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After looking back at my profile I realized that I forgot to post my first set of questions for my surgeon.  So here they are.

Surgeon
> How many surgeries have you preformed?
> How often do you perform weight loss surgeries?
> Which surgery option do you perform most?

Insurance
> Is Smart for Life an acceptable diet program for the 6-month requirement?
> Having lost weight and gained it back, does that qualify as failing a program?
> What is the estimated cost?
> Does insurance cover all expenses related to the surgery (hospitalization, medicines, etc.)?
> Do you have financing for my portion of the expenses?

Complications
> How often do your patients have complications?
> What is the most common complication?
> What has been the worst complication with your patients?
> Are there ways to avoid complications?
> How many patients of yours have needed follow-up surgery?
> Is follow-up surgery covered by insurance?

General
> At what point is it truly necessary to consider this procedure?
> Does my previous weight loss effect your opinion on me needing the surgery?
> Which surgery would be best for me? 
       > Is it a laparoscopic surgery?
       > What is my normal weight range and what is the expected weight loss?
       > When will the weight loss start?
> Why don’t you recommend the other surgery options for me?
> What pre-op and post-op tests do you conduct?
> Does the anesthesia make the patient sleep throughout the surgery?
> Is the surgery performed at the hospital?
> Is there a weight loss unit at the hospital?
> Is there someone on call during non-office hours?
> How bad will the scars be?
> How long before I can get pregnant?
> What are the details of recovery (time, pain, etc.)?
> How often and what type of follow-up care will there be?
> What are the long-term medical needs (vitamins, surgery, medications)?
> What percentage of people gain weight back?
> Does the stomach stretch back to its original size over time?
> With my age and having no children, do you foresee me needing plastic surgery?
> Is there nutrition, psychological, exercise, etc. support after the surgery?

Good luck!

Well friends, I am in no way a poster child for VSG, but I'm still very happy to have done this. I had some complications but the surgeon was still able to do the sleeve. So I am finally feeling like a normal VSG patient today. Here's what happened:

Went in at 8:30 a.m. for surgery on Tuesday, Dec. 7. Surgery started close to 2 p.m. so it was a long wait. When the doc got in there he saw that my stomach was connected to my spleen, back and bottom. Now, that sounds weird but apparently your stomach is usually connected to your spleen with some tissue and nerve endings. They are loosely connected and there is plenty of room between them to cut it loose. Well, my stomach was only about 1cm away from my spleen and that centimeter was tightly connected with adhesions and tissue. On top of that, my stomach was also connected to my back and bottom areas. Doc said to think of your insides like a fish bowl and my stomach was connected to the back and bottom of the bowl as well as my spleen.

So.....he had to spend an additional 1.5 hours cutting my stomach away from my spleen, back and bottom area. Then he was able to do the sleeve and remove the pesky part of my stomach. Of course, all of that was super complicated for him but it became an issue for me because I lost 2.5 pints of blood. A few times he even said I was lucky that I was young and able to recover from this better because of my age and lack of health problems. He also said it was just a fluke that I had those issues. He told my sister that no one will ever know how difficult it was to do my surgery. I commend him for completing it and not just walking away. I even asked if he would be able to charge more. He said there is something they can file but insurance companies just deny it so he didn't plan on it. He just wanted to get it done and get me healthy. Very kind.

The surgery took about 4.5 hours and they normally take only 2-3 hours. After surgery, I was sent to SICU around 7 p.m. I think. I can't recall times very well but I do remember the recovery. I was in MICU for Tuesday and Wednesday night I think. Then I went to the post-op floor and had a private room (all rooms in the hospital are private). While in SICU I found out that they started another IV in surgery so I had two at that point. I also learned that my blood pressure, hemoglobin (part of your blood count), and oxygen were all low. So they had my IV pumped with liquids and vitamins. Everyone in SICU was nice and very helpful but that department is so busy that I could only sleep for about 15-20 minutes at a time. So by the time they got me to a post-op room, I was exhausted.

They got me moved to my room and kept my on morphine for the first day. Morphine was okay, but it didn't help with the internal pain. After 2 days of lying down, they had me stand up for my swallow test. Standing up for the first time was difficult, but they pulled me to the machine and it turns you upright so that helped. As soon as the lab and surgeons okayed my swallow test (3rd and last leak test), they started me on liquid lortab. The lortab helped a ton more than the morphine did. The lortab actually helped with the internal pains. The incision areas haven't really hurt much yet, it was all more internal pains since they had to do lots of cutting.

So I was on lortab and in a regular room. They had laps drawn every few hours to check my hemoglobin. It was low every time so the doc requested 2 units of blood be transfused. Here an interesting part - the hospital blood bank didn't want to give up 2 units right away so they asked if he could use 1 and see how that goes. You see, blood is like gold in the hospitals. And the interesting part is that I do marketing for the American Red Cross Blood Services. For almost 7 years now I've been developing recruitment and awareness campaigns through PR and media to increase blood donations across the Midwest. Not to be full of myself, but the 8-state area I cover recruits about 750, 000 blood donations each year.....and they were hesitant to give up 2 pints. It just made me laugh. I've even worked with the hospital blood banks to garner media interviews and increase donations for the hospitals. My surgeon and his team knew that too so they thought it was funny that they were holding back on "the blood lady". Anyway, so the first pint brought me from ghostly white to having rosy cheeks. But my hemoglobin was still too low. And my blood pressure was staying around 80/50. So my surgeon went and talked to the blood bank manager and got the second unit approved. After that second pint and lots of IV liquids and vitamins, my hemoglobin was just low not dangerously low anymore, and my blood pressure went up to 100/55. But my oxygen was still in the low 80s. So we started breathing treatments and kept me on oxygen. After about a day of those treatments and walking, I was up to the low 90s with a blood pressure of 110/58. So that was all much better.

The doc came in on Friday and said he wanted me to stay one more night so we could continue working on my oxygen levels. And that was fine by me because everyone was really helpful and I felt safer being there anyway. The main issue was that I was dehydrated so they couldn't get blood with just one stick and every IV clogged up quickly. So after 16 needle sticks, plus 5 different IVs, and 2 pints of blood, I came home on Saturday around noon.

I had my friend stay the night with me last night (Saturday) and she plans to stay tonight too. I've been walking and trying to do things on my own so I'm prepared to handle stuff when she leaves. So far the only part I dread is (Warning: TMI) wiping my butt. I had 4 BMs in the hospital but they were all liquid (like baby tar poop). And of course, I am so swollen that I can't reach back there right now. All modesty went out the door when I had to have the nurse wipe my ass. I asked if I should tip her or something. She laughed and said it was no big deal. Thank goodness! Oh and the saying "never trust a fart" is soooooooo true! Take my word, be close to a toilet after every walk.

It's all been a wild ride but I think after the first 4 days of craziness, I'm finally on track with what normal VSGers experience. I slept in today and am now sitting on my couch watching television. Going to get up for a walk then probably take a nap. So that's all for now. Thank you all for the kind words, prayers and thoughts over the last few days. I know they helped guide my surgeon's hands and keep me going. I can't even express how much it means to have total "strangers" supporting me.

Thank you!!!!

Just thought I would share the questions I asked my surgeon at my 1-week pre-op appointment today (Dec. 7 surgery).  Naturally, every surgeon will have different answers and these are just summaries of what my surgeon said.

Q. What are the side affects of removing the Ghrelin hormone?
A. They do not know the long-term affects, but it will suppress your appetite for 12-18 months.  What they found is that your body will start developing Ghrelin in other areas after about that time so you will get your appetite back.

Q. When is the catheter in?
A. Goes in when you're under anesthesia.  Comes out in the hospital when you're awake but shouldn't hurt.

Q. Will there be a drain?
A. Yes, goes in while you're under.  Comes out in the hospital when you're awake and it feels "weird".

Q. Do Gas X Strips help and is it okay to use them?
A. It is okay to use them, but there is no real information on if they help.  About 90 percent of the gas is removed from your intestine and stomach after surgery.  Pains often come from the stomach spasms and the intestine not knowing which way to flow.  The flow stops after surgery and takes about 3-5 days to get back to normal.

Q. How large is the sleeve?
A. The actual french number doesn't really say much because a tight 40 could be the same as a loose 32.  So it's really just a number, but he uses a guide that allows for a 38.

Q. Do you use stitches or glue over the staples inside?
A. He uses a reinforcement that dissolves after 4-6 weeks.  You definitely want to use something, but none of the options have been proven to be better then others.

Q. Do you perform a leak test?
A. Yes, he actually performs 3 of them while you're still in the hospital.  The first is done during surgery by submersing the staple area in water while forcing air through and looking for bubbles.  I can't remember the details of the second one, but it is done during surgery through another endoscopy.  The third and last one is done by testing the fluids from your drain for saliva.  If saliva is found, that means there is a leak. 

Q. Is there anything I can take for nausea after surgery?
A. Nausea is typically due to the anesthetic, which generally happens within the first 12 hours after surgery.  So the hospital staff will give you something as needed, but he usually doesn't send you home with anything.

Q. How long do I need to be on pain medicine?
A. As long as you need - liquid Lortab.  He gave me the prescription today so I can get it filled before surgery.

Q. With my developing ulcers, should I stop caffeine consumption forever?
A. A large part of the stomach that produces acid will be removed so the chances are decreased, but there will still be a part left that can produce acid so I should probably stop the caffeine.  But some tea or small amounts of caffeine here and there are fine.

Q. Why do some people have their gallbladder removed and others (like me) don't?
A. If you're not having issues with it, there is no reason to take it out.  Laparoscopic removal is difficult and he puts all WLS patients on Actigal for 6 months after surgery to help prevent stones, etc.

Q. Will I need to crush my medicines or will I be able to swallow with the sleeve?
A. You will probably need to cut the large pills in half, but should be able to take a sip of water to get them down just fine.

Q. I heard you shouldn't have red liquids before surgery.
A. No, that doesn't matter.

I think that's all I asked....which seems to be a super long list now that I've typed it out.   I hope this helps someone else as much as it did me.

I am so excited!  I found a few pre-mixed protein shakes that are really yummy.  First, I should explain that I still like some of the powder shakes that I tested.  Don't think just because I'm moving on to the pre-mixed shakes, that the powders aren't good.  They are but I just can't handle foam/bubbles in anything.  Probably 10 years ago I realized that I do not know how to burp.  I know TMI, but hey, I tell it like it is.  So not being able to burp means no soda, no bubbly drinks, no champaign, no foamy stuff.  That was kind of good because it meant I never developed a taste for soda, except with rum or vodka.

So after trying some of the powder protein drinks, I realized that I had that same foamy tummy feeling I get with soda and decided to try some pre-mixed shakes.  Now, I think if you mix the powder drinks by hand, or choose a certain kind, there really isn't foam....but I don't have to worry about that now because I found something super yummy that I don't have to mix.

This "review" will be a little different because all of the shakes from each brand have the same qualities so I will just lump them together.

Adkins Advantage Milk Chocolate Delight Shake, 15g Protein
Adkins Advantage Dark Chocolate Royale Shake, 15g Protein
Adkins Advantage Vanilla Shake, 15g Protein
Adkins Advantage Strawberry Shake, 15g Protein
Adkins Advantage Mocha Latte Shake, 15g Protein
> All of them are super yummy.
> Rich flavor
> Thick and creamy like SlimFast
> Do not need to be kept cold unless opened so I can just throw it in my purse for later.
> The only down side is that they are 15g protein vs. about 25g protein from the powder drinks.
> 15g protein, 160 calories, 9-10g fat, 2-5g carbs, 1g sugar

EAS AdvantEDGE Carb Control Chocolate Fudge, 17g Protein
EAS AdvantEDGE Carb Control French Vanilla, 17g Protein
EAS AdvantEDGE Carb Control Strawberry Cream, 17g Protein
> All of these are yummy too.
> They have a nice flavor, but not quite as rich as the Adkins, but still very good.
> Thicker than the powder drinks, but not as thick as Adkins.  Thicker than most protein shakes.
> Again, do not need to be kept cold unless opened.
>17g protein, 110 calories, 3g fat, 2-4g carbs, 0g sugar

Overall, EAS has better nutrition facts then Adkins, but I like the slightly richer flavor of the Adkins.

There you go, another review....and a really good find.  Uber excited that I have some go-to protein drinks now.  Yay!  Bring on the surgery!

I blended each of these two protein drinks with ¾ cup of hot faucet water for 10 seconds. I have no desire to bust out the thermometer every time I make a hot drink, so I just stick with hot water from the tap – that’s never over 130 degrees.

As with all protein drinks, there is a lot of foam. Maybe bubble bath is an ingredient…? Not sure, but I am having a difficult time with any foam so I will be asking my dietitian if skimming it off the top affects the amount of protein consumed. Don’t know if she will know, but it’s worth a try.

I skimmed off the foam on these so I could get to the real flavor for each of these reviews...plus I couldn't handle the bubbles this morning.

ProBlend 55 Mocha Cappuccino, 27.5g Protein
> Tastes like watered down hot cocoa.
> You can tell there’s a bit of a "diet" taste, but it’s not too bad.
> Not overly sweet so this might be good for people who can’t handle the sweet stuff yet.
> Before the foam was removed it looked pretty creamy. But after, it just looks like dark liquid. So if you drink this "as is" with the foam, it would probably be mildly creamy.
> I will not be buying this one since it did not knock my socks off.

Nectar Cappuccino, 34.5g Protein
> There is a cinnamon-y goodness in this one.
> Same thing on the foam – if I had left it on, it would have been a creamy drink.
> This one also has a bit of a coffee flavor, which cappuccino should have.
> But it still has a bit of a "diet" taste, but again, that’s not bad…maybe it’s because I haven’t yet brushed my teeth this morning. Ha!
> I will probably not buy this one because the one from my first protein shake review is still the best. So I’m done with fancy coffee type flavors.

My next review will be on unflavored and chicken flavored Unjury. I hope to do that tonight with some broth and creamy soups. Have a great week people, and make good decisions this Thanksgiving!

In order to stick to my regular blog timeline and promise to share my experiences – good and bad – I first have to share a few posts I made with some concerns right after my endoscopy. As you will see, I was a posting fool last weekend, but it really helped to get my concerns out and hear what people had to say. So my advice is that no question is a dumb question – ask anything!

I called this one "Endoscopy Yesterday - Threw up Tonight (classy huh?)
Post Date: 11/12/10 10:39 pm
Has anyone gotten sick after the upper endoscopy procedure? I simply felt tired after the procedure yesterday, then a bit groggy today. Then I started coughing a bit tonight and ended up throwing up. I hate throwing up!!!!! Temp is normal and I'm feeling okay now, but just wondering if anyone has had this happen to them.

Summary of Responses: Basically everyone said this could be normal but I should call my doc if I’m really concerned.

In retrospect, maybe it was too early after a procedure to eat pizza…?

This next one was me moving on from worries about the upchucking to anxiety, but I I was a bit more PC on the title of the post with Reactions to Anesthetic
Post Date: 11/14/10 12:10 pm
Okay, I "went under" for my endoscopy on Thursday and am having some side effects to the anesthetic.....I think.
Threw up Friday night.
Emotional all weekend.
Groggy all weekend until this afternoon, but it still comes and goes.
Total anxiety attack just a bit ago, including crying, lasted like 2 hours.

Is this normal?!?! I am ready to call my doctor's office but I have been forcing myself to wait until Monday. And if this is normal, how the heck am I going to handle the actual surgery?

Summary of Responses: Call your doc now; don’t worry about waiting to call. Anxiety is fairly normal after any anesthetic and everyone handles it differently.

This is me continuing to be a head case, entitled Anxiety About Surgery – Normal?
Post Date: 11/15/10 6:27 pm
I've lost a lot of weight before (113 pounds) and of course regained it. But now that my system had a jolt of anesthetic from the endoscopy, I am all anxious and worried about surgery...and life...and waiting...and not having control.

I can't put my finger on what's going on in my head, but it's like I'm stuck in a life that I don't really enjoy and I've put myself here...so should I just try to lose again? Can I dedicate another 2 years to losing again? Will I gain it back and be at square one again? Why can't I keep weight off and will surgery fix that? Ugh!

Am I being silly by asking my doc for Xanax tomorrow?

Summary of Responses: Go for the Xanax and don’t be ashamed to ask for it. And we’ve all successfully lost weight and put it back on, so now we’re making the decision to make it permanent. The sleeve is a tool that will not only help you lose but keep it off. And of course, only do it if you’re 100% positive that you want it – after all, it’s permanent!

Blond moment entitled "Oh yea, almost forgot insurance was submitted today"
Post Date: 11/15/10 7:11 pm

All of my anxiety overshadowed the fact that my records were submitted to the insurance company today. Yay! For some reason I am only about 95% sold on this and a week ago I was 105% sold. So I'm crossing my fingers that the answer comes back quickly and my emotions subside long enough to make a clear-headed decision.

But the best part is that all of my insurance-required appointments are complete! Now I just have the endocrinologist tomorrow (not required for insurance) since my cortisol levels are elevated. Then I'm done done done with doctor appointments until surgery! Of course, my 6-month dentist cleaning and annual female check up creeped into my schedule this week too....ahhh it never ends.

Good luck to everyone waiting on their approvals!!!

Xanax! Xanax! Xanax!
Post Date: 11/17/10 4:46 pm
That's me chanting and cheering for my new friend - The Anxiety Eliminator! After a really good day with only two mild freak-out espisodes, I was really hoping to just keep those little pills in my purse. But of course, when I got home....alone....with nothing much to do.....I started thinking....and freaking out about God knows what. Pesky brain!

From what I've researched, anesthesia can trigger emotions for weeks after even the smallest procedure (ie: that damn endoscopy). So I'm not crazy! Just dealing with emotions from the year of hell. Sounds weird, but that makes me feel "normal".

So take my advice - deal with life as it presents itself. Don't hide from your feelings - good or bad - because they will sneak up on you when you least expect it. So call the bozo who did you wrong and tell him to suck it. Or call the person who was there when you needed and give them a heartfelt thanks. Or just cry, or laugh, or whatever it takes to deal with life right here, right now.

And if all else fails, The Anxiety Eliminator to the rescue!

BACK TO THE BLOG OF RANDOMNESS

Good Find – Muscle Milk Light
Here is a link to my post about it and it includes pics and Nutrition Facts. http://www.obesityhelp.com/forums/VSG/4277321/Muscle-Milk-Light-Good-Find/

Endocrinologist – High Cortisol Levels
Because my original lab tests came back with elevated cortisol levels, my surgeon wanted me to see an endocrinologist before surgery. Thank goodness this wasn’t one of the appointments required before submitting my request to insurance. I just have to have this figured out before surgery so that my surgeon is in the know.

So I went in for my appointment and let me tell you, the endocrinologist had the bedside manner of a rock, but a judgmental "I’m better than you" kind of rock. He walked in with a student of some sort. He didn’t exactly explain who it was, just mentioned that she would be watching/learning. He had me sit on the bed and started to talk to the "student" about ALL of my signs of obesity and high cortisol levels possibly causing it. It was so awesome to be called obese like a dozen times in 30 minutes (feel the sarcasm). He started by pointing out my "trunk like" figure. Lovely! Then went on to point out my mild hunch back, which of course is typical in an obese person like me. Then he had me lay back just waiting to poke fun of purple streaks on my belly, but I fooled him!!! No purple streaks! But of course, he did his mental body slam again by telling his "student" that most people as obese as me have them so he was just sure I would. Then he moved on to my "flabby and unusually large upper arms". Again, he blankly explained to his "student" (not me) that ALL of those were signs of obesity and when coupling those with my elevated cortisol levels, there might be a medical reason for me being so obese.

Then he moved on to actually talking to me. He said that my cortisol levels went up by 10 since last year, which is a lot for a year. As I began to explain my year from hell and how I know cortisol levels change with stress, he quickly moved on to telling me that he wanted me to piss in a jug (my words of course) for an entire 24 hours and bring it back for testing. Then he told me that if there is a medical reason for me having gained the weight back, then I should put off the surgery because if we can control that, I will have a chance to lose it normally.

Okay first, arse hole! Second, people have this surgery every day without having a medical reason for having gained the weight. So if you can "fix" that medical reason, I still have to spend the next 2 years of my life on an extreme diet and dealing with the roller coaster of weight loss.

Before I even walked into his office, I thought everything was fine health wise and I still wanted the surgery. So just because he points out that something could possibly have caused the gain and he can probably stop that, doesn’t mean I will change my mind about having the surgery. Clear as mud I’m sure, but frankly I was over him the moment he said "trunk like". I was like, "Girl hold my purse and let me take off my earrings!"

So I took home a bright orange biohazard bag that contained a lovely ½ gallon jug, a handy plastic pee filter, and a slip of paper reminding me to store my urine jug in the refrigerator. The refrigerator! I texted my friend that night "I have pee in my fridge. I might have it for dinner." She nearly pissed herself!

So that was my endocrinologist experience. I went potty in the jug, delivered it to the lucky lady at the lab and am waiting for the results. I did call the surgeon’s office and tell them that he said something about him recommending that I not have the surgery. She said let’s just wait and see what the tests say. If there isn’t anything that stands out, we don’t need to worry about that. Also said "I got the impression that he was not supportive of WLS in general" just so they know for future reference. You see, they get $18,000 a pop on the sleeve and they are very careful to refer people to doctors who are supportive and understanding. Oh, they didn’t refer me to him, my PCP did but I still wanted them to know. Jack ass!

Other than that, I’m just taking my Xanax "as needed", which has been about every other night. I’m also waiting to hear from my insurance company, which should be within the next week. Crossing my fingers that they say yes AND that I still get to have a regular Thanksgiving dinner…my last "fat girl" holiday dinner.

That’s it for now friends. Later tator tots!

To stay true to my reason for blogging, here are the details of today's procedure.

My instructions were no food or drink after midnight last night, no aspirin for 7 days prior and no herbal supplements for 2 weeks prior.

My friend (a.k.a. driver) and I showed up at 9 a.m. They had me fill out a little paperwork and took my friend's cell number so they could call her when I was ready to be picked up. After waiting for just a few minutes, they called me back into the "surgery" area. They had me give a urine sample (only for women who can still have children) and put on a hospital gown over my clothes. They also had me put on comfy socks with the gripy stuff on the bottom. Then they walked me to my little area, where they would prep me for the procedure. The area was pretty much your standard pre-op area that was divided with curtains. There were actually 2 other people having the procedure right before me so I could hear them going through the same prep work.

The nurses were super nice and introduced themselves to me instead of just jumping into the paperwork. After meeting them, they verified the information I had on my paperwork and had me sign 2-3 more papers. Then they put a paper bracelet on me, as well as a blood pressure cuff and a little monitor on my finger. Lastly, they put a big sticky sheet on my upper back. That would later be hooked to another monitor during the procedure. Then they started my IV. They gave me fluids first to plump up my veins. The nurse said it was like Gatorade for my veins. The IV wasn't painless, but it wasn't bad either. It was pretty much like having blood samples drawn for lab work.

Since I came in with a headache, when the anesthesiologist came in he said he would give me a little pain medicine in my IV. I heard him giving the lady next to me the same thing so I imagine if you come in with any pains, they just try to make them go away before the procedure. Plus with no fluids for several hours and no morning coffee, I'm sure lots of people come in with caffeine headaches. So he put a little syringe of magic juice into my IV. About 2 minutes later I was drunk on magic juice. I just wanted to sleep....so I did. The doc was running late and with the magic juice I really didn't mind.

After about 15 minutes I was no longer drunk, just tipsy. Then the doc came in and asked me a couple of questions and wanted to know if I had any questions. Since I didn't really, we were off to the "surgery" room. The nurse pushed my gurney into the room and had me roll onto my side. She placed a pillow behind me to keep me propped up how the doc needed me. Then she attached the sticky sheet and blood pressure cuff to the monitors. The worst part in my opinion was the yuckiness she had to spray in my throat to help numb it. The little bottle looked like a mini bottle of WD40 with that long skinny straw to help get it to the back of your throat. It wasn't painful at all, just yucky tasting. It was supposed to taste like cherry but it just tasted like yucky old medicine. But it did the job. Then she had this little mouth guard that you simply wrap your lips around and it keeps your mouth open. The best way to describe it is that it was like a short piece of plastic pipe so the little scope thingy (very technical I know) could fit right down the middle and into your throat. The mouth guard was strapped around my head to stay in place.

So there I was, on my side with "cherry" yuck in my numb mouth, a blood pressure cuff on my arm, a finger monitor on my right hand, a sticky sheet on my back and an IV in the top of my right hand. Sounds overwhelming, but it really wasn't. All of that happened within 3-5 minutes. Then the magic juice guy started the IV drip. The last thing I remember was him telling me that the medicine might sting a little as it hits my vein. Snore......................

Then I was woken up by a nurse parking my gurney back in the curtain area outside of the "surgery" room. The only reason I knew I was done was because I was still on my side and surely they wouldn't have me out there again unless they were done. I had no pain at all. No scratchy throat. No difficulty swallowing. Nothing. It was just like I had a nice nap on a rainy morning. The nurse gave me some ice water, which went down just as easy as before the procedure.

I laid there until the doc came over to tell me about what he found. Yikes! He found something? Yea, but he wasn't really worried about it....and he had some cool pictures of the inside of my stomach. He said I had about 3 ulcers that were developing, which although I didn't expect that, it wasn't surprising (read My Story and you will understand why). He also said I had several tiny blood clots that were dried up. So they were old blood clots. He said the acid was probably causing the ulcers and they probably caused bleeding. I said those aren't the bad kind of blood clots, and he said yes they were and they can be caused by several things like caffeine. So that was a bit disturbing. But he gave me a prescription for Omeprazole (generic Prilosec), which should heal up the ulcers. I mentioned that I take Zantac pretty much daily and he said to take this prescription instead.  So the pesky little blood clots shouldn't be an issue.  He left the cool pics with me and sent me on my way. (I'm thinking about posting the pics on here but not sure if people would want to see that - so let me know if you do.)

The nurse had already called my driver so she popped in when I was getting up and ready to leave. Perfect timing. They made my friend/driver sign something stating that she would get me home and we were off. I was soooo ready for Starbucks but in light of the ulcers, I decided to pass even though the doc said I could have one last one. Looks like it will be decaf peppermint mochas for me now. When we left I was thirsty and hungry so we stopped and grabbed me something on the way home. I ate and fell asleep. Unfortunately, the headache is back but I think I will have to suffer through these until my body gets used to the decaf. Thank goodness I don't drink soda.

So that's it. Super easy, painless (except the sticky sheet on my back being pulled off), and pretty much an easy procedure. If you have questions, send them my way. I'm sure I forgot something but I wanted to get this blogged before I forgot the details of the day.

Good luck! 

Pre-Op Appointment 5 - Psychological Evaluation
After completing the standard paperwork with my personal and insurance information, I was taken into another room. There were two other individuals in that room taking a bubble test and certainly neither of them needed bariatric surgery. I learned later that they were taking pre-employment psych tests. My test was a bubble test too and it was super long. There were like 400 questions on the main test and two other tests with about 15 questions on each of those.

The main test was simply a list of statements and you answered True/False. But some of the statements were interesting and I caught myself giggling during the test:
"I often hear voices that others around me do not hear." 
"I frequently want to hurt small animals."
"Someone is following me."
"I secretly want people I do not like to fail just to see them suffer."
"I suspect someone listens to my personal conversations."
"I feel that someone is out to get me."
"I see special things that others do not see."

Maybe giggling through my test was a sign that I really AM crazy....or the voices were just telling great jokes. Ha!

The second and third tests were more complex. They were more like problems you had to figure out.
The second test was fill in the blank:
AZ  BY  CX  D__
1357  24_8

The third test was multiple choice and focused on vocabulary. They would give you a word and you had to choose the synonym (most similar word).

After all three tests were complete, I met with the psychologist for about an hour. My experience was a bit different because I had gone to this psychologist before for my weight concerns so she had a bit more insight on my situation. But overall, the questions were basic and she simply wanted to know how I felt about the surgery, how I would handle life after and if I had any major concerns. It was super simple and painless and she told me right them that she would give the okay for me to have the surgery.

All in all it took about 4 hours, including the wait time when I arrived, the wait time after the tests and filling out the paperwork. Good luck and just be yourself.

Pre-Op Appointment 7 - Sleep Apnea Evaluation
When I made this appointment, they mailed me a packet of paperwork that needed to be completed prior to my appointment. It included a sleep log and insurance paperwork. The sleep log included what time you went to bed and woke up, any time you woke up during the night, the amount of caffeine you consumed, and how long it took you to fall asleep each night.

I turned in my sleep log and paperwork when I arrived for my appointment. They weighed me and took my height measurement. Then the nurse took my blood pressure and pulse. When the doctor came in, he listened to me breathe then we sat down and chatted. Once he saw that the request came from my bariatric surgeon, he wasn't as concerned with me actually having sleep apnea since he knows it's just a standard test they have to do in order to submit the request to insurance.

So he wasn't all that interested in my sleep log and mainly wanted to know if I had any major problems sleeping. I snore, wake up often and have to go to the bathroom at night - all of which are signs of sleep apnea and being overweight. So he wants me to wear a monitor on my finger tomorrow night and it will record my sleep patterns. Then when I return it to his office, he will download the info and decide if I need a CPAP. He said that if my surgeon wants me to use it before surgery, he would let me know. Then most people don't need it after surgery because they start losing weight so fast, but it will be up to me if I use it after surgery.

That's it. I will wear the little monitor tomorrow night and be done with this part of the pre-op hooplah.

These two protein drinks were samples I received from VitaLady.com.  I made each of them with 3/4 cup of cold water from the faucet and mixed them in my little blender.

Nectar Caribbean Cooler, 34.5g Protein
> Strong pineapple flavor, like a pina colada
> Pretty sweet, not bland at all
> No powdery taste
> Creamy and a little foam but not enough to bother me (I don't like the foam)
> Definite buy for me

Allmax (Isoflex) Chocolate Mint Supreme, 27g Protein
> Very minty, more mint flavor than chocolate
> This is for you if you love mint!
> Slightly creamy
> Drink separates from foam quickly, so you could probably skim off the foam if you wanted (not sure if the foam contains protein though)
> I really like mint, but I'm not sure I could handle this much mint as a regular drink after surgery.
> If I used it as a regular drink (alone), a full container of this would probably last me all year.
> Good - I made 1/2 cup of warm instant NesCafe coffee. Then I added 1/2 of the drink (already mixed with cold water) to my coffee. It was good, kind of like a peppermint mocha but not creamy since there was no milk.
> This would be a good alternative to the Special Combo mentioned before. But I still think the Special Combo is the bomb diggity!

I just realized that there are 3 different brands of strawberry in my mix of protein shake samples from VitaLady.com. So I did the good old fashion taste test. I blended each shake with 1 cup of cold water in my handy dandy little blender. Then I poured them into small glasses (see picture) and started the taste test for the superior strawberry protein shake (so official huh?). Even with just 1 cup of cold water, each shake filled a small glass and I dumped out the 1/4 cup extra - this is probably because they all foam up a bit, and they foamed up about equally. I dislike the foam factor because I worry that the bubbles will affect my tummy once I have surgery. I guess we will see.

Here are my picks from best to worst.

Nectar Strawberry Mousse, 34.5g protein
> #1 pick for me
> Probably the sweetest of the three (I like sweet right now, but who knows what I will like after surgery), but it didn't taste super sugary sweet. It was more of a rich robust sweet if that makes any sense (kind of like the difference between milk chocolate and dark chocolate).
> Very nice strawberry flavor
> The most creamy of the three
> The closest to tasting like a canned Slim Fast Strawberry Shake, which I think are yummy

ISO Pure Zero Carb Strawberries and Cream, 25g Protein
> #2 pick for me
> It was the prettiest of them all...does that count for anything? A beautiful baby-girl pink.
> It had a slight tang to it, nothing noticeably bad, just a little tang.  Maybe that's the protein taste.
> It definitely had a strawberry flavor but it wasn't overly sweet. A lot of people can't handle the super sweet ones so this might be a great choice for them.
> Had I never tasted #1, I would have probably bought this one. 
> This might actually be #1 for people who like their protein shakes a little less rich.

ProBlend 55 Strawberry Twist, 27.5g Protein
> #3 pick for me, but that doesn't mean it was bad
> This one is the most bland of the three, but it still had an obvious strawberry flavor
> It was also the least sweet
> It seemed to be the least creamy as well
> This one would be good for people who can't handle a strong flavor but still want a fruity shake.

That's all she wrote...at least about strawberry protein shakes anyway.