LaLaLauren
3 1/2 Month Update
Feb 21, 2009
I now use "the daily plate" to track my food...I'm kind of obsessed with it...but in a good way. Tracking my food and getting to see the nutritonal info in everything that I eat has really made me make better food choices. Seeing the nutritional information of "restaurant" food had led me to the point where I'd rather pack a lunch or eat at home rather than eat out because I can usually make something 1. more healthy and 2. tastier than an "acceptable" item on a menu in a restaurant. I never thought I'd see the day where I didn't get excited to eat out! I was a huge fan of eating out pre op. Don't get me wrong....I still eat out and enjoy it...its just not every day and I really try to balance out my food choices for the rest of the day (ie: eat a light dinner because I ate out at lunch, etc.) Case in point: last Friday we were going to Chick-fil-A for lunch. I really wanted the chicken strips salad but once I saw the nutritional info, I decided against it. By my standards the salad wasn't worth the calories/fat/sodium and I wound up picking the grilled chicken cool wrap with fat free honey mustard dressing. I wound up eating half of it....and it was pretty good. I always check to see if the restaurant I'm going to has a website with nutritional information before I leave the house. Being able to pick out what I'm going to eat ahead of time based on the nutritional information is great. It really helps me make better choices.
My clothing situation is getting more and more bleak as the weeks pass. I've managed to go through all of my clothes and weed out everything that is too big....its A LOT of stuff. The clothes that fit me are from 5 or 6 years ago when I lost 50 pounds on weight watchers. I'm glad I kept some of that stuff but I know that it isn't going to last too long. I'm going to need to get all new spring and summer clothes......which is exciting but worrisome because its so expensive. I'm really going to have to look for sales and try and go to thrift shops.
I'm getting self conscious about the jiggle in my stomach. My skin is really starting to sag and hang and its pretty unsightly when I wear a t shirt. I've been trying to wear more structured clothes to try and mask the jiggle. I have a few blazer/jackets that have been life savers....a denim one, a black courduroy one, and an army green one....I've been wearing them like crazy. When I was going through all of my clothes I came across a pair of size 26 denim bermuda shorts that I wore all the time over the summer. I never realized until that moment that I was wearing a size 26...I always thought my biggest size was a 24. Well, they look absolutely huge now....I put them on and they just fall to the floor....the don't even stay up! I'm keeping them as my "before" pants since they're the biggest ones that I've ever had to wear.
There are some beautiful pieces of clothing that I can't bear to give away yet....a few really nice dresses and some really nice professional attire. I just left them hanging in the back of my closet. One day I'll make peace with giving them away....but I want them to go to a good home....to someone who will love them as much as I did. I was definitely NOT prepared for the emotions that came along with giving away the clothes that I adored and worked so hard to acquire to make myself look good on the outside while I felt like crap about myself on the inside. When I weighed 306 pounds I made a conscious effort every single day to have on a great outfit that fit well along with coordinating jewelry/shoes/purse. I made sure that my hair was always done and that I always had on make up. I had to be sure that no one ever had an opportunity call me a slob, or messy, or unkempt. It was as if being stylish made me less fat and more likely to be accepted.
I had a little scare this week with a dramatic increase in heartburn and burping coupled with abdominal pains and diarrhea. I prepared myself for the worst (gallbladder problems, stricture, ulcer, etc.) and called Bayview. They wanted to see me the following day so when I went to Bayview the NP felt that I had 2 different issues going on. She said that the burping, nausea, heartburn was unrelated to the pains and diarrhea. I had a low grade fever and she felt that I had a bit of a stomach bug. She gave me a prescription protein pump inhibitor (Nexium) because my OTC Pepcid clearly wasn't cutting it with the heartburn. Once I started taking the Nexium I felt back to normal in a day or so. I am so thankful that my problem had an easy solution and that it wasn't a serious issue at all. I've noticed in the past few weeks that my hair is thinning. I started noticing that quite a bit of hair was coming out when I'd wash my hair....and then I looked at the back of my head in the mirror one day and noticed quite the baldish/sparse hair spot on the back of my head. I got some good hairspray and have been poofing up the back in an attempt to hide it. I suspect that only *I* know its there. Regardless, I started taking Biotin...we'll see if I have any results from it.
I'm still plugging away one day at a time. My biggest challenges right now are: 1. Making smart choices when I want to snack in the evenings 2. Meeting and trying to exceed my daily fluid intake goals and 3. Making myself get to the gym AT LEAST 4 days per week 4. Getting in each and every supplement every day (I developed a new organizational system to try and help)
Today I got labs drawn for the frist time since surgery......keeping my fingers crossed that all is well in that arena!
Thats all for now!
One less medication!
Jan 05, 2009
buying smaller clothes
Jan 03, 2009
I survived the holidays!
Dec 28, 2008
I am very pleased with how I handled the holidays....I made/bought dishes that were WLS-friendly and took them everywhere I went. I realized at my work Christmas party (where I didn't take a WLS friendly desssert) that I MUST take a dessert that I can eat wherever I go because I was really missing something sweet at the end of my meal and was tempted by the sugary dessert table. Needless to say, I toted around WLS-friendly desserts for the remainder of the holiday gatherings. My sister's boyfriend got me a GREAT Christmas present....its a Splenda recipe box filled with splenda recipes. There are a ton of great ideas for desserts that I can't wait to try. Another challenge I have encountered is dealing with people who have rude comments about what I'm eating. One particular comment that came from my father was, "Thats a lot of food....are you gonna eat all that?" My resposne was to look at his plate and respond, "Thats REALLY a lot of food....are you gonna eat all that?" I then got an apology. I vaguely explained my dietary needs with help from my sister (who could tell my blood was boiling). In what world is it okay to comment on how much food someone is eating, especially when they barely have 1/3 of what everyone else is eating? I tried not to let it get to me and told myself that the comment came out of truly being uninformed about gastric bypass surgery. Some people just expect us to eat a tablespoon of pureed mush for the rest of our lives. Those poor uninformed souls. =)
I have been having a great time cooking new meals, discovering new recipes, amending old recipes to make them WLS friendly. I manage to eat out with no problems. For a while I would stick to meatloaf, meatballs, chili, lunchmeat, and bean soup since I knew these were safe foods for me. I've started venturing out a bit and am enjoying (and tolerating) seafood....shrimp, crab, fish, and mussels. I made a great meal ou of the appetizer of mussels last night at Bertucci's! I was watching The Food Network yesterday and saw Paula Deen make an incredible looking Seafood Cioppino....it was a tomato and wine-based broth with scallops, shrimp, clams, and fish in it. I might be trying that out for New Years Eve later this week. I've noticed a dramatic increase in my energy level and am looking forward to starting my water aerobics class in January. I feel flabbier by the day and vow to get my butt into the gym to work with the weight machines.
I used a gift card at Lane Bryant the other day and bought a size 18/20 sweater and my size 22 jeans are baggy now. Prior to my surgery I was in a 26/28 top and 24 pants. I've noticed that I fit much more comfortably into booths at restaurants....I no longer get a red mark on my stomach from where the table was pressing into me...and in fact, there is now often space between my stomach and the table. I was talking to Jay yesterday about how this will be the first New Year in as long as I can remember where my "resolution" does not involve sticking to another diet or to "finally" lose the weight. Thats pretty exciting.
People at work continually comment on how big my clothes are getting and they call out to me, "Hey Skinny!" I would have never thought that I'd be called "skinny" at 250 lbs....haha. People comment on how "healthy" I look and how I "glow." Its all very flattering but I wonder if at some point they're going to comment about how I've lost too much weight (I know that tends to happen to people who have had WLS). I have 10 days until my official 2 month weigh-in and pictures......more joy to come!
thoughts 3 weeks post-op
Nov 29, 2008
I am so blessed to have had the opportunity to have gastric bypass surgery.
I am blessed to have a job where I have excellent health insurance that
covered the cost of my surgery.
I am blessed that I have a job that allowed me to take off for three weeks.
I am blessed that I had enough time saved up at work to get paid for my entire time off of work.
I am blessed that I live and work within 10 minutes of a hospital that is a Bariatric Surgery Center of Excellence.
I am blessed for having Dr. Lidor as my surgeon….and I am blessed that she is skilled in performing my surgery laparascopically.
I am blessed because I have had no complications thus far.
In three short weeks this surgery has changed my life. I have lost 25 pounds as of my first post-op appointment and all of the work I had to do to satisfy my insurance company’s requirements to qualify for surgery and the periods of pain and discomfort have been worth it….100% worth it.
So now I'm a post-op!
Nov 12, 2008
So I live to tell my story of gastric bypass surgery......thank god for that! I went into the hospital at 10 a.m on Friday November 7th. While they whisked me away and had me get in a gown, support stockings and on a gurney REALLY quickly, I actually had to wait in the pre-op holding area for THREE hours. Luckily they let my Mom, Dad, and Jay sit with me while we waited. They did all kinds of things to me there....pregnancy test (negative!), Lovenox injection, started an IV, drew blood, asked a million questions, check my blood sugar. Apparently the surgery in "my" operating room room was taking longer than expected and then the room had to be cleaned so they came to me and said that it'd be another 45 minutes so we sent my mom and dad to get something to eat/drink and use the bathroom....and maybe 10 minutes later they come to take me into surgery. I told them that they had to wait until my parents came back so we called them on their cell phones and they came to say goodbye. I don't really remember much after getting into the operating room. They had me scoot onto the operating table and then started putting "feel good" medicine into my IV...then put a mask on my face and I was OUT. I remember waking up in the recovery area and they kept telling me how good I looked...that I didn't look like I'd had surgery. The nurse wanted me to use the incentives spirometer and was pointing to the arrows and numbers on it and I told her I couldn't see it without my glasses so they let my mom come in with my glasses.
I stayed in recovery for what seemed like forever and finally got into my room around 9 p.m. The nurses fussed over me for a while once I was in my room and then my family was able to come in around 10:00 p.m. (it was a LONG day of waiting for them). I felt pretty good at that point and was oriented to all of my tubes and gadgets. I have 5 two-inch incisions from the surgery. They were closed with glue so I don't have any sutures or staples. I had a JP drain in my lower abdomen, squeezy things on my legs to prevent blood clots, support stockings, oxygen, a catheter, 2 IV lines, and a morphine pain pump. They told me that I could hit the button for the pain pump every 10 minutes. If I was hitting the button in the right time frame it would beep twice and then dispense medicine. I can remember praying for that double beep a few times...10 minutes seemed like an hour at times! They told me that they were going to let me rest for a bit and that they'd be getting me out of bed at 1:00 a.m. I actually wound up getting up into a chair before 1 a.m. and I don't remember it being all that difficult. I was sore but its really wasn't too bad. I walked with the nurse (and I think maybe Jay or Megan too) at 1:00 a.m and then went to bed.
I was able to stay asleep for an hour or two at a time that first night. I remember being really hot and sweating. The nurse and the tech came in ALL the time to check vitals. I had some issues with breathing....I wasn't breathing enough (my pulse-ox was frequently in the lower 80's) and they kept shaking my leg and telling me breathe and take deep breaths. My blood sugars got out of whack (even thought I'm not a diabetic) and I had to get insulin a few times. I felt like a human pin-cushion between the blood draws, the finger sticks and the lovenox injections. My drain site leaked like crazy throughout the night....through my gowns and onto my bed and they had to keep changing my dressings. All of that aside, I still managed to get into one my own cute night shirts. =)
On Saturday morning I felt really good. They took out my catheter and they told me that I'd be going for a "leak test" at 8 a.m. I went down to radiology where they had me drink a medicine cup of some kind of dye and then had me stand in front of an x-ray machine. They could watch the liquid go down my new GI tract to make sure there weren't any leaks. There weren't any leaks so that was great news. Megan and Jay came to see me shortly after I got back from the test and I had talked to them on the phone to tell them how good I felt. By the time they got there I was in misery...and it all started going down hill.
Apparently the "leak test" can cause some bloating from doing 2 oz. of liquid like a shot. I had much more than some bloating....I started sweating and got horrible pains in my upper abdomen and was in misery. I had to ask for my pain medicine (which was now liquid oxycodone) earlier than due which made me feel like a crazed drug seeker. One of the doctors came in and explained that I was probably experiencing severe gas from the leak test and the fact that my surgeon had to load my abdomen with excess air and saline because my liver was "huge." Great. So they also cut a piece off of my liver to biopsy....they say that there is increased risk of liver disease in people getting weight loss surgery. So the gas pains were like nothing I had ever experienced in my life. The oxycodone wasn't helping much so they swiched me to oral Dilaudid while they waited for the Dilaudid pump to arrive. (Now I really felt like a sissy but I this was REAL pain that made me sweat....there is no other way to describe it!).
The next day and a half were a blur with the pain and the medicine and the fever I developed. They thought I may have had a urinary tract infection from the catheter so they did a urine test....that was negative so they kept giving me the IV antibiotics. They kept telling me that the best medicine for the pain was to walk....and I did. A lot. I did laps around the unit as much as possible then went back to my room exhausted, took a nap, got up and did it all over again. The fever finally broke and the gas finally started escaping my body and I was feeling like a million bucks. They told me I could go home on Monday morning so I was pretty happy about that.
On the morning of Monday November 10, 2008 I got myself up, dressed, washed and packed up to go home. They d/c'd my Lovenox injections since I'm so mobile and took out my IVs. I hadn't needed any pain medication for over 8 hours so they just gave me prescriptions for oxycodone incase I needed at home. For the next 6 months I have to take a medication to prevent gallstones and Pepcid to coat my stomach so I got all set up with those. My drain was removed that morning...all I can say is that it felt like snakes and worms were being pulled out of a hole in my abdomen. There was over a foot of tubing inside of me!!!! (hopefully that was the most unpleasant thing that a Bulgarian will ever do to me!)
Megan and Nick came and got me and brought me back to my mom's house (where we planned for me to stay for a week until I feel comfortable with going back to my house). I've been feeling better with each day that passes. On Monday I struggled all day to get a few ounces of fluid in me. I felt really full all of the time and really still needed my abdominal binder for comfort. The binder really holds tight to my abdomen so I think my stomach had a lot of difficulty expanding at all. While I was in the hospital I spent a lot of time in semi-reclined postions (either in bed or in the recliner chair). It was uncomfortable to sit completely upright or lay completely flat or on my side. I had no idea how I was going to sleep or sit around since my mom doesn't have a recliner chair (nor do I at home) so my dad went and got me an incredibly comfortable recliner chair that has been a HUGE lifesaver. I will continue to thank him profusely for that chair for the rest of my life =)
Yesterday was the first day that I really didn't wear my binder. I was able to get in 32 oz. of water/crystal light and 2 carnation instant breakfasts each made with 8 ounces of milk (each had 13 grams of protein). I also had 3 oz. of yogurt spread throughout the day plus my medications and vitamins. It was a total of 31 grams of protein and even though my goal is to take in 60-80 grams of protein per day, I was pretty pleased with being able to take all of that in so soon.
Yesterday I went out for about an hour to run a few errands with Jay (pick up prescriptions, get some yogurt, and of course browse around at Target). I was so tired and sore by the time we were leaving Target that I felt like I was staggering through the parking lot! It felt good to get out but I clearly need time to build my activity tolerance. I can now cough, sneeze, take deep breaths and laugh (kind of) without much pain....so thats a good thing. Last night I was able to get to the "3000 mark" on my incentives spirometer so thats definite progress.
I feel even better today and have already been able to get in almost 24 oz of water (I woke up at 5 a.m and started working on it) and I had a protein drink made with 8 oz. of milk for breakfast...that gave me 28 grams of protein so I'm half way to my protein goal for the day. My incisions are starting to itch (so they're definitely healing) and the hole where my drain was isn't draning much at all. I still have some pain on the side of my abdomen but its totally manageable and I haven't even needed a Tylenol since I was released from the hospital. I'm looking forward to starting pureed foods on Monday (one can only eat so much yogurt, pudding, jello, and broth) and being able to face the water stream in the shower (I'm not allowed to let the water beat on my stomach...they said it might loosen the glue holding my incisions together...yuck!).
Thank you to everyone who has called, sent cards/gifts, visited, texted, emailed, left messages, prayed, and asked family/friends about me....it means the world to me to know that I have such great people in my life! God bless everyone who had to look at me with my greasy dissheveled hair and messy eyebrows....thanks for telling me I looked good.
All of the medical staff at Bayview were wonderful to me....my needs were always met and they were very attentive. The nurses, techs, and doctors were all very sweet and caring (especially the Bulgarian resident!) and my private room rocked!
Thank you from the bottom of my heart to everyone and keep posted for more updates!
Oh....as of this morning I've lost 18 pounds...how cool is that?
Insurance Approval!!!
Jul 12, 2008
So I found out on Friday (7/11/08) that my insurance company approved my surgery!!! I learned that I had to be proactive about following up with my insurance company because I just wasn't getting anywhere with obtaining straight answers from my surgeon's office. I was getting a lot of contradicting information and was told several times that they'd look into an issue and call me back.....and then never called back. So anyways, thats all water under the bridge and I have an authorization for the surgery! The authorization is for August 8th and 9th so I called my surgeon's office to let them know that I had been approved and apparently all the people who I needed to speak with were gone for the day and will be returning to the office on Tuesday 7/15/08 and would be calling me with a surgery date on Wednesday 7/16/08. I heard through the grapevine that Dr. Lidor is going out on maternity leave and her last surgery date is August 8th. I sure hope that'll be my surgery date.
I've went out and bought my chewable multivitamins last weekend. I got big bottle of Flintstones Complete (200 count) at Costco. I've been taking them every day so I can get used to the taste. They're chalky and have that earthy vitamin taste (i describe it as tasting like dirt) that makes me want to gag but I just keep telling myself...." its mind-over-matter so chew it and get it over with." I swear that I get a metallic taste in my mouth after chewing them so god only knows what the chewable or liquid iron is going to be like. I'm pretty good at self-talk and just tell myself to suck it up and get it over with. It works for me =)
My friend gave me a big box of chewable Caltrate samples that she got from her doctor. I tried them and they're chalky but don't have the dirt taste to them. I was reading the box to try and figure out if they're Calcium Citrate. It didn't say anywhere on the box so I was taking to the dietician at my work about it and she told me to look at the ingredient list. Sure enough, it said Calcium Carbonate....so I'll have to go get some Calcium Citrate. Citracal probably.
I found an AWESOME blog last night from a woman (Shelly) who used to work for OH and had WLS. I swear, I'm in love with her. She has TONS of recipes that she has developed herself. She totally hit the nail on the head when she said something to the effect of, "the surgery was on my intestines, not on my taste buds." I was getting nervous the other day as I was reading some of the message boards on OH about what people were eating a year + out of surgery. It was a lot of the same stuff day after day and a ton of cottage cheese. I had myself wondering if this was how I would HAVE to eat forever. This woman's blog totally boosted my mood about being able to cook and enjoy food again after WLS. She looks and feels great and 2 years out has lost 150 pounds. She's my new hero! The blog address is: www.theworldaccordingtoeggface.blogspot.com. Check it out...I feel like she's been my "maintain the guts to have WLS guardian angel." Her blog is so great and she obviously puts a ton of time into her postings and the development of her recipes.
So my new hero Shelly had some advice for pre-op patients and one thing that I haven't really done yet is to make a list of things I want to do once I've lost a lot of this excess weight. Here goes...
1. Comfortably fit into a restaurant booth....and not worry as I'm approaching the booth that I'll have to squeeze msyelf in there.
2. Fit comfortably in a seat at the movies.
3. Fit comfortably in a coach seat on an airplane...and have extra room on the seatbelt.
4. Fit into the seat on a roller coaster.
5. Ride a horse (they have a max of 250 pound limits!)
6. Buy clothes at a non-plus size store/section.
7. Shave my legs with ease.
8. Cross my legs.
9. Sit my knees to my chest.
10. Paint my toenails without being a contortionist.
11. Have a lap that I can sit things on (ie: a notebook, a plate of food)
Thats all I can think of for now. =)
So much has happened
Jun 08, 2008
My letter of medical necessity was pretty easy. I found a template online and basically included all of my person information. My doctor's office reviewed the letter and had the doctor sign it. I'll post the letter sometime soon.
My psychological evaluation was pretty simple. I went to Dr. Gewanter here in Baltimore. The psychiatrist at Bayview didn't take my insurance (Independence Blue Cross of Philadelphia, PPO) so they suggested going to Dr. Gewanter. He asked me about my childhood, my current life situation, and my understanding of the surgery and post-op requirements. He kept telling me that I'll be so happy with my body after the surgery, wished me luck, and sent me on my way. I was in his office for less than an hour.
Bayview requires that all surgical candidates go to at least 1 support group at Bayview. I've been to 3 so far and I plan to keep going. The format of the group isn't what I thought it would be. I thought we'd be talking as a group the whole time. Instead, there is some type of "seminar" for the first 30 minutes and then a more typical support group for the second half. During the first one I went to, they had someone from the plastic surgery department come in and do a presentation on body contouring for post-op patients. They consider reconstruction/contouring to be just as important to some patients as the actual WLS itself in that it "completes" the surgical intervention. The second group I went to had a seminar about the importance of follow up with your PCP after surgery. The third was about the role of exercise post operatively.
The consultation with the dietician was pretty enjoyable for me. The paperwork I got from the Clinical Nutrition Department at Bayview said that I had to take all of my medications in their original containers to my appointment. I took them with me and she seemed surprised that I was able to follow directions. I guess she gets a lot of people that don't bring them. She suggested that I try a different antidepressant...that Lexapro isn't "weight friendly." I haven't been able to find any information on how it isn't weight-friendly....and I don't really think its a good idea to start messing with my meds before a major life change. I'll have to ask my doctor about it the next time I see him. Anyways, the dietician had all kinds of food containers and pretty much tested me on what to look for on food labels and in ingredient lists (no sugar in the first 3 ingredients...fructose and lactose allowed!!). We talked about how I don't like sweet or fruity drinks. I was worried about protein drinks that are flavored...I know I won't like them. She suggested just getting the unflavored protein powder so that I can add it to my DECAF tea or water. She recommended getting as many of my vitamins in chewable or liquid form as I could...so I need to work on that.
I had all of weight watchers records copied and sent to Bayview to be sent to my insurance company.
All of my information was submitted to my insurance company at the beginning of June, 2008. The insurance company has 30 days to give me an answer (approval or denial). I'm overwhelmed with emotion--excited and scared at the same time and for the first time since I've started this journey I catch myself getting really impatient. I keep telling myself that the longest part of the wait is over and by this time next year I hope to be well on my way to my goal weight.
Initial consultation with my surgeon
Aug 03, 2007
7/31/07 I went to my initial consultation with Dr. Lidor yesterday. I was a ball of nerves before the appointment and was mostly hoping that I would get a good feeling about her. I had all of the required paperwork with me but still had to do a bunch more paperwork when I checked in at the bariatric center. I basically had to re-write a lot of the information (medications, medical conditions, physician’s information) again which ticked me off a little bit.
When they called me back I first met with the nurse who weighed me (291.5) and took my vitals. My blood pressure was 140/83 which was pleasantly surprising given the fact that the last time I had it taken it was right before my dental implant surgery about 6 weeks ago and it was 180/110. I couldn’t believe my eyes when the nurse pulled out a tape measure to take my body measurements. I had a sense of humor about it so the nurse and I had a good laugh. My waist measured 55” and my hips are 54 ½”. I can’t believe that I’d have to lose 20 inches from my waist to have what physician’s consider a healthy waist size for a woman. That’s a little disturbing.
Next I met with Dr. Lidor’s nurse practitioner (Renee). She was very friendly and personable. Initially she asked me about my understanding of WLS and which surgery I was considering. Once I started talking she told me that she could tell I had done my homework on WLS and wished that all of her patients came in with such a good understanding of the procedures/risks/benefits. That made me feel like I’m doing a good job at being an informed patient! I talked with Renee about my thoughts for the Lap Band procedure versus my thoughts about laparoscopic RNY. She explained that Lap Band isn't all that effective with resolving comorbidities (that I have) such as high blood pressure and diabetes/pre-diabetes. Because of this, coupled with the amount of weight I need to use, I would not be a candidate for Lap Band surgery with Dr. Lidor. She explained statistics on the average percentage of excess weight loss among Lap Band patients (about 20-30%) versus the average percentage of excess weight loss among RNY patients (60-70%) and how RNY patients have a higher long term success rate than Lap Band patients. I was not aware of these statistics and am glad that I have chosen to have laparoscopic RNY.
Renee checked out my heart and lungs and answered questions that I had prepared and said that the next time I saw her would be post-operatively. Next I met with Dr. Lidor. She was friendly but stern about the seriousness of WLS and the lifetime commitment that will have to be made on my part. She stressed the importance of my support system and strongly encouraged me and my supports to attend the WLS support groups at Bayview. She checked out my abdomen and talked about the possibility of needing excess skin removed from my abdomen after losing the weight. She said that insurance companies generally cover the removal of abdominal skin because of the health problems that tend to occur in that area when there is excess skin (rashes, infections, etc.)
I was a little frustrated over discussion about my taking Metformin for my PCOS. She wanted to know why I wasn’t doing finger sticks and I tried to explain that I’m not diabetic—that I have insulin resistance. She suggested that I talk to Dr. Adashek (OBGYN) about whether I should stop taking the Metformin at the time of surgery. She explained that since I will be eating very little food, my blood sugar will naturally be lower and doesn’t want me taking Metformin to lower my blood sugar even more. I totally understand her rationale. I’ll be emailing Dr. Adashek to let him know about my progress with the WLS and to talk about the Metformin.
Dr. Lidor explained that within the past 6-8 months all of the insurance companies have begun to require the 6 months of diet and nutrition classes before your case is even looked at for approval. Basically this requirement is ridiculous because if 6 months of dieting worked, I wouldn’t need bariatric surgery. Because of this new requirement she has about 70 patients who are stuck in the process of taking these classes and has days where she doesn’t even perform a surgery because everyone is stuck waiting for their 6 months of classes to be completed. She said that once I’m approved by the insurance company she can schedule me for surgery fairly quickly. I guess I had a mixed reaction to this because I figured that it would take months after my nutrition classes are over to be scheduled for surgery. I’m scheduled to complete my nutrition class the day after Christmas so I can be submitted to the insurance company around the end of the year.
After meeting with Dr. Lidor I met with her secretary Lillian who gave me a big binder for all of my paperwork. She is in charge of keeping track of my surgery requirements to be submitted to the insurance company. I need to schedule an appointment with a psychologist. She gave me the name of one that is in network with my insurance company. The psychologist at the bariatric center is out of network for me. I also need to meet 1:1 with the dietician who teaches my nutrition class. She’ll go more into depth about eating habits and nutritional requirements after surgery.
I need to pick a support group to go to and have Dr. Weglein (PCP) write a letter of medical necessity for the insurance company. Other than doing all of that, I just need to finish up my nutrition classes and wait for approval. The required appointments and paperwork actually don’t seem too bad.
I’m not telling many people at work about my plans for WLS. I find that people are totally supportive or totally think WLS is a cop-out/bad idea. It’s nearly impossible to tell how people are going to react when I tell them of my plans and I’m too sensitive at this point to have negative feedback about my decision. I’m excited and looking forward to getting some of these pre-approval requirements met.
