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I met with Nancy for my first consult with her this week and scheduled my second visit with her for a month out.  I've scheduled appointments with PT and Nutrition.  I'm waiting to hear back from the psychiatrist so that I can schedule with him.  I have a comprehensive physical with my PCP scheduled as well as my monthly chiropractor appointment.  I'll attend a pre-surgical support meeting when it comes up in Derry (I'll have to check my book for which Monday that is.)

So, basically, I'll be spending more time with health care providers this month than I'll be spending with my husband!  Thankfully my boss is very understanding and flexible about all this.  I mentioned today that I was feeling guilty for scheduling all these appointments during work hours, and SHE SCOLDED ME.  Seriously.  She made it very clear that she knew this was important and that I wouldn't take advantage of the situation.  She also reminded me that there IS life outside of work.  Many things these days are making me feel lucky and blessed.

By the way, thanks to all of you who replied to my query on the surgeons.  Everyone had glowing reports of their own surgeon, which made me feel good that I couldn't make a bad decision but didn't really help me narrow down who I'd want to work with!  In the end, I chose Dr. Paciulli for what might seem like a poor reason - she's female.  Let me explain...

When I met with my new PCP (who happens to be female) I realized afterward that I was more open & honest with her than any other doctor I've seen.  Then I started looking back and realized that this is a trend in my life.  I'm sure that a student of psychology could make some accurate guesses about my past based on that info and maybe I should be working to break out of this tendency, but right now I need every edge I can get to be successful here.  If choosing Dr. Paciulli from a group of great surgeons because of her gender will help me in the long run, then I'll happily be 'sexist'.

My official weigh-in was higher than I thought it would be (damn those two weeks of not really caring what I ate) and my goal weight is lower than I thought it would be - so basically, I have more to loose than I ever imagined - 200 lbs.  Gosh, that looks even worse in writing.  I suppose if there's anywhere that I can freely put that in print, it's here.  Still depressing, though. 

Finally!

DH got a new job with insurance that covers LB surgery.  I'm so excited that I could burst!  There are a few kinks in the plan that I'll gladly work through. 

First, I can't go to the surgeon that I wanted to.  That's unfortunate, but I'll definitely deal with it since I have to go to a "Distinction Center" instead. 

I was hoping to dive right in and start the meetings right away, but the local meeting is booked for this month.  I'll have to travel to the one next month, but I'll have to deal with that as well.  The alternative is waiting until September for another local meeting.  Screw that!

As best as I can tell from their website, none of my current doctors are members of the new insurance.  I'll only really miss my chiropractor (who's awesome) so maybe I'll pay the extra money to keep going to him.  We'll have to see about that.

So, basically I'm back to waiting.  I'll have to wait until we get a member number and can be sure about what doctors are covered.  Then I'm going to have to start establishing a relationship with a new PCP while finding out what Portsmouth's program requires.

BUT...

At least now I know there's hope.  At least now, even if I'm not quite "on the road" I'm at least going around the big turn leading to the onramp!

Hubby finally had a job interview today.  All the calls that he's received until now have been for temp to perm positions and we just can't gamble on that kind of thing.  Well, this was for a permanent position and we were both very excited.  I think I was more nervous than him.

He has mixed feelings about how it went.  He thought he was meeting with only one person.  That person seemed to like him and was trying to "sell" the company to hubby.  Then he brings in Interviewer #2 who is much further up the food chain.  That seems like a really good thing, but Int. #2 either didn't want to be there in the first place or he wasn't impressed with hubby.  Either way, hubby didn't have the warm, fuzzy "this job's mine" feeling we were hoping for by the end of the interview.  Now the waiting starts.  Maybe some other opportunity will come up.  Who knows.

All I know is that my life is still on hold and I'm ready for SOMETHING to happen.  I can't move forward until he has a better paying job - preferably one with insurance that covers LapBand surgery.  I've been kind of avoiding the board for a while because I was obsessing about it.  I've since decided that there's nothing wrong with a little obsession now and again.

I've been debating for a long time about whether or not I would be telling my friends.  I finally decided who I was going to tell, and since all but two are on a certain blogging site I decided to break the news that way.  I wanted to re-post that message here.  I was going to re-post it to the message board, but it turned out much longer than I thought it would so I'll just copy it over here:

Hi all. I'm sure that some of you are surprised to see me since it's been FOREVER since I posted. Well, I finally have something that I feel is worthwhile to post, so I thought I would. You will notice that this is a friends only post and would like to keep the info herein relatively private. I know that there are some people who occasionally read over someone's shoulder so I'm counting on you being in this little loop. I'm warning you now that this is going to be a long post, so now might be the time to go get a frosty beverage...

You back? OK, here we go...

Nearly all of you have been around since Al and I weighed a total of somewhere around 160 pounds more than we do now. You saw us watching what we eat and getting exercise. You complimented us and supported us. For that we thank you.

Now it's several years later. I'm still watching what I eat (although in the interest of full disclosure, I will admit that I've not been QUITE as strict as back then) and I'm exercising even more than I was when I was losing the weight, and I'm getting nowhere. I suppose that keeping most of the weight off is a little better than "nowhere" but not much. I can't continue like this. I need to do something now while I still have my health before I turn into another statistic. I don't want to end up needing 20 pills a day to live. I don't want to end up dead.

Now you may be thinking, "quit eating so much" or "get more exercise" or probably most likely "well, you lost before so you just need to try harder." Believe me, I've tried. One can only try for so long with no results before anxiety and depression take over.

So why am I sitting here, bearing my soul and crying like a crazy person? Believe me, it's harder than you can probably imagine for me to be this candid about something that is for me so emotionally charged. It's because I feel like I need to do something drastic. I need help. I can't do this on willpower alone.

I plan on having weight loss surgery.

Before you go nuts, I'm not going to have a gastric bypass. They scare the hell out of me. Rearranging my insides so that I suffer from malnourishment? Only having an 18 month window to lose all that I need to before things go back to "normal"? Maybe that's what's right for someone else, but it's not my cup of tea, thanks.

There's a procedure called Laproscopic Gastric Banding - LapBand for short. Basically, what they do is place an expandable ring around a part of your stomach, about 1/4 of the way down from it's top, that can be filled and unfilled as necessary to accomplish several things. First and most obviously, it makes your stomach a different shape so that you can eat less in a sitting (between 1 and 1.5 cups of food per meal). It forces you to eat slower so that you realize when you're full BEFORE you get to that uncomfortable spot.

I will be able to eat normal foods (although some people find that different foods upset their new tummies) just a whole lot less of them. I will have to remember to eat my proteins first and keep track of what I'm eating even more carefully than I do know. Since I'll be eating so much less, each bite needs to count nutritionally. Will I be able to have cake on my birthday? Probably, but only a few bites. Will I still be able to go out to eat? Yes, but my doggy bag will be bigger. Could I totally sabotage myself by only eating bad food? Yes, but I've been avoiding those foods 97% of the time for several years now - I can continue to do so.

I don't want anyone to think that I'm taking the easy way out. As a matter of fact, if any of you say this to my face, I'll probably punch you in the nose. :) This will be anything but easy. Like I said, I'll still have to watch what I eat. I'll still have to exercise. But with the Band, I will have a chance to succeed. Weight loss with a Band is meant to be slower and more controlled than a bypass. Two pounds per week is ideal. Some people go faster some go slower, but few people ever put all the weight back on unless they just give up on it altogether (ie, unfill the band and eat like they used to).

This paragraph is going into some technical things about what they're going to do to me, so you can feel free to skip right over if you like. OK, so what happens is that they place the balloon-like band around my tummy, stitch it to some of the muscles around there, and attach it to a "port" that sits just below my skin. Rarely do they inflate the band at this time - the stomach is very sensitive and there's usually a good bit of swelling at first, and they don't want to stress out your tummy more than necessary. I'll have to have just liquids for a few days, then just soft food to let the tummy heal. When I'm healed up enough to really start the program, I go for a "fill" where they put saline into the band via the port under my skin. This is where "bandster hell" starts. There is no one correct amount of saline. It's a very individual thing. Putting too much in basically closes up the stomach, so they err on the side of stingy. Also, too much stress on the tummy too quickly and I'd end up with too much swelling. Most people have to have several fills, spaced a few weeks apart before they get proper "restriction." The goal is to be able to eat a little over a cup of solid food before feeling full. If I can't eat that much, I'm not going to be able to get the nutrients that I need and they will take a little out. Eventually, I'll find my "sweet spot". Then, a few weeks later (depends on person, but I've heard around 6 weeks), I'll have lost enough weight that the fat around my tummy will shrink, the band will loosen, and I'll have to go for another fill. There's a lot of aftercare, but it's meant to be a tool that will continue working so long as I continue the program. When I reach my goal weight, we set the fill level to a place where I can easily maintain the weight. If I start putting weight on, I can always go back and have a little fill to keep me in line.

I know that was painful, but I feel that I need my friends to know how this is going to work. Most likely, I will NOT just shed pounds like someone with a gastric bypass could. I don't want you to think that I'm failing if I don't lose 20# each month. I'm telling you all this because I don't want to keep it a big secret. I'm telling you all this because I don't want you to think that I'm taking the easy way out - it's a tool, that's all. I'm telling you all this because I'm hoping for your love and support through what could be a difficult journey at times, and your love and encouragement through what I hope will be the successes.

Now that all that's over with, I should tell you that I have no idea when this is happening yet. I've been researching for months, following people's successes and issues on another message board, making sure that nothing's going to really surprise me. I've been searching my head and heart to make sure this is the right thing for me. I've been keeping it to myself for so long that I feel like I'm going to burst. And I've been waiting for Al to get a new job in hopes that his insurance will cover it since mine doesn't. Now you all know why I've been making him study so much. =-P If it turns out that whatever awesome new job he gets doesn't cover it either, then we'll have to start looking into a way to self-pay. Pray that we don't have to go this way. It's a bit expensive, but as Al has often said to me "we'll do whatever we need to get you healthy".

"WTF - you guilted me into reading this long-ass post and you don't even know WHEN it's going to happen???"

I'm letting you all know about this NOW for several reasons. First, as I've said, I've kept it pretty much to myself for so long that I often feel like I'm going to burst. Al thinks I tend to obsess over things - I have no idea what he's talking about. =/ I also want you all to have time to adjust to the idea. I want you to ask me questions (just not in the middle of a crowd of acquaintances, OK?) I want you to understand how much this will mean to me. I want as much support as I can get all lined up for when the time actually comes, because it's not always going to be easy and I don't want to be all alone.

But I'm not obsessing...

I broke down with my husband a few days ago.  It was actually what he likes to refer to as "an attack of the crazies" but at least I got stuff off my chest and he listened to me.

I very eloquently (NOT) told him that this is one of the biggest decisions I've ever had to make and his refusal to really discuss it with me mas making me feel very isolated.

He seemed surprised that I needed more than "I'll support you no matter what" - boys are silly.  He sat down with me and looked over some of the info that I've gathered and he actually asked me some really good, challenging questions. 

I still feel like a kid waiting for Christmas - a kid who really thinks this is the year that she's getting a pony.  I want so much to start down this road. 

It's been a few months since I last wrote here and figured I should put down some thoughts.

It's been an emotionally trying few months for me.  My husband has been spending nearly every free moment studying to update his Microsoft certifications.  This is great for his career, bad for our social life.  It's a necessary evil and I don't begrudge him the time spent, but it's left me with way too much thinking time. 

I'm more convinced than ever that I need a Lap Band to finally give me the edge that I need to start loosing weight again.  Having made that decision, I've had a hard time convincing myself that it's not a waste of time to go to Curves between now and then.  I dropped from my 5 days a week to barely 2 for a while.  Thankfully, one of the women in my office wanted to start going with me, so I'm back to 3 times a week religiously.  I still wonder if it will do me any good as far as the weight loss goes, but I know deep down that it's still good for my overall health.

Eating healthy has become an onerous chore too.  Well, eating healthy isn't the chore.  Cooking healthy is the chore.  I feel like I spend half my life planning, shopping, prepping and cooking our meals.  I'm not sure why this is bothering me since I have much more free time these days (with the hubby studying and all) but it does.

I guess I feel like I'm just holding my breath until some magic little something changes and I can move on with my life - the life that I'm convinced needs the Lap Band.

Maybe I'm fixated too much on the band, but one thing has really been weighing on my mind...Who do I tell?  Everyone seems to have different feelings about this but I can't pin mine down.  So far, my husband, our mothers, his sister (who works for the surgeon I'll be going to), one co-worker and 3 friends know that I'm "considering" it.  So far, these have all be either actively supportive or at least pleasantly neutral.  This makes me think that I should just tell everyone.  Then certain people come to mind who I'm convinced will think I'm taking "the easy way out".  One of those people is in my office.  The easy solution would be to just not tell my office, but we are so small (7 people) that it's bound to be noticed.  Telling nearly any one person (other than the one who already knows - she'll keep it to herself) guarantees that everyone will know.  This isn't because they are mean or gossipy, it's just like a big family or sorority (only one guy) and we all just like to TALK.  As far as friends go, I can't really see anyone being overly negative, but I can just hear a few people saying "why don't you just eat less" or "seems pretty drastic to loose a few pounds."  I'd rather not point out that I should loose somewhere in the neighborhood of 150 more pounds.  Then I get into a cycle of "why bother" thinking.  I don't even know if I'll be able to pay to have this done.

I think that I'd really like to have someone to talk to about this - not just talk, but real soul-bearing discussions.  My husband is really, really sweet and supportive, but the most I can get out of him is "we'll do whatever we need to so that you can be healthy and I'll be here for you the whole way."  As I said, very sweet and supportive, and I love him dearly for that but not really helpful when I just need to talk about it.  He's also quick to point out - rightly so - that I've a tendency to obsess over things.  I think in his mind, talking seriously will just feed the obsession, when I really think that maybe it would help me.

My mother, like every other conversation that I've had with her, said something about someone that she works with who had the gastric bypass, then moved to another topic.  She lived in PA, so when we talk, it's really just a lot of catching up on daily life stuff.

I have some girlfriends that I can talk to about some things, one I've already told about this, but I'm having a hard time picturing myself being so vulnerable with her.  She's so self-confident and sure of herself that I feel like I'd be letting her down to be so wimpy.

So, to make a long story even longer, I feel helpless and vulnerable and alone.

I attended the Information Meeting at the Dartmouth-Hitchcock Manchester today.  First off, I didn't really expect it to be standing room only.  I got a seat right in the last row - then they added a few more rows - then people were standing around the walls too!  My husband came with me for moral support & to learn more about the whole thing, and I'm really glad that he was there to hear all the stories, too. 

The surgeon, Dr. Gould, wasn't in, but his PA did a presentation comparing & contrasting LB vs. RNY.  I really think that LB is they way for me. 

Some other interesting things:
(1) an RNY alumni showed up with her fat pants & I'm pretty sure that you could fit 4 of her current self into them.
(2) a Plastic surgeon, whose name is slipping my mind right now, showed some pictures of skin removal & breast lifts and I was shocked at how visible the scars are.  He talked about different things that he does to minimize the visibility of the scars, but stressed that it's a trade off:  it's either skin or a scar.
(3) I got the whole "appeal to the insurance company" question answered.  I read on the message boards about people appealing, but didn't know under what circumstances this could be done.  Sue explained it very simply as "you cannot appeal for coverage that is excluded".  The appeals are for things like being denied because one of the doctors didn't fully document something that the insurance company required.  Stinks for me, but at least now I know.

So I've read all kinds of online info, I've watched the message boards looking for the good AND the bad, I've attended an informational meeting and after all that, I still think this is the way for me to go.  I'm up to all the challenges that I will face with one big exception:  where the heck am I going to get the money???

Currently, my insurance doesn't cover bariatric surgery of any kind.  My husband doesn't have insurance at his work, so he is on mine.  I'm hoping that as more of the insurance companies jump on the band wagon (ha!  BAND wagon - I slay me) mine will follow.  However, if that doesn't happen, we are going to either have to look into some other insurance options (not sure if any would even take me!) or consider borrowing from my 401K to pay.  I suppose that if I don't borrow from it now, I may not live long enough to need it later.

So, now I'm at a stand-still.  I didn't even bother getting weighed in at the meeting today.  They require a minimum of 3 meetings at this center - more if a lot of time lapses between.  Since I don't even know if this is a realistic thing for me yet, I figured I'd wait until I'm ready to move forward to do the "official" three meetings with weigh-ins, etc.

I guess that's it for now.  As friendly as everyone is on the message boards, I still feel a little weird posting there - kind of like being at a party were everyone knows everyone else but me - so I think that this blog is going to really be just for my own edification for a while.