Modified Liquids

Since things have been so delayed due to my surgeons office loosing my psych eval, and having to wait for 3+ wks for my psychologist to get back in her office to resend it. I decide to go on and make some big changes in prep for surgery in hopes that when I am approved I can swing a 1 wk preop all Liquid Diet instead of 2 wk. The purpose of the liquid diet pre-op is to drop several LBS quickly to shrink the liver to make it easier for the surgeon to work around. The surgeon described it to me as your liver is very "real" time.... if you are gaining weight it is larger even if you are small, if you are loosing weight it is smaller, even if you are heavier. Also my Dr wants me off Advil and Aspirin for wks prior to surgery so I stopped those 2/21/13.
Starting 2/25/13 I have been eating what I am calling a modified liquid diet, cconsisting of Protein shake for breakfast and lunch, cottage cheese for snack and reasonable dinner with my family... so far I am down 2 LBs, total loose since my first Dr appt 11 :)..woo hoo! Still holding my breath I can have a March surgury date!

Why I Choose Lapband

So I know I have some family and friends that read this as well as some new WLS buddies, So I thought I would layout the different WLS options and why I choose Lapband.

First there is an option called the Sleeve


with this surgery the surgeon removes half of the stomach. Patient would eat about the same amount of food as a Lapband patient,  focusing on protein and veggies.  No need for adjustments (or fills) though.

 Second is Gastric Bypass


With this the surgeon makes a small stomach using the top part of your stomach  and also by passes part of your intestines. 
With this surgery your body goes through about a year of whats called the "dumping syndrome" where if you eat something you are not supposed to you will physically get sick, fever, chills, nauseous, headache etc.... ( this side effect only last about a year so if you dont learn from your mistakes and correct your habits you will be able to eat like the old days eventually) BUT an upside you dont have to be adjusted every 4-6 wks to hit your "sweet spot" like with the band.

3rdly Lapband


With this surgery nothing is cut or removed. A band is placed at the top of the stomach creating a small pouch. This helps a patient feel full quicker and longer. The lapband is adjustable through the port that is placed just under the skin( filled with saline). Also Lapband is removeable.

Ok so that was a little nugget about ea of the  WLS options so here is why I choose Lapband.
1.  non-evasive surgery ... I dont want parts of me removed :) Im a wimp
2. Same Day surgery
3. I like the fact that the band is adjustable and removable.
4. recovery time is short, some go back to work next day. Even though I just have a desk job I will have a couple days off so I can get used to the limited calories (being on liquids only first 2wks).
5. Sleeve is not available on my insurance plan, even if I wanted to go that route ( makes that easy)
6. I have done I lot of praying, research and talking with medical professional and I just feel this is the right fit for me

Everyone is different and there is Pros and Cons to all of the above. And my list of why's could go on and on. It just comes down to doing some research and talking with your Dr.

Cardiologist

I went to see the cardiologist today for surgury approval. He said my EKG was fine and my heart sounded good. So he is approving me for surgury!!!! YYYYYYAAAAAYYYYYYY!!!!!!!!!!
So now I am down to just waiting on the shrink to get back home to resend her eval, so that it can all be sent to TriCare for approval!

Possitive

Today I am in a much more possitive mood. I found out the surgeon finally got what he needed paperwork wise from my family Dr. ( Still waiting on the Pysch Eval to be resent) and I have been rescheduled at a much closer Cardiologist for the surgury clearance for Monday at 1:30,  should not really miss more than my lunch break at work so that makes me feel SOOOOO much better. At least I feel like I am back to getting somewhere and not just standing here waiting on other people.
Shew....

Cardiologist Apt # 1

This morning I got up and drove almost an hour to the cardiologist my surgeon had sent me to, Only to be told that the surgeons office did not send over the approval code from the insurance company. Cardio Office said that is never their job that the referring Dr Office is always supposed to do that and I would have to come back another time...
WHAT???? So I missed 2 hours of work for an appt I did not get to have . So I rescheduled for Monday and they told me to make sure I call the surgeons office and have them send over the approval code.

So when I got to the car I left a very passionate voice mail for the manager of the insurance dept at the Surgeons office. Who called me right back, said ( of course) it was the Cardio's responsibility to get the approval code....She was very upset they turned me away said even if they thought it was the surgeons office responsibility she still could have done it herself since I was there... They told me to cancel my Monday appt and they are sending me to someone ....So the below pic is a reminder to myself today.... I am too Blessed to be Stressed...
And it is so True! Big deep breath, its in the Lords hands and it will all work itself out.

Happy Wednesday

Pic is of me at work today in one of my purdy new scarfs:-).
I go to the Cardiologist tomorrow morning. ...praying everything is fine and I am approved for surgery on his end... then I am back to waiting on my surgeons office... seems they lost my psych eval when in was sent in and now the psych dr is out of her office for at least another wk and a half due to a medical condition of her own... and only once she gets back in the office and resends the eval will my file be sent to the insurance company for approval.  So I am a little frustrated right now. The surgeon has a case mgr whose whole job is to run down the ppwk and make appt and loosing that eval was a Huge mistake ( esp since i had warned her to watch out for it that the dr was getting ready to be unavalible for wks)... its delayed things by 3 wks. Oh well thats my rant... it will be ok, it will happen sooner or later.

Craft time

So one of my favorite things to do is work on crafts . I have been planning while I am on liquids pre/post op I would sit in my bed room and work on different things while my family eats dinner consisting of real food..lol... this is a pic of one of the things I will be making during this time... my mother in- law taught me how this weekend during our visit and so far I have knocked out 7! Pretty huh!

Recipe Time

Ok So I have been playing with my protein shakes since its important to know what you like before you are stuck on all liquids for several weeks, and its very highly suggested to have a variety so you don't get bored. So here are a few that I am really enjoying

1. I just call it the Coffee Drink
    . 1 scoop Unjury Choc Protein Pwdr
    . 6 Oz  Skim Milk
    . Med Decaf Coffee


2. Pumpkin Shake
    . 12 Oz Unsweetened Almond Milk ( could use 8 if you wanted to)
    .  1/2 C Pumpkin Puree
    . 1 Scoop Unflavored Unjury Protein Pwdr
    .  a little bit of pumpkin spice

3. Chocolate and Banana
    .2 Scoops Chike Protein Pwdr
    . 12 oz Unsweetened Almond Milk
    . 2/3  Banana

These are just a few of what Ive tried and enjoyed :)

Mini Fridge

Well hubby delivered my mini fridge to my office today... this will help me get my afternoon snack in since that is my busy time of the day. Plus after surgery I will be on liquids and have nt told anyone here about my surgery so I realy dont want to put all my protein shakes/soup in the main kitchen... I just want my privacy through this.
On another note I have had to take a big deep breath today bc I am very frusterated w the paperwork side of the process right now. I emailed my case mgr yesterday bc I still had not been called to schedule my cardio apt ( friday I was told they would call me monday morning)  I also asked just to verify that she had gotten what she needed from my family Dr and Shrink... she gave me a number to call for the cardio but said she had not received anything from the Dr and Shrink. .. ( she has to have this before she can get approval from the insurance co) I called the Drs office and they never rcvd her request form so I asked her to resend it to them ... why she did not follow up I dont know. Then I called the shrink got her voice mail.. today the shrink calls me from the HOSPITAL. .. she had surgery and when released will be going into rehab for 2 wks.. she said she sent the case mngr the eval last week and she has no way to resend it for weeks they will have to find it......grrrrrrr....Big Deep Breath it will be ok

Cardiologist

So I have my appt made for the Cardiologist. Its next Thursday at 9:15.  The lady who scheduled the appt realy could not tell me anything about my apt. I asked can I eat before I come in she said I dont know, Maybe if they decide to do a stress test on you, if you can run on the treadmill you can eat a small breakfast but if you cant run on the treadmill you have to be fasting. Can you run on the treadmill??? WELLLLLLL you see what had happen was.....
my knee kills me all the time I dont know if I can run on an treadmill plus. I have a really bad track record with treadmills I do much better on elliptical where  your feet are firmly planted... I have face-planted on a treadmill twice so I typical steer clear of them. I did ask her how long would I have to run , she could not even answer that question...
SO I am going to show up fasting dressed for work, in work shoes and if they decide to do a stress test will have to do the non treadmill kind..

This not Drinking with meals "Thing"

OK so we decide ( myself and the dietitian ) that since the not drinking with meals would be the hardest for me, I should go on and "practice". SO here I am today... First I stopped drinking 20 min before lunch.... I know I was supposed to wait 30 But I was hungry and when I am hungry and cant eat yet I normal guzzle some water. BUT since I cant do that decide 20 min was a good start... DID NOT drink anything with lunch, but now I am watching the clock for when I can break open the water bottle.... I am so thirsty... Maybe its all in my head, I am sure it will get better.
I literally drink water ALL DAY LONG to get my 100 oz in , and that 100 oz of plain water, that does not include the protein shakes or the about 32 oz of crystal light I drink once I make it home for the day.... Oh well practice makes perfect right... work on it now it wont be as hard after surgery :)

Before (now) pic

EEEEKKKK another Pre Op Appt

Got a call from the surgeons office today. They said my EKG showed a "slight abnormality" She said not to get and I quote  "get my panties in a bunch over it"...LOL
That it was slight and it very well may have always been there but they are sending me to see a Cardiologist to get checked out and OK for surgery.

Also just remembered I never posted my "before" pics I took the other night. I will do that this evening.

Snack

Ok so at lunch I hit walmart for a snack of some sort .. found these little cups w lids and cashews... cashew container holds 26 servings I ended up w 30 full little cups ... close enough for me ( little shy of a serving in ea but very close)

Waiting Game and Notes from the Nutrionist

So I am now in the waiting game part of my journey. I have gone to all my pre-op visit
Attended the WLS Seminar
Meet with Family Dr
Meet with Surgeon
Meet with Psych Dr twice
went to Hospital for... xrays, ultra sounds, labs, ekg, upper gi
Meet with the Nutritionist
and Had a Sleep Study ( they called me yesterday, All is well no Apnea)
Now I am waiting on the insurance to approve the surgery. My Case Mgr assured me no one that qualifies is normally denied but they have to wait for approval to proceed and that could take as many as 14 days so I wait.
I meet the Nutritionist yesterday, SUPER NICE and a wealth of info that I had not read anywhere or thought of myself.
He was impressed that I had already started making changes to my diet even before meeting with him ( basically by sub-ing Unjury Shake for a meal once a day, and already having small forks and plates/bowls purchased)
We discussed the fact I am HUNGARY from like 3 pm on... and he suggested me bringing a snack and setting a reminder on my phone to eat it at 3 so when I get home at 5 I don't feel the need to eat the house :)
He also gave me the info for the Liver Reduction Diet that I will be starting now.
We discussed how much I drink at dinner and I told him that was the only thing that really scares me is breaking the habit of drinking about 32 oz of water/crystal light with my dinner ea night... He suggested filing my cup with crushed ice that way if I get choked or need a little something I can have it. And we decided I would start that now since that is probably going to be the hardest thing for me to break.
We also discussed the first 3-4 wks after surgery diet in depth, I will see him again 4 wks after surgery and he will teach a group of us at that time how to ea from wk 4-8 then 8 wk on...
He also suggested that i find another brand of shakes that I like as well as the Unjury b/c I will be on all liquids for a total of 4 wks, 2 wks prior and 2 wks post and he said one kind will just get boring... DUH why is it the simple things I dont think of :) on the main floor of the office bldg he is in there is a store that you can buy such items so I went to see what I could find. I picked up some soup 15 Gr Protien :) and some Chike Pro Powder 25 gr. Also grabbed a box of protien bars for that snack I am supposed to be having now... they are nasty so will remain nameless :) I will finish the box but wont get them again..My plan is to try the soup and the protein pwdr and make sure I like them over the next wk or so and if so go on and pick up some more on my last pre-op with the Dr. I dont want to have to driver 45 min(one way)  just for food after surgery, so I need to make sure I have enough at home to last me till my first post op appt.
Well thats about if for now. Will know more once I get the OK from insurance.

My Moto for this Journey

Sleep lab visit

As far as sleep labs go. The one I went to was nice. My hubby had been to one run by the VA and it was very clinical, this one not so much... well except for the zillion cords hanging from my body when I tried to sleep... I arrived at 745 for my 8 o' clock appt and was buzzed right in... I was asleep by 930:-)...
First thing they did was put me in my room, it was set up like a small hotel room w a bathroom and TV w satellite. .. I watched 2 videos on sleep apnea and CPAP machines, then went down the hall for weight in and blood pressure check as well as some last minute paperwork. After that I was back in my room putting on my PJs and shortly after that the tech was in hooking me up, he explained each cord and what it was looking for during the night. Once I got in bed we did a physical test to make sure everything was connected properly. The tech came over the intercom and had me move my legs and my eyes... etc...then off to sleep. .. I was restless even for me, I dont normally disturb myself but last night I did. However if they noticed sleep apnea in first 2 hrs they would have woke me up and put me on the Cpap machine. They didnt so I have to wait for results of the rest of the night,  should take 7 to 10 days... they woke me up at 5 am sharp and I was in my car at 530 and that was even taking a shower!.. all in all a easy process. I wrote this bc I was very nervous going in and maybe this will help someone else know what to expect when they have to have a sleep study done.

Pic from Dr office

This is a pic from the dr office of a model of the stomach and lapband....I snapped the pic bc a) I was bored, and b) hubby was not 100 % clear on the port....

Day of Tests

I had my BIG day at the hospital today... got there for my 9 o'clock at 8:45... was walking out the door at 11... so not terrible considering all I had to have done. I thought I would walk you through everything I had done today so you would know what to expect if  you are looking into to similar procedure. After registration I went to radiology and Labs.
1st Lab called me back first, I was taken into a small room with a recliner and a TV they drew some blood then hooked me up to the EKG machine.... Hooking me up took longer than it did for the EKG to get its reading... then I was done in there and back in the waiting room.
2 nd .  was the ultra sounds..... with a "S" I thought this would be a quick little process bc it was listed as gallbladder ultrasound. But in reality it took about 20 min she looked at the stomach, liver, pancreas, gallbladder and kidneys.... Next time I would have stuck a clean shirt in my bag bc even though they took steps to protect my shirt I still ended up with goo on my shirt and I went straight to work from there, but it will be ok.. from there they took me to a dressing room where I put a gown on... oh yes an oh so fashionable hospital gown,  :) undress from waist up... and wait for x ray tech to get me.
3 rd.... Xray started with Chest xray done real fast, done by 10... well then it was time for the barium swallow upper GI and for this we had to wait for a radiologist who was not free, so I sat for 30 min... by the way when they say show up for this thing fasting that means NOT EVEN WATER....this was not explained to me well so I had had about 8 oz of water... no biggie but it was seen on the Upper GI .... the barium was NASTY the first cup was about 16 oz of really think chalky like stuff... like ground up slightly moist tums, was drank standing up.... second cup was drank through a straw, laying down, was thinner but tasted way worse same chalkiness but the flavor was strong like they were trying to over compensate for the consistency with a faux citrus.
After I made it through that I was back to the dressing room to get out of the gown and back in my work shirt. The tech had a cup of water and a wash cloth for me also since i manager to get barium all over the side of my face... and she walked me out...
With the exception of the fact my tummy still wants to puke of the chalk i swallowed a pretty painless adventure. All the techs said the Dr would have the results by end of the day today. YAY!
I am down to sleep study tomorrow night and nutritionist on Thursday!!!!

2 appts down

Ok got 2 apts down, today was my second appt with the psychiatrist. Tomorrow is my big appt at the hospital with all my test. .Sleep study is Wednesday night... not really looking foward to that since I dont sleep well when I am not at home plus if I am not at home I normally wake up w a head ache but thats ok... then the nutritionist on Thursday:-) one at a time... gonna knock em all out this week!