some popsicles, which helped the head hunger and the desire to have something solid in mu mouth. I will be taking another pain pill shortly with the hopes that I can go walking a bit. The best news of the day is that I am down to 279. Did you get that - 279. Let me say it again - 279. Yes that is large - but I have not seen that number in so long that I cannot even remember. It is all downhill from here. But of course I know I will have my speed bumps.

8-24-06
I am exactly two weeks out today and I am at 266. That is 25 since surgery and 32lbs from the start. I told myself when I reach 265 I will put the scale away. I almost think I will miss it.

I have felt pretty good. I have noticed that I feel antsy when just sitting around at home - could that be more energy. Is that what energy feels like. What a strange sensation to want to get up and do something. I even raked the yard the other day. How weird.

I went for a job interview yesterday (the second interview with them) and they offered me the job. I start on Wednesday. It will be so nice to be back to work.

My only problem is my eating. For the past two days, my upper stomach has felt swollen, overfull, and pushed beyond its limits. I have had a difficult time getting in any fluids and a much harder time just getting in my protein. I thought that I needed to just eat some food, give my body something to digest - what a stupid thought. (I guess that comes from my desire to eat when I was not feeling well). I tried a bit of food last night (3 small bites of refried beans) and ended up following it up with some hot green tea to help move it through. (Of course I waited 45 minutes before drinking)

This morning wasn't too bad, so I thought I would try some scrambled eggs. Man, I wish I would have just drank a protein drink. I usually love my eggs, but this morning they tasted like something was missing and when I was done I was in bad shape. I felt like I needed to throw up, but it would not come up. So it left me with a nauseous feeling. I am still trying to figure out how to get this feeling to pass. I do know one thing, no food today - just liquids, protein and water.

And I was doing so well. Maybe tomorrow, but I will do my protein drink first. That way if I get sick at least I already got my protein in.

9/9/06
Tomorrow is my one month anniversary and it has been an amazing day. I weighed myself this morning and I am now just barely below the extremely obese - I am now obese. I love it. Then I went for my doctor's appointment and was weighed in and I actually lost a bit more than I thought. (But to stay consistent I will stay with my weight on my scale)

Then, as if that was not enough, I went shopping and discovered that I now fit into a size 20 from a 24. It was wonderful. I love it. Things have been going pretty well and I have been doing pretty good with the foods that I do eat. Although i do recognize that I have not been eating enough protein. I will still keep trying and I know that I will have to drink some protein supplements as well as eat my meals.

9/24/06
Okay - so today may not be the best day to update my profile; since, my state of mind is not in the best place. However, for those who read these, it is important to know that there are some thorns in the rose garden. I have been doing really good and I can consume just about anything that I want to. This is good and bad. I have been experimenting this weekend and unfortunatly I have tried some food that is not so good for me. I like it and I ate it. Yes, I had a shake and I had a Jamba Juice. Way too many calores and carbs. This has caused me to backslide.

The worse part is that it has caused me to feel terrible in every sense of the word. My body feels terrible because I have not gotten in the nutrients that I need - primarily protein and I have not gotten in enough liquids. Then my mind and heart feels terrible. I am disappointed in myself for allowing myself to consume such bad foods this weekend. I know what I need to do and tomorrow will be a fresh start. It is time to up the fluids and up the protein. So tomorrow will be primarily protein drinks and lots of water.

10/11/06
I am the worst at updating my profile. But here goes. I am now eating what I should be. I have a protein shake in the morning. Although I do blend the Nectar Peach with some frozen fruits - mangoes, papaya, strawberries and pineapple - YuMMMMMM!!! I know fruits are not necessarily recommended, but I feel that there are more benefits to fruits and it is worth it for me. I will then eat a small snack (if I remember, which only happens about 2x per week). My snack is usually a boiled egg or some rasberries.

Then for lunch I will eat some lunchmeat with some cheese. I will also have grilled salmon or chicken. I will then have a Nectar tea in the afternoon. For dinner I will vary with all different kinds of protein meats. We do eat out sometimes and I always find something that I can eat that is grilled and primarily meat. I stay away from rice, pastas or any starches. I also try to make sure I get in some dark green veggies.

We just purchased an eliptical trainer and I realized how weak my legs have gotten since the surgery. The first night I only lasted five minutes. That was horrible and I could not believe how much pain my legs were in. But I am now doing 15 minutes at a time and it is the third day. I am determined to reach the 30 minute mark soon. I want to build up my thigh muscles and butt muscles again. Especially since I feel my butt is melting away and i have always loved having a booty I can shake. LOL.

Life is great and I am very glad I chose the VSG.

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