Update

Just a quick update, nothing really exciting but progress none-the-less.

I have been ticking things off my "to-do before surgery is approved" list and that is a good feeling.  When I started this process and I was working on filling out the giant packets of  paperwork I looked at the algorhythm of the whole process (yes my surgeon's office actually has an algorhythm sheet of what to do when and what to do next etc) and it looked so overwhelming, but slowly but surely I am checking things off the list.

I saw the exercise specialist right before Christmas and with the walking I am doing I also need to start building muscle by doing some strength training.  It doesn't help matters that we had a huge snowstorm and now it's a little tricky to go outside walking.  I haven't walked in a while, not gonna lie about it.  I am going to look at getting an exercise bike and keep it in the living room and some small weights to start with.  After surgery I really want to get a personal trainer and go to a gym and actually have help to progress to where I want to be.  BUT for now I will keep doing what I am doing, which isn't much, but I am going to work on that.   I don't want to wait until after surgery to start working out so I need to get my butt moving...literally!

I did my fasting labwork yesterday and that wasn't bad, but holy cow they took like 8 vials of blood!!  Geesh!!  Waiting on results of those but I'm sure that will take a while.

Yesterday afternoon I saw the nutritionist.  It was basically a get to know each other appointment, she asked me some questions about my dieting history and eating patterns and I got weighed.  262.something...ridiculous and embarrassing!!  I have only ever been this heavy in my life when I was 9 months pregnant!  Unacceptable!!  I have no doubt in my mind that I am making the right choice in having gastric bypass.  Basically the nutritionist gave me some introductory information and told me to start eating between 1200-1400 calories per day so I can take off some weight before surgery in April.  I also have to do a 2 week liquid protein diet before surgery to lose weight and shrink my liver, that is going to be tough.  I go back and see her to discuss all the fine details of eating closer to the surgery date, plus she will see me post-op in the hospital.  Basically it is going to be a high protein diet.  I hope to lose 20-25 pounds before surgery, I am shooting for around 240# when I head to surgery.

I have to have a gallbladder ultrasound, see the pulmonologist, get weighed in at the surgeon's office (the medically supervised diet requirement), and see the psychiatrist to get cleared.  These appointments will all happen in January.

So, if I'm being honest, I have to say I haven't told many people about this surgery.  I guess this reason is two-fold.  The first reason is I am kind of superstitious,  and I don't want to jinx it by telling everyone and then finding out it's a no go.  Dumb I know.  The second reason is pretty valid, I think.  The people I have told have been less than supportive, I don't mean my husband, he is all for it and will probably have weight loss surgery himself once I am fully recovered.  The friends I have told gave me the typical, don't you want to just diet and take the weight off, change habits...blah blah blah!!  Of course everyone has the .00001% bad outcome horror story they have to share too.  Whatever...I am not going into this blindly and it isn't a spur of the moment decision.  I have been overweight my whole life, yo-yo dieting my whole life and have given this surgery serious consideration for years.  So yeah, just skip the opinions and well-meaning advice, I need your support and not your opinion.  Anyway, I'm sure I will tell more people over the next few weeks but for now I am happy not having to hear everyone's opinion.  Opinions are like assholes, everyone has one and they are usually full of shit... 

 I will update again as I go to more of these appointments.  I will take pictures, stats, and post my progress once I get my tail in gear and start dieting and exercising.

Also...almost forgot to mention.  I have been OBSESSED with watching You Tube videos about people documenting their gastric bypass weight loss journeys.  There is a wealth of information out there and if you have the time check it out, it is awesome!!!  I had considered doing  video blog on you tube but I don't think I am chatty enough to talk into a camera for that long.  So I will just stick to typing in this blog! :)

Until next time!!  I probably won't post until after the new year so...HAPPY NEW YEAR!!  Here's to a healthy 2013!!

Moving faster than expected

I had my appointment with the surgeon and his nurses yesterday (12/13/12) and it sounds like things are going to move more quickly than I thought, with a tentative surgery date for April.  In the meantime, I am going to see the nutritionist and do the exercise evaluation next week, I need to have lab work drawn, a gallbladder ultrasound, and see the psychiatrist and then closer to surgery see the psychiatrist, nutritionist, and surgeon again.  The reality of this is sinking in.  I had feared the insurance wouldn't be cooperative but it sounds like the nurse talked to them and they are going to approve it.  I probably won't breathe easy until I have something in writing.
Pressing onward...

Dare I hope this is going better than expected?

After I attended the weight loss surgery informational seminar earlier this month I started right in on all of the paperwork, and I won't lie, it was A LOT of paperwork to fill out but it could have been worse.  I contacted my OB/GYNs office and also my family nurse practitioner's office and requested that any records or office notes that list my weights be forwarded to the bariatric surgery nurse coordinator.  I was honestly thinking it would take a while but it actually has been very quick.  Everyone I have had to speak to by phone or email so far has been very nice and very accommodating.  The bariatric RN gathered all of my weight data and she not only talked to the insurance company but also contacted my nurse practitioner for a letter of medical necessity for the surgery and a referral to the surgeon, so I guess that step, I can say, came together nicely and much quicker than I thought it would. I was worried because my BMI range was not always over 40 during the last two years, which is what the insurance company wants, but I guess they will attribute the times my BMI was under 40 to times I was actively dieting.  As soon as the referral is received by the surgeon's office I can go in for my initial appointment with him.  There are many steps to take after that before the actual surgery and I'm sure things won't keep going this smoothly, but so far this is going well.

First step...Check

I attended a weight loss surgery seminar at the hospital last night.  It is the first requirement, the first step in starting the process of getting weight loss surgery.  The bariatric program is at the hospital I work at and it is an all inclusive program, all of the specialties a patient needs to see during the pre-op phase, the surgery itself and the hospitalization, and all of the post-op follow up care are done on site.  All of the team members were there, the nurse who is the bariatric surgery coordinator, the exercise consultant, the nutritionist, and the surgeon.  All of the members of the team got up in front of our little group and gave their presentation, I'll be honest I have been researching weight loss surgery for months and maybe even years off and on and nothing they told me about the surgery itself was new information to me.  It was helpful to hear how the process works, all the appointments that need to be done to get clearance for surgery and things that will  happen post-op were all nice to hear about.  The biggest take away I got is to have patience.  Nothing about this process is going to be speedy.

My medical insurance is going to make this very difficult for me.  I have been obese my entire life, I can diet and lose weight but the weight always comes back on.  I don't feel as bad about this since talking to the bariatric nurse who said this is typical of all of their patients.  Hence, my BMIs are all over place if looked at over time.  The insurance requires a documented BMI of over 40 for 2 years.  Obviously I don't have that because my BMI has dipped down to the mid to upper 30's at various times in my life (35 is still classified as morbidly obese).  The only way the insurance will cover a BMI of 35 or greater is with some very specific co-morbidities, none of which I have.  Apparently the health system I work for just came up with this new policy and sprung it on the bariatric team with no notice.  They also require a medically supervised 6 month diet, which to me is so stupid.  I know I can lose weight, they can look at documented weights for me my whole life and see I can lose weight, I just can't keep it off.  The bariatric team is not happy about the new policy and has met with "the powers that be" from the health system we work at to see if this can be changed.  Hopefully they will see reason.  I'd hate to think they would willingly tell me to stay morbidly obese with a BMI of over 40 until I reach the 2 year mark and then proceed with surgery.  How detrimental to my health will that be?  Just makes me shake my head.    I'm sure there is an appeals process if we get to that point, but they may not budge.  There is also the option of medical tourism and having surgery in Mexico, but we will cross that bridge when we come to it!!

Anyway, for now it's lots and lots of paperwork to fill out, pulling together old medical records with documented weights, and then setting up the initial appointment with the surgeon and the doctors.  I will keep pressing on and pushing toward this goal.