Red Light….GREEN Light

After weeks of frustration, uncertainty, and disappointment yesterday I meet Dr. Darren Soong of the Surgical Weight Loss Center of Las Vegas who assured me my medical history including six previous abdominal surgeries would not be a problem for him.

WAHOO!!!

The thought of riding home still worries me.  It’s going to freakin’ hurt!

But after meeting him, I am much more calm about him.  He was kind and knowledgeable.  He said I am the “perfect candidate” and as long as I stay as determined as I am now he really felt like the surgery would give me relief from many of my co-conditions.

Knee brace, come to momma!

In case you have not read my other posts, I have needed a knee brace for a very long time but my thunder thighs are literally so big there is no brace available to me.  Walking around living the best life I can on this unstable, injury-damaged, but non-surgical knee hurts.  Sometimes, it hurts a lot and sometimes it is even enough to limit my mobility which only increases the effects of fibromyalgia and chronic fatigue syndrome and all my spinal conditions.  It has been a damn vicious cycle.  It is time to hop off the hamster wheel.  When every doctor I have says, “lose weight,” when I say “lose weight,” and when I have given that endeavor my all with limited success it is time to explore all options, including surgery.

Of course, I have tried to lose weight without surgery.

When I told Dr. Soong what I had done and how my results did not equal my effort.  His first question was about my thyroid and I assured him my primary and I are on top of it and I am still not losing and that is what prompted me to drive nearly 200 miles to see him.

I really have come to the end of the line.

I live in a body I do not like.

I live in a body who does not like me–my poor knee is doing all she can and I trust that so it is time to help her out.

I know it is not good for me.

I also know more than 10 years of trying is more than enough.

Of course it is still scary to do something this drastic.  However, it is equally as scary to just sit here every day knowing all the good things I do for my body are not yielding good results.

I have decided on the Vertical Sleeve Gastrectomy as my procedure.  Honestly, I was more interested in the LapBand but when the surgeon’s office local to me would not return phone calls I decided I did not want him involved in my after care at all.  Had I chosen the LapBand I would either have to go to his office or drive back to Las Vegas every few months for band adjustments.

If his office is going to be so rude and disrespectful to a potential patient, they are certainly not going to have my help building their practice to the point they can be certified as a Center of Excellence.

Today this blog was renamed “On My Sleeve” with thanks to my friend S.W. for the inspiration.

I have two more visits with my primary doctor and so lab work to complete but everything should be a go for the end of August or the first part of September.

Now to wait….patiently.

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My Uncle Died This Morning

He just turned 70 two weeks ago today actually but he could have lived much longer had he not fallen prey to sugar.  He was obese, diabetic, and a closet smoker–he thought he was sly enough to hide it from all of us but we knew.

His death today could have been prevented by a healthy weight and a healthy lifestyle.  In fact, all but one of the adults in my family who have died could have taken better care of themselves.  My father–lung cancer.  My grandmother–obesity.  My uncle’s overarching health–diabetes, obesity, smoking.  And soon enough my mother who is already suffering from obesity and smoking related complications, my sister’s obesity, my husband’s obesity and cigarettes….and my own obesity if I do not stop it.

I have decided this is not going to be me.

My children are not going to be sitting around some day in the future saying or wondering “If mom had taken better care of herself, would she still be here.”

I am mad as hell at my uncle right now.  The secret runs to the frozen yogurt store and the not-so-well hid cigarettes complicated his health and it killed him.

His brother, my other uncle, has Type 1 diabetes  and was forced to take care of himself and did and his whole life is the last one standing.

This is NOT a coincidence.

I am doing my best to eat right, avoid sugar, exercise and be healthy.  My weight is NOT cooperating and I know it is slowly affecting the quality of my life.

My uncle loved to golf and dreamed of spending his last days on the links.  He did not live that dream because ultimately, in reality, he did not want it enough to stop the bad habits–and most of them were habits.  His last days were spent as an invalid…just like my grandma and father before him and eventually my mother as well.

My other grandma is a spry little old lady she’s in her 90s and still living.  She does have Alzheimer’s but to date it cannot be traced to personal habits.  Her husband died of sudden cardiac arrest at a young age but my other grandfather lived a long life.  He was a police officer and though I was not blessed to know him I can assume his job kept him on the healthier side of living.

June 24, 2013 was the last day my uncle breathed and it did not have be that way.  He could have died on the golf course instead.

In less than 48 hours, I am going to meet with a skilled man, one of the best surgeon’s in the field in my area, who I hope will give me the only tool I have not tried to change my life and my children’s memories of me.

We all want to go out kicking and screaming but how often are we making the choices we need to get what we want.

PS…I am so tempted to click this blog live right now and let the friends become frenemies if that is what is going to happen.  If there is one thing I know I am it is an advocate for life, for THRIVING and I really want this to be heard right now, in real time.  If I knew for sure I was going to be cleared for surgery maybe I would but since I am not the wise thing to do right now is to sit here talking to myself and being patient.  If I impress nothing on you, let it be this–YOU DO HAVE THE POWER TO AFFECT REAL CHANGE IN YOUR LIFE!!!  I’ve been failing at this weight loss thing long enough I should be awarded a PhD but damnit I am not giving up.  I will not go quietly.  I will not leave me or you without hope.  If you do not like the number on your scale get up and do something about it.  Try again even if you feel like you have tried a thousand, million times already.  Do anything but sit there resigned to what feels like fate.  FIGHT FOR YOUR LIFE!

Thank Goodness For Blogs

Dear Friends,

Today is June 20, 2013 for the past several days I have been watching many of you post your negative reactions to the AMA’s vote to recognize obesity as a disease.

I want to post back.  I want to educate you but I also know I am super vulnerable right now so in this moment I am grateful I have this blog to bare my soul and release my tears.

You see it is you who I am very afraid to share this journey with because maybe you won’t understand what a battle obesity has been for me.

Maybe you will think my decision to have weight loss surgery is a cop out.

Maybe you think I sit here stuffing my face and if I would just stop the pounds would melt away as some of your general comments have indicated.

No, I am not taking them personally because I could bury you in the mountains of data I have amassed on my TWELVE YEAR battle against the DISEASE that is obesity.

There is not one single thing in the way I eat or the activities I do which, on paper, would indicate that in real life I am or should be obese.

Not one of the near-dozen doctors I have been to can explain what is going on inside my body.  Thankfully, they have been willing to listen to my struggles and believe me.

There is something broken–whether it is genes, or hormones, or something else–and I have failed at fixing it.

I have tried.

For some people, for me obesity is NOT a choice but it IS a disease.

My body will not bend to my will no matter how hard I have tried.

I choose to be healthy in all aspects of my life including my weight.

 

Getting My Irish Up

It has only been a couple of days since I met with my primary doctor and my emotions, attitude about, and thinking about surgery have been all over the place.

No, I am not having a change of heart.  I am still 1000-percent committed to moving forward with surgery–and that is precisely part of the problem–I am ready.

NOW!!!!!

So I copped a bit of an attitude and decided if the local surgery center is not going to bother to call me back then they were absolutely NOT going to get my business including managing my after care with the Lap Band.  It has been three weeks since the patient advocate said she would call my insurance company and I have not heard from her.  So, I started thinking about my other options.

Yes, me thinking is about as bad as it sounds–those of you who know me can please stop laughing now.

I am absolutely anti-Roux-en-Y simply because the thought of such an invasive re-routing of my internal plumbing gives me the willies.  Besides, I honestly think it is a bad idea to traumatize my fibromyalgia body any more than is necessary.  That poor little chick has been through enough and I have brought her to the point she manages pretty fine, most days.

And that is when I started thinking about the Vertical Sleeve Gastrectomy which also happens to go by half a dozen equally goofy sounding names.  To be honest, the names are partially what initially turned me off to the procedure.  Hey, I’m a writer, a wordsmith, a lover of words so for me these things do matter.

When I started this blog the working title was “Taking a Lap.”  It’s cute, right.  All sorts of word play can happen there.  But, that is not the only reason why I was drawn to the LapBand.  I really like the idea of it being adjustable to my needs.  I also really like it has the least risk and best recovery times of all available surgeries.  Because, again I do have to think very practically about how this self-induced trauma is going to effect fibromyalgia.  In her case, less is better.

However, if I indeed have to travel to Las Vegas for my surgery and my surgery is the LapBand, my follow-up care will be with a surgeon who did not perform my surgery as it is just ridiculous to travel to Las Vegas every month for check-ups.  Besides, like I said, if the local center here cannot bother to return my calls I am sure as hell not going to let them manage my care.

And then I decided, mostly for my husband’s benefit, to attend the local center’s pre-surgery class.

I really do not want to have surgery in Las Vegas.  I have a history of DVT (deep vein thrombosis) so having surgery and then nearly immediately being immobile for several hours to get home could be life-threatening if I develop a clot.  Of course, any surgeon will take precautions but this is my body and ultimately I am responsible for her.

I am sure I was glaring at the doctor the whole time because in my mind I’m thinking, “Your practice sucks you asshole.”  However, I really started to like the guy.  Frankly, it pissed me off.

I was going to take my copped ‘tude and just leave but as luck would have it while the patients were speaking he ended sitting right behind me and my husband.  Before we left, I asked my husband if he had any questions and as luck would have it by the time he answered me the other potential patient stepped aside and the doctor said hello.

Oh sweet mercy!

I took a deep breath, forced myself to maintain a quiet, respectful tone and let him have it.

Graphic courtesy of Quality Stock Photos

Graphic courtesy of Quality Stock Photos

He was not pleased to hear A) My insurance company adamantly insists I am approved to have my surgery at his practice and B) His patient advocate is the only person stonewalling me and C) that I have an appointment with another surgeon in Las Vegas next week.  He assured me he would get to the bottom of this and someone would be calling me.  Honestly, he looked about as pissed as I feel about this whole process.

It is 4:44 a.m. the morning after and the fact that I am up at this time of day really says a lot.  You see that fibro girl is going to have hell to pay for not getting her rest.  I had a hard time falling asleep last night too.

My big thought, the one I think all the time now is “I do not wish to be an obese person and it is time to stop fighting my body and let the surgery compensate for what my body does not want to do.”

I am ready to move forward.

Before I started this post, I did some more reading about the sleeve procedure and learned something new–there is no prohibition of NSAIDs after surgery.  With my current medical history, having to avoid NSAIDs could be catastrophic so I feel better about the sleeve.

I am a writer, like I said, and honestly the thought of renaming this blog with some cute, playful variation of the über clinical cacophony that is “vertical sleeve gastrectomy” is more difficult than letting myself explore the procedure itself.

Las Vegas or fifteen minutes from my front door, lap or sleeve–I need to know.

I am ready to change my life.

Say It Ain’t So, Doc

Image Courtesy of Quality Stock Photos

Image Courtesy of Quality Stock Photos

 

I met with my doctor again today.  The whole purpose of this appointment was to ask if he had four months of chart notes about my inability to lose weight.

“No,” was his answer.  “Charting weight loss failure is so tedious,” he continued.

In his defense, we talk about this literally all the time but always as a side conversation a long with whatever is going on at that appointment.  He honestly felt awful because now I have to wait.

For the next two months I will have an appointment just to remind him to chart my weight loss failure.

Even knowing this surgery is in my future, I have been keeping up with my efforts to lose weight.  I have never been more thankful than in his office a few hours ago.

It’s been almost five weeks since he gave me the referral for surgery so I could have been scarfing down all the junk I normally do not let myself eat.  I could have gained by now.  But, I did not do that.  And, I have not gained an ounce.  Despite my fairly normal eating habits and some good effort in the gym and at home, I also have not lost an ounce.

Back to the beginning.

Back to waiting.

Back to patience.

Back to working on new band-friendly recipes.

Back to me.

Reason #7985 to Have Surgery ASAP

MY KNEE IS FREAKIN’ KILLING ME!!

About 15 years ago, my family went to a water park.  As I was going down one of the water slides, I slipped and jammed my knee.

The next day I went to the doctor.  All the usual tests later and I was diagnosed with patellofemoral syndrome and sent through physical therapy.

My knee has never been the same since.

Part of the problem is anatomical.  I have wide hips, knock knees and a tendency to pronate when I walk or run.  However, I also have abnormally heavy thighs which increase the pressure on my knee.  Bracing would help.  Unfortunately my thighs are so abnormally large there is no brace made to fit them.

For 15 years, I have been in pain and for 15 years I have gone to doctors for relief.  Without fail, they have all mentioned bracing my knee to help the properly align the patella.  For 15 years, I have seen these doctors look at me and my thighs with vary stages of contempt and disgust as they say, “But your thighs are too big.”  Some go one to kindly suggest weight loss others have been total assholes.  Either way, I have left the room crying not because of what they have said but because I have tried since before I injured it to lose weight.

At the time of the injury, I was a personal trainer at a women’s fitness facility.

I was not out of shape but like the joke goes my shape just happened to be round.

And thus began the last decade plus of my life doing everything I could to help my body not have so much pain in just this one tiny part.

I failed.

I want to lose weight so my knee will feel better.  On the days it does not, I deserve the option of strapping on a brace.

Today is one of the days I wish something, anything could help my knee.

It hurts.

This helps…only as long as it fits around my leg.

knee brace

The Blank Week

I do not know how else to describe this week but blank.

There is not a single external thing I can do to push this process along.  Sure I can continue to make smart food choices and convince myself drinking water won’t actually kill me.  I can also go to the gym like a good girl.  The problem is none of these things are moving me closer to a surgery date.

The patient advocate at my local clinic has not bothered to call–not that I am surprised.

Last Thursday, I made an appointment for Monday, June 17 with my primary to let him know I have gotten precisely no where–okay, not no where but it feels like it.  I also need to know if he has the four months of diet failure in my chart.  We have been talking about it for over a year but I just do not know how he’s charted it.

On Wednesday, June 19 my husband and I are attending the weight loss surgery seminar given by the clinic that won’t call me back.  It feels sort of empty and hopeless but on the off chance they will agree to the surgery, I have to take the class.

The good news is I am wearing a top I bought last year and it’s hanging off my neck and shoulders.  I have not taken my measurements–I keep forgetting–but I feel like I might be firming up just a bit.  If it is a non-scale-victory, NSV, I will take it!

Blank.

I feel blank.  UGH!

Impasse

It has been three weeks since my doctor gave me a referral to my local surgeon.  I am no closer to having surgery than when my doctor sent the referral.

My local surgeon says his office and hospital cannot perform the surgery because they are not approved by Medicare for weight loss surgery.

My Medicare supplement plan says the surgeon and hospital are approved by my plan.

The surgeon’s office says they are not a Center of Excellence and that only COE’s can do weight loss surgery on Medicare patients.

The insurance company says they follow Medicare rules AND the surgeon and hospital are approved according to their approval team.

The surgeon’s office said they would start the approval process but the patient advocate said, “I already know this is going to fail…but I’ll get the authorization going if you want me to but I have to tell you this is going to fall apart.”

Sigh.

My other option is to go to a surgeon over two hours away who is willing to perform surgery on me without conducting a pre-op physical exam.  His practice is a Center of Excellence.

Excellent…..?

His practice happens to be out-of-network so my costs will double not including the travel and hotel expenses for my husband.

I have had six abdominal surgeries and have a history of blood clots.  How is it in my best interest to be cut open by a doctor who does not know me and then remain immobile while traveling immediate following surgery just to get home?

I heard the patient advocate say she would start the approval process but I also heard the doubt in her voice so I am not surprised it has been a week and I have not heard from her.  No part of me believes she is working on this because she is already convinced it is not going to happen.

While I know the details will be worked out, I am at an impasse.

However, in writing this out–this is why I love being a writer–I realized there may be a middle-ground solution.  I could ask the patient advocate at the COE to schedule me for a pre-op appointment and see what she says.

This whole process is nuts!

Answers sign