Out of Park and In To Drive

Feb 20, 2009

I had my initial consultation on Monday, February 16th at Pittsburgh Bariatrics at UPMC St. Margaret.  Fortunately, I changed my appointment to a holiday so that my husband could stay home and watch the children.  It took me 1 hour to get there from my house, 3 hours for the appointment, and then another hour to drive back.  With 2 kids under 3, I never would have survived!  My appointment was at 9:00am and I was schedule to meet Dr. John Means who also lead the information seminar I attended on January 22nd.  I was in the waiting room until 9:30am and then I was brought back to meet with the Dietitian.  I got on the scale and received my initial height and weigh measurements before moving to her office.  We then reviewed the information packet that I mailed in and talked about weight loss prior to surgery and eating habits after surgery.  We made some goals for the next 6 months, which is the recommended time frame for their pre-operative diet. (NOTE: When I spoke to BC/BS, they indicated that there was no preliminary diet requirement for authorization, so I believe that it is a Pittsburgh Bariatrics policy although they would lead you to believe that it was the insurance provider.)  After signing up to attend their in-house dietitian sessions for the next 6 months, she provided me with my "homework".  I am to:
                       o Keep a food journal
                       o Exercise 10 minutes/day for 3 days/week  
                       o Stop drinking with my meals and immediately prior to eating
                       o Get into the habit of eating protein first at meals
                       o Start gradually eliminating soda from my diet

I have to admit that I was surprised that it was so lenient and not abrupt with change.  I assume that they feel a gradual approach will lead to long-term success rather than a severe behavior change at the outset.

So, from there I was to meet with Dr. Means.  I got into the Exam Room around 10:23am and didn't see Dr. Means until about 11:30am.  It was a long wait in a white-walled room with no periodicals.  Anyway, I did get to see him and he reviewed my chart and asked me about my health history and support system (which I informed him was lacking at the moment - but, that's a different post for another time).  He asked me which procedure I was interested in which is the RNY.  I explained that I had more than 100 pounds to lose and I also have a huge sweet tooth, so the Adjustable Band probably wouldn't be the best fit for me personally.  He agreed and told me everything looked good so far and that he'd see me in 6 months for my pre-op work up.

I then met with the scheduler who gave me all of my scripts and information for the various pre-op evaluations prior to surgery.  Most are the same as I've seen in the past with 2 exceptions:
                       o Chest X-Ray
                       o Liver Ultrasound (no gallbladder req'd since mine has been removed)
                       o Psychology Evaluation
                       o Upper GI (new to me since my first attempts)
                       o Blood work (TSH and H-Pylori)
                       o EKG
                       o Letter from PCP (new to me, although in the past I needed a referral, so same concept) 

After I complete my medically-supervised diet on 7/6/09 along with the list of above reqt's, I will receive a surgery date after which I will have to complete another set of tests req'd by the hospital prior to surgery.  She also told me that a few of the pre-req's expired after 6 months (like the EKG and Chest X-Ray), so I will wait a bit before doing those req's.

So, in a nutshell, I'm on my way (again!).  My next appt is for my first dietitian evaluation on March 2nd.  I think after that appt, I'll start making appts for the list above.  Based on the initial consultation, the 6-month diet, and the list above, I'm looking at a September-October surgery date.  The holidays will be interesting! 

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