Wednesday, July 9, 2014

July 8, 2014

Heya, Critters!

As you know, today was the day I've been waiting for for exactly one month and four days! Who's counting, though? ;)

I actually managed to sleep last night. The nervousness did not kick in until we pulled up to the office building. I signed in, filled out my paper work, and sat in the waiting room for almost 30 minutes. Knowing what a busy practice this is, I was expecting to wait past my appointment time, but with all the nerves and anticipation I was filled with, that time just ticked by.

Everyone I met today was incredibly nice, polite, and genuinely seemed to care about me. This is not a feeling I'm used to at any medical office, especially from a staff full of pencil thin, gorgeous women. Being tall AND large, I always feel judged in some way. Today, these women did not look at me like a fat slob, but like a person taking charge of my health and doing what I could to better myself. That was a feeling I truly appreciated.

My surgeon was just as personable and knowledgeable as I thought he'd be. Even his facial expressions showed he was actively listening to what I had to say and he was truly invested in my health and my journey to become healthier. They're such a busy center, they let us know if they did not think bariatric surgery was right for the patient, they would tell them so and try to help find other ways to lose weight/get healthy. After carefully reviewing my personal health/weight history, and that of my family, my surgeon deemed that bariatric surgery was definitely going to help me. I am a perfect candidate for it, especially being "so young." 31...I certainly don't feel like someone people would consider "young!"

Before even asking me what surgery option I was considering, my surgeon suggested the two options he thought would be the most beneficial for me: a gastric sleeve and gastric bypass. If you'd like to know more about either option, just click on the phrase. (The links will take you directly to my surgery center's definition pages for the respective surgeries. There are other links once you get to those pages that will give you more information about the process and other types of surgery available, if you're interested.)

The two options my surgeon presented were the two options my husband and I were considering. I expressed my concerns about the surgeries, and he gracefully addressed them, understanding my hesitations, but still let me know which surgery he felt was right for me and why.

The concerns I brought up were with the gastric sleeve, I was worried about the long-term results/effects, as this surgery is relatively new. It hasn't been around long enough to give patients an idea about what they can expect 20-30 years down the road, in regards to further health issues or potentially regaining weight. As far as gastric bypass goes, I was worried about "Dumping Syndrome" (Usually 10-15 minutes after eating a sugary or starchy food, the individual who is “dumping” begins to experience many of the following symptoms: Sweating, Flushing skin, Rapid heart rate, Dizziness, Low blood pressure, Abdominal pain, Vomiting, Diarrhea, Shakiness, and Fainting. *Information taken from the Obesity Action Coalition website*). Since I experience similar "dumping" symptoms on a fairly regular basis with just about everything I eat, I was worried this would escalate and be extraordinarily uncomfortable and significantly limit the types of foods I could eat. As it stands, I already can't eat lettuce AT ALL, and I have a hard time from day to day with other foods, such as cheese, raw vegetables, and meats. This is all since I had my gall bladder removed in 2009 (yep, a month and 3 days before my wedding, I had to have my gall bladder taken out - that was fun!). I also expressed concern about the rapid weight loss documented with gastric bypass procedures. While I do want to lose weight, I don't want to lose it so quickly that I end up with tons of loose skin that prevents me from wearing short sleeves or other clothing that could reveal these not-so-appealing areas of skin.

My surgeon let me know my concerns were valid, and the reason he leaned towards gastric bypass for me over the sleeve was because of the long-term effects. He knew both surgeries would help me, but he didn't want me regretting my decision to get the sleeve a few years down the road on the off chance the weight loss wasn't as aggressive as I was hoping, thus rendering the whole process kind of useless. He knew the chances of me succeeding and meeting my health goals and staying healthy were significantly higher with gastric bypass. My surgeon also said that I was "young enough" to not have to worry about excess skin in the amounts I was afraid of. Skin elasticity apparently remains into your mid-to-late 50's. He also reminded me that muscle-building would help with any of my concerns, as muscle would fill in the areas where my skin did not tighten. He understood my concerns about "Dumping Syndrome," and said my current similar issues needed to be filed in the backs of our minds while we were working together during this process. We may need to revisit it, depending on what the required Endoscopic test reveals. I may have a minor form of IBS that was kicked into gear by having my gall bladder removed, or I could just still be producing too much bile, which causes the random issues. He made it sound like gastric bypass would help get rid of some of the excess bile or make it so it was not produced in quite the same quantities, so in the long term, this surgery might help even those issues.

I have so many tests and other appointments I have to make/keep in the next few weeks and months in order to get things going so I can have this surgery before the end of the year. My surgeon assured me, as long as I kept up my end of things and kept the ball rolling, I would be able to have this surgery before 2014 was up, so I wouldn't have to worry about all my insurance caps and deductibles being reset. It would suck to pay out all this money for appointments and such this year, only to have it be erased and have to pay the full cap all at once next year.

Setting yourself up for bariatric surgery is a process in itself. They even give each patient a checklist to help them make sure all the bases are covered.

I have to attend at least 2 pre-op support group meetings (I'm going to one on the 17th, and then another one in early August), meet with a Dietician three times, have two Psychological counseling sessions (one for testing, the second to go over the results), get lab work done, meet with a Gastroenterologist for the Endoscopy, and have a sleep study done. Two sleep study sessions, if I end up being "positive" for sleep apnea. I was able to "get out of" having a gall bladder ultrasound since I don't have mine anymore. Lucky for me, too, the hospital I'm working with is the same hospital I went to for my gall bladder surgery, so they have that on record.

This week, I have to make sure my weight-related records are sent from my primary care physician to the surgery center, make an appointment for my Psych tests, get my lab work done (once I figure out where I'm supposed to go to have that done...), and wait for my phone calls from the GI and Sleep Study people. I'd like to have as much of this all done (scheduled at the very least) by the time I meet with my surgeon again on August 5th. Didn't leave myself with much time, but I feel like if I get everything done NOW, I'll have time to get stuff fixed and tie up loose ends if something happens to be forgotten or be incorrect.

I've been really worried about telling people what I'm doing and that I've decided on surgery. After all the backlash I received when this first came out as just a THOUGHT in my mind, I don't want to know what they'll say once they know I'm set on this now. My three best friends continue to prove to me that they're my best friends for a reason. They're all on board with this and know that I wouldn't just jump into something this life-changing. They know I've done my research, and will continue to research what I need to as things come up. They know I've been struggling with this for over a decade. They know me and they know I just want to be healthy and feel better about myself. They're behind me, 100%, and I love them for it. Heck, they're the ones who convinced me to go to the doctor when my stomach issues got really bad. They helped me get the ball rolling to get my gall bladder out - who knows what would have happened if I'd waited on that!! I've been friends with these girls for 19, 17, and 16 years. We've seen each others' highs, lows, and everything in between. Of all the people in the world who's opinions I value the most (aside from my hubby, obviously), theirs are right at the top. Yeah, my family means a lot to me, too, but we're Italian. We're stubborn, set in our ways, and it's hard to change our minds. Especially as we get older. My parents (ok, my mom's German and Irish, but the temperament is basically the same) are awesome and incredibly supportive, but they still think about gastric bypass surgery as it was when it first became available. They have a hard time seeing the improvements and how safe it truly is. It's actually as safe as (if not safer) than all of the joint replacement surgeries my mom has had (not to mention less invasive), and safer than my gall bladder removal. These surgeons are even going to use my previous surgery scars, since this is a laparoscopic procedure, too!

Living in the 21st Century really is incredible. Getting to grow up with the technology and see all the improvements that have been made just in my lifetime alone simply amaze me.

Science is fascinating, isn't it??


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