During my monthly visits with my doctor, it was discovered I have hypertension. I was floored. Even though I had been overweight most of my life, I had always had perfect blood pressure. This was a first for me, and perhaps, we decided, a sign from my body that it was indeed time to pay attention. Of course, I decided it was also my body's way of rubbing it in that I was getting older. It's not like I really need to be reminded, thank you very much.
To summarize my 6 months of dieting with my doctor, I lost weight the first month, gained weight the 2nd, lost during the third, gained during the 4th, gained during the 5th and lost during the 6th. After 6 months, I ended up back where I started, and that's pretty much the pattern of my life thus far. With the medication, my blood pressure came slightly down to just under the borderline mark. With that sort of under control and the 6 months then behind me, I moved forward again.
The bariatric surgeon's office was kind enough to provide referrals for a nutritionist and a psychologist. Well, actually, they required patients to use their nutritionist as she is well versed in the various weight loss surgeries and the food requirements of each. The downside was that neither took insurance and required cash up front. I have great insurance that covers almost everything with but a small copay on my part...a nice benefit of working for the government. These two visits, however, cost me a little over $300 out of pocket. A small price to pay is what I'm hoping in the end. Another plus, at least, is that the nutritionist includes 6 months of follow up in her fee...a good deal really for $150.
The nutritionist was really nice. She went through an evaluation with me of my diet, my likes and dislikes, my history, my current lifestyle, etc. She went over a packet of information about how and what I will be eating post surgery. Basically, after surgery, the diet is full liquid diet for 2 weeks. Then, for weeks 3 and 4, the diet becomes pureed, with food the consistency of applesauce. After that, solids can be started, however the bites must be really small and will probably be about a 1/4 cup of food for each meal. I believe she said that eventually you work up to about a cup of food for each meal. More than that consistently and you probably need a "fill."
For those that aren't familiar, the band is placed on the upper part of the stomach, creating essentially a new MUCH smaller stomach before the rest of the stomach. The band is empty when initially placed. After 6 weeks of healing, you get your first "fill." A fill is when the surgeon adds saline to the empty "pillows" inside the band. This is accomplished through a port that is also placed during surgery, just below the skin. It is the fill that actually gives the restriction for food intake. Fills are needed when weight loss slows or stops and more food is being taken in at a meal. Based on what I've read, fills are sort of hit and miss until the "golden" amount of saline is reached to get the optimum restriction needed to lose weight. The first fill may be perfect for some and others may require a little more. I've also read that on average, the 1st year sees 3-4 fills, the 2nd year less, and so on. Too little and you eat more than you should...too much and you can't get food down and vomit it back up. It's a delicate balance to find the right amount from what I gather and better to add too little and have to add more than add too much and have to take some out. It's a learning experience I guess.
The eating is a little complicated and will also take some learning and adjustment. I will have to learn to eat slower and with very small bites. I also have to learn to eat meat first so I get my protein in before getting full. This is important because as weight is lost, they don't want muscle to be lost as well. She said I would need to consume 50 grams of protein daily, which is a lot. To aid with this, I will have to drink a protein shake daily for the rest of my life. I will also have to take vitamins daily forever...a multi, a calcium and B12. The multi and the calcium must be chewable for at least the first 3 months and the B12 is a tablet that dissolves under the tongue.
The nutritionist was helpful in another, more personal, way as well. She told me she believed that the band was the right choice for me. This eased my mind as I still wasn't sure which route I should take, band or bypass. I think it wasn't until after talking to her that I finally solidified my choice.
A couple weeks later, I had my appointment with the psychologist. I was a little nervous going in to meet with her. I was envisioning her probing into my childhood and bringing me to tears as I laid on a couch in her office. It was nothing like that, of course. She asked me some pretty basic questions about my life, some history-medical and emotional, what I hoped to gain from the surgery, etc. It was about 45 minutes and I was saying goodbye and getting her well wishes.
A few days after that, I met with the surgeon again since I had not seen him in over a year and a half. That was a very quick appointment, about 15 minutes. He looked through my file and saw that I had completed everything. He asked if I had any questions and then said that his office would send everything over to the insurance company for approval and we would go from there. The next day, his office coordinator called and confirmed that she was sending the paperwork and had a few last minute questions. I asked her how long it usually took for a response and she said 2 weeks or so. So, I hunkered down for the 2 week wait, anxious for what the insurance company would decide about my future.
Three days later, while I was in a meeting, my phone buzzed in my pocket. I looked down and saw the surgeon's office number on the screen. I was nervous, anxious, excited...just so many emotions came over me wondering about the message that was being left on my voicemail at that moment. As soon as we had a break, I dialed into my mailbox immediately. She said it within the first few words of her message. Approved. A whole new wave of emotions flooded and I wanted to tell someone right away. No one at work knew and I wasn't ready to share it with them yet, and perhaps never would, so I quelled an outburst and opted for a text message to my sister. She congratulated me immediately.
It's actually strange upon reflection that I didn't text my husband first. He was next, though. I think it's because I still wasn't sure how he felt about it all at that point. I knew he would be worried and I knew a more involved discussion was needed besides a simple text. I think sometimes, however, I don't give him enough credit for being in tune with things. I hope I'm around for a very long time to give him the credit he deserves.
On that note, tomorrow morning I will be 48 hours from surgery and I'm starting to get scared. Thoughts of my dad and his heart attack the day after his surgery keep clouding my mind. I hugged my son at least a hundred time this past weekend, thinking what his life would be like if I didn't come home from the hospital. I wanted to somehow permanently ingrain his mind with the knowledge of how much I love him. And, my husband...his allergies are so bad right now. He coughs all night and is getting little sleep. It's bad enough that his MS makes him tired, but that coupled with the horridly high pollen count we are having is putting such a strain on him. It's really just NOT an option for me to not come home. They both need me...and I hope the powers that be, whoever or whatever they are, know that too.
You write so well! Thank you for sharing this odyssey with us...I'll be praying for your speedy recovery and will be rooting for you as your weight loss journey begins.
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