ShariB
I have been overweight since I got pregnant with my first son. I have been able to loose large amounts of weight (75-80#) on three occasions. Every time the weight comes back and I am heavier than before I started. I have finally come to the conclusion WLS is my only hope.
February 2006 – had my annual physical
Total cholesterol is down a bit only 358 (434 in 2005)
PCP again urged me to consider WLS.
I am morbidly obese; I have high cholesterol and triglyceride levels, asthma, severe sleep apnea and a host of other weight related issues. For years my primary care physician has been recommending weight loss surgery. Four-years ago she told me that any risks from surgery out weigh the risks of staying obese. That scared me enough to lose nearly 80 pounds, which I soon regained and another 20 pounds. That was the third time in the last fifteen years I have lost and regained a significant amount of weight. I do not believe my weight has EVER been stable. I am always losing or gaining. I currently have a BMI greater than 48.
I have been very reluctant to have surgery. I felt if I just tried harder I could lose weight in a much less drastic way. I have been struggling with this for months. When my friend had bypass surgery it made me stop and take a hard look at myself. I realize, year after year, my weight is going higher and my co-morbidities are getting greater and more severe. Working harder is not working. Do I want to end up having heart surgery? Do I keep trying to lose weight and failing or do I intervene? If I continue on the same track I am on, I will probably not live to 60. If I have surgery I could lose the weight and keep it off, having a normal life. I will get to see my children grow up. I will get to see my grandchildren and I will have the energy to play with them. The idea of anesthetic and surgery scares me, but so does heart disease and living crippled from arthritis. Surgery seems like my only option at this point.
Today I scheduled an appointment with my primary care physician to discuss my options and get a referral to a surgeon. Hopefully I will have my first consultation before the end of
Several months ago I felt God telling me that I had lots of tools in my toolbox, but they didn’t have handles. I began to ponder the idea of tools without handles. Attempt to dig a hole with a shovel that has no handle, or drive a nail with a hammer that has no handle. It can be done. But it is very difficult, often painful, and very time consuming. I pondered these things and wondered what they meant.
Tonight I believe it was revealed to me.
I have learned over the years what to eat, how to eat, when to eat, etc. I have lots of “diet” tools. But they don’t have a handle. I can dig a hole with that shovel that doesn’t have a handle, work and white-knuckle it every day, or I can have a handle put on my tools. I believe the Lap-Band can do that for me. It will help me to use the tools I already have in a more efficient way. It is not a quick-fix or a magic wand; it is a means to utilize the tools God has already given me.
Called insurance to get predetermination address, gave info to
Met with
Crestor is working total cholesterol is 171, lipids are 343
Weight is increasing even with a low-fat diet - weight 356, BMI 48.2
Letter of predetermination will be sent today
She started listing things wrong (co-morbidities) in my file
High Cholesterol
High Triglycerides
Severe Apnea
High normal blood sugar (rising)
Increasing blood pressure
Asthma
GERD
Osteoarthritis (Foot pain – plantar fasiaitis)
Degenerative disc disease (
My own reasons –
All of the above health issues
Urinary Stress Incontinence
Fear of heart disease, diabetes and premature death – I want to see my grandchildren graduate High School and more…
Physical limitations due to size – don’t fit in a lot of places; airplanes, roller coasters, movie theaters - can’t do a lot of the things I would like to; hiking, horseback riding,
Shame and embarrassment of size – I feel everyone is staring at the fat lady…
Inability to find clothes that fit me, without going to specialty stores and paying out the nose.
Well I have decided on Cleveland Clinic. They are not that far away, it is the best hospital in the area. The surgeons there have preformed this surgery 100’s of times. It just felt right.
I want to hear something from insurance. Will they or wont they approve? It has only been a week. I need to be patient, but I want to hear something yesterday. I anticipate that I will be denied, and will need to begin an appeal process. I just need to know how to proceed, what do I do next?
Called insurance, they have no record of anything from
Met with
Went to a seminar with
Talked with
Talked with
Went to see
Chiropractor got back from vacation. He worked on my back three times. The last time the adjustment popped it back in and I have been fine since.
December, 2006
Have been seeing
I had my annual sleep study in late November. I thought my apnea had gotten much worse – the prescription is for BiPAP 22/17 with 2-3 liters of oxygen. I got a copy of my sleep study and a friend that is a sleep tech reviewed it. Things are not as bad as I originally thought. Yes, my oxygen saturation did drop to 73%, but only one time after moving; most of the night I was between 87-95%. I only had 7 hypopneas all night long and most of those were at the 22/17 BiPAP setting.
Bought a new car two days before Christmas. I like it, but the seat belts are too short. They fit but are uncomfortable. I am trying to find an extender. I know this is a temporary issue, but I need to be comfortable when driving.
I haven’t been very good about updating this.
I have completed the 12 month supervised diet. I hope it is adequate for insurance. While hubby was having treatments I ATE, and I haven’t stopped.
Dr. Z is no longer in network.
I went to a workshop at Cleveland Clinic early in June. Hubby knows someone that has had by-pass at Cleveland Clinic and
I have an appointment with the nutritionist and psych on Friday, July 27. I'll have one with
I weighed 378 when I went in for my workshop. That is a BMI of 51.2 too high for insurance. Because they measured me at 5’ 11 ¾” I need to loose 12 pounds to be at a BMI of 50. That ¼” makes the difference of 3#. I am having a hard time not eating like crazy. Don’t know if it is nervous energy, fear of failure, just plain binge disorder, or what is causing me to eat. But I fear my weight has gone up and not down in the past month.
This last 20 pounds has really hindered me. My feet hurt ALL the time; the plantar fascitis is back and worse than ever. I can’t put on socks or tie my own shoes, I have trouble cleaning myself, I have trouble dressing myself, I am short of breath and my heart just pounds if I do anything, the heat is unbearable – I pop out in a sweat and gasp for breath if I do anything. The house is getting messier and messier because it hurts to move around. My animals are being neglected because it is exhausting to care for them. I have moved a chair into the basement so I can sit down and rest between tasks. You’d think with all these issues I’d stop eating
370#
Meet with Psych and Nut. today. Not much to report. Psychologist seemed happy with my responses. Recommended I schedule a post-op appointment with
Answered all the questions correctly for the nutritionist. She was happy with what I was doing now. I’m down 8 pounds since the workshop in
I have noticed I am going to have to make some significant changes in my diet. I didn’t realize it, but I have been trying to fill up on lots of low calorie bulk foods; lots of salads and veggies. Once the band is in place I will not be able to do that. I need to learn to eat small portions of nutrient dense foods. I am working on reestablishing my thinking but it is not easy. I am still having trouble with not drinking during meals and I need to slow down even more. Hopefully the band will gently teach me these things.
Catch-up
After fighting with the finance department at Cleveland Clinic, I had the Lap-Band placed on November 6, 2007. I did very well with it and lost a total of 140 pounds. I had only occasional issues with being stuck. Usually at that time of the month, or at restaurants with other people. It took me a while to figure that one out. I was self conscious of how slowly I had to eat and the small amount I was eating in front of others. They often questioned me about it. So, I unconsciously tried to eat faster and would get stuck every time!
I had a Vanguard Band placed, total capacity was 11cc. I had a total of five fills and 7.5cc in my band.
First adjustment six weeks after surgery
12/21/07 3cc. total
2/8/08 5cc. total
5/19/08 6cc. total
10/24/08 7cc. total
9/25/09 7.5cc. total
3/11/11 checked under flouro, no adjustment.
11/3/11 checked under flouro, no adjustment.
Weight loss was fairly rapid the first year - 100 pounds. I lost another 40 over the remaining three years (averaged about a pound a month).
Looking back, I think my band may have started eroding about a year prior to the removal.
I realize I felt the fluid being placed in my band until the final fill in 2009. They removed all the fluid and put it back plus a little, and I felt nothing.
Mid-summer 2010 I began running a low-grade fever and felt like I had the flu, achy all over. It lasted about two days and then went away. I felt fine for 6-8 weeks and then it happened again. This became a pattern until August 2011. Every few weeks I would run a low-grade fever and feel bad for two - three days and then feel OK again.
In August 2011, I began having pain on the left side of my abdomen, up high, under the ribs. Over the next three months the pain intensified, the fevers were more frequent and lasted longer. I was changing jobs, insurance, and doctors at this time so it took me a month to get in to see the doctor. By the time I got in to the doctor, I was in severe pain and had a fever almost every day, and I was feeling yucky almost all the time. PCP thought it was probably a kidney stone or infection due to the location of the pain. She sent me for blood work and a CT scan.
Scan showed kidneys were fine, but there was fluid in my abdomen. The doctor that read the scan said it was band related and sent me to my surgeon. He did a barium swallow under flouro and deemed the band in proper working order and sent me back to my PCP for further evaluation. This was a Thursday afternoon. I called my PCP and scheduled an appointment for 8:30 Monday morning.
On Saturday the fever shot up to 103.5 and nothing I did brought it down. Because I had the appointment on Monday, I decided not to call the doctor. By Sunday evening I was very sick and my husband insisted on calling the doctor. I am very fortunate that he did. My PCP was very concerned and told him to get me straight to the emergency room. When I got there I was in septic shock, the infection was now systemic, my kidneys were shutting down, my heart rate was very high and my blood pressure very low. I was told that if I had not come in, I probably would have slipped into a coma before morning. Once the infection had progressed that far, it was unlikely they would have pulled me back and I would have died.
They did an endoscopy and found the erosion. I spent three days in ICU before they could do surgery to remove the band. I discussed the possibility of converting to the sleeve at that time. The surgeon I saw said I was so filled with infection and in such a fragile condition, he was not willing to do anything more than he had to.
The scariest thing about this whole misadventure - I had no idea I was so sick. No idea that my kidneys had stopped working, or that my blood pressure was scary low. I didn't know I was knocking on deaths door. My husband tells me that being mildly sick for so long had just taken the fight out of me and that is why I didn't realize how sick I was. At the time, my husband was traveling frequently for business. If he had been out of town when I got so sick, I would have surely died.
I considered suing the surgeon at Cleveland Clinic, not for the erosion, but for neglect, failure to investigate the problem, and failure to return calls in an emergency. When I saw Dr. Brethauer and Dr. Kroh on Thursday they did the barium swallow proving the band had not slipped. I specifically asked them about the possibility of an erosion. They said an erosion is highly unlikely, but the only way to rule it out was an endoscopy, but they saw no reason to to do that. When I was in the emergency room, the doctors tried to reach Dr, Brethauer. They called every 30 minutes for five hours and NEVER received a call back. Finally my husband asked if they could please call the bariatric surgeon on staff at this hospital.
I cannot, in good conscious, recommend Dr. Brethauer or the Cleveland Clinic Bariatric unit to anyone. I saw Dr. Brethauer a total of two times over four years. I saw nurses and assistants for all of my appointments, including all but the last fill and the two final checks. These were done by a different Fellow each time. They have no follow-up program after surgery.
