Psych Eval part 1 today
Just got back from a Spring Break vacation in Phoenix and am really proud of myself as I lost 5 lbs while on vacation!! That's a first. We did lots of walking and on the go everyday so combined with a meal replacement shake in the AM and two reasonable small meals, I had good success. I also made sure I drank 64 ozs water everyday, which was easy in dry Phoenix. We'll see if I can keep it up now that I'm back home. I saw the psychologist today for the first part of two sessions. She basically took my history, asked some questions about the particular procedure I have selected, asked about my surgeon of choice and my feelings, thoughts and fears about the surgery itself and the lifestyle changes I will make. I took a written pre-bariatric questionnaire of about 175 questions. We will meet again in April. I am still experimenting with protein powders and recipes and decided to make a notebook of my favorite recipes for each stage of pre and post surgery. My first dietician appt. and weight management class is day after tomorrow. Will post again then. Enjoying the journey thus far.
Just adding a few photos
A few pics of the "heavy me" so I can compare with the upcoming "new me".
1st Weight Management Class
Went to my first class last week and was given a sample menu plan and encouraged to stop caffeine drinks and diet drinks with artificial sweeteners, like Crystal Light, etc. Not sure I can do that completely. Especially when I go on the full liquid pre-op diet. I can only take so much of the milk based protein drinks as I prefer flavored waters and teas. I have heard many of you say Crystal Light has been their saving grace and I feel the same way. What have your doctors said regarding this? I am still working on trying to increase my activity but it is slow going as I can only walk a quarter of a mile (about 20 mins.) and my left hip and back hurt so bad I have to stop. I am praying it will be easier when I've dropped some of this weight. Insurance says I cannot have a gain between my first class and my last one in May. Now that it's a requirement, I'm hungry for all the things I shouldn't eat, but mostly BREAD. I'm sure it is a psychological head thing and I've heard I will go through similar challenges after the surgery. I tell myself...you can do this, you can do this, and try to find something to do to distract myself.
Psych Eval Session 2
Had my second session yesterday. Got the results from the questionnaire I completed the session before and I am mentally "normal" and cleared for the surgery from an emotional standpoint. I shared with my counselor about all the things I'm doing to prepare for the surgery and getting my support systems in place so when I have challenges (and I will - that's life) I will have steps in place to deal with them. One of them being able to journal here and share with all of you. Some other things I've done is make a list of 50 things to do instead of snacking. I've also written a list of the things I hate about being fat. I'll review these often to keep myself reminded and motivated. I also have the option of scheduling one on one appointments with the nutritionist at my surgeon's office should I reach a stall or need any help with food issues. I'm already learning that my war against fat (and it is a war) is won day by day and battle by battle. What I'm about to undertake is not a "diet" but a lifestyle, and though it will enable me to lose weight more quickly, I will continue to have challenges. I am doing everything I know to prepare for them and have my battle plan in place! I also found out about a wonderful app for my smartphone from my counselor, called "Lose It", I can even sync my Bluetooth scale and Fitbit to it and have everything in one place to track my food, weight, and exercise! I can set multiple goals for short term and long term and track each separately within my account. The fitbit tracks my movement and sleep patterns and will even let me set a silent vibration alarm to wake me in the morning. My Lose It app will also send me reminders on my phone when to take vitamins/meds, drink water, and eat my snacks. I continue to try recipes and save my favorites for post-op. A great website for this is The World According to Eggface. The writer, Shelley, had a gastric bypass surgery several years ago (lost 158 lbs.) and has developed many recipes which are suitable for the puree and final stages of bariatric weight loss surgery.
FINALLY!! The scale is moving in the right direction.
I did not get on the scale all week as I was discouraged it was moving so slowly. Glad I did! Pre-op weight down to 230 lbs from starting weight of 241at my first visit to the surgeon. Now if I can do that again between now and mid May, it should be a good loss before I start the pre-op diet in June. I must say I have to give credit to a new APP I downloaded on my phone called Lose It! It helps me track everything I put into my mouth and my exercise, water, and weight. I have a Bluetooth Smart scale and it sends my weight to the APP whenever I weigh. The scale also measures BMI, fat percentage and hydration. I heard the new Samsung Galaxy 5 phone tracks your steps and physical activity everyday. I ordered a Fitbit wrist band that is supposed to sync with the Lose It App also and record my daily physical activity/calories expended, etc. It really does help in making me aware of where I'm at with diet, exercise and water. Cool tools to help me get where I want to be. Six weeks to go to complete the weight management requirement for my insurance. I will try to lose as much as I can between now and then so the surgery will go well and hopefully help me get to my goal weight sooner! All of you are encouraging me so much - and helping me to be prepared for the changes and what to avoid and what works well. As someone said - Onward and downward (with the lbs. that is)!!!
2nd Weight Management Class Today
Well, I'm down 19 lbs since first seeing the Dr. 2/24. Was 243 on my first visit and weighed in at 224. Today the nutritionist led the class. She had bypass surgery 12 years ago and shared her story. Basically the class was a Q&A. Feel like I'm on track. I've quit sodas and caffeine, I'm working on increasing my activity level. My Fitbit has really helped in that area. A great investment to help me keep aware of my activity level, my food intake and sleep patterns. OH! I am down one pant size. One more class to go in late May and then I wait for the insurance company's approval. I'm thinking of going on an all liquid diet once the final paper work is submitted so I will be ready for a quick surgery date and don't have to wait another two weeks to complete the liquid diet. I am going on a family reunion trip to Canada in mid August and want to be on regular food by the time I travel if at all possible. I've added photos taken today.
EGD will e May 5th
My EGD surgery was changed to 5/5/14 due to scheduling conflict for the Dr. He wants to make sure I don't have a hernia. If so, that will change how they approach the surgery and they will take care of it at the time they perform the sleeve.
I have a Hiatal Hernia
Had my EGD yesterday and the Dr says he will repair the hernia when he performs the sleeve surgery. I suspected I had one as I've had GERD for years and occasionally severe enough to cause chest pain and pressure in the upper stomach and chest. I will be glad to have it repaired. Down 22 lbs and hope to lose another 10 -12 before surgery. I spoke with a bariatric nurse with my insurance company today who will be my case manager. She will call me monthly once I've had surgery and is available as an additional resource post surgery. I also found out that once the Dr's office submits the file for approval, it will only take a couple of days to get approval provided everything is in the file that they require to make a decision. Good to know since I am hoping for a surgery date no later than mid June so I will be on regular food by the time I travel to Canada in mid August for a family reunion.
Two Weeks Until Final Weight Management Class
I am down to 218 lbs (25 lbs from 243 on Feb. 24th, and down 4.5 inches in the waist). I hope to lose 4-5 lbs more before the final weigh-in that goes in my file for insurance approval. Insurance does not require a certain weight loss, but encouraged me to lose all I can so the surgery will be safer and go easier on me. My surgeon requires a two week liquid diet prior to surgery to shrink the liver, so I will actually start that on Monday, May 26th. If I get a quick approval, as I hope to, I will be half way through the liquid diet and hopefully can get a surgery date for the week of June 9th. WOW! I just realized that is just 3 1/2 weeks away.
Completed Final Weight Management Class and Nutritionist Session Today
Completed my final WM class today (down 30 lbs. since first class in March) and nutritional counseling to prepare for surgery. Lost 2.5 inches in neck and 4 inches in waist. File being submitted to insurance tomorrow and should have surgery approval on Tuesday. I wanted to start pre-op diet today but was told NOY to start until I see the Dr. again for pre-op session and lab workup. Have to complete two week liquid diet prior to surgery so looks like the earliest date is week of June 16th, which is about a week later than I had hoped. I am going to Canada for family reunion in August and wanted to be on regular diet before I leave. Depending on how I do, I may still be on soft foods and just beginning to introduce solids. It will be interesting to see how I will travel and get acceptable choices for a soft diet. Once I get to my relative's home, I'll be fine with access to blender, etc. but two days travel getting there will be a challenge. Guess I could take baby food jars (YUCK!) with me and eat those if no other alternative. I will add some current photos this weekend.
Heard from Insurance today and surgery is denied - so disappointed!
My ins co called today and said I do not qualify for coverage of the gastric sleeve as my BMI is under 40 ( when I began this journey it was 39.9). If I had comorbidities it has to be over 35. My high BP does not qualify because it is being controlled with THREE medications. I had a sleep study done two weeks ago that showed some obstructive airway events so waiting to hear if the doctor recommends a CPAP. If he does, then I will qualify, but have to get all this finalized by the 18th when my surgeon has a peer to peer appeal hearing with the ins co approval committee or my case will be closed and I will have to start all over again and go through another 3 month waiting period, psyche exam, weight management, nutrition counseling, the whole deal. Please join me in praying that the sleep study report will be finalized and will qualify me for the surgery by the 18th, as I cannot afford it as self pay. I am just so disappointed - all this hard work - I'm down 30 lbs and was ready to start my 2 week liquid pre-op diet and I get this news. I am determined to keep going, whatever it takes to get to a healthy weight and BMI again, but not sure I can do it without the help of the surgery. I've never been able to stay on a healthy eating plan for more than 4 months and I am approaching that in a few weeks, and felt I have been starving this whole time - don't know if I can keep it up long term with my stomach at regular size and producing ghrelin.
Posted most recent pics
Just posting a few pics after losing 30 lbs after completing my 90 day weight management program. Down two sizes in pants and one in tops, but not sure if it really shows or longer hair just makes my face look slimmer.
Appealing Insurance Denial
I spoke with a patient advocate and was encouraged to appeal my ins co denial to cover the surgery. I also got the results of my sleep study and have sleep apnea and will go overnight to the sleep lab at the hospital to have them monitor me and get my pressure settings for my CPAP machine. I also got some high blood pressure readings that were taken at a local urgent care over the past 16 months that should help to prove that my blood pressure is NOT under control most of the time even on 3 medications. There will be a hearing on the 18th and this additional information will be submitted to the insurance company. Hopefully the initial decision will be reversed and I will be cleared to set a surgery date before the end of June.
Approved for Surgery by Insurance Today!
My surgeon had a peer to peer phone conference on Friday with my insurance co. and explained about the sleep apnea recently diagnosed. They requested documentation and it was faxed late Friday. Today my doctor's office called to say they received official approval and the surgery scheduling coordinator will be calling me to set a date. Thank you all for encouraging me and praying with me that this decision would be reversed. Now I've got to psyche myself up for the liquid pre-op diet. I CAN DO IT!! I didn't come this far for nothing and I want the surgery to go as smoothly as possible with NO issues from a too large, inflexible liver.
Got My Surgery Date!
I am scheduled for surgery Sep. 8th. Pre-op appt to get lab order is 8/22 and I start my all liquid diet 8/25, when I return from my family trip to Canada. Feels so good to know this is really going to happen. Enjoying all of your posts and making notes so I will be as prepared as possible. EEEEEEEE!!!!!! (squeal) SO HAPPY right now.
Pre-Op Appointment Today
Saw Dr Yu today and the nutritionist for my all liquid pre-op diet guidelines. Also got my post op prescriptions to be filled before I go into the hospital. I start the diet Monday and find myself thinking about having a favorite meal every meal until then, but I don't want to regain the weight I've lost, so I'm sticking to my 1000 calories/day. The doc said he was very happy about the 36 lbs I've lost while waiting for surgery. Said I may not lose much on the liquid diet sine I've already lost all the easy weight. (Easy weight my a_ _! I worked hard to lose this 36 lbs.) Trying to work up a schedule of meds and liquids for post op so my daughter and mom and dad who will be helping me when I return home from the hospital, will have an idea of when I should be taking meds, vitamins, etc. Got a script for Stadol nasal spray for pain as I cannot tolerate the codone meds. I've never taken it before so not sure how I will respond to it. I also found out I will have a Qi pump while in the hospital. Will probably have to stay 3 nights instead of the usual two for everyone else as I have a clotting disorder that will have to be monitored post surgery and have a higher likelyhood of bleeding since I will be on high dose thinners starting 12 hours after surgery. They want to get my blood at the right level to prevent a clot but keep me inpatient so they can check daily for leaking and excessive bleeding of the stomach. They would rather have me bleed than clot, so a little longer stay than most folks. That's usually how it is after any surgery I've had. I had a pulmonary embolism in July of 2009 and don't want that to happen ever again as it was NOT a pleasant experience. I'm trying to psyche myself up for the liquid diet. Hope I can stick with it!
Started LIquid Pre-Op Diet Today
I have been very busy helping my daughter with her newborn so haven't thought much about food until now...almost bedtime, and my family's usual snack time. I'm trying to be satisfied with a Crystal Light fruit punch with protein powder, but can tell I am going to miss chewing big time. Day 1 down, 13 to go! Lord give me strength!
Day 4 of Liquid Pre-op Diet & Down 4 lbs
It's a good thing I'm seeing such good loss since I STARVING TO DEATH!!!! This liquid thing is tough. Have to keep busy, busy, busy, or all I think of is FOOD. Can't remember when I last weighed 204. Hope it continues through next week. It would be great to be in the "1"s before surgery.
Day 10 of Liquid Diet
Well, i am not doing so good. I have not been able to totally adhere to the liquid protocol I was given. I have eaten vegetables in soup a couple of days but have kept my overall carb count below 50grams so I will stay in ketosis. Not sure how the Dr will feel about that but it is what it is. This is REALLY hard for two weeks!! The problem for me has been I miss chewing. I get a film on my teeth and a yucky taste in my mouth from the protein drinks and not enough variety. I caved at day 6 and day 9. I am at 202 lbs. Hope to get in the "ones" before surgery day next Monday. I am down one pant size and two sizes in tops, down two sizes in bras also. Will try to post a pic on Sunday for my pre-surgery picture. So, down 61 lbs from my high weight of 263, and 41lbs from my weigh in when I got my surgery referral from my GP in late Feb. 67 lbs to goal to lose post-op. Do I dare shoot for that by year end? I would have to average 4.4 lbs per week until year end to reach it. I know there will be stalls from time to time so a better time frame would probably be by Valentine's Day.
Bariatric support meeting last evening...
Attended a support meeting last evening provided by my surgeon's office. Both pre and post op patients attending. Talked about eating myths after WLS and guidelines for the four stages of eating after surgery and then for those post op about staying on track long term and the importance of attending meetings at least quarterly to avoid weight gain again. I spoke with the nutritionist after the meeting and told her I hadn't ashered to the liquid diet entirely. She said as long as I ate protein and non carbohydrate veggies and stayed in ketosis, the liver will still shrink and become flexible, but to try and adhere until surgery day on Monday so my stomach will shrink also and make for an easier surgery. She suggested freezing my protein drinks/shakes so I can satisfy my chewing need. 3 days to go!
All went well but had a restless first night. Throat is very dry. Lots of pressure on my left side. Hope to get my drain bulb pulled todsy.
sleeve went fine but...
Had my sleeve on Monday and had to go to ER Tuesday night with severe pain on left side going all the way through to my back. I had a large cyst on my left kidney that hemmoraged. Lost 4 pints of blood. Getting transfusion of two bags of whole blood and a bag of platellets. Get more tests tomorrow to find out if bleeding has stopped. Appreciate all your prayers.
Home from the hospital today
After 8 days in the hospital following my kidney hemorrhage, I am finally home. VERY WEAK and still some infection but on liquid antibiotics now. Got to start full liquid diet a couple of days ago but find I cannot stomach the taste of protein shakes/drinks, or anything sweet or salty tasting. I was on IV vitamins and iron in the hospital and now Doc wants me to take liquid version but I cannot tolerate them either. My stomach hurts when it is empty and hurts when it is full. I have acid stomach and especially bothersome at night. I take acid reducer but it doesn't seem to help. IN the hospital they were giving me Carafate which coats the stomach and prevents ulcers. I did not have as much trouble with it on that. I am going to talk to my Dr about getting a script for a bit longer until my stomach is healed. I know I am not getting enough protein and liquids, but doing the best I can. He said as long as I am getting at least 24 ozs per day I should not get dehydrated. Not sure if I am getting that or not. I enjoy SF popsicles as they make my tummy feel better, hydrate me, and satisfy the chewing, I miss. Hopefully this phase will pass quickly. The Dr suggested I make some protein popsicles out of my powder and cyrstal light to help me get in more protein. Not sure how many ozs a pop is, but I guess every little bit helps. I weighted 202 when I went in for surgery and weigh 199 today, so only down 3 lbs in the 9 days since surgery. (Had a 6 lb gain for the first few days following, but have lost that now.) I'm in "onederland"! 59 lbs to goal. Need to go lay down, I'm exhausted! Thank you one and all for the prayers and well wishes.
Went shopping this evening and I'm in a size 12 jeans!!!
I never thought I'd get into a size 12 again. Visited my daughter a couple of weeks ago and she gave me a size 16 pair of jeans she used t wear. They were a little loose in the thigh area but fit in the waist. Now they are getting loose in the waist also so time to shop as I don't have anything smaller than an 18 in my closet and the one pair she gave me. I went to Old Navy and was expecting to fit into a 14 in the flirt style but they were too big in the thigh area also and a little snug in the waist. The saleslady suggested a different style called sweethearts and they fit fabulous in a size 12. I couldn't believe it. I am now in size 14-16 tops and size 12 jeans, and I still have 35 lbs to lose to reach my goal range of 135 - 140 lbs. I started this journey in size 22 or 24/3X plus size tops and 2X plus size jeans and had to shop at plus size stores and departments in the mall stores and now can shop in the regular misses department and regular stores. The problem is now there is so much to choose from and so many more styles to choose from that it is taking forever to shop and figure out what styles are becoming on my new body and shape. A fun problem to have though. I have hit a plateau on weight loss but this shopping trip lifted my spirits and I honestly don't care that the scale is not moving. At my last postop meetinig the nutritionist said that I will not lose like I did before the surgery at a few lbs a week but rather lose at a rapid pace a few weeks and then stall a few weeks, but my overall average will be about 3-4 lbs per week when all is said and done. It is actually a good thing I have slowed down. My skin is hanging off my upper arms like a bat. I also have lost volume in my cheeks and my eyelids are sagging (especially in the AM when I first get up). The eye doctor said if they sag a little more, my insurance will pay for eyelid surgery because they will begin to block my upper peripheral vision. Maybe a little Juvederm will help my fill in the hollows of my cheeks. I'll wait until after the first of the year and save up for that. Prayers and good thoughts going everyone's way. ZenLady, you've been in my thoughts today. Hope all is well. My camera was acting up so will get new battery and post a pic soon.
Just posting a post op pic
Wish I had a better fitting top for this pic. It is so big that I had to bunch it up in the back and clip it to stay snug so you can see the weight loss. I seem to be losing more in the legs which were already thinner than the rest of me. The big roll of fat around my middle will be the last to go I'm sure! Not brave enough to post a pic with shorts or underwear. Nobody wants to see the fat apron on my lower pelvis or the sagging breasts - including ME!! Just happy to be in my size 12 jeans!
8 Weeks Post Op
I have been on solids a couple of weeks now and can only eat about 2 oz of meat at a meal. I get too full and know if I push it, I will start to hurt. My doctor says it is because everything is tight at first. I had a hiatal hernia repair and the opening to my sleeve is REALLY tight. Have to chew, chew, chew and even take a few sips of water with food or it just won't go down into the sleeve. He says in time it will loosen up and things will get easier. He said I will know when it happens as I will be able to gradually eat more and should not have to drink with meals then. I see him again in two months. I have only lost 32 lbs since surgery 8 weeks ago, but that is an average of 4 lbs/wk, which is what I was told to expect. The majority of that was during the first month. I've had stalls over the past month, but again was told that is how it is after the sleeve. They say I will probably not lose as quickly as others who have 100 lbs or more to lose. I lost the majority of my weight (61 lbs) in the weight management program my insurance required before surgery. Post surgery I gained 6 lbs from swelling and inflammation, and now have lost down to 177, for a total loss of 86 lbs. Only 37 lbs to goal, but it will most likely come off very slowly now. I hope to be to goal by Valentine's Day at the latest. I would probably do better if I could exercise more but am restricted from anything except walking due to the hematoma on my kidney. Over exertion will cause it to hemorrhage again they say. All in all, I am very pleased with my progress and especially the knowledge that I can keep it off now. That is still foreign to me, and find myself wondering from time to time if it will really stay off. I know there are some who gain again, but NOT if they are eating sensibly. If they gain more than a few pounds, it is because they are either: grazing (eating too frequently), eating sweets, eating high fat foods, or drinking high calorie beverages. I had a friend who had a serious binging problem and would eat ice cream and drink milkshakes (several times a day) and she put half her weight back on before she got counseling for her binging problem. She is back on protein shakes and a sensible diet now but she is still in treatment for her emotional issues that drive her to binge. I also learned at post surgery nutrition class that about a year to 18 months out, we can handle more food and tolerate sweets again without it making us feel sick. Need to stay aware of that and not eat more or sweets, just because I can.
FINALLY broke my 3 week weight stall!
12 Nov 2014
2 months post
Wish I could exercise. I'm sure it would melt off if I could be more active. Anyway, 24 lbs to my goal of 150 (the weight I was briefly and felt the best at over 26 years ago after my last daughter was born) and 39 to the doctors goal of 135. He says I need to be at the bottom of my weight range so I have room to float as my weight will fluctuate about 10 lbs over the course of a year once I hit goal and he wants me at a BMI of 25 at the top of my range. We'll see. I am 5 feet 6 inches tall and will be 63 next month. I don't need to weigh what I did in my twenties. Clothes are already fitting well and looking good. Another 30 lbs and I should go down another size at least. I am in a size 12 jeans that are actually baggy in the thigh and butt, but fit just right in the waist, and in a 14/16 or large misses top. I have always carried most of my weight on the top half of my body . I have an apple shape, rather than a pear shape like most women. I was always broad shouldered and a little on the busty side. When I put on the weight it went to the waist line first. I looked like a barrel on toothpicks as my legs and thighs were the last place to gain. My legs are already super thin and I have no butt. I don't want to lose anymore on the bottom but the top half is REALLY resistant. Lots of sagging skin under the arms and on the tummy. So far spanx wear is keeping it all in place but don't want to have to wear it in summer as it's so dadblasted (Texas adjective ;-)) hot and humid here in Houston. We'll see where things are next spring before it gets too hot.