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