SilentlyWeeping623

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So I just got the call.

My Pre-Ops are confirmed for 4-21 in the AM. Oh how I love to commute into Boston in the AM.....

Getting more nervous......

Write more later 

Just wanted to leave a note....I am confirmed for 4-27-09.....19 days away. Still dont have my preop appts. yet though. 

Totally freaking out

Forgive me, I am just putting together my thoughts, so this entry will be rather rambly and discombobulated.

I called BCBS to see if I had been approved for my surgery....because I am nervous, and had a break at work. They said they had not even gotten any paperwork yet (uh-oh).

So then I called the OCC which is now the Weight and Wellness Center. No one answered (oh no!). Waited a while, because common sense dictated at 1 p.m. they might still be at lunch (dur! WHEW!) Called back and was actually able to speak with Tania on the phone. She is the surgical admin person at OCC. So nice and friendly. I asked her about the paperwork, which she said she was working on today (I swear I have ESP). She would submit to BCBS tomorrow and I should have an approval or denial letter by end of week next week. April 10th. Mark that day folks. She didn't forsee any issue with my approval because of my weight and comorbidities. I don't either....BUT, you never know. I also asked her what the next steps would be, and she said that on her end it would be calling me by the 6th to schedule all the pre-op meetings.

Nervousness!!!!!

Not that I should be surprised by it all, I knew this was all coming. HELLO!!!!! I signed up for this stuff, I have known that the date would be about where it is for two months. But its really getting real now.

I will have to make some phone calls tonight after work to talk to everyone that my friends have introduced me to that have had the surgery. One of them is a nurse, which is SO cool. Cuz I 'm a geek when it comes to health stuff, so it will be good to pick her brain.

Another thing I wanted to mention, my aunt I think is flipping out about the surgery....she is already on FMLA because of her other health concerns. She's worried that if she doesnt have enough FMLA time for this surgery that she may lose her job. I dont want her to think about that. I dont believe she would lose her job, as she likes what she does and she is GREAT at it, and everyone at her work knows that. But I am afraid that she might back out. I dont want her to. I dont want her to use the FMLA thing as an excuse not to go through with it, or to wait until "later". Its makin me freak out.

Oy.....

So I had my final pre-op (sorta) appointment on Thursday 3-5 with the nutritionist (Meghan).

I had gained a pound on the scale there. (Dont worry, that lb and two more are gone for good as of this AM) I was worried, but kind of on the tail end of it. I had felt like, okay, I slipped, and I will fix it. And I have. I went to the gym on Saturday, I am walking every evening after work (even if only for like 10 minutes). I am watching my diet better. It seems to help if I go back to basics, like the protein shakes. I know I need veggies and fruits too, but if I take a couple days and have the shake + fruit for breakfast, and a shake (or bar) + veggie for lunch and then a dinner, it reminds me how simple this can be. I don't have to make it complicated. I just have to stay focused, remind myself what is important.

Meghan was great, she was encouraging, reccomended a recipe book (Recipe's For Life after WLS, by Margaret Furtardo), and helped me figure out a little bit about my vitamins and about how to adapt recipes I love now for after the surgery. I need that for cravings. Let's face it, I love pizza, and im 26...to not have it ever again.....well that would suck. So getting a recipe to help satisfy that craving is a great thing for me.

I found out I will not need any more appointments until I meet with the surgeon, anesthesiologist and PA for the preop H&P. This is good. But scary. I am on my own, and I really need to prove to myself that I can lose the weight on my own. Having the appointments meant I had accountability. Now the only one who I am accountable to is me. But so far so good. I have to get down to 219 (Tufts scale) for surgery. That means from right now (228.4, my scale.....but theirs and mine are fairly close) I have only about 10 lbs to lose in 6.5 weeks. Not too bad. I will set my goal at 2 lbs per week. That should get me down 13 lbs, and put me exactly where the doc wants for a good surgery.

I'm still nervous though.

2/23/09 -- HOWL at the moon

So the HOWL (Healthy and Optimal Weight for Life) is a once monthly meeting (3rd Monday of every month at Tufts-NEMC) where post-op banders and bypassers come together to meet and discuss issue/ questions/ problems. This meeting is open to anyone interested in WLS at Tufts. Its at 6, after work for most of us, lasts about an hour, and each month there is a new topic.

Our topic was dealing with cravings. I got a lot of good information there, how to cope with my desire for pizza (new recipe) and what to do if you really cant get a craving out of your head. I think it was amazing to have such a support system in place for post-op. This is the rest of your life we're talking about, and no one is going to be perfect all of the time. I also like that it was moderated by a nutritionist AND a surgeon. Megan (my nutritionist) and Dr. Kim were the moderators. I found Dr. Kim to be very supportive, and just as patient and willing to answer any questions anyone had as Dr. Shah was.  And Dr. Kim had a baby bump too! So in my opinion, the place is teeming with good luck!

I made a new friend too, Viv and her daughter are looking into the surgery. Viv was part of one of our BCG's so we have seen her around. I was so glad she came, and brought her daughter. I do hope we keep in touch. She is considering the lap-band.

I can not stress enough how important support is. Seeing mom and daughter there, being there with my aunt, being able to talk to all of these people, 6 months, 1 year, 5 years, 10 years out is so very helpful and encouraging. Even if you slip, you can get back on track. I need that, and I love that Tufts has that.

Ok, gotta go.....work calls!

12/14/08 – My first appointment Dr.'s Seigel & Stiles

Okay, so here's where it started off interesting. When I made the appointments for me and my aunt, I told the woman that I spoke with that we wanted to do everything together. She booked us at 1 & 1:40 – with two different doctors, and our appointments overlapped. I have to admit I was nervous. I didn't know if this would work out for us. We meet with Dr Seigel together. He is my doctor, and we go through the history, I tell him the who what when where and why of it all. He thinks I am a good candidate. YAY! Wants to see me in 6-8 weeks, and have labs done now and see the nutritionist and a bunch of other stuff.

We see Dr Stiles. She is going through the same stuff I went through with Dr Seigel with my aunt when I come in. We are able to explain to her better that we want to do this together. She gets it. She tells us that they are starting a new program called “Immersion Day” where you have a few appointments and go through some of the behavior change meetings. She tells me to nix the appointment with Dr. Seigel in 6-8. She'll get us into Immersion Day and we'll follow a different program from there.

After the New Year, her scheduler will call us with details. We get labs done and gratefully get the heck out of the city.

1/2-ish –The Immersion Day Call

Lee calls from the Obesity Consult Center (hereby referred to as the OCC because I am a lazy typist). He wants to schedule me for Immersion Day. I ask him if he has called my aunt first. “AnnMarie?”

“Yes that's her.”

“I just left her a message.”

Insert huge sigh of relief. I like Lee already. We get set up for the second day of Immersion Day....1/14/09. We'll be meeting with the Psychologist, Have 2 Behavior Change Groups (BCG's), meet with Dr. Stiles over lunch, and have a group meeting with the nutritionist.

1/14/09 – The First Big Day

So I took the day off from work. Our first appointment was at 10....I think....maybe 9. The opening meeting was a Behavior Change Group. We met with Dr Greenberg (Izzy, he rocks). There were about 6 of us in the group. It was a complete whirlwind. I don't remember a lot of what we talked about, but I know that we all were scared. At this point I was sold on the band still. After that we hung around 'til lunch. Dr Stiles went over our lab results. Mine still sucked. After lunch we each had our own meeting with Dr Greenberg. He told me to think about the gastric bypass. I did.....for about a day. Then I decided I would still have the band. It was okay if I had to work harder at losing the weight. I just hated the idea of someone replumbing what God gave me. Our exhausting day ended with another BCG.

I got to meet Lee and Louise. They are the admin staff at the OCC. Louise is amazing at taking care of you (if you're good to her. She likes Mike Lowell....keep that in mind). Louise helped me a lot with my insurance, as I have BCBS, and at the time they were fighting with NEMC over how much BCBS was going to pay the docs at NEMC. She helped calm me down and is an amazing resource at the OCC. Lee I think was a bit taken aback by me and my aunt. We went to him after our appointments, to schedule meetings with the surgeon and sign up for all the rest of the BCG's and get our follow-up appointments in order.

I went home very very tired. I was totally overwhelmed. What the hell had I gotten myself into?

1/21/09 – The Surgeon

Most of my questions were for the surgeon. I remember that much about what I asked during Immersion Day. So that is why I tried to sneak in to see her early. I get the impression that you normally don't meet with the surgeon until you have completed the BCG's, and met with the doctor overseeing your care twice and the nutritionist and psychologist twice.

Originally, my aunt wanted to see Dr. Shikora. He is the director of the program, and came highly recommended by our endocrinologist. He was booking out in March. However, Dr Shah, one of his....oh I hesitate to use this word....understudies..... had two back to back appointments on the 21^st. I opted to see Dr Shah because I'm not picky, and my aunt went along with it.

So we get there, and Dr. Shah had an emergency, so we had to wait. That was okay, because our next appointment wasn't til 4...the BCG. So we waited. I was nervous that we would get hurried because of the delay. I mean, I understand completely that Dr Shah had to take care of this patients emergency. If I were in their shoes, you bet your ass I would want to be taken care of, but I was afraid that might not leave time for me and my aunt. Gosh, I hope that doesn't come off selfish.

Anyway we finally got in to see her. She spent an HOUR with us going over every little question I could think of. It was amazing! I was so happy to have met with her, to have learned all I did, and that she was willing and able to take the time to really talk to me and my aunt. The only downside? She totally wanted me to have the bypass.

But, I knew that I had made a good decision in saying I would see her. (Here comes the cheesy superstitious part) When we met, she had a baby bump. Now the last time I was operated on, my surgeon (who removed the mass on my thyroid) was having a baby too. So of course, since that turned out well, this will too. Gotta love girl logic! :-)

I liked what she had to say about why she specifically was encouraging me for the bypass too. I don't think I wanted to hear that the bypass was better for me, but she is right. If it will put my diabetes into remission, help with the cholesterol AND make my blood pressure better then I thought to myself, maybe I should consider it.

So I did.

2/3/09 – Almost There

So today I had meetings with Dr Stiles, Meghan the nutritionist, and my final BCG. I told Dr Stiles that I was changing my mind and would do the bypass. She was very supportive. Meghan said I was doing all the right things, keeping a food journal, and trying new foods for after surgery. I was starting to feel like I had a handle on things. Much less nervous, and I had a plan, and could see steps being taken to make everything come out as good as it can.

2/11/09 – Surgery Date and Final Psych Appt.

Okay, so I get a call about an hour before I have to leave work for my second appointment with Dr Izzy. It's my surgeons Admin Coordinator. She wants to schedule me tentatively for April 27^th. Dr Shah is leaving on maternity today, and the week of April 27^th is her first week back. Okay. I can do this. Freaked out a bit. But I am okay. Deep breaths. You have come this far, you can do it. And then I go get my head evaluated. YAY! Dr Greenberg was so cool though. He was understanding and knew what I was going though and prepared me for the day before and the day after surgery. The time when apparently, most people chicken out/ get scared/ question what the hell they are doing. I told him too that I was going to have the bypass. He was all for it, and said (and this I thought was the best thing ever), if this wasn't right for you, I would be the first to tell you. I appreciate having him as a resource at the OCC.

So I am sure you wanna know everything there is to know about me (it's okay if you don't, I'm gonna share anyway....just skim this entry)

It all began 26.5 years ago in a small town south of Boston.....Okay, maybe I shouldn't go THAT far back.

I have been heavy most of my life. It didnt start to really bother me until the end of college. I was involved in a car accident a month before graduation and hurt my neck and back (which had been already injured from a previous car accident waaaay back when I was 11). I started to suffer from depression, which I did not seek treatment for until....oh three years later or so (I'm stubborn....gimmie a break). I was in constant pain, and my weight shot up 20-30 lbs in a year or so.

What sucked the worst about it was being in pain, not being able to exercize and (while I was being MRI-ed and CT-ed for all the neck and back pain) they discovered a growth on my thyroid. They biopsied it. The results came back inconclusive. So of course I had to have the mass, and half of my thyroid removed (dur!). Once it was removed, the final results came back as benign. But what was left of  my thyriod went on the fritz. Up until that point, it was easy to maintain and lose weight. All I had to do was get on an elliptical for half an hour a day. (It's okay, you can hate me.....I hate that it used to be that easy too)..

Since then I have really had a seriously cranky time trying to lose weight. I'd lose a couple pounds, and then five would come back on. I had hired a personal trainer, and lost nothing but a chunk of change....though I shouldn't be too upset about that. He did teach me a lot, and now I can use what he taught me to lose more weight and get more muscles. I have two (count em two) nutritionists. One is at my PCP's office. The other is part of the surgeons program. 

So, flashing forward....Mid 2008...the sun is shining, its not snowing (hey, the weather in New England is nuts)....and there I am at my doctors office. She has just told me that I have diabetes, crappy cholesterol AND my BP is starting to get high.

***NOTE: The following part of this entry will contain adult language, you have been warned****

I lost it. I completely fucking lost it. Had an emotional meltdown on the way home, at home, at work, at my friends. I am too friggin young to be this sick. Bite me. My last PCP said she didnt think I had diabetes. Where the hell is this coming from? And how in the hell did I get such shitty cholesterol? My PCP reccomended seeing her nutritionist. So I made an appt with her. I also made an appt on my own to see my endocriniologist (thank GOD for PPO's).

So after the emotional meltdown, I got pissed. When I get pissed, I get motivated. Motivated to learn and just fix whatever the hell is broken.

The first thing I did was swap birth control. That I  think helped a lot with my BP. My endocrinologist put me on asprin. How does it feel to be 26 and on asprin. Just fucking great. So the good news is that has helped, and my BP is normal now.

November 4th 2008, an historic day. For the nation, and for me. But for two different reasons. I went to see my PCP before I voted. Where I was still at my highest weight ever (242), she calculated my BMI (44-ish) and said that she would like me to think about lap-band sugery. Coincidentally my aunt was told the same thing by her endocrinologist (same guy I see).

Cue another emotional meltdown. Reference getting pissed.

So I am great at research. That is what I did. I researched the hell out of the band, and banded with my aunt (ha-ha, cheestastic joke) to get this done.

I get referrals from everyone, including friends, doctors, Romans, countrymen....etc.

Because of their website and the information from my doctors and knowing that the director of this program was the first to do a laproscopic bypass, I decide on Tufts-NEMC in Boston.