Turning 40, Thanksgiving, Insurance Approval and a Surgery Date!

Well, it's been a while since I posted and a lot has happened since then.  I am now 40 years old!!!  I celebrated my birthday with two of my best girlfriends; all thanks to my a big surprise from my husband who treated us all to a night on the town.  I am proud to say that I passed on having any of my birthday cake and was pretty content watching my kids enjoy it!  I am not really a big sweet eater anyway, it's pasta, rice and overall portion sizes that are my problem.  I made it through Thanksgiving as well and I am really proud of myself as I did not gain a pound and overall I have lost 17lbs since I started this journey!! 

I went through a rough patch where my appetite seemed to increase overnight.  I had to get really creative about keeping myself busy and not giving in to over eating.  I had a bit more fat and sugar on Thanksgiving than I had been typically eating and I think eating that caused me to start craving carbohydrates again.  I also think that I am going to struggle with hunger around my "time of the month".  Hopefully I will be more social and more active as I continue to lose weight, thereby giving me something else to focus on besides eating.  Thanks to the new, tiny stomach I'll have, eating smaller portions won't be a problem!!  I experienced my first weight loss stall for about 5 days, but sure enough I started back on the losing track with no problems at all.  I am definitely starting to notice a difference in my clothes and how they fit.  My bra is too big now and a couple pair of my pants have room around the waist.  My family has mentioned that they notice a difference as well.  I have been doing well on my own and I would be fibbing if I said that I didn't consider continuing on my current plan and not having surgery, but after much thought and prayer, I realize that surgery is necessary for me to maintain a healthy weight.  I have been able to lose weight in the past; significant amounts of weight.  However, I have NEVER been successful in keeping it off.  God has been good and everything has fallen into line perfectly to lead me to where I am now.

I met with my surgeon a week and a half ago and I got the call this morning that my insurance approved the surgery and I am scheduled for January 5th, 2012, which is right around the corner!  I have a lot to do to prepare in terms of grocery shopping for the items I will need for the full liquid and puree stage of my post-op diet as well as getting things organized so my husband doesn't want to jump ship (hahaha).  I also have to purchase my vitamins and protein supplements.  If there are no complications, my expected hospital stay is just 1 night...that is unbelievable to me.  I am hoping for 2 nights because I don't deal with pain very well; I am definitely a chicken when it comes to pain!  I had my surgery nutrition instruction so I am all set in regard to what I should be consuming directly after surgery and what my nutritional requirements are in order to stay hydrated and heal properly.

I am excited, nervous and grateful all at the same time.  There are so many things in life that I have missed out on that normal weight people take for granted.  There has been so much anxiety and worry that has gone into thinking about how I could become a healthier person by losing weight and for once in my adult life I feel a real sense of hope that I am on my way to a more active, healthy and enjoyable lifestyle!  Till next time...

Cardiac Stress Test, Psychological Evaluation and More...

Well, I have lost a grand total of 9 pounds on my pre-op eating plan and I must say that I am quite proud of myself! Surprisingly I haven't felt too deprived. If I crave something I find a way to prepare it in a healthy way. I was getting a bit bored with my snack selections, so I have been on a mission to mix it up a bit. I have only come across one meal I am not a fan of and that's turkey burger on on whole wheat bread thins; talk about gross. The turkey was dry (it was 99% fat free) and bland despite my seasoning it with Mrs. Grass onion soup and other spices. But any way, enough about that, LOL!

I completed the cardiac stress test and they aren't kidding when they say "stress" test"! I thought I was going to cough up a lung I was so out of breath. First I had to lay down on my back with this Darth Vader like mask on that covered my nose and mouth. I had to lay there for fifteen minutes as my baseline metabolic rate was calculated...that is, how many calories I burn while at rest. Then it was treadmill time. Oh my goodness, I learned in ten short minutes just how out of shape I am. I was sore for three days afterward and my left knee is still sore. The results were good though and that is just one more pre-op requirement checked off the list!

I had the pre-op psychological evaluation done as well and from what I can tell, I "passed" and am not too nutty to have surgery. However, I do have to meet with the psychologist in about 2 weeks to discuss the report she will be submitting to Beaumont Hospital for my surgery file. I was asked about my life history, what issues I believe I have with food and questions regarding my knowledge about the surgery I am choosing to have.

I have saved the best news for last! I finally, got a straight answer from my insurance company and....drum roll please.....THE VERTICAL SLEEVE GASTRECTOMY IS COVERED AS A STAND ALONE PROCEDURE and I DO NOT NEED TO COMPLETE A 6 MONTH MEDICALLY SUPERVISED DIET!! Woohooooo!!!
The next step in the process is to see the surgeon after my psychological evaluation is in my file. In the meantime, wish me luck on my lifestyle changes...till next time !

New Eating Plan Update!

I am doing really well with the eating plan the dietitian gave me. I am consuming about 1,400 calories per day; I have been logging everything I am eating and drinking. I am proud to say that I have lost 6lbs since last Friday...WOOOHOOO! I always lose quite a bit of weight during the first week of any diet plan I start so I am sure that the weight loss will slow down, but that is quite alright!

Eating every 3 hours has really helped me not feel deprived and too hungry. I have been amazed at just how much food I have been able to eat. I have actually been out to dinner and had no problems finding something within my eating plan guidelines. I had a lean steak with veggies and it was great. I do admit that it was hard to be in a restaurant setting and not think about all other fattening things on the menu, but the key to my plan is everything in moderation. So it isn't like the higher calorie foods are off limits, but I know they are not really healthy for me and eating them is not in line with what I am trying to accomplish. Now, I am not saying that I will never, ever have dessert again but right now it just isn't a good choice for me because I know I will over do it.

I still haven't had any soda and I am actually beginning to love water...now that is a shocker. For the most part, water used to make gag, LOL. My only source of "discomfort" right now is all of the Halloween candy my kids have around the house...thank goodness for Yoplait and Greek yogurt; those are my sweet treats!

New Eating & Exercise Plan and Several Appointments Out of the Way!!

Hi there! I have been one busy bee!! I had my first appointment with Beaumont Hospital's weight control center which handles every aspect of getting me ready to consult with their surgeon regarding my surgery. As I mentioned in a previous blog, I also had an appointment with Henry Ford Hospital's weight loss surgery program, but I was so impressed with Beaumont's that I decided stick with them.

Since my last time blogging, I have seen a dietician, exercise physiologist and had a complete medical overhaul with the surgeon's nurse practitioner. I had several more tubes of blood drawn and another EKG done as the first one showed a fast heart rate which they felt was probably due to having had an albuterol treatment for my asthma just before having the EKG. My bloodwork did show a vitamin D deficiency (which I was already aware that I had), a protein deficiency...more about that in a minute...and iron deficiency.

I am now taking prescription strength vitamin D and the dietician has given me an eating plan to follow that reduces my calories to around 1600 per day and is high in protein. It is very important to get my protein stores up before surgery as protein is very important to the healing process. The eating plan is quite straight forward and I do not have to count calories just pay attention to serving sizes. I really did learn a lot at my nutrition appointment. Such as how important it is to eat small amounts about every three hours to keep my metabolism going.

I have to admit that I was a little hungry yesterday, but I think a lot of it was head hunger. My mind always plays tricks on me if I start focusing of food and eating healthy; I become hyperfocused to a large degree. Suddenly any and everything edible looks just oh so delicious and I just have to have it....all in my mind. I can really see that this head hunger phenomenon is going to be a struggle. I have been recording what I am eating along with my blood sugar levels in the morning before breakfast and right before I go to bed as my they have been creeping up a bit.

On to the exercise physiology aspect of my journey...I have been given a pedometer to track how many steps I am taking in a day and the goal is to be at least around 10,000 steps. Well, let's just say I am waaaayyyyyy off from that number, LOL. Yesterday I only totaled 1,283 steps!! So, my plan is to walk, walk, walk. Whenever and where ever I can! It is getting cold where I live and so I will have to move indoors soon, but I am determined to get to that 10,000 step mark. I was also given exercises to do in the gym and to workout for 30 minutes at least 3-5 times per week.

Change is not easy but it can be done!! I may not have to do the 6 month supervised diet as I wrote before, but I am still checking into that and I will keep you all posted on the final outcome. In the meantime I have a goal to lose 17 pounds in the next 2 1/2 months as prescribed by my surgery team! My psychological review and stress test are both coming up soon and after that, it is off to see the surgeon!! Wish me luck!!

First appointment went well!

Well, I had my first appointment with my internist to get the ball rolling in the surgery process. I had an EKG done, lots of blood drawn, and a chest x-ray. I discussed the surgery in depth with my physician and she gave me her recommendation for the either the by-pass surgery or the sleeve gastrectomy. The sleeve is pretty much not an option for me as my insurance does not cover it as a stand alone procedure.

I have been doing a lot of research on the Roux-n-Y vs. the sleeve and the duodenal switch. I am fairly certain that the roux is the best choice for me. I do have a concern about the potential for weight regain that seems to be an issue for some people over the long term. I plan to discuss this at my surgeon consults next week. I have a surgeon consult appointment next Tuesday at Beaumont Weight Control and another surgeon consult with Henry Ford West Bloomfield next Thursday. I will compare both programs and choose which one I feel is best for me. I have other medical conditions (Rheumatoid Arthritis and G6PD)and I want to find out how the surgery will affect those conditions or if they put me at an increased risk for surgery.

My insurance is going to require a six month failure at a supervised diet, which I think is ridiculous. Obviously I have failed plenty of diets as I wouldn't be where I am right now! This pushes my surgery time frame back and it looks like I won't be having surgery until May or June 2012!! The insurance language regarding what "supervised" means is vague and of course I am getting the run around from them when I call to inquire about it. Henry Ford said that I should join Weight Watchers and keep documentation of my weigh in's but I would hate to do that and then Blue Cross doesn't accept it as a professionally supervised program. Beaumont has physician supervised weight control programs, but from what I understand the program is very expensive. I will just have to wait and see what options I have after I meet with both surgeons.

I have been doing well drinking without a straw and staying away from soda! This week I am going to begin practicing eating slowly and chewing my food completely which are things I will have to do after surgery. I will post next week after my surgeon consults!

Let the insurance games begin!

Well, I kind of knew this wouldn't be a smooth process but I was hoping I was wrong! We just recently switched health insurance carriers and I was sure to contact the new carrier, with the employer group number, BEFORE we switched to make sure that the gastric bypass and the sleeve gastrectomy were covered. I was told yes and I was also told that failure at a 6 month medically supervised diet was not a pre-requisite. I even had the company mail me a copy of the surgery requirements as documentation of what I was being told.

We got our insurance cards and I decided to call the insurance company back just to be sure that I had all of the information regarding pre-requisites for the surgery, only to be told that there is a 6 month medically supervised diet requirement!!! Uhhhggg!!! I asked about the documentation I had stating otherwise and was asked when I received that letter as they (the insurance carrier)had JUST updated their information regarding requirements. Well, of course I panicked and called the surgeon's office and spoke to Kim who handles billing issues. She assured me that the information they were giving me was outdated and to call back and speak to a supervisor. Well, I did that and was told the same thing....Um, now what???

I don't want to go through with all of the preliminary testing and doctor's appointments only to receive a denial letter down the road. I am going to fax my insurance card to Kim as she volunteered to call the insurance company on my behalf to check on the benefits. I'll keep you posted...

My Story & Starting the Weight Loss Surgery Process

Well, I am finally taking the first steps to having weight loss surgery! I have been dreaming about the day when our insurance would cover the procedure and the day has arrived. I really feel that I should document my journey as being overweight has really affected my life in so many, many ways and I want to document this transformation for myself.

A bit about me...I am 39; soon to be 40 in November :-). I have been married for 17 years and my husband Mario and I have 6 children. I am currently in graduate school studying to become a licensed counselor. Weight has been an ongoing issue in my life. I have been overweight since childhood and have been on weight watchers so many times I can't even count. I have joined Jenny Craig several times as well. I have tried e-diets and countless other diets. I have lost weight dieting only to regain what I initially lost plus more. This yo-yo cycle of losing and regaining became a familiar way of life for me. The guilt I would feel after regaining the weight was a heavy burden. I have suffered a great deal emotionally and physically in relation to carrying 100+ extra pounds on my 5'4" frame. Always being picked last for team sports in gym class in grade school, not being asked on many dates in high school, not being able to play comfortably on the floor with my children are just of the few humiliations I have endured in relation to being overweight. My health is also another reason I am embarking on this journey. I have rheumatoid arthritis, asthma, diabetes and degenerative disc disease of the neck and lower back. Losing weight can't eliminate all of these conditions, but it will certainly help.

As time has gone on I realize that I can diet until the cows come home but my weight problem is a much deeper issue then just a lack of will power. I need assistance with my weight issues and food addiction. This blog will detail the good, the bad, and the ugly of my surgical weight loss journey. I intend to be brutally honest as I am not just doing this for myself, but anyone who is thinking about weight loss surgery or anyone who is struggling with weight issues.

Now on to the "fun" stuff (I am joking here, but trust me, I know how serious the decision I have made is)...I have attended the introductory weight loss surgery seminar at the hospital I chose and purchased what is known by my surgeon's office as the "blue binder". I am sure I will mention it a lot as it has every bit of information that I will need to prepare myself for bypass surgery and information regarding my care afterward. I am scheduled for a physical and preliminary blood work and an EKG next Wednesday with my primary care physician. Once that is complete I will have my initial consultation with the surgeon (woohoooo :-)).   I have already begun to make little changes that will be a normal part of life for me after surgery.  For example, I have given up diet soda and I am no longer drinking out of a straw and I have actually made it one whole week without either! This sounds little but for me it is HUGE.  I love an ice cold soda and call me neurotic but I HATE drinking directly from the glass when eating out, :-).  My next change will be to make sure that I am eating a healthy breakfast daily.  I will let you know how things are going next week...Let the journey begin!