It's Almost Time, a Hodge Podge of Thoughts

1. Blood work
2. Fitness Consultation
3. Nutrition Consultation
4. Sign Pre-op Paperwork
5. EKG
6. Start pre-op diet (10/24)
7. Pay in full (10/24)
8. Pre-op physical (10/26)
9. Stop taking all medications (11/1)
10. Start Hibiclens (11/4)
11. Pick up post-op meds (11/5)
12. SURGERY DAY (11/7)
13. Post-op Follow-Up (11/14)
14. First Fill (12/7)

As you can see, we're all caught up on THE LIST up to the big one - surgery day. 

I'm not nervous anymore. I'm not really scared of the surgery. Right now, I really just want to get it over with, because that means my pre-op diet is over. I know, I know, after surgery is when the real diet fun begins. You don't have to tell me that. I'm just looking forward to getting the surgery over with and starting to learn how to live with the band. 

The surgeon's office called in my meds early, so The Hubs picked those up on Friday. They prescribed me Loritab Elixir (which I have heard tastes just lovely!), and Promethazine, which is an anti-nausea medication. What I don't understand is that one is liquid and one is pills, so why couldn't they give me the Loritab in pill form so that I don't have to drink the gross liquid? Meh. 

I also found the Hibiclens at the Wal of Marts, and took my first shower (of three) with it. Now, I graduated from high school. I'm (mostly) college educated...one would think that I'd be able to handle soap and water with no problem, right? DUDE. That stuff is so thin, it might as well BE water. No matter how hard I tried, I couldn't get it to lather for shit. But I will try again tomorrow. I will not let showering beat me. LOL

Looking back on THE LIST and the past posts about this surgery, I can't believe my surgery will be happening exactly two months after my first post about the possibility. September 7th, I said, "Hey, this might be happening!" and in 2 days on November 7th, it really will be happening. Sur-real. The quickness of my process is one of the only things I'm grateful about with not being covered by insurance. 

And speaking of cost, I'm not sure I ever really broke it down for you. My self-pay options were: (1) an $11,900 surgery which included two years of aftercare visits, or (2) a $9,900 surgery which included my surgery follow-up, but aftercare visits cost $75 each. 

The Hubs and I decided to go with the $9,900 package. I would have to go to aftercare visits more than once a month for the next two years in order to make that $2000 worth it, and I just can't see that happening. I know that I will be going in, but I haven't read anyone's bandster story that mentions going in every 3 weeks for an entire two years. 

Anyhoo...$9,900 is the total cost of my surgery. We paid $350 of that for the Consultation Fee, and then the rest is divided up between financing through Care Credit and our very own cold, hard cash. I will be paying off the financed portion for the next four to five years unless I win the lottery. 

So that's it. Surgery is paid for, I've lost enough weight through my pre-op diet to be cleared to go, and all I have left to do is call the surgery center to answer my pre-op questionnaire. Oh, and I also have to stock up on post-op liquids and take pre-op photos. Once all that is done, it's just show up, get an IV, go to sleep, and wake up to my new life! 

I am SO ready. 

Making Progress, Drowning in Paperwork, and Pre-op Diet Shopping

1. Blood work
2. Fitness Consultation
3. Nutrition Consultation
4. Sign Pre-op Paperwork
5. EKG
6. Pay in full (10/24)
7. Start pre-op diet (10/24)
8. Pre-op physical (10/26)
9. Stop taking all medications (11/1)
10. Start Hibiclens (11/4)
11. Pick up post-op meds (11/5)
12. SURGERY DAY (11/7)
13. Post-op Follow-Up (11/14)
14. First Fill (12/7)

This morning I had my fitness consultation and also went to the surgeon's office to sign all my pre-op paperwork. 

My fitness consultation was supposed to be at 8 am, but signals got crossed and the trainer didn't show up until about 8:45. She then rushed me through what was supposed to be an hour-long consult and I walked out at 9:10. Basically, she tested my strength ("Try to push my hand up with your leg", "Try to push my arm away with your arm", etc.), showed me some exercises to do around the house, gave me a resistance band and showed me some exercises to do with that, and then told me I was good to go. Man, I feel like I really got my money's worth on that one! Blargh. 

Then I drove over to the surgeon's office (they're all in the same hospital complex) and signed my life away on a bunch of forms. 

Lap Band Paperwork. So far. 

In this folder, I have:

• A map of the hospital complex showing where I have to be, and for what
• My orders for my blood work and EKG
• My final financial agreement, which shows how much I'm financing, how much is left, and how the remainder amount needs to be broken down (i.e., one check for anesthesia, one for hospital, etc.)
• A copy of my signed Consent for Photo Use (I did not consent, LOL)
• "                            " Informed Consent for Surgical Procedure/Sedation
• "                            " Authorization for Lap Band Surgery/Acceptance of Risk 
• "                            " Consent for Blood Transfusion if Necessary
• Notice of Patient Privacy Practices
• Supplemental Informed Consent for Lap Band Procedure
• Two documents regarding my pre-op diet requirements
• A document describing the Hibiclens product I have to bathe with for three days prior to surgery
• A document describing Surgery Day procedures
• A copy of the Discharge Instructions
• A document showing the dates for my post-op eating phases (i.e. Start Phase 1 day of surgery, Start Phase 2 November 15th, Start Phase 3 November 22nd, Start Phase 4 November 29th)
• A document describing my post-op diet requirements by phase
• A document re: "Points for Success", (i.e. Bandster Rules)
• A document re: Long-Term Follow-Up Care Policy, (i.e. 10-day post op visit, and come in for adjustments regularly)
• A huge packet on nutrition and fitness
• Several documents showing exercises/stretches and giving exercise guidelines
• My official Lap Band Surgical Information Kit (the yellow thing)

SO. MUCH. STUFF. 

I did get an official surgery time of 10:00 am, and I have to be there at 8:30 am to prep. I am super happy I have a somewhat early surgery time so I'm not sitting around all day waiting (and not being able to eat or drink anything!)

Also, I went grocery shopping for my protein shakes and pre-op diet supplies. I found out that soups are super hard to find that fit the requirements! And since I'm still lost on protein shakes, I just picked up several kinds and will try them out to see what works. A friend of mine sent me chocolate and vanilla samples of Arbonne protein powder, and I bought EAS AdvantEdge pre-made shakes in chocolate and vanilla, a pack of Slim Fast High Protein shakes in chocolate, and a tub of Slim Fast High Protein powder in chocolate. I also bought a mixing bottle. I guess it's going to be a time of trial and error there. 

I also bought sugar free Jell-o, but forgot to get sugar free popsicles. I found the specific brand of sugar free/fat free salad dressing they require and bought one in Raspberry Vinaigrette and one Ranch. I'll wait until next week to buy the veggies, since they go bad so quickly. 

There is just so much to wrap my head around, I'm really struggling to keep everything straight and to make sure I'm getting everything done that I need to without forgetting anything. Oh, and remembering that my wedding anniversary is this Thursday and the Hubs and I are leaving on Saturday for a quick getaway that I'm nowhere near prepared for too. 

Stuff. Everywhere I turn.

But I will get through it all, and it will all be worth it and turn out fine. Right? Right.  

Consulting the Nut (and other things)

So, I started writing this post and then it all kind of got jumbled and ramble-y in the end. I apologize in advance. Pay no attention to the man behind the curtain.

Okay, so if you've been following along, you know that there are five pre-op requirements that I have to fulfill:

1. Blood work
2. EKG
3. Fitness Consultation
4. Nutrition Consultation
5. Pre-op Physical

Last night, I crossed the first one off the list by having a phone consultation with the Nutritionist. Originally, I was supposed to come to the office and do this in person, but they took pity on my extremely limited paid time off and the fact that I work about an hour and 20 minutes away from the office, and they arranged for me to have a phone consult. (Holy run-on sentence, Batman!) 

Aside from signals getting crossed and me expecting a 7 pm phone call which didn't come until 8:10 pm, everything went fine. She asked me about how much sleep I get, what times I eat normally, what "normal" meals are for me, how much pop I drink, etc. She walked me through the pre-op and post-op diet paperwork that I received at the office. She told me about two bandster rules, which I have heard about a zillion times so far:

Small Bites! Chew, Chew, Chew! Eat Slowly!

and

Protein First! Then Veggies! Then Fruits/Starches! 

All in all, I don't really feel like I learned anything I didn't already know from my two years of research and following so many amazing banded bloggers. Still, it was nice to have affirmation from someone else that the band is an amazing tool and that people do succeed with it, and that I can succeed with it too. 

At any rate, it's one thing checked off the list. My blood work will be done Saturday morning, my fitness consult (and signing of all my operation paperwork) will be done next Monday morning, my pre-op physical is scheduled for October 26th, which is a little later than I would have liked, but the earliest I could get in with my PCP, and I am going to schedule my EKG today.  

After that, all that's left to do is pay (ohmyjeebus!) and start my pre-op diet, both of which have to be done on October 24th. 

I'm kind of starting to panic a little bit because I feel like ever since my consult, things are just snowballing so fast. October is a crazy busy month for us in general - lots of birthdays and anniversaries, our anniversary on the 18th, our trip to Gatlinburg the weekend of the 20th, a wedding to go to, a performance of Dracula to see (a friend of mine is in the play!), and Halloween. Not to mention, crazy stuff at work. And then all these band requirements are thrown into the mix, and it just seems like a whole lot of juggling going on. It also seems like time is just completely flying and surgery day will be here before I know it, which just makes me feel completely unprepared. Blargh. 

I just need to get organized and make a plan. Oh, and I'm still completely lost on protein shakes! I almost wish the doctor's office would have required one specific one so that I didn't have to figure it out on my own. I could really use some bandster advice here, guys! Please help?

Pre-Op Diet

I knew going into this that there would be some sort of pre-op diet I would have to succumb to. According to the research, your liver can be very fatty if you're overweight. Doing this pre-op 'crash' diet helps you lose fat off your liver quickly, which helps the surgeon reach your stomach and lessens complications during the surgery. (The nurse at my consultation explained that the liver is actually one of the first places in your body that you lose fat, which I didn't know.) My surgeon suggests a loss of at least 10 pounds before surgery. Ten pounds in two weeks. Wowza.

After reading a bunch of bandster blogs, it became apparent that the length and food options on pre-op diets varies widely. Some doctors require two-week diets, some one week, some three days, and some don't require a pre-op diet at all! (Lucky freaking ducks!)

Some diets allow for a Slim-Fast type plan of two shakes and a 'sensible' dinner. I've read about some 3 day diets that allow nothing but clear liquids for three days. (Sounds super fun!) My prescribed diet is somewhere in between. While I'm not thrilled, I knew that this was part of the deal, and it could definitely be worse.

Where do I find a holey spoon like that?

The Rules:

• Start two weeks before surgery. (For me, that means October 24th.)
• Maximum of 800 calories per day. (The sausage biscuit I get at McDonald's for breakfast some mornings is more than half of that calorie requirement! Peace out, buttery yumminess!)
• Minimum of 64 grams of protein per day. 
• 4/5 Protein shakes per day, any flavor, any brand. Any fruit, additives or milk I mix in have to be counted toward the 800 calorie limit.
• 1 cup of broth, low-fat broth-based soups, or 98% fat free cream soups without pasta.
• 1 cup of certain salad veggies (lettuce, cucumber, carrots, onions) with certain fat free dressings (any brand of FF Italian or Ranch, Maple Grove Farms Sugar-Free Raspberry Vinaigrette, SF/FF Balsamic Vinaigrette, FF Greek) (2 tbs)
• 1/2 cup of certain raw veggies (carrots, celery, cucumber, broccoli, tomato.)
• Sugar free Italian Ice or Sugar free Popsicles.
• Sugar free Jell-o.
• Water, coffee (yuck!), tea (yuck!) and other sugar free beverages are allowed. 

This is going to be so freaking hard. You don't get to 270 pounds by harboring a secret love for vegetables. However, I originally thought I was only going to be allowed protein shakes, so I'm taking the soups and veggies and sugar free Jell-o (which I already eat and LOVE, btw) and I'm going to make the best of it. 

I'm kind of looking at the two week diet as the first challenge in this long obstacle course of being banded. Can I make it through this? If I can, then everything else shouldn't be too hard. And I'll be able to look back and say, "Hey, remember when you subsisted on protein shakes and lettuce for two weeks? If you can do that, you can do anything!"

Okay, fellow bandsters. Help a girl out. Protein shake suggestions? I really have no idea which way to go on those! And what was your pre-op diet like? Was it the hardest thing you've ever done? Help!  

Ho-ly Crap.

So. Much. Information.

(and a surgery date, but we'll get to that in a second.)

I was feeling seriously anxious before I met The Hubs at the doctor's office. Laura Belle's comment and an urgent Facebook message to my banded friend who used to work at this doctor's office helped enough that I was able to keep myself from refusing to walk in the door. I really don't know what it was, but I was just so stressed out about everything.

As per usual, the things you blow up in your head to be a big deal are not big deals in reality.

I walked in, signed a few pieces of paper (HIPAA, etc.), handed them my debit card for the $350 "Program Fee", and waited. I had originally been told that I would be meeting with the counselor for the psych eval first, but I ended up meeting with one of the nurses first. The thing that I LOVE about this office is that, with the exception of ONE front desk receptionist and the surgeon, every single person who works there is banded. They have been through the pre-op diet, the surgery, and are now living with the band. And they are all SO NICE and willing to share their experiences and answer any questions. Love them.

Anyway, she took my height (5' 5.5") and weight (270.0 lb), and tried to take my blood pressure, but the new fancy fandangled blood pressure cuff they had just bought wasn't working. So I told her that my blood pressure at a doctor's appointment last week was 107/70, and that's what she wrote down. Oh, and she also measured my neck. At that office, if your neck measures more than 17 inches, they automatically require you to do a sleep study. Luckily, my neck was well under, at 14 inches.

She explained stuff I already knew about the band (basically Lap Band 101), and also went over the pre- and post-op diets. I'll cover those more in another post, but Holy Jeebus in Heaven, I get to eat veggies! I never thought I'd be so happy to see the word "salad" in my life. LOL

Next was the psych evaluation with the counselor. Maybe it's the nature of her job or something, but she was definitely not as warm and friendly as the other ladies. She was fine, though. She asked me about stresses in my life (um, hello? What's NOT stressful?) and about my support system. She kind of jumped on me about my relationship with The Hubs and whether or not I thought he would handle my weight loss and subsequent attention from men well. This is something that he and I have already discussed at length, and I feel 100% confident that he and I will be fine, but it didn't seem like she believed me. Later in the discussion, I found out that after her band and weight loss, she divorced her husband and married a new guy, so maybe she is biased in this area? I don't know.

She also talked about how friendships can change, and how if you have overweight friends they can sometimes not be super supportive because they are jealous or wish it was them losing the weight. They can feel 'abandoned' once you start losing weight, etc. And another thing she mentioned (which I hadn't thought about) was how even if you have skinny friends, sometimes they can become uncomfortable with your weight loss because you are getting closer to THEIR weight. Wowza. The human mind is amazing. I love my friends dearly and am not doing this in any way related to them. I hope all of my friendships survive through this process, because I truly love and need the people who are in my life.

After the counselor, we met with the surgeon. He is actually pretty awesome. Very friendly, down to earth. Not at all a cocky, I-don't-have-time-for-this-nonsense kind of guy. He spent a good 20-30 minutes with us discussing the technical aspect of the surgery and answering all of my random questions. He was also very positive about the possibility of pregnancy after the band and said, "Oh, yeah! We have had A LOT of 'band babies!'" LOL

Then, after the surgeon, we met with the lady who deals with the financial portion and the scheduling. I had actually talked to her several times before today, asking her questions and having her double check that my insurance would not cover the surgery. She (like everyone else) was incredibly awesome. Friendly, warm, funny, and knew what she was doing. We talked about all of the financial information, pre-op tests and such that I'll have to do, and the other appointments I'll have to make.

Then, we scheduled my surgery.

I have a surgery date. For the Lap Band.

Me!

November 7th. Forty-one short days from now, I'll be banded. How freaking surreal.

Luckily, there's a litany of other things that I have to do between now and then to keep me occupied:

• Make appointment with PCP for pre-op physical
• Bloodwork
• EKG
• Fitness Consult
• Nutrition Consult
• Pre-Op appointment to sign paperwork

Oy vey. So much stuff. 

I am just really having a hard time registering that this is all really happening. I'm still a little scared, but now at least I'm getting excited, too. I'm gonna be a bandster! Woot! 

Got any advice for me? I'm kinda taking all I can get...

Consult Day

Well, here it is. Consult Day.

I am scared as hell.

I really don't know why I'm so nervous. I don't think there's really anything rational to be afraid of today, but for some reason, I'm shaking in my boots. (Well, not really, I can't fit boots over my fat calves. But I'm shaking in my Fashion Bug flats, fo sho.)

I also found out on Monday when they called to confirm that the Program Fee is $350 instead of $300. I was convinced they had told me $300, but The Hubs seems to think I told him $350 at some point, so whatever. $50 is not a deal breaker here, and anything I pay now comes off the surgery cost, so that's $50 I don't have to pay later. Oh well.

I think it's just the reality of everything that is hitting me right now. This is the farthest down this path I have ever traveled. After today, I am monetarily invested in actually going through with this. If I don't have the surgery, we're out $350 now, which is A LOT of money to us. I feel like I'm hitting the point of no return, and even though I know that I want to do this, and I've wanted to do this for YEARS, now it's real. Now it's scary.

What if I go though all this, spend all this money, have SURGERY, and still fail?

Uno Week-o

(I did not take Spanish lessons, why do you ask?)

So. One week until my consult! I am super duper excited to get it over with and get this process rollin', rollin', rollin'.

After much dilly dallying and indecisiveness (on his part, not mine) The Hubs has decided to come with me to the consult. It's not that he doesn't support the surgery or anything, I just think he couldn't decide whether it was worth missing 3 hours of work (read: money) to go. He finally relented, saying, "Well, I guess I'll go, because if I end up having this surgery in the future, it will help." Okey dokey, kiddo. See you there.

So the way they do this is by bringing me in for one $300, 3 hour session of meetings with the Surgeon, bariatric nurse, and the psychiatrist. Apparently, The Hubs is allowed to join me for everything but that last part. Wouldn't want him helping me pass that, I guess. Although, I don't think he would be much help. LOL

Then, I guess if I get the go-ahead from everyone, they tell me what my pre-op tests are and schedule me for my nutrition consult and my fitness consult, which I'm hoping that they offer at better times, because I have, like, NO MORE days off work, and the days I do have, I'm going to need for recovery.

Oh, and if you were wondering, the $300 is a "Program Fee", which is common (at least around here) for bariatric surgery programs. Basically, it's $300 for the surgery, nutrition and fitness consults and it's non-refundable. However, if I do go through with the surgery, the $300 is taken off the final cost, bringing it down to $9,600.

So I'm gathering up my last minute questions and trying to think of anything that I haven't thought of. And waiting very impatiently for time to pass.

Hopefully, it will be here before I know it, and I'll have a definite plan in place that will take me to Bandsterhood!