Rants and Raves About My Journey Through Bariatric Surgery

Wednesday, February 24, 2010

Webster's Dictionary defines the word "ready" as. . .

READY: prepared mentally or physically for some experience or action; prepared for immediate use; willingly disposed; inclined; likely to do something indicated, displayed readily and spontaneously.

No this is not the start of a 3 paragraph high school theme paper. The word "ready" is important for a few reasons. First, every time I tell someone about my plans for surgery, inevitably the 2 questions they ask are, "Are you nervous?" and "Are you ready?" My answers never change. No, I'm not nervous and yes, I'm ready. But the more important reason the word "ready" matters is because this past week, I finally understood what it meant to be ready for this surgery and for the change that will come from it.

After a successful visit to the cardiologist this week, I found out that my heart murmur, while noticeable, is very mild and no cause for concern. There is no reason to treat it at this point and my only limitation is that I see a cardiologist every year to make sure it doesn't get any worse. So that means, I have received clearance from all 3 of the consults I needed. My file is now complete and ready to be sent to the insurance for approval when the time comes.

Even that is not really being ready for all of this. That happened sometime between last Tuesday and last Friday. I don't know exactly when it hit me (isn't that the case with most revelations?) but I know for sure the readiness was there last Friday, Feb 19. I know this because I willingly walked into a local fitness place and joined. And then I had some other errands to run, but when I was done. I went home and changed and went BACK to the gym and worked out for almost 45 minutes. If you know me at all, the sheer fact that I was willing to do this is a shock. And you will be even more shocked to know that I went back on Sunday, Monday, and again tonight. The gym thing could be scary. I'm so overweight and there is a temptation to let my mind wander into how the other people at the gym could be judging me. And I'm not really able at this point to run on a treadmill for an extended period of time or spend more than about 15 minutes on a bike or cross trainer. Those things could scare me, but I'm handling all just fine, taking it all at my own pace. (PS- Just in those first 4 days of cardio, I've dropped 4 pounds).

The true feeling of ready is an acceptance of the fact that I've made mistakes in the past regarding food, exercise, and my weight. And its not about making myself feel guilty for those mistakes, its about starting to make the right choices NOW. I can't change the decision I made last month not to take advantage of some gyms beginning of the year deals. And I can't change the 25 pounds I let myself gain after last spring's bad break up. What I can do is challenge myself to eat healthier today and plan for tomorrow so those choices are easier. And I can will myself to go to the gym and figure out how to work the ellipticals, the weight equipment, and that weird stair-mill thing.

So while you may not feel it or see it, I am already a changed woman. I can feel it way down in my core (which happens to be killing me after a particularly grueling yoga class this evening). And I can not WAIT to get this surgery scheduled and to have the procedure to make this process go smoother. So if you see me, go ahead and ask me. My answer now more than ever is, "Yes, I am READY!"

Monday, February 22, 2010

February's Work

FEB 2, 2010
This is the day of my first 'group meeting' through the surgeons office. I'll admit I was a little nervous going into this. I wasn't exactly sure what a 'group meeting' involved and since I rarely consider myself a joiner, that kind of meeting seemed a little much for me. But as its all part of the process, I conjured up my bravery and set off to the meeting. I checked in at the surgeons office and was weighed in (actually GAINING weight from my last appointment). Then I was sent off to a conference room, where my fellow surgery patients awaited the start of this meeting. Promptly 45 minutes after the designated start time, the nurse began to talk. (By the way, have I ever told you how much late people bug me? If I'm on time, shouldn't you be too? Just saying. . .) The one thing that strikes me about the surgeon's staff is that most, if not all of them, are former bariatric patients. I guess that is a good way to be able to relate to your patients and it definitely gives them an understanding of whats going on. In my experience, it also gives them an attitude of "been there, done that," which I'm not exactly appreciating right now. It was during the nurses not so rousing pep talk, that I realized that this meeting was more like a lecture on the insurance process and how we should all be on a 1200 calorie diet starting now. Yeah right. A nutritionist came in to talk about our diet over the next 3 months. I don't care what anybody else says, if you're overweight, you NEVER want to hear a size 2 lecture you on eating habits. As soon as she walked in the door I completely zoned out. Like she has ANY idea about eating habits of an obese person (and no, she wasn't one of the former surgical patients- THAT would have been an advertisement). So basically what I took away from that meeting was, for my insurance to pay for my surgery, I have to show a good faith effort and lose 6 pounds over a 3 month medically supervised weight loss period. 6 pounds total? Sounds easy enough to me. Now, can the ultra thin, anorexic looking nutritionist PLEASE SHUT UP?!? (Actually after the insurance talk, she did shut up. And the silence was the best thing I'd heard all day).

FEB 11 & 12, 2010
11 days into the month and I finally got my new insurance card for my new insurance carrier. I quickly faxed it over to my favorite insurance specialist at the surgeons office. The next day, I received a call from her that I finally have confirmation that I am DEFINITELY covered by insurance for some form of bariatric surgery. I still don't know which ones, but according to the insurance specialist, my new carrier is very good about covering whatever the doctor requests. So that was a VERY good day.

FEB 16, 2010
Its echo day! I'm mostly excited about this test, but I have NO idea why. Why would I be excited about getting pictures taken of my heart? I don't know, but I am. I was also excited that I took the whole day off for this test, but I didn't have to be there until the afternoon, so I spent the morning watching Olympic curling. I still don't fully understand that sport, but I like watching it! Anyway, I got to the office, met my echo tech and we got right to work. She started by taking the regular echo pictures. Mostly that didn't really involve anything major for me other than laying on the exam table quietly, but there were some times I felt like she was really jamming that wand in to my chest. And I don't care how hard you push, my ribs aren't going anywhere. Then, she hooked me up to a 10 lead EKG (which doesn't sound like much but that's a lot of wires hanging off your chest!) and called in a nurse for my stress echo. Now, I'm going to try to make this next part seem as dramatic as it actually was, but I will warn you that it seemed like a really BIG deal at the time. So, they put me on a treadmill and asked me to walk. The first 3 minutes were nice and slow. Then the treadmill jumped speeds and it was a little faster. At some point I asked how long I would be on the treadmill and the answer was until my heart rate reach 190 bmp. Are you F-ing kidding me? 190?!?!? So I walked for the next 3 minutes until the treadmill jumped speeds again. I'm not a runner and probably hadn't been on a treadmill since high school gym class! This was getting WAY out of control and I could hardly keep up! I made it about 8 minutes and my heart rate hit 185bmp when the nurse called it. And when I say she called it, I mean: she hit a red PANIC button on the treadmill which DEAD STOPPED while I was walking/running on it. Not cool. Then the echo tech was yelling for me to get on the table for the echo because apparently she only had 1 minute to get all the pictures of my heart she needed OR, I'D HAVE TO DO THIS ALL OVER. NO THANK YOU! (Note: This is still stressful for me and I'm typing this part SO fast. . .time to slow it down. . .) But everything worked out well and she got all pictures she needed. Start to finish, I was only in the doctors office for about 45 minutes. Well, I'm glad a took an ENTIRE day of vacation for this, but I did glimpse my Cardio-god on the way out. Also on the positive side, before my echo, my blood pressure was pretty high. After it was over, it had dropped back to a normal level, which the tech said was a side effect of the exercise.
Now doesn't that just open a brand new can of worms?

So I'm still awaiting my echo results. I have an appointment tomorrow for those. And I've made some progress on the side effects of exercise, and that will be my next post.

Friday, February 19, 2010

Consult For Me Again, Dr McDreamy

JAN 28, 2010
Well cardiology day had finally arrived and it didn't take long to realize I'd found myself a true, blue Cardio-god (another 25 bonus points for the TV reference) for a specialist. (if you can't already hear it, imagine a soft angelic choir singing "ah-AH" in major chord progressions). I will admit that the nurse cracked me up, mostly because I was unintentionally cracking her up. So she came in, took the usual history, my pulse, and my blood pressure. Then she got up and handed me a gown, asked me to undress from the waist up and then left me alone. Ok, no problem. A few minutes later, she came back with this machine on a cart and asked me to lay on the examining table. Again, I can do that. Then she gets out all this little sticky pads and starts putting them all over me. Now you should know, that I'm pretty much game for whatever, but that I've never (to my knowledge) had any tests done on my heart, so I had no idea what was going on. So I asked the nurse exactly what she was doing and she said, "Setting up your EKG." Oh, ok. Wait. "What exactly is an EKG?" She looked at me and started laughing as she apologized saying that she never sees new patients and forgot that I wasn't a regular at this. It was at that point that she fully told me what was going on, which basically included me laying flat on a table for about 3 minutes. I like these kind of tests.

After a few more minutes, the doctor himself walked in. Now, I've been keeping my posts fairly anonymous as not to throw specific people under the bus, but I'm going to tell you my cardio doc's name mostly because if you have heart issues, you should demand to see him. Even if you don't live near Chicago, the drive might be worth it. Anyway, Dr J Stella came in to talk about my heart and the surgery and my EKG results.
Its important to note here that every one's heart operates slightly differently than the next person. Most of cardiology is based on generalizations. And, if every person went to have their ticker checked out, they would probably find out at least one way that they vary from the 'norm.'
Knowing that, what Dr. Stella told me was he found 1 smallish issue in my EKG. The first was that I have a Right Bundle Branch Blockage (RBBB). Ahhh-that sounds bad! But, alas, it is not. Basically as the good Dr explained, the heart has 4 chambers, 2 atria that sit atop 2 ventricles divided into right and left sides by a muscle called the septum. My understanding is that the septum between the right and left side of the heart is where the electrical impulse comes from to make the heart contract (beat). In a 'normal' heart, the impulse travels down the septum to the bottom of the heart and then up the sides of the ventricles to the atria, where the charge meets again. In my slightly abnormal heart, the charge goes down the septum but only travels up the left side, in a circular motion until it gets all the way back around to the septum. Dr Stella informed me that this is very common and is not a cause for concern. In fact, according to a study(that he actually quoted to me because he rocks) there is no evidence that a RBBB is a precursor or predeterminite factor for heart problems later in life. Score!
[Sidebar: I'm not a doctor, not a cardiologist, and have a little (but not much) medical training. Don't use me as a source. And do NOT skip seeing a cardiologist because I told you a RBBB is no big deal if you think you have one. Let your cardio-god tell you himself!]

My second issue Dr Stella found after listening to my heart was that he believed I have a small heart murmur. Again, that sounds bad. Unfortunately this time, he wasn't able to assure me so quickly that I needent worry about it. What we did do was schedule me for an echocardiogram (an ultrasound of the heart) and a stress echo (where they do the echo after exercise) for about 2 weeks out. And basically I get to stew over that diagnosis for the 3 weeks until my next appointment with him! (PostScript- At one of my best DQ moments, I did tell someone that they were aggravating my heart murmur. That was actually kind of fun)

See? What did I tell you all about 4 posts ago? If I was going to fail any portion of these consults it was going to be cardio. I haven't technically failed, but I've definitely been shuffled to the remedial section of class. More on the echo portion and my first "group meeting" at the surgeons office soon!

Thursday, February 18, 2010

Consults, Part 1

JAN 21, 2010

Today, my surgical clearance consults began! I began my morning with a venti, non-fat, no whip white mocha at Starbucks and I was off to visit the psychologist for a written exam. As I entered the office I found the place to be comforting and quaint (which is probably good for that kind of office), but there were these weird machines all over the place making strange noises and the whole office smelled like oranges. I had trouble figuring the place out. The receptionist put me in a room with a laptop and a desk. As she was explaining to me the procedure, I learned that there was a questionnaire about eating habits and weight loss. Then there was an 'exam' of sorts on the computer that asked all sorts of questions about my personality that was about 180 questions long. Then, she said the final 'exam' on the computer was 500 questions long. Seriously?!? You want me to answer 680 questions about my personality? The thought running through my head was, "You're gonna fail, you're gonna fail, you're gonna fail." Great, where do I put THAT thought? (Again MSN, still waiting on that sarcasm font). But I sat down and got to it. Really most of the questions were true/false or yes/no and a good majority of them looked very similar, mostly like, "Do you hear voices?" "Is the man in your TV trying to tell you something?" "Do you feel like there is someone standing over your shoulder right now?" Ok, I'll have to admit, I did look behind me after that one. So how do I answer? For the long test, all questions were T/F so I kind of got in a rhythm to get them answered quickly and I think I missed about 4 questions. So all in all, not so bad.

JAN 22, 2010
The next day, I had to go back to the office with the strange machines on the floors that smelled like oranges to meet with my shrink. I've never seen a shrink, except when my parents divorced when I was about 7. But that really doesn't count because I distinctly remember lying to that guy. (Hmmm maybe shouldn't tell my new shrink about that one huh?) The first thing he did after introducing himself was explain to me that the machines on the floor were white noise so people couldn't hear conversations of the patients. Ahhh, light dawns on Marblehead. (50 bonus points if you get the 80s movie reference). Now, you have to understand that I felt like a was pretty messed up in the head and I wasn't exactly sure how this was going to go. I had made myself a promise that I would be completely honest, no matter how crazy it made me sound. But you know what? Some of you might disagree, but according to my shrink, I'm perfectly normal in my brain. Whoa! Seriously?!? The 3 issues that I thought for sure I'd get hung up on were my parents divorce, my grandmothers death, and a particularly painful breakup. Nope, my reactions and feelings were normal, normal, and slightly vengeful, but normal. All I can say is: ?!?!?!? He asked my about bariatric surgery and my ability to follow through. And I was surprised at how much I actually knew about the procedure and the recovery process (I HAD been doing a lot of research). At the end of my hour, he shook my hand and told me he'd write up my clearance and get it sent to the surgeon in about a week. Wow! This was the most painless process.

One down. 2 to go.

JAN 26, 2010
Its pulmonology day! I will admit that I was slightly annoyed that I had to take off work to go see this guy because "he only sees new patients during the day." I don't find that practice to be all that accommodating, but really what his office was telling me was, show up and I'll sign your permission slip. Basically my clearance procedure included a tech of some sort sticking me in a chamber and sealing it off and making me breathe oddly in a tube. That process took about an hour. Then I waited almost another hour to see the doctor. He and I spoke for exactly 6 minutes and he said, "Thanks for coming in. Good luck with surgery." I physically watched him write "CLEARED" in big sloppy handwriting on the jacket of my chart. As I walked up front to check out, he tossed my chart and the receptionist and said, we have a form letter in the file. Put her name on it and send it to the surgeon. Well thanks for your time, Doc. By the way, did you want to look at the chest Xray you requested? No, you think the radiologist had it under control? Oh yes, I feel super confident in your abilities.

Now I have 2 done and cleared. Just the cardiologist left and more on him in my next post!