Forgot to Mention...

I forgot to mention in my post earlier that I found out in November or December that John Muir Medical Group now accepts my HMO insurance so I will not have to go to Stanford for the surgery. YAY. That means everything will be local so that will make things much easier.

Completed Process But Now On Hold

Well, it's been awhile since I've written. I have basically completed all of the steps to get the surgery. I met with the surgeon in December and he said he would only perform the sleeve on me, not RNY. This was due to my having arthritis in my right hip (a congenital problem which has led to the deterioration of the cartilage and early arthritis) that could require use of ibuprofen, and also because I was diagnosed in November with colitis (see below). I was actually happy, since I have always wanted the sleeve, but it was never covered by my insurance so I thought I would have to get RNY. However, in November 2010, Anthem started covering the sleeve.

While I was going through this process, I was also trying to figure out what was going on with my body due to some symptoms that I was having. In July 2010, I had a bad case of diarrhea that lasted over a week. I got worried when I started having blood in my stool. I went to urgent care and they sent me for some lab work and prescribed antibiotics. Meanwhile, I got a mole and skin tag removed by my PCP and I got an infection from that so I had to take more antibiotics. I then developed what I now know was an abscess and ended up in the ER in September for that, but at the time nobody knew what it was. I was diagnosed with a yeast infection (I had been having chronic ones since I started the antibiotics in July) and sent home. I had numerous appointments with my PCP and a gynocologist, but no one could figure out what was wrong and I was prescribed more antibiotics. I was also tested for STDs (which I knew was not the problem, but the gyno was conviced I had herpes.....lol). I was finally referred to a GI doc, who said I likely had IBS and started me on a high-dose probiotic. I got a colonoscopy in November and was diagnosed with colitis, possibly Crohn's.

Once I heard I may have Crohn's I started doing research and realized I had all of the symptoms. The abscess I had since September had turned into a fistula. I started a new med, Lialda, in January and after about a week and a half I got really sick. I thought I was having a flare up from Crohn's and I ended up in the ER. My GI doc still hadn't confirmed for sure it was Crohn's so they wouldn't give me prednisone. I needed an endoscopy for the WLS so I had that in February. It showed I had a small hiatal hernia and some irritation of the stomach lining, but nothing serious. I also completed a WLS class through my medical group in February. I had a small bowel follow through x-ray to confirm Crohn's, but it showed nothing. My GI doc was now convinced I did have Crohn's though. I tried another new medication, Asacol, but after three doses, I started getting sick like I had in January, so I immediately stopped taking it. In March, I started a new medicine, Welchol, which is normally for cholesterol, but is used to help absorb bile (I have no gallbladder). The doctor said it would help my intestines be less irritated from the bile, and so far it's worked great.

So even though I've completed everything, my GI doc will not give me clearance for the surgery. He thinks I need to wait until we get my Crohn's under better control. I have a follow up appointment in early May to talk with him further. Hopefully he will give me clearance, but he mentioned at my last appointment he may refer me to a specialist at UCSF.

So basically I am on hold for now. It sucks, but I'm trying to stay positive and focus on getting healthier and getting the Crohn's better managed (it has been much better since I started the Welchol). I talked to the nurse in charge of the bariatric program and she said my PSYCH and NUT stuff should be good until at least August, so hopefully I can get clearance by then so I won't have to start the process all over.

NUT and PSYCH

So I went to my NUT and PSYCH appointments at the end of August and both went well. I pretty much knew everything the NUT went over. She discussed stuff like portion control, vitamins, etc. The PSYCH appointment went well also and the psychotherapist said she would recommend me for surgery. She basically wanted to know if I had support, did I understand the ramifications of surgery, if I thought I'd have any transfer addiction problems, etc. She was really nice and I felt comfortable talking to her.

I forgot to mention in my last post that I received a letter outlining the process after I heard from my PCP about my referrals for NUT and PSYCH being approved. After the NUT and PSYCH appointments, and once my PCP faxes over my 3 months of weigh ins (see the post prior to this one for information on that), I will get a nurse case manager and will schedule my consultation with my surgeon. Once I meet the surgeon, I will find out what tests I need to take and if I need to lose any weight pre-op.

So the process goes on. I've only had minor delays so far. I'm hoping I can get a Feb. or Mar. surgery date, but we shall see!

Good Thing I Called!!

I haven't written in awhile, as I've been pretty sick since the end of July. I'm just now starting to feel better so it's been a rough road. I have been to urgent care, my PCP, the ER and a specialist and no one knows what is causing my problems for sure. I am seeing two more specialists on Oct. 28th so hopefully someone will figure it out and "cure" me once and for all.

Anyways, I went to my PCP on Sept. 20th and got my last of three monthly weigh ins. The PCP was then going to fax that sheet to the bariatric department and then I would be contacted by a case manager. Well, I never received any mail or a call from a case manager, so I called yesterday and the bariatric department said they never received the fax. So I called my PCPs office and was told they did fax it. So she reads me the fax number and lo and behold, it doesn't match the one the bariatric department had just given me on the phone. So I asked her to refax it. The bariatric department told me once they receive the fax, it should take 3-5 business days to be contacted by a case manager. So there went three weeks down the tubes!

So I'm really glad I called. It's so true what I always read on the WLS message boards: you have to be your own advocate!

I LOVE my doctor's office!

I was just at the doctor's office on Friday and I already got a call from the nurse this morning (Monday) saying she submitted the first part of the authorization and telling me the additional steps I need to take. She said it's a multi-step process. So they have my weights from July and August, which they submitted, but the insurance company requires 3-6 months of weigh ins so she told me to come in September and just tell the front desk I'm there for a nursing appointment weigh in (no appointment needed). I already got my authorizations for the NUT and PSYCH consults. I scheduled the NUT appointment for 8/25 and I'm hoping to schedule the PSYCH for the same day so I can just take a whole day off work and get both appointments taken care of. I'm just waiting for the PSYCH to call me back.

So the process is officially underway. I'm so excited and I'm so glad I have a great doctor/nurse who knows the process!

Weight Loss Attempts

I had to prepare list of all of my weight loss attempts for my PCP. It was pretty depressing. First, I was amazed how much detail I remembered about specific weights I was at certain times of my life. I remembered my weight at 15, the first time I joined WW, in college, in law school, etc. It just shows how much I have been obsessed with my weight and how I relate that back to certain periods in my life. It was also depressing to see how "little" I actually weighed when I was younger and how much weight I've gained over the years. I've almost doubled my weight since I was 15-16 years old.

My PCP is now going to submit an authorization to my insurance and I should be contacted soon regarding the psych and nutritionist appointments.

Weight, Height, BMI: Random Thoughts

I was having random thoughts on my BART ride the other day about my BMI. According to my the nurse at my last doctor's appointment (earlier this week) my height is currently 5'4" (I shrunk half an inch...lol). So that puts my BMI at 50.6! UGH!

So to get to the "overweight" category I have to get down to 174 and to be "normal weight" I would have to weigh 145. So I need to lose over half my weight. It seems so overwhelming. Not to mention that I haven't weighed less than 145 except for a very brief period in 10th grade!

But I am determined to do this for my health and I would really like to be in the "normal" range; so I am going for it!