Hello everyone, I'm new here, a friend of mine knows I'm thinking about surgery and suggested I visit this site. I've been reading here and there on this site and finally am ready to ask some questions. I'm guessing this information is somewhere but since I didn't find it in my wandering around I figured that it was best if I just ask outright!
First off: a little bit about me.
I'm a 38 year old high school math teacher. At the beginning of the summer my weight was 350. Last week it was 324, but not due to dieting. I just had an awful summer with a severe ear infection that took two kinds of steroids, three kinds of antiobiotics, and an entire month to cure. None of the meds were good for my digestion, so I have been dieting because food is not appetizing. If I could keep up this sort of weight loss then of course I would not need to think about surgery, but I am pretty sure that this is "temporary" weight loss. With school starting Wednesday, I am sure to get swamped in the stress-filled life of high school.
When I saw the doctor last week I asked her about gastric bypass. I wanted her opinion on it, whether she felt it was worthwhile, or if it was a mistake. I figured that the best place to start is with the opinion of the doctor. She wasn't sure my insurance covered it, so she cautioned me on that score, but she said that in a case where the number one desire is to be HEALTHIER, then she was all for it. If my number one desire was to be HAPPIER she said that it would be important to understand that the loss of weight will not all by itself make me happier.
One thing I learned (do not know how true it is) is that gastric bypass frequently cures Acid Reflux. This is one of the medical issues I've been having that is a serious problem in my life. As a teacher, I need to use my voice. The reflux has been impacting my larynx and making my voice useless for my chosen profession. I have had to face this coming school year with the knowledge that it might be my last year teaching if I cannot get a handle on the Acid Reflux. So when I heard that the gastric bypass often cures that problem, I began to lean much more heavily towards the surgery than I was before. If it can cure my #1 problem that impacts my job, then it might be worth it just for that reason alone! In addition to reflux, of course I suffer from chronic back pain, and the doctors are sure that someday my blood pressure might rise.
After I went to the doctor's office I called my health insurance provider. I wanted to know if Gastric Bypass was covered and was surprised to find that it actually IS covered?!! Of course there are a lot of conditions to being covered... I have to have been 100 lbs over my target weight for five years before having surgery. (I've been 250+ since I was married six years ago, and I'm 5'4"). I also have to have tried to lose weight traditionally, which the lady explained meant that my doctor's office had to have recommended weight loss and given options that I tried. I'm not sure about that, but we'll see what we see as I proceed through the process. Finally, if I pass a psychological evaluation, and if I get it done through a provider under the plan, it is covered.
Tomorrow I will call the health insurance company again (a different division) and get more specific information. Find out what they want and need, and who I am supposed to contact for the next step. I was a little confused about the steps from the first person I spoke with and I need to clarify. I also need to find out what "covered" means... 50%? $100 copay? what does it mean?
Once I understand the financial obligations and the "first step" beyond thinking about it... you know, sending for records, or getting an appointment with a doctor... then I'm curious about what the next steps are... both for Lap Band and for Gastric Bypass (not sure which is covered nor which is more applicable to my situation)
So... after that long introduction, I wonder if anyone can tell me what the "normal" timeline is from the moment of "interest" to the moment of surgery... and beyond. I guess part of the thing that concerns me is my very full life and how I do not want to miss time with my students.. how long before I can expect to have the surgery? (if all goes well). How long will I be out?
Sorry to be vague but I am curious but also know that I don't even know enough to know what to ask.
Though, now that I wrote the prior sentence I realize that I have had some questions pop up as I've read through posts on this site...
1. Hair loss? Is that common with WLS? Is it preventable?
2. Pre-surgery weight loss?
3. 6-month waiting?
I just wonder about all the things I've read as I've perused the board. But a synopsis would be great.
I can't answer all of your questions. I'm sure there are some people that can answer your questions. There are lots of other web resources, including obesity help, which has to do specifically with weight loss surgery.
This place helped me out a lot. I never joined but just lurked but I was able to get a lot of questions answered by just searching their forums for specific things.
Last edited by jiffypop; 08-06-2007 at 08:44 AM.
Reason: to remove the link to obesity help.
Hi Sasheena - my goodness, you're brave - teaching math!!!!
let's start with the last three questions first.
hair loss. it's caused by the hormonal changes from the rapid weight loss. there are ways to MINIMIZE it, but it happens to pretty much every one. make sure to get in your protein - yes, all of it - and your vits. AND some people have found that a certain shampoo [noxil??? can't remember the name - someone else around here surely does!] can help as well. HOWEVER, your hair will grow back. honest!
the 6 months. some insurance companies require 6 months of supervised diet. others don't. for those companies that do require the 6 months, they'll often include WW, physician-supervised plans, gym memberships, pretty much anything as long as you can document the effort. they're looking for tenacity and ability to adhere to a regimen.
pre-surgery weight loss. some surgeons require it of all patients, others don't. and those who don't require it generally require it for higher-risk or higher-weight patients as a safety precaution. IT'S ALWAYS A REASONABLE IDEA TO LOSE SOMETHING BEFOREHAND. and remember, you don't have to worry too much about HOW you do this, as long as you do it. [that was an obscure way to say that this might be a time to consider a liquid fast for a couple of weeks - but there are many paths to losing weight before surgery].
now, the 'normal timeline.' i've heard of people getting their surgery 1 month after their first appointment, but more often than not, it's 2-3 months AFTER THE SURGEON APPROVES YOU as a candidate. <notice i didn't say AFTER INSURANCE APPROVAL - that generally happens in the 2-3 month period - the surgeon has to file his paperwork>
Sure sounds like you have a huge handle on things. from this point on, it'll be a matter of doing what your insurance company and the surgeon want, and doing your own research about what life is like afterwards, as well as looking within yourself to figure out the changes you need to make in order for all this to work over the long haul.
generally, surgeons require a pysch evaluation. GO FOR IT! it's not to decide whether or not you're crazy [although, someone who teaches high school math just might be!!!! ], but rather to make sure you've thought about this thoroughly, and that you have support systems in place, and that you're willing to change and do the work. and let's face it, we didn't get into this predicament without having issues with food - if additional counseling is suggested, that's just fine. we all need to figure out a different way to live.
hope this helps! and i know others will jump in here. thank goodness!!!!!
Jiff is a one stop shop for all bits of WLS knowlege I will add the shampoo/conditioner is
Nioxyn I just use the conditioner and it's great!!
good luck with your decision!
Congrats on doing this big step. Sometimes getting started is the hardest part.
Sounds like you know exactly what to do in terms of steps to have this surgery. First, insurance. Then finding out what you have to do...and in the mean time you should be reading like a mad woman to find out what surgery is for you. The most common surgeries are roux en y, duodenal switch, lapband, gastric sleeve and mini bypass. There are pros and cons to every surgery - every surgery has possible complications and possible negative/positive outcomes. Typically people start out debating Lapband vs roux en y as you said - they are definitely the most common.
For me, I was 288 lbs before surgery - and am now 140 a year later. Less than half the woman I used to be. It is a personal decision as to what surgery you want and you decide. I can only give my reasons for choosing the surgery I had. Please remember that everyone is going to be gung-ho about their surgery - I would suggest reading some good books and sites but taking that fact with a grain of salt -- and that there are many sites that are very one sided as well. Read about personal experiences too - could you live with their way of life? That's always good to hear about too.
I would suggest going to obesityhelp.com to "find a bariatric surgeon" and looking to see about different surgeons in your area. See when they have a seminar or consult and meet them, ask them questions. I had a choice of many surgeons in my area, and chose mine based on their experience with surgery, their rates compared to the national average and the fact that they did a mandatory leak test the day after surgery. I would suggest researching as much as you can. It makes me cringe when people have this surgery and don't even know what kind of surgery that they had -- a relative of mine was like this - she had no clue what surgery she had other than "gastric bypass" ---ummm....hello?!?!?! There are many different kinds of gastric bypass surgery.... It also upsets me when I see people newly out of surgery who ask "what is a stricture?". YOU NEED TO DO RESEARCH BEFORE not AFTER surgery. Yikes.
Your time for surgery depends on the requirement of your insurance company, your required amount of testing before as well as how long it takes for you to find a surgeon. Sorry there is no hard and fast rule. You could have surgery in two months if things go smoothly, or in a year if you have more hoops to jump through.
Hi, I'm taking my first steps too! I decided that I'm going to have surgery unless some major roadblock is put in front of me, and right now it would only be medical, because my family is behind me. I am attending my first meeting on Wednesday. I am reading, reading, reading right now, I really have learned alot from Weight Loss Surgery For Dummies. It is a great read. I also have started to eat better (i.e. no soda) and trying not to look at every meal as my last meal. Right now I have to learn to exercise. I also decided to cancel my vacation in September, so I could take the time off whenever I needed to, so I could just worry about getting better, not about getting the mortgage paid.
Thanks,
Michelle
I'm starting to feel it all coming together, but it's barely a week since I "Asked the Doctor" if she thought it was a good option for me, and if so what is the first step. In that week I have also redecorated my living room, built a desk, cleaned the house, attended teacher in-service meetings, and had two full days of exhausting school. It has been a very "loaded" week for me. I am glad that it takes time for the surgery to happen. I would had to make my decision based on an emotionally and physically exhausting week with so much information coming at me so quickly.
Some of the thoughts that have been going through my head in the last week.
I was at the in-service at the beginning of the school year and i found myself looking at the different women who work in the school district (and a few of the men, but they were irrelevant to my purpose). I looked at all the women's body types, from morbidly obese and stick-figure thin. I watched the discomfort with which the really large women moved (we had to learn to juggle and break wooden boards during our in-service). I also watched the way the thinner women moved, the comfort with which they sat on the thin bleachers, and the ease with which they picked up the tennis balls that fell to the ground. I found myself wanting to be able to move like the women who were thinner and eliminate this ponderosity of movement that seems universal in very obese women.
I find myself thinking about different things. Is it worth it to give up my favorite foods? CAN I give up my favorite foods? Perhaps it is easier for me to contemplate making a change to my life because I was so ill for the last six weeks. I still have very little appetite and find myself rarely drinking soda (I've vowed that when this 12-pack has gone, I will buy no more, and I really believe this will happen). I begin to feel that it is possible for me to actually do this huge thing and make this positive change.
I have some more questions:
By hair loss, what exactly is meant? Will I lose ALL my hair? Or will it just thin out and be brittle? I really like my thick beautiful long hair and would truly miss it if I lost it. How long is the hair-loss phase? (does it seem vain that my question is on my hair?).
I know that a Laporascopic procedure has a quicker recovery time than an open procedure, but if you've already had surgeries they might not be able to do a laporascopic procedure. I worry about this, as I have already had two laproscopic procedures. Will that mean I am not a candidate for a lap? (I know, the doctor will be able to tell me more)
Those silly dancing carrots (they ARE carrots aren't they?) drive me crazy, but they do bring me to another question I have... I recently became quite fond of juicing vegetables and fruits. Will I still be able to have fresh-made carrot juice after I"ve recovered from the surgery? Or will there be too much natural sugar in the juice?
I have to explain that I am a big one for doing research. I want to make a very informed decision before I do this thing. Every time I eat, now, I think about how it will be different "after". I was having Sushi yesterday and I said to my husband, "If I have the surgery, my typical meal might only be one or two of these." Strangely enough I didn't find that distressing. I could stretch one little tray of 6 pieces of sushi to three meals or possibly six. Suddenly, I thought to myself, food becomes a lot less expensive!
Regarding the psych eval. That is a requirement by my insurance company but I do not find the idea that scary. I tend to have my head screwed on straight, and if my self-image is off, and I really need some help, well they'll catch it. I am, as you say, a math teacher!
My current "action steps" are:
Seminar on Tuesday to meet the surgeon and ask as many questions as I can and learn as much as I can.
Make appointment with surgeon and with my current doctor and with my former doctor to get letters of recommendation and request all of the information that the insurance company requires. Luckily when we moved my hubby continued with our former doctor, so we still regularly see both my old doctor and my new doctor, and they have data going back 6 years for me.
After I see the surgeon and two doctors, IF all three concur that the surgery is the right step for me, THEN I'm sure that everything will be much clearer and I will know what the next steps are. It's just exciting and scary and just kinda weird to think about it.
By hair loss, what exactly is meant? Will I lose ALL my hair? Or will it just thin out and be brittle? I really like my thick beautiful long hair and would truly miss it if I lost it. How long is the hair-loss phase? (does it seem vain that my question is on my hair?).
Somewhere between 4-6 months out or so, your body freaks out a bit because it is not getting the same nutrients as before, so it starts to pull out some protein from your hair/nails temporarily, until it "resets" itself. For most of us, this means 1-2 months where we find more hair coming out than normal and a little thinning. I thinned out on my hair line but no one noticed other than myself. I've always had "tangley, coarse hair" and found that when I brushed out my hair, if it was too tangled, I ended up with some hair in my brush. Was it noticeable? No not at all but I DID end up cutting it shorter into a bob so that I would not pull as much hair out in the future - it made it more manageable, less tangley. Nobody knew of my hair loss until I told them. Now some people have very, very thin hair that you can see their scalp somewhat before surgery - those are the people that have to worry the most as the hair loss might be more noticeable for them. The hair loss turned out to be much hurrah about nothing for me. No wigs required! LOL!
In terms of having surgeries done, it really depends on what surgeries you've had and probably how long ago, what method they used. That's something I'm sure that your surgeon is more qualified to answer than I. Having it done open however, is not the end of the world from what I've been told - just a longer recovery time to think about.
In terms of juicing, well after surgery we are encouraged to eat our fruits and veggies rather than to drink them...but having one day should be okay I imagine. You should be able to tolerate juice after surgery - although you are typically supposed to water them down - 1/2 apple juice 1/2 water. There is the odd person that dumps on fruit/vegs but it is generally pretty rare. Watered down would probably be better for you.
Psyche requirements isn't supposed to be so bad. Sometimes it's a questionnaire, sometimes its a talk with a psychologist or therapist. You are a teacher and usually they think we are pretty normal. LOL!
i lost my hair in the front of my head - it was quite thin to start with, and it thinned out noticeably. but within a year, my hair was thicker than before surgery!
as for the juices - even now, it's a good idea to EAT your fruits and vegs rather than to juice them - the fiber helps fill you up.
having said that, you MIGHT be able to get away with small amounts of low-carb juices cut with water [and, BTW, that would probably leave out the carrot juice as it's loaded with carbs]. you'll have to play it by ear. but please keep in mind that we have to limit our carb intake very severely for a while after the surgery, and we might never get back to the carb amounts we could tolerate before surgery.
you sound like you really and truly have all your ducks in a row!!! keep us posted!
Thanks for the answers, it helps a lot. I have very fine hair but a tremendous volume, so I can hope that it will just thin a bit, and then come back. It's just that it is LONG and i don't want to cut it. I've discovered from experience that when my hair is short it always looks "harry potter-ish" ... a mess no matter what. Long is neat, short is not! I don't want to start at short all over again.
Since I got sick this summer I haven't used my juicer, and I am actually quite fond of eating fruits and vegetables as well as juicing them. The juice was just part of my effort to pull myself off of pointless sodas, and in fact, my eating and drinking habits have been affected positively by my efforts with the juicer, even though I don't use it much anymore. I don't drink much soda, and I have perhaps six cans of soda to go before I am done with my soda for good. (I got one out for lunch, but put it back again). Overall I am much less inclined towards foods and beverages that are bad for me. Overall anyway.
Today I made two appointments. I called to get my initial consultation with the bariatric surgeon. (Seminar on Tuesday was already scheduled). When the surgeon's office found that I have a vacation coming up in October, they said (which startled me) that they should get me in to see the surgeon as soon as possible so that if we can get it cleared through my insurance, I might be able to have the surgery during my vacation. That was startling to me, as I had expected it to be a longer process... and it still might be depending on the insurance company. That made me wake up and take notice. So my consultation is the 5th of September. We'll see what happens.
I also made an appointment with my former doctor to get a recommendation for the surgery. I ended up changing doctors from his office to a closer one because they had a physician's assistant who was condescending and deprecating towards me and my size. She always made me feel lousy, so I stopped going to that office. Now I'll go back to see if they'll recommend me for the surgery.
I was too late in the day to call my own doctor to get an appointment. I'll make that appointmen on Monday.
The hardest thing for me is to deliberately plan time away from work. I dislike having to turn my students and my classroom over to a substitute. That's why I hope that it is possible to do a lap surgery as opposed to an open one.
Thanks again for all of the answers. It helps me to have answers from those who have been through this.
In the last couple of weeks I started my research on the Lapband. I have a seminar scheduled for Tues. 8/14 and a dr. consult for 9/4. If I qualify, I have a 100% coverage with my insurance. Whoopee! The key is qualifying and what hoops I have to jump through to make it happen.
My BMI is 36/37 but I am pre-diabetic, high cholesterol, on meds for both that doesn't seem to help. I "think" I have a pretty good history on my weight/gain journey over the last few years if they determine that is necessary. At 53, my knees and back are starting to cause much discomfort. I want to be able to waller around with my grandkids and regain some activity in my life. I REALLY see this procedure as a preventive measure and sure hope my dr. & insurance agree now that I have decided to delve in.
Any thoughts on my qualifying with my BMI being so low?
This thread has been very helpful to me and I appreciate your willingness to share.
What are the steps if you want the surgery?
], but rather to make sure you've thought about this thoroughly, and that you have support systems in place, and that you're willing to change and do the work. and let's face it, we didn't get into this predicament without having issues with food - if additional counseling is suggested, that's just fine. we all need to figure out a different way to live. 
I am, as you say, a math teacher! 
