What a rollercoaster this afternoon was! I got to my appointment early (big shock there), and filled out a little paperwork (I wasn’t aware this was going to be Weight Check #1), before the most adorable nurse took me back for my workup. Height, weight (I only cried once), and measured around the neck, waist (I told her I hadn’t had a waist since I was 14, so she said she’s make one) and hips. The hips I’ve known I had for a very long. She then took me back to the exam room, and said she would send in Dr Ali.
45 seconds later, in he comes. He introduces himself and asks how to pronounce my last name (everyone does) and I introduce my mom. He said he was glad to see that I’d brought a family member, and I replied that I was lucky to find out I have a huge support system behind me in this. This he was pleased to hear.
He spent the next fifteen or twenty minutes going over the patient history information I filled out on the UPMC portal. (I’m a huge proponent of portals.) He asked specifically about my history of depression, and asked about the Remeron I was taking. I told him m PCP put me on it for anxiety because I didn’t want a controlled substance (I know it can cause weight gain), but it made me sleep 14 hours a day. But at least I wasn’t eating if I was asleep! I told him I’d advised the doctor, and he wanted me to try half the dose, so I did, but still wasn’t happy with the result, so I’ll be calling him to see what else we can try. I told that otherwise, I’m not currently taking anything for depression. He gave me a funny look, but I told him that I don’t have depression now. Sure, I have down days occasionally, but nothing like the past. (It was pretty dark for a few years) I told him I wasn’t ready for surgery before, but I am now.
Then the talk turned to procedures. He had asked what procedure I was interested in, bypass or sleeve. I told him I had some a lot of research, and liked the idea of the sleeve, because with the family history of osteoporosis, and my personal history of hypocalcemia, I feared that the malabsorption that goes with bypass could exacerbate that. I had also seen my sister puke a bazillion times since she had her bypass, plus the dumping syndrome, so if I was a candidate for the sleeve, that’s how I wanted to go. My mom interrupted, and asked if I would lose weight slower with the sleeve, and I jumped in, without even thinking and told her that I would lose weight at the same rate with the sleeve as the bypass. The difference was that eventually the weight loss would slow sooner with the sleeve than the bypass. I told her that after a year or so of losing weight, I’d be more physically able to be active (by then, hopefully I’ll be sporting a shiny new knee!), so the rest of the weight will come off. I apologized to Dr Ali for interrupting and he laughed and said that I had definitely done my homework, and he was very pleased. He also told us that the sleeve is a much less invasive procedure than the bypass, which made Mom happy.
So here are the nuts and bolts.
- Yes, I’m a candidate for the Vertical Sleeve Gastrectomy.
- He would like me to lose about 40 lbs over the next six months.
- He wants me to start taking one high protein meal replacement shake a day. Either replace a meal or use it for a snack, whichever I decide. I’m thinking that’s my new breakfast.
- He wants me to eat 5 servings of fruits and vegetables a day; 3 the next week or two, then up to five.
- He gave me an order for a bariatric psych evaluation.
- He gave me an order for nutrition classes. I already have this set up, along with my monthly weigh ins. Month 5 will be done in Erie at his office; otherwise, I can do my weigh ins with he nutritionist.
- He gave me orders for a chest xray.
- He gave me orders for an EKG.
- He gave me orders for an obscene amount of bloodwork – Comprehensive Metabolic Panel, Lipid Battery, Hemoglobin A1C, and fourteen other tests. Some of them, I’ve never heard of before.
- He gave me an order for an Arterial Blood Gas. Those suckers hurt!
- He gave me an order for a sleep study.
- He gave me an order for an Endoscopy. They will call to let me know when those are happening.
- He gave me a food diary to document my diet, as well as help increase my water intake, and document my exercise. He is aware of my knee issue, and said to do what I can, so I will. I have a few ideas for that, too.
With that, we said our goodbyes, and he said he’d see me in September. I’m really glad that I chose him. He was glad that I have such a good outlook, and despite my little crying jag, which he said was normal, he said that he is sure things will go very well.
I’m glad it’s over. I was so nervous I barely slept last, and I’m a hurting unit now, but I’m also very excited!!! The first step is done. Now it’s on to the work of getting approved by the insurance company, and figuring out how I’m paying for my out of network deductible! I’m determined to make this happen, so I’ll do what I have to do.
Be kind, rewind, and love each other,