Journey starts TOMORROW!

Officially!!!

Tomorrow starts the new me :)

I couldn't be happier. I am not really nervous. I'm just so anxious. I haven't been able to really sleep past 9 lately because I just want to get up and read the forum to make sure I haven't forgotten to ask something. Or, get little things done around the apartment.

My surgery is tomorrow, December 20th, 2010. At 1:30 p.m. I have to be at the hospital by 11:30.

Nervous.

I have been going back and forth all week if I wanted to post my starting weight.

I have NEVER felt comfortable with sharing my weight with anyone.

But, after much thought I decided I would share. After all, the purpose of this blog is to show others that they can do this too!

When I first started my journey I was 317 pounds.

That was how much I weighed at my first appointment with Dr. You.

The next appointment I was 309.

Most of that was because I was sick. And, I thought I'd gain it all back after I felt better.

Last Monday, December 6th I started my Pre Op Diet.

As of Saturday December 11th I am down to 296.4.

I'm very excited. My goal for myself was to be under 300 by surgery day.

Since a lot of people are asking...

how things work in order to have surgery, I figured I'd make a quick post about it.

Basically, I decided in July that I wanted to have WLS. I knew my insurance covered it since my mom who has the same insurance as me had Lap Band in February. But, I called the insurance company to ask for myself.

While the requirements will change per insurance company, here's what was required for me by Cigna: (This is simply copied and pasted from Cigna.com)

CIGNA covers bariatric surgery using a covered procedure outlined below as medically necessary when

ALL of the following criteria are met:

• The individual is ≥ 18 years of age or has reached full expected skeletal growth AND has evidence of EITHER of the following: a BMI (Body Mass Index) ≥ 40 , a BMI (Body Mass Index) 35–39.9 with at least one clinically significant comorbidity, including but

not limited to, cardiovascular disease, Type 2 diabetes, hypertension, coronary artery disease, or pulmonary hypertension

• Failure of medical management including evidence of active participation within the last two years in a weight-management program that is supervised either by a physician or a registered dietician for a minimum of six months without significant gaps. The weight-management program must include monthly documentation of ALL of the following components: weight, current dietary program and physical activity (e.g., exercise program)

I also had to meet with a nutritionist twice. And, have a psychological evaluation done.

My surgeon had to write a report also. And, just to have extra documentation I had my Primary Care Doctor write me a letter stating it was medically necessary.

So once I found all this out, I decided to go online and find a surgeon. Originally, I wanted the LapBand so I went on to Lapband.com and registered for a seminar. It is required to attend this education seminar.

Once I changed my mind about the Lapband I followed up with the insurance company to make sure they covered the Gastric sleeve (or VSG) Which they did.

Scale!

Well, it was about time for me to get a new scale. The one I had would CONSTANTLY change the numbers on me. I'd get on it, it would show me one number. Get off. Back on, only to see a completely different number. This never failed.

So I wanted to find a scale that would WORK! I went onto AMAZON.COM and searched.

The first one I found looked interesting so I read the reviews. I was amazed. There was a lot of positive reviews. People saying they tested the item, and it was correct. I also noticed that any of the negative reviews had comments from the Company offering to help.

I decided to order that scale. :) Well, it came in the mail YESTERDAY! And, of course I had to play with it. First order of business was to get on and see how much I currently weighed. With the other scale not working correctly, I just felt the difference in my clothes to know I lost some weight. So anywho. I'm currently down a total of 21 pounds from the FIRST visit to my surgeon's office where I got weighed :)

Then I decided it was time to play on the scale. I got on and off. Each time it read the same number. Then, I got on with a bottle of mouth wash. Slight difference. Ok, YAY! It's working. Then I get back on without it. I get the first number.

Needless to say, I'm excited that I have a working scale. It also came with a tape measure so I decided I will start tracking my inches AND pounds lost. I will update my blog on Sunday's. :)

Not much longer until surgery!

Pre Op Diet...

Monday started the Pre Op Diet.

To say the VERY least I wasn't prepared. I would blame that on two things.

The biggest thing was that I wasn't even officially approved for surgery yet. I was simply starting it because I know my surgeon requires 2 weeks of a Pre Op diet. And, in our last appointment he scheduled me for December 20th. I was so nervous that my decision would be overturned, and if I didn't start my diet I'd be pushed back in time. And, that wouldn't work! So I decided to start early on! It was just hard to get my brain to catch up on WANTING to start in the event and my heart feeling like WHAT IF I DONT GET APPROVED?

Oh, and that I didn't go grocery shopping before Monday. Bad idea on my part. I know. But, I didn't have the money to go out and shop. Especially because it seems like the "healthier" stuff is always more expensive.

So, anyway I started the week very simple.

I packed the following:

If you can't see it it's only a bottle of water (which I kept refilling at work) Raspberry Greek Yogurt, Oatmeal, a Protein Shake, Water Packets, and SF Pudding.

I didn't realize until Monday night that on my list of approved items, I could have Raw Veggies as long as they were plain.

Needless to say, Monday and Tuesday did NOT go over very well. I was tired, cranky and just annoyed. But, I kept telling myself that I couldn't cheat. That if I allowed myself to cheat NOW it would just be THAT easy to cheat after surgery. And, once I have surgery, I want to be in the best mindset to succeed.

Tuesday night Phil and I had an appointment and I was feeling down and sluggish. I didn't want to move. I just wanted to curl up and sleep! But, on the way out, I thought to pick up a Muscle Milk to get some extra protein, and vitamins. But, when I walked into 7-11 I seen a Slim Fast Meal Replacement Shake. It was so good. Tasted just like Yoohoo! And, within ten minutes I was feeling great.

I really feel like I just wasn't eating enough calories. I wasn't getting enough protein. So of course I would feel bad.

We also went shopping on Tuesday. So I picked up some stuff.

Everything was on my approved list, except the Slim Fast Shakes. I only bought four of them. And, decided to only use them in emergency situations where I needed a pick me up. I have yet to drink one. But, I wanted to have them on hand because at work, being sluggish isn't an option.

So shopping I have been feeling much better. I have a little more energy.

I also picked up some unflavored protein powder on Wednesday. I can add that to just about anything to get to my minimum of 60 grams protein per day. I don't like the smell, and while I think it does slightly change the taste of things, it's still worth the added boost to my food to help me reach 60 grams.

The lady at the pharmacy also gave me three samples. Two chocolate protein shakes (one with Splenda, one with OUT) I prefer WITHOUT!, and a chicken soup flavored one.

Since yesterday I've been tracking my food on spark people. And, I can see I'm finally getting more calories. I'm suggested to get about 1000 a day. Yesterday I had about 700. And, today I'll probably end up with the same.

I'm feeling much better. But, I'm still starving. I want real food. But, it's mind over matter. I still open the fridge in hopes of talking myself into eating something. But each time I do, I grab one of my approved items. Step by step, I'm going in the right direction. I CAN DO THIS!

I'm also down a total of 12 pounds. It could be more but my scale sucks and it constantly giving me a different number. But, It did read the same number the past 2 mornings.

APPROVAL!

Today, I called to see if anything had changed with my reconsideration. And, I found out!

IT'S BEEN APPROVED!!

They faxed over a document on Friday saying I had been pre approved. But, there was no paper in the fax machine until today so I didn't get it until today! After I had talked to the insurance company.

Whoohooo I am excited!

UPDATE:

As of December 8th I have received my approval letter in the mail!

And, today I received my date! December 20th, 2010 at 1 pm.

Life after the D word....

blah! I faxed off all the necessary paperwork on Thursday. I was lucky enough NOT to have to appeal the decision, just fax the addition information over to the authorization department.

And, I have been waiting impatiently ever since.

Especially since I am supposed to start my scheduled PRE-OP diet tomorrow (Monday, December 6th)

But, after debating the decision back and forth, asking other sleever's opinions, I have decided to just go ahead with the PRE-OP diet, and hope for the best.

So starting tomorrow I will be on liquid's only. I have a nice little bag packed for tomorrow.

As for tonight, I wanted some real food. For the past few weeks I have been trying to make better choices, and as a result, I'm down 9 pounds.. well, some of that was from a cold! But, down nonetheless!

Tonight, I decided I wanted a sub. A cheeseburger sub with mustard, raw onions and pickles.

I didn't go all crazy like I thought I would. I'm trying to not think of this as the Last Supper. But, as a new start to my NEW and improved life.

Anyway, off to finish some stuff up before bed.

Additional Information!

After talking to the insurance company I learned I was denied because I didn't have enough information for the six month diet program I was on! And, I didn't have proof it was supervised by a doctor!

However! I still had my journal from Transitions so I fixed things up a bit! And, faxed it over :)

Man, I hope this works! I want an approval !

Denial....

So the insurance company DENIED my request.

I'm really not 100 percent sure why right now. I'm waiting for the letter to come in the mail.

But, the person I talked to on the phone made it seem like it was because I didn't have six months of documented weight management. Which I DID! So, I'm pretty confused.

But, it'll get figured out soon. And, I'll try again :)

I have faith that with some patience I will get my approval. Now, I'm just hoping I can still have my December 20th date!

At first I was really upset. But, after I talked to some people I realized this is just a little bump in my journey.

My mom was denied TWICE before getting her approval. Once through our old insurance company and again by Cigna. But, with Cigna.. (who we have now) she submitted everything on the 1st. was denied. Fixed things.. and was approved and had surgery on the 17th (of Feb) So I'm not going to give up.

This little bump is nothing. I'm on the road to a healthier and happier me. Even if surgery is delayed. Gym starts Monday.

Not approved... but, not denied!

This waiting game SUCKS. I haven't heard back from the insurance. While it's only been a few days or so... I'm STILL anxious.

I am just hoping and praying that it will be approved with little to no issues.

I really want my December surgery as planned :)

a daaaaaaaaaaaaaaaaate!

Oh my gracious!

I can't believe it! But, I have a date!

As long as my insurance approves the surgery, my date is December 20, 2010!

That's so exciting to me!

That will mean my pre op starts on December 6th!

goodness GRACIOUS!

As long as my Insurance company approves my surgery, I have a date!

December 20, 2010!

That is only..... 29 days

Education Class....

Yesterday was my MANDATORY education class.... I was really nervous.

Part of that was because I didn't know what to expect.

But, once I got there it wasn't all that bad.

I met a lady named Diane who I chatted with a little bit before the class started.

There was only three people there for the class.

We had to take a quiz to see what we already knew about the requirements for surgery.

I took it and got ALL THE ANSWERS RIGHT!!

Then we went over some pre surgery stuff... and then post op stuff.

I'm really hoping I get approved for surgery in December.

I'm still hoping my paperwork gets submitted to insurance this week.

Friday is my appointment with Dr. You

frustrated...

I had my last appointment with the nutritionist over a week ago.

I called last Thursday to see if they submitted the paper work over to my surgeon's office. Only to find out they haven't. I gave them a call.... and the lady was kind enough to say they'd fax it right over. Today is Monday and they STILL don't have it! I called again, and she said the same thing. I even gave her the number to make sure they had the right one.. since my surgeon just switched offices. And, now I just wait and hope they submit them soon!

I am HOPING AND PRAYING for a December surgery. This will work best for me. I have seven days off for Christmas break... and just feel like this is the best time. I don't want to be laid up during Spring Break!

I am hoping that once my paperwork is submitted to insurance I'll get a quick approval.

Blahhhhhhhhhhhhhhhhhhhhhh

What is the Sleeve??

During this procedure the surgeon removes about 85 percent of the stomach so that it takes the shape of a tube or sleeve. This operation is performed laparoscopically, meaning that the surgeon makes small incisions as opposed to one large incision. He or she inserts a viewing tube with a small camera (laparoscope) and other tiny instruments into these small incisions to remove part of the stomach. The tube-shaped stomach that is left is sealed closed with staples.

______________________________

The following is from my surgeon's page:

How a sleeve gastrectomy works to help you lose weight

During this procedure, a thin vertical sleeve of stomach is created using a stapling device and the rest of the stomach is removed. The sleeve is about the size of a banana. This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption. Food consumed passes through the digestive tract in the usual order, allowing it to be fully absorbed in the body.

The sleeve gastrectomy procedure

The majority of weight loss sleeve gastrectomies performed today use a laparoscopic technique, which is considered minimally invasive. Laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures.

The length of time of the surgery varies. One study found that the average operative time was 1 to 2 hours and the average hospital stay was 1 day. Patients usually return to normal activities in 2 weeks and are fully recovered in 3 weeks.

Sleeve....

So originally when I started my journey, I thought I was going to have Lap Band surgery. I did a lot of research, felt as if I was 100 percent secure in my decision... and waited for everything to be complete so that I could have my date. But, when meeting with my nutritionist she made a comment that made me start to think. She said that the band is the LEAST invasive surgery... which means you lose the LEAST amount of weight. I know I have a lot of weight to lose and I started to think maybe I should look into the other weight loss surgery options.

That being said, I went home that night and started looking things up. I knew I wasn't comfortable with the idea of Gastric Bypass.. It's just too severe. And, I originally wasn't too comfortable with the idea of the Gastric Sleeve. From when I learned in the consult, it was a fairly new procedure. Only about five years old, that scared me. I wanted something that had been around a little longer... that had more success rates.

Once I started to research, I read a lot of things. I learned that a lot of people with the band eventually end up gaining their weight back. The band requires a lot of up keep, and a lot of times people struggle with being able to eat. I have watched my mom struggle with her band. She often gets stuck. The look on her face when this happens, scares me.

After I spend some time researching the sleeve, I decided I wanted to continue on this journey for weight loss surgery. But, switch to the sleeve.

Supplement Reviews

Basically this is only a place for me to write about the different supplements I've tried.

That way if there's one kind I try, that I ABSOLUTELY hate....

I don't make the mistake and buy it again.

Anyway.

So far I've tried:

Bariatric advantage's tropical fruit multi vitamin.

The first crunch into it reminded me of a Flinestone vitamin.

But, it left a GROSS after taste. YUCK! I don't think I'll have take them again.

Then, I tried Celebrate Vitamin's grape multivitamin. It was actually good.

The after taste is minimal.

I think I'm going to give a few more a try before making my final decision. Afterall, I'll need to take these supplements daily for the rest of my life. So I don't wanna just JUMP into picking my first batch.

But, Celebrate sent me a bunch of samples to try....

Final Meeting with the Nutritionist

Today was my last meeting with the nutritionist BEFORE surgery.

I'll have to meet with her one more times about 2-3 months after surgery.

But, for now... I'm done! :)

We basically went over my meal plans for after surgery.

And, set up some plans for me to start NOW!

The plans for now are :

Start drinking 1% milk, or skim. If I chose soy, it has to be LOW FAT.

I need to add more vegetables in my meals. Either raw, or frozen. I should be eating about 2 cups per meal.

I should start getting in the habit of bringing my lunch to work about 3 times a week.

Start cooking dinner more. At least 3 times a week.

Buy a pedometer, and try to get 10,000 steps in EACH day.

I'm happy to at least have a plan while I wait for the insurance company to decide.

I am going to start researching different vitamins.... look into purchasing some items that were suggested to me!

I have a class on November 16th.

my paperwork should be submitted soon! :)

YAY!

Alright, I just found out that my psych evaluation report was faxed to my surgeon's office.

Now, I have to finish up my last nutritionist appointment on Wednesday...

and ALL my paper work will be submitted :)

After this appointment my next thing to do is my

Track THREE class that will be on November 16th

Rant....

When I booked my appointment with the psych for my eval, the lady mentioned there would be a 150 dollar report fee. She said that rarely this is covered by insurance but to check with mine to see. So I called and spoke with five different people who ALL said it was covered. Today when I went to my appointment, I told them what the insurance people say and they said ok and just charged me my co pay. You could tell they were hesistant because they kept saying how theyve only had one persons insurance pay for it in the past, blah blah blah. But since I signed a waiver saying if insurance refused to pay I would, they let it be. I left the office, and called the insurance company again to check AGAIN because with the ladies responses I wasnt feeling very confident. The rep I talked to this time told me the report wasnt covered. Blah. What the .......... Now, I am mad because I have to go back in a week to pick it all up. And, let them know about the insurance issue. As well as pay the 150 report fee. :( I feel stupid. I know mistakes happen, but it's still rather awkward.

I also recieved an email from the coordinator of my bariatrics program telling me she was worried with some of my documentation. Turns out shes not sure about my weigh in from August because it mentions being seens for sun burn AND Lapband. She states that most insurance companies want to see that a patient is being seen primarily for weight so it worries her that sunburn is listed first. This annoys me. First, because while it does say sunburn, it also has a note about lapband follow up. Why does it matter if I was being seen for multiple reasons? Especially it still says LAPBAND on there? She then asks what I want to do next.... After talking to my mom, who has been through this journey.... with the same insurance company.... the same doctor....she said i should just submit it as is. She said when she went for her monthly doctor visits she didnt have to say lapband each time to be approved. So I decided to submit. Hopefully, ill be approved. But if not, ill face that when it comes to it.

One appointment down, two to go. Then I can have all of the paperwork submitted to insurance and be on my way.

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