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For some reason the Major Tom song keeps running through my head everytime I talk about the countdown....::sings:: the count goes on...four, three, two, one.

Anyway, I went to all my pre-op appointments today. First I met with the PA, Chris, in the surgery department. He did a physical exam and answered all the questions I had about the surgery itself and about any complications after surgery. Then he gave me my prescriptions for Urisoidol and after surgery pain meds. Next I met with the department RN, Patti and she went over the pre-surgery showering, where to check in, what my dad should do while I am in surgery, had me sign some forms and gave me some booklets and packets on the surgery.

My next stops were in the pre-admission department where they took blood....and thank goodness they did that first cause I had been fasting since the night before and I wasn't so much hungry as I was thirsty. After the 9 tubes of blood, I met with the pre-admission specialist who had me sign some forms regarding my stay and whether people could call and ask for me. After the specialist, I met with the anesthesiologist who went over my medications and medical history and talked about the anesthesia with me. The cute pharmacist, Dave, was up next. He reviewed my meds and vitamins and let me know when I should stop taking them before surgery. I was released to go get some food at that point and after lunch I went back to pre-admissions to meet with the final car on the train, the RN. She was super nice and like everyone before her, asked me how on earth I qualified for surgery. I told her my BMI is over 42 and that I have sleep apnea. She was shocked. She said,"you carry it really well" and she couldn't believe my BMI is that high. I told her she wasn't alone and I have gotten that since I was a kid. So that is the end of my pre-admission surgery train. At this point, the only thing between me and the surgery is time (and my ability not to gain 10 lbs in the next 10 days).

Stay tuned for more as it comes...

So the countdown continues and I am 11 days 'til surgery today. I have been nesting like crazy. I have acquired the following in preparation:
baby spoons
toddler sippy cups
2 extra nalgene bottles
4 blender bottles
protein sample packs in lots and lots of flavors
protein jello shot from my RD that has 15g of protein in this tiny little jello shot
tiny glass bowls that hold 1 cup of food with lids
little ramekins that hold 1 cup of food with lids
heating pad
gas-x strips
tylenol (used to be an advil junkie)
various water flavorings
various extracts as recommended by RD
torani SF syrups
SF pudding
SF jello
SF popsicles
digital food scale
home ice cream maker to make protein ice cream recipes from the world according to eggface
several tubes of lip balm for the hospital stay
biotene mouthwash to help with drymouth
smooth move tea
digestive enzyme pills
various herbal teas
broths
juices
greek yogurt
Brita water pitcher
blender
fresh tube of neosporin
peppermint essential oil to help with possible nausea
alcohol swabs to help with possible nausea (sniffing them is supposed to help)
extra measuring cups, spoons, shot glasses
flushable wipes
loofa on a stick
and finally...a coffee maker for my dad who will be coming in to town to take care of me and cannot go a morning without several cups of his joe (I like the smell, but hate the taste).

I had my last visit with my RD before surgery yesterday and she pleasantly informed me that I do not have to be on the pre-op liquid diet at all. She said the surgeons decided that only people with a BMI over 45 need to be on that diet and since mine is only 42, I am exempt. Rebecca also told me that the research on fatty liver syndrome and shrinking your liver before surgery has been inconclusive so the docs decided only 45 and higher needed to do the diet. I know she was expecting me to be super excited about this but I was actually kind of disappointed. It has been extremely difficult to eat the foods I feel like I need to say goodbye to but still not gain ANY weight. I am proud of myself for being able to balance that and now that I think about it, I should be looking at this as practice for the rest of my life instead of being disappointed. I really just need to keep my mindful eating in check...keeping the unhealthy foods in check, listening to my own body and not overdoing it.

The last food on my funeral list is macaroni and cheese. I like the boxed kind but what I am really talking about is the gourmet kind that I consider myself an expert on. The best mac and cheese on earth comes from this handmade cheese shop in Seattle called Beechers. The second best mac and cheese on earth is from right here in Wisconsin at Kate's Pizza Amore and that's where I plan to make my final pilgrimage next week.

I've been thinking that maybe the last weekend before surgery I should go liquid just to help clear out my system. I know there will be a lot of cleaning going on as well! Stay tuned for more as it happens...

Yesterday I had an EGD (Esophagogastroduodenoscopy) test as part of my preop appointments. They asked me to do a quick physical in the morning with a Nurse Practitioner and I certainly will not be going back to her again. I didn't care for her personality, which is besides the point, but when I told her I was having bariatric surgery (I had to explain what VSG was to her) she asked,"How did you ever qualify for that surgery?" I know she didn't mean it as a negative comment...actually I'm sure she thought she was complimenting me but I felt like it was kind of inappropriate. She met me for all of 30 seconds before making that comment. She has no idea what my life has been like, what other medical problems I have and so forth. I constantly get told by people that I carry my weight well. I tell you though, being inside my own body and carrying this weight around is not an easy task. I am bottom heavy as I've said before and because of that, I do not let the girls out (my legs). Ever. The fact that I have a photo on my profile here of me in shorts is a HUGE leap forward in my confidence that this surgery will be the tool I need to help me. I am thinking about taking another photo that shows how when I stand with my feet together (after some adjustment to get my feet together) there is no gap from my thighs all the way to my ankles. Anyway, enough of that sob story. I don't need to justify my choice to have this surgery to anybody. 

The EGD: I don't remember anything about the test itself, at all. I actually even doubted they did anything cause I felt perfectly fine when I came around from the anesthesia. I shoud explain that this procedure involves swallowing a tiny camera on a flexible tube that allows the docs to get a good look at the insides they are preparing to hack apart. They took a look at my esophagus, stomach and the first part of my intestines. There are photos in my medical record that I can see and I gotta tell you, I look as cute on the inside as I feel. They had me fast for 6 hours before hand which ended up being more like 14 hours since I didn't want to wake up super early for breakfast. I checked in and they got me situated in a hospital bed. This was the first time I have ever even laid down in a hospital bed and I gotta say, it was pretty comfortable. They got me hooked up to a monitoring machine and put an IV in with some saline dripping (again a first for me). The IV was about the worst part. Once my time came for my test, they wheeled me in to the procedure room  and made sure I had oxygen in my nose and that my bp and heart rate monitors were working. The technician sprayed some cherry flavored numbing spray in my throat and they asked me to roll onto my left side. The nurse injected my IV with something to make me sleepy (my chart says Fentanyl and another drug that starts with a V but I can't think of right now). She said I wasn't sleepy enough so she gave me more and that my friends is the absolute last thing I remember about the procedure. Next I remember I was being wheeled out and when I got to my room again, they had me drink an apple juice. When I finished they said that was the test to know if anything went wrong. I vaguely remember the doctor coming to talk to me about how it went. He said everything came back normal and wished me luck on my upcoming surgery. They took out my IV and had me sit and then stand and then slowly walk to make sure I could. I felt pretty ok from then on...like I was drunk. A little happy and I had that lightheaded, carefreeness that comes with being drunk. My friend walked me home (I live literally next door to the hospital) and that was that. My throat is still a teeny tiny bit sore but nothing to write home about. Stay tuned for more fun pre-op stuff next week as the countdown continues!

It took 3 weeks to get my surgery date but I finally got it! June 11th sounds like a great date for a new chapter of my life to begin.

I was on an emotional rollercoaster the whole time. When I first got my approval I was ecstatic. Then the fear set in and I had butterflies in my stomach for the next week. I was going through that Oh My Gosh am I really doing this phase. Then I got angry. I mean really grumpy all the time snapping at everyone angry. That lasted about a week. (a little fyi tmi...I don't have a period so I don't attribute my mood swings to that) I didn't want to read any posts on here cause it just made me jealous of the people who were moving along smoothly or who were complaining about not losing fast enough. Finally in the last week of waiting for my surgery date, the calm set in and I got back on track. I had been eating things I wasn't even hungry for just because I knew they would greatly reduced after surgery and I really was feeling awful about doing that. I had a visit with my RD and she assured me that what I was going through was normal but the fact that I had gotten myself back on track and was maintaining the same weight since I first saw her was a positive indication of my future success.

So now I am less than a month away from being sleeved (as long as I don't gain any weight or take up smoking according to the docs office). I am in the calm but still get nervous and excited at the same time. I have been trying to focus on the things I can control and not worry about the things I can't. I have been reading a bunch of books, taking my vitamins, making sure to get in 10,000 steps a day and drinking my minimum of 64 ounces of water. My father is going to fly in for my surgery and I have a little bit of anxiety about that cause he snores and my walls are thin. I feel bad that his first visit to my new home is to take care of me. I don't know how much sight-seeing I will be up for once I am post op but I am guessing not a lot.

APPROVED!

I work for a hospital as a medical photographer and we are responsible for taking all the photos a hospital could ever need. Tonight was the annual Bariatric Ball held for WLS patients. Some 400 people were in attendance this year. I was not supposed to be the photographer at this event but in a twist of fate, I was tapped last minute for photo coverage. I am so glad I went too because the department secretary was the one checking people in and I had been talking through emails earlier this week with her about my packet being sent in for approval to the insurance company. I wanted to check it got sent and see if she knew how long I should expect to wait. She told me that it was submitted last week and we should be hearing something this week. So anyway, when I saw her she double checked my name badge and said "Oh, we got your approval today!" I'm pretty sure the next thing that happened was I squeeled and gave her the biggest hug while tearing up. That put me in just the best mood for the rest of the night. She said "you won't be able to work this event next year because you will be in attendance!" I checked with her three times that night to be sure she had my name right. She said she remembered me specifically because she honestly didn't think I would get approved because of a kink in my required dietician visits. She also remembered that I moved to Wisconsin from Hawaii (it makes me really memorable around here, lol). She assured me she had my name right and encouraged me to talk to the PA Chris who handles pre-ops. I told her I didn't want to bother him while he was at the event having a good time and that I would check in next week. Once he gives the ok that I don't need to jump any more hurdles like quitting smoking or meeting a weight goal (neither of which apply to me) I will get my surgery date!

So now the reality sets in. She said because of my choice of surgeon I will be having the surgery sometime in May. I am hoping for late May since my work schedule won't be condusive to time off before that. I know most people are anxious to get the first available date but I need this to fit in to my life and frankly late May is only about 4 or 5 weeks away and man, does that seem close for such a MAJOR life change.

I am truly thrilled tonight as I write this but also extremely nervous and scared.

So now in addition to April 20th being the sad anniversary of the Columbine tragedy as well as Hitler's birthday, it will be the date I learned I was approved by the insurance company for a Vertical Sleeve Gastrectomy.

So this is me by the numbers on paper. Of course it says nothing of my sparkling personality, wit, humor, intelligence, and vibrance for life.

Bust: 45"
Arms: 16"
Waist: 41"
Hips: 47"
Calves: 20.5"
Neck: 15"
Thighs: 29"
Pant Size: 20W
Shirt Size: XXL
Bra Size: 38C

I had a hard time picking ONE outfit to wear in my before pictures. Each look is so different to me. I plan to save these outfits to do updates as I go. (hopefully...still awaiting insurance approval at this point). Click on my "Befores" album to see.

I read the post about turning points for people that made them decide it was time to pursue surgery. Mine include: 1) A young boy asking me why my belly was so big. I told him cause I ate the last child who asked me that. 2) A man at the movies had a fit when I decided to sit in front of his kids and when we got in to a verbal argument, he told me to "go gain some more weight." 3) I was at a turning point career-wise after looking for years for jobs in my field. I decided to consider the military but was told I was too heavy to be accepted. I needed to lose at least 80 lbs before they consider me.

Another hurdle cleared. I am officially not crazy and I have been cleared for surgery! I met with my psychologist today for what they call the 2nd part of the psychological examination but lets be honest, it's really the 3rd.

Phase 1: A one hour interview with questions about mental illness history, abuse of any kind, how you deal with stress, religous/spiritual beliefs, family, eating habits, etc.

Phase 2: A questionnaire consisting of no less than 500 true/false questions. It took me 2 1/2 hours to complete which I am told was rather quick. Some of the questions were pretty obviously meant to weed out people with some serious mental illnesses. Other questions were more subtle.

Phase 3: A follow-up in which my psychologist went over the analysis of my questionnaire. One red flag that was raised for me with the psychologist was T/F I sometimes adjust the dosage of my medication if I do not feel like it is working. I answered true, chosing to read the question literally and thinking about when I take a couple ibuprofen for a headache and it doesn't work so I take more. She warned me to be aware of the signs of depression once I am post-op and also to get used to the new attention that will be coming my way. She encouraged me to send her updates'questions (she reminded me that I could send positive ones). I was given some literature on books to read not just about bariatric surgery but also about accepting your body no matter what.

All in all, it wasn't as bad as I was building it up to in my mind. So my next step in the process is to get insurance approval. They will submit my packet next week or the week after. I'm still pretty pessimistic about this part but why worry about it today when it hasn't even been submitted yet?

I have been doing a couple things over the last few months in order to prepare for the changes in post-op life. I gave up caffeine first about 5 months ago. (NOT EASY) Headaches and withdrawls ensued. The next thing to go was Diet Coke, my drink of choice. I used to mix it with this Organic Italian Lemon Juice from Costco and it was so YUM! That was even harder to give up than the caffeine. It took a couple tries to stick. I had one in Mid-March on my birthday but didn't feel like I needed another. It was actually hard to get through one 12 oz. bottle. The newest thing I have started doing is taking daily vitamins. I was already taking a Vitamin D3 supplement at the advice of my doc. I have chosen to add a hair/nail/skin supplement that has biotin in it since I already have super thin hair that seems to fall out all day, everywhere. I added a B Complex mix that has 5 different kinds of Vitamin B in it. I'm hoping it will help with the afternoon blahs that hit after lunch. Finally I added calcium citrate. I don't drink milk and use Silk sparingly so I'm sure I could use a little extra :)

That's pretty much where I am at for now. It's totally cart before the horse but I also took some photos this weekend in different outfits. I am a photographer so this thing is going to be allllll about the photos for me. I'll post those soon.

More to come when it comes....

So I thought I was on visit 4 of 6 when I went in on Monday for an appointment with my Registered Dietician. I did a six month program through my hospital called Winning Weighs that was 6 months of classes on nutrition, coping and movement. It also included 3 personal visits with a Registered Dietician. I decided to get in to the Bariatric Surgery program when I had 2 months left in Winning Weighs. I really feel much more comfortable with the decision I've made to have the surgery after taking these classes. Not so much in reference to the "honeymoon" period but rather in reference to long term results with my sleeve. I feel like I have a fighting chance now to succeed. I understand what will need to be done for long term success. Whether I will be successful remains to be seen.

So back to my RD visits. We talked about the importance of protein and she gave me a booklet that explained pre-op, hospital stay, post-op and the kinds of changes not just physically but emotionally and mentally I will be going through. They tell me I have now completed my 6 required visits and will wait until the 2nd part of my psych eval is complete on April 5th before they submit my packet for approval to the insurance company. Then it could be 2 or 3 months before I get a surgery date...provided I get approved which, honestly, I'm pessimistic about. I'm nervous about my psych eval results. This will be a review of the 500 question personality exam I took a few weeks back. It was long and complicated and you never really know what it reveals. I was as honest as I could be.

I'm trying not to get ahead of myself. I haven't told anyone at work about this yet. I wanted to wait until I get a surgery date before I say anything in case it all falls apart. I have been obese a long time but my medical files are thin cause I didn't have insurance for a long time. They may take a look at my file and say I don't have a 5 year history in which case I will be in for a fight...stay tuned for the next update after my psych eval.

I started a video blog tonight. Link is here: http://www.youtube.com/watch?v=1eLRBl4M7Ok

Completed my MMPI test today. WOW was that a lot of questions. Have my 4th required visit with my dietician scheduled for late March. I get the results from my MMPI test in early April. It seems like this process takes forever but I like the way Gundersen has it set up almost as a check-list so I just have to think about checking off the next item on the list. I worry about qualifying since Chris the PA told me he thought I would have a hard time getting approved by insurance since I lost 60 lbs a few years ago. (I have since gained back all 60 + 10) to put me firmly over 230 lbs on a 5'3" frame. My team hasn't mentioned getting a letter from my PCP or even when my paperwork will be submitted to the insurance company. The more posts I read on here, the more I think I should maybe be concerned by this? I have to say that my initial consultation went well with my surgeon Dr. Ayman (pronounced EYE MUN). He is nice, has an informative manner and doesn't talk down to you. He even made me laugh which helped to ease my fears some. Stay tuned for more as it happens...