End of Year Update

Well, I really thought I would have had my DS surgery and be well on the road to recovery by now. Unfortunately that's not the case. I ended up having lung surgery in September. Thoracotomy with lung wedge resection. Fortunately nothing was cancerous. Still, the surgery was pretty hard on me and it was about 6 weeks before I starting feeling like myself again. Plus the pulmonologist wanted me to wait until December at least to have another surgery.

After recovery, I started to have some concerns about my surgeon. In my particular case, I had been told that I might not be able to get the full DS in the first surgery, due to my previous open gallbladder/T-tube placement and potential scar tissue. I decided to go for a consult with another surgeon, one who is known for doing lots of revisions. The new surgeon did not feel the scar tissue would be a problem and so I decided to proceed with him.  I didn't have to start completely over, but it did mean I had to get my records sent over, and the new surgeon wanted me to have a consult with a cardiologist. After that consult and nuclear stress test, and two more support group meeting attendances (required by my insurance), I am finally done with everything needed to be done pre-op. This has been a long time coming.

Psych'd Out and Slightly Bummed Out

A couple more updates to report. Saw my primary care. She was very pleased that I had lost 7 lbs while in CA. I'm trying to keep that going, I would love to have lost 15 lbs or more before the surgery.

Also had my psych consult. I was kind of worried about it beforehand. Turns out I had nothing to fear. She asked me a lot of questions like 'Do you think you overeat?' (yes) 'Do you think you have problems with portion control' (yes). And lots of other questions about what/when I eat stuff. Also questions about depression/suicidal thoughts, etc. At the end, she said that she thought I would do well with the surgery and wished me luck. It was about 20-25 minutes altogether so not bad at all.

Today I went back to the pulmonary specialist. I went through a series of breathing tests with the respiratory tech, then saw the NP. She went over the results of both the breathing tests and the sleep study. It turns out I do have sleep apnea but it was mild. She said they would only treat it if I had other issues such as cardiac problems or if I have upcoming surgery. Since of course I am anticipating upcoming surgery, she looked specifically at the results where I was lying on my back, and said that those looked fine and I wouldn't need pre-surgical treatment. Yay for that.

Then we talked about the results of my chest CT from back in June. The larger mass is still stable, but the smaller mass in my right upper lobe has increased in size. Looking back at the two prior CT's (in 2008 and 2010) the mass has increased at each study. The pulmonologist is out of the office until Monday but she is going to review the results with him and see what he wants to do. She thinks he'll want another biopsy though. I explained that they had tried to biopsy this smaller mass via bronchoscopy when I had the mediastinotomy for the big mass biopsy, but they couldn't visualize it, and she told me that there have been new techniques developed for bronchoscopy in the intervening years. So perhaps they would be successful now. Still, I'm pretty upset about the thought of a potential delay in getting clearance for surgery. About the lung mass itself, I'm actually not that worried. It's been there at least 9 years that I know of, so the chance of it being something malignant is pretty remote, that's not the nature of cancer, to be so slow growing.

All Psyched Out

Had my psych consult today. I was slightly worried about it ahead of time but it turned out I was worried for nothing. The psychiatrist seemed very nice and personable and mainly asked me a bunch of questions about my eating habits, any

Back to Business

I was away for a couple of months visiting family but I'm now back home and resuming pursuit of my goals. I did lose about 5 lbs during my time away which is something I guess.

Earlier this week, I had my first appointment with the nutritionist, which is required as part of my surgeon's process. I guess these used to be individual meetings but they just changed them to be in a group setting. Small groups, I should say. There were about 7 other patients there. I thought the information presented would be very helpful for people not having bariatric surgery or at least not having the duodenal switch surgery.  However, while I wait, I can certainly incorporate the helpful eating habits being discussed.

I will have another meeting with her just prior to my surgery, and that meeting will also include one of the nurses who will talk about what to expect in the hospital and immediately postop, etc.

I also attended my first monthly support group meeting earlier this week. The topic was plastic surgery after weight loss which was still interesting to me even though it will be quite a while before I can even think of that.  More importantly, it gave me a chance to meet some new people, and especially those who have also had the DS surgery. I did meet some really fantastic people and it was great to see how good they looked. It definitely gives me hope and inspiration for the future.

Last night I had my sleep study. I'm sure glad that's over.  I was really tired from staying up late a couple days in a row and thought I would have no problem drifting right off. I'm sure that I would have, if only I had not been attached to a gazillion wires all over my body and had two nasal cannulas as well, so it felt like my nose was completely stopped up.  The technician had to come in to fix wires multiple times during the night and once apparently I removed a bunch of the facial wires and took out the nasal cannulas. I must have done it deliberately because I slightly woke up afterwards and realized nothing was on my face. Then another time he had to fix one of the left wires that got pulled off when I rolled over. The saving grace was that the bed was very comfy, I could go back  there now and sleep some more, without the wires this time! Although  of course the technician didn't give me any results, he also didn't need to come in and attach one of the cpap machines, so either I don't have sleep apnea or it was mild enough that it didn't qualify for their protocol [which would have required him to wake me up to put the machine on me]. I will have the results when I see the pulmonologist next week.

Primary Care Visit

Saw my primary care yesterday to discuss having the surgery. I would have seen her sooner but she was totally booked up earlier. I was kind of nervous about the appointment because my previous primary care was not very enthusiastic about any type of wls, and I assumed she'd be the same. Instead, she was surprised and pleased. She said she had a number of patients that had done really well, they had lost over 100 lbs and had a new lease on life. She was not at all familiar with the duodenal switch surgery and asked me if I wasn't interested in the band instead. I explained my reasons and she was particularly on board with the fact that I was interested in long term results and that I wanted this surgery to be the only one I have. She immediately got busy documenting issues in the chart so that there would be no question come insurance approval time. I also told her I wanted to start a documented diet because 1) I really do want to lose at least 10-15 lbs before the surgery so I can maximize the possibility that the surgeon can do the full DS in a fell swoop, rather two separate operations 2) I'm still not sure if my insurance requires a supervised diet for a specified period of time, as they refused to give me the specifics required for approval when I called them. Since I'm going out of town for 2 months, the doctor advised me to call into the office in a month, so she can document my weight and diet status, then I will see her again in August. I left her office feeling really positive and excited.

Pulmonary Clearance

Just got back from my pulmonary appointment. I actually went to this pulmonary group in 2003-04 after the mediastinal mass was discovered so they still had the chart notes from back then. The dr reviewed my most recent CT films from last year and agreed that it looked like the mass was caused by an infectious process of some kind. Nonetheless, he's sending me for another chest CT since the previous one is almost a year old but I anticipate this will be a non-issue in giving me clearance for surgery. I do have to have a sleep study even though I don't believe I have sleep apnea, and I will have breathing function tests when I have my next appointment. I'm hoping to get the sleep study done before I leave for my 2 month out-of-state trip next week but I'm still waiting to hear back from the sleep center people. I already had a mammogram appt set for Thursday and I was able to schedule the CT at the same facility for just prior, so I won't have to make to make a separate trip for that.

Finally met Dr. G

I had my long-awaited appointment with Dr. G yesterday. He spent quite a bit of time explaining the different surgeries he performs and eventually agreed that the Duodenal Switch surgery was appropriate for me. He went over my test results and informed me that I had a kidney stone, which was a total surprise to me. Hopefully that will never be an issue, but it's good to know. He expressed some concern about what scar tissue and adhesions I might potentially have as a result of my open gallbladder removal and subsequent T tube placement. He said that it could be possible that he can't do the entire DS surgery in a single operation if there is too much scar tissue, in which case he would do only the stomach portion in the first surgery, and then do the intestinal portion down the road after I had lost some weight and give him more room to work with.  That was pretty disappointing to hear, and I hope that scenario doesn't come to pass. No way to know until he actually gets in there, as scar tissue doesn't show up even on a CT scan.

The only additional pre-op testing he is going to require is clearance from pulmonology (which I already knew about and have scheduled for later today) and an endoscopy, which he requires for all patients. Unfortunately, since he only does these the 1st 2 tuesdays of each month, and I'm going to be out of town until Aug. 10th, I can't have that done until September. I'm hoping that after I get back home, and have my NUT and psych appointments (both in August), they will go ahead and put me on the surgery schedule, even though I won't have had the endoscopy yet.

Dr appts galore

For someone who isn't really a fan of going to the doctor, these few weeks have been a test of my patience. Part of that is my own fault, I put off the annual gyn exam and postponed the mammogram.  Now that I'm motivated to finally move forward with the ds surgery, I realized that I needed to get those things out of the way too. Fortunately, I was able to get scheduled for those this week.

Next week I have some kind of dr appt every day, including my first visit with Dr. G, seeing my primary care doctor so she can get on board with everything, and getting a clearance from the pulmonologist.

I got a call yesterday from a nurse at Dr. G's office who asked me cautiously if I had gotten a phone call from my primary care about my chest xray results. After a moment of confusion, I realized what she was talking about. I have a mediastinal mass and some lung nodules discovered while having a routine chest xray 8 years ago. After many chest CTs, two separate, fairly invasive surgeries to biopsy it, I have never had a formal diagnosis other than an opinion from one specialist that it was definitely some type of infectious process that I had previously been sick with. They theorized that my body just walled the infection off.  For the last 6 years or so, I have an annual chest CT to check on it and it's still always there, pretty much unchanged. Anyhow, the nurse said that Dr. G would want to get surgery clearance from a pulmonologist, so I set up an appt with the Abington pulmonary group I saw previously, albeit not since 2004.

I had given this previous medical history to their office, as well as mentioning it to the technician taking the xray, because I didn't want anyone to freak out when they saw a egg sized mass on the xray, but perhaps that info wasn't on the chart. I think the nurse was pretty relieved when I explained to her that this wasn't news to me! It made me remember when I first got the phone call about it, so many years ago. The radiologist report said that it was highly suggestive of lung cancer so it was a pretty traumatic time in my life.  I am still so grateful that it didn't turn out to be the case.

Low Vitamin D?

Got my bloodwork results today. Overall things looked really good. I was kind of worried about the cholesterol but all my levels were great. The only thing out of whack was the Vitamin D level, it was seriously low at 13

More Tests Done

I had to do a bit of driving around today, two different hospitals in two different directions from my house, but I was able to get done: arterial blood gas; chest xray; abdominal ultrasound; and EKG. My wrist is still throbbing from the ABG, why does that hurt so much? I guess it didn't help that the respiratory therapist had to stick me a couple times and dig a bit the 2nd time to keep the vein from rolling around.

Labs done

Labwork done. I think I gave a pint of blood. I was able to call around to a different hospital and get an earlier appt for the abdominal u/s so I'll have that, the EKG and the chest x-ray done tomorrow.

Labs and Tests

I received my packet from Abington in the mail today with the lab slips for the testing I will need to have done before I meet with Dr. G.  Fasting bloodwork with about 21 different tests ordered: stool sample (ugh); chest x-ray; abdominal ultrasound; EKG; and arterial blood gas. The hospital can't get me in for the u/s until June 2nd, but they assured me the Dr would have the results by the time for my appt. I hope that's correct. I'll go get the bloodwork done tomorrow just to get that one over with.

Fresh Start

In this blog, I plan to share the good and bad of my journey through weight loss surgery. I am hoping to have a surgery called the Duodenal Switch. I'm just getting started in the process, having attended an informational meeting with Abington Hospital's Bariatric Surgery program, and subsequently having an intake appointment with one of the nurses. I have my first surgical consult scheduled for June 6th with Dr. G at Abington.