As addressed in my previous blog, I have started a new job which excludes itself from an insurance policy including bariatric surgery. After talking with my healthcare provider, I have decided to continue to complete my dietary visit requirements. My provider advised that if I completed my dietary visits, I could place a hold on my weight loss surgery for up to a year. Hopefully something will change to allow me to have this surgery.
That being said, I have unfortunately gained 4 lbs this month. It is not surprising as this is typical with me. I will lose weight and then gain it all back. I am working to lose it again but my dietary visit at the end of December will be the telling factor. That's all for now.
Happy Holidays and Merry Christmas to you all!
Sunday, December 1, 2013
Monday, November 4, 2013
Bad News Bears
Today is a sad day. During the course of my job change, I of course had to switch insurance companies. Unfortunately my new job has opted for a policy which excludes the insured from receiving the bariatric surgery. If you remember a previous post, I warned of this. It is a let down for me, but I have decided to continue to follow my diet plan to the best of my ability. I may continue to post updates here if I continue to reach weight loss goals. But past history has shown that weight loss will be slow and arduous for me. We shall see what happens. To the rest of you out there who have successfully gotten to have your surgery, best wishes. I hope the next part of your journey is also successful!
UPDATE: I have talked to the doctors office and they said to go ahead and continue my diet visits to complete the 6 months requirements. Perhaps I can convince my employer to opt into that policy within the next year.
UPDATE: I have talked to the doctors office and they said to go ahead and continue my diet visits to complete the 6 months requirements. Perhaps I can convince my employer to opt into that policy within the next year.
Pre-operative tests
There are several preoperative tests that are either required by insurance, or your pre-existing conditions, or your doctor. Below are the test that I was required to complete:
Psychiatric Evaluation:
This is done by a licensed professional to ensure that you mentally understand the requirements of the program, the results of the surgery (both positive and negative), and have a good support group to go to with questions. This also will address your habits of eating and what reasons you choose to eat (other than hunger).
Consult with a Dietician:
This consult is required to address your physical eating habits and show you healthy alternatives. The dietician should also tell you what to expect to eat after surgery.
EKG:
This is a requirement for every surgical candidate to ensure that you are not going into surgery with cardiac abnormalities.
Endoscopy:
In my case the physician required an endoscopy to ascertain if I had a hernia he also took a biopsy due to my previous history with H. pylori.
Psychiatric Evaluation:
This is done by a licensed professional to ensure that you mentally understand the requirements of the program, the results of the surgery (both positive and negative), and have a good support group to go to with questions. This also will address your habits of eating and what reasons you choose to eat (other than hunger).
Consult with a Dietician:
This consult is required to address your physical eating habits and show you healthy alternatives. The dietician should also tell you what to expect to eat after surgery.
EKG:
This is a requirement for every surgical candidate to ensure that you are not going into surgery with cardiac abnormalities.
Endoscopy:
In my case the physician required an endoscopy to ascertain if I had a hernia he also took a biopsy due to my previous history with H. pylori.
Thursday, October 3, 2013
Choosing Your Doctor
The first and most important step in the process of following through with any type of bariatric surgery is choosing your doctor. There are several aspects of choosing your doctor that you should be made aware of.
Insurance Coverage
The first step, is to find out which bariatric surgeon falls within your insurance network. When an insurance considers a doctor, or a facility, in network, that insurance has specifically made a contract with that entity to provide for services to you. Your insurance provider should have a list of providers who do bariatric surgery. If they do not, you can call your insurance company and ask a representative. If the doctor is not in network with your insurance, forget it unless you are willing to pay for the entire process out of your own pocket.
The Doctor
The first thing you want to look for, is a group of doctors who specialize in bariatric surgery. By looking for a group of doctors, you will have a doctor on call 24/7. Having a gastric surgeon on call at all times is absolutely crucial in case of complications after surgery. Do not use any surgeon who does not have someone to take call for him if he is not available.
The second important thing with choosing a bariatric surgeon, is finding someone who is fellowship trained. A doctor who is fellowship trained has spent months or years training with someone who is experienced at doing this type of surgery. Any general surgeon can actually do this surgery, but a physician who is fellowship trained knows not only how to do the surgery, but what complications to expect after the surgery. The fellowship trained surgeon also knows what type of tests you will need to have before your surgery, to ensure that you are at your most healthy when going into surgery. There will be another blog on my experience with these pre-screeners.
The second important thing with choosing a bariatric surgeon, is finding someone who is fellowship trained. A doctor who is fellowship trained has spent months or years training with someone who is experienced at doing this type of surgery. Any general surgeon can actually do this surgery, but a physician who is fellowship trained knows not only how to do the surgery, but what complications to expect after the surgery. The fellowship trained surgeon also knows what type of tests you will need to have before your surgery, to ensure that you are at your most healthy when going into surgery. There will be another blog on my experience with these pre-screeners.
Make sure to ask the surgeon how many surgeries, of the type you have chosen, they have performed. You want someone who has performed in the hundreds of your type of surgery if that is possible. If it is not possible, but they are fellowship trained, I wouldn't necessarily exclude the doctor from being your choice.
The Staff
Assess the staff on your visits and ask other clients about their experiences. How does their nursing staff treat you? Do they have an insurance specialist who can guide you through the confusing process of obtaining insurance approval? Do they provide you information or suppliers on obtaining meal helpers like protein supplements and high quality vitamins? Do they help you get through the process of your pre-screeners such as helping you schedule them?
A good doctor and staff will meet all of these criteria. Some even more. Make sure that you have the best from the beginning, so that you don't suffer unduly after your surgery. These suggestions are all of my opinions, based on my experiences up to this point. Happy doctor hunting!
A good doctor and staff will meet all of these criteria. Some even more. Make sure that you have the best from the beginning, so that you don't suffer unduly after your surgery. These suggestions are all of my opinions, based on my experiences up to this point. Happy doctor hunting!
Types of Bariatric Surgery
Hello everyone! I have been remiss in keeping up with my blog, but now I have the time to do so. Today's blog is about the different types of bariatric surgery covered by insurance at this time (2013). This is a not medical advice, but simply a tool to help you start your journey. At the end of the blog, I will also tell you which surgery I have chosen and why.
"LAP" or "Realize" banding
When people think of Gastric Banding, most people call it the LAP band. What most people don't realize is that there are several different types of this product that are out. The reason that people know this type of surgery as the "Lap Band" is because it was the first big hit of its kind. The Lap band, as I will continue to call it hence forth, is a device which is placed around your stomach. (see photo)
As you can see above, the band is placed around the top of the stomach which is where your feelings of fullness generate. In the bottom right hand corner of the picture, you can see the port. This port is sub-dermal (under the skin) and allows for the band to be adjusted by injecting saline into the device. This process tightens the band, or reduces the band.
Although this process is minimally invasive, because it is done laparoscopically, it has its own negative aspects. There have been reports of the band slipping from its proper position, causing perforated bowel, and obstruction of the stomach to name a few. If seeking this type of surgery, you should speak with your doctor to understand fully all of the risks.
Gastric Bypass
When most people think of bariatric surgery, this is the type of surgery that they connect the phrase "bariatric surgery" with. If I am not mistaken, there are a couple of types of bypass surgery, but I will only be discussing one, The "Roux-en-Y".
In this surgery, the top portion of your stomach is sectioned off from the rest, and reconnected to a part of your small intestines. This surgery bypasses the duodenum which is responsible for most nutrient absorption. The patient will still have all of their organs, but those organs are re-routed to restrict both how much the patient can eat, as well as nutrient absorption. This type of surgery is the most invasive; even though it can be done laparoscopically, many surgeries start out as a laparoscope and then some, by necessity, become an open surgery.
This surgery is very effective, a person will lose roughly 70% of their body mass simply by having this surgery. However, there are some serious complications that can arise by having this type of surgery. The most major being death, which can happen with any surgery, however it has occurred more often with this type of surgery than others. See this excerpt from the mayo clinic to read further about complications, most notably the vitamin B12 and D deficiencies as they are common with people who I personally know that have had the gastric bypass surgery.
Gastric Sleeve
The gastric sleeve is a surgery where approximately 3/4 of your stomach is removed from the body. The stomach is then stapled closed and the staples will remain with you for the rest of your life. Your body will scar over the staples, and you will still be able to have procedures such as MRI. This surgery, while also a major surgery, is minimally invasive because it is usually done laparoscopically. This does not mean that complications won't arise, but the likelihood of the surgery becoming an open surgery is far less than the gastric bypass. This surgery is only restrictive in the amount of food you eat. It does not intentionally restrict the patient's nutritional absorption. However, patients who do this type of surgery also lose around 70% of their body mass by just having this surgery. Complications from the surgery can include death, but from my understanding this is not that frequent an occurrence. There have been some patients who also experienced problems with vitamins B12 and D.
From the varied resources I've had, including the experiences of my friends, most people are recovered from all three types of surgery in about a week and can return to normal life. Some have needed up to three weeks recovery time. Each surgery has it's own restrictions for lifting weight for a time after that, as well as other restrictions, but those are things you should discuss with your doctor based upon your body. The most serious concern after any of these surgeries, is the development of a blood clot. As soon as you are able to stand on your own two feet and start walking, and after being cleared by your doctor to do so-start walking. Up and down the halls or in circles around your room if need be. Blood clots can be very life threatening, and are not uncommon. So do yourself a favor and get up even if you are still in some pain.
My Choice
For me, the choice was simple, I wanted the Gastric Sleeve, even when it was still in the experimental stage. To me this is not only a permanent tool in helping my weight loss struggles, but the most risk-free procedure. As with any surgery infection is a possibility, but I didn't like the thought of a large foreign body device in my abdomen (the Lap Band); this could be a foothold for bacteria to grow on, which would necessitate the removal of the device. Also, many people who have had the lap band removed after a successful weight loss have gained their weight back. The gastric bypass was always out for me; in my opinion it was too invasive and too complicated for what my body needed. My personal opinion is that the Gastric Bypass should only be reserved for the Super Obese; those people who are so large that they cannot even take care of their basic functions anymore. I just need a tool which will restrict how much I can eat, but will eventually allow me to lead a normal life. No tablespoon sized portions, but a normal meal, roughly thought of in today's standards as a kid sized meal. Right now a piece of meat should not be any bigger than the open palm of my hand, but after my surgery and after a full recovery I will only be able to have a piece of meat that is 1/3 of that size.
It is important to remember that with any of these surgeries you can still gain weight. These surgeries are only a tool for your use. It is up to you as the individual to follow your diet plan and make a lifestyle change. It is solely on your shoulders to follow the dictates of your doctor for a plan to lead a healthy life. These surgeries can and will cause significant weight loss, but it is possible by your actions and your choices in food to stretch out your "new" stomach. If you cannot make the changes needed, then you will eventually return to your starting point. Some people even have to have new surgeries. Don't let yourself be one of those people. Persevere and "Just keep swimming" even through the darkest of times, and eventually you will meet your goal.
To those of you who are reading this and starting your journey, I wish you all the best.
It is important to remember that with any of these surgeries you can still gain weight. These surgeries are only a tool for your use. It is up to you as the individual to follow your diet plan and make a lifestyle change. It is solely on your shoulders to follow the dictates of your doctor for a plan to lead a healthy life. These surgeries can and will cause significant weight loss, but it is possible by your actions and your choices in food to stretch out your "new" stomach. If you cannot make the changes needed, then you will eventually return to your starting point. Some people even have to have new surgeries. Don't let yourself be one of those people. Persevere and "Just keep swimming" even through the darkest of times, and eventually you will meet your goal.
To those of you who are reading this and starting your journey, I wish you all the best.
Friday, June 28, 2013
Introduction, and explanation
Hello everyone,
This blog is about my journey to have bariatric surgery. It is my hope that this blog will help another person in their journey as well. I understand that this is a controversial, yet more accepted weight loss tool; but I also know that it is an extremely effective tool. There are many who would ask why someone would have bariatric surgery, I myself used to be one of those people. I never thought of it as an option for myself until about two years ago.
Two years ago, a very close friend had decided to do the gastric bypass surgery. She was successful with the surgery but also had a lot of nutritional problems. It was then that I realized that this is not a quick fix tool. This is a tool that will require a lot of sacrifice and dedication. You cannot simply have the surgery and everything is better. Firstly, each requirement from your insurance company may be different. Secondly, your doctor or group may have various requirements that must be completed. The requirements for my surgery will be discussed at a later time.
You may be asking, "Why is she taking such a drastic step just to lose weight?" There are so many reasons and I intend to be completely honest. For my entire life, I have been overweight; always teased and looked down upon of course, although I feel I have overcome my internal struggle at society's treatment of me. I love myself, I just really and truly want to be more healthy. I don't care if I look like a model, I would be happy with just being a healthy weight. Related to my health, I have many health problems that have also affected me and which would get better if I could lose weight: Asthma, Polycystic Ovary Syndrome (PCOS), and recently a Vitamin D deficiency, also I have Sleep Apnea.
What is Asthma? According to my doctor, it is actually a form of "Chronic Obstructive Pulmonary Disorder (COPD)". I have had this my entire life, and when I was young, I was in the hospital on numerous occasions for asthma attacks which could have, and sometimes almost killed me. When someone has an Asthma flare up, their lungs become inflamed and narrow the airways. You can read more about it HERE.
What is PCOS? Polycystic Ovary Syndrome is a disease in which the female ovaries forms "cysts" which are actually structures called "follicles" which retain the immature egg, instead of fully developing and releasing the egg. This disease causes an excess production of both female and male hormones, increased insulin levels, and makes it hard to lose weight, and can cause Vitamin D deficiency. I have all of these symptoms of PCOS. You can read more HERE.
Aside from these health reasons, I also would like to be a police officer. Whether that actually happens is something completely unrelated; however, unless I can pass the physical fitness test I will never get the chance to be a real contender.
I would also like to have a family someday, and my continued weight gain decreases the chances that I could actually conceive a child. Furthermore, I'm not really interested in being with someone while I'm overweight. It's just how it is for me. But I always appreciate man candy, it goes easy on the eyes. :)
I hope that whatever your opinion, you will enjoy reading about my progress over the next couple of months to the next couple of years. For those of you reading because you have made this decision, I hope this helps you in some way.
This blog is about my journey to have bariatric surgery. It is my hope that this blog will help another person in their journey as well. I understand that this is a controversial, yet more accepted weight loss tool; but I also know that it is an extremely effective tool. There are many who would ask why someone would have bariatric surgery, I myself used to be one of those people. I never thought of it as an option for myself until about two years ago.
Two years ago, a very close friend had decided to do the gastric bypass surgery. She was successful with the surgery but also had a lot of nutritional problems. It was then that I realized that this is not a quick fix tool. This is a tool that will require a lot of sacrifice and dedication. You cannot simply have the surgery and everything is better. Firstly, each requirement from your insurance company may be different. Secondly, your doctor or group may have various requirements that must be completed. The requirements for my surgery will be discussed at a later time.
You may be asking, "Why is she taking such a drastic step just to lose weight?" There are so many reasons and I intend to be completely honest. For my entire life, I have been overweight; always teased and looked down upon of course, although I feel I have overcome my internal struggle at society's treatment of me. I love myself, I just really and truly want to be more healthy. I don't care if I look like a model, I would be happy with just being a healthy weight. Related to my health, I have many health problems that have also affected me and which would get better if I could lose weight: Asthma, Polycystic Ovary Syndrome (PCOS), and recently a Vitamin D deficiency, also I have Sleep Apnea.
What is Asthma? According to my doctor, it is actually a form of "Chronic Obstructive Pulmonary Disorder (COPD)". I have had this my entire life, and when I was young, I was in the hospital on numerous occasions for asthma attacks which could have, and sometimes almost killed me. When someone has an Asthma flare up, their lungs become inflamed and narrow the airways. You can read more about it HERE.
What is PCOS? Polycystic Ovary Syndrome is a disease in which the female ovaries forms "cysts" which are actually structures called "follicles" which retain the immature egg, instead of fully developing and releasing the egg. This disease causes an excess production of both female and male hormones, increased insulin levels, and makes it hard to lose weight, and can cause Vitamin D deficiency. I have all of these symptoms of PCOS. You can read more HERE.
Aside from these health reasons, I also would like to be a police officer. Whether that actually happens is something completely unrelated; however, unless I can pass the physical fitness test I will never get the chance to be a real contender.
I would also like to have a family someday, and my continued weight gain decreases the chances that I could actually conceive a child. Furthermore, I'm not really interested in being with someone while I'm overweight. It's just how it is for me. But I always appreciate man candy, it goes easy on the eyes. :)
I hope that whatever your opinion, you will enjoy reading about my progress over the next couple of months to the next couple of years. For those of you reading because you have made this decision, I hope this helps you in some way.
Subscribe to:
Posts (Atom)