3 week follow-up

I had my three week follow up with the doctor today and everything is going fine. My incisions are healing nicely and I'm down 48 pounds from my official weight when I left the hospital. (I gained 8 from the fluids while I was in there). Eating is going well, I'm taking it slow and I'm feeling much more positive about my progress.

What I like so far:

Mint herbal tea (for some reason it is the easiest beverage for me to tolerate) I have tried lots of other things and none of them go down as easy with the tea. I started out drinking crystal light but I don't feel great when I drink it, so for now I'm sticking with the tea. I used to love plain water and right now it makes me feel sick when I drink it, I'm not sure of the reasons behind that but I'm going to go with what feels good.

Seafood, so far all kinds of seafoods seem to be going down easy. I made scallops marinated in lime juice, and I've had lobster tail, shrimp, fake crab and tuna. No problems with any of them. Good thing I loved seafood before the surgery. Jeff wishes I would lay off the lobster tail though.

Tonight I made Zucchini Ricotta bake, basically you make it like lasagna but replace the noodles with zucchini. I may never eat real lasagna again. (sorry honey)

I can't drink milk but I can have yogurt, butter and cheese without a problem. It is possible the lactose intolerance was a passing issue, but I haven't been brave enough to try it yet.

I have also been able to eat salad, deli meat and cheese, Cobb lettuce and field greens and my favorite food olives.

What I haven't liked:

One night I decided to have some three cheese mashed potatoes and a chicken finger. Bad Idea, I'm not sure why the potatoes didn't' agree with me but they made me feel really ill. The chicken also didn't go down well, I think it will be a while before I try them again.

Hamburger, I went out to Red Robin with Jeff for his birthday and the burger was too much for me. When I met with the doctor today she said lots of people have problems with hamburgers early on, so I think next time I'll stick with something easy like soup.

I'm looking forward to Thanksgiving. Other than the occasional cracker I have eaten next to no carbs since the surgery. It doesn't make sense to make mashed potatoes for myself. The only carbs I have had are really those that are included in the veggies that I've eaten. That might be contributing to my rapid weight loss, but whatever it is I don't want to mess it up.

I've gotten a few requests for pictures. I will be taking one month pictures this weekend and will post them on the blog. Once I do that I will probably make the blog private, if you read it email me and I will send you an invite so you can continue to read it once it goes private.

Today is a Better Day

I feel much better today. It might have something to do with the scale telling me that I am down 45lbs and the fact that a shirt I have never been able to wear is now loose on me. I decided I was pushing my diet too quickly, that I need to relax and let my body take the lead. So I'm sticking to the basics and am going to be eating a lot of seafood for the next couple of weeks. I got recipes so that I can make the things I can eat slightly more interesting. I'm working on gathing recipes and will post the ones on here of things I end up liking.

My follow up appointment with my surgeon is on Monday, after that I will be cleared to exercise. Jeff is on the hunt for a Wii fit for me and I am going to do my cardio by walking/jogging on the treadmill.

I'm noticing in many subtle ways how much better I feel:

My back no longer hurts, this started about two days out from surgery and has never continued. I am now happy to go to the mall and walk laps, as a matter of fact I'm actually looking forward to the next time I go.

My knees don't hurt.

I'm cold all the time. Jeff and I have been "arguing" about the thermostat on a daily basis. I used to be hot most of the time, now I walk around in long sleeves, pants, thermal socks, and a fleece bathrobe. I told him I was going to buy some freezy freaky gloves to prove to him it is too cold in this house. (For those of you who do not remember freezy freakies, they are gloves that had hidden designs that would appear, when I was a kid the big thing was to put them in the freezer and see how long it took before the design disappeared.)

The Good, The Bad and The Ugly

I haven't posted in about a week mainly because I have been trying to adjust to how different things are. When I left you last time I was completely focused on food, thinking and dreaming about what I would eat, when I could eat it, how excited I would be to be able to feel normal again.

I am now on the opposite end of the spectrum, no only am I not thinking about food I am completely repulsed by it. Eating is a chore, there is no more joy in it. My life is consumed by food rules, how much I can eat, when I should eat it, how I should chew it, what order I should eat it in and even when I follow the rules some things just don't feel great. Tonight I ventured out to a restaurant for the first time since the surgery. I went to Red Robin with Jeff and my parents to have a belated birthday celebration. I was able to eat about one third of the burger patty and that was it. Right now I'll just keep trying, one day at a time until eating feels normal again. I've talked to others who have had this surgery and they assure me that the way I feel is normal and that it does go away, eventually.

On a positive note, I am down 42 pounds, bad part is my wedding rings are getting very loose, I can probably wear them for another month at the most, then it will be on to a cheap wedding band until it is time to resize them.

Food and Hunger

One of the benefits of this surgery is that most people never feel hungry again. I can honestly say I'm not hungry, even though I am existing on about 300 calories a day I do not feel hunger. I am occasionally thirsty. That being said, I am more focused on food now than I have ever been, I believe it is because I can't have it. The doctor's have assured me that once I can eat again the fixation with food will go away. Right now I'm watching the food network, when a tv show has food in it I focus in on what others are eating and long for the day when I can eat food again.

I have started a grocery list and looked for recipes that I can eat after surgery.

The therapists call this head hunger, and now that I can no longer feel physical hunger, I realize how much was truly in my head. This will be my cross to bear and the thing that I must work the hardest on to make sure that this surgery is successful.

Who I would like to thank

I'm not used to accepting help and the reason is that i'm a bit of a control freak, but people have been so helpful after this surgery that I just wanted to thank them.

Jeff has been amazing, he spent hours just sitting in the hospital while I slept in a drug induced haze and woke up every hour or so to ask him for something. He has made emergency trips to target for pain medicine, and soy milk, he's done laundry, all the heavy lifting and the million other things that need to be done to keep the house running. He's dealt with the whining the *very* occassional mood swing and my constant need for attention. I'm wondering if I can drag my recovery out about six months or so.

My mom and Mike have called to check on me every day. My mom spent 10 hours waiting in the hospital for me to be wheeled back to my room, only to find me in a drug induced haze. She brought me some yummy chicken broth which was the only thing that made the first few days tolerable and has picked me up and taken me out to keep me busy and keep my mind off of the million food commercials that seem to be on every channel.

John and Bette (my in laws for those who don't know) drove up and spent two days with me so I didn't have to be alone when Jeff went back to work. They shuttled me around and took me to vote in the pouring rain and basically took care of my every need. It was great to have the company and I was a little nervous to be alone those first few days after surgery. I'm not sure how many it was but Bette did what seemed to be 15 loads of laundry and swept my kitchen floor. Anyone who knows me knows how important the cleanliness of my kitchen floor is (and no this is not a joke, the last time my neices came to visit Autumn was pretending to be me and was swiffering the kitchen floor.)

Amber who has been kind enough to bring the baby to visit and take me shopping. Holding a baby is the best medicine.

My friends Andrea and Monika I have not known them for long but they have been keep me company and keeping me from losing my mind, Andrea has answered millions of questions about my surgery and helped keep me sane. I'm also a wee bit obsessed with her two adorable children, like I said baby medicine is the best medicine.

All my other friends and family who have been calling and checking on me and keeping my spirits up. It has done wonders to know that so many people care and are supporting me through this.

Lactose Intolerant

Things have been going so good that there was bound to be some set back. The last few days I have felt a little blah and had a stomach ache, I assumed it was just some residual pain from the surgery, but tonight I put two and two together and figured out it was milk. I knew this was a likely side effect but was *hoping* I wouldn't be in the majority that has this side effect. It is likely that I will still be able to eat things with milk in them and just can't drink a glass of milk. If that is the case it is not the end of the world.

Tylenol and Protein Powder

I haven't needed narcotic pain killers in a few days but I felt like I needed something, so I decided to take tylenol. The pills make my stomach feel full so I decided I would try children's liquid. That was a mistake, it did not agree with my stomach and I could feel it burning as it went down, so instead I decided to make tomato soup with protein powder. If there is one thing I underestimated about this surgery it was how hard the liquid diet would be. I thought I was prepared, I have every flavor protein powder out there and I don't want any of it, the idea and smell of it are revolting to me right now. I went out and bought some creamy soups to mix with my protein powder thinking that would help, it has a little but not really. I'm just going to have to suck it up and be a big girl, but I am counting down until the 17th when I can have real food again.

A week and a half later

I've been home for a week and I honestly don't feel like I had surgery. I've lost thirty pounds. To be fair I gained ten while I was in the hospital and I believe I was retaining quite a bit of fluid when I went into the hospital so a lot of the weight loss may be fluid, but it still feels good to see those numbers on the scale.

My incisions are tiny, less than half an inch each and aside from the occasional itching do not bother me. I have no internal pain and I'm completely off of my narcotic pain killers. I believe I'm doing so well because for once in my life I am focusing on me, taking care of myself and not allowing myself to play second fiddle to everything else going on in my life. I still get tired easily and I am sleeping a lot, but at this point I don't expect any major or even minor complications.

I sit here day after day drinking liquid out of a 1 ounce medicine cup every 15 minutes. If that does not sound like enough to drive someone insane try it for a few hours. If I never see a medicine cup again that will be ok.

I am however going insane from drinking protein shakes. I am not hungry and though I am currently existing on about 300 calories a day, I don't feel hungry, weak, lightheaded or any of the things you would expect from such a drastically restricted diet. It is amazing to me how much of my hunger before really was all in my head.

The problem with the protein is I seem to be developing an aversion to them, they don't bother me, so far my new stomach has tolerated everything, I just don't want them. I long for the day I can take a bite of a chicken breast. I still have ten days to go on this liquid diet and I believe it is going to be a struggle. I'm determined and just need to find things to distract myself.

Coming Home (Originally written on Nov. 2nd)

The next morning the nurse came in and said that the surgeon had indicated my catheter could be removed. I felt like a real human when that came out. I was even allowed to take a sponge bath. I got cleaned up the best I could with a washcloth and bucket, put on my own pj's and went for a walk around the halls. I noticed the nurses never came in after that to ask me to walk. I don't' know if it was because they were just keeping notes of how many times I went on my own, or if the surgeons orders were that I only had to do it twice. The walking made me feel much better, but I was usually tired when it was over and went back to sleep. The nurse then came in and said the cardiac monitor and the pulse ox could be disconnected and all I would have to have was the IV.After they removed those they came in about every four hours to check my vitals. I was taking my pain medicine in a pill, but was still getting Zofran through the IV. They brought me Carnation Instant Breakfast, broth, bottled water, watered down soup and a popsicle for breakfast. After no water for more than 24 hours I wanted to guzzle the whole bottle but I restrained myself.I was keeping down all my liquids, walking and all my vitals were stable so the doctor said I could go home on Saturday morning. They let me walk out of the hospital and I have been up on the treadmill twice since I got home. So far so good. I get tired easily, today I have walked on the treadmill and taken a shower and I think it might be time for a nap.

My Other Scary Moment

Around midnight I woke up with some really severe chest pains. I started hitting the nurses call button and layed there for about an hour just hitting the button over and over again, and no one came.I was not able to take a deep breath because of the pain and so I couldn't yell out, they would not have heard me anyway, the woman in the next room was pucking and yelling. At this point I could not have gotten myself out of bed, there was no way for me to maneuver without ripping my catheter or IV out. So I disconnected my heart monitor and pulse ox. Finally after twenty minutes someone came. The nurse checked my vitals and Dr. Porteneir's intern came, after about twenty minutes they determined that I was ok and the pain was the gas bubbles settling under my ribs. It was scary. My surgery was at Durham Regional Hospital and while the nurses overall were great and everyone that came into the room (except for one) was kind and respected my dignity, there were many times when I asked for something simple and no one came. For example, it took them six hours to get the compression boots for my feet to prevent clots, I asked for a heating pad and got it the next day, it took three hours to get a bottle of water and then the incident with the call button. Dr. Porteneir's intern was upset about that and said she was going to say something to the administration, I hope she does cause I could have saved myself a whole lot of fear. The surgeon, anesthesia and all the doctor's I saw after the surgery were great and so far I have not had any complications, but if I could have chosen a more attentive hospital I would have.

The Recovery Room

I have had two bad moments during this surgery and this was the first one. They brought me out of anesthesia really slow because in the past I have had a history of anesthesia induced combativeness. I woke up and was more nauseous than I had ever been in my whole life. The nurse kept rubbing her chest with her knuckles and shouting my name to get me to wake up and I was saying no I'm gonna puke.They hit me with everything they could for nausea. My bladder also did not wake up right away and they had to give me some drug to stimulate my kidneys. I remember laying there in pain, all alone and crying over and over that this was a mistake.When they wheeled me to my room it was awful. They took me into the elevator and down the hall and all the bouncing made me feel like I was going to die. My Husband and mom and two friends from OH saw me for the first time and I was laying in the bed crying saying this was a mistake. I think it was the first time my Husband was truly freaked out. To be honest I was really scared as well. I think right at that moment is when the Fentyl kicked in and I started to feel better, after about an hour the nausea started to subside. My memory is spotty but I remember a nurse asking how I was doing and I said I would be better if you would get some of this shit off of me. She also told me that I would feel better when I walked and I replied that I wanted to walk then. At 9:30pm they got me up and I walked the halls. I felt so much better.

Pre-Op Prep

After they wheeled me way from my Husband and mom they took me into the pre-op anesthesia prep area. They started an IV there, gave me warm blankets, confirmed what type of surgery I was going to be having. Checked and re-checked my name a few times. Dr. Porteneir came to talk to me and asked if I had any last minute questions. I waited another twenty minutes or so then they gave me Versed and wheeled me to the operating room. I remember getting off the gurney and onto a metal operating table. They strapped in my legs and put compression booties on my feet, they also attached my arms to the table and began putting heart monitors on me. I don't remember anything after that.Apparently there must have been some delay because my surgery did not start until 2:45 pm.

Morning of Surgery

I woke up and got in the shower and my Husband paced the house like a caged animal. He checked and re-checked the bags I had packed, the phone list, etc. I felt calm and at peace, but nervous. We got to Durham Regional Hospital and were given a room in the Ambulatory Care Unit. We checked in at 10am and my surgery was supposed to be at noon. They took me back to OR prep at 12:45. The waiting was making me nervous and on top of that the hospitals pager system was broken and I heard three Code Blues while waiting to go back. When they wheeled me away my mom and Husband started crying. I was really glad they had each other there for support. It would have made it much harder if my Husband was going to be out there by himself.

RETRACTION: Jeff and my mother have informed me that they were not crying and have requested a correction of this blog. I will say that that is how I remember it. :-)

Pre-Surgery Jitters

I think I ran the gamut of emotions before surgery. I am an anxious countrol freak by nature and the fact that this would be out of my control was something it was hard for me to grasp. I googled weight loss surgery and death rates, researched complications over and over. I worried myself insane, I was not worried about the lifestyle changes after surgery, I was worried about one thing, dying. The Friday before surgery I almost cancelled, I was overwhelmed with fear. I do not know how I got beyond it but I did. The day before surgery I was calm and at peace, the morning of I had expected to be a basket case but I wasn't.

Pyschological Evaluation

I see a lot of people post with questions about the psychological evaluation. This is what I experienced when I had my appointment at Duke.I think my process might have been a little different, my appointment was scheduled only nine days after my brother died and I was an emotional basket case. I basically told her that I was having panic attacks, not sleeping and taking xanax to get through the day and on top of that I was anxious about getting addicted to xanax because I was taking it daily. She assured me that .25mg of xanax two times a day, nine days after a death in the family does not make an addiction, and while I knew that on an intellectual level, it made me feel better to hear it. My psych tests were normal though I did score high on the anxiety and depression scales. I have struggled with anxiety my whole life and she made sure that I had skills to deal with anxiety and that the depression was situational and not out of proportion with the loss. During the session (which lasted about 2 hours) she asked me questions to see if I was prepared for surgery. She wanted to know if I had told anyone that I was having it. What changes I anctipated would happen after surgery. What my goals were? What made me decide to have surgery? etc. I think she wanted to make sure that this was a well thought out decision and not one that I took lightly. She said she didn't have any concerns about clearing me for surgery as long as I felt I was doing better over the next few months. So that is my novel, but if I can make it through in that state, I think most people can.

PS. When I went to Duke for my pre-admission testing I snuck a peak at my records. It did not state that I was a neurotic basket case, I was pleasantly surprised as I thought the woman must have thought I was completely insane.

The Insurance Approval Process

I went to a seminar at Durham Regional on January 11th. I got all my applications materials into Duke in mid February and my first appointment was May 21st. I went to my first apointment with Duke, I had my psych eval and meeting with the RN. The nutritionist was out that day so he reviewed my records and sent me something later. I continued going to my Primary Doctor once a month every month. We did a low fat/low calorie diet with increased exercise and I tried Meridia for three months, but stopped because it was causing anxiety. I requested and received five years of medical records documenting a BMI over 40 (though I don't believe this is a Cigna requirement). I had an EKG, a Barium Swallow and blood tests. The tests were not that bad but I threw up twice during the barium swallow, it tasted awful.

All of my tests were normal and I have no co-morbid conditions, but my current BMI is 54.I sent all my medical records to Duke on August 11th. I was submitted to insurance on September 17th. UHC gave me a problem and would not give me a letter in writing stating that WLS was an exclusion on their policy. (They also told me they did not have a fax machine). They said the only thing in writing they would give me would be a denial EOB after I had the surgery and submitted it to insurance. They have still refused to send something in writing, but we submitted to Cigna with a copy of the plan documents.It was submitted to Cigna on 9/22. They initially decided to deny it on 9/25 stating that I did not have a nutritional eval. Duke forgot to send it with the intial eval, I called Debra and she faxed it right over. I called Cigna again and they said to expect a decision next week. Debra from Duke called me at 4:15 on 9/25 (today) and told me that Cigna had called and approved it. I called Cigna to confirm because it seemed too good to be true. I had heard horrible things on here about Cigna and was really worried about insurance approval, I must say the process was very easy and everyone I talked to at Cigna was very helpful. I have heard things about Duke being very slow and it did take a while to get my first appointment. However, from the time they got my medical records until the time I was submitted to insurance was only a little over a month. Everyone I have talked to over there has been very polite and helpful. My approval from Cigna may have come faster because I called a lot. I was always polite with them though. Anyway, that's my story. I hope it helps someone who is reading all the bad stuff on here about Cigna.

Infertility

My husband and I have been trying to have a baby for almost three years. We each have our own separate issues, but together it makes it next to impossible to conceive. I have polycystic ovarian syndrome, which has not only contributed to my weight issues, but has also made it extremely hard to lose weight. It was a vicious cycle. Having a baby is my motivation to stick with this process, to follow all the rules. When I step off the track or feel discouraged, I merely need to look at the pictures of my neices and other children who are dear to me and that will put me back on the straight and narrow.

Insurance Approval

I started thinking about having this surgery in April of 2007, I started looking into it and learned that my insurance through my employer did not have coverage for weight loss surgery. At first I was very disappointed, but with some further research learned that it was covered by my Husband's insurance plan. We had to wait for his open enrollment period and in January 2008 I was on my way. My insurance plan required six months of supervised weight loss before they would approve the plan.

I went in and saw my doctor seven times for seven consecutive months (I was told the first month would not count because that is when the doctor would give me the outline for diet and weight loss. I kept a journal at home and shared this with my doctor. At every appointment I showed up and told them I was there for a follow up for obesity. I tried Meridia but could not tolerate it because it caused me to feel very anxious. At every appointment they monitored my weight, blood pressure, pulse, height and respiration. The doctor took my vitals and we talked about the progress on my diet. It was nothing major. I'm happy to answer additional questions for anyone struggling with this part. I made sure that I went once each month, though sometimes the appointments were more than 30 days apart and were not always with the same doctor.

I was nervous about getting approval because I had heard some nightmare stories. While I was researching this surgery I stumbled upon the Obesity Help website and I got all the information I would ever need from that site. Unfortunately knowledge is not always power and after reading about everyone's problems with insurance I was quite nervous about the approval process.

Why weight loss surgery.

I think there is still a definite bias against people who choose this surgery. As if we are somehow failures because we couldn't get control of our weight on our own, that if we were somehow more dedicated, or tried harder that we would be able to lose weight. Is that true? Maybe, but I do know that i've been on one diet or another for the last 15 years and nothing worked, my battle with my weight was something I could not win on my own. I needed to bring in reinforcements.

I realized I had a problem when I started taking myself out of pictures, I didn't want to be in photos. I love pictures, I am the family photojournalist, I can count on one hand the number of pictures of me that exist from the last two years. I always offer to take the picture and I am in them only when I am forced. I felt like I was disappearing from my history.

Some will still question my decision, some will still see it as unnecessarily risky and that's ok. I've been judged for my weight most of my life, it seems ironic that there will now be some who judge me for the way I choose to lose it.

For once in my life, I feel as if I am on the path to success with my weight. I have made this decision carefully, I have done the research, weighed the risks and decided that the risks to my health if I stayed this way were much greater than the risks to my health that came with the surgery.