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I go to see my surgeon tomorrow for what i hope will bring me closer to my surgery date!. I really hope he is going to give me my Date when i do see him and not make me come back to see him in x amount of months of what have you to met whatever goal he sets that he thinks i need to meet for his personal reasons to do the surgery on me. so i am feeling many things excitement being one of the top but hand in hand with nervousness. 

 So on June 3rd 2015 i had my appointments to talk to the pre-surgery consult and the psych evaluater . This was neat appointment for me since i am about a hour drive away from my health education building in Fontana, I was able to get both Meetings in the same day one right after another. I know for some people these are not always scheduled the same day and can be done days/weeks/or even a month apart from one another, well not common it isn't uncommon so i was very happy to be able to get mine done all in the same day only hours apart. So for sake of having some times lines as to how long this is taken me and who i am going through and all the questions i know i was looking for when i started my journey i am going to type out a sort of time line guide i wish i had really kept up with. So maybe this might help out some one else who is reading this or maybe just give some insight on my personal journey so far.

Insurance: Kaiser

who sent me to start the options program : my OB/GYN specialist [ I was inquiring while i was pregnant and he said he would send in the request for me to get started after my pregnancy, uncommon i know but that's how it went lol]

very first appointment: 4/15/2014 this was the class where they talked about all the classes they offer that you have to pay for and they did not really go into any detail about the weight loss surgery classes til the very end. When they did talk about it they only mentioned that it was available and that you could go sign up for it after this class in the lobby so that is what i did. once you sign up for it in the lobby the receptionist will give you a number to call and i had to wait til the following week to call and set up an appointment with the consultant for the options class. 

5/7/2014 Options class Consult visit:  this is the meeting i had with the person who would decide if the options class was right for me and to go over various other tips that might help with weight loss. I had a few of the co-morbidites of the qualifications to go to that class which some are : Diabetic, high BMI, and weight related pains. We talked for about 30 mins and then i was told that i was good for the classes and that i would be contacted from some one to make my options appointments. He also set up a Sleep test for me on this day.

5/13/2014 Sleep study:   My initial sleep study was scheduled for pretty far out when they first called but i requested to be placed on the on-call list so that if any one canceled i would be asked to come in so on may 13, 2 hours before the study was to take place they called me to let me know some one had canceled and so there was a spot that i could take.  I had time to take my own pillow and blanket and anything i wished to sleep in i also took a bag with my hair items hair brush  rubber bands etc and tooth brush and tooth paste. I got there just in time and was asked to change into my pj's after that two women came in and started placing the nods all around my head. you are hooked up to a LOT of wires and before they place each wire they scrub each spot very roughly before sticking it on with adhesive it ended up hurting my skin causing small scabs about a day after. so if you have sensitive skin...this will suck if you are required to take it. the bed i had to sleep on was very stiff and being stuck to all the wires doesn't really make this a night you are going to get the best sleep of your life. they have you lay on your side or back and they make you try out the c-pak machine to let you know if you stop breathing at any point that you are there they will come in and hook you up to it. thankfully i passed. I had very horrible sleep and i was so tired the next day so you might want to have scheduled nothing to do if you end up going home in the morning so you can catch up on some sleep. 

5/16/2014 Binfo class:  this was the class they send you to to give you an over all kinda view of what is going to happen in the Options classes. From the attendance policies to the seriousness of the surgery and answering any questions you might want to know before going into the classes. they then give you a number to call the following week to set up your classes. 

5/20/2014 first Options class with DANA STARR COLBERT: this was my very first Options class where they weight you and start going over the contents of the green binder they give you. you need to bring this folder with you to all 12 classes. every time you come you will then weight yourself and write it down. they will tell you the system of how things work, in my class you had to sit through the entire class and turn you slip in at the end. you also had only 2 times to make up classes imminently if you miss a class. you could only be 15 min late or you could not check in at the receptionist area to go to the class. you were not allowed to leave early or it would count as an absence. they give you hand outs every weekly class and they are as follows:

1. Introduction to options/program goals
2. surgical and medical information
3. getting to your personal why/reasons i eat
4. food plan overview: pre-Surgery Part 1
5. Balanced fitness
6. food plan overview: pre-surgery part 2
7. embracing change
8. meal plan review
9. understanding surgery/ vitamins and minerals
10. eating post surgery/ vitamin and mineral review
11. communication / choices and taking responsibility 
12. ongoing lifestyle changes

in this class you will get several hand outs that you MUST MUST MUST keep nice and safe for your entire time in the options program. some of the more important ones are : 

• Support group meeting verification
• patient Pre-operative check list- bariatric surgery 
• Bariatric Health education paper with requirements that need to be met per your personal needs to meet them
• Bariatric Surgery vitamin & mineral supplements Pre-op Vitamin supplementation 
• The Attendance Policy
• List of suggested Support group meetings 

those are just some of the things i got in my first class which changes as they modify the program as they go along. so this is my personal experience with Options. 

my classes ran from May 20th 2014 to Aug 5th 2014

5/29/2014 Mandatory Labs:  Once  you are given the "green light" you will be allowed to go get these tests done. trying to get them done before the teacher of the class tells you to will not work because they have to put in the requests for every one in the class to get it done. All these tests must be completed before graduation, otherwise you will not move forward. 

• you will not be reminded or called to complete your testing
• tests can uncover vitamin or mineral deficiencies which can take time to treat. Deficiencies will be treated with medication in addition to the supplements recommended in class
• for a safe surgery your medical conditions must be stable. this will be evaluated by your bariatricians Twice during the options class 
• Bariatric surgery requires lifestyle and behavior changes. your mental and emotional readiness will be evaluated by the mental health team AFTER you complete the classes
• all weight loss surgeries will be performed at St. Bernardine's Medical Center with Kaiser Permanente surgeons; Surgeries may be preformed at other locations if necessary.
• if you are currently taking NSaid's you need to talk to your PCP to talk about discontinuing it 
• you must complete one support group meeting 
• additional medical/cardiac clearance and other tests may be required , you can be notified by phone or letter.

The tests you are going to have to complete are :

• H. Pylori Stool test
• Lab tests [blood,urine,stool]
• EKG/ECG
• Chest X-ray
• age appropriate colon/breast/cervical screening

its important to let you know that there are "expiration" on the chest X-ray and the EKG and the Sleep Test. I think its in 4-5 months then you have to retake them again. you also have to have a 12 hour fast before the blood tests.

  

6/9/2014  part 2 options consult visit: i had to go and do a check up with the same person i saw for my first options consult visit to see how i was doing in the options classes and to go over any new information i had to offer and to see if i had taken any of the suggestions we discussed and applied them to my life. 

 

8/4/2014 After my last class i got a note in the mail stating that i had low iron and my A1c was to high to continue on and i had to get that under control before i could move forward. I also had to work on my Iron.

 

it took me til 5/13/2015 to get my A1c where it should be. if you had read my previous blog entry i mentioned i had had a bad year 2014. My cousin who was more like my sister passed away unexpectedly and traumatically. It really set me back and affected me badly. I stopped trying to get my A1c in order i stopped trying to continue in the program and i begin to just eat what i wanted. I have never went through something like that before and i was not prepared for the toll it took on myself. I was already dealing with my baby being born 1 month before his due date and the pregnancy hormonal dump on top of that and towards the end of the year he had stopped breast feeding this all culminated in me gaining 40lbs from my options class. it made me feel horrible and scared that i wasn't going to be able to continue in this class, i felt like i was slipping to far and that they would tell me i need to redo the class, i had to get over that and through the help and support of friends and family i started to pick myself up and get back on track. i talked to people about my loss and my guilt on the gaining of weight and i started to work on tediously controlling my diabetes. i had been still going to take my labs to monitor my a1c and it was steadily going down. when i realized i was getting closer to my goal i called back to the weight loss education center and started going over anything else i needed to do before i met my goal. that's when i found out that i needed to redo some blood work and the ekg/chest x-ray. I ended up getting that done 5/14/2015  but I couldn't get my EKG done til 5/27/2015  that same day i made a walk in to the weight loss health education center and asked to talk to the women in charge of moving me on the the next stage, it had taken so long that i was worried i was just paper work that was going to be left around. I also didn't want to play phone tag with her which was something that has happened before. that same day after a LOOOOOOOOOOONGGGGGGGGGGG round and round conversation with her we came to the conclusion that i could move on to the next step. 

6/3/2015 i was able to meet both doctors, the last consult for determining which surgery i wanted and the psych evaluation. 

Consult: i came in early in the morning and was the first one to see her that day. i was taken back to a room where my vitals where once again got. when Dr. Turner came in we talked a bit about why it had taken so long, she examined my belly asked me about my non existent gallbladder and looked over my belly and listened to my lungs. we then went to her office and she said that she thinks that the best surgery for me is the RNY. i agreed and then she said she was going to send my docs to my PCP pending my psych eval.  over all it was a nice and quick 30 min visit.

 

Psych Evaluation: right after the consult I waited to meet the Psych Eval. Doctor. she took me back to her office where we talked for roughly an hour. I know this is the one meeting that a lot of people get worked up for because its not something that is the same for any one, it all ends up depending on your personal life style and what your doctor asks. While i was there a few things she did ask were  

• "how do you cope with wanting to reward yourself with food"
• "do you have people who support you and who are they"
• "do you have people who have had the surgery that you talk to" 
• "have they been successful " 

mostly she just let me talk to her about how i felt about the surgery that was going to take place, why i waited so long, if if i had reached out to any one in my stages of grief over my cousin, i answered as honest as i could and listened when she had advice to give. there were no set questions or tests she was a very nice woman who i felt very comfortable with and at the end of the time we had she told me " i don't see any reason why you shouldn't continue in this program" so that let me know that she was on board to send everything to my PCP.

 

on 6/3/2015: i sent my PCP a email through kp.org and let him know that i had completed everything that i could and he should be expecting my paper work from the bariatric program and when he got it i would appreciate it if he could let me know when he sends it back so that why i could continue. My doctor has seen me several times and worked with me get to my a1c goal he knows how important this is to me and how hard i have been working to get to where i need to be. he never tried to discourage me and thought it was a good idea too.

6/4/2015 : my PCP being very awesome responded to me that he had gotten my paper work and has already sent it back to the health education center.

 

so that is where i am at as of 6/6/2015 i plan 6/9/2015 to call the center and see where i am now with them and how i can keep things moving along. I think its very important to keep calling your doctors and keeping up with your files to make sure you don't get set on the back burner. I only have til Aug 5th for the surgeon to schedule my surgery, I've been told that as long as he has it scheduled even after my date that i will still be able to go through with the surgery. i am excited and nervous and waiting feels like minutes are years but i have made it this far and even though i never could visualize it the finish line is right in front of me. Wish me luck...i know this was a LONG post but I hope it can help some one who's looking for anything that might help them here. I know when i first started i had so many things that i wanted to know about this program and the steps it takes. my steps were a long way around and there are many people who have completed this in shorter amounts of time then i have so i hope i didn't discourage any one. If you have any questions that i didn't answer and i might be able to ask away!

 

FINALLLY i have gotten my A1c to a 8.0. So this up coming Wednesday i am going to FINALLY go to my psych evaluation and then a pre op. consultation. I am excited and nervous, i just want everything to go right since all of last year was not to kind of a year for me. My "cut off date" Aug 5th is fast approaching and it would be nice to get everything i need for my surgery done so i can continue with it. I would really like to know what else is going to be required of me like losing weight asked by the surgeon or if there will be liquid diets etc.. it kinda sucks not really knowing whats going to happen and having a vague guideline that's like a "one size fits all" time line.  

I am coming up to my half way point on my classes. we have gone over risks, portions, physical activity, have gone and got a lot of lab work done and of course i did my sleep study early and everything with that was fine. also my EKG was good. the only thing now that i have to work on is my A1C levels and get the under 8. if you are a diabetic you have to have them under an 8. My iron is really bad as well so i have to take 3 pills a day while making sure i don't conflict with any other vitamins i am taking now like my calcium and i got prescribed a super dose of vitamin D that i have to take 1 pill a week for the next 8 weeks. Other then that i am just attending the classes and trying to absorb what they are telling us in roughly 1 hour. i am trying to keep up with my walking schedule and other activities i do so i can lose some weight before the surgery, now they keep saying " it is not required to lose weight" but then in the class where we were being taught food calorie counting and the like she dr. said that we should lose 10% of our weight ... i am trying to any how but i can see that being conflicting for those who have been repeatedly told what i was/am being told. also we learned that they expect the women to be down to a 1200 calorie intake before the surgery so that way its not a shock when you begin to eat again. 

      its odd how fast and still slow everything seems to moving. the only thing i  cant get done right away that i would like to is you have to go to at least one support group meeting and get a paper signed saying you attended, well the only one in my area goes on the same time i am supposed to be at my options class, so i have to wait til the classes are over to go to one of them and the lady who was teaching stressed that its important to get it done and signed because sometimes that can cause a hang up in getting your surgery date. I am trying so hard to make sure i can get my surgery done before the end of the year even though that seems so far fetched...just the idea of getting such an evasive surgery in only 5 or so months. here's hoping though. 

Finally got Kaiser Permanente. I've already had a consultation and was approved for the "options" program. I was told I was going to need a sleep study and it was scheduled far out like 3 months away, however I opted for them to call me last minute should anyone cancel AND of course some one did. So on May 13, 2014 @ 7:15ish at night I got my call to go in for the sleep study last minute. I arrived in the Kaiser fontana sleep study area and was told to bring things I would be comfortable sleeping in button down if possible and was hooked to an array of wires. TIP: pee before all this happens, ask and just try to go lol. Lights out are by 11pm and it takes 30/45 minutes to set everything up. It's a small room and the beds are not bad but not comfortable. Me I tossed abd turned all night. And bad news if your a stomach sleeper. Got to go home by 6:20 ish in the morning. 

Skip to May 16th 

BINFO orientation class. This is the first orientation class you go to before you start "options" which are the official 12 classes needed in order to get bariatric surgery. Binfo is about 3 hours long and you can bring a guest. They go over the 3 surgery offered. They also try to answer questions like how long the program is. What type of labs are required of you. Where you have to travel for surgery and doctor consults. They give you that opportunity to think seriously about taking the next steps into the program and if you are serious continuing onto the options program. That going through this program things have also changed from what it used to be so a lot is required on your part if you want to get everything done asap.

I am hoping that soon, 6 months worth of soon, i will be able to really be on the road to seeing if and how i can accomplish my WLS goals. I am waiting now with in these 2 weeks for some one to contact me to start the 6 month monitoring process of my weight and diet plans. we will see....