educationrulz

Best wishes for a speedy recovery. There are several of us taking the plunge on the 22nd, so hopefully we can all come back in a few days and post our progress. The VST crew here has talked me down from the fit of nerves I was having (for the most part) and I'm just ready to be on the recovery side now.

Thanks everyone. You are reminding those of us with last minute nerves of all the reasons we chose this surgery in the first place. I have the feeling that I will be much better tomorrow morning. But if not, I definitely plan to ask for some IV cocktail! :001_wub:

Jeannie, I have UHC so my response is conditional to the fact that I have a different insurance. But, I asked this same question of my nurse case manager during my phone intake interview and she very clearly told me "YES" if I lost too much weight before surgery and my BMI went below 40 (or below 35 with comorbidities) the insurance company would deny me for the surgery. I tried to get some more specifics without totally annoying the lady and I asked something about how this related to which weight was submitted to the insurance company. We had this conversation over 6 months ago, so I'm a little fuzzy on the details, but I remember something to the effect of this applying to my weight at the time the request for surgery was submitted to insurance. So, I took it to mean that if I was still at 40 BMI when the paperwork was submitted, but then lost weight and went under 40 BMI after I was approved it wouldn't matter. But, if I was under 40 BMI when the request went in, they would automatically deny it. Although I'm nowhere near as close to 40 as you are, that moment was when I decided that I wouldn't be working too hard to lose anything during my 6 months of MD supervised diet with my PCP. My PCP thought I was a total flake, but oh well...I got my surgery approved. I think the trick for you is going to be the fact that your doctor requires you to lose some weight before surgery. This seems unrealistic in your case since it might hurt your chances of being approved. I think you should discuss this more specifically with your doctor so that he is clear about your conflict. It sounds like he has already told you that it won't matter, so maybe that means his office will play around with the numbers that are submitted to insurance. But that could be tricky if your PCP or weight watchers is involved in providing documentation. The bottom line is that the insurance company is the bottom line so I think your surgeon needs to be more specific with you about why it doesn't matter and needs to explain to you exactly how they will handle it if you get below 40 BMI. I don't know if this helps you any but I hope it at least gives you some ideas about what to ask your surgeon or your BCBS case manager. Good Luck!

Leave it to a man to just cut to the chase! :confused1: But you're right, I do know what I'm getting into and it's what I want. I appreciate everyone's thoughts on this and it is helping me come out of my fog. The point about KEEPING the weight off and not just losing it really hits home. And, I too am tired of aching joints. I have actually started to calm down in the last half a day and I feel like I'm going to be ok. Despite my nerves, it's not in my personality to back out of something once I make up my mind. So, I'll definitely be at the hospital at 5:15 a.m. on Tuesday and I'll post an update as soon as I can after surgery. Thanks everyone!

Hey Big Kahuna. Congrats on a successful surgery. It sounds like we have very similar post op diets. I'm so grateful that I'll be able to have somewhat regular foods the first week - assuming my stomach tolerates it. I was really worried about being on clear liquids for a long time and being too weak to do anything. I'm sure your energy level will continue to improve as your diet progresses so just enjoy the excuse to rest as needed for now.

Hey kalex. I'm a day behind you and not feeling so calm. But I do at least feel like I'm about to take this bull by the horns and really do something about my weight problem once and for all. That's the most peace I can say I have for right now. Best wishes to you for an uneventful surgery. Enjoy that yummy mag citrate. :001_rolleyes: We'll be on the other side soon!

Well, I'll be having surgery on June 22, 2 days from now. I can't quite describe how I'm feeling but I'm definitely not totally calm and confident. I know I want and need this surgery but I keep having these weird flashes of "Can't I just do this on my own?" or "Do I really need to go get my dang stomach cut out just to lose this weight?" So far, I haven't talked myself out of it yet or picked up the phone to cancel the surgery, but I feel like I'm close to that sometimes. I've been extremely busy this week and have barely had any time to log on and read posts this week. Maybe that's part of the problem because I usually feel better after that. But I'm in the middle of teaching a class and I've been cleaning my house like crazy all week because it's been kind of a mess. So, I really couldn't log on more. My sister is coming with her kids for the week to watch my daughter and the dogs, so at least that part of things has been taken care of. I pretty much just need to go in, have the surgery, and recuperate. So what is wrong with me?!! :001_rolleyes: I feel like heading for the hills and forgetting that I ever started all of this! I know, totally crazy... Any words of wisdom from those who have made it through these last minute freak-out sessions would be greatly appreciated.

Well, I have had such a busy week this past week getting prepared for surgery. I'm mentally and physically exhausted, but excited about having everything out of the way. Now, I just have to continue my pre-op diet and make a few last preparations before my surgery on the 22nd. I thought it might be a good idea to post what I went through with pre-op appointments in case anyone out there is wondering about this aspect of things. I actually scheduled all of my own preop clearances. (The surgeon's office scheduled the preop appt I had with them and the hospital.) The surgeon's office has specific doctors they work with for the clearances and I went with those instead of trying to do something closer to home. I didn't want any delays with the results getting to my surgeon. This actually ended up being for the best because the surgeon's office and all of the doctors they use for clearances are tied into the hospital's computer network. They are all able to view most of the same info, reports, data, etc. about patients using the hospital's doctors. This should help prevent any delays if a piece of paper gets lost along the way. I actually had my first preop clearance last week, which was pulmonary. This appointment was quick and to the point and a total breeze. I guess that's because I don't have any pulmonary isses, but it felt somewhat like a waste of time. I wish I had scheduled this one on the same day as one of the other appointments and that would have been one less day of driving 45 minutes each way to the hospital offices. This past week, I had the Upper GI, cardiac clearance, phone intake with the hospital admissions department, pre-op appointment at the surgeon's office, and pre-op intake at the hospital. This was all done over 3 days. Wednesday morning I went in for my Upper GI. This required that I have nothing by mouth after midnight. I was allowed to take my meds that A.M. with a sip of water. As others have said, this test is not pleasant. It's not the one where they put you to sleep and put the camera down your throat. This is the one where you drink a ton of nasty stuff and roll around on a table like a beached whale while the GI doc looks at live action xrays of your stomach handling all the nasty stuff you drink. I got a quick look at my GI system in action at one point during the test. It was pretty cool to see the liquid running through my system on the screen as I drank, but I was too queasy to stare at it much. I managed to drink everything they threw at me, but I was SOOO sick to my stomach afterward. I had planned to run and eat immediately after, but I didn't feel like it. My stomach was full of chalky stuff! But, I decided that instead of walking around without any sustenance in my body, I would make myself eat something. I went and got a meat omelet from IHOP and immediately felt better. Lesson for me, go ahead and eat after the Upper GI even if you don't feel like it. The stuff seemed to move through my system fairly quickly after I ate. I learned a couple of days later that the results from this test were that I have significant GERD. Go figure. That explains all the recent burping - which I never did up until about 3 or 4 months ago. I did my phone intake with hospital admissions after the GI appointment. This was basic info gathering, a review of my current medications, and somewhat of a test of my understanding of what I was about to do to myself. Later that afternoon was my appointment for cardiac clearance. When I got to the back, I was given an EKG. Then, the cardiologist came in and reveiwed the EKG and my history information. He said that the EKG was normal and that I seemed to be in good health for my weight. He then said he wanted me to do the treadmill test. Now, I had thought this was automatically part of the cardiology clearance, but apparently it's not because they had not scheduled me for one. They couldn't fit me in that afternoon, so I had to come back the next day. GREAT! :cursing: But, I didn't balk because I am too determined to have this surgery to let an extra appointment get in the way. For the treadmill test the next day (which was Thursday), I had to have nothing to eat or drink - except small sips of water - 4 hours before the test. I was instructed to wear or bring something comfortable to wear during the test. Since I had to go in to work that morning, I took a gym bag with me. I changed in the private exam area and the tech swabbed off my chest area with alcohol and hooked me up to an EKG machine. I was allowed to keep on my bra, a hospital gown, and my bottoms and tennis shoes. She took my vitals and then had me get on the treadmill. I started off at a moderate paced walk and then the speed picked up. I never had to actually run but I did get sweaty and exhausted toward the end. The point was to assess how much exertion it took to increase my heart rate and how my body responded during the phase with a high heart rate. I was able to do this at a fast walk. I think the whole thing took about 30 minutes from the time I entered the room. The actual treadmill time was about 5 to 8 minutes. The next morning, Friday, I had my appointment with the surgeon. This went really well because my diligence with my preop diet paid off and I came in 1 pound under weight from my initial consultation.:thumbup1: Lord I was so worried about that because my weight had been up and down (mostly up) since that initial consult appointment and your surgery can be cancelled if you gain weight. I think I"m in the clear now because I don't expect to gain any weight on this low carb preop diet. I turned in all of my surgical clearance forms to the insurance coordinator and she put together the packet for me to take to my hospital appointment later that am. She had to get the GI clearance from the computer network through the hospital because they hadn't given me anything after my GI appointment like the other two had. I then spent some time with the nurse reviewing my preop and postop instructions and the progression of the diet. This was really interesting because my surgeon has changed his bariatric diet progression recently and it's much more liberal than it used to be. I plan to post it in another blog, but I'm thrilled to only have 2 days of clear liquids post op!! Yay!!! :thumbup: By day 7/8 postop, I'll be on pureed/soft foods. I'm really excited about that. After talking quite a while with the nurse (she also took some measurements for reference points), I got to meet with the doctor. I think I surprised him with my list of about 20 questions, but he took a seat and answered every one of them. I'm going to try to post that as a separate blog also for anyone who needs ideas of questions to ask. I thought of a couple more as we talked, so it was very informative. I'm very comfortable with getting the procedure done after our Q&A session. After that, I went over to the hospital and completed my preop admission. I met with the intake rep and handed over my ID and insurance card (for the umpteenth time) :scared0: and got a nice little armband for the remainder of my preop. Then, I went to the testing area to meet with the preop folks. First, I talked to the anesthesia nurse practitioner about my anesthesia history. Nothing significant there. Then, I met with the bariatric nurse specialist to review everything I would go through on the day of surgery, immediately post op, and long term post op issues. This aspect of the preop visit was unexpected and very helpful. I learned about the bariatric wing of the floor I would be on postop, some things to remember for the morning of testing (like to request an antinausea patch before surgery), got to review aspects of the diet progression, and got some tips and tricks for eating postop. The bariatric nurse specialist will be visiting me throughout my stay in the hospital and checking on me post op for quite awhile. It will be nice to have another point of contact when I have questions. The last leg of my hospital preop appointment was the general surgical nurse. She took some vitals and reviewed my chart and history briefly. She made sure that all clearances were in order and on file and made sure that my chart was complete. She then took a few vials of blood and took that hospital bracelet off my arm. I was so glad of that because I once had to wear that thing around for almost a week before a surgery because "that" hospital had to know that I was the same person who had given the blood during the preop - STUPID. The nurse reviewed the procedures for the morning of surgery with me and that was it. Anyway, I hope this "book" I just wrote about my preop tesitng helps someone get a better idea of what they might be in store for in the days before surgery. I'm sure it's done differently in many places, but I guess the overall point is the same - to make sure we're healthy and sane enough to go under the knife. If I had any advice, it would be to plan your appointments strategically and be clear about what's expected at each appointment. I'm not sure that I could have cut down on my driving any because there was so much to get done, but I might have been able to cut out at least one or two days of the back and forth with better planning. Now that I'm done with that, it's on to week 2 of my preop diet and just trying to keep my head on straight until surgery day. I'm still getting a case of the nerves here and there, but I'm going to see it through. :thumbup:

Let me rephrase this for you Papillon: STAY OUT OF THE SAUNA!!!! The last thing you need to be doing post-op is sucking the hydration out of your body when all you can do is sip, sip, sip. Save that for the past 6 week phase when most of us are cleared for strenuous exercise.

I pray that I will be able to reach the same peace with myself a year from now that you have reached. To be glad that you made such a drastic (positive) change in your lifestyle and feel pride in yourself for following through has got to be an awesome feeling. Oh Lord, my mouth is watering again :-} Thanks for all of your great updates and pics of your personal journey. It's a wonderful resource for those of us who haven't crossed over yet.

Girl, you are too cute in your little white summer pants! I needed to see that side by side comparison of yours because I too am about 270 (having mysteriously gained a few pounds recently:confused1:), a little over 2 weeks pre-op and about to start my pre-op diet, AND needing the strength it's going to take to lose these extra few pounds so my surgery isn't cancelled. :cursing: Seeing so clearly how you have gone from your pre-op weight to goal has given me that little extra motivation I need to kick-a$$ on this pre-op diet. I will not be denied my cute little summer outfits and getting up off the floor effortlessly!!! :drool5: Thanks for all the sharing you do on this forum. It has been a HUGE help!

This is great Sparkle! Thanks!

Hey guys. Just getting caught up on the responses here. So, I'm reading everyone's responses and trying to take all of this in and own it. It really helps to have other people rationalize this for me because I didn't come to any of the conclusions that you guys presented. I think I'm struggling because of years of my weight affecting my romantic relationships. Of course there are men who like larger women, but I guess after a certain point when you're not comfortable with yourself it doesn't matter if someone else doesn't mind. I guess I have no frame of reference for feeling attractive and feeling like I could attract the average man. I agree that men are not as caught up with the fine details as women are likely to be. So I can see everyone's point about them not caring how I got to a healthy, attractive weight. It seems like all of the issues I'm worried about in terms of post op are coming down to having to deal with it when it comes. Despite my somewhat irrational fears of dealing with these situations, I am still quietly excited about being able to come out of my shell a little bit. I might even get out there and shake my tail feathers now and then. :wink0:

I'm coming up on surgery pretty soon and looking forward to some post-op dating experiences once I've healed and recovered. But, I keep having these wierd thoughts about how a man might react once he finds out that I used to be obese and had to cut my stomach out to loose weight.:thumbup1: Like, is he going to go running away screaming at the top of his lungs? Is he going to be thinking that I'm going to blow my surgery and get fat again? Will he think it's just better to dump me before I get big again or before I cut some other part of my body off? I know this is crazy, nonproductive type thinking, but I can't help it. I'm doing my best to be prepared for how things will be post-op and this is one issue I can't rationalize or wrap my mind around. So, I'm coming to you guys for advice. I know that the men here will naturally be biased because you're pre- or post-op yourself so you're okay with the need for the surgery. But, can you step out of the situation and think about how you might act if you met a woman who had lost weight because of surgery? Ladies, what has been your experience with dating and telling a man that you had WLS? Did they run off, pretend to be ok with it, or really accept it and continue with the relationship? For clarification, I'm not talking about telling a man I don't know well about this. I'm talking about the point where I have been dating someone for several months or more and am beginning to build a serious relationship with - someone I don't want to hide things from... HELP before I drive myself crazy thinking about this! :svengo:

Cool, that's what I was hoping you'd say. Just think, by this time next year you'll be at goal and on top of your game. :thumbup1:

Hey Bigga, Keep the jokes coming! :laugh0: But for the slow to catch on, like ME, give us a little by-line at the end that says "JUST KIDDING". :001_tt2: I keep thinking about that thread you started somewhere else about the law enforcement personnel competition you wanted to attend a couple of weeks after surgery. What did you decide to do about that? Congratulations and keep rockin that sleeve!

Hey guys. I'm going in on June 22nd. It seems like it's going to take forever to get here but I'm sure the time will fly. I start my two week low carb high Protein diet on the 8th. I've been incorporating some low carb meals for the past few weeks so I think I'll be in the right frame of mind by the time the 8th comes around. I'm nervous but SOOOO excited about having this surgery. Glad to join all of the other June VSGers! :thumbup: Good luck to everybody with upcoming surgeries!

It's good to hear that you made it home safely and are starting to feel better. Congratulations!:thumbup:

Why are you hesitating to go straight to your surgeon with this issue? You don't seem to think it's a clear cut case of typical post-sleeve symptoms, so let him figure it out. That's what they get paid the big bucks for! :001_cool:

Have you talked to your surgeon about this? What size boughie did they use?

That's just sadistic! :001_cool:

Ok Bigga, that might be a little TMI! :laugh0: It sounds like you're going through all of the typical stages so that's good news. Congratulations!

I have United Healthcare and they covered the psych eval (took one visit, was cleared for 2 visits), but they don't cover nutritionist consults. Luckily the WLS portion of my policy did not require the NUT consult so I opted not to do that since I couldn't seem to find time to fit it in. Now I'm at the point where I don't feel like I need it since there's so much info here and on other websites.

Hey chelle, my surgery date is a week after yours and I'm also worried about the pre-op diet. I hate to admit it but I'm one of the lucky ones who gets to do a 2 week low carb high Protein pre-op diet so I KNOW I shouldn't be complaining. I guess I'm not complaining, I'm just worried that I won't be able to stick to it. Maybe it will help you to be working and in school right up until you're surgery date. Hopefully this will give you something else to focus on during those tough moments. Although I'm as inexperienced at this whole thing as any other pre-op person, my advice would be that if you slip up on the pre-op diet, make sure it's a pure protein like meat and not a carb. Carbs seem to be the big no-no for pre-op WLS patients so at least you'll know what to steer clear of. Good luck and congrats on your upcoming surgery!

Donna, I know how you feel. I just got my approval and date scheduled last week so I think I'm still in shock too. I think this is the time when the nerves really begin so set in. But I'm sure you've thought long and hard about this so we'll just have to keep reminding ourselves how important this is when our nerves try to get the best of us. Congratulations on your approval and scheduling! We'll be on the loser's side in no time. :thumbup1: