I visited a bariatric surgeon a good 2 years ago now.  I'm in an ***, so he was the one in my networks that my Primary Care Physician referred me to.  I like him a lot.  He initially recommended a Lap-Band.  He said it was the only kind of weight loss surgery he did.  It made deciding between procedures easier for me.  He told me that my insurance (BCBS of IL) required me to go to 6 months of a formal weight loss program - or a nutritionist before they'd approve the surgery.  So off I went!

I joined Weight Watchers in November.  By January I'd lost about 10 lbs.  In February I got knee surgery to clean up some ripped cartilage.  Then it was a few weeks of lying around with nothing better to do than eat, sleep, read, and watch TV.  Well, here come the 10 lbs. back!  I stayed on WW for another 9 months though - essentially getting nowhere.  Now, I love WW - it's great.  IF you can stop eating freaking Ding-Dongs like it's your JOB.  And I just couldn't get my mojo back.  Still - I made sure to stay on the program long enough to pass my 6 months required by my insurance company.  Then I went back to visit my bariatric surgeon again.

What he told me deflated me greatly.  Weight Watchers didn't count as an organized weight loss program unless it had been supervised monthly by a doctor.  Well, that hadn't happened!  So I went back to my PCP and got a referral to go to a nutritionist at my local hospital.  I started 6 months of that and essentially did nothing but go to the sessions.  I knew how to eat.  I just didn't know how to STOP eating everything that I shouldn't eat!  Unlike prior attempts at weight loss, it wasn't just about cravings this time.  My stomach had stretched to the point where I was hungry after eating the proper portion size.  And I was heavily addicted to sugar in all forms.  Food is like a siren song to me at this point - constantly calling to me.  I can't just put in a vegetable for a snack - my brain wants that sugar, and it's going to keep thinking about it until I satisfy that craving.  I need help beyond just information at this point.

I had lost my bariatric surgeon's name, but I knew I'd recognize it if I came across it.  And I did.  I saw his website and saw that he did many different kinds of surgeries now - including new ones that weren't even on the market when I talked to him a few years earlier.  I found out that he was sharing his practice with another doctor in the past that had since moved to another state.  That doctor performed bypass surgery, and as a professional courtesy, my doctor didn't perform those surgeries.  Now I had to go over whether Lap-Band was indeed the best surgery option for me.

In the meantime, the hospital nutritionist had given me information at our last session from the hospital.  It outlined the information they give out to bariatric surgery patients, and some of what I saw scared me enough to make me re-think surgery altogether.  It said that I was to "go off and never again go on anti inflammatory drugs."  I am on two of those per day in order to help with my arthritis.  I know my knees won't hurt as much after I start losing weight.  But it's not only weight-bearing joints that are suffering - it's all of them - even my fingers and shoulders, etc.  The thought of being in constant pain from not being on anti inflammatory meds terrified me!  I'd had to go off those meds each time I'd had various surgeries over the years (because they act as blood thinners - which don't go well with surgery), and I was miserable after a few days.  Was this limitation worth the benefit?  I decided to go back to my bariatric surgeon and lay my concerns out on the table.  This took many months for me to do, as we were in the middle of buying a house and moving.  But as soon as that was settled a bit, I made the appointment to see my bariatric surgeon.

I'm so glad I did!  He still did recommend the Lap-Band surgery for me.  He said he really preferred that surgery for its lack of complications.  There was no "dumping" syndrome, no probability of malabsorbtion, no refraining from anti inflammatories, no constant battle to get high amounts of protein in.  And he thought it would be plenty to offer me the benefits I needed.

From there, I was given a list of doctors I needed to get clearance from and a number of tests/ procedures I needed to have done before surgery would be approved by my surgeon:

Laboratory:  Blood panel - CBC, DMP, TSH, PT/PTT.  Urinalysis

Cardiology:  EKG, Cardiac clearance from cardiologist

Radiology:  Upper GI with double contrast

Pulmonology:  Pulmonary clearance.  Breathing test, give them the chip to my CPAP machine.

Routine Wellness Screenings:  Mammogram, Pap smear

Radiology:  Upper GI with double contrast. 

Misc.:  Primary Care Physician clearance, Psychological Evaluation, Nutrition assessment, Six months of supervised nutritionist sessions

I'm almost done.  It's taken me months!  I counted the appointments today, and it will come out to 19 altogether!  Wow! As soon as I get the upper GI done, I'll be able to go back to my PCP and get surgery clearance.  Then I can go back to my surgeon for a visit, and to schedule surgery.  I'm probably less than 2 weeks from getting back to my bariatric surgeon.

I know there is a one-week no carb diet I will need to follow prior to the surgery.  This shrinks the liver, making laproscopic surgery possible.

The good news is that I've learned throughout this process that I'm actually very healthy!  My lungs are normal.  My physical and test results are fine.  My heart is doing well.  My mammogram and pap smear are clear.  My blood pressure and pulse are great.  My psych eval turned out well.

I shouldn't be surprised, but many of the doctors questioned me about why I can't just lose the weight with no physical help.  "You should be able to do this by yourself.", "Can't you just go on a diet?", etc.  Ugh.  Maddening.  At least the bariatric surgeon gets it.  That's what's most important.

I'm getting closer!