Thursday, July 02, 2009
Lots of paperwork had to be filled out.. and then back to the exam room to wait for 40 minutes for the PA to give us information and a quick physical exam. She went over everything that was expected of us as far as testing goes. The psychiatric exam and nutritionist have to be from their department, but otherwise he can have all his testing done locally.
The doctor came in for about 10 minutes and gave him a lecture on being willing to change lifestyles that have been engrained for years. It's that, or no surgery- it would be a waste of time. I like this surgeon. He doesn't mince words- says what has to be said and gives the ultimatum. Wendell finally said 'yes, I can comply'.. we are off to the races!!!
Labs, chest xray, ekg, pfts, and other tests to be completed as soon as he can get them scheduled.
This doctor reminded us that the surgery is a tool, not a cure. We can use this tool effectively or not. Wendell told him he wanted the gastric bypass. The doctor said okay.. start the exercise program now and let the lifestyle changes begin.. that includes decaf coffee if he wants coffee.
We came home with 2 booklets and a pile of papers to be completed as soon as we can do so.
Provided all this can be done in another couple months, I think we may be looking at September possibly for the surgery.. I'm just guessing. The surgeon never discussed a timetable.. just get the paperwork done with labs and doctor checklists.. and then give them a call when it's done. Then we talk schedule.
The prep for this surgery is a bit different. Although the bowel is involved, there is no real 'bowel prep' pre op. It's a full liquid diet for a week prior to the surgery and then meds get eliminated including his regular dose of insulin. He'll be on a sliding scale from that point on, and hopefully that will be the end of insulin for him. Amen.
More later if I missed anything.. and updates as they happen.
Monday, June 29, 2009
Friday, June 12, 2009
Now, 1st step is the education session last week where the surgeon describes the surgeries available and initial paperwork is filed with his office indicating a desire to have one of the procedures done.
2nd step is being called to inform you that you are a candidate and set an appointment with the surgeon. Most people don't realize that insurance companies require the patient to follow a supervised diet with their PCP or the hospital's group weight loss clinic for 6 months before the bariatric procedures will be covered by insurance. So if you are considering this surgery, get going with a program with your PCP. Wendell was fortunate in that his PCP's nurse just had her procedure done a few months ago and she knows the ropes. She started Wendell on his diet and supervised weigh ins in March this year.
Next will come the scripts for psychological evaluations and the nutrition evals and education.
This is a whole new world of weight loss.
Wendell is hoping for the bypass surgery. It's a bit more complicated and requires a 2 day 2 night stay in the hospital. He's good with that.
Pray all will fall into place easily.. that this is God's will for his life.
Thursday, June 11, 2009
Wendell and I went to an education session given by Magee Hospital Bariatric surgeons last evening. It was a 2 hour experience where the doctor explained the 2 most commonly performed bariatric procedures. One is lap banding and the other is gastric bypass or Roux en Y.
We both went in thinking that the banding would be better for him, but when we came out, we were both convinced that the gastric bypass is really the better choice for life.
You have to meet certain criteria in order to be a candidate for this surgery. The BMI has to be at least 35 or more with associated medical conditions like diabetes...... or a BMI over 40.
You also have to fail the supervised diet for 6 months. That is, you have to follow the plan for 6 months without gaining, but without exceptional losses too.
It involves life style changes in exercise and diet and requires life long follow-up.
The doctor described the risks and the benefits of each procedure. He mentioned that with the bypass, 85-90% of type 2 diabetics are not any more. That is exciting news. He also said that men do better with the bypass and the loss is generally more rapid in the first year than the banding. 70% of excess weight is lost that first year. The weight loss with banding is at a much slower rate, but also sounded to us like the complications could be a problem.. like the band slipping..
One thing I thought was interesting was that he said you can't eat concentrated sugars after the bypass.. you might try, but you won't do it twice. Also, you say goodbye to red meats and bread.
There is a malabsorption risk with the bypass, so one must be on vitamins and minerals daily for life afterward.
We learned that eating habits at the table would change dramatically. He described it as taking a very small bite of food, purposefully placing the fork by the plate, and chewing at least 20 times before swallowing. No drinks with meals either. No more fast foods.. meals will take 40 minutes or more to complete.
There is a psych evaluation, nutrition eval, and then labs and testing as needed prior to surgery. Wendell has 3 months of supervised diet therapy already, and the final testing and instructions are due the last 2 months.
We may hear by the end of this week whether he's a candidate, or perhaps early next week. I'm praying he will be chosen.
After he gets settled and is doing well with this, I'm going to apply myself. I asked about blood thinners and having the surgery, and he said it can be done with injections in the belly (Lovenox) and perhaps an IVC filter to catch the clots if any form.
Sunday, May 31, 2009
Tuesday, May 05, 2009
Monday, April 27, 2009
Wednesday, April 22, 2009
Monday, April 13, 2009
Sunday, April 05, 2009
I try to catch Wendell before he's dressed, but didn't .. so I put him on the scales anyway just for a check.. and he's gained a pound... BOOOOOOO!!!! The thing is, I think he has at least a pound of loss because of his clothes and shoes especially.
I'll recheck him in a day or so.
Blood sugars have been stable in a normal range aside from the past few days when he was 111 and 115.. hmmmm he's also been feeling ill. I would think the BS is elevated for that reason.. today he is back to 96.. and normal.
As for myself, I stayed the same.. and I was dressed too.. but not with the heavy clothes that Wendell had on. I should probably go to the 1200 cals.. but I'll try one more week of 1500, and then move if I need to.
Pray for our success!! We can do this..
Sunday, March 29, 2009
Wednesday, March 25, 2009
Here we go...!!! Wendell weighed in at home this morning, so I'll be keeping track of his losses here in the next months. He had been using a 1600 ADA diet, but the doctor decided to eliminate 400 calories more, and he's now on 1200 calories. He can do this.
I have joined him on the diet.. I also started at 1600 calories, but now am seeing some results with 1500, as of Monday. It's Wednesday. As of March 21st, I've lost 6#, and it hasn't been too difficult to stay with the program.
Exercise: we are heading to the pool today for an hour or so walking.
I have walked around the yard and have done very little, but some yardwork, and I feel that's why I've lost so quickly.
Tomorrow I will post some of his meal plans. They are filling despite the lesser calories. It helped to limit to 1600 calories for a week before going to the 1200. He is adjusting.
Monday, March 23, 2009
Today, so far, so good. We are adjusting well to the program. More later..