I was always thin as a child and into my twenties...
I was always thin as a child and into my twenties until I had my first daughter at 28. Pre-pregnancy weight 130- full term pregnancy weight 208 - post pregnancy weight 183. My first diet experience took me down to 153. The next thing I knew I was back to 183, then two more pregnancies and I was over 200 lbs post pregnancy weight. My heaviest weight was 263. I am now at 240.
Over the years I've lost and gained the same 80-100 lbs time and again. Then came thyroid disease in my 40s, menopause in my 50s and now bone loss and arthritis in my 60s, which limits my exercise. I'm sure many of you have a similar story. I beat myself up for many years and of course the "thin" world cannot relate and can be cruel. I went to counseling and the whole thing was an uncomfortable experience. The counselor was a string bean who never had a weight problem her entire life. Her approach was that there must be some psychological problem that drives me to eat and make bad food choices, etc. I came out of it feeling worse about myself than when I started. What is wrong with me that I cannot get control of my weight for the long term???? What I now know is there are many factors involved. It’s not just your genetics, willpower, exercise, or eating habits. What it takes to balance the weight equation that leaves so many struggling, is a balancing act of each of these elements.
All of this has led me to researching weight loss surgery as a tool to help me regain control of my weight. I've learned that the gastric sleeve procedure removes the part of your stomach that creates the appetite hormone ghrelin. After this procedure most people have less hunger and combined with healthy food choices, exercise, and portion control, allows for weight loss success. I know it's not a magic bullet, but a tool to help me get to a healthy weight again. Hopefully the smaller stomach sleeve will help with portion control for the long term, so I can drop the pounds and get to a place where I can move and exercise again and still breathe and not be in pain. My insurance requires 90 day doctor monitored weight management prior to surgery, a psych exam, a BMI of 35+ with co-morbidities. I saw the surgeon earlier this week and am on a plan to complete requirements and have surgery in late June. For now I am working on gradually increasing my exercise and practicing portion control. I am also trying to eat more often, but smaller meals per day and trying to increase my water intake. I see the weight management/nutritionist the end of March. Dr. Yu wants to do an EGD to check if I have a hiatal hernia, which is scheduled for early April. I will try to find a picture and will post updates periodically. All of the experiences I read on this blog greatly encourage me and give me strength and confidence to embark and complete this journey to health and fitness. I hope my story brings strength and encouragement to others contemplating the gastric sleeve procedure.
?I will have to be on a liquid diet 2 wks prior to surgery...
I will have to be on a liquid diet 2 wks prior to surgery and the final
four days of that will be clear liquids. I understand this is to shrink
the liver for an easier surgery. I have been sampling protein shakes
and have ordered my liquid vitamins for post surgery. I know I have
lots of time yet, but bariatric items are expensive I've found, so this
allows me to spread the cost over the next few months so it won't be so
much all at once. I plan to have my pantry stocked with whatever I
need for each stage following surgery, especially those first four to
six weeks. I see the dietician/nutritionist once a month until surgery
so I will update with any new information I learn. Thank you all for
your continued encouragement .
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.
Dr. Yu is with Texas Laparoscopic Consultants of Houston, TX. Dr. Sherman C. Yu was recently named one of America’s Top Surgeons by Consumers Research Council of America, and has been recognized as a Centers of Excellence® Surgeon by the Surgical Review Corporation. Dr. Yu is a member in good standing with the American Society for Metabolic and Bariatric Surgery, and was the first surgeon in Houston to perform the Single Incision Laparoscopic (SILS) gastric sleeve procedure. Dr. Yu is also the first surgeon in the Houston area to perform the SILS adjustable gastric band procedure. Dr. Yu focused on bariatric surgery, and continued to do research in the field of obesity surgery. He published many articles in peer-reviewed journals and presented his findings at national and international meetings. After completing his fellowship, Dr. Yu was offered the position of Assistant Professor of Surgery at the University of Texas Health Science Center, a position he held until 2008. He then decided to join Dr. Terry Scarborough in private practice, where they established Texas Laparoscopic Consultants in the Texas Medical Center.