Tag Archives: doctor

Surgeon – Six Month Post-Surgical Update

Today I saw my surgeon for my six month update.  I had blood taken last week so that they could test my vitamin/protein levels in my system to make sure that I am receiving the proper nutrients. 

Everything looked good.  I still weigh 196.  My total weight loss to date is 102 pounds.  He cleared me to kick up the exercise.  I am going to join a gym, do yoga, and I have been meditating.  The surgeon then wants to see me in three months.  In between, I will have my annual physical with my primary care doctor.

So far, health-wise, I’m doing pretty good.  I know I feel great, so much better than I did before.  Just the fact that I can walk as much as I like and not struggle to breathe or stand is a miracle to me.

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Bloodless

That’s how I feel today.  I had to go get some blood work done.  Of course, I had to fast, so no food since dinner last night.  I also did not have much water this am.  I have since eaten, but they took 7 vials of blood, so I’m still a bit woozy.

I went to my primary care doctor, who I have not seen since just before the surgery.  I had one phone conversation with her after the surgery, but all of my follow-ups have been with surgeon.  I am scheduled for my annual physical, which is coming up soon. 

The nurse in her office did not recognize me.  I saw the look of confusion on her face as we walked back to the dreaded scale.  “I’m going to have to weigh you,” she tells me.  I knew she would definitely be surprised.

Most of the staff in her office knew that I was having the gastric by-pass surgery.  I’m not really sure what they expected.  The nurse weighed me and then entered my weight into the little mini lap-top they carry around with them.  Everything in their office is very high-tech. 

“Wow! Oh my God!”

“I know.”

“A hundred pounds!” she continued. 

“I know.”

“Oh you look so good, Colleen.  I didn’t recognize you.  Wait until the doctor sees you.”

The nurse takes me back to the little room.  She does the standard, “What brings you here today,” routine.  Checks my temperature, my blood pressure, my pulse.  All are normal.  Still no meds on my part. 

The nurse leaves and I hear excited chatter up at the nurses station, but I cannot really make out what they are saying.  Then I hear the hurried clicking of high heels on linoleum getting closer to the door.  A quick rap and my doctor enters not waiting for me to say anything.  She is all smiles when she enters the room and I can tell she is excited to see my progress for herself.  “Wow, Colleen! One hundred pounds!  You look so good!  How are you feeling?”

We had a nice conversation about everything I have been through.  She asked me specific questions about different things.  I told her about my struggles with constipation and feeling unsteady.  I also told her all of the good things like being able to breathe and walk. 

She’s very happy that my blood pressure is normal.  I shared with her the blood test results from the health screening my employer did.  She was happy to see my triglycerides were way down.  My blood sugar is normal.  My cholesterol is normal.  My good cholesterol still needs to come up some, but she’s not overly worried about that just yet.

After the appointment, she sent me across the hall to get blood drawn.  The surgeon’s office wants to check my vitamin levels to make sure I’m taking enough vitamins.  Malabsorption is a serious problem after the gastric by-pass surgery.  They take so much blood for that test though.  It may take me all day to recover.

Dealing With New Insurance, Etc.

So, I have to go see my primary care doctor next week and the week after that, the bariatric surgeon.  Since changing jobs, I had to jump through all kinds of hoops to make sure that I have the correct plan that covers both of my doctor’s offices and covers what I need it to cover.

I spent an hour on the phone arguing with the insurance company to make sure that I had everything lined up for my appointments.  Then I had to call both doctors and get the appointments moved around and all of the new information to them.  It was a hassle, but it’s done now.  I hate dealing with this stuff.

I had the same insurance for seven years.  I was pretty much on insurance auto-pilot.  I knew my plan.  I knew what I needed to do.  I knew how much to set aside every year in flex-spending to cover what I needed to have done.  Now I have to re-learn everything all over again with a whole brand new insurance company and a brand new plan.  What a freaking nightmare.

I think I have everything covered, though.  I see my primary care doctor on Tuesday.  Then I see the surgeon’s on the Monday after that.  It has been three months since I visited the surgeon.  I have not seen my primary care doctor since before the surgery.  She will be so shocked to see me.

I have to get some blood-work done for the surgeon’s office and I also will probably have to get some basic blood-work for my doctor as well.  My workplace did a blood screening recently and my numbers were pretty good.  Cholesterol – normal.  Triglycerides – normal.  Good cholesterol – a tiny bit low.  Blood sugar – normal.  So, yeah everything is looking much better than it did 6 months ago.  I am going to take those test results with me to my doctor.  I will have my regular preventative care check up in July.

Wish me luck.

What Is Gastric By-Pass Surgery Exactly?

So, I have had some questions lately from friends.  Some people have asked me to describe what is involved in a gastric by-pass surgery.  Not what I have to do to get ready, but what the doctor actually does to your insides that helps you eat less and thus lose weight.  I have also had people who are considering different procedures and ask my opinion, because you know, I’m an expert, right?

OK, you can stop laughing now.

But seriously, unless you are researching gastric by-pass surgeries because you want to have one, you may not be aware of what actually happens when the doctor performs the surgery.  I know I was not aware.  And if you are considering the surgery, the best thing to do is to reach out to people who have had one of the procedures and ask questions.  Each procedure is different and each person reacts differently to the results after the surgery.  Oh and yes, there are several different types of gastric surgeries one can consider.

I want to spend some time today discussing some of the different surgeries and the doctor does.  I will also include some YouTube videos and other links that will describe the surgeries better than I can.  This post might be kind of long.

What is Gastric By-Pass Surgery?

Gastric By-pass surgery is when a surgeon somehow creates a much smaller stomach and re-routes your digestive track to that smaller stomach.  This will help an obese overeater eat less and help them lose weight.  There are several ways to achieve this smaller stomach.

The surgery can either be an open surgery or a laparoscopic surgery.   An open surgery is exactly what it sounds like.  This is a traditional surgery where the doctor makes a long incision to operate.  A laparoscopic surgery is when a series of small incisions are made and tiny surgical tools are used to perform the surgery.

The different types of Bariatric surgeries are the Roux-en Y gastric by-pass, the lapband, the gastric sleeve, the lapband and gastric sleeve combo, and the duodenal switch.  The Mayo Clinic has an excellent site with pictures and vivid descriptions of each of these surgeries, but I will give a brief description here.

Roux-en Y Gastric By-Pass

This is the surgery where a small pouch is made and the rest of the stomach is cut off and then the intestines are rerouted to the small pouch.  An alternate version of this is to staple the larger stomach off from the pouch.  This is the surgery that I had.

bariatric-surgery-4-162-2col

This YouTube video further describes the procedure if you’re interested.  It is not graphic and does not show a live surgery, but uses pictures to show what he doctor does.  I could not watch videos of live surgeries.   Too gross for me.

The Lapband

The lapband is when a small band is used to create the small pouch instead of stapling.  Sometimes the larger part of the stomach is reduced to create a gastric sleeve.  There are a couple of different bands.  One is a metal band that stays in your stomach.  The other is an adjustable band that occasionally needs to be filled back up with fluid to keep it firmly tight around the pouch.

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Gastric Sleeve

A gastric sleeve is when part of the stomach is removed to create a smaller narrow sleeve type stomach.  This can be done on its own or in combination with the lapband.

sleeve-gastrectomy-2col

Duodenal Switch

This is the most drastic surgery.  Usually, the stomach is left in tact or this procedure can be done in combination with gastric sleeve and the digestive tract is rerouted to by-pass most of the intestines.  This is very drastic.

I am not very good at describing this surgery, so I am going to refer you to the YouTube video and the link I provided above.  This was not a surgery that I wanted to have.  Too drastic for me.

These are the primary procedures.  Each surgeon has their own speciality.  You will need to work with your surgeon to decide which procedure is best for you.

Advice

As far as my advice, I am happy to listen to anyone who wants to ask questions.  I will happily answer them.  If you have decided you definitely want one of these procedures, great.  I have all kinds of advice and ideas.

If you are on the fence, my advice is to think about this some more.  Go back to the drawing board.  Talk to your doctor.  Join a gym, try a new diet plan.  Buddy-up with a friend.  Seek counseling.  Join a support group.  Try to lose weight the traditional way through diet and exercise.  Do not rush into a procedure because you feel helpless.

If after you feel you have tried everything and you feel surgery is your best option, go for it.  Just remember, the surgery is a tool, not necessarily the answer.  You will still have all of the problems you had before the surgery.  The desire to eat or overeat is still there.  Any depression or self-doubt persists.  Laziness is still a problem.  So, unless you are willing make those changes as well, the surgery will just be one more, albeit very expensive and drastic, short-term fix.

Don’t get me wrong, I have no regrets.  I learned a lot about myself and my health, both physically and mentally, through this process.  I am glad I did it.  I could not, however, have done this before I was ready.

A New Milestone

So, since the surgery, I have been wearing the same clothes I was wearing before the surgery.  Before the surgery, I mostly wore a size 28/30, depending on the style.

Well, today I am wearing a size 26 blouse that I have not been able to wear for quite a while.  I also tried on a couple of size 24 blouses I have hanging in my closet.  I was able to button all of them.  I tried them on before the surgery, and I could not.  A couple were still quite snug once buttoned, but more than one fit me pretty well after being buttoned.  I’m not sure that I am ready to wear them just yet.

When I tried the blouses on, I was not wearing the binder that I still have to wear.  I have been wearing a support garment since the surgery.  The binder is a bit bulky and I still need a little extra room under my clothing for now.  Once I get the clearance from the surgeon to stop wearing the binder, I will probably still wear something under my clothing for support.  I have a pair of Spanx, and I will probably buy a couple more.  The support is actually kind of helpful as my muscles continue to heal.  I’ve noticed that if I take the binder off for a couple of hours, my muscles in my abdomen and back start to hurt.

It was nice to try on the size 24 blouses and button them.  I know that before surgery, I could not even do that much.  I know that probably in the next few weeks, I will be wearing them.  I’m not ready get rid of my size 28-30 clothing yet, especially while I’m wearing the support garment.  I still feel that I can wear them comfortably without feeling as if they are ridiculously too big for me yet.  Once I move from the binding garment to Spanx or some other kind of support garment, I probably will be ready to toss that clothing.

On another note, I did go to the surgeon’s office this week.  I met with the nurse about my progress so far.  I told her all of my ups and downs with the diet, drinking fluids, taking vitamins, etc.  She is so wonderful.  She had the surgery herself 17 years ago, so she really knows first hand some of the things I’m going through.

She was happy to hear I had a menstrual cycle.  She did tell me they may become more frequent now that I am losing weight.  She’s told me this before, so I was not surprised.  I told her about some constipation I’ve been having.  She is convinced that I am not getting enough fluids.  I think she is probably right.  So, I’ve spent the past two days just drinking water like crazy.  The other day I was up until almost 1:00am to make sure I met the daily water requirements.  I have to say, it has really helped.  I will spare you all the details, but I am feeling much better.

Overall, the nurse felt that I am right on track.  I’ve lost 40 pounds.  I look much better.  I feel much better.  I’m walking a lot.  I can walk much, much farther than I have been able to in the past couple of years.  My back feels better.  My breathing has improved.  So many good things.  She really commented on how I looked.  She said that my face has really opened up.

Well, I guess now is a good time to post a current picture of me.  Just as a reminder, this is what I looked like before the surgery.  This is a picture of me and my baby sister at her wedding.

IMG_0584

 

Here is me today:

 

Photo on 2012-12-01 at 12.21

 

I just took this on my laptop, so this is as recent as we can get.  My hair is still a little wet, and obviously I need a haircut.  Not to mention, I’d like to get my hair colored again.  The grey is getting crazy.

What do you think?  Do you see any difference?

 

 

 

A New Low

So, I weighed myself today and I hit a new milestone.  I’m down 40 pounds.  I was a little bit pleasantly surprised.  It has been more than a week since I lost anything and it seems as if my weightloss has slowed down.

I think some of the slow down is natural.  I also think some of it had to do with the return of my period.  So, now that I have completed my cycle, I decided to see if there was any difference today, and there was.  Today, I weighed in at 258 pounds.

Tomorrow I go to the doctor and will get an official doctor’s office weigh-in so, I would say that this number is tentative until I am weighed on the doctor’s scale.

I’ll take it anyway, though!  🙂

Five

Five days until my surgery.  Do I have enough topics to write about until then?  I’m sure I can come up with something.

I talked to the doctor who did the endoscopy and colonoscopy.  Good news.  No H pylori, no celiac disease, and nothing that would prevent me from getting the surgery.   Thank goodness.  Now, I just need to get them to send the pathology  information to the surgeon.

I hate having to hunt down information.  I had to go to my doctor to get copies of my chest x-rays to the surgeon’s office.  Then I had to chase down the GI doctor to get results.  This whole process has been an oddessey.  I understand the necessity of all of these tests, but sometimes chasing down test results and running from doctor to doctor is really irritating.  That said, it is good to know that so far, nothing major is wrong with me that cannot be fixed ask I lose weight.

Seriously though, if you are considering weight loss surgery, prepare  yourself for a lot of doctor’s appointments.  More than you think. Here are some things to consider that I have learned along the way:

  • Plan a year in advance before the surgery.
  • Purchase short-term disability insurance.  My employer offers it and it is inexpensive.
  • Short-term disability pays only 60% of your paycheck, but it’s better than zero if you run out of vacation time.  Check your employer’s plan’s policy.
  • Purchase supplementle insurance.  I did not, but if you’re concerned about expenses and covering for time off, you could consider it.  Figure out how much you would pay vs they money you think you might need.  If the insurance is more than what you think you need, set the money aside in a savings account instead.
  • Set aside as much as you can in your flex-spending account.  I did $2,000, which is about $76.00 per pay check based on 26 paychecks a year.  The money is taken out pre-tax, so it was not as big of a hit as it looks.  The peace of mind in paying insurance co-pays and prescription drugs co-pays was well worth it.
  • Many leave of absence requests only allow you to use the time you have accrued so far that year.
  • Save your vacation and sick time for your leave of absence if you can.
  • Purchase a week’s vacation if your company allows for that.
  • If your company allows you to  roll over vacation/sick/personal time, plan ahead and save some of your time from the year before.
  • Check your insurance plan and make sure you use doctor’s that are covered by your insurance.
  • Make sure the doctors you use obtain the correct pre-approval for all the tests you will need.
  • Ask your surgeon if anyone is assisting them and if there are additional costs.
  • Check with your insurance company to find out if they cover assisting surgeons.

I have to say, I am very lucky.  My employer has been fantastic about everything.  Everyone from my manager on up the leadership chain of command have really been cheering me on.  Some of them even occasionally read my blog.  I have also been very open with them about everything I am doing.

I work for a very large corporation with a lot of employees, but I really do feel that my leadership is truly concerned about my health.  Of course, if my health is good, I show up to work more often, I work harder and more effectively, and I bring positive energy to my job.  I know that they want to see that.  But I do also feel that my boss and his boss really care about me personally.  There might be aspects of my job I do not like, but that comes with any job.  Nonetheless, I do feel valued and they have really worked with me this year with all of the surgery preparation and my leave of absence.

So, my advice is plan ahead and prepare.  Prepare yourself by planning your time off for both the leave of absence and doctor’s appointments.  Prepare your insurance and money ahead of time.  And prepare your employer as well.  You’re not required to tell them everything or be as open as I have been, but if you at least talk to your immediate supervisor or someone in management that you trust, that way they can be prepared and may be more supportive.