pkitty
16 Jan 2005
Might as well start writing my profile, right? I'm 39 years old, 4'10", turning forty on 16 Feb (yikes!), and am currently unemployed. It's been a lousy market for techs, but I want to switch fields entirely anyway. I've got a wonderful husband, three psychotic cats, and thank goodness, no kids! (some people make wonderful parents; I'm only suited for the role of crazy aunt)
I've tried all the usual diets. OptiFast was the worst, oh my, I was an unpleasant person while on that stuff. I decided to change my eating habits in recent years, trying Atkins both straight from the book and with some modifications. Something's not right when you eat 1500 calories a day, avoid all sugar and starch, eat nothing but meat and veggies and SF Popsicles and a little dairy, drink 84oz of water, do light aerobics, and lose only four pounds in six months. I have dropped weight, though, down to 255 from a high of 280+, but it took me three years to lose that weight.
I brought up the topic of WLS with my PCP late last year, and her reaction was "what took you so long?" She's very supportive. I wonder if it's due to a difference in medical training? She's a CRNP, not a doctor, so she lacks the standard MD arrogance. Just a thought. Two of her other patients are in the pre-op phase too, and she's very excited to see how everything turns out for us.
I had chosen a surgeon and paid the initial fee ($399 - his full program fee is $2000), but have decided not to stay with him. He's great, his nutritionist is great, but I was unimpressed with the guy who handles the insurance, and a post-op friend has been a little less than pleased with the followup from the physician's assistant. I thought the PA was okay, but nothing more, and it turns out that all your followup is with the PA. Another huge factor is that this doctor is in northern Virginia and I'm in Maryland. There's a river between his office and my home. Maybe in other parts of the country this would be considered a negligible reason, but in Metropolitan Washington DC it's a major factor. Our rush hours last from 5am-10am and 3pm-7pm (no exaggeration!), and the bridges over the Potomac are terrible traffic chokepoints.
So I have tentatively decided on a different surgeon, although I'll reserve final judgement until I actually meet with him. Stay tuned.
Meanwhile, to make Aetna happy I've begun the 6-month diet (as of December 17). Because I'm serious about it, I've consulted with a dietician and set up a workout routine with a personal trainer. So far, so good. Well, not so good, since I've actually GAINED two pounds since beginning the diet. I hope that's mostly muscle!
The dietician wants to lower my sodium intake to 2000mg daily. That's the standard recommendation, but wow, it's tough to accomplish. One can of Progresso soup can have anywhere between 500 and 1000 mg of sodium. And I thought I was being so healthy! Once again, it's a reminder of why cooking from scratch using real foods is so much healthier than eating commercial stuff. I'm having my resting metabolic rate tested on 7 February. My basal metabolism should be about 1850 calories (and that's just resting; factor in normal daily activities and it's 2700 calories). The lowest rate the nutritionist remembers recording was 900 calories a day. I'm betting that mine is not too far above that.
As for the workout... if you've been thinking about joining a gym but are feeling intimidated, stop worrying! Most gyms offer a free trial period, so take advantage of it and give it a try. I joined a Gold's Gym close to home on 3 January. It has a separate women's gym with weight machines (scaled to suit women) and four cardio machines. I do my weight training there; the main weight training area is full of grunting sweaty guys and scary-looking machines! I'll eventually graduate to those, however, since the selection in the women's area is basic. I do my cardio (treadmill) in the main gym. At first I was shy about it, but you know what, nobody there cares what you look like. I crank up the iPod and start walking, no worries.
17 January 2005
Hi. Gosh, it's cold today! I met with my PCP to begin Month Two of "Make Aetna Happy". I've lost 1.5 pounds since December 17. Whee. Golly, diets DO work after all, who needs surgery? I should have made a bet with my PCP as to how my RMR test turns out. She's expecting it to be pretty low, too.
My husband is acting like a kid in a candy store. To be more accurate, he's acting like a kid who knows that he'll eventually be handed the keys to the store, and he's scouting out the candy ahead of time. In other words, he hits the Victoria's Secret website a couple times a week. "Would you wear that? What do you think of this one?" His taste is a trifle sleazier than mine, but what do you expect? He's a guy! I should note that he is the most wonderful, supportive husband anyone could ever want, and he loves me as is. If Victoria's Secret made lacy lingerie in my size, he'd be just as happy to have me wear it now even with my huge belly and saggy breasts. Of course, at my current size there's no way I would put on anything like that - it would be a sad sight.
20 January 2005
Who the heck ordered all this snow? Didn't the forecast call for mere light flurries?
Hmmm. The Washington Post hosts live online chats, some with special guests and others with regular hosts. Every Tuesday, a fitness expert hosts a chat about exercise. He offers to answer questions via email if you miss the chat, so I sent him a question about the routine my PT wants me to do. He was alarmed that any PT would throw that much work at a newbie exerciser with a 50+ BMI! Something I forgot to mention before is that the PT told me to do 150-200 ab crunches daily, which really horrified the Post's expert. He said the abs are just like any other muscle group, so they need recovery time. I did get the impression that my PT just has this set routine that he gives to every woman, even though I explained my situation and goals to him. Luckily I don't have to follow his routine if I don't want to, and there are several other PTs available at the gym. Maybe one of the other ones will actually listen to me? In the meantime, though, I rather enjoy the circuit training. I'll probably cut it down to three sessions a week (all the upper body work as one group, done twice weekly, plus one leg session) and just do cardio the other days. I was going to do cardio today, but my car is still snowed in. Besides, most of the TVs will probably be tuned into the inaugural coverage. Bleah.
18 February 2005
I'm now 40, as of two days ago. Ugh. My husband turned 34 today. Of course, he's whining about how old he is. We're off for a romantic weekend - we also celebrated our 4th anniversary this week! I met with my PCP yesterday, and told her I was happy we've knocked two months off the 6-month diet. She looked confused. In her records, the diet had actually officially started on 2 November, which is when we discussed my getting WLS. So I'm actually 3.5 months into the program! I'd better get set up with the surgeon's office ASAP. Oh, yeah, about my resting metabolic rate? It was 1490, much higher than I expected but certainly much lower than what it should be for my size. Still doesn't explain why I can't lose weight on a 1300-calorie diet, sigh.
Something I found odd about the previous surgeon is that, at his pre-op info session, none of the post-ops who showed up were actually his patients. He's a highly regarded surgeon who has done hundreds of patients, so go figure. He is also more focused on DS, which I definitely do not want. (I'd really prefer to have the Lap Band, but Aetna won't pay for it without a huge fight, and I'm happy with the RNY as an option) I've decided to go with Dr. Gary Harrington, who heads the bariatric program at Washington Adventist Hospital. Dr. Harrington schedules his pre-op info session to coincide with the post-op support group, which could explain why four or five of his post-ops came bouncing into the info session to offer their help! The meeting started off with a 2-year post-op who talked about her experiences (the icky as well as the good), and closed with a 3-year post-op who is also Dr. Harrington's insurance coordinator. Both are his patients.
Wow, only 72 more days before I can apply for approval...
22 February 2005
My dietician is a perfectly nice, competent, informative, helpful, and friendly woman. So why is it that after each appointment with her all I want to do is stuff my face with salty carby food? She's a bad influence on me! Very strange. I have one more appointment with her (making three total), but after that there's not really any reason to keep seeing her.
Meanwhile, I've scheduled my appointment with Dr. Harrington - March 18. My husband might accompany me, but he's a bit squeamish about all the actual surgical stuff. He's not a fan of biology! However, he wants to be supportive, and would like to meet the man who's going to rearrange my digestive system.
I'd long since tossed/donated all the clothes that didn't fit (so no closet shopping for me, alas), but today I finally threw out clothes that fit but were stained or otherwise not presentable. I also ditched all my D and DD cup bras, which don't fit. They used to, but almost all the (tiny bit of) weight I've lost over the last three years has come from the upper body. I'm now a 46C. Went to Lane Bryant to try on some bras, and the clerk insisted on measuring me for proper fit. "You're a 46DD." Um, no I'm not. She insisted that I try on a 46DD, and then another. When I showed her just how badly they fit (underwires poking my armpits and gapping out when I sat down, enough extra room in the cups for a family of squirrels), she had me try on four different 46Ds. No, no, no, and no. Lady, I told you I was a 46C... Something else became brutally clear in the harsh light of the LB dressing room. I will need plastics on my arms. Oh yuck, it was not a pretty sight. Working out at the gym has really started toning the upper arm muscles, so now when I hold my arm parallel to the floor you see two distinct halves: the toned upper arm and a rounded swinging flap of flabby skin. So much for wearing sleeveless tops.
I'm looking forward to never having to shop at Lane Bryant again. Right now it's still impossible to imagine life as a normal-sized person, but the days are ticking by until I can apply for approval.
15 March 2005
My husband nagged me to update my profile, so here it is: Hi Erik! My meeting with Dr. Harrington is on Friday, and I'll have something more informative to write after the appointment.
16 March 2005
This is Zilla, also known as Colombe's Jeux Sans Frontieres. He's a 10-year old Chartreux neuter, and (sadly) my sole remaining purebred. We're down to two cats now, Zilla and Kuroko (a pretty little stray kitty we adopted). Coaster (Sol-Mer West Coast Weekend, a solid black American Shorthair), my precious third cat, had to be euthanized last week because of advanced lymphoma. I lost two other cats, both Chartreux spays (my much-beloved Bear, aka Bellereve's Fleurette of Colombe, and Zilla's mother the goofy Emoi, aka Minoux's Emoi of Colombe), a year earlier. I hope to get back into showing and maybe breeding at some point after surgery. Hey, we ought to save enough money on human food afterwards that we can afford to restart the cattery (breeding cats is a hideously expensive hobby). My husband longs for the pitter patter of little paws.
18 March 2005
I've just returned from my consultation with Dr. Harrington. He's very professional, and I found him very likeable as well. Definitely the kind of person I want slicing up my insides! His patient coordinator Alfreda told me that Aetna is looking for six monthly PCP visits, rather than six full months on the diet, so I can apply for approval after my sixth weigh-in on April 4. Wow! Surgery would happen about three weeks after approval, and Aetna (when they're not being difficult about documentation, and I have been OBSESSIVE about documentation) shouldn't take more than two weeks to grant approval. So... mid-May? If all goes well, I might even be able to fit on a roller coaster before the season ends!
I will not require a lot of pre-op tests, since my health is relatively good (for now) despite the morbid obesity. I'll have to schedule bloodwork, gallbladder ultrasound, chest x-ray, and EKG, plus the psych evaluation and nutritional counseling (both will be done with Washington Adventist's program personnel). Not too bad. Dr. Harrington is not the strict autocratic type, which is good because I do very badly working with that sort of doctor. I had looked into another surgeon, who was recommended by my PCP, but I just knew working his strict program would drive me into full teenage-level snotty rebellion mode. This would have been a Bad Thing.
22 March 2005
If I'm this cold now, what the heck will it be like after I've lost weight? Will I actually look forward to summer in future years, rather than dread it? We'll see. In the meantime, I've scheduled my pre-op session (includes nutritional info and a protein drink taste test) and psych evaluation, for April 12 and April 6 respectively. Since Dr. Harrington wants all pre-op workups done no more than 30 days before surgery, I won't schedule the bloodwork et al until I've got a surgery date.
23 March 2005
When it rains, it pours. We took Zilla in for his yearly checkup and vaccinations, and the vet confirmed what I had suspected - he's been losing a lot of weight. The vet suspects hyperthyroidism, which is what Zilla's mother had as well. It's pretty common in older cats, and I'd guess we're at the early stage of it. Have to drag the poor boy back to the vet tomorrow morning for bloodwork. We're not too far from several veterinary hospitals which can handle the radiation therapy, which is a quick and thorough cure. Expensive, though - probably somewhere around $1200. And we've just blown through close to $800 on Coaster's vet bills. Thank goodness for a good human insurance plan, the vet bills won't impact our ability to pay for the small out-of-pocket costs for the RNY.
26 March 2005
Ah, so it was hyperthyroidism. Zilla's now on thyroid medication, and we'll see how he's doing after a month. Meanwhile, thanks to the generosity of my husband's former co-worker Jodi, I've got a whole bunch of clothes to shrink into! She's now 5 months post-op and doing extremely well. After I whined about not being able to closet-shop, she let me rummage through her collection before she donated them to Goodwill. I now have a nice selection of pants/jeans running from 28W to 24W. Thanks to my husband's nagging, I've also ditched most of my granny panties in favor of nicer ones from Lane Bryant. Boyshorts are really comfortable! Who knew?
Even as I type, I'm wearing the 28W (petite) jeans. They're tight, since my belly is about 61" around, but at least they're on and zipped. They also need to be hemmed about three inches, as my legs are very short! You know, I haven't bought pants for nearly two decades. Long skirts look so much better on me, since anything else emphasizes the huge belly. Jodi also gave me some tops, which are all 3x. If it weren't for the belly, I'd be wearing 1x tops - these 3x ones flop around my upper torso, but get a little stretched out where they hit The Wall O' Fat. Very depressing. I can't help but fear that I'll lose weight rapidly on the rest of my body, but the belly will stay the same size! Eeeek!
4 April 2005
The final required visit to my PCP has been completed. I've requested my relevant records from her office plus additional ones from my gynecologist's office. I should be able to give Dr. Harrington's office what they need for insurance submission by the end of next week. Yay! I had her look through my records to find my original weight at my first visit to the office: 290. Egad. I've lost nearly forty pounds since that visit... and am still wearing the same size bottoms. How depressing.
Spoke today with a friend who worries me a little. We've known each other for twenty years, since college. I've always been the fat one, even though her weight has fluctuated greatly through the years. I haven't told her about my pursuit of WLS, and don't intend to tell her anything until the surgery is actually performed. I don't know how supportive she'll be, or how jealous she'll become. Right now she has no insurance and not much income, so there's no way she could get WLS. I mentioned my current weight to her today, and she seemed slightly miffed that I'm lighter than she is (our BMIs are similar, though, as she's 6 or 7 inches taller than I am). I'm not worried about telling any other friends, just her. If I tell her now, she probably wouldn't be the alarmist type (you know, the kind who tells you about how her cousin's niece's teacher's sister's hairdresser had bypass and died). She would just ask question after question after question after question, many of the theoretical type that I couldn't possibly answer as a pre-op. When my pouch is established and giving me commands, then I can answer questions.
This is a daruma. In Japan, these dolls represent Bodhidharma (founder of Zen Buddhism), and are good luck charms used to set goals and help you follow through on them. When you purchase a daruma, both eyes are blank. You color in one eye to set your goal; color in the second eye when the goal is achieved. A daruma will accompany me to the hospital, assuming I can borrow a pen from a nurse to color in one eye. The Japanese saying that goes with the daruma is "nana korobi yaoki" (translation: fall down seven times, get up eight). The dolls have a rounded base, so you can try to knock them down, but they'll just pop up again. You know, like Weebles, they wobble but they don't fall down.
And this is a maneki neko, the good luck cat of Japan. I'm trying to find a red one to bring to the hospital (wards off illness), but otherwise I'll bring my little white one. I hope the Seventh Day Adventist hospital doesn't mind me bringing Zen Buddhist charms!
Meanwhile, after months of reading angst-filled posts on the forum, I've asked my husband to hide our scale while I'm in the hospital. He can bring it out once a month, but has been instructed to otherwise keep it locked away where I can't get to it! I don't want to obsess over minor stalls or water weight gain. Once a month, I will weigh myself and take measurements (so I'd better have him hide the measuring tape too!).
6 April 2005
I'm back from the psychiatric exam! That was an odd experience. Oh, not the exam itself, but the journey... Maureen is the bariatric program coordinator for Washington Adventist, and she also handles some of the psych exams. I had a 10am appointment with her, so I left the house at 9am. Around here, it's still rush hour at that time. There are two basic routes I could take to the hospital (where the exam is done). Tried one way, and couldn't even get out of my neighborhood because of construction plus the normal volume of traffic. I wasted a lot of time before pulling a U-turn to head to the other route. In all it took me 45 minutes to drive the 9 miles. This left just enough time to go through the admissions process (the exam is handled as a hospital outpatient procedure)
I ask the admissions clerk how to get to Maureen's office. "Take the elevator to the 2nd floor. They said it would be self-explanatory after that." Um, okay. On the second floor I see two closed wards plus the social work office. So I ask the SW receptionist where to go. "Go through the door marked 'Ward 2100', then press the intercom button." After a few moments and a quick chat on the telecom, I find myself in the locked psychiatric ward. YIKES! They page Maureen, but she's been called away for something and I have to wait a few minutes. In the locked psychiatric ward. Ah, she's available, so they send me to her office, which is *outside* the locked psych ward. I couldn't help but wonder if this was a test to see if I was mentally stable enough for surgery! :-) Maureen noted that perhaps future patients should be sent directly to her office instead of into the ward... the evaluation itself was painless. We talked about my life a bit, and about post-op life. I filled out a brief self-evaluation form, but it was nothing like the marathon test-taking that so many others have experienced.
Next step is the pre-op class next Tuesday.
10 April 2005
We went to Tysons Corner Center yesterday to wander around a bit. I stopped off at Lane Bryant to take advantage of my RealWoman dollars whilst my husband skipped off to the Apple Store. Surprise! He bought me a new green iPod Mini! I already had a first-generation iPod (now three years old) that has some issues with maintaining a battery charge, and Erik thought a shiny new (and smaller) one would be perfect to take to the hospital and gym. I'll have to load it with all the soothing new-age music in my collection... or should I bring happy, upbeat, bouncy tunes to the hospital?
Still waiting for my PCP's records to arrive, and for the call from my gyn to announce that those records are ready.
12 April 2005
The pre-op class was today. Most of the information wasn't new, but bear in mind that I went through a prior nutrition class for a different surgeon, plus I've been low-carbing and using Fitday for a few years now. The most useful aspect was the protein drink taste test. Before this class I'd tried and liked Designer Whey, Unjury, GNC 100% Whey, Nectar, Matrix, ProPlete, and IDS (the latter four from bariatriceating.com). At the class we tried MetRX, Atkins, Isopure pre-mixed (something fruity), and a couple others. Except for the Isopure, they were horrible! There was also a soy protein bar which reminded me why I dislike soy protein bars. Oh well, at least I'll know better than to buy the MetRX. Did I mention it was horrible?
20 April 2005
Finally! My PCP medical records are here! I was initially told that I'd probably receive them "by the end of the week." That was April 4. The PCP's office manager investigated yesterday and learned that the records were mailed by their records management company on the 11th. The envelope was actually postmarked the 12th, and arrived on the 20th. Eight postal working days to travel 11 miles? I could have crawled there and picked them up in less time. Oh well, not that it matters because my weight records from the gynecologist haven't arrived yet (were supposed to have been available by the 15th). Arrrgh. I was really hoping to have insurance approval before the end of April, which would get me into surgery in mid-May.
Must try to be patient. It's tough when things are so close, and yet out of your control...
22 April 2005
I called Alfreda at Dr. Harrington's office, and she said not to worry about the earlier records. Hurray! So I brought in my PCP's records (which start in December 2000), plus a printout of my "specialist list" (contact information for my PCP, nutritionist, and personal trainer, plus the dates for every appointment with each of them). I also found a photo time-stamped September 1984. I was 19 in that picture, and must have weighed about 185 pounds. Alfreda said she would fax in the information to Aetna today, and she expected a quick approval based on all my documentation. And she scheduled my surgery date... May 3. That's a week and a half from now! Eeeeeeek! I was able to schedule a PCP visit for Monday (blood work and EKG) and the ultrasound and X-ray for Tuesday. My pre-surgical appointment with Dr. Harrington is Friday. My panic attack starts now.
I have a date!
25 April 2005
Wow, that was a lot of blood in those little tubes. No wonder I felt so goofy afterwards. My PCP was positively giddy about my upcoming surgery! She has a nursing grad student working with her who hadn't dealt with bariatric patients before - when I first saw her on the 4th, she wasn't familiar with the surgeries, but by this visit she had done her research and had lots of questions.
I also had an eye exam today. As long as I was there, I got samples of colored contact lenses (Acuvue 2 in sapphire blue, deep blue, and jade green). My eyes are a very pretty deep brown, but what the heck, maybe I'll get blue contacts before our trip to New Zealand. I'd never pass for an elf, but at least I can be a hobbit!
27 April 2005
Waiting... waiting... I'd bite my nails if I hadn't already bitten them all off. The info was faxed to Aetna last Friday, but they've had a bit of a backlog. Alfreda told them that my surgery date was coming up rapidly, so they've promised her an answer tomorrow. Have I mentioned that Dr. Harrington's staff is the greatest? This process would be astronomically more stressful if I didn't know that two very helpful and efficient people were working hard on behalf of the patients. Thank you Alfreda and Jackie!
The records I requested from my previous gynecologist's office finally arrived. All that waiting for two pages! It turns out that they didn't bother to record my weight on earlier visits, so the first page is from mid 2001, by which time I had already started with my current PCP's office. Consequently, having these records wouldn't have done much good for the insurance process. Good thing, too, since they're not exactly legible.
Those colored contact lenses are amazing. The green ones are more subtle but still dramatic, the dark blue ones are just gorgeous, and the sapphire blue ones are startling. So tempting...
29 April 2005
Everything is official now! I had my final pre-op meeting with Dr. Harrington today, all my tests are done, and Aetna has given official approval. The surgery coordinator at Washington Adventist called this morning to give me my pre-op instructions. My RNY is scheduled for Tuesday at 2:30pm. I definitely have it easier than many others here - Dr. Harrington doesn't require a pre-op liquid diet or bowel prep. All the rooms at the hospital are private, too.
My "before" photos:
30 April 2005
Ah, last meals. I've decided to eat very lightly for the two days prior to surgery, so I've had a few final feasts in the past week. No, I didn't go completely overboard, honestly! (I even lost a pound) On the Friday that I got my surgery date, we had already made reservations at The Melting Pot for a leisurely fondue dinner. Last dim sum outing was on Monday at New Fortune in Gaithersburg MD. I can still do dim sum after surgery (maybe, possibly, hopefully, pretty please?), but certain items will be too starchy or sugary for post-op consumption. And this evening we went to Cantler's Riverside Inn for a crab feast with friends. Crabmeat should be great post-op, but certainly not in this kind of quantity, or with butter-dipped hushpuppies on the side!
Tomorrow, it's protein shakes and chicken noodle soup. Whee.
1 May 2005
Such strange dreams last night, all about my upcoming surgery. In one, I was a bit perturbed to discover that I hadn't brought any clothes to wear home except my short nightgown, and I was hoping people would mistake it for a sundress (it does look like one, come to think of it). My subconscious was kindly trying to remind me that I need to alter a loose cotton dress that Jodi gave me, because I had planned to wear it to and from the hospital but hadn't shortened the hem yet. As it is, it puddles on the floor. It's hard being this short sometimes!