Pre-op testing phase 1

Last week, I had the required bloodwork (H. Pylori test, CBC, CMP) and my 5th diet check-up with my PCP, as well as my gallbladder ultrasound. Sadly, no stones. No two-for-one with this surgery! The technician did tell me that my liver is fatty, but heck… I figured that was to be expected.

This week I have the psychiatric evaluation Monday afternoon. Fun!

In other news, Lee & I got some pretty bad news in the mail yesterday. We’ve only lived in our new house since February, and it turns out the mortgage company underestimated our property taxes by nearly $400 a month. Yes, that’s right, our steady, fixed interest, 20% down conservative mortgage payment just went up by almost $400 a month. That may not sound like much to anyone, but to us it’s a serious problem. Especially considering the new motorcycle Lee just bought two weeks ago. I cried for a few hours wondering what in the heck we’re going to do (things are feeling a bit out of control these days), but Lee assured me we can make it work. I hope he’s right. It sure makes spending another $1500 toward my out-of-pocket maximum for surgery a little more scary. In the meantime, I’m researching part-time gigs I can do to earn some extra cash (on top of working full-time, being a PhD student, and teaching classes as an adjunct–sheesh).

Ah, well, life goes on. There’s always a way.


Reporting back from the consult

Friday was a blur. We arrived at Dr. Jawad’s office 30 seconds late (how I HATE being late!). After backing my truck into a tree (no damage), I scurried into the doctor’s waiting room that was filled with folks for today’s consults. I signed in, paid my program fee, and took a seat near my mom. I was immediately called back to a desk where a medical assistant took my blood pressure, weight, and temperature. I went back out into the waiting room and within 5 minutes Nicky (office administrator) came in and gave a short presentation on insurance, how the process works, how the day will go, etc. Once Kevin–the office’s Nurse Practitioner–arrived, he took over and started a PowerPoint presentation. Unfortunately, it was the exact same one I had seen at one of their information sessions so it was somewhat redundant.

After Kevin’s presentation, they started calling people back into exam rooms in the order we had arrived. Since I was last, I waited about an hour and a half to be called into my exam room. Kevin came in, asked which procedure I was interested in (and agreed RNY is right for me), went through my chart and medical history, and answered a couple of questions for me. Then he listened to me breathe, listened to my heart, and examined my abdomen. Kevin left the room, handed my chart off to Odalys (insurance coordinator) who then came in to discuss insurance and what I need to do next.

I loved Odalys. She seems like the kind of person I can hand my original physician’s letter of medical necessity to and not worry that she’ll lose it. She was, of course, impressed with my preparedness. I brought my 5 year weight history, notes from my 5 month supervised diet (1 month left!), recent labs, a letter from my first physician who retired, and my medical policy bulletin. We talked about timing. In the next 30 days, I will:

  • have my 6th follow-up with PCP for 6-month diet
  • have PCP write a letter of medical necessity (actually, I’ll write it, she’ll sign it)
  • have my 6th follow-up with my nutritionist for 6-month diet
  • get a gallbladder ultrasound
  • have a psych eval
  • get blood drawn to test for H. Pylori, Complete Blood Count, and Complete Metabolic Panel (no TSH necessary since I’ve had that tested twice in the last 6 months)
  • Nutritional eval for weight loss surgery (either with my regular nutritionist or a bariatric specialist)

I’ll have documentation on all of this sent to Odalys by October’s end (note to self: schedule everything October 22nd or earlier), and then she will submit everything to BCBS. BCBS has 14 days to give an answer (according to my policy), so I ought to have approval by November 15th or so (barring any insurance hold-ups). Once Odalys gets a faxed letter of approval/pre-determination from BCBS, my file goes to the surgery scheduler.

Now. Assuming the scheduler gets my file my mid-November (and yes, I realize I’m compressing what could take weeks of phone tag between me, Dr. Jawad’s office, and insurance), I will begin begging the scheduler to squeeze me in for the beginning of December. Very early December is ideal for a number of reasons:

  • I get about 11 days off over Christmas / New Year’s so combined with a week of sick time and a week of vacation time, I’ll have almost the entire month off to heal
  • My sister’s wedding is December 29th, so I’ll be able to lose that quick first 30 pounds or so before the event
  • I’ll have this done before I turn 26 in January and something just feels good about going into the new year and my 26th year of life in the recovery phase rather than the preparation phase
  • I’ll be able to get through the holidays without gaining weight like I normally would
  • I’ll be healed in time to teach my spring classes which started January 7th without having to either (1) have a substitute for the first couple of weeks or (2) have to give up the classes (and income) for the entire semester
  • I’ll have time during my month off to work on some very important PhD materials due in early January (which I haven’t even had time to begin thinking about)

In some ways, December does present a problem:

  • My fall classes don’t end until mid-December, so I’ll have to work with my profs to wrap them up early (which would actually be very nice!)
  • I have to wonder… will I really feel good enough to host Christmas at my house and be my sister’s Maid of Honor on December 29th if I have surgery that same month? All indications point to yes, I’ll feel normal after just a couple of weeks, but that’s assuming everything goes well.

Dr. Jawad’s office normally schedules a month and a half out, so I would normally be scheduled for early January and I’ll deal with that if it’s the outcome. But Odalys said that they fill up 3 surgeries per day in December first, and then go back and do a 4th surgery each day if they’re busy enough. I have my fingers crossed that I’ll be able to be a 4th surgery on one of those early December days. Right now I’m debating on whether I should go ahead and contact the scheduler to keep her informed of my situation, or if I should wait and let it unfold without bothering her (yet). I’ll probably just wait for now.

Ok, so that’s about it. I’m moving right along, taking the necessary next steps. And I’m very excited to be nearing the end of this pre-op hoop-jumping phase! Onward!

Today’s the day!

I’ve been waiting for September 21st for about 5 months. Today I finally get to go to my pre-op consultation with Dr. Jawad. What’s next? One more month of follow-ups with PCP and nutritionist, get a letter from PCP along with copies of my last month’s chart, get psych eval and other pre-op testing, and submit to insurance at the end of October. BCBS has to answer me in 14 days, so my real, final answer should come in about 40 days. Then I get scheduled at Dr. Jawad’s office (and pray there’s a break in the 2-month waiting list for me).

I shouldn’t be nervous about today’s appointment, but I am. I’m worried that I’ll find out the wait is longer, the staff sucks, the doctor is a doofus. I want to walk out of there today with a healthy dose of reality about the procedure, but with confidence that I’m in capable hands. My mom is coming with me this morning and I’m also a little nervous about having her there. This will be a lot of new information for her, and it probably would have been easier to go by  myself as planned. Oh well. And who knows? Maybe I’ll be glad she was there.

I’ll report back later this afternoon. Cheerio!

Maybe reverse psychology will do the trick


The folks at Knock Knock have written a new self-hurt series. One of the titles is How to Get Fat and includes 192 pages of get-fat advice. In their own words:

It’s not easy to put on weight. Everywhere you look it seems there’s another excuse not to eat. Too busy for snacktime or meals, the incessant desire to get out there and exercise—sometimes it just feels like the cards are stacked against you. Even if you’ve failed at weight gain before, with this easy, step-by-step guide, you’ll discover your inner corpulence. Explore the pleasures of amplitude—it’s time to get fat!

And all this goodness comes at the low price of only $9.95! I think I’ll order one for myself and one for a friend!

(Seriously, y’all, Knock Knock has the best greeting cards ever. I’m getting this one for a friend’s bridal shower next week.)

September 11th

This day still hurts. Partly because of the memory, partly because of the pain, but mostly because we purposefully bury it all and go on about our day.

Obesity = selfishness

From Oh My Stinkin’ Heck:

This will not beat me.

Because if it beats me? It beats my husband, my kids, my parents, my extended family, my friends …
Winner takes all.

Well said.

Motorcycle Mama

I just took two days off of work to enroll in a Motorcycle Safety Foundation Rider Course. Yep, I spent two days in the Florida heat learning to ride a motorcycle. It was hot, dirty, challenging, exhausting, and AWESOME. I can hardly believe I did it!

I have to admit, I’m not the most coordinated person. I made my high school’s softball team many years ago, but I pretty much warmed the bench all season. I have no balance, no natural coordination, no desire for anything physically challenging.

And to be honest, I’m terrified of motorcycles. But after about two years of trying to dissuade my husband from buying one, I realized  it’s a losing battle. Lee is going to buy a motorcycle and there’s nothing I can do about it, except make sure he’s not riding by himself.

And taking the course together meant that Lee had to TRY riding a motorcycle before he actually invested money in one. As luck would have it, though, he is a natural rider and he’s more pumped about getting a bike now than he ever was before. Honestly, I am too. It’s so fun!!!

We are big on safety, including all the proper riding gear, riding with groups, lots of practice, avoiding busy highways, etc. I just can’t wait to get my own bike!  It should be within the next 6 weeks or so.

The one down side is that I felt obligated to fill my parents in. (We were all at the hospital last night for the birth of a baby, and they asked about my sunburn.) They did not take the news well. In fact, my mom didn’t say a word (which is a bad, bad sign) and my dad was his usual sarcastic self (“just because you took a class doesn’t mean you can buy a bike” and “meghan, on a motorcycle? she can’t even hold a cup in her hand!*)

Three awesome outcomes from the motorcycle class:

  • My Florida driver’s license now has a “motorcycle also” endorsement on the bottom. I think that makes me bad to the bone, b-b-b-b-baad.
  • My legs muscles hurt like a mo’fo. I feel muscles I forgot I had. It feels great to be this sore!
  • My husband has a new respect for me. For the last 24 hours, all he could say was, “I’m so proud of you. You did such a good job out there!”

And a note to my training bike: You weighed 300 pounds. I weigh 330. Thanks for hanging in there with me, you little trooper.
*referring to my B12 issue which had me dropping stuff all the time. My B12 levels are now normal thanks to Animi-3 vitamins.