Person number one we will call Bob.  Bob is in his mid-thirties, has an unsatisfying job in customer service and lives at home with his Mom because he can’t hack it in the real world.  He is a total mommy’s boy.  Bob develops a crush on me and it is quite evident.  I politely inform him I am not interested in him in that way and continue to try to help him through his WLS journey by answering questions and trying to be supportive.  Bob thinks that having surgery is going to make him thin and attractive immediately (in his words “maybe not immediately but within a year or so”) which will then allow him to have a girlfriend for the first time in his life and get him the career he so desperately wants.  Apparently no one informed him that the reason he doesn’t have a girlfriend or the career he wants is because of his personality, not his weight so imagine how he felt when I told him the truth!  His response was well my Mom says I have a great personality.   I reduce contact with Bob to a minimum but continue to answer questions he has as a new post-op until he calls me two weeks after surgery asking me if it was a bad idea to eat a sandwich and some ravioli for lunch.  I became very angry at this point and told him to stop calling me because he doesn’t listen to me anyway.

Individual number two I will call John.  John is very young and pretty naive.  John thinks that he can continue to live his life how is does already and just lose weight because he had WLS.  I tell John about Bob and he say “Oh I would never do anything that stupid”.  John also thinks the ladies will come running once he is skinny.  John needs to lose over 400 pounds to even be close to having a “normal” BMI so I am thinking eating whatever you want and not exercising is not going to equal skinny, with or without WLS.  John also thinks he will get his dream job once he is skinny.  He believes because he is so young that his skin will just bounce back after being stretched out to carry almost 700 pounds.  Which it might but I think a snowball has a better chance at surviving in hell (which is just MY opinion on the subject).  Anyway, he is basically Bob all over again but swears he isn’t going to be like Bob post-op.  Guess what?  He is a couple weeks out from surgery and is eating sandwiches and tacos.

Take away lesson:

1)      WLS will not suddenly make the ladies (or guys) come running to you.  The weight loss might make you physically more attractive to some individuals but if you have a shitty personality you still are not going to get anywhere with finding a mate.

2)      WLS will not suddenly make someone offer you the job you have always wanted.  Again if you have a shitty personality and are lazy with a bad work ethic no one is going to hire you anyway even if you do get skinny!

3)      Statistically you will not be as skinny as you want to be.  Sure some people get to their ideal weight but most people will still be overweight or obese after WLS.  I am not telling you that you will fail (unless you are Bob, whom I did tell that to)- I am giving you information backed up by science (statistics), but losing that 100 (or 200 or 300) pounds is going to be better for you then not losing all that weight!  Just be realistic in that your end result might not be what you want it to be!

4)      Do not test the limits of your stomach just after having surgery.  Your stomach is still healing and doesn’t want to have to deal with sandwiches, ravioli and tacos two weeks after having 90% of it removed!  In this case the individuals had a duodenal switch (DS).

5)      Do not call Lisa crying that your stomach hurts because you ate sandwiches and ravioli two weeks after surgery.  She will laugh at how stupid you are and tell you not to call her anymore.

So total I have lost 64 pounds already!  I feel great!  I have gone down 8 sizes in jeans already in 2 months!   I do get tired pretty easily and have some exhaustion issues but I bet when I do my labs next month it has to do with iron levels.  Other than that it has been an awesome journey post-surgery.  Still have to get used to drinking at least 80 ounces of water a day and taking in all my vitamins but I have been able to get 80-100 plus grams of protein in a day just from eating food and some protein bars on some days.  Protein shakes make me ill and vomit.  I’m still trying them out to try to find one that works!  I have lots of vitamin and protein reviews to get done, as well as some recipes.  One of my resolutions is to update my blogs at least 4 times a week but I am hoping for 7 days a week.  We will see how well that goes!  Hope everyone had a great Christmas and New Years!

SURGERY DAY- 11-4-09

I had to be at the hospital to check in at 9:30am.  My Mom flew in the day before so we got the kids on the bus and left for the hospital.  Once I checked in I had to have some blood drawn to type my blood in case I needed a transfusion while I was at the hospital, as well as a pregnancy test.  Then  I was taken to the pre-surgery area to be weighed (326), asked to strip completely and put on a hospital gown and paper booties on my feet and to have a nurse take my vitals and go over my history with me.  My surgeon had an emergency surgery to perform so I was pushed back about an hour.  Mom was allowed to sit with me until the surgeon was ready for me.  He came and talked to us and answered my Mom’s questions.  Unfortunately when it was time for put in my IV the nurse blew out two of my veins (so much so that I still have huge bruises on my arms) and the anesthesiologist had to come put my IV in.  Once in the operating room (warning: it is freezing in there!) I was out pretty quickly and the next thing I remember is waking up in the recovery area being asked how my pain was.  I was hooked up to a pain pump that dispensed pain medication with a touch of a button and you could hit the button every 15 minutes.   After I was awake they took me to my hospital room and I was lucky enough to have a room to myself.  My Mom was waiting for me in my room by the time I got there.  Once in the room they put pressure stocking on my legs and strapped me into this device that sort of feels like a blood pressure cuff that gently squeezes on the legs to help prevent blood clots.  I also had several shots in my belly to help with the prevention of blood clots as well.   They put the catheter in while I was asleep so I didn’t even notice it.  No food or drink was allowed on the day of surgery but they did bring me some tiny sponges on a stick and a pitcher of ice water to swab my mouth and lips with to keep them from drying out.  I slept a lot on this day.

ONE DAY POST OP – 11-5-09

Today they removed the catheter and the pain pump.  First thing in the morning they had me see if I could stand up and luckily I did it in one try.  The pain was not too terrible but it certainly was uncomfortable.  Later on in the day I was allowed to shower and change into my own pajamas and then walked around the floor.  After I got back from my walk they gave me liquid pain medication and I promptly took a nap!  I was able to eat at this time.  My meals were 1 ounce of chicken broth and 1 ounce of jello. It took me an hour to eat it.  My Mom went home to take care of the kids and my friend Scott came up to the hospital to stay and help me out.

TWO DAYS POST OP – 11-6-09

When the doctor did his rounds in the morning he told me that I was going great and could go home today.   They ended up not getting around to releasing me until late afternoon so the day consisted of taking a shower, walking around the floor three times and eating my chicken broth and jello.  They sent me home with some liquid lortab for the pain.

AT HOME

I have followed my diet plan from my doctor and my nutritionist and have been doing really well.  I did however somehow pull a muscle in my lower back which has made moving around painful.  I am once again on lortab for pain and also a muscle relaxer.  I go back to the doctor this coming Monday to start some physical therapy to help work out the spasms in my back.  I also ended up with a kidney infection and am on antibiotics for that.  So far I have lost 33 pounds since surgery and I am very happy with the pace of the weight loss.  I am sure if I was able to move around more I would lose faster but I am limited to walking right now until the pulled muscle heals.  It does get a little bit better each day though.

So today I reported to the hospital bright and early at 7:45 AM to start my pre-surgery testing and labs. They had to draw 12 viles of blood for all the blood levels, vitamin levels, thyroid function, and serum levels. Luckily the tech found a good vein in my arm and it didn’t even hurt this time. I have really deep veins so I usually get poked at least three times and they have to go deep which usually hurts quite a bit. The 12 lead EKG was kind of tricky because I have been rather blessed in the chest region and it was hard to find a spot to get a good reading so while it wasn’t quick it was at least painless. The pregnancy test was pretty simple- just pee in a cup. Since I had my tubes tied almost six years ago, I know there is no way I am pregnant. Granted I did take a home pregnancy test that I had sitting in the bathroom just to make sure on Sunday (it was negative of course) so that I wouldn’t have any random surprises. The chest x-rays were pretty straight forward as well. The one thing that did surprise me was the upper GI scan.

I assumed that they were going to do an upper GI scope where they shove the scope down your throat and into your stomach so I was worried if they were going to put me under for that because there is no way I could have tolerated a scope down my throat while being awake. Turns out they do it all through x-rays so I had nothing to worry about. You have to drink three different kinds of barium (barium crystals, thick liquid barium and thin liquid barium) and then drink some water to check for reflux. The barium crystals were the worst. They pour the crystals into a tiny bit of water and tell you to drink it like a shot. First off, it tasted awful. Secondly, the second you swallow it starts to make air bubbles in your stomach and your stomach fills up with so much air so quickly it hurts. Of course, you aren’t allowed to burp and relieve the pressure (though I almost burped in the doctors’ face which would have been mortifying). The liquid forms of barium also tasted pretty gross but it was over pretty quickly.

I had a lot of the same blood work done about two weeks ago by my primary care doctor and they were all normal so I am not worried about any of that and all of the other testing went well today so I should be all clear for surgery. I have my last appointment with my surgeon on Thursday!

pre-op testing TODAY; pre-op surgeon meeting in 3 days; nutritionist in 8 days, liquid diet in 11 days, Mom gets here in 14 days, surgery in 16 days!

I posted a few weeks about how I had my psychological evaluation for my weight loss surgery and guess what?!  I called my surgeons office this morning just to check after allowing three weeks (an extra week just to make sure!) for the report to be sent from my psychologist’s office to the surgeons office and they have received the report.  I was also excited to hear that the request for insurance approval was sent off yesterday!  She said it usually takes about 30 days with my insurance (the insurance says 30-90 days but this person handles this kind of thing on a daily basis and said I should hear something in 30 days) and that I would get the letter about 3 days before the surgeon’s office did.  This has been what I have been working toward for the past 4 months (technically the last 4 years)!  Everyone from the surgeon’s office to my own family doctor keeps assuring me that it will go through my insurance without any problems but I am still on pins and needles just waiting for the approval (I hope it’s an approval!).  Most of the surgeries seem to be scheduled about a month out so I should be having my surgery in about two months!  I am so excited that I am dancing around my bedroom (that counts are exercise too, right?!).  If for some reason I do get denied then I will just have to do whatever more the insurance company asks for me to do.  It is a covered procedure through the insurance and I have done everything (and MORE) for the eligibility requirements so maybe I shouldn’t be so worried about it and should just relax like they are all telling me to do.  They deal with insurance and this stuff everyday so they would know best, but I guess I don’t want to assume and prepare for an approval and then be destroyed if I get denied.  So- 29 days and counting till I (hopefully) have my approval and surgery date!

At the very end of my steps to surgery was the last step I personally needed to do before surgery: a psychological evaluation.  After the psych eval all of the paper work is submitted to the insurance company and then I play the waiting game waiting for approval.  The couple of weeks leading up to my psych eval I was worried.  I felt like it would be some kind of test and if I failed then I wouldn’t be able to have surgery.  I searched online to see what I could expect but didn’t really find any information.

I am not out to provide some sort of cheat to pass a psych eval but I can tell anyone out there worrying about it- rest at ease.  After you fill out lots of paperwork (TIP: if you take lots of medication I would just put all the bottles in a Ziploc bag and bring them to the appointment-including your vitamins and supplements!) one of the first things the doctor will go over  is medical history- family history, if you have any children, any history of depression, anxiety, or any other mental issues.  Then there is a bit of a common knowledge aptitude test to just make sure you are mentally sound.  I won’t give out any of the questions that was used but simple math equations, cognitive questions, simple critical thinking questions, and other related areas of mental assessment questions.

I was so nervous I didn’t prepare any questions, so you might want to just write some questions down beforehand to ask the doctor at the end of the evaluation.  Like: Am I approved/cleared for surgery?  How long will it take for you to prepare your report and get it to my surgeon?

Go in prepared.  Know about your surgery (lap band, RNY gastric bypass or the duodenal switch).  Know why you are having surgery.  What is your motivation?

Even if the doctor does not approve you on your first visit, he/she will tell you what you need to do in order to be approved. If you have a history of drug or alcohol abuse, the doctor may suggest AAA or other support meetings and additional meeting with the doctor.  The best thing to do is be honest because this psychological evaluation is there to help and protect you and make sure you are ready for the surgery.

My psych eval was a positive experience and I was approved/cleared for surgery.  Anyone had any complications or extra hurdles they would like to share about the experiences?