39 Yr Old Male, 5'10.5", 269lb W/ Co-morbidities, fat kid and fat adult, RnY Gastric Bypass soon - Medford, MA

April 2016 I'm retroactively entering this info....

April 2016

I'm retroactively entering this info.

I'm 39 years old (40 in December), I'm 5'10.5" apparently (always thought I was 5'11", lol) and currently 269 lbs.
While my weight alone doesn't make me eligible for surgery, my co-morbidities do. Those being: Type 2 Diabetes, high blood pressure, high cholesterol, depression, and sleep apnea. I'm on 9 medications for all of this, and I'm sick of it.

Started the process for Gastric Bypass at the end of April 2016.

39 Yr Old Male, 5'10.5", 269lb W/ Co-morbidities, Gastric Bypass Soon

April 2016

I'm retroactively entering this info.

I'm 39 years old (40 in December), I'm 5'10.5" apparently (always thought I was 5'11", lol) and currently 269 lbs.
While my weight alone doesn't make me eligible for surgery, my co-morbidities do. Those being: Type 2 Diabetes, high blood pressure, high cholesterol, depression, and sleep apnea. I'm on 9 medications for all of this, and I'm sick of it.

Started the process for Gastric Bypass at the end of April 2016.

First meeting with doctor. Very nice guy who has been practicing these procedures for over 20 years. Tells me that while I am not too big or overweight in general, my midsection is. With my BMI and co-morbidities, I am an excellent candidate. He approves me to begin the process. In the meantime, my blood sugars are running at 500, I'm stressed, anxious, and depressed about an upcoming job layoff and loss of insurance.

Update 2 - May 2016

After meeting with Dr Sandor, it's time to make and go to appointments for tests and everything else.
My NP Christine (or Project Manager as I like to call her) tells me all the things that need to be done and appointments that need to be made.

Cardiologist Semanuk: Noticeably handsome guy, great personality. It was like talking to a friend. Hives me a clean bill of health, says my heart is heathy, no issues. Asks me if I work out: "No". Asks me if I played football: "No, I'm just fat." He laughs. has no problem signing off on me for this step. I think I found my new cardiologist, not that I had one before.

Nutritionist Erika: we need to start thinking about how you eat and why, and start changing little things. Skim milk instead of cream, less carbs, more protein, small bites, lots of water, try tiny sips. yeah, whatever, can I go?

Outpatient testing: Breath into this machine, breathe in, breathe out till you have no breath, keep going, keep going, keep going, keep going! Whew!
Repeat. Repeat, Repeat
Next, we need to, I forgot the proper term, but he needed to take blood out of an artery in my hand. I cant remember if it hurt, so it mustn't have been so bad, right? Needle goes in, vialS (plural) get filled. Gauze, and pressure, quickly gets applied. "do you want me to hold that for you?", I say. "No, I'll do it. It you don't put enough pressure on it, it will literally shoot out like a geyser on to the ceiling and all over", he says... Umm okay, I'll let you do that then.

Next, drink this chalky glue shake. Not as bad as I expected. Stand here and don't move. Xray. Drink some more of this slightly thinner shake. Stand here and don't move. Xray. The machine is now going to flip back and put you into a lying on your back position. Drink some more of this, yes, while lying down. don't move. xray. Now, I need yo to slowly turn over as we need the mixture to coat your insides. start turning, they lift the machine a little as I'm pancaked in there. keep turning. "Um, I can't, my shoulder is hitting the thing" I have wide shoulders. "Oops" keep turning. xray. keep turning, xray. Okay, the machine is now going to stand you up. Here's some water to drink. You're all set. The nurse and doctor disappear. As I leave the room I remember what the breathing/artery blood guy told me: "Before you leave, go to the bathroom and make sure you don't have any of that white gunk on your face. They won't clean you up or tell you if you do" He was right.

That's it for May.

June 2016

June 7: Mental Health Eval with Deb: Prior to appointment was given several forms to fill. One of them being a PHQ9 form/questionnaire. We talk about things. How I am depressed, and just feel "Meh" all the time. We talk briefly about family, health, love life, etc. There's tears, my tears.
She asks me if I filled out the form truthfully, I said yes. "Well, according to this, your depression isn't under control. We need to get these numbers (which correspond to feelings) better. I'll need to talk to your prescriber and see what we can do, if we can do better or if this is as good, mood-wise, as you'll get"

"sh*t...", I think "This is going to push back surgery... for who knows how long" Stress and anger set in.

I leave, sunglasses on, tears in my eyes, hating this woman. Hating her for telling me my truth.
I have been on a mix of drugs trying to treat this depression, and I was just waiting for something to happen, for this depression to clear. 450mg Wellbutrin (max dose) and 40mg Viibryd (max dose). My prescriber told me of a patient who took 7 months for Viibryd to take full effect. A year later, and I was still waiting on something, anything to happen.

Let me just say, if you suffer from depression, ask your doctor for this PHQ9 form. It will change your life. It will make you go get some help, or a change of medication.

June21: I go see my depression med prescriber, rehash what was said at the psych eval. She suggests a couple things. I add that my insurance is probably going to change, she switches ideas "this won't be covered by Aetna", she suggests weaning me off Viibryd, and onto Effexor. Like, a 3 week process of lowering a dose of one, while adding the new and ramping up, you get the drill. Hmm, i won't get my hopes up. Nothing has worked yet.

Same day, I see my PCP: I'm proud of you for taking this step (to have surgery), it will definitely make you feel better and you'll be healthier. I rehash what was said at psych eval, and at earlier appt regarding my meds. I'll see you in 3 months

June 23: NP Christine: I've gotten your results from things, looking good. Have you seen Ellen yet? (Ellen Klee is the endocrinologist, I need to get my blood sugars in control) "Um, no, I'll make an appointment as soon as possible" Appointment over as there is nothing left to discuss.

June24: Ellen Klee, endocrinologist: My usual meds for my Type 2 Diabetes are, 52 units Novolog injection with meals, 90 units Lantus Solostar injection at night, and max dose of Victoza injection. also at night.
She suggests trying something new, dropping all of the above and taking 90 units Tresiba injection in the AM, and a once weekly Trulicity injection. Of course, I need to check my blood sugars daily and report back. can do it via email and a web accessible Google spreadsheet. (more on this "next month"

June 28: Erika Nutritionist: so, how's things? I lie. "great, having issues with xyz. BTW, can I get that sheet of what I should be eating?" "sure, I'll print that out, and some recipes for you too" I can tell by the look on her face that she knows I've done nothing regarding this aspect for the last month. Ugh, I gotta do better. I decide, I will go shopping and buy this stuff, and eat healthier!

July 2016

First week of July, I'm weaning off Viibryd and fully on 75mg Effexor. I don't know how I feel, I feel.. weird....cant really explain it., just , weird.

July 7: pick up home sleep study kit. I already know I have sleep apnea as I have a cpap machine, but it's been 5 years so they wanted to retest. My main issue is the amount of pressure I need needs to be adjusted, or something. I have turned my own machine way up, but the mask can't seem to handle the pressure (literally) as the flimsy silicone, flaps around the area of my eye, blowing air at my eye which I then have to struggle to adjust. In the middle of the night it gets to the point of, you know when you blow up a ballooon and then you pull apart/squeeze the end to let the air out and it makes a high pitched farty sound, yeah, THAT. That is happening on my face with the cpap mask. I rip the mask off. Every. Night.
On a follow up phone call, they state that Yes, I have Sleep Apnea. i told them I knew that, but OI really just needed to figure out the proper pressure and get a different mask. An appoint is made for like, months down the line. UGH. This is part of the reason why I don't want to go t obed at night.

somewhere between July 10-15th: I know this sounds cheesy and/or cliche, but, this fog of dread lifts! The world seems brighter! I'm smelling things I haven't before! I feel.... Happy! OMG, what is this miracle drug. I wish this had come into my life YEARS AGO!! I start coming out of the shell I have crawled myself into. Being more outgoing and social again.

July 19: meet with depression med prescriber: I tell her how at one point the "fog of dread" lifted, etcetera...she is glad to hear this. Renews my Rx for the full 75mg of Effexor.

Weight is coming off slowly, I've lost about 15lbs and that's just by eating healthier and walking. I forgot to put this earlier, but due to my BMI, weight and co-morbidities, my criteria for pre-surgical weight loss was ZERO. I was told to maintain my weight at 269.

July 26: Erika Nutritionist: Things are going good, she's noticed the weight loss, give me some other tips. Nothing too eventful

July 29: Ellen Klee, endocrinologist: I've been keeping track of my blood sugars. Via email she told me to up the Tresiba from 90 to 110, which saw my lower blood sugars go even lower to a very healthy range. That day, I skip lunch and head to my appt. We discuss how things are going, etc. I start sweating profusely and feeling a bit light-headed. Uh Oh, this has happened a couple of times before. I'm having a low blood sugar episode. She brings me some OJ and some peanut butter and graham crackers, and water. After my episode clears up, she is a bit concerned about this happening. I tell her that it usually never happens, my blood sugar is usually too high, and hardly ever too low. She told me to keep an eye on it, especially with healthy eating and the amount of medication being taken, I could be at risk again. If my sugar is too low, I should lower Tresiba down to 100 units.
As far as clearance, she said I was clear for surgery. I mentioned that Nutrition wanted to wait for my A1C, but that would be another 2 months away! She said, she'd still have me do a A1C, but I wouldn't have to wait for it to be cleared. It was then that she told me that they are actually a TEAM TEAM, like. They get together once a month and discuss patients in the program!! I thought they would just look at my entries in the computer system and see stuff, but they are actually a TEAM!! She said I'd probably miss this month's, but could make next month's meeting.

Through August 16th, 2016

August 11: Psyche Eval with Deb van Etten: She asks me how things are, and I tell her good, really good and then "I have to say that when I left here last time, I hated you...." "I get that a lot.", she said. "But, I also need to thank you. I don't know where I'd be right now if I hadn't seen you. I'd still be stuck in a rut, waiting for a medication that was probably never going to work, to work" I told her what I was switched to, etc. She stated that you just need to try different combination of meds until you get it right, it's a common thing. She also said that she knew I was different, better, happier, when I walked in. I mean, she does this everyday. She knows people better than they know themselves!! I can't thank her enough!

August 15: depression med prescriber: Things are going well still, glad to hear. Continues refills for my meds. See you in 2 months

August 16: So... I guess my appointment was at 10am, I thought it was at 9am, and I show up at 8:20am. I check in. "I'm either really early, or really friggin early!"
"yeah, you're appointment isn't until 10, but NP Christine just got here, maybe she can get you in earlier! or now even!"
"Okay, but wait, I have to reschedule my Erika Nutritionist appointment for next week as I'll be in Atlanta on a business trip." She said she'd check to see if Erika could take me today as well a bit later.
NP Christine: you're doing good, looks like you are down 15 lbs, have you spoken with Deb (psych)? I told her how great the last appointment went and that she verbally told be that she would get my approval for surgery. I also discussed the blood sugars being way better and that Ellen would give my approval before the A1C test (which 9/15, i think). With that information, she said, "Well, i think with this information, I'm going to submit you to Dr Sandor for consent."
"What does that mean?" "Well, you meet with him, you both give your consent for surgery, pick the surgery and date." "what?? seriously?? that's awesome!!"
we go to the front desk: "Erin, can you see what Dr Sandor has available for this Thursday?"
"He's completely booked up, he has no room"
"Have a seat while you wait for Erika, she'll see you in a few minutes"
I sit. In the meantime i hear NP Christine talking with Erin at the front. I think she's going to finagle something to get me in asap.
While in the waiting room I strike up a conversation with a very friendly woman who told me that her son had the same name as I do. It's Italian and not very common. Anyway, we get to talking and she tells me her story, and I get more excited about the thought. We talked about the good, the bad, the ugly. She said it's the best thing she has ever done and has never been happier and has lost 60lbs in 6 months.

Erika Nutritionist: how's things? any issues? problems? etc? nope, all good. eating healthier and better. I'm just looking forward to NOT having to eat so much to feel full. great, great, great.
We discuss that 2 weeks prior to my surgery I will be on a liquid diet. 4 shakes a day, 2-3 fruits/veggies a day, calorie-free, caffeine free, carbonation free liquids, cottage cheese, egg whites, tuna fish. Confused, I ask, "All of this counts as a "liquid diet"? cottage cheese" solid fruits? eggs?"
"Oh, and provided everything goes well (with insurance, they clear me), this is our last appointment. Our next one will be 2 weeks AFTER your surgery."
Oh sh*t, this is getting real. I get nervous, I'm kinda shakey

Checkout: "okay, so the only thing Dr Sandor has is for this Thursday at 10:15am."
"um, okay. do i have to be here?"
"Oh! Yes, this is where you fill out your consent, and pick a date and stuff"
"oh my god, ok, yes. yes. I'll take it"
Now I'm really shaking.
Thursday 8/18/2016 can't get here fast enough!


I figured I should post some pics. I really do smile sometimes.

August 18th, 2016 - Consent day, and then we wait

This morning I had an appointment with Dr Sandor. When I checked in about 30 minutes early, there was an A1C lab slip waiting for me. They said I could do it now or after. Went downstairs via elevator, door dings, I step out. Hmm, the directions I was given... I cant take a right here, hmmm. To my left is a nurse's desk, like the one they all are behind while they are checking on patients... "Hi, um, Where is the lab?"
"It's actually dow-"
"Oh my g-d, am i on the wrong floor? I'm on the wrong floor! yup, there it is, I'm on 2" I continue: "The door dinged and then opened, no one came in or out. The door dinged so I got out" LOL
Embarrassed, I press the DOWN button... and I wait... screw it, I'm taking the stairs which were literally right next to the elevator doors. Finally find the Lab.
I'm always concerned about the phlebotomist's digging for veins. Ed was really good, got it on the first try. Once done, I leave to head back up to my appointment.. again I get lost.
a nurse and a construction guy: "Can we help you? what are you looking for?"
"Um, the elevators?".. I continue walking as they are as well
"they're right-"
"Oh wait, I found the door. I took the stairs down, I took the stairs down"
I run up the stairs to the 3rd floor, and yes, I am out of breath.
I get my vitals checked. The Blood Pressure machine beeps and a yellow word, HIGH, appears on the screen. "yeah, it's a little high"
"I just ran up 3 flights of stairs!"
Sit here, the doctor will be in shortly.
Over the intercom, a Code Red and sirens sound..... When I was down at the lab, a lady had walked in complaining of chest pains and numbness in her arm and a leg. I hope she's okay.
The doctor comes in. Says it's great to see me again.
We discuss all the things, has some papers for me to sign, the consent forms. You picked Roux en Y
? Yes. (I think, basically, this is the classic "gastric bypass")
He goes over the paperwork, what is expected of me, what is expected of him. The good, the bad, the ugly, the possible death.... he gives me the paperwork to read over myself, and sign. I sign.
"so, the only thing is this: you changed insurance."
"Well Cigna's minimum nutritionist appointments is 3. Aetna, might be 6, so we'll see. If it's an issue, we just add a couple more appointments. (I've had 4 nutritionist visits) We'll submit the paperwork and we'll see what they say. I'm going to submit you"
We walk out to the front desk. From here, it's kind of a fog. 'this is happening, this is really happening, oh my g-d, this is going to happen". I signed things, I don't know what.
The woman who submits paperwork is not back in until next week. I'm shown a Calendar Book. a hand is waved around the area of the last 2 weeks in September, like, a month from now.
"She'll submit you, and when she hears back form the insurance company, and everything is good, this will be the time frame it would be scheduled for, if it's a "GO."
I leave, heading toward the elevators... oops, I passed the elevators. "Shoot! I always do that!!"
I get on, Press 1, and head out and to work.
so, as of now, my date is TBA

Sigh... Insurance: A blessing and a curse

So, with my recent insurance change, I need to adhere to their policies. I got a call on Tuesday stating that I was denied. Aetna makes you have 6 Nutrition appointments. So, I've made an appointment for September. Will need one for October, and then we'll see.
Currently in business in Atlanta. Can I eat my feelings? Lol. I'm not actually upset about it, just mildly disappointed. I hate waiting!!!

9/16/2016 - Closer.....

9/13/2016 - Okay, had my 5th Nutritionist visit. Wait has volleyed a bit. I'm still basically at about 15lbs lost. Just watching what I eat, for the most part. But, damn, I am so hungry. I cannot wait until I don't have to stuff myself to feel full.
anyway, My main concern, well, poops... and how difficult they are. How the heck do I get fiber in? I've gotta try getting it naturally, but am going to supplement it with that fiber powder that dissolves in water, and drink more watre in general. yadda yadda yadda. Another appointment before I can be re-submitted for surgery, October 11. Did the whole "let's look at the calendar" thing again, and it was suggested that provided insurance approves, surgery could be the week of November 7th. Okay, cool. Not holding my breath. I leave. Again, I miss the elevators. ugh.

9/15/2016 - "Hi, I had to wait on the doctors booking secretary to get back to me on a date. It looks like he can do your surgery on November 1st. Does that work for you?"

Internal Monologue: "Holy sh*t, that's a lot sooner than the 7th, okay, not a lot sooner, but sooner. I'm gonna miss that appreciation party thing, whatever, this is gonna change my life!"

Externally: "Oh wow, that's definitely sooner than the 7th. Yeah, that works for me!"

Um, okay, so, we have a date, a tentative date, but, a date. OMG, I have a date! I need this month to, like, fly by.

And here's a photo from this past weekend. I did not have ice cream, but I did have a lobster roll. Yeah, weird place, it's ice cream and seafood.

9/23/2016 - Sleep Health

Diagnosed with Sleep Apnea, like, 7 years ago. Of late, haven't been sleeping well, tried using my CPAP, but just a combination of irritations with it. I don't think the air pressure is strong enough. Originally it was at 9, I have since, slowly pushed it up to 20. The mask has neoprene straps with velcro on the tips, over time as the neoprene stretches, you need to adjust the velcro. At this point, I can't get the mask on tight enough since the velcro is only on the tips, and in order to make it tighter you need to pull back tighter, the velcro tip reaches my hair. It's not going to stick to that. So I finagle a weird angle. The straps on the back of my neck are so tight that they leave red marks that last all day; leading people to ask "what happened to your neck?" Ugh...CPAP. "what's that?" "Can we just talk about something else, i'm fine, it's fine, don't worry about it." The mask itself is made of clear silicone, very thin. With the pressure up so high, the mask struggles to stay sealed, it flaps, it blows air directly into my eye, it's annoying. I can't sleep. I adjust the mask again, trying not to move, the simplest movement breaks the seal, again, it flaps. I re-adjust. I wake up to... you know that sound when you blow up a balloon, and then stretch the part you blow in, and it makes that high pitch squealing sound? THAT. I wake up to that.. the mask is flapping and doing that.. that squealing, farty sound. LOL. I'm so stupid.
SO, I had a home sleep study on July 7th.... it takes up until now to finally see the doctor to 'interpret" my results. Basic gist, home sleep studies suck and don't really tell them much. She confirms I have sleep apnea. Yeah, I already know that. She thinks that after surgery, maybe 6 months after I won't need the CPAP anymore. She says that the home sleep test showed that the amount of air pressure I needed was low. She suggested I set my machine to auto, so that if it noticed I needed more pressure it would increase, if not, it would decrease. My device is 7 years old. It doesn't do that.
"Maria can check the machine for you, and it not we can set it to 10, or 11" "Maybe 12"
Hmmm... the reason I raised the pressure myself was because I wasn't sleeping well. Now I'm supposed to lower it? Whatever. I can just do it myself
"I'll just do it myself"
"Make an appointment for 6 months after surgery for a follow up evaluation"
I kinda left there feeling like I wasted my time. Told me nothing new. I don't know... SO, I'll go home after work and change the setting. Wait, I have a concert tonight.. And then I'm leaving to go to a friend's house in RI in the morning, Should I take this thing with me? Maybe I will. I don't know
I would love a good night's sleep again. I would like to wake up refreshed again. I would love not waking up in the middle of the night constantly, and yawning. I would love to not have to drag myself out of bed, tired, and yawning. I would love not to yawn all day. I would love coming home and not feeling like I need to take a nap, because, if I do, I'll be up all night. I would love to not toss and turnall night. Of late, I have been waking up on my stomach, head turned to an uncomfortable position, back aching because I'm no spring chicken. What the heck is a spring chicken anyway?... wtf. I just want this to end. So, Yeah... Might update after I make the setting changes, or not. I have my 3 month Endocrinologist follow up appt next week. I'm kinda dreading it. I have been eating better, but, not all the time, bad carbs sneak their way in. It's going to be time to measure my A1C. (A1C is your 3 month blood sugar measurement) I'm terrified, what if the number is bad? Does it then push my surgery back? *sigh* I hope not.
After this, October 11 is my final nutritionist appointment.
so... stay tuned, more to come!

The "last" Endocrinologist appt.. Uh OH!

Went to do blood/urine labs the day before my appt. I haven't been doing well. And it showed.
9/30 was my appt. "Um, your A1C, is still pretty high, it's at 9 point (something, I can't remember)"
"Have you been keeping track? what have your numbers been running?"
"I haven't been keeping track, but yes, I have been eating bad, sometimes, not ALL the time"
"Well, you're going to need to get these numbers done, you can't have the surgery if your blood sugar is this high. And I don't want to have to delay it"
Revised the plan, upped the Tresiba, might need to re-add the Novolog.
It's been a few days now, but my numbers are running high in the AM. What the F is happening? Can I NOT eat ANY carbs now? I really need fiber in my diet, and that comes with carbs! wtf.
I really need this to happen on November 1, I cannot delay this anymore. I need this. I need this. I need this. It's been so hard to deny myself the stuff I want. I can't even do moderation because I'll overdo it. I eat yogurt, cottage cheese, or chicken for dinner. I'm hungry after, I'll have this HOOD Maple flavored cottage cheese which is like crack to me. It is so good! And low in carbs per serving. It. IS. LIKE. CRACK. I don't know what to do besides starve myself... dammit.
Nutritionist appt on 10/11... to be continued

10/11 - Nutritionist Appt

My blood sugar numbers are all over the place, even with being strict on what I'm eating, very low carbs, high protein. I just can't get this sh*t under control unless I literally don't eat.

So, I head into my Nutritionist appointment. Weight is still steady at 15lbs lost, so 254lbs. Remember, I didn't even need to lose 1lb for this.
I bring up my main concern which is blood sugars and how my Endocrinologist said she didn't want to have to delay the surgery and I'm freaking out about it. The nutritionist said that she doubts that she would delay the surgery, but we did need to get my numbers down so I could heal properly. I shared my numbers via a url as I use Google Sheets, which is awesome, you should try it. She noticed that my eating times were just all over the place. I would need it to be more structured, and at set times, eating at those times whether I was hungry or not. So we came up with a plan that I'm trying out. Measuring my blood sugar so. many. times. a day.
At the end of the appointment, the Surgical Coordinator happened to be at the fornt desk with her grandson, who was the cutest little chunker you have ever seen with the biggest blue eyes. She said that she had already started submitting my paperwork to insurance, and just needed a not from today's session to add on to it. Said things were looking good so far and she would contact me soon with more info. So, we wait.

10/13 - The Call

"Hi.... so, we got your insurance approval..."
"what?! OHMYGOD that's awesome!"
I will be sending you an email with some paperwork, with dates and times. You'll be second for surgery that day at 10:45 am, on November 1st. Read it over, and ask any questions. There's also an appointment for pre-operative testing where they'll do some labs on you on October 24th"
"Holy crap, sh*t just got real!"
She laughs
"Christine will be sending you a link to a video about the surgery and the hospital. She'll ask you to watch it and then respond that you watched it."
"Oh, okay, cool. yeah, um, I've never had surgery before, so I don't really know what to expect."
"Really? Me neither, it's all a coordinated effort and everyone's done this before. The video will talk about the hospital itself and your stay here."
"Okay, cool. Wow, thank you!"
I'm freaking out. I'm excited. I'm nervous. I text my friends the info I have.
I get the email, it's 3 pages. The first page just states Who I'm having surgery with, The date and time I need tobe there. the procedure I'm having, "Laparascopic Gastric Bypass Roux En Y", my pre-operative appt info for 10/24, and a re-statement of REQUIRED FASTING before surgery. Not even Chewing GUM! WHAT?! whatever, you'll justhave to deal with the empty stomach bad breath then. LOL
Page 2: Literally the back side of page one where you can see the ink text bled through the paper, What is this, is this a mistake?
Page 3: Insurance approval, authorization number for 2 surgical days. So, a 2 day stay.
So, now I have to call back and explain Page 2..... voicemail. I leave a message. I'm such a worrier. WORRIER...... not warrior. I leave a message asking if there is supposed to be something else there.
I hope I hear back soon. I'm sure it's fine.
Did I tell you that I'm freaking out yet?
Okay, I'm done for now. Stay tuned!
Winchester Bariatric Surgeon

First meeting with doctor. Very nice guy who has been practicing these procedures for over 20 years. Tells me that while I am not too big or overweight in general, my midsection is. With my BMI and co-morbidities, I am an excellent candidate. He approves me to begin the process. In the meantime, my blood sugars are running at 500, I'm stressed, anxious, and depressed about an upcoming job layoff and loss of insurance.

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