Neil Fishman
From My Old Profile
Jan 27, 2008
/10/02 well, it's been a wild ride. I started the proccess in february, went for the overnight sleep study because I knew I had sleep apnea. The endocrinologist, gastroenterologist, psych consult, etc all went without a hitch.
UNTIL I went to the cardiologist. EKG Normal, Echocardiogram inconclusive. He orders a Nuclear stress test. I get a phonecall from the cardiologist that the test is "positive but inconclusive" and that the cardiologist will call the surgeon. He sends his report to the surgeon, and refuses to clear me for surgery. The cardiologist tells me on the phone that my stress test showed heart wall damage, and that I needed an angiogram (cardiac catheterization) to really diagnose the problem. The problem is the maximum wight on the table for the test is 400 lbs, and that I weigh over 430. His adivce was "lose 50 lbs and give me a call."
I felt like giving up. I cant get the surgery, I'm a diabetic, and now I'm in heart failure. I cant be treated, and I cant exersize to try to lose weight. I seriously considered suicide.
Luckily, an angel of a friend reccommended another cardiologist to me. He called me at home at 8PM, because my friend explained my case to him. He asked me to fax him the cardiologist report in the morning. I did, and he called me by 9:30am. he got the report, and he says the films of the stress test were so bad there's no way he could have concluded anything. He wrote on the report that my ejection fraction was 35% (the percent of blood your heart pumps with each beat. 55-75% is normal. anything below 40% is considered heart failure.) The 2nd cardiologist asked me to come in for re-evaluation THAT DAY. He repeated the EKG and the echocardiogram, and both were normal. my EF was 60%. He said an angiogram was an invasive, unneccessary procedure, and he sent me to the cardiac care center at the hospital for a debeutamine contrast stress echocardiogram, the very next day. The test was normal, and I got my cardiology clearance.
5/15/02 Hi folks,
My surgery is tomorrow, and I just wanted to post and thank everyone that emailed me with advice, support, encouragement, and positive energy.... thank you all.
Today didn't go uneventful. I got a call this morning that my primary care physician never faxed over his final evaluation clearance to the surgeon's office. His office didn't open till noon. When I finally got through on the phone, his receptionist nonchalantly tells me that it's in my chart, and she'll fax it "soon."
I tried to stay polite, I really did. I explained that this was critical, that without the clearance, my surgery for tomorrow would be cancelled, could she PLEASE fax it for me now while I waited on the phone for confirmation. She said no, and hung up. I called back, and got the office manager/Doctor's wife on the phone. After another "Don't worry, we'll get around to it 'soon'", I threatened to ride to the office, go behind the desk and fax the damned thing myself, and beat the crap out of anyone that got in my way. It got faxed while I was on the phone.
The moral of the story is simple. Doctor's aren't God. their time isn't any more important than your's. If they overbook and overschedule and overwork their staff, that's their fault, not yours. I believe that when i choose a Doctor, they are working for ME. I am their employer. I hire them to perform a service for me. I dont treat or put my doctors in any higher esteem than I would a plumber or carpenter. Never let your Doctor's bully you, dismiss you simply because they're prejudiced about obesity, or because they have better things to do. YOU are your own best advocate. Take command of your own care, ask the hard questions, and choose a doctor or surgeon as if you were interviewing someone that you're hiring to work for you, because that IS the bottom line... They work for YOU.
Off my soapbax now. If you read this before 10 am Thursday, send some positive energy my way. With my high BMI, I may need it. I dont have an angel. I'll post as soon as I'm home and up to doing my post-surgical griping. ;-)
5/21/02 Hi folkses,
Well, here I am. Here's my update. Surgery was Thusday, May 16th at 7:30a, and lasted a little over 3 hours. When I woke up in recovery, I had terrible neuralgia (numbness) in both my hands from the wrists down. I couldnt feel a thing, and it scared the heck out of me. I woke up asking the nurses in recovery to let me stand up (it's all YOUR fault, Nancy!)
I stayed in recovery for almost 12 hours, constantly being reaccessed by Dr. Nicastro (who did all my post-surgical care.) Actually, I never even saw Dr. Macura. The only reason I know he was there was because he was the one who came out to talk to my family after surgery. At 10PM, Nicastro finally decided I was stable enough to go to the med/surg ward, and not ICU. In my haze, I knew that was a good sign. The first thing I asked for was a spirometer. The nurse was hesitant, but I told her I would feel better if it was on my tray when I woke up. Through the night, every time I woke up, I took off my cpap masked and used the spirometer as best I could, put the cpap back on, and fall back out.
Friday morning, 6AM. My hands numb, my ass aching, I couldnt take it any more. I figured out where the controls for the bariatric bed were, and I sat up. The nurse came in, and I asked her to help me stand. She said she needed Doctor's orders before I could get out of bed, and I told her that Nicastro had written orders in my chart that I should be helped out of bed as soon as possible. She got two attendants, And I stood up, and walked in place at the foot of my bed for about 15 minutes. At 10AM, the day nurse brought in the Big Comfy Chair and told me I should sit up for at least 1/2 hour. I got out of bed myself, and walked around to the chair. that's when I saw the liquid seeping from my hand. My IV had infiltrated. Like Catherine said, at least 8 people tried to find a vein. The poked me at LEAST 30 times. Finally, The Cheif Resident came in and found a vein. I sat in that torture chair for 3 1/2 hours with no morphine (because the IV/PCA wasnt working. Oh, and by the way, that first cough happened while sitting in the chair was by far the worst pain I have ever felt in my life. But I brought up a huge ammount of material, so maybe the whole ordeal was a blessing in disguise.
From there, every day got a bit easier. They removed the catheter on Saturday, which gave me a little more mobility. I spent alot of time sitting in the chair, and pacing near my bed. by saturday afternoon, the feeling in my hands started coming back. That was a big relief, as I was starting to think nerve damage. I had made up my mind to spend as little time as possible actually IN bed during the day. I was allowed ice chips by Friday evening, clear liquids on Saturday afternoon.
Sunday I went on Phase II diet (pureed foods) And during morning rounds Dr. Nicastro sat down and talked to me. He's truly a wonderful man. He said he had real apprehensions about during the surgery on me, because of my high BMI, and that I carry so much of my weigh in front of me. He was really worried I would develop respiratory problems. He says I was the best patient he ever had. He said that was strictly because of myself, because he had never seen someone as well informed, as pigheadedly motivated and so absolutely dedicated to my own recovery. I told him straight out that it wasnt all me, that my friends here on the support groups that motivated me, drilled into my head what I needed to do. I suggested that the support group links be included in his patient guidebook, and I really think he's going to do it.
Sunday afternoon the gas pains started. I remembered the advice, grabbed my IV pole, and started walking circles around the ward. I have to laugh, and only post-ops will appreciate this, but we now now the exact path a fart takes thru the human body. You can feel that first sucker weaving it's way through. When I finally delivered that little bundle of joy, it was like a celebration. In all of written history, there is nothing so over-rated as sex and as under-rated as a good fart.
Monday morning, Nicastro and the Cheif Resident make rounds, and I advise them That I was able to take food, and I had bowel movement. He just shook his head and mutted, "amazing." He checked my JP drain outputs, and decided they could be removed before I left the hospital that morning. I was discharged by 10am Monday morning, and home sitting on my porch by 11am.
I slept comfortably last night on my lift-chair recliner (what a godsend), and woke up to nausea this morning. 2 ritz crackers cured that. For breakfast, I had 1 whole egg plus one egg white salad really well mushed on 1/2 slice of whole wheat toast. It tasted like a feast. I followed that 45 minutes later with a 6 oz cup of decaf coffee, and have been sipping water all afternoon. Oh, and I'm not on any pain meds at all. It's hard standing up, but I'm feeling amazingly well, considering today is only the fifth day out.
7-31-2003... Yup, It's 14 months later. I apologize for not updating this sooner. I've been busy with work, life, the message boards, and telling my story. I'll cut to the chase; I'm healthy, happy, and living life. the diabetes - Glugophage, Glucotrol, and 200 units of insulin a day... are all gone. The C-pap machine has been donated, no more sleep apnea. Off all medications. I can Walk, breathe, sleep, swim, play, and have been reborn. May 16th, 2002 is now officially my re-birth day. Ok... I am now 248 lbs... a loss (so far) of 193 lbs. For the first time in years, I'm living, not just surviving. If you want more details, e-mail me. Oh yeah, and thank you all that helped me along the way... you know who you are.
Neil
11/16/03 Ok, 18 months, 238, a total loss of 203 lbs. I know, I only lost 10 lbs since my last post. No excuses, I've been screwing around. After 8 years of diabetes and insulin, I've been living life. For awhile, I went through this stage of denial... not wanting to think about the surgery, the obesity, of where I've been, and just be who I am now. So yes, I'm eating too much, too many carbs, and too many deserts. I walk alot, but don't exercise enough. No excuses, except to say I'm human, and all my old habits are still there. I didnt get to 450 lbs because I wasnt lazy and had great self-control to begin with. But fun-time is over, and I'm back on track. I recently spent a week in Aruba. Snorkeling, riding ATV's over the desert, riding waverunners, climbing in and out of boats... being human, and active. I have a life again. I'm starting to get to the point where it's finally sinking in that I'm not obese anymore. The binge was actually a positive step, that I could be human, and not gain weight. The BPD/DS gives you that latitude over the RNY. I went to see a broadway show last night... and didnt worry about fitting in the seat, or walking the stairs. It was actually the 1st time I did it without thinking to myself, "hey, I did it," I just did. I was just being me. That was a huge thing to realize... that I'm getting comfortable being the new me. Well, hopefully, with some excersize and some healthier food choices, I can drop these last 40 lbs or so and start considering plastics for the skin.
Neil
UNTIL I went to the cardiologist. EKG Normal, Echocardiogram inconclusive. He orders a Nuclear stress test. I get a phonecall from the cardiologist that the test is "positive but inconclusive" and that the cardiologist will call the surgeon. He sends his report to the surgeon, and refuses to clear me for surgery. The cardiologist tells me on the phone that my stress test showed heart wall damage, and that I needed an angiogram (cardiac catheterization) to really diagnose the problem. The problem is the maximum wight on the table for the test is 400 lbs, and that I weigh over 430. His adivce was "lose 50 lbs and give me a call."
I felt like giving up. I cant get the surgery, I'm a diabetic, and now I'm in heart failure. I cant be treated, and I cant exersize to try to lose weight. I seriously considered suicide.
Luckily, an angel of a friend reccommended another cardiologist to me. He called me at home at 8PM, because my friend explained my case to him. He asked me to fax him the cardiologist report in the morning. I did, and he called me by 9:30am. he got the report, and he says the films of the stress test were so bad there's no way he could have concluded anything. He wrote on the report that my ejection fraction was 35% (the percent of blood your heart pumps with each beat. 55-75% is normal. anything below 40% is considered heart failure.) The 2nd cardiologist asked me to come in for re-evaluation THAT DAY. He repeated the EKG and the echocardiogram, and both were normal. my EF was 60%. He said an angiogram was an invasive, unneccessary procedure, and he sent me to the cardiac care center at the hospital for a debeutamine contrast stress echocardiogram, the very next day. The test was normal, and I got my cardiology clearance.
5/15/02 Hi folks,
My surgery is tomorrow, and I just wanted to post and thank everyone that emailed me with advice, support, encouragement, and positive energy.... thank you all.
Today didn't go uneventful. I got a call this morning that my primary care physician never faxed over his final evaluation clearance to the surgeon's office. His office didn't open till noon. When I finally got through on the phone, his receptionist nonchalantly tells me that it's in my chart, and she'll fax it "soon."
I tried to stay polite, I really did. I explained that this was critical, that without the clearance, my surgery for tomorrow would be cancelled, could she PLEASE fax it for me now while I waited on the phone for confirmation. She said no, and hung up. I called back, and got the office manager/Doctor's wife on the phone. After another "Don't worry, we'll get around to it 'soon'", I threatened to ride to the office, go behind the desk and fax the damned thing myself, and beat the crap out of anyone that got in my way. It got faxed while I was on the phone.
The moral of the story is simple. Doctor's aren't God. their time isn't any more important than your's. If they overbook and overschedule and overwork their staff, that's their fault, not yours. I believe that when i choose a Doctor, they are working for ME. I am their employer. I hire them to perform a service for me. I dont treat or put my doctors in any higher esteem than I would a plumber or carpenter. Never let your Doctor's bully you, dismiss you simply because they're prejudiced about obesity, or because they have better things to do. YOU are your own best advocate. Take command of your own care, ask the hard questions, and choose a doctor or surgeon as if you were interviewing someone that you're hiring to work for you, because that IS the bottom line... They work for YOU.
Off my soapbax now. If you read this before 10 am Thursday, send some positive energy my way. With my high BMI, I may need it. I dont have an angel. I'll post as soon as I'm home and up to doing my post-surgical griping. ;-)
5/21/02 Hi folkses,
Well, here I am. Here's my update. Surgery was Thusday, May 16th at 7:30a, and lasted a little over 3 hours. When I woke up in recovery, I had terrible neuralgia (numbness) in both my hands from the wrists down. I couldnt feel a thing, and it scared the heck out of me. I woke up asking the nurses in recovery to let me stand up (it's all YOUR fault, Nancy!)
I stayed in recovery for almost 12 hours, constantly being reaccessed by Dr. Nicastro (who did all my post-surgical care.) Actually, I never even saw Dr. Macura. The only reason I know he was there was because he was the one who came out to talk to my family after surgery. At 10PM, Nicastro finally decided I was stable enough to go to the med/surg ward, and not ICU. In my haze, I knew that was a good sign. The first thing I asked for was a spirometer. The nurse was hesitant, but I told her I would feel better if it was on my tray when I woke up. Through the night, every time I woke up, I took off my cpap masked and used the spirometer as best I could, put the cpap back on, and fall back out.
Friday morning, 6AM. My hands numb, my ass aching, I couldnt take it any more. I figured out where the controls for the bariatric bed were, and I sat up. The nurse came in, and I asked her to help me stand. She said she needed Doctor's orders before I could get out of bed, and I told her that Nicastro had written orders in my chart that I should be helped out of bed as soon as possible. She got two attendants, And I stood up, and walked in place at the foot of my bed for about 15 minutes. At 10AM, the day nurse brought in the Big Comfy Chair and told me I should sit up for at least 1/2 hour. I got out of bed myself, and walked around to the chair. that's when I saw the liquid seeping from my hand. My IV had infiltrated. Like Catherine said, at least 8 people tried to find a vein. The poked me at LEAST 30 times. Finally, The Cheif Resident came in and found a vein. I sat in that torture chair for 3 1/2 hours with no morphine (because the IV/PCA wasnt working. Oh, and by the way, that first cough happened while sitting in the chair was by far the worst pain I have ever felt in my life. But I brought up a huge ammount of material, so maybe the whole ordeal was a blessing in disguise.
From there, every day got a bit easier. They removed the catheter on Saturday, which gave me a little more mobility. I spent alot of time sitting in the chair, and pacing near my bed. by saturday afternoon, the feeling in my hands started coming back. That was a big relief, as I was starting to think nerve damage. I had made up my mind to spend as little time as possible actually IN bed during the day. I was allowed ice chips by Friday evening, clear liquids on Saturday afternoon.
Sunday I went on Phase II diet (pureed foods) And during morning rounds Dr. Nicastro sat down and talked to me. He's truly a wonderful man. He said he had real apprehensions about during the surgery on me, because of my high BMI, and that I carry so much of my weigh in front of me. He was really worried I would develop respiratory problems. He says I was the best patient he ever had. He said that was strictly because of myself, because he had never seen someone as well informed, as pigheadedly motivated and so absolutely dedicated to my own recovery. I told him straight out that it wasnt all me, that my friends here on the support groups that motivated me, drilled into my head what I needed to do. I suggested that the support group links be included in his patient guidebook, and I really think he's going to do it.
Sunday afternoon the gas pains started. I remembered the advice, grabbed my IV pole, and started walking circles around the ward. I have to laugh, and only post-ops will appreciate this, but we now now the exact path a fart takes thru the human body. You can feel that first sucker weaving it's way through. When I finally delivered that little bundle of joy, it was like a celebration. In all of written history, there is nothing so over-rated as sex and as under-rated as a good fart.
Monday morning, Nicastro and the Cheif Resident make rounds, and I advise them That I was able to take food, and I had bowel movement. He just shook his head and mutted, "amazing." He checked my JP drain outputs, and decided they could be removed before I left the hospital that morning. I was discharged by 10am Monday morning, and home sitting on my porch by 11am.
I slept comfortably last night on my lift-chair recliner (what a godsend), and woke up to nausea this morning. 2 ritz crackers cured that. For breakfast, I had 1 whole egg plus one egg white salad really well mushed on 1/2 slice of whole wheat toast. It tasted like a feast. I followed that 45 minutes later with a 6 oz cup of decaf coffee, and have been sipping water all afternoon. Oh, and I'm not on any pain meds at all. It's hard standing up, but I'm feeling amazingly well, considering today is only the fifth day out.
7-31-2003... Yup, It's 14 months later. I apologize for not updating this sooner. I've been busy with work, life, the message boards, and telling my story. I'll cut to the chase; I'm healthy, happy, and living life. the diabetes - Glugophage, Glucotrol, and 200 units of insulin a day... are all gone. The C-pap machine has been donated, no more sleep apnea. Off all medications. I can Walk, breathe, sleep, swim, play, and have been reborn. May 16th, 2002 is now officially my re-birth day. Ok... I am now 248 lbs... a loss (so far) of 193 lbs. For the first time in years, I'm living, not just surviving. If you want more details, e-mail me. Oh yeah, and thank you all that helped me along the way... you know who you are.
Neil
11/16/03 Ok, 18 months, 238, a total loss of 203 lbs. I know, I only lost 10 lbs since my last post. No excuses, I've been screwing around. After 8 years of diabetes and insulin, I've been living life. For awhile, I went through this stage of denial... not wanting to think about the surgery, the obesity, of where I've been, and just be who I am now. So yes, I'm eating too much, too many carbs, and too many deserts. I walk alot, but don't exercise enough. No excuses, except to say I'm human, and all my old habits are still there. I didnt get to 450 lbs because I wasnt lazy and had great self-control to begin with. But fun-time is over, and I'm back on track. I recently spent a week in Aruba. Snorkeling, riding ATV's over the desert, riding waverunners, climbing in and out of boats... being human, and active. I have a life again. I'm starting to get to the point where it's finally sinking in that I'm not obese anymore. The binge was actually a positive step, that I could be human, and not gain weight. The BPD/DS gives you that latitude over the RNY. I went to see a broadway show last night... and didnt worry about fitting in the seat, or walking the stairs. It was actually the 1st time I did it without thinking to myself, "hey, I did it," I just did. I was just being me. That was a huge thing to realize... that I'm getting comfortable being the new me. Well, hopefully, with some excersize and some healthier food choices, I can drop these last 40 lbs or so and start considering plastics for the skin.
Neil
