GwenS
update
Mar 25, 2009
3/26/09 It has been a really long time since I posted. After my son's accident in 2007 then multiple surgeries trying to fix the problems with my legs (Multiple seromas after knee lift) then, working 2 jobs on top of having Fibromyalgia etc. I just haven't had the time or energy. I am having some awful muscle cramps and bone pain. They found out that I have osteopenia (thinning of the bones) & Fibromyalgia. I am constantly hurting and tired but, I am not sure any of this has anything to do with the fact that I had gastric bypass. I also was suppose to have my tonsils out as a child which never got done. So, I go April 9, 2009 to have that done. Life is like a box of chocolates. LOL
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Gwen's story
Apr 28, 2007
My normal weight from around 14 - 21 years old ranged between 95 and 115 pounds. Over the years, after having children (I have a son 13 & a daughter 18 years old) and several surgeries, I gained and gained and gained.....When my son was in 2nd grade he came home upset and said he had been in a fight at school. When I asked why, he didn't want to tell me. Finally, he said it was because the other boy had said his mother was a fatso. I weighed around 200 back then. I hurt for both of us.
In 2/04 I hit 40 and it hit back. By my 40th birthday my health was going down hill. I had been researching gastric bypass since 1999. But, until recently I did not get serious about having the surgery. In April 2004 I started having health problems that began to interfere with my work (I am an LPN) and life in general. I love animals, children, crafts and remodeling houses. But, as I got sicker, I was less able to do the things I loved. In May, I was diagnosed with hypertension and hyperthyroidism. I had previously been diagnosed with GERD and osteoarthritis. Immediately after starting on the medication for my thyroid, I began gaining about 2 lbs per week, until I reached 250. Just what I needed, to gain more weight. My blood pressure continued to stay up even after my medication was increased to 3 pills a day. My arthritis and GERD got worse. And in June, my gallbladder attacks had gotten bad enough to have surgery. I got serious about wls at that point.
On 8/09/04 I gathered all the information I could together about wls, downloaded all the required paperwork from Cahaba Valley Surgical Group's internet site and took it to my primary care provider and asked that he refer me, ASAP.
Today is 8/10/04, and my pcp has given me the referal. All I have to do now is mail the information and wait. I HATE TO WAIT! I have told a few people what I plan to do and have gotten varied responses. Some think this is not what I should do. "Just cut back and exercise", they say. Yeah! Well. I cut back and began walking after the thyroid meds. made me start gaining weight. I never lost a pound. I only maintained my current weight. And, cutting back is not so easy when you are hungry all the time, just like exercise is not so easy when you have gotten so heavy and stiff from arthritis that you can't hardly walk. My 13 year old told me, "Mama, don't worry about it, we love you just the way you are." My sweet, sweet little man. I don't love me the way I am. My husband knew me when I was really thin. I'm sure he would rather have me thin, but he told me this was up to me. He would stand by me whatever I decide to do. And, he's right. This has to be about me. I have always tried to put everyone else first. My family, my friends, my patients, my animals, even casual acquaintences have always come first. But, now it's my time. And, I feel like I have to do this if I want to live.
8/14/04 Frustrated and still waiting. I know it has only been 4 days since I put my paperwork in the mail. But, as I said before "I HATE TO WAIT!" I called the doctor's office late Friday evening but only got voice mail. I am ready to have this surgery and a chance to begin my life again. My husband took my son camping again this weekend. I hate feeling so bad all the time and don't feel like going with them. Maybe I'll hear something from the doctor's office on Monday. If not, I'll be calling them again.
8/17/04 I have a consult date. I had to change doctors to get an earlier date. Dr. Stahl's earliest appointment was for the end of Oct. I am going on 8/31/04 to see Dr. Sherer. Yeah!!!!!
Thinking of all the things I want to do when I lose weight:
1. Ride a horse---A friend told me about her sister going on vacation. They went to ride horses and the man told her they had a policy that no one over 200 could ride their horses. She was mortified and I would have been too.
2. Take my son to the beach without feeling like a whale
3. Have a normal blood pressure reading without 3 blood pressure pills a day
4. Play with my neices and nephews for more than 10 minutes at a time, before having to rest.
5. Not hurt constantly from arthritis & because my body is to big for my back and legs to stand anymore.
8/26/04 Well, I am getting very anxious for Tuesday (8/31/04)to get here, so I can meet Dr. Sherer and find out about my surgery. I go back to my pcp in the am because, even after increasing me to 3 blood pressure pills a day my pressure is still up. (142/110 as of yesterday) I went to a support meeting on Monday at Shelby and met the nicest people. I wish I already had a surgery date. As I said before "I HATE TO WAIT." Wish I hadn't of told some of the people here at work that I was planning to have the wls. Most of them are making negative remarks. But, as my administrator told them I am stubborn and when my mind is made up there's not much chance of changing it, so they had just as well save their breath.
8/31/04 Just met with Dr. Sherer. He's not only nice but, really knows his stuff. Good and bad news. I am a good candidate for this surgery to be done laproscopic. But, with my history and family history, he wants me to have a sleep study before he will apply to insurance or schedule the surgery. Also, he said he thought he was booked up for surgeries until sometime in November already and booking more each day. I called the respiratory doctor and they said he couldn't see me until late October but, after begging, she found one slot open 9/08/04. Well, at least that's only a week away. Then, if they can get me scheduled for the sleep study quickly, I can apply to insurance so that I can get on with getting a surgery date. Have I mentioned that, "I hate to wait!!!!!!!!!!" Oh yeah, the nurse weighed me and got my height. Guess what I have always been 5'6". She measured me at 5' 4 1/2 " So I'm shrinking, just not in the right direction.
9/08/04 I met with the Respiratory doctor today. He said if he had to make a bet, he would bet that I have sleep apnea. I am scheduled to come in for my sleep study 9/28/04. That seems so long away. I asked to be put on thier cancellation list, in hopes of getting in a little sooner.
9/11/04 I went to the wls support meeting in Tuscaloosa today. I met some new people and a few I have been in contact with on line. (Hello, Shanon and Donita) We had a good time finally talking face to face, right before we were run out of the library by a skinny old librarian. :lol:
9/12/04 My dear sweet hubby went today and bought me a new exercise/weight machine. We decided that it would be a lot cheaper to buy one than to join a gym and this way we can all use it. Plus, it will save me the driving time to and from another town to go to a gym.
9/14/04 I have really prayed this last few weeks that if God meant for me to have this surgery he would give me a sign. You know, like make things go smoothly with this process or something and if this wasn't meant to be put some bumps in the road to help stop this surgery. I got a call from the sleep lab late yesterday afternoon. They had a cancellation for last night and wanted to know if I could come. Well, of course I could! I guess that was my sign to continue on!!! Sleep study is out of the way. Yeah!!!! As soon as Dr. Sherer gets the results, he said he would send everything to BCBS for approval. Got my finger and toes crossed. My surgery is getting so close, I can just about taste it. (LOL)
9/15/04 Sleep lab called and left a message----I do have sleep apnea.
9/20/04 Called the surgeon's office today. They don't have the results of my sleep study yet. She said as soon as she got it and the doctor reviewed it and approved everything, she would send the information to BCBS for pre-approval. Needless to say, I called the sleep lab and asked could they send the results to my surgeon asap. Vicki at the sleep lab has been great. She said not only would she get that typed up and sent today, she would put my name back on the cancellation list and try to get part 2 done ASAP. Vicki called my house several times this afternoon before I got home. Guess she had an opening at the sleep lab tonight but, I missed it. That was quick.
9/22/04 Vicki called and has another appointment available for this Friday night. Needless to say I took it. Things are still moving along fast. Not as fast as I would like but, faster than what I have heard of with most people. I really feel that this is a sign from God that I am doing the right thing. So I am onward bound.
9/23/04 Dr. Sherer's office called today. I'm approved!!!!!!!!! I have a surgery date 11/24/04. I'm so excited, I feel like I am going to jump out of my skin. Everyone keeps saying "Are you sure you want to do this?" And, "You will miss Thanksgiving Dinner." ----------- Yes, I want to do this and I'll be missing a lot of dinners from here on out---that's the point isn't it? I'm still impatient. 2 months seems like so far away. I asked to once again, be added on the cancellation list. It can't hurt. It's worked for me so far. But, even if I do have to wait, that will give me more time to work out and try to get myself in a little better shape before surgery.
9/29/04 O.K. the past week has seemed like a month. I want my surgery now!!!!!! I have tried to keep busy. Went to the sleep lab last Friday night for round 2. Between all the wires and the c-pap machine attached-----I felt like I had an octopus on my head all night. I was so tired when I left that I had to go home and take a short nap before getting ready to go to the "Bama Bash" on Saturday. It was great. I even ran into an old friend that I haven't seen for about 20 years. We have talked on the internet and didn't even know we knew each other. Then, on Monday, I went to Shelby for a wls support meeting. I'll stop now, since this is becoming a book rather than a quick post.
10/25/04 O.K., another month to go. It seems like forever. I had to go on the c-pap machine a few weeks ago and I'm still not use to it yet. The mask was breaking me out in a rash so they gave me the nasal cannula type. Maybe after surgery my sleep apnea will resolve and I can quit using it. I can't imagine spending my life with that thing attached to me every night. I have been working out on my new weight machine some. But, they have changed my thyroid medicine again and my appetite has increased and so has my weight. I have gained 5 pounds recently. This sucks. My main concern is after surgery, I will out eat my pouch. The doctor said they would probably adjust my meds again the 5th of January. Which means about 6 weeks after surgery my appetite will probably increase again. I'll go down in history as the only person to have this surgery and gain weight.
11/18/04 6 days and counting before surgery. I am not nervous, just ready for it to be over with. I have had so many people, especially friends of my children beg me not to do this. They all said I wasn't big enough to have this surgery, they love me like I am and want to keep me around. I tried to explain that without this surgery, I may not be around much longer anyway. Besides, I am uncomfortable in my own skin. I always feel like I have on a heavy parka, with multiple sweaters and pairs of pants on under it. And, that is even before I put my clothes on. But, it feels good to know that I am loved by so many.
11/19/04 I have a angel. Dixie Dawn (Mason) has volunteered as my official angel.
12/05/04 OK, I haven't updated like I should. Surgery went well and fairly uneventful. It took around 4 hours because of all the scar tissue built up from previous surgeries. The pain wasn't as bad as I expected. I only took pain medicine through midnight the first night. The nausea was worse than usual. Usually after surgery I get really nauseous. But, after a few sips of Sprite and a few crackers I feel better. Of course this time no Sprite or crackers were allowed so the nausea was harder to get over. I was up walking 3-4 hours after I got in ICU. In fact, I walked so much, they booted me out of ICU that afternoon. I did pretty well until 4 days after surgery I had the bright idea of eating a few bites of homemade chili. Not sure if it was the chili, eating it to fast, eating too much or a combination of the three. But, can you say "Dumping Syndrome" I was sick for the next 16 hours or so. My chest hurt. I gagged and occasionally vomited. My stomach hurt. I felt awful. And, had multiple bouts of diarrhea. The next day I stuck to my clear liquids and blander foods and finally determined that I might live. I am more cautious about what, how fast and how much I eat now. I'm not sure about my weight loss at this point. I had been weighing on the scales at work or the doctors office. So, my home scales may not be telling an accurate story. But, according to what the doctors scales said and my scales are now showing (which could be off by as much as 5 pounds easily) I have lost around 10 pounds in the 11 days. I'll know more accurately when I go back to the doctor in a few days. My hardest thing is to drink enough and remember that I have to eat slower. I'll try to update more after my first post-op visit with my surgeon.
12/08/04 First pre-op visit. In two weeks I have lost 11.5 pounds. I wasn't to happy but, the doctor said that since I wasn't as big as some people who have this surgery, I probably wouldn't lose as fast as they do. Besides I had a recent change in my thyroid meds that could effect my weight loss as well. He wants me to lose at least 63 pounds. I told him I had more 125 -130 pounds loss in mind. He said that 125 may make me happy but, it would only take about 63 to make me healthy and that was what he was most interested in. I was worried because it seemed like I was eating too much. But, he said I was doing fine and that he would rather me eat more real foods to get in my protein and nutrients rather than so many shakes etc.
12/14/04 Yesterday was my first day back at work. It seemed long and I missed my afternoon nap that I had come accustomed to but, other than that, all went well. I weighed when I got here this morning and I have lost 18 pounds. Yippppeeeeee. Tommorow will be 3 weeks. I had hoped to lose 30 pounds my first month. Doesn't look like I will meet that goal. But, I guess I'll take it as it comes.
12/17/04 Walked a little over 1 1/2 miles at lunch yesterday. Whewwwww!!!!!!!!!! Never could have done that before especially since a lot of it was up hill. -20 pounds today. 5 more days before I will be at my one month mark. And, I'm pretty certain I'm not gonna make my goal of -30 pounds in the first month. But, maybe I can meet my personal goal of -45 by the end of month 2.
2/02/05 Time has really gotten away from me. I meant to update more often. Oh well, today I am 10 weeks post-op and down 41 pounds. I didn't make it to my 2 month goal of -40 pounds. But, I'll take what I can get. I had a goal of losing 50 pounds by the time I was three months post-op. That gives me 2 weeks to lose 9 pounds to get back on track. I'm off both blood pressure pills now and my blood pressure is running normal. I don't need my c-pap machine most of the time lately either. I go back Friday to have my liver profile done again because all my last blood work was good except for the liver profile and my B-12 level was a low normal. So, they will keep a watch on my liver and I've started on B-12 injections.
2/16/05 My liver test are a little worse than they were. I know that Zoloft (antidepressants) can cause an elevation in your liver test. So, I stopped taking it last week. My PCP said that he thought a combination of having surgery twice in a six month period of time, taking large amounts of Ibuprofen prior to my last surgery and possibily some of the medications that I have been on could have caused this problem. I am coming off all medications that I don't just have to have and we will keep an eye on things. Today is my 3 month anniversary. I have lost 46 pounds which is 4 pounds away from my 3 month goal. But, I have not been exercising like I should the past few weeks. Between having a virus, it raining a lot and just feeling kinda weak and tired here lately I just haven't been up to walking or using my exercise machine and I know I haven't been getting in as much fluid or protein as I should have. But, starting today, I will try to remedy that.
2/28/05 Well I weighed today and I am down to 203 (-52.5 pounds)in less than 3 1/2 months. My BMI is 34.8 which means according to my BMI, it is no longer high enough for me to have gastric bypass. That is really cool. I am struggling to stay off the Zoloft. I have had a few crying spells and get angry very easily. But, I am trying to work this out without the medicine. I will be going to see the thyroid doctor and the surgeon in March. So, maybe one of them will have some good news regarding my liver.
3/16/05 I am 16 weeks post-op today. I have lost 56 pounds which puts me in "onederville"---199.5 to be exact. Both the surgeon and the thyroid specialist think the Zoloft is what was making me have abnormal liver test. I had my blood work done again and in just the three weeks or so that I have been off the Zoloft, my liver test are already looking better. I go back in May to have them done again and the thyroid doctor said they should be a lot better if, not all the way back to normal. Yeah!!!!! I am feeling better too. I am trying to take B-1 in addition to my multivitamin, B-12 injection and calcium. I have heard a lot of people say that they have problems with their muscles especially in their legs when their B-1 levels got to low. Also, their memory started failing them. I can't hardly remember my name lately. So, I will blame it on the B-1 whether that is it or not. LOL
4/22/05 Well, I am 5 months out and down 71 pounds. My health hasn't been this good since I was in my twenties. I had bloodwork done again this week and I hope it will show a continued improvement with my liver function. I have had a respiratory infection (highly allergic to fresh cut grass) so, I haven't been able to walk like I should be. But, when I do get to walk, I am up to 2 miles at lunch. I used to could only do about 1/3 of a mile and I was pooped.
5/24/05 I am 6 1/2 months post op and minus 79 pounds. My liver is back to normal. However, my thyroid is acting up a little again. (Hence, the slow weight loss over the past few months) They changed my meds again and I am to go back to the thyroid specialist in August. I have been looking into some information about the lower body lift. But, I am very afraid that I will not have quite enough loose skin to meet the insurance standards of medical necessity. I am sure I will have enough to look nasty though and I just don't have the cash flow to pay out of the pocket. This is all very depressing. But, I guess I can start documenting any and all problems that occur due to the loose skin and hope for the best.
5/24/05 Update!!!!I started my documentation today. I saw my general practioner regarding the boils/risen and rashes to my abdominal fold, between my thighs, to the fold at the bottom and to the inside of my buttocks. Also, about the pain to my knees caused from a combination of arthritis and my thighs being so big they bump together when I walk causing stress to my outer knees. He documented all my complaints and gave me medication for each. He stated to come back as needed with any other problems or if the medication he gave me did not help. And, stated that when the time came he would refer me to a plastic surgeon. Yeah!! Maybe I will get approved afterall.
6/24/05 My weight has been back and forth this week from 89.5 to 90 pounds lost. Not to bad for 7 1/2 months post op though. I had set monthly weight loss goals for myself beginning 2 weeks after surgery until I was 16 months post-op, which should put me around 125 pounds lost and at my maintenance weight. For a while I was a little behind schedule but, I had a goal of 90 pounds lost by the time I was 8 months post-op. And, I am already there. Yeah!!! I have been suffering from awful constipation lately. But, I hate to take anything for it because for several years now (since having problems with my gallbladder) I have had bouts of constipation then diarrhea. I am afraid to take very much in the way of stool softners or laxatives because I still have bouts of diarrhea even since I had my gallbladder removed. I can work with constipation but, diarrhea makes it can of hard to come to work. So, I guess I'll just have to try to find a happy medium. The past month has been rough. My sister-in-law was in a wreck on June the 2nd which hurt her, her 12 year old son and 16 year old neice and killed her 7 year old son. Then my son did a flip off the trampoline onto the ground Father's Day and broke his ankle. He went yesterday for a cat scan because the x-rays were not telling them everything they needed to know about the break. He may have more than one break which could result in surgery. Cross your fingers that the cast will be enough to take care of his injuries.
7/28/05 Well, I'm down 98 pounds as of this week. I've lost more the past few weeks than I had been. A lot has been going on. I have been doing good to eat 2-3 times a day and sleep 3-6 hours a night, between my son having to go back to the doctor every two weeks for x-rays, another nephew (19 years old) dying, a brother-in-law in the hospital having strokes etc. I haven't had time to snack a lot. I know I haven't been getting in my fluids either. Bad girl! Bad, bad girl! I feel really run down and tired lately. It is almost time for my B-12 injection and I will be going back to see the thyroid doctor in a few weeks to see if my medication needs to be adjusted. But, it's probably just exhaustion. I NEED MORE SLEEP!!!!!!
8/02/05 I had been losing and gaining the same 2 pounds for weeks putting my weight loss back and forth between 96 and 98 pounds. But, finally today I weighed and I have lost exactly 100 pounds. I just made it to the century club and it is an awsome feeling!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
8/12/05 I saw the thyroid doctor yesterday and he said he thought it was time to try to go without the thyroid meds. That was the last of the 20 prescription pills I was on before surgery. So, now I'm down to just vitamins and calcium. This scares me a little. Because in the past, everytime my meds got a little off I either gained weigh or after surgery stopped losing. But, he said if any problems arise to come back sooner otherwise we would do another blood test in Oct. to make sure that everything is doing ok without the meds.I just weighed and have lost a total of 103 pounds in about 9 1/2 months which still amazes me. I am in a size 8 blue jeans and if all the loose skin/flab was removed from my lower body I could get into a 6 easily.
8/23/05 Well, I am down to 150 pounds that is a total loss of 105.5 in just 39 weeks. I have started back hot flashing and have been a little more hungry especially for sweets and bread since stopping the thyroid meds but, I just try hard not to give in to the head hunger.
8/31/05 Down to 149 this week and a size 6 pants. That's a loss of 106.5 pounds. The head hunger has won several times lately. I even ate 1/2 piece of cake with 1/2 small glass of milk. I prayed that I would dump like never before and wouldn't ever want to try that again. But, no such luck. My heart raced for a few minutes then I was fine. Darn it!!! That means I'm one of the few that can tolerate sugar. Nothing seems to make me sick anymore and I don't like that. The dumping tended to keep me on track. I will be glad when it's time to have my next blood work done and see if I need to go back on the thyroid meds or if this is all in my head. I am trying really hard to get back on the wagon with not only what I'm eating but amounts also. Anyone reading this post please pray that I can get back on and stay on the wagon. I am so scared of coming this far then ending up right back where I started from.
PS.
We didn't have any major damage from hurricane Katrina Monday night. Mostly trees down on power lines. And, our power is still off at home. Guess I better close for now.
9/20/05 Well, the past few weeks have been pretty rough. I have started back feeling bad, tired and very irritable. I have frequent headaches, palpitations, hot flashes and my appetite has severely increased. I had my blood work drawn again last week to check my thyroid. Because last year when I started having all these problems, it was related to hyperthyroidism. My labs have changed a lot since the doctor took me off the thyroid meds 5 weeks ago but, they are still with-in-normal limits. They thyroid doctor said everything looks fine but, I don't agree. I think the major changes in the numbers even though they stay with-in-the normals have caused me some problems. I'll just have to wait another month and repeat them and hope things get better in the mean time. I have managed to loose a little more weight. I'm down to 145 which makes me a "normal" weight according to doctors charts. That's a total of 110.5 lost. I am in anything from a size 4 to a 7 pants according to the brand. So, maybe I'll get to my goal weight of 125 - 130 over the next few months. However, if I don't that's fine. Because I wanted to lose enough to get to a size 6 and I'm already there without losing as much as I thought I would have too.
9/26/05 Feeling better this week. My thyroid levels must have leveled off for now. I have lost 112 pounds and am wearing anything from a size 4 to a size 7 pants according to how they are made. I don't think I will really try to loose much more weight. If I loose another 3 pounds then get approved for plastic surgery and have as much as 10 pounds of skin removed that will put me at goal. My hubby has informed me that I have lost enough. Never thought I would hear that. LOL.
10/18/05 Went to the doctor yesterday. I have another rash under the excess skin role at my abdomen, my buttocks and where my thighs rub together. The doctor said it was a staph infection and wrote prescriptions for antibiotics by mouth and topical. I am scheduled for carpal tunnel release on Friday but, he said if we didn't have this infection under control we may have to post-pone my surgery. I had increased my calorie intake to try to slow down my weight loss. I don't want to loose too much. I have lost 115 in almost 11 months. My goal was to lose 125.
10/25/05 My carpal tunnel surgery went well. Guess I increased my calorie intake too much, because I have gained 2 1/2 pounds since last week. I wish I could blame it all on the IV fluids and the brace I have on my arm etc, but, I know I let things get out of hand the past few weeks. I seem to be able to tolerate sugar. Which is not good. I have been sipping on soda's and eating candy, snack cakes etc. I guess that just goes to show you can't take this weight loss for granted. And, that the weight can be gained back. We may never gain back to where we were but, we can gain. I still have the same old demons that I use to have. The only difference is I now have a tool to help me fight the demons. But, it only works if I use it properly. I still have to stay away from sweets and soda's whether I can tolerate them or not. I have to realize that they are the poison that ruined mt body before wls and they will do it again if I let them.
11/15/05 I am pretty much over the carpal tunnel surgery except for a little tenderness and some peeling dead skin at the surgery site. Well, my weight has stabilized. I am staying pretty much between 137 and 139. I will be going to see Dr. Sherer next week for my one year check-up and will ask him about referring me to a plastic surgeon at that time. My PCP had already told me that he would write me a letter of medical necessity. The surgeon that did my carpal tunnel surgery has also told me to let him know when and he too will write me a letter. He said that the only way to keep these rashes and staph infections under control would be to remove the source that is causing them (the excess skin). So, my fingers are crossed. I know many people apply for insurance to cover and are turned down. I pray that I can get approved for the LBL that I so badly need because I just can't afford to pay for the surgery even if I could get a loan.
11/28/05 Saw Dr. Sherer last week. He said everything was looking good so far. I am still waiting to hear from my lab results. I asked them to fax me a copy of them but, they haven't yet. He had said I could go for a plastic surgery consult in about 6 months. But, after I explained that if I waited 6 months that would be the vary time that I can't take off work, he OK'd it for me to go ahead and get my consult now. Besides my weight has been fairly stable for the past 3 months. I am staying pretty much between 135 and 140. I called Dr. Howell in Tuscaloosa for the plastic surgery consult and he had an opening 12/16/05. Wow!!!I thought I would have to wait a lot longer than that for a consult appointment. Maybe this is a good sign. Now, if only BCBS will cooperate, I may have my Lower body lift by Jan or Feb. If I wait much longer than that, I'll have to put it off indefinetely. I work at a nursing home doing quality assurance, infection control and education. When the state comes in to do their yearly survey, I have to be here. And, since we never know exactly when they are coming, I would not be able to take off until after they have completed their next survey and everything is back in compliance etc.
12/19/05 My weight is swaying back and forth between 135.5 and 133. I saw Dr. Howell regarding having a lower body lift. The good news was that he doesn't think I need that extensive an amount of work done. Just a tummy tuck and thighplasty using the excess tissue that is normally thrown away to do a little augmention of my flat buttocks will do the trick. The bad news is he doesn't think that I have enough excess skin for insurance to pay for any of my surgery. The worse news is it will cost a little over $10,000 that I just don't have or anticipate being able to get any time soon. So, I am very depressed to say, that my reward for all this hard work to loose around 122 pounds will be nothing more than flabby loose skin and an extremely flat butt. He said it could take between 2 and 6 weeks to get an answer from BCBS but, not to be surprised if I were denied. On the other hand, he said he had never had a patient with as much documentation as I did of rashes etc. upon walking in the door for a consult and that could sway things a little but, again, "not to count on it". So, here I sit depressed. And, my computer at home crashed a while back, so other than a few minutes here and there I can't even get online anymore. So, I also feel really isolated from my wls family.
1/30/06 Well, I have been approved for the tummy tuck! I went back to the plastic surgeons office last week for some additional pictures and they are suppose to be filing for approval of my thighplasty this week. They said I heard back about my tummy so quickly because they were able to file it over the internet but the thighplasty will have to be done per snail mail. So, here I sit anxiously waiting to hear something. Well, not just something...but, "yes we will aprove this surgery too." is what I really want to hear. I will let you know when I hear something.
2/18/06 Frustration is taking over. I know that insurance takes their sweet time. But, I am going nuts waiting to hear something. My birthday is tommorow and I would love to hear from them Monday saying "Yes! We will cover your thighplasty."
2/24/06 YEAH!!!! I spoke with the Dr.'s office yesterday and found out I was approved not only for the tummy tuck but, the thigh lift as well. Yes!!!! Dr. Howell will also be doing muscle tightening of the abdomen and a butt lift/augmentation at no extra charge. Now, I am impatiently waiting to hear from the surgery scheduler and get a date. I am staying between 126 and 128 pounds and feeling better than I have in years. I have had many e-mails wanting to know exactly what I did to get approved. In addition to my primary care physician, I had 2 other doctors document my rashes and the treatments for them and the fact that they continued to reoccur even with treatment. I took pictures of the rashes every month and dated them so insurance could have a kind of picture trail to prove they reoccurred. Then, in my haste, without thinking, I gave the original pictures to the plastic surgeon with the dates they were taken etc. So, my first advice would be to get 2 copies of your pictures. One for you and one for the PS.
Many people wanted a copy of the personal letter I wrote and gave to my PS to include with the paperwork he submitted for my approval. Rather than trying to e-mail it to everyone and missing someone or someone in the future not having access to this information I have decided to post it on here. So, here it is:
To Whom It May Concern:
On 11/24/04 I had gastric bypass surgery and after losing 121 pounds my general health (blood pressure, respiratory status etc.) has significantly improved. However, several new complications have occurred as a result of losing so much weight in a relatively short period of time and being left with an abundance of loose skin that daily exercising has not resolved.
I have reoccurring rashes, blisters and ingrown hairs to the area where the excess skin overlaps from my abdomen onto my pubic area. I have reoccurring rashes and boils to my inner buttocks and the fold of skin at the bottom of my buttocks. There have been numerous occasions when I have suffered skin tears to my inner buttocks and the fold of skin at the bottom of my buttocks in relation to friction of the now fragile loose skin in that area, caused by scooting up in the bathtub, moving over while seated on the pew at church etc. My thighs rub together and clank together with every step I take, resulting in my knees being forced outwardly and causing frequent pain to both knees. I also have difficulty sleeping when lying on either side, due to the excess skin on my thighs causes my knees to bend inward also resulting in frequent pain. I have reoccurring rashes, ingrown hairs, folliculitis and boil type lesions caused by friction at my thigh area from the simple act of walking. I have to buy new pants frequently due to this constant friction caused by my thighs rubbing together which causes my pants to knot up and wear down in the thigh area until holes have formed. (See attached piece of fabric cut from the inner thigh portion of my pants.) Now, if the fabric from the inner thigh portion of my pants is this worn, please try to imagine what the integrity of the skin to my inner thighs is like. These rash type areas have been noted by several physicians to be a staph infection, which requires antibiotics. And, either they never completely resolve or after a short period of time they return even with the use of antibiotics.
In the beginning I diligently tried to resolve these problems myself with the use of good hygiene practices (2 baths daily using an antibacterial soap and paying special attention to dry carefully between the folds of skin), over-the-counter analgesics (both oral and topical) and various creams and ointments (such as Neosporin and Hydrocortisone cream) used for the relief of itching & rashes and to help prevent infections to these areas without any long-term success. After a while of fighting a losing battle, I saw my primary care physician. I am limited to the oral medications that I can take due to allergies to many medications and stomach problems. Therefore, I was treated with over-the-counter topical analgesics and a prescription antibiotic salve, which did very little toward the permanent resolution of these problems. Since then I have had several prescription antibiotic ointments and oral antibiotics. I thought that after the weather cooled down, my symptoms might improve. However, as the weather becomes cooler, I continue to have complications.
After exhausting all other revenues to find relief of the above mentioned complications, I am now requesting reconstructive surgery to remove the excess redundant skin from my abdomen, buttocks and inner & outer thighs in an effort to finally resolve the pain and suffering that it has and obviously will continue to cause.
My insurance policy clearly states that “reconstructive surgery” is covered so long as, it is medically necessary and is performed primarily to restore or improve the way the body works or correct deformities that result from disease, trauma or birth defects. The excess skin that I now have, that causes me to have the above mention health problems, is directly related to the disease known as “Morbid Obesity.” The treatment for the morbid obesity was gastric bypass, which was previously approved by your company and as a direct result of that covered treatment, for that covered disease, I now have other health complications that requires medically necessary reconstructive surgery to correct.
Before making any final decisions in my case please refer to the attached physicians documentation of my condition, as well as the enclosed pictures of rashes and the fabric sample from the inner thigh portion of my pants. If you still do not feel the evidence before you justifies approval of the requested procedures, please allow me to appear before you, to see up close, the condition of my skin prior to making your final determination.
Sincerely,
Gwendolyn F. Smith
I also included the
following in my letter:
contract #
policy #
home address
phone #
2/24/06 I have a date. My ps is scheduled for 3/16/06. 20 days away. Wow! That's not really that long.
3/07/06 Well, one week from today is the day. I go tommorrow for my pre-ops then next Thursday I have a tummy tuck with muscle tightening, thigh lift and butt lift/augmentation. Can you say OUCH!!!!!!!!! I am not so sure about the ride home. I live 30-40 minutes from the hospital. I won't be able to sit, I can't lay on my tummy, I'm sure from expierence of having previous abdominal surgeries that even laying on my side will not feel real good and laying flat on my back will be out of the question because after a tummy tuck you can't really stetch out. Wow, I guess that only leaves my head. LOL
5/24/06 Well, I didn't realize that it had been so long since I had updated. The surgery wasn't nearly as painful as I thought it would be. Of course, 1/2 my lower body was numb for the first 6 weeks or so. I ended up in surgery 11 hours. After doing the tummy tuck, thigh lift and butt lift/augmentation the plastic surgeon didn't like the way my thighs looked so he cut me down toward my knees. That helped my thighs a lot however, it left large puffy areas at my knees. And, about a week and a half after surgery one side of my butt fell and both sides were wrinkled and still saggy. I really wish I had insisted on having the lower body lift (belt lipectomy) rather than agreeing to have the butt lift/augmentation. I have had a sermoa to my butt and one on my left leg that has had to be drained weekly for the past 5-6 weeks. I have been pretty aggrevated with the results of my plastic surgery up to this point. At first the plastic surgeon wasn't really wanting to go back and fix anything unless I was willing to pay for it in full. He finally agreed that my butt did need to be redone and said that he wouldn't charge me a lot to do it. But, I didn't feel he should charge me anything. If you buy a new car and it only runs for about 10 days the car dealership is responsible for fixing it. I figure my butt is more valuable than a car so, he should fix it. Anyway. As it turns out, the only way to fix my seromas after this long is another surgery. And, since he will have my leg opened up anyway, he has agreed to go ahead and fix both my knees. And, while I am already in surgery he will do a revision to my butt as well. If insurance agrees to pay for the remainder of the belt lipectomy to be done he will do that---otherwise, he will just repeat the butt lift/augmentation to both side and try to get them looking better. I guess I can't really complain, since up to this point, insurance has covered all my surgeries which is almost unheard of. Otherwise, I am doing good. I was back at work full-time within 3 weeks after surgery. I had heard so many awful stories about pain that couldn't be controlled and needing help to shower get dressed etc for months after surgery. But, after a few days I was able to go to the bathroom unassisted and shower. I did need help with my bandages because there were so many in so many different places. I needed help for the first 1 1/2 to 2 weeks with putting the compression garment on and off because it had so many fasteners and zippers. But, otherwise, it really hasn't been that bad. Ok, I guess I have updated enough for now. I will try to update when I know more about the next part of my surgery. And, good luck to those of you that are just now going through this.
8/31/06 I had the revisions of my previous surgery on 7/13/06. I did pretty well at first. I went back to work after 2 weeks and was working ovetime by the 2nd day I was back. Not a good idea. I developed another seroma in my right leg almost immediately after returning to work. I have been having to go 1 -2 times per week to the doctor to get it drained. My butt is not perfect but, looks better than it did after the first surgery. My knees have stayed so swollen, it is hard to tell if they are going to look better or not later down the road. The doctor wanted me to take a few weeks off work and see if the seroma would resolve from complete bedrest. But, I have used up all my sick time for the rest of this year and all my vacation/holiday pay etc. until September. So, unless I take off without pay, I can't take any more time off until next month. Besides, I have gotten so far behind at work from all the time I have had to take off, I probably won't ever catch up. No one does most of my job while I'm off. I just have to work harder to try and catch thikngs back up. I am about ready to let him repeat the surgery to my right leg again rather than keep on getting it drained.
09/28/06 The doctor said my leg seems to be doing better. I am going to have it drained once every two weeks now rather than once or twice a week. I am however, suffering with awful muscle spasms in my legs feet and back. I'm not sure if that is from the gastric bypass or just me. I have had some muscle spasms since I was young but, these are a lot worse than my usual.
In 2/04 I hit 40 and it hit back. By my 40th birthday my health was going down hill. I had been researching gastric bypass since 1999. But, until recently I did not get serious about having the surgery. In April 2004 I started having health problems that began to interfere with my work (I am an LPN) and life in general. I love animals, children, crafts and remodeling houses. But, as I got sicker, I was less able to do the things I loved. In May, I was diagnosed with hypertension and hyperthyroidism. I had previously been diagnosed with GERD and osteoarthritis. Immediately after starting on the medication for my thyroid, I began gaining about 2 lbs per week, until I reached 250. Just what I needed, to gain more weight. My blood pressure continued to stay up even after my medication was increased to 3 pills a day. My arthritis and GERD got worse. And in June, my gallbladder attacks had gotten bad enough to have surgery. I got serious about wls at that point.
On 8/09/04 I gathered all the information I could together about wls, downloaded all the required paperwork from Cahaba Valley Surgical Group's internet site and took it to my primary care provider and asked that he refer me, ASAP.
Today is 8/10/04, and my pcp has given me the referal. All I have to do now is mail the information and wait. I HATE TO WAIT! I have told a few people what I plan to do and have gotten varied responses. Some think this is not what I should do. "Just cut back and exercise", they say. Yeah! Well. I cut back and began walking after the thyroid meds. made me start gaining weight. I never lost a pound. I only maintained my current weight. And, cutting back is not so easy when you are hungry all the time, just like exercise is not so easy when you have gotten so heavy and stiff from arthritis that you can't hardly walk. My 13 year old told me, "Mama, don't worry about it, we love you just the way you are." My sweet, sweet little man. I don't love me the way I am. My husband knew me when I was really thin. I'm sure he would rather have me thin, but he told me this was up to me. He would stand by me whatever I decide to do. And, he's right. This has to be about me. I have always tried to put everyone else first. My family, my friends, my patients, my animals, even casual acquaintences have always come first. But, now it's my time. And, I feel like I have to do this if I want to live.
8/14/04 Frustrated and still waiting. I know it has only been 4 days since I put my paperwork in the mail. But, as I said before "I HATE TO WAIT!" I called the doctor's office late Friday evening but only got voice mail. I am ready to have this surgery and a chance to begin my life again. My husband took my son camping again this weekend. I hate feeling so bad all the time and don't feel like going with them. Maybe I'll hear something from the doctor's office on Monday. If not, I'll be calling them again.
8/17/04 I have a consult date. I had to change doctors to get an earlier date. Dr. Stahl's earliest appointment was for the end of Oct. I am going on 8/31/04 to see Dr. Sherer. Yeah!!!!!
Thinking of all the things I want to do when I lose weight:
1. Ride a horse---A friend told me about her sister going on vacation. They went to ride horses and the man told her they had a policy that no one over 200 could ride their horses. She was mortified and I would have been too.
2. Take my son to the beach without feeling like a whale
3. Have a normal blood pressure reading without 3 blood pressure pills a day
4. Play with my neices and nephews for more than 10 minutes at a time, before having to rest.
5. Not hurt constantly from arthritis & because my body is to big for my back and legs to stand anymore.
8/26/04 Well, I am getting very anxious for Tuesday (8/31/04)to get here, so I can meet Dr. Sherer and find out about my surgery. I go back to my pcp in the am because, even after increasing me to 3 blood pressure pills a day my pressure is still up. (142/110 as of yesterday) I went to a support meeting on Monday at Shelby and met the nicest people. I wish I already had a surgery date. As I said before "I HATE TO WAIT." Wish I hadn't of told some of the people here at work that I was planning to have the wls. Most of them are making negative remarks. But, as my administrator told them I am stubborn and when my mind is made up there's not much chance of changing it, so they had just as well save their breath.
8/31/04 Just met with Dr. Sherer. He's not only nice but, really knows his stuff. Good and bad news. I am a good candidate for this surgery to be done laproscopic. But, with my history and family history, he wants me to have a sleep study before he will apply to insurance or schedule the surgery. Also, he said he thought he was booked up for surgeries until sometime in November already and booking more each day. I called the respiratory doctor and they said he couldn't see me until late October but, after begging, she found one slot open 9/08/04. Well, at least that's only a week away. Then, if they can get me scheduled for the sleep study quickly, I can apply to insurance so that I can get on with getting a surgery date. Have I mentioned that, "I hate to wait!!!!!!!!!!" Oh yeah, the nurse weighed me and got my height. Guess what I have always been 5'6". She measured me at 5' 4 1/2 " So I'm shrinking, just not in the right direction.
9/08/04 I met with the Respiratory doctor today. He said if he had to make a bet, he would bet that I have sleep apnea. I am scheduled to come in for my sleep study 9/28/04. That seems so long away. I asked to be put on thier cancellation list, in hopes of getting in a little sooner.
9/11/04 I went to the wls support meeting in Tuscaloosa today. I met some new people and a few I have been in contact with on line. (Hello, Shanon and Donita) We had a good time finally talking face to face, right before we were run out of the library by a skinny old librarian. :lol:
9/12/04 My dear sweet hubby went today and bought me a new exercise/weight machine. We decided that it would be a lot cheaper to buy one than to join a gym and this way we can all use it. Plus, it will save me the driving time to and from another town to go to a gym.
9/14/04 I have really prayed this last few weeks that if God meant for me to have this surgery he would give me a sign. You know, like make things go smoothly with this process or something and if this wasn't meant to be put some bumps in the road to help stop this surgery. I got a call from the sleep lab late yesterday afternoon. They had a cancellation for last night and wanted to know if I could come. Well, of course I could! I guess that was my sign to continue on!!! Sleep study is out of the way. Yeah!!!! As soon as Dr. Sherer gets the results, he said he would send everything to BCBS for approval. Got my finger and toes crossed. My surgery is getting so close, I can just about taste it. (LOL)
9/15/04 Sleep lab called and left a message----I do have sleep apnea.
9/20/04 Called the surgeon's office today. They don't have the results of my sleep study yet. She said as soon as she got it and the doctor reviewed it and approved everything, she would send the information to BCBS for pre-approval. Needless to say, I called the sleep lab and asked could they send the results to my surgeon asap. Vicki at the sleep lab has been great. She said not only would she get that typed up and sent today, she would put my name back on the cancellation list and try to get part 2 done ASAP. Vicki called my house several times this afternoon before I got home. Guess she had an opening at the sleep lab tonight but, I missed it. That was quick.
9/22/04 Vicki called and has another appointment available for this Friday night. Needless to say I took it. Things are still moving along fast. Not as fast as I would like but, faster than what I have heard of with most people. I really feel that this is a sign from God that I am doing the right thing. So I am onward bound.
9/23/04 Dr. Sherer's office called today. I'm approved!!!!!!!!! I have a surgery date 11/24/04. I'm so excited, I feel like I am going to jump out of my skin. Everyone keeps saying "Are you sure you want to do this?" And, "You will miss Thanksgiving Dinner." ----------- Yes, I want to do this and I'll be missing a lot of dinners from here on out---that's the point isn't it? I'm still impatient. 2 months seems like so far away. I asked to once again, be added on the cancellation list. It can't hurt. It's worked for me so far. But, even if I do have to wait, that will give me more time to work out and try to get myself in a little better shape before surgery.
9/29/04 O.K. the past week has seemed like a month. I want my surgery now!!!!!! I have tried to keep busy. Went to the sleep lab last Friday night for round 2. Between all the wires and the c-pap machine attached-----I felt like I had an octopus on my head all night. I was so tired when I left that I had to go home and take a short nap before getting ready to go to the "Bama Bash" on Saturday. It was great. I even ran into an old friend that I haven't seen for about 20 years. We have talked on the internet and didn't even know we knew each other. Then, on Monday, I went to Shelby for a wls support meeting. I'll stop now, since this is becoming a book rather than a quick post.
10/25/04 O.K., another month to go. It seems like forever. I had to go on the c-pap machine a few weeks ago and I'm still not use to it yet. The mask was breaking me out in a rash so they gave me the nasal cannula type. Maybe after surgery my sleep apnea will resolve and I can quit using it. I can't imagine spending my life with that thing attached to me every night. I have been working out on my new weight machine some. But, they have changed my thyroid medicine again and my appetite has increased and so has my weight. I have gained 5 pounds recently. This sucks. My main concern is after surgery, I will out eat my pouch. The doctor said they would probably adjust my meds again the 5th of January. Which means about 6 weeks after surgery my appetite will probably increase again. I'll go down in history as the only person to have this surgery and gain weight.
11/18/04 6 days and counting before surgery. I am not nervous, just ready for it to be over with. I have had so many people, especially friends of my children beg me not to do this. They all said I wasn't big enough to have this surgery, they love me like I am and want to keep me around. I tried to explain that without this surgery, I may not be around much longer anyway. Besides, I am uncomfortable in my own skin. I always feel like I have on a heavy parka, with multiple sweaters and pairs of pants on under it. And, that is even before I put my clothes on. But, it feels good to know that I am loved by so many.
11/19/04 I have a angel. Dixie Dawn (Mason) has volunteered as my official angel.
12/05/04 OK, I haven't updated like I should. Surgery went well and fairly uneventful. It took around 4 hours because of all the scar tissue built up from previous surgeries. The pain wasn't as bad as I expected. I only took pain medicine through midnight the first night. The nausea was worse than usual. Usually after surgery I get really nauseous. But, after a few sips of Sprite and a few crackers I feel better. Of course this time no Sprite or crackers were allowed so the nausea was harder to get over. I was up walking 3-4 hours after I got in ICU. In fact, I walked so much, they booted me out of ICU that afternoon. I did pretty well until 4 days after surgery I had the bright idea of eating a few bites of homemade chili. Not sure if it was the chili, eating it to fast, eating too much or a combination of the three. But, can you say "Dumping Syndrome" I was sick for the next 16 hours or so. My chest hurt. I gagged and occasionally vomited. My stomach hurt. I felt awful. And, had multiple bouts of diarrhea. The next day I stuck to my clear liquids and blander foods and finally determined that I might live. I am more cautious about what, how fast and how much I eat now. I'm not sure about my weight loss at this point. I had been weighing on the scales at work or the doctors office. So, my home scales may not be telling an accurate story. But, according to what the doctors scales said and my scales are now showing (which could be off by as much as 5 pounds easily) I have lost around 10 pounds in the 11 days. I'll know more accurately when I go back to the doctor in a few days. My hardest thing is to drink enough and remember that I have to eat slower. I'll try to update more after my first post-op visit with my surgeon.
12/08/04 First pre-op visit. In two weeks I have lost 11.5 pounds. I wasn't to happy but, the doctor said that since I wasn't as big as some people who have this surgery, I probably wouldn't lose as fast as they do. Besides I had a recent change in my thyroid meds that could effect my weight loss as well. He wants me to lose at least 63 pounds. I told him I had more 125 -130 pounds loss in mind. He said that 125 may make me happy but, it would only take about 63 to make me healthy and that was what he was most interested in. I was worried because it seemed like I was eating too much. But, he said I was doing fine and that he would rather me eat more real foods to get in my protein and nutrients rather than so many shakes etc.
12/14/04 Yesterday was my first day back at work. It seemed long and I missed my afternoon nap that I had come accustomed to but, other than that, all went well. I weighed when I got here this morning and I have lost 18 pounds. Yippppeeeeee. Tommorow will be 3 weeks. I had hoped to lose 30 pounds my first month. Doesn't look like I will meet that goal. But, I guess I'll take it as it comes.
12/17/04 Walked a little over 1 1/2 miles at lunch yesterday. Whewwwww!!!!!!!!!! Never could have done that before especially since a lot of it was up hill. -20 pounds today. 5 more days before I will be at my one month mark. And, I'm pretty certain I'm not gonna make my goal of -30 pounds in the first month. But, maybe I can meet my personal goal of -45 by the end of month 2.
2/02/05 Time has really gotten away from me. I meant to update more often. Oh well, today I am 10 weeks post-op and down 41 pounds. I didn't make it to my 2 month goal of -40 pounds. But, I'll take what I can get. I had a goal of losing 50 pounds by the time I was three months post-op. That gives me 2 weeks to lose 9 pounds to get back on track. I'm off both blood pressure pills now and my blood pressure is running normal. I don't need my c-pap machine most of the time lately either. I go back Friday to have my liver profile done again because all my last blood work was good except for the liver profile and my B-12 level was a low normal. So, they will keep a watch on my liver and I've started on B-12 injections.
2/16/05 My liver test are a little worse than they were. I know that Zoloft (antidepressants) can cause an elevation in your liver test. So, I stopped taking it last week. My PCP said that he thought a combination of having surgery twice in a six month period of time, taking large amounts of Ibuprofen prior to my last surgery and possibily some of the medications that I have been on could have caused this problem. I am coming off all medications that I don't just have to have and we will keep an eye on things. Today is my 3 month anniversary. I have lost 46 pounds which is 4 pounds away from my 3 month goal. But, I have not been exercising like I should the past few weeks. Between having a virus, it raining a lot and just feeling kinda weak and tired here lately I just haven't been up to walking or using my exercise machine and I know I haven't been getting in as much fluid or protein as I should have. But, starting today, I will try to remedy that.
2/28/05 Well I weighed today and I am down to 203 (-52.5 pounds)in less than 3 1/2 months. My BMI is 34.8 which means according to my BMI, it is no longer high enough for me to have gastric bypass. That is really cool. I am struggling to stay off the Zoloft. I have had a few crying spells and get angry very easily. But, I am trying to work this out without the medicine. I will be going to see the thyroid doctor and the surgeon in March. So, maybe one of them will have some good news regarding my liver.
3/16/05 I am 16 weeks post-op today. I have lost 56 pounds which puts me in "onederville"---199.5 to be exact. Both the surgeon and the thyroid specialist think the Zoloft is what was making me have abnormal liver test. I had my blood work done again and in just the three weeks or so that I have been off the Zoloft, my liver test are already looking better. I go back in May to have them done again and the thyroid doctor said they should be a lot better if, not all the way back to normal. Yeah!!!!! I am feeling better too. I am trying to take B-1 in addition to my multivitamin, B-12 injection and calcium. I have heard a lot of people say that they have problems with their muscles especially in their legs when their B-1 levels got to low. Also, their memory started failing them. I can't hardly remember my name lately. So, I will blame it on the B-1 whether that is it or not. LOL
4/22/05 Well, I am 5 months out and down 71 pounds. My health hasn't been this good since I was in my twenties. I had bloodwork done again this week and I hope it will show a continued improvement with my liver function. I have had a respiratory infection (highly allergic to fresh cut grass) so, I haven't been able to walk like I should be. But, when I do get to walk, I am up to 2 miles at lunch. I used to could only do about 1/3 of a mile and I was pooped.
5/24/05 I am 6 1/2 months post op and minus 79 pounds. My liver is back to normal. However, my thyroid is acting up a little again. (Hence, the slow weight loss over the past few months) They changed my meds again and I am to go back to the thyroid specialist in August. I have been looking into some information about the lower body lift. But, I am very afraid that I will not have quite enough loose skin to meet the insurance standards of medical necessity. I am sure I will have enough to look nasty though and I just don't have the cash flow to pay out of the pocket. This is all very depressing. But, I guess I can start documenting any and all problems that occur due to the loose skin and hope for the best.
5/24/05 Update!!!!I started my documentation today. I saw my general practioner regarding the boils/risen and rashes to my abdominal fold, between my thighs, to the fold at the bottom and to the inside of my buttocks. Also, about the pain to my knees caused from a combination of arthritis and my thighs being so big they bump together when I walk causing stress to my outer knees. He documented all my complaints and gave me medication for each. He stated to come back as needed with any other problems or if the medication he gave me did not help. And, stated that when the time came he would refer me to a plastic surgeon. Yeah!! Maybe I will get approved afterall.
6/24/05 My weight has been back and forth this week from 89.5 to 90 pounds lost. Not to bad for 7 1/2 months post op though. I had set monthly weight loss goals for myself beginning 2 weeks after surgery until I was 16 months post-op, which should put me around 125 pounds lost and at my maintenance weight. For a while I was a little behind schedule but, I had a goal of 90 pounds lost by the time I was 8 months post-op. And, I am already there. Yeah!!! I have been suffering from awful constipation lately. But, I hate to take anything for it because for several years now (since having problems with my gallbladder) I have had bouts of constipation then diarrhea. I am afraid to take very much in the way of stool softners or laxatives because I still have bouts of diarrhea even since I had my gallbladder removed. I can work with constipation but, diarrhea makes it can of hard to come to work. So, I guess I'll just have to try to find a happy medium. The past month has been rough. My sister-in-law was in a wreck on June the 2nd which hurt her, her 12 year old son and 16 year old neice and killed her 7 year old son. Then my son did a flip off the trampoline onto the ground Father's Day and broke his ankle. He went yesterday for a cat scan because the x-rays were not telling them everything they needed to know about the break. He may have more than one break which could result in surgery. Cross your fingers that the cast will be enough to take care of his injuries.
7/28/05 Well, I'm down 98 pounds as of this week. I've lost more the past few weeks than I had been. A lot has been going on. I have been doing good to eat 2-3 times a day and sleep 3-6 hours a night, between my son having to go back to the doctor every two weeks for x-rays, another nephew (19 years old) dying, a brother-in-law in the hospital having strokes etc. I haven't had time to snack a lot. I know I haven't been getting in my fluids either. Bad girl! Bad, bad girl! I feel really run down and tired lately. It is almost time for my B-12 injection and I will be going back to see the thyroid doctor in a few weeks to see if my medication needs to be adjusted. But, it's probably just exhaustion. I NEED MORE SLEEP!!!!!!
8/02/05 I had been losing and gaining the same 2 pounds for weeks putting my weight loss back and forth between 96 and 98 pounds. But, finally today I weighed and I have lost exactly 100 pounds. I just made it to the century club and it is an awsome feeling!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
8/12/05 I saw the thyroid doctor yesterday and he said he thought it was time to try to go without the thyroid meds. That was the last of the 20 prescription pills I was on before surgery. So, now I'm down to just vitamins and calcium. This scares me a little. Because in the past, everytime my meds got a little off I either gained weigh or after surgery stopped losing. But, he said if any problems arise to come back sooner otherwise we would do another blood test in Oct. to make sure that everything is doing ok without the meds.I just weighed and have lost a total of 103 pounds in about 9 1/2 months which still amazes me. I am in a size 8 blue jeans and if all the loose skin/flab was removed from my lower body I could get into a 6 easily.
8/23/05 Well, I am down to 150 pounds that is a total loss of 105.5 in just 39 weeks. I have started back hot flashing and have been a little more hungry especially for sweets and bread since stopping the thyroid meds but, I just try hard not to give in to the head hunger.
8/31/05 Down to 149 this week and a size 6 pants. That's a loss of 106.5 pounds. The head hunger has won several times lately. I even ate 1/2 piece of cake with 1/2 small glass of milk. I prayed that I would dump like never before and wouldn't ever want to try that again. But, no such luck. My heart raced for a few minutes then I was fine. Darn it!!! That means I'm one of the few that can tolerate sugar. Nothing seems to make me sick anymore and I don't like that. The dumping tended to keep me on track. I will be glad when it's time to have my next blood work done and see if I need to go back on the thyroid meds or if this is all in my head. I am trying really hard to get back on the wagon with not only what I'm eating but amounts also. Anyone reading this post please pray that I can get back on and stay on the wagon. I am so scared of coming this far then ending up right back where I started from.
PS.
We didn't have any major damage from hurricane Katrina Monday night. Mostly trees down on power lines. And, our power is still off at home. Guess I better close for now.
9/20/05 Well, the past few weeks have been pretty rough. I have started back feeling bad, tired and very irritable. I have frequent headaches, palpitations, hot flashes and my appetite has severely increased. I had my blood work drawn again last week to check my thyroid. Because last year when I started having all these problems, it was related to hyperthyroidism. My labs have changed a lot since the doctor took me off the thyroid meds 5 weeks ago but, they are still with-in-normal limits. They thyroid doctor said everything looks fine but, I don't agree. I think the major changes in the numbers even though they stay with-in-the normals have caused me some problems. I'll just have to wait another month and repeat them and hope things get better in the mean time. I have managed to loose a little more weight. I'm down to 145 which makes me a "normal" weight according to doctors charts. That's a total of 110.5 lost. I am in anything from a size 4 to a 7 pants according to the brand. So, maybe I'll get to my goal weight of 125 - 130 over the next few months. However, if I don't that's fine. Because I wanted to lose enough to get to a size 6 and I'm already there without losing as much as I thought I would have too.
9/26/05 Feeling better this week. My thyroid levels must have leveled off for now. I have lost 112 pounds and am wearing anything from a size 4 to a size 7 pants according to how they are made. I don't think I will really try to loose much more weight. If I loose another 3 pounds then get approved for plastic surgery and have as much as 10 pounds of skin removed that will put me at goal. My hubby has informed me that I have lost enough. Never thought I would hear that. LOL.
10/18/05 Went to the doctor yesterday. I have another rash under the excess skin role at my abdomen, my buttocks and where my thighs rub together. The doctor said it was a staph infection and wrote prescriptions for antibiotics by mouth and topical. I am scheduled for carpal tunnel release on Friday but, he said if we didn't have this infection under control we may have to post-pone my surgery. I had increased my calorie intake to try to slow down my weight loss. I don't want to loose too much. I have lost 115 in almost 11 months. My goal was to lose 125.
10/25/05 My carpal tunnel surgery went well. Guess I increased my calorie intake too much, because I have gained 2 1/2 pounds since last week. I wish I could blame it all on the IV fluids and the brace I have on my arm etc, but, I know I let things get out of hand the past few weeks. I seem to be able to tolerate sugar. Which is not good. I have been sipping on soda's and eating candy, snack cakes etc. I guess that just goes to show you can't take this weight loss for granted. And, that the weight can be gained back. We may never gain back to where we were but, we can gain. I still have the same old demons that I use to have. The only difference is I now have a tool to help me fight the demons. But, it only works if I use it properly. I still have to stay away from sweets and soda's whether I can tolerate them or not. I have to realize that they are the poison that ruined mt body before wls and they will do it again if I let them.
11/15/05 I am pretty much over the carpal tunnel surgery except for a little tenderness and some peeling dead skin at the surgery site. Well, my weight has stabilized. I am staying pretty much between 137 and 139. I will be going to see Dr. Sherer next week for my one year check-up and will ask him about referring me to a plastic surgeon at that time. My PCP had already told me that he would write me a letter of medical necessity. The surgeon that did my carpal tunnel surgery has also told me to let him know when and he too will write me a letter. He said that the only way to keep these rashes and staph infections under control would be to remove the source that is causing them (the excess skin). So, my fingers are crossed. I know many people apply for insurance to cover and are turned down. I pray that I can get approved for the LBL that I so badly need because I just can't afford to pay for the surgery even if I could get a loan.
11/28/05 Saw Dr. Sherer last week. He said everything was looking good so far. I am still waiting to hear from my lab results. I asked them to fax me a copy of them but, they haven't yet. He had said I could go for a plastic surgery consult in about 6 months. But, after I explained that if I waited 6 months that would be the vary time that I can't take off work, he OK'd it for me to go ahead and get my consult now. Besides my weight has been fairly stable for the past 3 months. I am staying pretty much between 135 and 140. I called Dr. Howell in Tuscaloosa for the plastic surgery consult and he had an opening 12/16/05. Wow!!!I thought I would have to wait a lot longer than that for a consult appointment. Maybe this is a good sign. Now, if only BCBS will cooperate, I may have my Lower body lift by Jan or Feb. If I wait much longer than that, I'll have to put it off indefinetely. I work at a nursing home doing quality assurance, infection control and education. When the state comes in to do their yearly survey, I have to be here. And, since we never know exactly when they are coming, I would not be able to take off until after they have completed their next survey and everything is back in compliance etc.
12/19/05 My weight is swaying back and forth between 135.5 and 133. I saw Dr. Howell regarding having a lower body lift. The good news was that he doesn't think I need that extensive an amount of work done. Just a tummy tuck and thighplasty using the excess tissue that is normally thrown away to do a little augmention of my flat buttocks will do the trick. The bad news is he doesn't think that I have enough excess skin for insurance to pay for any of my surgery. The worse news is it will cost a little over $10,000 that I just don't have or anticipate being able to get any time soon. So, I am very depressed to say, that my reward for all this hard work to loose around 122 pounds will be nothing more than flabby loose skin and an extremely flat butt. He said it could take between 2 and 6 weeks to get an answer from BCBS but, not to be surprised if I were denied. On the other hand, he said he had never had a patient with as much documentation as I did of rashes etc. upon walking in the door for a consult and that could sway things a little but, again, "not to count on it". So, here I sit depressed. And, my computer at home crashed a while back, so other than a few minutes here and there I can't even get online anymore. So, I also feel really isolated from my wls family.
1/30/06 Well, I have been approved for the tummy tuck! I went back to the plastic surgeons office last week for some additional pictures and they are suppose to be filing for approval of my thighplasty this week. They said I heard back about my tummy so quickly because they were able to file it over the internet but the thighplasty will have to be done per snail mail. So, here I sit anxiously waiting to hear something. Well, not just something...but, "yes we will aprove this surgery too." is what I really want to hear. I will let you know when I hear something.
2/18/06 Frustration is taking over. I know that insurance takes their sweet time. But, I am going nuts waiting to hear something. My birthday is tommorow and I would love to hear from them Monday saying "Yes! We will cover your thighplasty."
2/24/06 YEAH!!!! I spoke with the Dr.'s office yesterday and found out I was approved not only for the tummy tuck but, the thigh lift as well. Yes!!!! Dr. Howell will also be doing muscle tightening of the abdomen and a butt lift/augmentation at no extra charge. Now, I am impatiently waiting to hear from the surgery scheduler and get a date. I am staying between 126 and 128 pounds and feeling better than I have in years. I have had many e-mails wanting to know exactly what I did to get approved. In addition to my primary care physician, I had 2 other doctors document my rashes and the treatments for them and the fact that they continued to reoccur even with treatment. I took pictures of the rashes every month and dated them so insurance could have a kind of picture trail to prove they reoccurred. Then, in my haste, without thinking, I gave the original pictures to the plastic surgeon with the dates they were taken etc. So, my first advice would be to get 2 copies of your pictures. One for you and one for the PS.
Many people wanted a copy of the personal letter I wrote and gave to my PS to include with the paperwork he submitted for my approval. Rather than trying to e-mail it to everyone and missing someone or someone in the future not having access to this information I have decided to post it on here. So, here it is:
To Whom It May Concern:
On 11/24/04 I had gastric bypass surgery and after losing 121 pounds my general health (blood pressure, respiratory status etc.) has significantly improved. However, several new complications have occurred as a result of losing so much weight in a relatively short period of time and being left with an abundance of loose skin that daily exercising has not resolved.
I have reoccurring rashes, blisters and ingrown hairs to the area where the excess skin overlaps from my abdomen onto my pubic area. I have reoccurring rashes and boils to my inner buttocks and the fold of skin at the bottom of my buttocks. There have been numerous occasions when I have suffered skin tears to my inner buttocks and the fold of skin at the bottom of my buttocks in relation to friction of the now fragile loose skin in that area, caused by scooting up in the bathtub, moving over while seated on the pew at church etc. My thighs rub together and clank together with every step I take, resulting in my knees being forced outwardly and causing frequent pain to both knees. I also have difficulty sleeping when lying on either side, due to the excess skin on my thighs causes my knees to bend inward also resulting in frequent pain. I have reoccurring rashes, ingrown hairs, folliculitis and boil type lesions caused by friction at my thigh area from the simple act of walking. I have to buy new pants frequently due to this constant friction caused by my thighs rubbing together which causes my pants to knot up and wear down in the thigh area until holes have formed. (See attached piece of fabric cut from the inner thigh portion of my pants.) Now, if the fabric from the inner thigh portion of my pants is this worn, please try to imagine what the integrity of the skin to my inner thighs is like. These rash type areas have been noted by several physicians to be a staph infection, which requires antibiotics. And, either they never completely resolve or after a short period of time they return even with the use of antibiotics.
In the beginning I diligently tried to resolve these problems myself with the use of good hygiene practices (2 baths daily using an antibacterial soap and paying special attention to dry carefully between the folds of skin), over-the-counter analgesics (both oral and topical) and various creams and ointments (such as Neosporin and Hydrocortisone cream) used for the relief of itching & rashes and to help prevent infections to these areas without any long-term success. After a while of fighting a losing battle, I saw my primary care physician. I am limited to the oral medications that I can take due to allergies to many medications and stomach problems. Therefore, I was treated with over-the-counter topical analgesics and a prescription antibiotic salve, which did very little toward the permanent resolution of these problems. Since then I have had several prescription antibiotic ointments and oral antibiotics. I thought that after the weather cooled down, my symptoms might improve. However, as the weather becomes cooler, I continue to have complications.
After exhausting all other revenues to find relief of the above mentioned complications, I am now requesting reconstructive surgery to remove the excess redundant skin from my abdomen, buttocks and inner & outer thighs in an effort to finally resolve the pain and suffering that it has and obviously will continue to cause.
My insurance policy clearly states that “reconstructive surgery” is covered so long as, it is medically necessary and is performed primarily to restore or improve the way the body works or correct deformities that result from disease, trauma or birth defects. The excess skin that I now have, that causes me to have the above mention health problems, is directly related to the disease known as “Morbid Obesity.” The treatment for the morbid obesity was gastric bypass, which was previously approved by your company and as a direct result of that covered treatment, for that covered disease, I now have other health complications that requires medically necessary reconstructive surgery to correct.
Before making any final decisions in my case please refer to the attached physicians documentation of my condition, as well as the enclosed pictures of rashes and the fabric sample from the inner thigh portion of my pants. If you still do not feel the evidence before you justifies approval of the requested procedures, please allow me to appear before you, to see up close, the condition of my skin prior to making your final determination.
Sincerely,
Gwendolyn F. Smith
I also included the
following in my letter:
contract #
policy #
home address
phone #
2/24/06 I have a date. My ps is scheduled for 3/16/06. 20 days away. Wow! That's not really that long.
3/07/06 Well, one week from today is the day. I go tommorrow for my pre-ops then next Thursday I have a tummy tuck with muscle tightening, thigh lift and butt lift/augmentation. Can you say OUCH!!!!!!!!! I am not so sure about the ride home. I live 30-40 minutes from the hospital. I won't be able to sit, I can't lay on my tummy, I'm sure from expierence of having previous abdominal surgeries that even laying on my side will not feel real good and laying flat on my back will be out of the question because after a tummy tuck you can't really stetch out. Wow, I guess that only leaves my head. LOL
5/24/06 Well, I didn't realize that it had been so long since I had updated. The surgery wasn't nearly as painful as I thought it would be. Of course, 1/2 my lower body was numb for the first 6 weeks or so. I ended up in surgery 11 hours. After doing the tummy tuck, thigh lift and butt lift/augmentation the plastic surgeon didn't like the way my thighs looked so he cut me down toward my knees. That helped my thighs a lot however, it left large puffy areas at my knees. And, about a week and a half after surgery one side of my butt fell and both sides were wrinkled and still saggy. I really wish I had insisted on having the lower body lift (belt lipectomy) rather than agreeing to have the butt lift/augmentation. I have had a sermoa to my butt and one on my left leg that has had to be drained weekly for the past 5-6 weeks. I have been pretty aggrevated with the results of my plastic surgery up to this point. At first the plastic surgeon wasn't really wanting to go back and fix anything unless I was willing to pay for it in full. He finally agreed that my butt did need to be redone and said that he wouldn't charge me a lot to do it. But, I didn't feel he should charge me anything. If you buy a new car and it only runs for about 10 days the car dealership is responsible for fixing it. I figure my butt is more valuable than a car so, he should fix it. Anyway. As it turns out, the only way to fix my seromas after this long is another surgery. And, since he will have my leg opened up anyway, he has agreed to go ahead and fix both my knees. And, while I am already in surgery he will do a revision to my butt as well. If insurance agrees to pay for the remainder of the belt lipectomy to be done he will do that---otherwise, he will just repeat the butt lift/augmentation to both side and try to get them looking better. I guess I can't really complain, since up to this point, insurance has covered all my surgeries which is almost unheard of. Otherwise, I am doing good. I was back at work full-time within 3 weeks after surgery. I had heard so many awful stories about pain that couldn't be controlled and needing help to shower get dressed etc for months after surgery. But, after a few days I was able to go to the bathroom unassisted and shower. I did need help with my bandages because there were so many in so many different places. I needed help for the first 1 1/2 to 2 weeks with putting the compression garment on and off because it had so many fasteners and zippers. But, otherwise, it really hasn't been that bad. Ok, I guess I have updated enough for now. I will try to update when I know more about the next part of my surgery. And, good luck to those of you that are just now going through this.
8/31/06 I had the revisions of my previous surgery on 7/13/06. I did pretty well at first. I went back to work after 2 weeks and was working ovetime by the 2nd day I was back. Not a good idea. I developed another seroma in my right leg almost immediately after returning to work. I have been having to go 1 -2 times per week to the doctor to get it drained. My butt is not perfect but, looks better than it did after the first surgery. My knees have stayed so swollen, it is hard to tell if they are going to look better or not later down the road. The doctor wanted me to take a few weeks off work and see if the seroma would resolve from complete bedrest. But, I have used up all my sick time for the rest of this year and all my vacation/holiday pay etc. until September. So, unless I take off without pay, I can't take any more time off until next month. Besides, I have gotten so far behind at work from all the time I have had to take off, I probably won't ever catch up. No one does most of my job while I'm off. I just have to work harder to try and catch thikngs back up. I am about ready to let him repeat the surgery to my right leg again rather than keep on getting it drained.
09/28/06 The doctor said my leg seems to be doing better. I am going to have it drained once every two weeks now rather than once or twice a week. I am however, suffering with awful muscle spasms in my legs feet and back. I'm not sure if that is from the gastric bypass or just me. I have had some muscle spasms since I was young but, these are a lot worse than my usual.
