Patience is Not My Virtue

I don't like to wait. At all. Right now I have no choice. All of my preliminary requirements are completed and now I just have to wait.

Palmetto Bariatric has to wait for my psych eval to come back. They said he usually takes 2-3 weeks to send it in. Tuesday will be three weeks, so fingers crossed. (He told me he would clear me, the fingers crossed is that he'll send it in by then.)

After that, Palmetto Bariatric will submit everything to Medicaid and then it's more waiting for them to approve the surgery. Once that's done, we can schedule the date. I have no idea how long that process takes, but I'm still hopeful that I can have surgery in June. I'd like to have it over the summer so I have time to recover before school (seminary) starts again. I also want to make sure we're still covered by Medicaid when I have the surgery since many insurance companies don't cover it and even if they do, we probably couldn't afford the co-pay.

Take a Pill (or several) and Call Me in the Morning

Yesterday I had a check up with my general practitioner. It really had nothing to do with my weight loss surgery, but I did learn that my blood sugar and blood pressure have come down. And while my liver enzymes are still too high, they have come down as well.

I thought it would be a good opportunity to show one of the many reasons I want to have this surgery. Here is a picture of all the pills I take on a regular basis.

And here they are in their little dispenser.

These pills include a daily dose of Losartan for blood pressure, Metformin for blood sugar, Levothyroxine for hypothyroidism, Pravachol for cholesterol (although mine is in the normal range), Vitamin D, and a multiviamin. In addition to these, I take the following every few days or as needed: low dose aspirin, Aleve and Excedrin Migraine. My hope is that after surgery, I will only need the thyroid medication and the multivitamin.

UPDATE: I have also now been put on 500 mg of Magnesium.

I also test my blood sugar from time to time. My kids think it's fascinating to watch me prick my finger.

 

It's not fun and hopefully after surgery, I won't need to do it anymore.

Last, but not least, is my CPAP. I've been sleeping with one for around three years now. I'm grateful for it because I sleep well for the first time in years, but it's cumbersome and not very romantic.

If you'd like to read the post about how I got this baby and see a photo of the CPAP in action, go HERE.

Cardiologist - Take 2

Today I went back to the cardiologist to get the results of my nuclear stress test. The results of the EKG and stress test were good. My heart is healthy. The walls, valves, etc. are all clear and performing as they should. (It is hard to see everything clearly because my boobs are so big.) My blood pressure was lower than ever. Of course, that's because I'm on medication. The cardiologist changed my blood pressure medication to one that hopefully won't make me cough so much. She is also putting me on a low dose of cholesterol medication. My cholesterol is in the normal range, but apparently since I have diabetes, they want it even lower.

She cleared me for surgery, so now I just have to wait for the bariatric surgeon to get clearance from Medicaid and schedule the date. I'm not very good at waiting, so hopefully things happen quickly.

Getting Nuked

Early this morning I had an appointment at the Echo/Vascular Department at the beautiful new hospital just down the road from our house. I was having my first ever nuclear stress test. I had to go fasting and couldn't take any of my medication. I was a little nervous about it because we had a friend in Houston that had a heart attack during a stress test, but the nurse that helped me said it only happens once in every 10,000 patients.

When I got to the Cardiology floor, I was ushered into this room. (Comfy with a great view!) I should also add that everyone I've met in the Cardiology Department, both downtown and at Parkridge, has been so nice. And everyone I've seen regarding this surgery, regardless of the department, has been supportive and positive about my choice. This has made things so much easier.

An I.V. was inserted into my arm. Then saline was inserted to make sure it was set up right. Next, radioactive material was inserted. The radioactive material had to work its way through my body for about an hour.

While I waited for the material to circulate, I had an echocardiogram. Afterwards, I had to walk around for awhile to help the blood circulate. I walked around for about 45 minutes.

Next I was ready for the x-ray machine that would locate the radioactive material and track it through my heart. The table looks pretty harmless, and was at first.

But then they lowered the part that looks like it has a grid on it. The visible portion is only half of a v-shaped unit. It comes right down on the chest and made me feel trapped. Here's a picture that shows it a little better.

I had to lie still while the unit very slowly rotated from the right to the left side of my body - about 20 minutes. I couldn't move at all. If you know me, you know how hard that was for me, especially to not rub my feet together. By the time it was finished, my lower back was killing me.

Next came the actual stress test. I was taken to another room with a cushy chair, nice view and a treadmill. They took my blood pressure, which was much lower than normal, and then got me on the treadmill. I walked at a slow pace with a slight incline. Gradually it got faster and steeper until my heart rate got up to 184 (I think). While I was on the treadmill, they continued checking my pulse and they also inserted more radioactive dye into my I.V.

When I finished, I sat in the cushy chair to get my breath back. I didn't experience any heart pain or anything like that, just shortness of breath because of the exercise. They said I did really well. I asked them how long I'd been on the treadmill since it seemed like about 15 or 20 minutes. I was surprised to find out it was only seven minutes. How embarrassing!

I had to wait another 20 minutes for the radioactive material to circulate. Then it was back to the torture chamber.

This time wasn't so bad because I was tired and fell asleep, plus I had an extra pillow under my legs. The time went by much faster. After that, they just took a minute to review the test and then released me. I think that's a good sign because a guy that went before me had an irregular result.

I go back to the cardiologist on Friday and will get the official results. Then I think it's back to the bariatric doctor to put everything together and submit it to Medicaid.

Psych!

The psychiatrist had this on his shelf, which I thought was pretty funny.

Today I had my first ever psychiatric evaluation. I wasn't really sure what to expect, but it was actually pretty cool. Basically, a really nice man sat back, asked me a few questions, and let me talk about myself for an hour (kind of like a really good first date).

The purpose of the visit is to make sure I understand what I'm doing, what could go wrong and how it is going to impact my life. He also wanted to make sure that I have a strong support group around me and that there is no one in my life that might try to sabotage me. I'm so grateful for David and his unconditional love and support. I don't think I could do this without him.

I'm pretty sure the psychologist thought I was basically normal. I guess I fooled him.

Upper GI

On April 29, I had an upper GI Tract x-ray. I had to go in fasting. Once there, they gave me a fizzy drink like Alka-Seltzer that made me want to burp, but I was told not to do that. The drink creates air in the chest cavity. Then I was given a cup to drink of a chalky liquid called barium.

First I stood up in front of an x-ray machine while they had me turn in different poses and they took different x-rays. Then they had me drink another cup of barium, lie down on the table, and turn around in different angles for more pictures.

I've never had this type of an exam before and I don't know the results yet. When they were finished, I had some pretty awesome belches.

Nutritionist

After my behavioral health consult, I met with the nutritionist. Since most of what she had to tell me I had already heard in my diabetes counseling, she gave me the fast version. One thing she said that I have heard since looking into bariatric surgery is "Bariatric surgery is a tool, not a cure for obesity."

Here are some keys to success:

• Keep a food journal. I need to not only write down what I eat, but when I ate it, how long it took me to eat it, and how I felt before and after I ate. Sounds like an Excel spreadsheet waiting to happen. (And I love a good spreadsheet.)
• I need to have a specific exercise plan. Walking is the best exercise after surgery. Start gradually and work up to 15-60 minutes of continuous exercise 3-4 times a week. Write down exercise in the food journal.
• Slow down when eating. It should take 20-30 minutes to eat a meal. Eat at regular times. Don't sample while cooking. Eat at the table, not in front of the t.v. or computer. Use a smaller plate. Chew 20-30 times before swallowing (this will be necessary after surgery). Put the fork down between bites. Don't graze. 

The following pitfalls can sabotage success after surgery:

• Frequent snacking
• Drinking calories
• Not being active
• Eating fried foods
• Not coming to follow-up appointments
• Eating too many refined carbs

With the exception of exercise, I am already pretty good about all of the above.

Two weeks before surgery, I will go on a high protein, low carbohydrate (20 grams per day) diet. This helps shrink the size of my liver, which helps during the surgery since my liver has to be moved out of the way.

After surgery, my diet will be as follows:

• Day 1 and 2 - Clear liquids
• Day 3 through 10 - Liquids, including protein drinks (which will become a standard part of my diet from that point on)
• Sometime between day 7 and 10 - Pureed, 1-2 tablespoons at a time (this sounds gross to me)
• Afterwards - soft diet (soups, soft veggies, potato, yogurt)

After I'm healed, I will never be able to eat the same again. This is a hard thing to realize. I will never be able to eat and drink at the same time and will need to wait 30 minutes in between the two. There are some foods that will always be difficult (my favorites: bread, rice and pasta). 

And worst of all, if I'm not careful, I can gain it all back. This is sobering to realize, but I am trying really hard to face everything and be honest with myself. No food is worth losing my life and I love my kids more than any food. I will try to focus on that.