The Journey Continues

Bariatric Journal

March 9, 2009
The journey to Bariatric Bypass surgery is going full tilt now. I wrote a long list of diet attempts and regimens and failures over the last 50 years. Pretty depressing accounts. I have worked and prayed and hoped and spent a boatload of money of cures for my obesity. I have failed. I weigh 545 lbs and am crippled. I am disabled (since July 1, 2008) and am applying for Social Security Disability. I cannot drive or walk. I stay home most days with my wife and need assistance from her with every single physical function. This is quite humbling and humiliating. Thank God for such a loving and caring wife. With all of the things I have messed up at in life, I got that one right. But I cannot even claim that. She is a true gift from God.

I went to the Bariatric Surgeon about a week ago and he said he could help me. I had been recommended to him by the Surgeon who did my two hernia surgeries and a dear friend who had the procedure a couple of years ago. His nurse then outlined the process I would have to go through to be able to have the surgery.

The greatest hurdle is dealing with the insurance company, even though we have coverage for the surgery. In typical fashion, the insurance company multiplies red tape and time tables. After a week of contacting them, the surgeon’s office finally got a call back today. So, we are off to the races.

I now have an appointment with my Internist, a psychiatrist, a nutritionist and will see a cardiologist, all of whom have to clear me for surgery. Additionally I have to have blood tests for specific things, chest ex-ray, clearance from a Pulmonologist, Cardiac stress test, etc. Once all is done and submitted to the insurance company, I have to wait for their approval before we can schedule the surgery.

However at least we are making progress toward that goal. I had intended to start this process last September after returning from the first graduation of the Seminary in Latin America. Unfortunately, I had to have emergency hernia surgery and subsequently got a staph infection that took over four months to treat. I also lost the use of my right leg and am now unable to walk at all.

But I am optimistic. After 50 years of failure, I trust this process will be a success and I will lose enough weight to be mobile again and be able to have knee replacement surgery. I have to “get down to” 300 pounds to have that procedure done. I have to have both knees replaced and will have a year of surgery and recovery from those procedures. But that is far in the future and not worth worrying about.

Now I just deal with insurance representatives, red tape, doctors and assistants and try to move forward as quickly as possible. I thought things moved slowly in the church, but I have discovered non-emergency medical issues move even slower, especially through the bureaucracy of health insurance.

However, instead of being aggravated, I am thankful for a competent and respected surgeon who says he can help me, medical insurance to pay for it, an employer that provides such good health coverage, a family who is supportive and the opportunity for a change. I do not think I have serious illusions about this. I know that my life after surgery will never be the same. But I am desperate. I cannot go on this way. Something has to change or I will continue to deteriorate and die much earlier than necessary. So I am hopeful and thankful. And scared. But hopeful and thankful. And scared…

Thursday, March 12, 2009
I went to the Nutritionist yesterday as required by the surgeon and the insurance company. She was a lovely lady and most helpful and encouraging. She spoke very favorably of the surgeon. She has seen a number of his patients and seen the success of the surgery and new lifestyle. She says my ideal weight is 250 in spite of the charts. This was due to my skeletal frame. I was thrilled. I remember 250 – just barely! However, all previous consultants simply looked at the height/weight chart and told me I should weigh 175. I knew that was not possible, but what do I know!

Then she told me I can expect to loose between 4 and 7 pounds a week after surgery. So if I need to go from 545lbs. to 250lbs. and actually loose 4 pounds a week, that means 74 weeks to get to my ideal weight. Assuming a surgery date of May 1, that means I will see 250lbs. by the end of 2010 if not sooner.

Since my orthopedist told me I could have knee replacement surgery, I would look at about next summer for the first surgery and January, 2011 for the second. Perhaps I will actually be mobile again by April, 2011! I can live with that.

The Nutritionist also told me I must have the ability to do aquatic exercises as soon as possible. She said we should build a pool and get the doctor to write the prescription for it and perhaps my insurance will pay for it. We will see. I believe it is a very long shot that insurance will pay for it since I have enough trouble getting them to approve an antibiotic!

That was all the good news. As she informed me of my diet after surgery I was overwhelmed. I understand from others that this works, is completely possible and satisfying. However, 2 ounces of food per meal (two medicine cups like you use to take cold medicine) does not seem possible. Additionally, I will have to drink a gallon of water every day for the rest of my life. She really wants me to drink 2 gallons. I’ll just move to the bathroom and set up my computer and TV and phone in there!

Anyway, the discipline after the surgery is the big issue. I pray I can do this successfully. I have no other choice. Do or die – really.

As an aside, it came out in the interview that I am a minister and pastured a large church in the area. She told me about her husband who is scheduled for surgery for aneurisms in the next couple of days in Houston, TX. She asked if I would pray for him. I asked if we could pray right there and she gladly said yes. So we prayed for him (Wayne). her and the medical staff. She wiped the tears from her eyes as we left. It is good to serve while being served!

Today we go to the internist to get Medical Clearance from him and set up other appointments including a Cardiologist and a Pulmonologist. We proceed…

March 11, 2009
3:45 pm
I just got back from the Internist. He assured me he would do all he had to do to give me the Clearance Letter required for surgery including all tests. He also gave me referrals to a Cardiologist and Pulmonologist. He was pleased I am taking this step since he had recommended it some time ago.

As the nurse was drawing blood for the lab tests, we began a conversation as she asked me what surgery I was going to have (must have been something on the form). I told her and she was very encouraging. However, she also said a word of warning to me. She had the surgery in 2001 and had some infection complications. She also did not do the proper follow-up and ate anything she wanted. She has regained a lot of her weight. She also told of every celebrity for whom this had happened. She assured me I would do well and was pleased the surgeon said he probably could do my surgery arthroscopically. She reminded me inadvertently that I must do what the doctors say and not fool myself with the self deceit that I know better than they do. Thank you Lord for the word of warning today.