Surgery. Part 1

It’s now September 29th. I can’t eat anything and I am now down to a clear liquid diet. I feel like garbage. I am tired and hungry, but so close to a surgery I had been putting off for 10 years. I wasn’t messing it up by eating or drinking something I shouldn’t. I live at the tip of Alabama and with the surgery being in Birmingham it’s almost a two hour drive, so me and my husband stayed with my parents the night before. It was halfway. I remember sitting with Scott, my mom, and my aunt that night. Is this the last time I’ll have a sit down talk with them? I had never had a surgery before and this was a major surgery. I was scared I would die. Honestly, if I kept going the way I was going I think I was gonna die anyway. I knew I made the best decision for myself but I still had doubts.

I tossed and turned for most of the night. I remember the sun coming up and not being able to keep my eyes open. Scott kept telling me I would be okay. But I was still nervous. Mom was coming with me. Her opinion on everything and anything is important. EVEN if I say it’s not. So for her to be behind me, and my husband supporting me I felt like I would be okay. The alarm goes off for us to wake up. I am now shaking I am that scared. We drive down in sunshine. I am nervous and I know Scott is. He doesn’t hide the nerves as well as he thinks he does. But he is there, ready to take care of me. I walk into the hospital by myself. All 307 pounds. I check in and they take me into a pre op room. I am given a gown, and an iv in my wrist for them to push fluids and meds. Scott and Mom finally make it to my little room / curtain. Mom, me, and Scott are on our phones. I think that honestly it was because we were scared. A transport tech comes in to wheel me to where they operate. I started crying because this is where I said bye to Scott and Mom. Mom gave me a hug and Scott kissed me. I was really crying to the point of hiccups. Am I really doing this? The tech saw I was upset. She grabbed my hand and told me I would be fine. Good changes are coming but I needed to stay strong. So I stopped crying. The doctor come in and saw how upset I was. Dr. Schmidt told me I was gonna be fine. He also gave me a light sedative to calm my nerves. When I stopped crying. I noticed the room I was in had the prettiest mural on the wall. So I sat there, staring at it. Watching all of the doctors and nurses that were at the end of the bed. There was me and two other women patients in the room. The lady to my left was having a hell of a time. They were going in for exploratory surgery (because they weren’t sure what was wrong) and the nurses couldn’t find an artery to put an IV in. I listened and watched. I know it was rude but I had my own stuff I was trying to forget. They tried her arm, her wrist, and then a spot on her leg. I didn’t even know they could do that. Ultimately they ended up putting the IV in her neck. Nurse and Anesthesiologist came in for me. They introduced themselves and then they asked if I knew if I was allergic to anything and I said not that I was aware. (this changes later, fyi YIKES!) A tech came over with a hair net and asked if I could put my hair in it. So I did. That tech wheeled me into the operating room. It wasn’t as big as they make them out to be in tv shows and movies, but the lights are very bright. They ask me to move from the bed I am on to the table. I remember saying I was scared when the Nurse put a mask thing on my nose. This was the point of no return. Then it went dark.

Process, Part 5

Sorry I have been gone. I have a ton going on right now but am trying to get back on track with this whole writing thing I am doing. So I haven’t been doing so great working out and my schedule this week has been crazy. Food has been a mess this week but I am maintaining, not gaining. Not to mention I haven’t been sleeping. Why haven’t I been sleeping? Well, after all this time, I have a puppy! A French bulldog I named Daisy. She smells, she whines, she bites toes, and I love her little face. Anyway, sorry for the delay.

daisy boo

So my food class was a week before the surgery. We drove for almost two hours to make it there. They really harped on the whole if you are late, you can’t attend the class. So what do I do? I go to the wrong hospital. We circled the whole building before I realized it was the wrong place. At this point I was panicking. I had approximately 5 minutes to get there or I had to reschedule. Scott (husband) hauled ass across town to get me there. Low and behold, I was five minutes late. I ran in and found out I was fine. Everyone got there late! It was a Saturday and we had to be there by 730 am. 

There was a lady running the class. I can’t remember her name but she works with my doctor. This amazing woman chose to have gastric bypass. This made me feel more comfortable because she had been through it herself. She knew what she was talking about. She wasn’t someone on the outside looking in. She also had the process she had to go through. She showed us her before and after pictures and she looked amazing. You know how sometimes if a person has a lot of weight on their body it tends to make them look older than they are? Well this lady looked 20 years younger post-surgery. There were more people in the room, like me, waiting on the surgery. There were people in there for every kind of weight loss surgery. At least 30 people in the food class total.

I was having it rough this specific Saturday. I cut all caffeine out a week prior so I had a mega headache. I decided that this was a good idea instead of doing it at the same time the liquid diet started. Now I was down to the liver shrinking diet (liquids only) so cream of soups, protein shakes, puddings, low calorie yogurts. That was it. Not only was I starving, I was tired. Sweet baby Jesus I was tired. I had help this Saturday. Scott came and helped me take notes. Without his help I have no idea how I would have made it through the day. He noted everything they said. I learned real quick that the Atkins shakes, while delicious, didn’t have enough protein and had too many sugars. They made a really big deal about liquid and protein. I had to sip water all day every day. In the first few months, it would be really easy for me to get dehydrated so it was important that I got in at least 64 oz. of liquid or I could end up in the hospital. The second was protein, I had to have at least 60 grams. I thought I was doing well with the Atkins shakes. There is a shake out there called premier protein and it’s highly recommended.

protein

 

It has 30 grams per shake. Almost double Atkins, with less calories and less sugar. Still, it tastes like garbage. The chocolate tastes the best to me. They have chocolate, vanilla, strawberry, and banana. They are VERY filling. I had to drink half and then go back and drink the other half of it later. It was that heavy. They gave us a sheet with all the foods that were high in protein and detailed out how we needed to eat afterwards. Your doctor might do this different than mine. I was on a liquid diet a week before, then the day before the surgery, clear liquids and sugar free popsicles. After the surgery is was clear liquids and broths I think this lasted a week for me, cream of soups and protein shakes a week after, then after I had the surgery it was two weeks before soft foods were introduced. I don’t think I ate meat for at least a month and a half. The teacher stressed how it was important to eat regular food and not to do baby food. Food is entered back into your life gradually after. Trust me, you don’t want to eat something before it’s time. I made the mistake of eating (or trying to eat) a sausage mcmuffin from McDonalds 3 days post op. I got down a bite and a half. Didn’t stay down. I puked in the bag that they gave me. To this day I can’t eat Mcdonalds. And that was the last time I had any food from there.

After the class, I had to go and have bloodwork done. They signed me in, took my weight, I started at 323 but when they weighed me that last time I was only 307. I was like yasssssssssss! Anyway, They were taking my blood, and the lady next to me (who was also in the class for the sleeve) was having severe caffeine and food withdrawal. She almost passed out she was that bad off. Made me glad I cut back on the caffeine a week before I started the liquid diet. After my blood was drawn, I visited another nurse who entered my information into the system for my surgery. I was to be there September 30, 2015 at 7:30 am, my surgery was at 9:30.

These are preop and post op foods that I ate.

 

Process, part 4

I went back for the second part of the sleep study and they attached me to all the wires again but this time the tech brought in a sleep apnea machine called a CPAP for me to use. The sleep doctor thought that I didn’t need a CPAP mask for my nose and mouth, and recommended a nasal only. The CPAP mask attached to a tube that was connected to a machine which forced air down my throat. After this visit they sent me home with my own CPAP to use. It was hard to get used to because I like to sleep on my side and stomach. It’s difficult to get comfortable sleeping with the mask on when you are used to sleeping in any position that isn’t on your back. hard with a cpap to sleep how i am used to sleeping. After a week of wearing it every night I started to get used to it and it did help me sleep better. I didn’t feel as tired like I did when I was waking up a hundred times a night.

Month seven comes and goes. I’ve completed all the required steps and turned in all the paperwork. Now it’s a waiting game to see if my surgery will be approved. My advocate Sunny sends everything off to the insurance company for review and told me that it could take a month to receive a confirmation that they were paying for it. Once it was confirmed she would call to schedule a time for my food class and surgery. At this point in time I met my now husband, Scott, and I didn’t waste any time telling him I was having the surgery. I was actually surprised he was interested in a relationship after I told him because my life was a hot mess but he became my hero. Scott was there for me through the hardest parts.

Well another month goes by, and I still haven’t heard from Dr. Schmitt’s office. I waited another week and then I called them. Sunny said she hadn’t heard anything but would check on it and call me back. Just my luck, she calls back and has bad news. My insurance apparently never received all of the paperwork that was sent. I did my part but I was mad and tired of waiting to have it approved. A couple more weeks go by and I get a letter from insurance saying sorry but we’ve denied the surgery. I called Dr. Schmitt’s office after crying my eyes out. Sunny said this is something that insurance companies do but she was still continue working to get it approved. That made me feel some what better and I waited again.

I am still not sure why insurance sent me that letter telling me that they weren’t paying for it because Sunny worked her magic and three weeks after that first letter, I received another saying that my surgery has been approved! Less than a day later I got a call to schedule my nutrition class and surgery. The nutrition class is required and usually scheduled a month before the surgery to give you info on how and what to eat before and after the surgery. They also walk you through the type of procedure that was selected.

At this point, I was excited. Scared and excited. My surgery was scheduled for September 30th 2015, the date that would change my life.

The process. part 3

After I was done with my appointment with Dr. Schmitt, they let me sit with Gwyn while we both spoke with the patient coordinator, Ashley. She filled us in on what it would take to have insurance pay for the surgery. This part of the process is different for everyone depending on what state you live in and what doctor you use. I had to complete a sleep study to determine if I had obstructive sleep apnea which can cause complications during surgery while under anesthesia. A general physician would also need to monitor my health for seven months. My doctor would fill out forms that documented my activities including exercise routines for the month, what my weight and blood pressure were, and what I did to try to lose weight. It was important that I tried my hardest so Dr. Schmitt could prove to the insurance company that I either didn’t lose enough weight or that I would gain it back.

Our forms would be forwarded to an advocate named Sunny, who would go back and forth with the insurance company to have them pay for the surgery. Some insurance companies are easier to deal with than others. At this point I was sad and frustrated. I had already waited 10 years to get here and now it was going to take almost another year for the surgery to happen. Before we were done with that first visit they took my picture. I didn’t want them to though. I was so big at 323 pounds and ashamed of myself but I knew they needed it for my before and after. I knew somehow I would get through this process and be successful.

YEAR

Having a general physician sign off on this is sometimes easier said than done. I lucked out and my general physician was happy to help me with this part of my journey. He was thoughtful and never made me feel ashamed for wanting to do this. Gwyn couldn’t find a general physician to agree that she needed the surgery right away. Each doctor she spoke with, and she spoke with several, all had their reasons for not signing the paperwork. Most of them only wanted to have her diet and exercise. Others didn’t believe in that type of surgery as a useful tool. Gwyn eventually had to stop her process because she couldn’t find a doctor who would help her.

I got a bill for that first Visit which had to be paid out of pocket because insurance didn’t deem it medically necessary. An hour office visit was 250 dollars and I was upset that it was such a big bill but at the same time I was happy to start the process. I was nervous to be going through this on my own. Looking back on it now, I wish I would’ve opened up to my mom more about what I was going through emotionally. I was not really talking to her about how I was feeling and that is something I wish I could go back in time to change but you can only move forward. She was there to support me when I would let her though and for that I am very grateful.

 

The next seven months went as expected. I would go to my doctor, have the paperwork filled out, they would fax it over and then repeat the process next month. In month 5, my general physician referred me to a doctor for my sleep study. I saw him once in the office and then picked my night out to go to the study. This was delayed twice due to weather and when I was finally able to go it was in the middle of a work week. I was instructed to come in by 8:30 so they could prep me. Which included attaching a lot of wires! They were on my head, chest, legs and attached with goopey goo. They concluded I had severe sleep apnea. I woke up over a hundred times in a 4 hour period and when I did reach the REM stage of sleep I wasn’t there long.

The process. part dos

Me and my friend Gwyn were on our way to Dr. Schmitt’s office. I didn’t want to step on the scale. I was nervous and afraid. The sleeve was a major surgery, and I wasn’t sold on it. I did research on my own, read about the procedures and looked up survival rates because that truly scared me. I wondered “Should I do bypass? Should I do the sleeve?” I knew it was going to be one or the other and I needed a permanent solution. I needed help.

We finally got there and settled into the office. Did the routine paperwork and insurance stuff. I looked at all the before and after pictures they had on the walls. They were all success stories and I wanted to be a success. There was also a BMI Chart on the wall, and against my better judgement, I went to see where I was on the scale. I am 5 feet, 5 inches tall and I weighed over 320 pounds. I was morbidly obese. My heart sank and I could feel tears rushing to my eyes. I already felt bad about myself and then to see something saying “morbidly obese” well, it’s hard. I kept telling myself “Today is a good day, you’ve got the best of friends by your side, and you are making the first step to do what’s best for yourself. You’ve got this!”

bmi

They call Gwyn back first then me. I remember her yelling down the hall to make sure I was okay and I did the same for her. The room I was in was your typical doctor’s office with posters on the wall of the sleeve. It’s not a new procedure but they want the public to know about it. They tend to sell the sleeve more for a few reasons. It doesn’t mess with absorption of nutrients like the gastric bypass does. It also doesn’t reroute the path to the small intestine. Mortality rates and complications are also much lower. I am sitting there on the weird table thing with the thin paper sheet and my vitals are taken by the sweetest nurse ever. I told her I was nervous, and she kept telling me “We are going to help.” My blood pressure was elevated. Throughout the entire process that was my only co morbidity. A co morbidity is something that is brought on by being overweight, like type 2 diabetes, high blood pressure, sleep apnea, etc. I am very lucky not to have type two diabetes with how big I was.

I am in this room by myself, trying to calm down when Dr. Schmitt walks in. He started asking me a ton of questions, “How long have you been thinking about surgery and what type of surgery I was interested in?” I was honest with my answers no matter how embarrassed I got. I needed help so there was really no point in lying because I would only be lying to myself. I said I have had issues with overeating and not eating right almost my entire life. I told him I used to be an athletic person and while I hate working out (lol), I don’t mind doing it. He said he thought the best option for me would be the sleeve. The procedure would take out 80% of my stomach, but doing so makes a smaller stomach, limiting the amount of food I am eating, and with the sleeve I could lose anywhere between 80 and 140 pounds.

It was decision time before I knew it. I told him I would like to continue with the sleeve and he started to explain that they had payment options available, but I stopped him. I said I would be using my insurance and he seemed disappointed for all of two seconds. I know now that is because it is a long process for all of the paperwork to get approved and he really wanted to help me now. He said “I will see you back here in seven months.” and I was off to see Ashley, the patient coordinator.

 

For the love of food.

I still have about fifty pounds I would like to lose. The odds of me losing it? Not sure. I try and eat wisely but sometimes I feel like my eating is out of control. Food is hard, and even if you have the surgery, you still have to eat better. I have good and bad days. It’s all about will power at this point. So with that being said, I’ve done pretty well this week. I haven’t overeaten or eaten anything to hate myself. I still can only eat small portions. I am supposed to eat three full meals and then maybe two snacks. But the snacking, that’s hard. It’s a habit that’s almost as old as me… I worry, I eat. I stress, I eat. I sit I eat. Everything in my life shouldn’t revolve around food. I do have one event coming up that is keeping me from completely messing up. My little sister is getting married in January and I am part of her wedding party.  I just want to look nice in the dress I get to pick out. I am sure I will now, but I just want to be a little bit smaller. Right now I am just maintaining.

So, yesterday was the 4th of July. We had hamburgers and hot dogs. What did I eat? OMG carbs. I had suddenly salad and a handful of fries. I just try and eat a limited amount of foods I like I didn’t eat a hamburger or hotdog. I wish I could say I had no regrets, but I always have regrets when I eat badly. It was just one meal I know but it still gets me. I always think “you start eating like this again, you’ll gain it back. Do you want to be that big again?” So I just try and eat a limited amount of foods I like. This next grocery trip, I do plan to eat better. What’s the point of working out if I am not eating better? I will blog about what I eat soon.  This will keep me honest and working on myself.

The Process. Part Uno.

YEAR

BEFORE AND AFTERSThis is my story. Yours might be different. With that being said, I am not an expert on the sleeve. I am just telling you what I went through. Just remember it’s your body. Your decision. Don’t let anyone make it for you or tell that you are taking the easy way out. Seriously, if people knew what your body goes through before and after the surgery they would shut up really quick about it. What’s a vertical sleeve? It’s a form of weight loss surgery. There are a few different options you could take. Gastric bypass, Vertical Sleeve (sleeve gastrectomy), duodenal switch, and gastric banding. I chose the sleeve. With the sleeve, the doctor takes a large portion of your stomach (about 80%), leaving you with a stomach the size of a small banana limiting the amount of food you can eat. My problem has always been portioning anyway. I don’t smoke, I don’t really drink, so food has always been my friend. Lots of food.

I was talking with my friend Gwyn (sorry lady, I can’t remember what function or holiday it is) and weight comes up. Gwyn says she’s considering the Vertical Sleeve and that she already had a doctor in mind. She was starting the process for insurance to cover and said she thinks it would be good for me to look into it. She knew I was having a hard time with my weight and that I was feeling down about it. She already did the research on the top surgeon for weight loss surgery in our area. Dr. Lee Schmitt in Birmingham, AL had the best background. Dr. Schmitt has been in this field for over twenty years. He is very proud of his work, focused on his patients, and overall he’s just a nice guy. At this point, I didn’t feel like I had anyone I could talk to about it, except Gwyn. I normally go to my mom for life changing decisions, but this one scared her, so I didn’t talk to her. I felt like I needed to do something. I felt like I was trapped in my body. I used to be this athletic, vivacious, and outgoing person. I let myself down when I let myself go. To get started, I had to watch a video to catch up with Gwyn. The video detailed statistics about obesity, the process before the surgery, and then explained the surgery. After I got done with it, we scheduled our very first appointment with the surgeon together. My process started October 13, 2014, with a mini road trip…

Curious? Wanna start your journey?

Find my doctors team here: http://www.alabamawls.com

nola me