Monthly Archives: August 2012

Doctor What?!?!

Two things today:

1. I went to my doctor for my pre-op appointment.

2. I heard on the Today Show that a doctor turned away a woman for being too fat.  I am outraged.

Also, I am going to add some pictures of me in this post. One is very current.  Some are from when I was thin, once upon a time ago in high school and college.

Number one.  Yes, I went to my doctor yesterday.  Friday, I received a call from the surgeon’s office that the insurance company declined the claim because they wanted a letter saying that I am medically cleared for surgery.  My doctor’s office requires a pre-op visit before they will provide that letter.

I have no problem with that.  So, I ran to the doctor yesterday afternoon for my appointment.  She did a full check up, took more blood, and made me do a breathing test.  Oh and weighed me again.

I have a funny story to tell about the weigh-in.  They were training a new nurse, who was shadowing the regular nurse.  She is young, short, and very thin.  A very sweet person.

I stood on the scale and she moved the bottom weight to 200 and tried to get my weight.  Yeah that wasn’t going to work.  She was kind of shy about taking it up beyond 250.

I have to say, the other nurses have no such reservations.  They weigh people all day long and can pretty much assess where the scale needs to be to get an accurate reading quickly.  They can dispassionately take your weight and height and move on to the next phase without question, comment, or judgment.  They see hundreds of people a day.

To help this new nurse out, I just moved it myself to 250 and let her measure the weight from there.  Then she apparently put the wrong weight on my chart.  My doctor came in the room and looked at my chart and had a confused look on her face.  She then said, “Your weight was 247?  You’ve lost 50 pounds in the last two weeks?”

I just smiled and shook my head and said, “No.”

We both just laughed.

college

Once we had a thorough talk about the surgery and what she was going to do, they made me take a breathing test.  I have asthma.   More than that, I have been diagnosed with pulmonary, obstructive disease.  That basically means something is blocking my breathing.  Specifically, the weight I carry in my stomach is pushing against the base of my lungs, crushing them and making it difficult to breathe.

To compound the problem, my father died of complications after a lung transplant.  He had a heredity disease called alpha-one antitrypsin deficiency.  Patients who have alpha-one lack an enzyme that protects your vital organs from your own immune system.  The primary organs that are affected are your lungs and your liver.  Damage to those organs can cause emphysema and cirrhosis.  My father had both.

I am a carrier for the disease, but I am non-symptomatic.  But because I have asthma caused by pulmonary obstructive disease, I get chest CT scans and breathing tests done every two years to make sure that I do not develop symptoms.

My doctor needed to do a breathing test to make sure my lungs can handle the surgery and the anesthesia.  My test results were very good.  She said that the results were stable compared to the test I had done two years ago.  Still not great since I still have some trouble breathing.  But good because my lung capacity has not deteriorated at all.

They also gave me a breathing treatment, which means they gave me a dose of albuterol using a nebulizer.  That clears the lungs, but also leaves me feeling a bit light-headed and sometimes gives me a slight headache.  I had to take a nap after the appointment I was so wiped out.

Number two:  I heard on the Today Show about a doctor who turned away a woman because she is obese.  As I said, I am outraged.  Unfortunately, they did not elaborate on the today show, so I had to turn to the Google machine to find a story.

I found this story on ABC saying that ob-gyns in Florida turn away obese patients.  And this story about doctors turning away patients that weigh more than 200 lbs.

Here’s what I have to say to doctors who refuse to treat obese patients.  Shame on you.  Shame shame shame.  Shame shame shame.  It may not be illegal, but it is certainly immoral.  You should be ashamed of yourselves.

I have been treated badly by doctors because of my weight myself.  I always come away angry, humiliated, and feeling like I have nowhere to go for help.  What do you when you’re sick and  you go to the doctor for help and they refuse to help you?  What if all doctors refused to treat obese patients?  Where are we to go for help?

I am very lucky.  My doctor is really cool.  She is concerned about my health because of my weight, worried that I was going down a very destructive path, and happy that I am doing something about.  She has never refused to see me or treat me because of my weight.

This country is struggling with an obesity problem.  We need doctors on our side if we are going to prevent obesity where we can and help us overcome the obesity if we’re already there.

To prevent or treat obesity, people need to learn more about nutrition and food, healthy exercise, and their overall health.  For this, we need doctors to be our partners, not consign us to a permanent  persona non grata status.

I know, the irony of it all hearing about healthy choices from a fat chick like me.  Get over it.  I know what I’m talking about.  I have lived it.  I am thankful for my current doctors.  They are working with me to help me save my life.  I could not do this without them.

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Surgery Update

I have to admit, I am getting a bit anxious about the surgery.  I have been planning for it for a long time, but until now it was theoretical, off some time in the nebulous distance.  Not anymore.  I have a tentative date and the countdown can officially begin.

Then yesterday, I received a phone call from the surgeon’s office.  The insurance company denied the claim.  The guy at the surgeon’s office assured me that this is becoming standard with the insurance company.  They deny the claim and give you another hoop to jump through.

The insurance company wants a letter from my primary care doctor saying that I am medically cleared for surgery.  My doctor already supplied a letter saying that I am a good candidate for the surgery.  She won’t do the “medically cleared” letter until we do a pre-op appointment.  I have an appointment for Monday.  I do not know what she is going to require.  Will I need more tests?  I do not know. I guess I will find out on Monday.

The surgeon’s office assured me that once they have that letter, they should get the insurance company’s decision overturned in a day or so.  We shall see.

Once the surgery is approved, I will then only need to do a pre-op with the nutritionist and then take a class on how to eat after the surgery, plus anything else the surgeon’s office will require.

For now, we have not changed the surgery date.  We are still on track for the end of September.

Today’s cat picture is of my former cat Pounce de Lyon.  I know, cute name.  Friends of mine found him as a kitten, nursed him to health and gave him to me as a present.  I had him for many years.  He was an awesome cat.  He was so beautiful and very friendly.

When I first got him, he attacked everything and everyone.  When I had guests over, he would get so jealous of them, he would try to bite them.  I had to put him in my bedroom when I had visitors.  Then my sister brought home two kittens.  He fell hopelessly in love with the female cat and became putty in her hands.  This mellowed him out quite a bit and he became much more affectionate.  He was always affectionate with me, just not with strangers.  Once he mellowed, he loved everyone.

My cousin came to visit, and Pounce ran into the room to greet him.  Pounce jumped into his lap, meowed, and laid down so that he could pet him.  At which point my cousin asked if this was the same cat as before.

The gargoyle and dragon belong to my sister.  She loves that kind of stuff.  Pounce used to love to curl up next to this dragon and pretend to be stalking.

The Board Is Set, The Pieces Are Moving…

The surgeon’s office called today.  They have everything that they need to submit to the insurance company.   They think they will have the approval by August 24.  We also set a tentative date for the surgery.

September 26, 2012.

The date is tentative based on when they receive the actual approval from the insurance company and when I finish some of the pre-op stuff that I need to do.

Once the approval is received, I have another appointment with the surgeon’s office.  At that time, I need to bring them the paperwork for the FMLA/Short term leave of absence from work.  And they will give me a list of other things I need to get done.  Here are some of the things that I already know that I need to do.

  • Pre-op appointment with nutritionist.
  • Pre-op appointment with my doctor.
  • All new labs, blood work and other tests.
  • Some sort of support group or class about what eating will be like after surgery.
  • Apply for FMLA/Leave of Absence and short term disability for work.

I am not sure what else I will need.  I am certain I will find out at my next appointment with the surgeon. 

The date may change, but it looks like it is definitely going to happen around the end of September.  Woot!

Antici…pation

So, I just heard from the psychiatrists office today.  They just completed the review and wanted to send it to my doctor.  I gave them his name and address and they are mailing it to him today.  Once the surgeon’s office receives their report, they will submit to the insurance company.

I feel a bit like I’m circling an airport waiting for a runway to become available so that I can land.

I am certain that once the insurance company gives the approval, things will move faster than I am prepared for and I will be complaining that everything is happening all too  quickly.  For now, I wait.

On a separate note, I went to the eye doctor this weekend.  For the first time in my life, I need glasses.  Everyone in my family wears glasses or contacts.  My brother needs glasses for reading, as did my mother and father before him.  Both of my sisters have worn glasses most of their lives.  I was hoping to escape wearing them altogether myself.  Now I need glasses for reading.  Also, I have developed an astigmatism, which makes seeing at a distance a little difficult.  I pick them up on Wednesday.

Today I am including a picture of a cat I had in the 90s.  She was very old when I took her on.  She had been a breeding cat.  The breeder was going to put her down, so a friend of mine took the cat and gave her to me.  Her name is Precious.

She did eventually have to be put down as she turned out to be quite sick, but I loved her very much and tried to give her a good home for as long as I could.

Perchance to Dream

I am a dreamer.  I dream almost every night.  Sometimes, I have highly imaginative, vivid dreams.  Some of my dreams are bizzare and unexplainable.  My favorite dreams, however, are about the most ordinary activity that you can think of.  Something so utterly commonplace, people do it every day, reflexively wihtout thinking.

In my dreams, I walk.  This is not an exceptional task.  People walk everywhere, everyday.  They walk inside their homes, up and down stairs, to their kitchens, bathrooms, and bedrooms.  They walk to their cars, through the grocery store, to the bus stop.

I had a dream the other night that I was walking through a park with an old friend of mine.  We just walked and talked.  At one point, I realized during the dream that I was walking pain free and it was the most remarkable feeling of freedom that I almost cried.

In real life, walking for me is difficult.  I have a crushed L5 joint in my spine.  My sacrum (base of my spine) is off center, which I found out a few years ago is a birth defect that I never knew that I had.  I have bone spurs in my feet, asthma, and as we all know, I am morbidly obese.  The first four problems would probably be manageable, but the excess weight I carry make the pain of standing and walking almost unbearable.

I do walk short distances.  I have to stop and sit to rest my back and catch my breath often.  Standing in one place is almost an impossibility.  Going to the grocery store, waiting in line at the bank, and walking to the bus stop are all very slow and painful activites for me.

I am often too embarrassed to go to public events.  Concerts, fairs, and summer festivals are very difficult for me.  In recent years, I’ve stopped going to big events like this.  I always have to think about how far I will have to walk. Will there be places for me to stop and sit? How will the people I am with feel about this?  Will they be embarassed to be seen with me?  Will they be understanding of my situation?  Will they think I deserve all of the pain and difficulty I suffer because it is my fault I am so big?  I also don’t like to be a drag on their fun.  They are capable of donig so much more than me and I will only hold them back.

I wasn’t always like this.  When I weighed close to 200 instead of 300 pounds, I could walk everywhere.  Yes, I had minor pain, but that pain did not stop me.

Let me give you an example.  I had a friend come to visit me in DC and she wanted to see the monuments.  We took the metro into DC.  We exited the Metro at the McPhereson Square station and walked to the White House.  We did a walking tour of the White House.  We then walked from there to the Washington Monument.  Then we walked to the Capitol Building and took a tour there.  We decided we wanted to see the Senate in session so we took the underground Capitol train to the Senate Office buildings and picked up some free tickets from my state’s Senate or Congress office.  I don’t remember which.  (That is a benefit that every US citizen can take advantage of once a year.)  We stood in line for a long time and finally made it in to see the Senate in session.  After we left there, we walked from the Capitol Building to the Lincoln Memorial.  While we were there, we saw the Vietnam Wall and the Korean Memorial.  Then we walked from there up 23rd Street to Georgetown where we hopped on the Foggy Bottom Metro to head home.  Then we went out for pizza with friends.  We did all of that in one day.   Oh to be young and relatively pain free.

Just so that you can see some of the distance we walked, here is a link to the National Mall.

Here is a better example.  I drew a red line to indicate our walking route.  Click the link to the google map to see the monuments.

I think just the distance between the Capitol and the Lincoln Memorial is two miles each way.  I could be wrong though.

As you can see, I did not always have a problem walking.  It came on slowly as I gained weight.  When I was living in Arizona, I became very allergic to everything there and limited my outdoor exposure.  My allergist also had to give me steroids sometimes to counter the allergic reactions, which of course helped me gain more weight.  Because of the pain I experience, exercise is very difficult.  Therefore, losing weight is also very difficult.

It is my hope that after my gastric by-pass surgery I will lose enough weight to allow me to start walking and exercising  more to rebuild my strength and my ability to walk normally.  The idea of regaining some of my former walking ability seems like a dream, but it is a one I hope I can will into reality.

Weekly Photo Challenge: Growth

I decided to do one of the weekly photo challenges on WordPress.  This week’s challenge is “growth.”

I am uploading a photo I took at my niece’s birthday party.  Her mom made this giant cupcake cake and a bunch of little cupcakes.  Not only does it represent the growth of the cupcake, but the growth of my niece who is now four years old and so full of energy, it takes an army to keep up with her.

Furthermore, this is a “growth” in how yummy cakes are made as it is gluten-free, peanut-free, egg-free, and milk-free to meet all of the allergy-free requirements from different members of our family.

Image

Faire Attendre

Patience is a virture, or so the saying goes.  My name, however, is not patience.

I just talked to the surgeon’s office today.  They have not received the psychiatrists recommendation yet.  They said it could take a week for the psych to send it over.  Once they have that, they submit to my insurance company.   That approval could take anohter week or so.

So, now I wait.  I am not good at waiting.

Now for a nonsequitor of sorts.

Due to my being a travel agent in real life, I often have to look up European train schedules on the Rail Europe website.  On the site, I enter the travel parameters and click the search button.  During high traffic hours, which seems to be any time I am at work and looking up train schedules, the website runs through a list of suggestions of fun things to do in Europe while the site compiles your list of train times.  Here are some of the suggestions:

  • Drink wine.
  • Become King of the lake.
  • Split your Lederhosen
  • Have an underwater tea party.
  • Stand in awe.
  • Join a polka band.
  • Bathe in spicy tomatoes.
  • Make a Viking weep.
  • Wear a soft cheese moustache.

This list cracks me up.  It doesn’t take much to crack me up these days.  I lost my mind booking roundtrips to Chicago years ago.  It does my heart good though to see someone in this industry has a clever sense of humor, unless of course those are serious suggestions.  In that case, I’m a little bit scared that they have allowed a complete lunatic to create their train schedule search engine.

But I digress…

In the Rail Europe tradtion of spontaneous silliness, I have been trying to come up with a list of useful (or not) things I could do while I wait for the approval from my insurance company to schedule my surgery.  Something other than stare at phone like a jilted teenager until the surgeon’s office calls.

Here are some of my thoughts:

  • Clean and organize closet.  (started, not nearly finished)
  • Pick lint off my pjs.
  • Wiggle my toes at the neighbors.
  • See how long I can stand at attention.
  • Count how many times in a day I can use the word canoodle.
  • Read the “Odyssey” by Homer.
  • Re-enact scenes from the Wizard of Oz.
  • Write a four chord song.
  • And last but not least…drink wine.

And that’s as far as I got.  I think I could use some more suggestions if you have any.

More on my surgery when I hear from surgeon.  In the meantime, enjoy this video by the Axis of Awesome: