Mood: Surly with a soupÇon of "I'll rip your throat out."

Ridin' Out The Storm

Day 1 of my fast was Thursday (two days ago). I made the fatal mistake of not eating everything I was entitled to, and rather, had a large salad w/extra chicken as my "meal" of the day. All went well on Day 1, or so I thought, until I woke up yesterday a.m.

I woke up with a headache so fierce, and it hadn't even blossomed into full force at that point. At 8 a.m., I called in sick, and went back to bed until 1. The rest of the afternoon consisted of me attempting to eat or drink or take my medications, and promptly vomit, cry, break out into a cold sweat, and then lay down for a nap. Repeat about 3X thru the day. I spent the greater portion of the day in the fetal position in agony, hoping for the sweet release that only death can bring.

As much as I *thought* I wsan't eating all that many carbs or refined foods, apparently I have been consuming them.

Luckily, I had some Rx cough syrup with some "special stuff" in it, which I promptly swigged down in the hopes of breaking the headache of doom. By about 9 p.m., I had calmed down enough to take in SOME sustenance.

Honestly, I hope this was the worst of the pre-op stuff. Eleven more days until surgery. Honestly I don't know how some folks can eat right up until the surgery and not have this interim period with the fasting. It gets you in a habit with the shakes and supplements.

As miserable as I've been the last two days, I can see the benefit of it.

But still secretly, or not so secretly, I"m open to any change: whether the surgery is a success, or if I die on the table under anesthesia. It's all good.

Pre-Op Nesting Continues:

Lovonox and Prevacid have been purchased.

Pre-op modified fast started at 9:30 this a.m. By 10:15 I was counting down the moments until lunch (decided to have my solid meal at lunch rather than dinner).

Every joint in my body is hurting. Extra strength tylenol is not cutting it. Can't wait until this weekend when I see my podiatrist, so I can start Celebrex ASAP.

We Have Now Achieved "Pre-Op" Status

Went to NYC to have the pre-op testing and admissions done.

So stressed out, from both, the transit getting there as well as the "holy shit, this is really really going to happen," I had explosive diarrhea AND a migraine which just refused to quit.

Took, what I believe is officially the last advil and excedrin I'm going to have for a good long while. Going to the internist sometime maybe this weekend to see about getting some Rx medication for my headaches to have "just in case," as I cannot take NSAIDs for 2 weeks prior to surgery and I'll no doubt be strongly told not to take them post-op due to concerns of ulcerations.

Weight was taken as the official start weight: 277.2. There. I said it.

Starting tomorrow, I will be on the pre-op modified fast until surgery, which is scheduled for 1/19/11. Don't have a time yet.

Did so much walking yesterday, didn't know it at the time, but hells bells, my shins hurt. Yanno that spot between the two bones of your shin? RIGHT THERE. THROBBING PAIN.

Still think it's pretty sad that I'd rather undergo surgery than be at the office. But there ya go... that's my reality.

Nothing Noteworthy, Really

12/25 Got period.
12/30 ENT follow up.
12/31 Abdominal ultrasound.

Call tomorrow to see if sleep center can cram me in and get me titrated prior to surgery.

Omnicef? Lovonox?

WTF.

I feel like it's burning a hole in my stomach after only one day's dosage (2x).

Takin' it for my sinus infection. That and Flonase. I think my body is finally revolting against all the chemicals I've been putting in it.

Dropped off my Lovonox Rx to be filled for my post-op use. Been informed by my pharmacist and again by a friend, of "how expensive" this Rx is. I'm hoping my insurance covers a lot of the cost.

ENT Results

Went to an ENT specialist yesterday due to my hearing problems, balance, chronic cough, sleep issues, and follow up for sleep study.

He ran every single test he's got. Turns out I've had a sinus infection for a long time. Rx antibiotics and a nose spray to help with that.

Tested me for allergies, to rule out environmental issues. Turns out I'm allergic to feathers. Fortunately for me, my pillows and comforters are all polyfill.

Hearing is normal. Balance is normal.

Go back in 2 weeks to follow up and see if the antibiotics help.

No need for follow up sleep study. Not yet.

Still tired of waking up feeling like crap.

Don't know if sleep issues are related to the apnea, or my weight. Only time will tell.

WLS Chronicles: This Shit Is a Full Time Job

2/3/11 First appt w/Nutritionist
TBA Two week follow up appt w/Surgeon
1/19/11 Date of Surgery
1/15/11 10 a.m. Dentist appt
1/15/11 10:45/11 a.m. Chiropractor Appt
1/8/11 9:15 Podiatrist appt
1/6/11 Start pre-op diet
1/4/11 10:30 Pre-op testing (blood, ekg, meet w/anesthesiologist)
1/4/11 4:30 Therapist appt
12/31/10 Abdominal U/S (gallstones)
12/21/10 Chiropractor appt
12/20/10 Fill Rx for Lovonox (for post-op)
12/18/10 12 noon, ENT appt
12/18/10 10:30 a.m., appt w/Internist
12/16/10 6:45 p.m., Chiropractic appt

Calls I've made thus far today:

Surgical supply co., for supplies for CPAP;
Sleep Ctr., to fwd sleep study to surgeon;
Podiatrist to shift appt to Saturday;
Anesthesiology group to ensure anesthesiologist for surgery is "in network";
RN for insurance who is my case manager re: surgical date

Emails I've made thus far:
Endocrinologist to advise re: surgical date.

Forms filled out today:
New patient forms for ENT specialist.

Possible appt to be made:
Sleep Ctr for possible follow-up sleep study to titrate/adjust settings on CPAP;
Imaging Ctr for abdominal ultrasound re: Gall stones.

Things purchased today:
More protein powder (mocha flavor)
Liquid vitamins: calcium, D3, Geritol w/iron, propolis
Kalhua flavored syrup

OY!

Trip to the Pharmacy

Went to Duane Reade and dropped off six (6) prescriptions. Good times. I'm a wreck.

They filled my Mobic & Effexor immediately. Popped a Mobic during lunch. Start the Effexor tomorrow a.m.

Here's hoping I start feeling even REMOTELY better-ish. Soon.

Funny thing is, the package insert for the Effexor warns me to be on the look out for:

thoughts about suicide or dying;
new or worse depression;
new or worse anxiety;
feeling very agitated or restless;
panic attacks;
trouble sleeping;
new or worse irritability;
acting aggressive, being angry or violent.

Shit.

That pretty much sums me up where I am at RIGHT NOW.

Makes me laugh.

Not in a "ha ha" kinda makes me laugh; but in a WTF is wrong with me, nervous, twitchy, half-giggle.

Better living through chemistry, bitches.

It's Not a Tooomah

Dx: Post traumatic osteoarthritis (same site on the foot where I suffered a fracture of my instep 36 years earlier).

Rx: Mobic.

Bye bye Gyno

The nuts and the bolts. Two appointments in quick succession. One on a Friday (the final appointment with my gyno, who hereforward will be referred to as ByeByeBye-no), and one on a Monday with my ReproEndoGuy.

I had cultivated a 10 year patient-doctor relationship with my ByeByeBye-no. For the first few years, despite my age and my PCOS diagnosis, he reassured me that when I was ready to try to get pregnant, they could do "ovarian drilling" to perforate my leathery ovaries. Ten years @ 2 appts per year = 20 appointments total. During the last four appointments (2 years), each appointment pretty much rendered me to the brink (if not outright) tears. 

Despite the fact that I have sought out an EXPERT reproductive endocrinologist, my ByeByeBye-no started to manifest signs that he knew what was better for me. Not sure how. He didn't do much beyond growing increasingly less polite or less professional, and in the final two years, almost bordering on hostile with me and my unique constellation of health issues ranging from PCOS to Factor Five Leiden Mutation, to Syndrome X, to depression and anxiety, to ... well, you name it. Always appending each appointment with a reminder that I should do something about my weight, even going so far as to suggest outright that I should consider weight loss surgery.

At the end of what would become my second-to-last appointment with him, I asked him flat out, yet rhetorically, "Why is it, by the time my exams are done, I am either in tears or on the brink of it?" No real response given by him. You'd think after what was nearing 10 years of being a patient, would have elicited SOME response.

So, during what would be the final appointment, there I sat in the paper gown, as he started in with the fat shaming questions:

Him: Have you tested your glucose daily?
Me: Why would I do that?
Him: For your obvious diabetes.
Me: I don't have diabetes. I have PCOS.
Him: So why are you not checking your glucose?
Me: Because my ENDOCRINOLOGIST hasn't indicated I should.

Things just went downhill from there. The exam was done, and we were wrapping things up:

Me: Well, all that will be a moot point next month.
Him: What's next month?
Me: I'm going in for gastric bypass.
Him: Well that won't fix your underlying issue.
Me: (taking the bait) WHAT ISSUE?
Him: Your OBVIOUS OVER EATING.

It was at that very moment that solidified my resolve that the doctor I once knew no longer KNEW ME or even remotely cared to know me as a person or as a patient. And there I was, obviously acting on and taking his advice, advice he had given me for YEARS, and rather than say,"Great! Good luck!" he had to slam me for something which clearly is not my issue.

So, on Monday, I go to my ReproEndoGuy. 
I adore my ReproEndoGuy, and I think you will, too, after reading this.

So I regale him of the ByeByeBye-no's dialogue from Friday's appointment. And when I got to the point in the story where I said, "and I took the bait and asked... WHAT ISSUE?" ReproEndoGuy said, "What did he say? What did he say?" And when I got to the point where he said the blurb about my obvious overeating, ReproEndoGuy turned to me and said, "What a fucking asshole! Anyone who knows you, knows you OVER SLEEP, not over eat!" I hugged my ReproEndoGuy for TOTALLY GETTING AND SUPPORTING ME. 

It would be another six months before I had to make the move (to a new Gyno) official, and the first Gyno I went to afterwards was not a good fit (and luckily I knew this RIGHT UP FRONT and did not have to waste a decade of my life cultivating a rapport with a doctor who turned out to be an asshole--no no no. She proved herself to be an asshole right up front. But in the three years since discontinuing seeing ByeByeBye-no? Yeah. Not one fucking regret. 

Not every fat woman is fat for obvious reasons.
Not every woman going to a gyno is looking for a baby farmer. This guy clearly was a baby farmer, and not necessarily focused on WOMEN's health.

Tomorrow: Podiatrist
Next Tuesday: Pre-op consultation w/bariatric guy; then visit w/psychotherapist.

Eventually will reschedule appt w/pulmonologist, and will need to schedule appt w/ENT specialist... also interested in getting a sleep study re-done, to make adjustments on CPAP.

This is my life. A never ending stream of doctor appointments.

Note

Pre-op consulation: December 14th.

Date fast approaching.

WLS Chronicles: Blaring Lack of a Support System

Here's an actual email exchange between me and the husband today in regards to my pre-op consultation in December, which I had hoped he'd accompany me to (obviously, read from the bottom up--yes, I am TOO lazy to restructure this in ascending order):
___________

3.
From Me to Him:
Dunno how long the appt IS; however, who knows how long I'll have to wait before seeing him. We could go for the appt, then lunch, then the shrink and go home, if you want...

And uh... what do you want me to do about the appts? THERE ARE A LOT. And I have a finite amount of time that I can take off to handle everything. If I take multiple days, it then cuts into either my sick time I have banked for the surgery/recovery, or it'll cut into my vacation time.

You don't have to go if you don't want to. I won't force you to do anything you don't want to do. Just keep in mind, I'm only in NY because of YOU, and YOU are all I've got as far as a support system. Either you're a part of this, or you're not. But this is my life. And I'm not going to beg you to love me enough to support me. Either you do, or you don't.

Lunchtime.

Peace out.
_______________
2.
From Him to Me:
ayayayayay!

cant get a reprieve that day either!hate these all day appts thingy.

how long is Dr. appt?
_______________
1.
From Me to Him:
Subject: Reminder: Dec 14th

10:30 Dr. [redacted] appt
4 p.m. Therapist

Wanna schedule a reservation someplace we haven't been together? Or shall I pick
a place?

It's Approved.

Insurance approved me for the surgery.

12/14 is the date I meet w/the surgeon for the pre-op consult.

I'm hoping to schedule surgery on 1/14 or 1/15, so as not to fuck up my holidays with this.

Where I"m at.

For starters, I don't give a shit that I ended the title of this post with a preposition. Fuck grammar in its ear.

Second:

Friday, I:

Went to get my blood work done (because so many things are wrong with me);
Went to the gyno where I was reminded of how many things are wrong with me, as well as giving me his 2 cents (unasked) regarding my pursuit of WLS, thus undermining this very difficult decision which took a long time for me to accept and an opinion which is bolstered by two of the very best, top doctors in NYC who are treating me (mercinary, IMHO, given that I'm there, vulnerable and in a flimsy paper gown that barely covers what it needs to cover.) Note to self: Find a new gyno;
Went to my internist to get my antidepressant Rx adjusted (only to realize after I got home that the Rx is the wrong Rx and the same dosage I'm at currently;
And finally, the last thing I did was a phone-in session with my therapist (too emotionally spent after the first three appointments to make the trek into NYC just for this appointment).

Took a nice longish nap afterwards. Just spent.

At this point, I don't even know if all my paperwork has been submitted to the insurance for approval yet, as I have to continually check, double check, and even triple, quadruple, and quintuple check if the surgeon's office has received all my documentation.

At this point, I just want to die. I don't even want to go in for the surgery. I just want to curl up in a fucking ball and die.

Work sucks syphilitic, leper testes. I'm a half step away from crocheting a voo doo doll and asking a friend to cast a spell, or teach me how to do such a thing. And my personal life is so chock full of ennui and meh, I cannot even stand it. I'm so full of rage and pissedoffedness that there are so many things going on in my life, none of which I have any control.

Roughly Two More Months To Go (For Insurance Approval)

Nothing new to report, other than a whole lotta "hurry up and wait." Oh, and a gout flare up. Good times.

Haven't lost much weight from month to month for my pre-approval monthly weigh-ins with my internist. Next weigh-in: July 31.

I go for my three month visit w/the ReproEndoGuy tomorrow. Not sure what any of the tests will show. Forgot and took a Claritin right before they drew blood. Not sure if that will skew things. Don't much care anymore.

Already started "nesting" a bit for post-op. I got two jugs of protein powder, a shaker jar, some vitamins, a pill crusher and some liquid Tylenol (tho I know this shit doesn't work on me, my aches, nor my migraines).

I just wish it were over with by now.

Still tired.
Still depressed.
Still achey.
Still bored out of my mind with job, with life, with everything.

To date it's been 9 months since I last saw my immediate family. I keep making plans and then flake. I think I might just surprise them rather than give them a head's up. At this point, I'd just assume have them think I'm an unreliable flake or uninterested in seeing them, rather than whine about what's going on with me.

I still don't know what the point of all this (life, existence, etc) IS.

Checkin' In

Currently at (almost beyond) the halfway point in documenting whatever "progress" on my "diet" in order to submit to get insurance to approve my weight loss surgery. Go for my fourth weigh in on Saturday. Two more to go after that. Brings me to August. Then submit for approval. Then after that, I suppose, there'll be a flurry of appointments with a cardiologist, a blood doctor, a pulmonologist, and who knows who else.

Received two jugs of Nectar brand protein powders and a bottle of liquid extra strength Tylenol in the mail yesterday. Starting to "nest" and prepare for what I hope to be the logical conclusion of all this planning. Buying things piecemeal so I won't get hit with sticker shock if I were to buy all my supplies all in one shot. Flavors purchased: (1) Fuzzy Navel; (1) Ice Tea (which I plan on mixing WITH brewed, ice tea (don't lecture me about caffeine; I'm not willing to endure the unpleasantness of the surgery and post-op in an un-caffeinated state.)

Still waiting for my Torrone "Marshmallow" flavored syrup, and B12 spray to arrive. Can't wait to try them.

Next on my list: propolis, calcium, and liquid vitamin supplements and an ice cream maker. I'm envisioning a lot of green tea flavored or mint chocolate flavored high protein "ice cream" post op.

I'm not optimistic. I'm a hybrid: stoic, fatalist, pragmatist. I don't like that this at all. But know I have no other choice. It's this and hope to reverse my health, adding a couple more GOOD QUALITY years to my life; or do nothing, and continue on the slippery slope to spending my "golden years" house bound, miserable, and with considerable health issues, not unlike my mother.

Went to lab yesterday for bloodwork. Not too many tubes this time. ONLY ten. Go on Monday to drop off my 24 hour "collection" jug. Gah.

Next appt w/the ReproEndoGuy: 7/15.

It's a wash

I was sleeping too much before Celexa, due to my depression and crying jags. Now I'm sleeping too much because of the Celexa. But at least the crying jags have cut down in frequency.

Five more months of documenting my "diet and exercise..." before submitting to insurance to see if they'll approve me for weight loss surgery.

Hurry up and wait.

In the meantime, I'm still dealing with my grief. Seventeen months since dad passed. I'm in shock still. Refuse to believe it. Miss him tremendously. Even though I've got siblings, and my mother is still alive, I feel like my entire sense of family is gone. Orphaned. And I've got the over-riding sensation that everything about existence is random and without meaning.

3/10/10

Went for my first official weigh-in to start the documentation my insurance co., requires prior to approving me for surgery.

Also marks two weeks since I started Celexa. I'm a zombie, but at least I'm not crying every day like I have for the last 17 months. EVERY DAY.