Here it is: Read at your own Risk
9/8/01
So, yeah, I know that everyone and their mom has an online journal of their gastric bypass experience these days but I'm gonna go ahead and throw one on the pile. Honestly, there's not a better way to get information. You can talk to doctors all you want but they're NOT going to tell you exactly what you want to know because they haven't had the surgery, and, most probably, never had the need to. Yeah, I mean they're not fat. They don't know what it's like. They know that, as a population of people, we're unhealthy. Heart problems, shortness of breath from walking to the mailbox and back, diabetes, joint trouble, sleep apnea. You know because you have one or more of those things. If you
don't, then someone you know must because otherwise you wouldn't be reading this. Well I'm fat and unhealthy and I'm fucking tired of it. I am scheduled to have laparoscopic gastric bypass surgery on the 20th of this month. Of course, it's up in the air right now. The pre-op has been a royal pain in my ass. I guess that's how it is with elective surgery. They (by "they" I mean the team of people that deal with medical stuff that you have to work through to get anything done) aren't much help with elective surgery pre-op. I realize now that I should have taken time off work just to get the footwork done for this surgery. Not that that would have done any good because the footwork has to be done in an undefined, sporadic pattern because you're dealing with a dozen or so people and they all have other work to do, vacation to take, bathroom breaks to take...you get the picture. Phone tag is a game that I have become quite skilled at over the last month or so. I'm not blaming them, except for, if I was actually dying from something I would be pretty pissed off to spend my last living days chasing these people. But, here's the key, you have to pretend like you don't mind. That's right, so it takes them a month to inform you of a crucial detail that you missed and that is going to take you at least a couple more weeks to work through. SO WHAT?! You can't up and chew them out because YOU NEED THEM. Ever tried to get a straight answer from a pissed off three-year-old? Well, it's even harder than getting it from a happy three year old, and that is a challenge in itself, now, isn't it? Let me detail my latest frustration for you.
Okay, here's a little background: here is a list of stuff that needs to be gathered and sent to the surgical coordinator before he/she can even ATTEMPT to get your insurance to pay for your "elective" surgery. Okay, some medical records, blood work, some lists of this or that. Well, one of these things is a required mental evaluation. Now, this isn't just an insurance-specific stipulation. Most surgeons will require. It is so that they can feel confident that you are aware of the severity of the measures you are taking, and that you are stable enough accept the life changes. Justifiable, right? Sure, so about three weeks ago I met with Dr. "Preston." A psychologist, a doctor of psychology. Dr. Preston was very cool. He and I had a great hour of conversation and I'm pretty sure he came away with the details he needed to confirm my mental stability, and that in his expert opinion, I was a good candidate for this surgery. He mailed his report to the surgical coordinator, "Bess." Did I say this was about three weeks ago? Well, I think it was Monday when I spoke to Bess to let her know that I was having my blood drawn this week and then all the requirements would be met and she could submit my claim to my insurance company, "Alpha" Insurance. Bess informs me that she did receive the report from the psychologist but, SORRY! Your insurance requires the mental evaluation to be performed by a "board certified psychiatrist." I'm thinking, "You've got to be fucking kidding me, you're telling me this NOW?!?!? Not only did I already pay Dr. Preston to evaluate me and write up a report, but, with two weeks to go until my surgery is scheduled to take place, I need to get an appointment with a "board certified psychiatrist," see the psychiatrist, have THEM write a report and send it to Bess. Sure no problem, that can happen in two weeks. But WAIT!! I forgot to mention this little factor, it can take up to six weeks to get insurance to approve a procedure like this, and GUESS WHAT?!? I can't afford to have the 10 to 30 THOUSAND DOLLAR surgery unless my insurance will cover it. Oh yeah and, is anyone else wondering why the FUCK it matters if the doctor is a psychologist or a board certified psychiatrist? What kind of stupid stipulation is that? Beaurocratic bullshit no doubt...but I digress. So, right away, I'm on the computer looking up, through my insurance website, mental health providers that not only accept Alpha but have an M.D. after their name instead of a Ph.D. Then, as I make call after call I realize there's another glitch. Not all psychiatrists are board certified. Well that takes out about half of the population of the psychiatrists on the list. By the way, the list is of over a hundred mental health providers within a 25 mile radius of my home. Only a third of them are Md.'s. Only half of those people are board certified, and only TWO that's right TWO of those have an appointment open before I'm scheduled for surgery. By the time I actually scheduled the appointment two more days had passed and I was on the verge of tears thinking that THIS would actually be the tripping point that would cause me not to be able to have the gastric bypass surgery.
So, I guess I should have started this journal earlier because I obviously have a lot to say. Anyway, next Wednesday I go to the hospital to have a "type and cross" blood test and some other stuff. Directly after which I meet with my surgeon, "Dr. Wyman," whose office is, thankfully, across the street from the hospital. I'm not sure what we have to meet about, but it's on the requirement list and that thing has become my bible for the last month. I think he wants to talk to me to make sure that I understand the different risks and benefits involved in having the surgery laparoscopically as opposed to open. We'll see. And that very night I meet with my board certified psychiatrist. Then, it will be only a week for Bess to get my surgery approved by insurance in order to have it done on the 20th. We will definitely see. It should be interesting. Stick with me...it might be a bumpy ride. G'night.
9/13/01
Last night a met with my "board certified psychiatrist." That's it. I'm done. After that I just wait. Well, I still have to make sure that Bess gets the report from the psychiatrist. She, the psychiatrist, said that she would write something up this morning and fax it over ASAP. I talked to Bess this afternoon and she hadn't gotten it yet but I left three messages at the psychiatrist's office asked them to call me when the information was faxed, what else can I do? I'll call tomorrow. All I can do is hope. I'll keep you updated!
9/15/01
Well I didn't go to work yesterday (Friday) but I did go in for a few hours today. Thankfully there was a message on my voice mail from the psychiatrist's secretary confirming that the evaluation had been completed and faxed to Bess. I hope that Bess got it. The call was from 3:30pm so I'm sure if the document had just been faxed Bess couldn't have done anything about it but she has it. And she has three days next week to push it. Of course everyone is kind of walking around dumbfounded after Tuesday's terrorist attacks on the World Trade Centers and The Pentagon. I'm sure that will throw a wrench in the processing of my claim for the insurance but I'm not selfish enough to dwell on that. How could I even think about my petty issue when there is such a tragedy? Yet, I do, so I guess I am selfish for that. But, then again, I don't feel selfish, because
it's not like I'm not thinking of, and praying for the people who were directly impacted by the terrorism. In fact, I am ready to stand up and do what needs to be done if anything is needed from me. I sound defensive now, like I'm trying to justify still caring about having my surgery, even though I don't really feel like I need to justify it, I'm just stating that I am fully aware of and emotionally stunned by Tuesday's events AND I am still trying to keep my life moving forward. I don't think that is shameful. Well, that's the latest...
9/17/01
Well, today I confirmed with Bess that she received the fax from the psychiatrist. Later in the afternoon Bess called me and said that the insurance company wanted another list of information so I faxed it to her. That gave me hope, the fact that they were looking through my file to see what was needed means that they are processing it. I am still holding out hope that I can have the surgery this Thursday but the chance is probably pretty slim. Still, I won't know for sure until Wednesday afternoon. If they haven't gotten back to Bess by noon on Wednesday then we will reschedule the surgery. Hopefully, I'll know before then. Considering tomorrow is Tuesday, the countdown begins!!
9/19/01
Okay, that was fun, all that waiting, now I just have to wait some more. Damn Alpha Insurance. When I called
Bess at T minus 24 hours to surgery she had still not heard back from Alpha, so she called them and called me right back. Apparently, the woman working the case was in some kind of training seminar but had not put her decision into the computer file of my claim, so there is no telling if she decided to approve or deny me. Bess asked if I wanted to go ahead and start the pre-op which is antibiotics, clear-foods-only-diet, and bowel cleansing regimen and then just hope for the best...or just reschedule now and give up the idea of surgery tomorrow. I took the second option. I'm really not into voluntary diarrhea on multiple occasions, if you catch my drift. So now I'm scheduled for next Friday the 28th. I now think it's better all around. I am having a really busy week at work and I hadn't set up anything to pass my tasks off yet because there was still so much on hold. It's better now, and the 28th will probably happen. Bess said that even if they don't approve me on the first go around that Dr. Wyman will write a letter of appeal, and I guess appealing is not usually too long of a process because she said that I should still be able to stay on the schedule for the 28th. I know she wants me to have it over and done with so that I will leave her alone once
and for all!! So, I'm still waiting. There is still this fear in the back of my mind nagging that they're going to deny me and that the appeals won't work. It's scary to think that there is still a possibility that this WON'T happen...really, really, frightening.
9/20/01
I actually got approved. I am so thankful to the blessed people at Alpha!!! When Bess called to tell me I was so psyched. Then I called my husband. He doesn't want me to have the surgery because he is scared so he immediately starts asking how much WE will have to pay and how we can't afford to pay very much etc. Well, for one thing, you can make payments (like with a credit card) if you do have to pay a percentage of it and we could easily afford something like that. But to settle his mind and mine I called my insurance company. Right off the bat the woman congratulated me on getting approved. She said that it was often difficult to get approval for this surgery. She also said that her sister-in-law was going through a similar situation and that she just had to keep at it with appeals, etc. Then, she went on to read my benefits information and told me that the hospital stay and the procedure were going to be covered 100%!!! I would have no out-of-pocket for the surgery!!! I am so excited now, and scared shitless of course. Hopeful, though. This afternoon I am truly full
of hope.
9/25/01
Well, the sites been down for a few days. I was trying to put some cool new stuff on and ended up destroying the whole thing. It took me a few days to figure out how to get it back up without re-doing the entire thing. The latest is just a little more information that I got yesterday when a nurse from the hospital called me. I asked how long I would be in ICU and she said probably overnight. I'm actually hoping it won't be that long. Since my surgery is early in the morning maybe I will be able to move into recovery in the evening, but I don't know. The thing is that I really don't want to be alone that night. I can't even have my trusty Pink Bear (yes, I know I am too old to sleep with stuffed animals but he really comforts me when I'm sick). I asked if I will have my own recovery room and the nurse said that generally you have to request those specially and pay extra for them. I don't really care, I just wanted to know, so I figure I'll just take what they give me. And I asked if I should bring my own PJs etc. Apparently in the ICU you aren't allowed to have ANYTHING so I will just have the hospital issue gown, robe, and slippers until I move to recovery and then I can have my own stuff. I'm packing a bag for my husband to bring to me with my robe and my Adidas sandals and shampoo etc. I am nervous and excited. I really want to have someone with me but in the ICU you're not allowed to have someone there the whole time. I guess I'll probably be to drugged up to know the difference though!
9/27/01
Okay, the bowel cleansing regime is bad times. Just as preparation for anyone who has to take 2 10 oz bottles of magnesium citrate....it DOES NOT taste like Sprite without the carbonation. It's gross and I wanted to puke. So I mixed it with orange juice and ended up downing 2 10 oz bottles of mag citrate and a gallon of orange juice. I'm not kidding. And the orange juice gave me heartburn (which I should have expected) except that I can't take my staple drug, Maalox Quick Disolve tablets. Thankfully the hospital gave me a couple of doses prescription strength Pepcid to keep stomach acid down since I won't be eating anything else for awhile. 12 and 1/2 hours till they cut me open. Hey, how much worse could it be than liquified bowels and a chapped asshole?? I'll let you know...wish me luck!!
10/8/01
I tried to journal earlier after the surgery but it didn't save to the site and I lost it. Anyway, I actually went back to work today. That's right, 10 days post-op and I went to work. I'd take my bow except that it hurts to do that =o) If you hadn't guessed, surgery went really well. I was in the hospital from Friday morning till Tuesday evening. Thankfully my mom was with me every night Saturday thru Monday. The first night I was in ICU she didn't stay, but in there you have a nurse checking on you every minute. Not that I really remember, I have a few sketchy memories from ICU but the rest of the time I was in the hospital I remember. It was rough, but I think I did well. I'm glad that my mom was there because she helped me so much. I know the nurses in the regular recovery unit would have been happy to help me but it sure was nice to have someone there just for me all day and all night. When I had to go to the bathroom she helped me by unplugging my IV machine and helping me get around. We took my little walks around together, she made sure I didn't run over anyone. She was basically my slave but thank God for that, I wouldn't have been nearly as amiable or comfortable without her.
I am on liquids for 2 weeks post-op and then I start pureed foods. Actually, on Sunday (yesterday) I had some soup with little chunks of brocolli and I survived. I had a few minutes of "dumping syndrome" symptoms but I just kept breathing evenly (oxygen aids digestion) and took little sips of my unsweetened tea and the nausea passed and I was all good!! I was so happy!! I am still tired and having some pain but I am off of the prescription pain killers so that I can function normally and I am able to drive to work and stuff. The worst thing about being at work is sitting, honestly. I am much more comfortable lying down or standing. Sitting is okay for a while but it gets aggrevating. I have an Ace Bandage wrapped around my middle for support but it gets bunched up and stuff. Anyhow, I think if those are my biggest complaints then I'm in pretty good shape. I have a follow up with my surgeon on Wednesday. I will let you know officially how much wieght I've lost. Unofficially, it was 10 lbs on Sunday!
10/17/01
Well, its almost three weeks post-op and I am doing pretty well, if I do say so myself! Actually, I didn't make it to work today, but I don't consider that a step in the wrong direction. The last two mornings I have had diarrhea from hell and this morning I decided not to push it but to stay home and get some rest. I'm sure it was the right decision. I feel better. I called the nurse practitioner that works with my surgeon to see why she thought I might be having this nasty little problem. She thinks that (unless it's a stomach virus of some sort) it's probably just the vitamins. When I went for my check-up a week ago they started me on supplements. I think it's probably that. She said to back off until my system calms down and then start up again.
I am taking 2 Flinstones chewables a day (you can take one adult multi or 2 childrens, and since I don't want to swallow those grown-up horse pills I'll stick with Fred and Wilma for now), a B12, and I am supposed to be taking iron and calcium but I haven't started those yet. I bought the calcium but they smelled so gross I couldn't stomach it yet. I think I will just try to get enough calcium in milk. Of course, I tried to have a glass of milk last night and I felt really sick. I think my stomach is just really raw from being sick the last couple days. The B12 is cool though. It's this little dot of a pill that you put under your tongue and it dissolves. Apparently, sublingually is one of the few ways to actually get B12 to absorb into your system.
Also, I am having some pain at the largest of my small, laparoscopic incisions. The nurse said that as long as the skin of the wound looks good that I probably just pulled some tissue somehow and it is re-healing. The incision itself looks fine so I figure that's probably what it is. She suggested a heating pad on the area to help the pain. I don't actually have one but I think I will buy one tomorrow. I figure, after this, I can always use it when I have cramps from my period or something. My next check-up is next Wednesday and I will post another official weight check then!
10/30/01
I'm taking the day off of work today. I have work to do but I am going to do it from home, I'm just gonna use a vacation day. I am feeling alot better now than the last time I wrote. I rarely have pain at my incision and I'm throwing up what I eat less and less. It's a learning process, that's for sure! I think I will go for a walk this afternoon. I need to get exercise on a regular basis now to keep the downward trend going steeply. I am still not allowed to do any rigorous physical activity because everything's still healing but once I am allowed to I definaly want to do some weight training to turn some flab into muscle and keep my skin from hanging. Right now I am just using special Ester C lotion to keep the skin in the most likely places from hanging. The Ester C really smooths things out. There were stretch marks on my arms that are hardly visible now. I am hoping it will do the same thing on my hips and butt.
Yesterday I went out and finished my vitamin shopping. I had stopped taking my vitamins because I was having problems with my stomach getting upset but when I went for a check-up last Wednesday (the 24th) he said to get back on them, even if it was a slow process of integrating them back in. I was taking the Flinstones Chewables but I don't like the taste of them. Since I can swallow pills now without crushing them I went in search of a small adult multi. Of course most multi-vitamins are like horse pills and I knew I wouldn't be able to get one of those down. I DID find a brand that makes "tiny" multi-vitamins specifically for people who have a hard time digesting. They are about a 1/2 inch long, oval and thin. Very easy to get down. I also got my iron supplement. It's not small but it's in a coated capsule form so hopefully it will go down easy too. I haven't actually tried those yet. I need to try and take each with food so that my stomach is lined when they go down. Hopefully that will stop them from making my stomach upset. Well, anyway, I guess that's all the excitement from today!
11/18/01
I had a check-up on Wednesday (today is Sunday) and I was ecstatic to find that I have lost 30 lbs.!!! Things are going really smoothly now. I still can't eat bread, but crackers I can do. At least that helps satisfy some of my carbohydrate cravings. I am exercising now. I try to walk at least 3 times a week and I go 2-4 miles depending on how I feel. I am excited to be able to be active now and not feel like its a waste of time. Before the surgery I had tried so many times to start exercise programs, I had even stayed with it for months at a time, and I never saw any results, it was SOOO frustrating. Now I feel good, I'm losing weight, and can enjoy my walks knowing that I am actually getting stronger and healthier.
All the stitches in my incisions have dissolved now, and really the scars don't look so bad. I think that if I am able to wear a two-piece this summer (which I plan to be) people will just think I was riddled with bullets =o) That should make for some interesting conversation, huh? Well there's not much more to tell, I'm feeling really good and I hope I will continue in this positive pattern.
12/24/01
First, let me start by saying Merry Christmas!! It certainly is one for me. I went in for a check-up with my surgeon this morning and I am down 46 lbs. Very close to 50 which is a huge milestone! The doctor says I am doing very well and I don't have to go back for a couple of months. I talked to him about my problems with vomitting and he didn't seem too concerned. I guess at this point in the game it is still normal. The other night I got really sick (I was throwing up on and off for a couple of hours) from eating a few bites of grilled chicken breast. The doctor said that unless I chew each bite of dense foods like that into almost a puree I am still likely to get sick from it. Since I have virtually no stomach to break down the food I have to break it down before it hits my stomach because the small intestine is not going to accept anything but finely ground food. I thought I was chewing well but he said that there is no such thing as chewing too well after you've had this surgery. Also, he said to make sure that I continue to count calories and keep my calories down around 1000. I am still doing well with keeping my calories down but it's hard to avoid things like chips and crackers when I know I can eat them and they will stay down. I need to get into vegetables and fruit. The worst thing about those foods is that they generally give me diarrhea because I don't have much fiber in my diet. The lack of fiber and the iron that I take daily keep me pretty constipated and when I eat something like an apple, I get days worth of bowel movements in a matter of hours. I know, yummy. I need to start integrating fiber into my meals everyday so that I can be regular instead of on-again-off-again which is really pretty miserable. I sound like I'm complaining but I'm not, I'm just explaining how it is. I am down to a size 16 in jeans from a 22. Not much to complain about there! In comparison to how great I feel about my body already, dealing with the side-effects is something I'm really taking in stride. Well, I have some last minute shopping to do...gotta run!
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Before Surgery: 249 lbs.
10/7/01: 239 lbs.
10/10/01: 232 lbs.
10/30/01: 226 lbs.
11/14/01: 219 lbs.
12/19/01: 206 lbs.
12/24/01: 203 lbs.
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