The Incredible Shrinking 'thann

The Game Is On!

Finally, all systems are GO for my weight-loss surgery.

Last you heard from me, I was on a 12-month physician monitored weight loss plan, as required by Blue Cross of Michigan. In January they changed that requirement to only 6 months, so I began the process of seeking approval.

The date of my surgery is April 29, only two short weeks away! Today I had my pre-admission testing and plassed with flying colors.

By the way, how did the physician-monitored weight loss plan go? I lost 25 pounds since last June when I first decided on weight loss surgery. This was mostly attributable to cutting out all preservatives, making most foods from scratch myself, and cutting back (if not cutting out) simple sugars.

So stay posted because things are really heating up!

'thann

Hurry Up and Wait

Alas. I just confirmed that I must go through a 12-month physician-monitored weight loss program before Blue Cross will approve me. My first appointment is tomorrow.

My primary care physician (PCP) wrote my letter of recommendation, but he couldn't honestly say he'd monitored me every month for the past 12 months, so it's hurry up and wait.

Discouraging, yes, but I have to lose weight somehow. I've dieted and failed so many times, this is just one more time.

The image below is my signature from the weight loss forum to which I belong.

'thann

Stressed Out!

One of the many hurdles that my insurance provider requires of a potential bariatric surgery patient is the stress test. I had my stress test this morning, and I will share my experience with you.

Until I researched cardiac stress tests on the Web after returning from the cardiologist, I didn't know there are various types. I assumed (incorrectly) that I'd just show up, have an EKG attached to me, and walk on a treadmill. Yes, that's one of the types, but the stress test I had is called a nuclear stress test.

When I arrived at the cardiologist I completed the obligatory paperwork. Then the technician took me back and injected thallium (a radioactive dye) into a port, followed by saline (to ensure that the dye made its way into my bloodstream). Then he sent me back to the waiting room with a glass of water (to facilitate the journey of the thallium to my heart). There I waited for 45 minutes, reading weird medical magazines aimed at older folks who have coronary disease.

Note to self: Always take a book!

After the waiting period, the tech took me back to a huge x-ray machine that looks a bit like a CAT scan. I laid on the table for about 20 minutes while the machine rotated around me, taking about 30 x-rays of my heart (now pumped full of thallium!). It was a very long 20 minutes, but I prayed the Rosary (using my built-in Rosary, my 10 fingers), which was perfect timing.

Then I was hooked up to an EKG and had my BP taken (normal), and was made to walk on a treadmill. To let you know how out of shape I am, typical people are on the treadmill for 10-15 minutes, with the machine increasing in both speed and incline. I didn't make it to 5 minutes before my maximum heartrate was reached, and my BP was elevated. Other than being winded (and knees aching), I was fine, no dizziness or palpitations.

Then I was injected with thallium again and sent out to the (boring) waiting room again. Afterward the tech redid the huge x-ray scan.

And that was it! I'll have results tomorrow, and then my primary care physician will send in the letter of recommendation. And then the Insurance Waiting Game begins! (submit > deny > resubmit > deny > resubmit... > approve), which will take weeks, if not months.

One good thing that came out of this: The technician, after asking a host of questions regarding my health history and habits, commented, "You have no indicators!" (meaning that other than being obese, I have no proclivity for cardiac disease).

This is my final medical test hurdle. Other than talking over the results with my own doctor, the next thing I should hear is the status of my insurance approval.

'thann

No Evidence...

I spent last night working on a Web site about our family vacation. (It's the latest replacement for boring family and friends with a vacation slideshow!) As I was creating each page, preparing each photo, it dawned on me that there is no evidence I was on this vacation. I have no photos of myself.

Many people are "camera shy," but I never used to be. I have boxes of photos of myself from when I was "normal sized," and even after Teddy was born. Until Teddy took my "before" photo to chronicle my weight loss surgery journey, I really had no good idea of exactly how large I am.

As proof that I used to be normal sized, and that I enjoyed being photographed, here is a photo taken two months before I became pregnant with Teddy. I was at a family reunion.

Here's hoping I'll be able to sit comfortably in an airplane seat again!

'thann

The Incredible Disappearing 'thann

Sorry to all my faithful blog readers (LOL!), but I was on vacation for a week, then spent the last week getting caught up with work.

Here's the latest in my GBS surgery saga.

As most responsible insurance companies should do, Blue Cross Blue Shield wants to make sure that a potential WLS (weight loss surgery) patient is truly ready and deserving of the surgery. GBS costs somewhere around $30,000 when all is said and done, and they don't want their money spent on someone who will: 1) Die under the knife, 2) Die after surgery because they don't adhere to the rigid lifestyle that such surgery requires, or 3) Commit suicide after surgery because the patient's true problem was psychological not merely physical. And I commend BCBS for being so particular.

So, as I said in a previous post, my psychologist was happy with my being a WLS patient, and said I am "highly motivated and likely to succeed." I still have more steps along the way, one of which I had this past week. I saw my primary care physician (PCP), Dr. Randy. I need a letter from him before BCBS will approve. The letter must delineate my struggle with my weight -- and Dr. Randy and I have worked on this for 15 years. I've tried every diet known to man, and then some, and I was under his care while taking the prescription drug Redux. He's also monitored me through knee problems and plantar faciitis, brought on my my attempts to exercise by walking.

SO ANYWAY, I was trepidatious about seeing Dr. Randy -- did he support WLS? I wasn't sure. I had myself all worked up, expecting the worst.

When I met with him, it turns out my concerns were in vain. He not only supports WLS for the right patient, he's had several patients have GBS. He said that my clinic, Barix, is the best in the area, and he was happy for me. He will write my letter based on our 15 years of trial and error.

Next I will have an EKG, and then a stress test. After that, all of my paperwork will be submitted to BCBS for approval. Chances are good that they'll deny the first time, but the Barix folks are used to that, and will resubmit.

Please pray that things go as they should. And of course, above all, that God's will be done!

'thann

Sanity Is Overrated

I have a sneaking suspicion that the psychologist who did my evaluation last Friday wrote, "THIS WOMAN IS INSANE!" on my eval. (Just kidding -- but I am sure he must have written something interesting...)

I arrived at the clinic the same time as the psychologist. I knew he was the shrink as soon as I saw him in the parking lot because he looked like a very tall version of Sigmund Freud, beard and all.

I am a very warm and funny person. I find humor in even the bleakest situation, and it really bugs me when people are so darned serious in situations where they don't have to be.

Dr. M (name has been shortened to protect the ultra-serious) didn't extend his hand to shake mine, and he was very formal. He began the session with a series of general health questions, which I answered truthfully, if perhaps adding a little too much detail. This went on a good 15 minutes: serious question, flowery answer, much scribbling on notepad. No smiles, no comments. It was a little disconcerting, I tell ya!

At one point he asked, "Do you have problems with memory loss?"

Aha! My opportunity!

I replied, "Not that I can remember."

Then I leaned in, looked him straight in the eye, and said, "That was a joke!"

Finally! A smidgen of a smile!

And he did loosen up and became just a little less formal.

What did he write on my evaluation? I have no idea, but I suspect it was favorable. Periodically he made positive comments like, "Good answer," meaning, I believe, "That should convince Blue Cross to cover surgery."

My next hurdle: Getting the note of recommendation from my primary care physician. Dr. K has been my doctor for more than 15 years, and he has seen me through many failed weight loss attempts. I am not sure how he feels about bariatric surgery, but I'll find out in a couple of weeks!

'thann

Am I Insane?

Well, by this time tomorrow an expert will know the answer to that question!

Originally my psych evaluation was scheduled for a month from now, but Barix called to let me know that they had a cancellation first thing tomorrow morning, so I grabbed the appointment.

Blue Cross Blue Shield requires a psych eval, to make sure a person is psychologically sound enough to undergo elective major surgery. I've had a gazillion psychological tests in my life (I used to work for the government),  but this is the first administered one-on-one with a psychologist. I find myself worrying about micro expressions (thanks to watching all those CSI-type shows!) and other "tells" that enable the psychologist to tell when you're lying or whatever.

I don't think I'll have any problems -- I am a very happy-go-lucky person, and I always wear rose-colored glasses. Well, perhaps he'll say, "Ruthann is so well-balanced that she should be able to lose weight by conventional means." I hope not!

We'll see.

Meanwhile, here is an amusing picture. I took my official "before" photo and doctored it. The cool thing is, I looked EXACTLY like this photo before I became pregnant with Teddy, and this is how I looked most of my adult life. Is the real me still inside? I guess WLS will let me find out. I'm not deluding myself into thinking I'll actually look exactly the same as I did 18 years ago, but I can certainly look more like that than I do now. God willing!

'thann

My Journey Begins

I've struggled with my weight on and off since I was in high school, but seriously only for about 20 years.

In high school I was a chubby teen, probably not even overweight by today's standards. I auditioned for an exclusive girl's choir, and was accepted with the provision that I lose weight over the summer. I did, and I pretty much stayed at that weight into my adult life, give or take 10 pounds.

After Ted and I were married I went up and down a little bit, but nothing particularly remarkable. I became pregnant in 1987 and had a miscarriage. After that I went into a depression and gained quite a bit of weight. When I was unable to get pregnant again, my doctor said that my weight was probably one of the reasons. I went to Quick Weight Loss Centers and lost about 70 pounds, achieving my pre-pregnancy weight. Indeed, I did get pregnant again.

The pregnancy was a difficult one -- I contracted preeclampsia (sometimes called toxemia) and was bedridden for four months. I gained 100 pounds during that pregnancy, and I was never able to take it off -- even after many dieting attempts. (But the pregnancy resulted in one incredible son, Teddy!)

I tried QWLC again, Weight Watchers, Atkins, South Beach, the prescription drug Redux, The Rotation Diet, etc. I joined three fitness centers and the YWCA. I bought a bike, weights, a treadmill, and good walking shoes. If I did lose any weight, nothing kept it off for long, and the more weight I lost, the more I gained.

Seven years ago I first toyed with the idea of gastric bypass surgery, but after the initial consultation I became overwhelmed by all of the things my husband's insurance company required (psych evaluation, stress test, etc.). It simply wasn't the right time.

I recently had one of those "straw that broke the camel's back" situations -- something I'll probably write about another time, and I decided to consider GBS again. Thankfully I live very close to one of the best weight loss hospitals in the world, Barix Clinics. Yesterday I had my first seminar, including a private surgical consultation. I still have to jump through hoops for the insurance company, but this time I have my ducks in a row and I'm ready and willing to deal with all of the red tape. It's time.

My best guess is that I should have the surgery some time before the end of this year, and by next year at this time I should be on my way to my ideal weight.

Right now I am 5'2" and weigh 270 pounds, which qualifies me as "morbidly obese." (My husband has no clue what I weigh!) My body mass index (BMI) is 49.5. Otherwise I am in excellent health -- no high blood pressure, normal cholesterol, no diabetes, no heart issues. I'm just fat.

I know this isn't a magic pill, and that bad habits will make the surgery ineffective at best, dangerous at worst.

Here is my official "before" photo, taken by Teddy as I was leaving for my first consultation yesterday.

The longest journey begins with a single step. I'm on my way.

'thann