The Big Day

A lot has happened on the surgery front since I lasted posted.

I GOT MY SURGERY DATE!!!!!

Before I get into that I will talk about the other steps in the process that have had to be done before I got to this point.

EGD: I had to have and EGD done to make sure that I don't have a hiatal hernia. If I did have one the surgeon would fix it while he is in there. This was quite the fiasco, let me tell ya. I had to reschedule my initial EGD because I wanted to make sure everything was square with my insurance since the EGD isn't cheap either. I called to reschedule and she gave me a day and told me to call the night before to get my procedure time. When I called to get the time they had to record of me.
the scheduler at the surgeon's office made an error and I was never officially added to the schedule...
This procedure was a big deal. This was the last item I needed to have done in order to have everything turned into my insurance for approval so this could have held me up big time since the surgeon only does EGD's one day/month. LUCKILY my surgeon has picked up extra shifts at our local hospital and the scheduler was able to get me in while he was at the hospital (as opposed to the outpatient clinic). I think she just felt bad so she pulled some strings.
All in all the EGD was painless. I don't remember a thing. the last thing I remember was laying on my side in the procedure room and getting an oxygen mask on. After that the nurse injected some good stuff into my IV and I passed out. It was all over in 20 minutes and they wheeled me into the recovery room and then the surgeon went to get my husband and tell him the results. No hernia! Woo hoo! the funny thing about being in the recovery room is that from what I remember it feels like I was doing everything with my eyes closed. I can remember conversation a little bit and getting dressed but I cant picture it in my mind. Over-all, it was painless.

The day after my EGD the bariatric coordinator at my surgeons office, Angie,  submitted all of my information to my insurance for approval. After a week went by I started to get anxious so I emailed my insurance to see if they could tell me if I had been approved. I received an email back within 24 hours saying that I WAS APPROVED!!!
I immediately called Angie naïvely thinking that I could get my surgery date. She informed me that the surgeon would have to review my record and then have the hospital look it over and THEN they would call me and get me a date. She said this step would take about a week.
A week later (January 28) she called and told me that they had a 2-12 surgery available so I obviously said HELL YES! However, I got ahead of myself as this meant that my pre-op diet would have to start the next day and I needed to run to the surgeons office that day in order to get my protein powder to last me until my pre-op appointment tomorrow.

So there it is folks. I'm still working my way through the pre-op diet and sobbing at the amount of money ($2,400) that I have to hand over tomorrow at my appointment. God bless my amazing husband and all of his support because this is a lot of money for us and he hasn't even bat an eye at it. Love him :)

Also- the pre-op diet has been making me feel pretty crappy. The point of the pre-op diet is to shrink your liver and open up the space where surgery will be. This means the diet is flushing fat out of my system. Blech.

Oh well, it will be VERY worth it shortly :)

Brief Hiatus

I apologize for the break in blogging there folks! Christmas with two toddlers is a little hectic and my husband and I have been running around like maniacs to get everything wrapped up and planned. We have to make sure that both my family and his get equal time so it takes a lot of scheduling and conversing back and forth with everyone to get a schedule set in stone.

Not a whole lot has happened on the surgery front lately. My husband found out that instead of renewing their health insurance in August like they usually do, his employer opted to change it to January. I halted my surgery appointments until we could determine which insurance, his or mine, would be better in the long run financially for the surgery. We determined just today that we will keep me insured on my insurance for numerous reasons but the main one being that it will be cheaper after it's all said and done.

Once I knew that I immediately called the surgeons office to re-schedule my EGD or upper GI endoscopy for January 6th- GAH! I also need to go in and get x-rays of my chest done as well as some labs drawn. They will send the x-ray and labs to my insurance which will help to determine if they will cover my surgery.
How nerve racking!!!

My husband and I also made the decision that I need to have my surgery before May 1st (when my insurance plan renews) because we don't yet know what changes will happen to my insurance and I have a pretty good plan right now. If we wait we run the risk of paying a lot more out of pocket because of the changes to health care this year.

It's crazy that this time next year I will be a different person...
I couldn't help but think over Thanksgiving how different Thanksgiving will be for the rest of my life. 1 cup of food next year. Half veggies/half protein. That's it. I am so used to having a plate full of food so it's going to feel so strange but I welcome it with open arms if it means a healthier, happier me!

Let's Get This Ball Rolling!

Well folks- it’s officially begun.

I met with my surgeon (who is incredible by the way) and have gotten the ball rolling.

Here is the breakdown of my appointment/morning:

8:00- Complete necessary paperwork and give them my insurance information.

8:15- Get “Before” picture taken and meet with nurse to discuss “The Study” (“The “Study” is just that- a

          study that collects data from people undergoing bariatric surgery and tracts their progress)

8:20- Meet with surgeon, Dr. Slikkers at Grand Traverse Surgery, to discuss different types of surgery

           and to hear his recommendations. He thinks the best option for me is the vertical sleeve

           gastrectomy, which is what I wanted anyway. He says I should be able to lose 85-100 pounds if I

           strictly follow post-op instructions. He tells me that I need an upper GI Endoscopy to check for a

           hiatal hernia; this is due to my heartburn and possible GERD which can get worse sometimes with

           the sleeve procedure. I also need to get a full lab work-up and a chest x-ray.

8:40- Meet with scheduler to get a date for my endoscopy and get my lab slips for blood-work and

          X-Rays.

10:00- Meet with a few people in a group with the nutritionist to discuss pre & post-op diet as well as

             changes to make now, while we are a few months out from surgery.

10:30- Meet with the nutritionist individually to discuss my concerns and questions. As it stands I am

            getting about 36 grams of protein/day and I need to bring that up to 80-100 grams/day… YIKES!

Overall I am super excited that the first step is out of the way but I am also so frustrated because this whole process is very expensive. The endoscopy alone will cost about $750, plus the x-rays, labs, protein powder, co-pays, and surgery costs. I am starting to feel more guilt regarding this whole process. My husband is so incredibly supportive but I know that it has to be frustrating to see so much money going towards this. He just keeps saying “it’s OK- really. It will make you happy.” What about his happiness? What about the kids? In the grand scheme of things I know this is nothing, especially in comparison to what my family and I will gain from me being healthier but still…for a young family like mine with 2 kids and daycare expenses- we are going to feel this for a while. We haven’t even paid off the hospital expenses from delivering my second son! I just feel selfish.

As promised here are my stats from my first appointment:

Weight: 229#

Height: 5’ 4-1/2”

BMI: 38

BP: 110/70

Big Step In the Right Direction

I met with my primary care doctor last week and she prescribed me my very low dose cholesterol medication so that my approval for surgery will not be a problem. I also met with the behavioral counselor at the weight center, which was my LAST appointment at the weight center. Its pretty unbelievable that it has been 7 months since I started this journey. 
The counselor specializes in weight-loss and issues related to obesity. It was so great to speak with her and have someone know where I am coming from (I even cried a little). I love my husband dearly but he has never been overweight and neither has anyone else in his family so he can't relate to the struggle at all. Mandy, the counselor, helped me determine what I need to do to put myself first and also things that I need to accomplish prior to surgery to ensure success post-op. Here they are:

1.  My first and most important goal is to slow things down. I have determined that many times when things don't go as planned or I stray off of my plan it is because I was just too busy and didn't have enough time to allow myself to make good choices.  
2. Increase my protein intake to 80 grams per day, which is where it needs to be after I have surgery anyway. This will make the post-op diet and adjustment less stressful. 
3. Realize that the only thing that is going to change after surgery is my stomach; I am still going to be busy and have all of the same responsibilities. I need to establish a healthier schedule now so that I don't sabotage my success post-op. 

My next step is to meet with the surgeon and get our introductions out of the way! I made my appointment for November 17th and I will meet with the surgeon that I have chosen first and then meet with the nutritionist (in a group setting). 
I am still not planning on having surgery until May 2015 unless I can come up with the insurance money sooner but with the holidays just around the corner that seems like a very slim possibility. The money that I am talking about is the deductible money that is due 2 weeks prior to surgery, in my case it is $1,000. 

I will tell you my weight and stats after my first appointment with the surgeon. 

I am so excited to have the ball rolling with my surgery! 

An End and a Beginning

Yesterday was my last appointment at the weight center and I went out with...a gain.
There are no excuses for why I gained weight back. I could have done a lot of things differently to avoid that but I didn't. The worst part was when the Doctor came in (with her student that was following her) and they have to tell you that you gained weight even though they know that you are fully aware. The look on their face was like they were telling me that my dog died.
It is what it is; I can't linger on that moment and let it affect me more than it needs to.

We discussed my plans with my insurance and the timeline for my surgery.
I will be switching to my husband’s insurance plan for the surgery because they have less out-of-pocket expenses. Since I will be saving about $40/week not paying for my insurance I will be opening up a flexible spending account to help with my deductible expense. This is what is delaying the surgery so much. As it stands I could have surgery at the end of this year but My insurance plan through my employer doesn't renew until May 2015 and that is when I can open the flexible spending account. My husband's insurance has an initial deductible expense of $1000 and that is what I will be saving for.
As it stands I need to meet with my PCP to get a referral letter for surgery as well as a low-dose prescription for cholesterol medication so that it is documented. At the beginning of the weight clinic my cholesterol was very slightly elevated which is why she suggests going on medication. Would I be ok without it? Sure.
Would it benefit me to be on it? Most likely. This medication will be my second and final co-morbidity in order to qualify for surgery.

At the beginning of the appointment they always get my weight, blood pressure, pulse, and hip and waist measurements. My weight was 228.4 and my BP was 132/70…very high for me; my normal used to be 117/70.

This is becoming more real and I couldn’t be more excited. I want my life back and I can’t wait for the journey to progress.

Inspiration

Making the decision to move forward with weight loss surgery was not easy. I still struggle with the feeling of defeat; that my weight beat me and I am surrendering. I have to remind myself why I want this and look at my inspirations; the self-hate just falls to pieces after that. I have 2 amazing children and a dreamboat husband, my friends, my life. 

A number of my family members have had weight loss surgery so I don't have to look too far for advice, motivation, and my future.
One of my best friends is my Aunt and she just celebrated her 1 year anniversary of her vertical sleeve gastrectomy. She has loss a total of 102 pounds and she said she has never felt better- EVER. She has more energy, is happier, and just wouldn't change it for anything. She said he major improvement is her energy because now she can do so many things that weren't even a possibility a year ago. The downside is that she waited too long to lose the weight and now she has arthritis so she cant exercise very much but she doesn't need to; she is perfect. Everything about her has changed; she is so much happier, her smile is brighter and she just radiates positive energy.

That is what I want; a total body and mind renewal. The kids are getting harder to keep up with and I just can't wait until the day that I can keep up with them (or maybe even outlast them....keep dreaming).

Weight Loss Program and the Insurance Loops

I started at the Healthy Weight Center at the end of April/beginning of May. They did an orientation and took my measurements and vitals, then showed me around the building. At the end of the orientation they make your appointments for the next 2 months; these include nutrition, medical, behavioral, and exercise. I was so excited to get started and meet with everyone so I wanted to make my appointments for as soon as possible. As a part of the program they also offer group classes and group exercise so I signed up for those. I was so excited and had a feeling that I may be able to pull this off; I had a sense of hope that I had lost a long long time ago.

Fast forward 5 months and I have one month left at the weight center. The time went by so fast and I have lost about 5 pounds that isn't near enough as I should have lost. Though the numbers on the scale don't say much I wish the knowledge I've gained could count as pounds too. Life just got in the way. Take last night as an example; my husband and I both got home around 5:45pm. We got the kids shoes and coats off and we changed out of our work clothes- it’s now 5:55pm. I look through the pantry, refrigerator and freezer for something to make for dinner; it’s now 6:00. I make dinner and sit down to eat but our 3-year old wants nothing to do with it. His only other alternative is scrambled eggs (I refuse to make 3 different things for him) so we make him some eggs. We finish eating, feeding the baby, and getting our toddler to eat- it’s now 6:45. I do dishes while my husband folds laundry and lets the dog out- it’s now 7:15. I get my lunch ready for work and change the baby's diaper. 
7:30 rolls around and it's time to give the kids a bath. I bathe the baby and get him in his PJ's. It's now 7:45 and he is tired, fussy, and wants a bottle. While my husband bathes the toddler I make baby a bottle and fight with him to get him to fall asleep (even though he is exhausted). The time is now 8:30 and the baby just fell asleep and our toddler is in his PJ's and needs to go to bed. My husband takes him into his room and tries to read him a book but he is HYPER and wants nothing to do with it. After listening to dad and toddler fight I go in to mediate- the time is now 8:45. I leave dad to read to him some more at he finally emerges at 9:00. We both collapse on the couch only to hear our toddler playing in his room. We let him play and figure he will pass out eventually- then the door opens. I go in to read a few more books to him and I am finally able to leave his room at 9:20-ish. 
The LAST thing I want to do at this point is exercise. I am frustrated, exhausted, and oh-so looking forward to another day at work away from my super-cute kids. 
My husband and I attempt to watch some "adult" TV (no it’s not porn- it’s HGTV) since all we usually get to see are over-cheery kids cartoons. We give up trying to watch TV at 9:45 and head to bed. 
So while other people may be able to workout at that point for 10, 20, or 60 minutes- I know that my sanity hinges on getting some sleep before the baby wakes up during the night. 

This is my life 5 days a week. Most nights are quite so bad because my toddler is not usually so difficult to get to bed but it's exhausting. 

Anyway- Until those kids move out- I don't see things slowing down one bit and I refuse to wait until that point to get healthy and feel better which is where the weight loss surgery comes in. 

Most insurance companies require a 6-month physician monitored weight loss program prior to being approved for bariatric surgery. Since my BMI is 38 I also need to bring some "co-morbidities" with me. My triglycerides were high when I started the healthy weight center, my cholesterol is very slightly high, and my BP fluctuates. The healthy weight program is put on through our local hospital by the surgery center that would perform the actually procedure so the doctor I see is actually someone who knows what it takes to get approved. She suggested that I talk to my PCP (primary care physician or regular doctor) about putting me on some cholesterol medication (low-dose) and that would seal the deal on being approved for surgery. It's just sad that you have to be extra sick in order to be approved as opposed to slightly sick and just don't want those co-morbidities to even happen in the first place. She said after surgery I won’t need the medications so it's a win/win. 

Anyone else annoyed with the process of being approved?