Thursday, January 30, 2014

Day 17 - Update and What I Did Before Surgery

First, I haven't lost anything in the past few days.  I've lost approximately 24 pound since Jan 1 and then I have hit a "stall."  Not unexpected - perfectly normal, but slightly discouraging.  I'm continuing on with the program and I know something will have to give eventually.  I understand that the process MUST have stalls and plateaus.  From what I understand, the lipids (fats) leave the fat cells, but there is still cellular structure left behind. That cellular structure is filled with lymph and "water" - but not all the way.  Water weighs more than fat, therefore I weigh the same amount, although I am smaller.  Eventually the cellular structure gets redistributed and I will lose weight again.  But as with all waiting, the anticipation gets to me.  The tape in my head says things like, "See, this isn't going to work either."

I also need to change it up a bit.  Maybe bump up the protein.  Maybe more exercise.  I need to get on the exercise bike today because it's just too cold outside to walk.  But I think the main thing is to NOT FREAK OUT because I'm not losing weight like I think I should.


This surgery had been a consideration for me for a long long time.  I think the first time I considered WLS (Weight Loss Surgery) was 1994 after my first child.  At that time, I was maybe 40 to 50 pounds overweight.  It took a few months to lose that "baby fat" but I eventually did it and was able to wear a size 12 in between kids.  After my second child, I encountered some medical issues unrelated to weight and gained.  I wasn't too concerned at the time with the weight and put that worry on the back burner.

After the second child, I became an At Home Mommy.  It just made sense at the time.  However, I really went through a grieving process at the lost of my identity as a career-woman. There was also additional stress in my extended family that caused me more anxiety.  Stress + Anxiety = Weight Gain.  Simple equation.  I still didn't consider surgery an option, but did some research.

In fact, I didn't really consider surgery as an option until we moved to Rome and I began to gain more weight.  By this time, I think I had tried every diet known to man (OK, an exaggeration).  I figured out that I have spent more than half my life on a diet, losing weight and then the other half gaining weight.  I have spent literally thousands of dollars on the pursuit of losing weight.  I know this because my loving husband, Bill, keeps meticulous records of our spending and one day I added it all up.  Thousands of dollars, and for what?  In 2012, I weighed more than I have ever weighed before.

So in November 2012, I attended a WLS seminar given by Harbins Clinic and the office of Dr. Ryland Scott.  I filled out preliminary paperwork to see what kind of coverage I had with my insurance companies.  Then I waited.  I was interested, but I wasn't ready.  When did I become ready?  Next installment....

Interesting Articles about Church Closings, Decline in Giving

7 reasons (among many) why my church died

Report: Church giving reaches Depression-era record lows

Tuesday, January 21, 2014

Day 8 - Theresa Vs the Volcano

Well, not the volcano, but her her health insurance company.

When I decided to get this surgery, I of course contacted my insurance company to make sure I knew what was necessary to be covered.  I contacted Bill's as well.  I ended up with a page long list of things that I had to do before hand to be qualified.  The list ranged from things like a doctor's letter with my weight for the last 10 years, 6 months of a doctor supervised weight loss program, psychological testing and so forth. I was assured that as long as I followed the plan, I would have no problems.

This was probably in late June 2013 or early July.  I immediately made appointments with my primary care physician, went on a diet and started working the list. If you have ever known someone who had done WLS (Weight Loss Surgery), you know that there are many hoops to jump through.  I finished the final hoop on Dec 13, 2013 and the final paperwork was submitted to the insurance companies.  Surgery was scheduled Jan 13, 2014 at 6:30 am.  All I had to do is wait a month and do the pre-diet. Little did I know that the fun was just starting.

On New Year's Eve, around 2:00 pm, I received a rather disturbing phone call from the surgeon's office.  They needed to "convert" my surgery to gastric by-pass so that insurance would pay for it.  I deliberately did not choose by-pass.  I didn't like some of the side effects, including the malabsorption issues.  I already have malabsorption issues with the pernicious anemia.  I don't need more.  I didn't choose the Lap-band because I really really don't like the idea of permanent man-made materials being left in my body.  If I didn't have VSG, I was going to just not have surgery.  Immediately, I called my health care coordinator at the conference office - but only was able to leave a voicemail.  I called my insurance company to no avail.  The people in the call center were polite but just not capable of helping me.  I called the GBOPHB (General Board of Pensions and Health Benefits) and talked to several people.  I called the Georgia Insurance Commission, but I could not really resolve this on New Year's Eve.

On Jan 2, I began calling again.  I was most displeased with the insurance company. Their call center employees are not at fault - the fault lies with those who wish the customer to NEVER talk to anyone who can make a decision.  EVER.  I finally talked to a customer service rep who asked if I had filed an appeal - I didn't know I could do that.  So she gave me a fax number and told me to get the doctor's office to write a letter and mark it "URGENT."

The doctor complied but didn't mark it URGENT.  They tried to recall the letter and do it again marked urgent, but was told by the insurance company that the letter had already been received, a file had been opened therefore it was too late. They guaranteed that we would hear back in 30 days!  Surgery was 11 days away - no way was I just going to sit and wait.

I called the Georgia Insurance Commissioner's office.  I was offered an opportunity to begin a case against the insurance company and would hear back - in 30 days.

That Thursday I also talked extensively to the General Board.  They were most helpful.  We discovered on the insurance company's website their own qualifications for 2014 - and that VSG was indeed a covered surgery.  We both searched online for the previous document - the 2013 - under which I was originally told that the surgery was covered.  I couldn't find it, but the General Board did.  It seems that VSG was NOT an excluded surgery in that document.  However, when we submitted the final paperwork, it was also NOT included under approved surgeries.  VSG did not appear in the document at all.  This was the basic problem.

On Monday or Tuesday, the doctor's office marked the appeal "urgent" and submitted it again anyway - by Wednesday they were told that it did not qualify to be urgent and we would hear back from them - guess what - in 30 days.

So the Doctor's office decided to go with my husband's insurance instead.  By Thursday, they had approved the surgery, but with a LARGE deductible and co-pay.  You see, we had decided to go with an HSA this year instead of a PPO for his insurance because my insurance was so much better.

AND - just as an aside - all this time I am working on my full-connection paperwork.  150 plus pages of papers, 10 DVD's - you know, nothing much at all.  So on Thursday I went and visited conference office and talked extensively to Karen in our benefits office.  What a lovely woman!  She reassured me that we would work it out.

And it was worked out.  Sometime after 4 on Friday (remember that surgery is Monday at 6:30 am!) I received a phone call that insurance would indeed cover my surgery.

Horrible story.  Torturous story.  Worse than the full connection papers. More stress than Christmas. But now done with.

Monday, January 20, 2014

Day 7 - One Week

And two cats down.  Since my cats weight differing amounts (Set of Coleman Cat Weights) = {7,8,10,10,12,12,15,16} and the average Coleman cats (Coleman Cat Standard) = 11.25, I can express my weight loss with the Set of Cat Weights or Coleman Cat Standard.  Today, I have lost approximately 2 Standard Cats, or about 22 pounds since the beginning of the year.  At this rate, I'll be invisible before Autumn, so I don't think the rate will be constant.

Today's big accomplishment will be BOTH getting dressed and bathed on the same day. Yes, high and lofty goals.  By this afternoon, I want to get outside and walk around a little.  I've been walking the length of the house, touching the utility room door, going through the Den, down the hall, touch the back hall closet door, up the hall, through the Living/Dining Room, Kitchen and to the utility room.  3 and 4 times at a whack.  I feel like Pastor Gerbil running the Parsonage Habitrail.

I think I was a little optimistic about my recovery rate.  I anticipated bounding out of bed around Day 4, twirling batons and ribbons.  I was mistaken.  I haven't had any serious complications except I encountered some breathing problems end of Day 2 into Day 5 that meant that I had to take hits off an inhaler.  Blech.  My pulse/ox was not very good without O2 in the hospital and the O2 was so very dry.  I ended up with bloody noses and a cough.  You know, it hurts to cough when you've been stabbed in the stomach six times.  I would hold a pillow on the incisions and cough, but still see stars.

Other lofty goals today: email people about EOY reports, weed out the inbox, be compliant with the Dr's instructions about water, vitamins, protein and meals.
Big Stuff.  =o)

Sunday, January 19, 2014

Day 6 after Sugery

I choose not to preach this morning - and probably a wise decision.  I'm hitting most of my goals:  drinking water, getting about 2/3 of my protein, getting my pills down, getting my vitamins and moving around.  However, I'm still not 100 percent when it comes to energy level.  By about 3:00 pm, I've hit a wall and have to go take a nap.

Tomorrow's big goal - to get completely dressed and get in ALL my protein.  Doesn't sound like much, but there it is.  it has occurred to me that I am a "recovering fat person" or "recovering obese person."  Food has always been my drug of choice - easier to eat your emotions than deal with them.  For that reason, I am always going to have dis-ease with food.  This is going to be a great tool to help with the disease, but I will ALWAYS be a fat person in recovery.

This was apparent several months ago to me - screamingly obvious when I had a deep struggle with a piece of cake.  Although it was small in volume, it won.  I lost.  And I will never ever really have power over food.  I can only depend on God to help me. I will tell you this - a fat person with an unhealthy fixation on food will indeed take candy from a baby.  And then search the stroller and diaper bag for more.

Saturday, January 18, 2014

Day 5

I have made a big life-style change.  A decision that literally will stick with me the rest of my life.  On Jan 13, I had a vertical sleeve gastrectomy.  It's taken me 15 years to get to this point, but I finally decided that my obesity was more life threatening than the surgery.

I started the journey in Nov 2011 when I attended an information seminar from Floyd Baratrics.  I pursued the idea of the surgery with fits and starts until I got serious in July 2013.  I just had enough with the weight.  By the time I started the two week pre-op diet Jan 1 (propitious day, eh?), I weighed the heaviest I have ever weighed in my life.  I lost 8 pounds.  I have lost an additional 11 as of this morning, making it a 19 pound weight loss.  I'm OK with that - I'm not feeling like it's "real" yet, until I see it stay off and I get down another 27 pounds.  I don't know why, but that weight will make it seem "real."

The surgery was more intense than I anticipated.  I guess I'm a "pie in the sky" kind of person.  The recovery is taking longer than I wanted - which makes me mad which makes me push which makes me overextend -- and I end up worse than if I hadn't pushed.